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: keflex attending: chief complaint: shortness of breath, pleuritic chest pain major surgical or invasive procedure: none history of present illness: 46 y/o male who is currently incarcerated who was transferred to for further evaluation and management of pna, pleural effusion, and cirrhosis. pt states that about 2 weeks ago, he noticed increasing weakness along with chills, sob, and pleuritic chest pain. he was sent from jail to the ed for further evaluation of the above-described symptoms. pt oxygen saturation on ra upon arrival to the ed were in the 80s. oxygenation improved with nc. initial cxr revealed a large rll pna and pleural effusion. he was started on levofloxacin for cap. he subsequently underwent a ct chest, abdomen, pelvis which revealed cirrhosis, splenomegaly, and a large right pleural effusion along with an infiltrate in the left lobe. pt is s/p paracentesis x 2. pt was transferred to for further evaluation and management. . ros: positive for night sweats, denies wt loss. positive for recen fatigue. positive for pleuritic chest pain and sob. denies n/v/d or abdominal pain. past medical history: pmh: 1. chronic hepatitis c, genotype ib. 2. hepatitis b 3. bipolar disorder 4. polysubstance abuse . psh: 1. ankle fracture in 2. eye surgery as a child social history: polysubstance abuse including h/o tobacco use, cocaine, and alcohol abuse. he is currently incarcerated for unarmed robbery. family history: n/c physical exam: pe: vitals: t 100.3 bp 108/64 hr 107 rr 39 93% ft with fio2 50% general: comfortable, mild respiratory distress. heent: nc/at. perrla. eomi. mm dry. op clear. nasal passages with evidence of dried blood. anicteric sclerae. neck: no jvd or lad. chest: no evidence of spider angiomata. cv: normal s1, s2 without m/r/g. pulm: significantly decreased bs on right. no wheezes. abd: soft, distended, evidence of ventral hernia, no fluid wave. normoactive bs. ext: no c/c/e. 2+ dp b/l. skin: b/l palmar erythema. neuro: a/o x 3. cnsii-xii grossly intact. good rom and strength in all 4 extremities. no asterixis. pertinent results: imaging studies: . cxr moderate right pleural effusion. . abdominal u/s normal appearing liver. no focal liver lesions. large right pleural effusion. splenomegaly. . cxr moderate-to-large right pleural effusion is again demonstrated and probably unchanged allowing for positional differences from semi-upright on the prior exam to upright on the current study. adjacent atelectasis is present in the right middle and lower lobes. the left lung is clear except for focal opacity at the left base peripherally, likely due to atelectasis. hemidiaphragm deformity may potentially reflect a small left pleural effusion. . cxr accumulating right pleural fluid. . acid fast bacilli stains x3 + bal specimen, pleural fluid stains- all negative. . chest (pa & lat) small stable right pleural effusion and right apical hydropneumothorax. opacity at the right lung base which may represent atelectasis versus airspace disease. . liver core biopsy- liver, transjugular biopsy: 1. fragmented biopsy with wide fibrous septa, bile-duct proliferation, and vague nodularity consistent with cirrhosis, trichrome stain evaluated. 2. mild septal and lobular mononuclear infiltration with scattered apoptotic hepatocytes (grade 2 inflammation). 3. no prominent cholestasis is seen. 4. no fatty change is seen. 5. no iron is seen on special stain note: the findings are consistent with chronic viral hepatitis. . transjugular hepatic wedge pressure - 24mmhg (normal <12) . 06:30am blood wbc-8.1 rbc-3.63* hgb-13.4* hct-38.9* mcv-107* mch-37.0* mchc-34.5 rdw-15.5 plt ct-213 05:50am blood neuts-64.4 lymphs-24.3 monos-6.7 eos-3.8 baso-0.9 06:30am blood pt-16.6* ptt-39.4* inr(pt)-1.5* 06:30am blood glucose-76 urean-10 creat-0.8 na-135 k-3.9 cl-105 hco3-24 angap-10 06:30am blood alt-103* ast-121* ld(ldh)-260* alkphos-133* totbili-1.6* 06:30am blood albumin-2.3* calcium-8.1* phos-3.9 mg-2.0 06:10am blood caltibc-217* ferritn-418* trf-167* 02:46am blood folate-10.5 04:00pm blood igm hbc-positive 10:16am blood hbsag-positive hbsab-negative hbcab-positive igm hepatititis a negative 10:16am blood hiv ab-negative 10:16am blood hcv ab-positive hepatitis be antigen positive hepatitis be antibody negative brief hospital course: mr. is a 46 year old male with history of hepatitis c, hepatitis b, and bipolar disorder who is currently incarcerated who was transferred to for further evaluation and management of pna and pleural effusion. . micu course: pt was transferred from an outside hospital to the micu for further evaluation and management of a recurrent right pleural effusion and possible pna. pt is s/p thoracentesis x 2 at the osh which revealed a transudative effusion. pt was started on of abx for cap on . upon arrival to the micu, the pt was hemodynamically stable. since admission, the pt was diuresed with lasix and spironolactone with significant improvement in his oxygen requirement. he completed a course of levofloxacin for cap which was stopped on . bcx, ucx, and scx have been ngtd. he is being ruled out for tuberculosis with 2 sputum cultures. ppd placed on was read as negative on . thoracic surgery was consulted and are planning to pursue a vats procedure on tuesday. etiology of pleural effusion is hepatic hydrothorax vs. parapneumonic effusion. liver was consulted for hep c/hep b/cirrhosis. liver is recommending vats prior to consideration of tips procedure. hepatitis serologies and viral load pending. hiv negative. . hospital course on the floor: pt underwent vats pleuradesis with chest tube placement with evidence for resolution of the effusion. chest tube placement was complicated by re-expansion pulmonary edema, which resolved with lasix diuresis and high flow oxygen therapy. the patient did not require intubation. the chest tube was removed three days after placement. he developed recurrent pleural effusion despite pleuradesis. pleural effusion was transudative in nature. underwent transjugular biopsy for measurement of his hepatic wedge pressure shown to be 24 (normal <12), with biopsy revealing chronic active viral hepatitis (full path results listed above). hepatitis be antigen positive with igm viral load greater than 200,000 copies indicated acute hep b infection. the patient was started on adefovir 10mg daily and should continue until follow up with dr. in liver clinic at . it is likely this patient had underlying chronic liver disease, that was well compensated until acute hep b infection. pt was started on spironolactone 100mg daily and lasix 40mg daily diuresis. he was on higher doses, but developed hypotension, and has since been stable on the above regimen. - serial chest xrays should be performed to assess for interval change in effusion. - at time of discharge there was no evidence for recurrence of effusion, the patient may require tips in the future should this recur given evidence of elevated portal pressures. - follow up abdominal ultrasound should be considered in the setting of possible ascites that may develop. . 1) fever/possible pneumonia- (afb negative x3 as above). developed fevers with loculated effusion (however, s/p pleuradecis last week, s/p chest tube placement) given recent instrumentation he was started on broad coverage for hap with vancomycin and zosyn for hap . his cultures of pleural fluid, sputum, urine and blood all returned negative and his antibiotics were stopped . he has been afebrile x48hours and without leucocytosis at time of discharge. . .. 2) bipolar disorder - patient was on doxepin and lamictal as an outpatient, and had not been taking it for some time. he was given klonopin 0.5 on admission, this was stopped 10 days prior to discharge today, and the patient has been quite stable from a psychiatric standpoint. . diet- low sodium medications on admission: medications upon transfer: riss senna protonix spironolactone 12.5 mg po daily levofloxacin 750 mg iv daily atrovent nebs albuterol nebs clindamycin 600 mg po q8h zofran prn ativan prn toradol prn . medications as outpatient: promethazine 25 mg po q6h prn loperamide 2 mg prn zantac 150 mg po daily klonopin 1 mg po bid lipitor lamictal 100 mg po bid oxycodone 50 mg po bid doxepin 100 mg po qhs discharge medications: 1. adefovir 10 mg tablet sig: one (1) tablet po daily (). 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day): hold for loose stools. 3. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 4. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 5. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 6. hexavitamin tablet sig: one (1) cap po daily (daily). 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 8. oxycodone 5 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed for pain. 9. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 10. spironolactone 100 mg tablet sig: one (1) tablet po daily (daily). 11. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). discharge disposition: extended care discharge diagnosis: acute hepatitis b infection portal hypertension . history of hepatitis c discharge condition: fair- stable on room air, repeat chest xray without evidence of recurrent effusion. discharge instructions: you were admitted for pleural effusion related to acute hepatitis b infection. please take all of your medications only as prescribed. call your doctor or 911 if you experience any worsening shortness of breath, chest pain, yellowing hands, skin or eyes, nausea or vomiting, or any other concerning symptoms. followup instructions: please keep the following appointment: liver clinic at , ( on ) , md phone: date/time: 9:45 procedure: insertion of intercostal catheter for drainage fiber-optic bronchoscopy closed (percutaneous) [needle] biopsy of liver thoracentesis other pleural biopsy injection into thoracic cavity diagnoses: pneumonia, organism unspecified unspecified pleural effusion cirrhosis of liver without mention of alcohol chronic hepatitis c without mention of hepatic coma portal hypertension other, mixed, or unspecified drug abuse, unspecified pulmonary collapse bipolar disorder, unspecified viral hepatitis b without mention of hepatic coma, acute or unspecified, without mention of hepatitis delta 

Answer: The patient is high likely exposed to