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: haldol / doxycycline attending: chief complaint: altered mental status major surgical or invasive procedure: intubation extubation history of present illness: 59 year old male hx chronic hepatitis c complicated by recurrent encephalopathy, s/p tips with redo, sbp, variceal bleed, on list who was admitted with altered mental status from country estates facility. . patient presented with mental status changes, slow onset increased lethargy and confusion, possible right arm tremors. found to be unresponsive on am of admission except to sternal rub. patient has prior history of recurrent admissions for hepatic encephalopathy and tips redos. per records sent in from facility, patient's lactulose had been uptitrated to 120ml q4h at some point, but his regimen on admission was 90ml qid. per patient, he has been having 4 bowel movements, but he was not oriented. per patient, he was not confused but just tired. . had a recent admission on for hepatic encephalopathy. . in the ed, vitals were t100 rectal, bp 112/49, hr 52, rr 17, 98% on ra. per ed attg, pt was opening eyes to voice, not following commands, withdrawing from pain. head ct negative for bleed. hypona of 125, ammonia 101, given ivf, given lactulose 30ml rectal, re-examination not much better, but was mumbling and more interactive. had us of abdomen to r/o ascites which was no ascites to tap. patient with low suspicion for sbp with no fever, white count, abdominal tenderness of ascites. patient sent up floor for further eval of likely hepatic encephalopathy. . on floor, patient lethargic but answering simple questions. alert and oriented x 1. slow in speech, poor historian. denied chest pain, shortness of breath, abdominal pain, change in abdominal girth. . past medical history: # hepatitis c cirrhosis. -- followed by dr. on list -- genotype 1 -- history of refractory ascites and portal hypertension. -- prior esopagheal variceal bleed s/p band ligation in . -- s/p tips () with redo x2 ( and ) -- history of encephalopathy and sbp. # recurrent left-sided hydrothorax dx # schizophrenia social history: no current etoh or tobacco use. sister involved in care. family history: non-contributory. physical exam: pe: 97.3 96-102/48-53 55-64 96%ra 2bm since mn gen: somnolent, slow to respond heent: scleral icteris, mild jaundice neck: supple, no lad, no jvd cv: rr, nl rate. no murmurs, rubs or lungs: ctab abd: soft, nt, mildly distended. nl bs. no hsm ext: no edema. 2+ dp pulses bl skin: spider telangiectasis neuro: oriented to self, , said year was . cn 2-12 grossly intact. 5/5 strength throughout. + reflexes, equal bl. + marked asterixis pertinent results: pertinent imaging: abd us : wet read is trace ascites, not enough to tap . head ct: impression: no acute intracranial hemorrhage or acute vascular territorial infarct. this was a change from the initial wet read and was discussed with dr. , attending, on rereview of the images. . cxr: findings: the tips stent is seen in the right upper quadrant. heart size is at the upper limits of normal. the lungs are clear. . . pertinent labs: hct ranged from 25-31 with slow drift downwards over hospital course. . on discharge: wbc-5.1 rbc-2.54* hgb-9.1* hct-25.4* mcv-100* mch-35.8* mchc-35.9* rdw-15.4 plt ct-70* pt-16.1* ptt-38.5* inr(pt)-1.4* glucose-96 urean-24* creat-1.1 na-133 k-3.4 cl-103 hco3-27 totbili-2.5* . calcium: on admission 12.4 (albumin 2.7); by discharge 9.6 pth-35 . spep-polyclonal igg-2996* iga-22* igm-311* ife-no monoclo upep negative brief hospital course: 59 year old male hx hcv cirrhosis complicated by recurrent encephalopathy, s/p tips with redo, sbp, variceal bleed, on list who was admitted with altered mental status likely recurrent hepatic encephalopathy. . # altered mental status: this was felt to be likely hepatic encephalopathy perhaps exacerbated by tips. ruq us in ed showed patent tips, no ascites to tap, and patient remained afebrile with no leukocytosis. his mental status improved after increased dosing of lactulose. however, after cutting back on lactulose to bm/day, patient became acutely somnolent and non-responsive to sternal rub requiring micu transfer and elective intubation for airway protection. his lactulose was then increased again to 12bm/day and his mental status improved to baseline shortly thereafter. he was extubated without incident and returned to the medical floor where he continued 90 ml lactulose q3-4 hours for goal 12bm/day. it was felt that he will need to maintain this number of bm as an outpatient to maintain his mental status. . #. hyponatremia: patient's na on admission 125 which is slightly below baseline. baseline is 131-139. diuretics were initially held and sodium returned to baseline. pt received normal saline and diuretics were subsequently resumed. . # hypercalcemia: he had been on calcitriol/calcium for osteopenia. on admission, ca noted to be 13. calcitriol and calcium were stopped and he was treated with ivf and diuretics with decrease in calcium levels. pth was noted to be 35, which may have been inappropriately normal in response to hypercalcemia. spep consistent with polyclonal gammopathy of cirrhosis and upep was negative. - pt may benefit from repeat pth, calcium as outpatient once off calcitriol for some time. . #. esld from hcv with tips s/p redo x 2. patient with recurrent admissions for hepatic encephalopathy. on list. meld 19 on admission. lfts, tbili, platelets within baseline range. he continued his home medications including rifaximin, cipro. . #. acute renal failure: patient's cr slightly up from baseline 1.3 from 1.1. likely prerenal with encephalopathy. after holding diuretics, pt's creatinine improved. . # schizophrenia: patient has been on risperidal for this. risperidal was held during admission, but restarted when mental status returned to baseline. . # pancytopenia: over hospital course, he did have a very mild hct trend from 30 to 25 over one week. this was in the setting of ivfs for his hypercalcemia. he was guaiac negative. he will follow-up with dr. . . # fen: low sodium diet afterwards . # ppx: pneumoboots, ppi medications on admission: risperdal 2 mg daily protonix 40 daily rifaximin 400 tid calcium carb 500 nadolol 20 daily reglan 5 mg tid calcitriol 1mcg daily lasix 80 aldactone 200 cipro 250 daily lactulose 90 qid discharge medications: 1. rifaximin 200 mg tablet sig: two (2) tablet po tid (3 times a day). 2. metoclopramide 10 mg tablet sig: 0.5 tablet po tid (3 times a day). 3. ciprofloxacin 250 mg tablet sig: one (1) tablet po q24h (every 24 hours). 4. nadolol 20 mg tablet sig: one (1) tablet po daily (daily). 5. furosemide 80 mg tablet sig: one (1) tablet po bid (2 times a day). 6. spironolactone 100 mg tablet sig: two (2) tablet po bid (2 times a day). 7. lactulose 10 gram/15 ml syrup sig: ninety (90) ml po q3-4h (): please titrate to 12 bm/day. 8. risperidone 2 mg tablet sig: one (1) tablet po daily (daily). 9. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. discharge disposition: extended care facility: country estates discharge diagnosis: primary: hepatic encephalopathy hypercalcemia end stage liver disease discharge condition: baseline mental status, ambulating with assistance, afebrile discharge instructions: you were admitted with hepatic encephalopathy which improved with lactulose. you were also found to have high calcium levels which may have been related to your calcium supplements as well as the calcitriol medication. please stop taking calcium supplements. please stop taking calcitriol. we have made no changes to your other medications. please call your doctor if you notice increased confusion, lethargy, abdominal pain, chest pain, fevers, chills, nausea, vomiting, or any other concerning symptoms. followup instructions: please follow-up with dr. in clinic next week. dr. office will be in contact with you to arrange a time for your appointment. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube diagnoses: cirrhosis of liver without mention of alcohol chronic hepatitis c with hepatic coma acute kidney failure, unspecified hyposmolality and/or hyponatremia portal hypertension awaiting organ transplant status hypercalcemia schizophrenic disorders, residual type, chronic 

Answer: The patient is high likely exposed to