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: patient recorded as having no known allergies to drugs attending: chief complaint: found down at home major surgical or invasive procedure: egd x 3 tips tube intubation history of present illness: 62 yo m w/ h/o "liver dz", and history of ulcer, who called ems due to feeling like he was going to "pass out". has been feeling lh for the past day. due to pre-syncopal symtptoms called ems. ems found the patient to be hypotensive, sbp 60s, and in transit vomited approx 500cc brb. . patient reports that he had been in his usoh until approx 3 wks ago when he noted the onset of post-prandial diffuse abdominal pain. desrcibed as mild and crampy. also noted with taking pills. some relief when accompanied by milk. no n/v/d. no prior hematemesis. no melana. no history of variceal bleeding. . in the ed, hypotensive 86/48, vomited 800cc brb. ngl performed, returned 500cc brb and did not clear. 2 14g piv, placed rec'd 4u prbc, 2l ns, octreotide, protonix. past medical history: "ulcer dz" "liver dz" chf social history: no etoh. +remote smoking history. stopped 30 yrs ago. family history: nc physical exam: t 96.2, bp 112/68, hr 68, rr14, 98% 2l nc elderly, well appearing male, alert and oriented, w/ ngt in place draining brb. perrl op w/ dried blood. jvp could not be appreciated regular s1,s2. no m/r/g lca b/l distended, protuberant abdomen. +bs. soft. nt. no fluid wave. trace le edema. no c/c no asterixis, palmar erythema, gynecomastia, spider angiomata. pertinent results: admission labs: 06:40am wbc-4.8 rbc-2.57* hgb-8.4* hct-25.0* mcv-97 mch-32.6* mchc-33.5 rdw-14.1 06:40am plt count-98* 06:40am pt-14.4* ptt-25.2 inr(pt)-1.3* 06:40am fibrinoge-228 06:40am urea n-37* creat-1.0 06:40am amylase-47 06:40am asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 07:03am po2-122* pco2-40 ph-7.32* total co2-22 base xs--5 comments-green top 07:31am urine mucous-few 07:31am urine granular-0-2 hyaline-* 07:31am urine rbc-0 wbc-0-2 bacteria-none yeast-none epi-0 07:31am urine blood-neg nitrite-neg protein-tr glucose-neg ketone-tr bilirubin-sm urobilngn-neg ph-6.0 leuk-neg 07:31am urine color-yellow appear-clear sp -1.023 07:57am plt count-66* 07:57am wbc-6.0 rbc-2.95* hgb-9.9* hct-28.1* mcv-95 mch-33.6* mchc-35.3* rdw-14.3 09:19am fibrinoge-246 09:19am pt-14.1* ptt-22.9 inr(pt)-1.3* 09:19am albumin-3.1* calcium-7.4* phosphate-2.9 magnesium-1.6 09:19am lipase-35 09:19am alt(sgpt)-27 ast(sgot)-28 ld(ldh)-147 alk phos-88 amylase-47 tot bili-0.6 09:19am glucose-72 urea n-36* creat-0.9 sodium-142 potassium-4.9 chloride-113* total co2-19* anion gap-15 09:32am freeca-1.06* 09:32am lactate-2.1* na+-140 k+-4.9 cl--114* tco2-21 09:32am type- temp-35.7 ph-7.33* 10:20am hct-31.4* 12:34pm pt-15.3* ptt-48.1* inr(pt)-1.4* 12:34pm plt count-134*# 12:34pm wbc-11.1*# rbc-4.23*# hgb-13.4*# hct-39.2* mcv-93 mch-31.6 mchc-34.1 rdw-14.6 12:34pm calcium-6.5* 12:34pm glucose-104 urea n-34* creat-0.9 sodium-140 potassium-5.7* chloride-114* total co2-16* anion gap-16 02:31pm plt count-158 02:31pm wbc-10.8 rbc-4.28* hgb-13.3* hct-39.2* mcv-92 mch-31.1 mchc-33.9 rdw-14.8 02:32pm fibrinoge-205 02:32pm pt-14.0* ptt-27.3 inr(pt)-1.2* 02:32pm caltibc-280 ferritin-33 trf-215 02:32pm calcium-7.0* phosphate-3.2 magnesium-1.5* iron-196* 02:32pm glucose-136* urea n-34* creat-0.9 sodium-139 potassium-5.6* chloride-114* total co2-16* anion gap-15 02:43pm type-art temp-36.7 rates-14/ tidal vol-700 peep-5 o2-50 po2-146* pco2-31* ph-7.35 total co2-18* base xs--7 -assist/con intubated-intubated 05:00pm fibrinoge-208 05:00pm pt-13.7* ptt-29.0 inr(pt)-1.2* 05:00pm plt count-182 05:00pm wbc-13.1* rbc-4.27* hgb-13.6* hct-39.1* mcv-91 mch-31.8 mchc-34.8 rdw-14.8 05:00pm hcv ab-negative 05:00pm hbsag-negative hbs ab-positive hbc ab-negative hav ab-positive 05:00pm calcium-7.8* phosphate-3.4 magnesium-1.6 05:00pm glucose-140* urea n-34* creat-0.9 sodium-141 potassium-4.5 chloride-114* total co2-17* anion gap-15 05:17pm type-art rates-14/ tidal vol-600 peep-5 o2-40 po2-108* pco2-30* ph-7.35 total co2-17* base xs--7 -assist/con intubated-intubated 07:54pm hct-37.1* 09:49pm fibrinoge-224 09:49pm pt-13.2* ptt-28.1 inr(pt)-1.1 09:49pm plt count-111* 09:49pm wbc-10.5 rbc-3.91* hgb-13.0* hct-35.4* mcv-90 mch-33.2* mchc-36.7* rdw-15.2 09:49pm calcium-7.9* phosphate-3.5 magnesium-2.3 09:49pm glucose-156* urea n-32* creat-1.0 sodium-140 potassium-4.2 chloride-114* total co2-17* anion gap-13 brief hospital course: 62 yo m w cirrhosis and varices admitted for an upper gi bleed x 2. the following issues were investigated during this hospitalization: . 1) gib: shortly after admission to the icu the pt. having massive hemoptysis with resultant hypotension. he was scoped emergently after intubation and found to have stage 3 variceal bleeding which was unable to be stopped with banding. he was started on protonix and octreotide drips with ciprofloxacin prophylaxis. esophageal balloon was placed with stabilization of bleeding. he required 12u prbcs and 7u ffp on hd1. a tips was successfully placed on , but followed by continued bleeding. he was transfused once more on . a ruq u/s on an confirmed patency of tips. his hematocrit remained stable after the transfusion on and he was transferred to the general medicine floor for continued management. . 2) liver disease: etiology is unclear but has been described as nash and cryptogenic in nature. there is no report of a liver biopsy. during this hospitalization, initial work-up revealed negative hepatology serologies and no evidence of hemochromotosis. an abdominal ct showed a 1.5 cm lesion in the right lobe of the liver and afp is elevated to 13.7. additional work-up was deferred given his acute medical problems necessitating icu hospitalization. he should pursue further work-up of this lesion as an outpatient. an appointment has been scheduled for him in the liver clinic here at . . 3) altered mental status - etiology unclear, but initially concerning for anoxic brain injury in the setting of hypotension upon presention, but repeat imaging showed resolution of initial changes, which was more suggestive of resolving metabolic condition (i.e. hepatic encephalopathy). infectious work-up in the micu was negative. on the general floor, the patient was maintained on lactulose and rifaximin for ammonia control. his mental status gradually and significantly improved and he was noted to be awake, alert and oriented x 3, often communicative. he was discharged on rifaximin and lactulose, which he should continue given his tips. . 4) seizure activity: patient was observed to be have brief episodes of tonic-clonic seizure activity on , and subsequently found to have frequent, intermittent seizure activity on eeg in the following 24 hours essentially c/w status epilepticus. he was seen by the neurology consult service and started on dilantin. his hospital course was thereafter significant for no seizure activity. the patient was discharged on dilantin with instructions to have dilantin levels checked, with goal of 15-20 (corrected for albumin). . 5) dm: the patient's outpatient metformin was held given the extent of his liver disease. his blood sugar was monitored and treated with an insulin sliding scale and glargine qhs. . 6) ventilator-acquired pneumonia: pt. was intubated in the icu to protect his airway. during this time, he developed a pneumonia with coag + staph aureus growing in his sputum. he was started on vancomycin, which was later switched to nafcillin once sensitivies came back showing mssa. he was treated for a total of 8 days. . 7) f/e/n: the patient was started on tube feeds in the icu, which were continued on arrival to the general medicine floor. during his hospitalization on the floor, he self d/c'd the dobhoff tube twice, the last of which was done the evening before his discharge from the hospital. prior to this last self d/c, the patient had just been started on pureed diet and nectar-thickened liquids after a speech and swallow evaluation which showed thin aspiration. because of this self d/c, there was not enough time for accurate calorie counts. thus, it is important that his nutrition be closely followed on discharge and tube feeds should be reconsidered if the patient's appetite or food intake should decline. medications on admission: lisinopril 10mg qd protonix 40 nadalol 40mg tid aspirin 81 mg qday insulin 70qam 65qpm metformin 1000 cyanocobalmin discharge medications: 1. artificial tear with lanolin 0.1-0.1 % ointment : one (1) appl ophthalmic prn (as needed). 2. sodium chloride 0.65 % aerosol, spray : sprays nasal tid (3 times a day) as needed. 3. levetiracetam 500 mg tablet : three (3) tablet po bid (2 times a day). 4. phenytoin 100 mg/4 ml suspension : two hundred (200) mg po q 8h (every 8 hours). 5. propranolol 10 mg tablet : one (1) tablet po tid (3 times a day). 6. lactulose 10 g/15 ml syrup : thirty (30) ml po tid (3 times a day): give for goal 3 bms/day. 7. rifaximin 200 mg tablet : two (2) tablet po tid (3 times a day). 8. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr po bid (2 times a day). 9. ipratropium bromide 0.02 % solution : one (1) nebulizer treatment inhalation q6h (every 6 hours) as needed. 10. albuterol sulfate 0.083 % solution : one (1) nebulizer treatment inhalation every six (6) hours as needed for shortness of breath or wheezing. 11. lantus 100 unit/ml cartridge : fifty five (55) units subcutaneous at bedtime. 12. insulin regular human 300 unit/3 ml insulin pen : one (1) unit subcutaneous qachs: give per attached sliding scale. discharge disposition: extended care facility: & rehab center - discharge diagnosis: cryptogenic cirrhosis esophageal varices hepatic encephalopathy seizure activity diabetes mellitus, type 2 ventilator-acquired pneumonia liver mass discharge condition: stable, tolerating po with pureed diet, alert and oriented x3 discharge instructions: you were admitted to the hospital for bleeding from your stomach, which is a complication of your liver disease. you were also found to have seizures. call your doctor or return to the er for fevers, chills, nausea, vomiting, abdominal pain, confusion, lethargy, tarry stool, or blood in your stool. it is very important that you take all of your medications as prescribed. your doctors your lactulose to make sure you are having at least 3 bowel movements per day. your doctors at the nursing home need to check your dilantin levels every other day, and correct this for your albumin. the equation is: corrected dilantin level = measured dilantin level divided by . your goal corrected dilantin level is between 15 and 20. if your level is persistently low or high, your doctors should your neurologist, dr. , at . followup instructions: provider: . / phone: date/time: 4:30 (neurology) . provider: , md phone: date/time: 2:30 (hepatology) md procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more spinal tap incision of lung other endoscopy of small intestine other endoscopy of small intestine insertion of endotracheal tube enteral infusion of concentrated nutritional substances endoscopic excision or destruction of lesion or tissue of esophagus transfusion of packed cells other irrigation of (naso-)gastric tube transfusion of other serum injection of anesthetic into spinal canal for analgesia intra-abdominal venous shunt insertion of sengstaken tube diagnoses: congestive heart failure, unspecified cirrhosis of liver without mention of alcohol diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acquired coagulation factor deficiency portal hypertension acute respiratory failure long-term (current) use of insulin grand mal status methicillin susceptible pneumonia due to staphylococcus aureus esophageal varices in diseases classified elsewhere, with bleeding hepatic encephalopathy other abnormal tumor markers unspecified disorder of liver 

Answer: The patient is high likely exposed to