Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: no known allergies / adverse drug reactions attending: chief complaint: failure to thrive major surgical or invasive procedure: chest tube placement and removal pigtail chest catheter placement pleuroscopy with pleural biopsy history of present illness: 60 year old woman with decompensated cirrhosis hemochromatosis and nash complicated by gastric varices, ascites, and hepatopulmonary syndrome. she is currently listed for tranplantation. she was recently discharged from for a long hospital stay initially for hyponatremia, complicated by fluid overload, respiratory failure, intubation, oliguric renal failure requiring cvvh, shock without clear etiology. all these issues resolved after 1 month stay and she was discharged to . she seems to not have been thriving at rehab since her discharge with poor appetite, poor motivation, and poor progress. she saw dr. yesterday in hepatology clinic and was complaining of shortness of breath. because of her hypoxia and known pleural effusion, dr. decided to admit her directly to the service for further candidacy work-up and evaluation as well as for a probable thoracentesis. . her last set of vitals prior to transfer were 99 81 20 129/54 96%2lnc fs 108. on arrival to the floor the patient generally felt well and denied any complaints. she did have a recent "gi flu" on monday with just symptoms of nausea and vomitting that seemed to have resolved. she also has had a recent dry cough x 1 week. . ros: denies fever, chills, headache, rhinorrhea, congestion, sore throat, shortness of breath, chest pain, abdominal pain, nausea, vomiting, diarrhea, constipation, brbpr, melena, hematochezia, dysuria, hematuria, hemoptysis, hematemesis, orthopnea, chest pain, sweats, edema. past medical history: 1) cirrhosis - heterozygous hfe mutation, ascites, gastric varices. also thought to be concominant component of nash. 2) dmii, diet controlled 3) gout social history: married with two children. she is on disability and previously worked as a cashier. denies tobacco and illicit drug use. drinks alcoholic drinks per week. . family history: father had throat cancer, mother had lung cancer. physical exam: physical exam on admission: vs - 97.9 100/50 89 20 95%3lnc general - pleasant, chronically ill appearing woman in nad heent - nc/at, perrla, eomi, sclerae anicteric but injected, mmm, op clear neck - soft, supple, no lad, jvd mildly elevated at 10cm at 45 degrees lungs - cta on left, right base reduced breath sounds with dullness to percussion 1/3 up, no r/rh/wh, good air movement, resp unlabored heart - pmi non-displaced, rrr, no rg, soft sm, nl s1-s2 abdomen - nabs, soft, mild ruq ttp, +flank dullness with ascites, no rebound or guarding extremities - wwp, no cyanosis/ecchymosis, 3+ pitting edema of bilateral lower extremities up to above the knees, +dp/pt pulses limited palpation by edema, no asterixis skin - no rashes or lesions neuro - awake, a&ox3, cns ii-xii grossly intact, strength and sensation grossly intact pertinent results: 1. labs on admission: 09:25pm blood wbc-3.9* rbc-3.09* hgb-9.4* hct-28.9* mcv-94# mch-30.5 mchc-32.6 rdw-17.4* plt ct-151 09:25pm blood pt-16.1* ptt-43.6* inr(pt)-1.4* 09:25pm blood alt-16 ast-30 ld(ldh)-97 alkphos-103 totbili-1.4 09:25pm blood albumin-2.8* calcium-11.3* phos-2.8 mg-1.5* 12:33pm blood pth-9* 06:35am blood afp-2.5 06:35am blood cea-3.6 . 2. labs on discharge: - ca -9: 6 <37 u/ml - ace 33 (reference ) - vitamin d, 25 oh, total 21 range 30-100 ng/ml - vitamin d, 25 oh, d3 15 ng/ml - vitamin d, 25 oh, d2 6 ng/ml 06:35am blood pep-no specifi ppd - negative. . 3. imaging/diagnostics: - cxr (pa/lat) : large right pleural effusion has minimally increased from . cardiac size is obscured by the pleural effusion. there are atelectasis in the right lower lobe. there is no evidence of pneumothorax left upper lobe opacities are consistent with atelectasis. ng tube tip is out of view passing the duodenum. . - cytology pleural fluid: negative for malignant cells. numerous lymphocytes and red blood cells. . - abdominal ultrasound with doppler : 1. the portal veins are patent; however, the left portal vein demonstrates reversed flow, the main portal vein demonstrates bidirectional flow, and the right portal vein demonstrates forward flow. 2. nodular coarsened hepatic architecture with no focal liver lesion identified. 3. scant trace of ascites in the perihepatic space and large right pleural effusion. 4. splenomegaly. . - ct chest w/ contrast : 1. large right pleural effusion associated with severe atelectasis of the right lower and middle lobes. 2. pulmonary edema. 3. tiny left pleural effusion associated with basilar atelectasis. . - echocardiogram : the left atrium is normal in size. left ventricular wall thickness, cavity size, and global systolic function are normal (lvef 70%). due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. there is no pericardial effusion. . - cardiac mri : impression: 1. likely iron deposition in myocardium, based on t2* images. however, as patient has normal cardiac function, the clinical relevance of this finding is uncertain. if indicated, a cardiac biopsy may assist in diagnosis. 2. mildly increased left ventricular cavity size with normal regional left ventricular systolic function. the lvef was normal at 64%. the effective forward lvef was normal at 61%. poor quality lge images, but no clear large areas of scarring or infarction. 3. normal right ventricular cavity size and systolic function. the rvef was normal at 72%. 4. mild mitral regurgitation. 5. the indexed diameters of the ascending and descending thoracic aorta were normal. the main pulmonary artery diameter index was mildly increased. 6. mild left atrial enlargement. 7. a note is made of a nodular liver, splenomegaly and ascites. there are bilateral pleural effusions, right greater than left. . pleural biopsy (): pleural tissue with chronic inflammation and foreign body. no malignancy identified. no granulomatous inflammation seen. brief hospital course: - and micu courses & micu green: 60 year old woman with cirrhosis nash complicated by gastric varices and ascites, type 2 diabetes (diet controlled) and gout who is admitted from rehab after being seen in clinic for failure to thrive at rehab and recurrent pleural effusions. . # hypoxia: on admission, 3l nc oxygen requirement with o2 sat in the mid-90s. chronic right-sided pleural effusion is large in size. thoracentesis was performed and 800cc of grossly bloody fluid was removed. procedure prematurally terminated due to patient discomfort. cytology did not show malignant cells. patient developed tachypnea and 6l nc oxygen requirement on hospital day 2. abg was 7.39/42/60. ct chest was obtained which showed pleural effusion and pulmonary edema. thoracic surgery was consulted and placed a pigtail catherter. patient unable to tolerate continuous suction and had another episode of respiratory distress overnight. transferred to micu. cxr there was positive for pulmonary edema. patient treated with diuresis. condition stabilized and patient transferred back to the floor. pulmonary was consulted who suggested workup for tuberculosis and sarcoid. sarcoid - ace was within normal range, workup for tuberculosis was negative, including a ppd test. a cardiac mri was also performed to rule out fulminant cardiac fibrosis (secondary to hemochromatosis), but lv/rv function was marginally diminished, with some iron deposition noted of unclear clinical significance. pleural biopsy was performed by interventional pulmonology to evaluate for the etiology of recurrent pleural effusion which showed chronic inflammation and foreign body. no malignancy identified. no granulomatous inflammation seen. on the patient was transfered back to the micu for hypoxia. her breathing rapidly improved with diuresis with 40mg iv lasix. the pt received one dose of meropenem for a question of pneumonia. she subsequently grew stenotrophomonas and was treated with bactrim which was changed to levofloxacin given renal failure and hyperkalemia. vent settings were weaned to 40% and psv 5/5. family meeting was held and overall goals of care discussed with patient and family on and decision was made to make pt . patient was terminally extubated and vasopressors were discontinued. she passed away peacefully on the morning of with her family at the bedside. # hypercalcemia: corrected serum calcicum was >12, in the context of failure to thrive, re-accumulating right pleural effusion was concerning for malignancy. she was hydrated with albumin. upep and spep were unremarkable. hypercalcemia resolved. . #. decompensated cirrhosis from hemachromatosis: no signs of encephalopathy or elevated liver enzymes on admission. labs were trended daily. maintained on tubefeeds for nutrition. kept on lactulose. hepatology was present on family meeting on and overall prognosis was discussed as well as listing. it was felt that patient would be unlikely able to recover enough to be listed for in near future and she was made as above. . #. : patient developed likely secondary to contrast induced nephropathy and hypotension/atn as well as underlying liver disease. she was started on cvvh and continued for approximately 36-48 hours. indications included hyperkalemia as well as volume overload. cvvh discontinued and pt made as above. . # uti: klebsiella grew out on urine cx from . meropenem started. completed course. #hyponatremia - patient was hyponatremic, and even on tolvaptan during previous admissions. . #. type 2 diabetes: diet controlled and maintained on sliding scale. # low vitamin d: was checked in setting of hypercalcemia. found to be low at 21. started on 50,000u weekly. should continued for 6-8 weeks and be rechecked. #depression - patient was seen by inpatient psychiatry consult due to noncompliance with pt and generally acting withdrawn and sad. she refused to see psychiatry but did agree to starting mirtazapine in the evenings which she tolerated well. medications on admission: 1) ciprofloxacin 500mg po q24h 2) furosemide 20mg po daily 3) heparin 5000 units sc bid 4) insulin humulin r sliding scale 5) lactulose 15ml po tid 6) metoprolol 12.5mg po tid 7) midodrine 10mg po tid 8) probenecide 500mg po bid 9) spironolactone 25mg po daily 10) tramadol 25mg po hs 11) trazodone 75mg po hs 12) ursodiol 250mg po tid 13) vitamin d 400 units 14) multivitamins 1 tab po daily 15) protein supplement 1 scoop po bid 16) acetaminophen 650mg po q8h prn pain 17) albuterol 1 neb q6h prn sob/wheeze 18) ipratropium 1 neb q6h prn sob/wheeze 19) magnesium hydrox/aluminum hydrox/simethicone 15ml po q6h prn gi upset 20) ondansetron 4mg po tid prn nausea 21) senna 2 tabs po hs prn constipation 22) tramadol 25mg po q6h prn pain 23) miracle cream to sacrum daily 24) anusol 2.5% cream pr tid 25) artificial tears 1 drop each eye tid discharge medications: patient expired. discharge disposition: extended care discharge diagnosis: patient expired. discharge condition: patient expired. discharge instructions: patient expired. followup instructions: patient expired. procedure: insertion of intercostal catheter for drainage insertion of intercostal catheter for drainage continuous invasive mechanical ventilation for less than 96 consecutive hours continuous invasive mechanical ventilation for less than 96 consecutive hours continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube insertion of endotracheal tube enteral infusion of concentrated nutritional substances hemodialysis venous catheterization for renal dialysis thoracentesis closed [endoscopic] biopsy of bronchus thoracoscopic pleural biopsy thoracoscopic decortication of lung central venous catheter placement with guidance diagnoses: hyperpotassemia acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site cirrhosis of liver without mention of alcohol diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hepatorenal syndrome unspecified septicemia unspecified protein-calorie malnutrition hyposmolality and/or hyponatremia severe sepsis gout, unspecified depressive disorder, not elsewhere classified atrial flutter chronic kidney disease, unspecified acute respiratory failure septic shock intestinal infection due to clostridium difficile other sequelae of chronic liver disease awaiting organ transplant status pulmonary congestion and hypostasis ventilator associated pneumonia other chronic nonalcoholic liver disease unspecified vitamin d deficiency other specified bacterial infections in conditions classified elsewhere and of unspecified site, other gram-negative organisms other hemochromatosis other specified forms of effusion, except tuberculous 

Answer: The patient is high likely exposed to