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: jaundice major surgical or invasive procedure: liver transplant intracranial bolt tunneled dialysis line post pyloric feeding tube placement ercp liver biopsy x 2 history of present illness: mr is a pleasant 70 yo previously healthy gentleman with no significant pmh who presented to liver clinic for the first time today on referral from his pcp for jaundice, dark urine and colored stool x 2wks. pt states that since he has generally been feeling unwell, with decreased energy, night sweats, decreased exercise tolerance and sob with walking short distances. he states that he initially attributed this to old age however became more concerned on when he developed dark urine, pale stools. this progressed to decreased appetite on and jaundice on . he postponed calling his pcp because of the holidays, however was then advised to go to the hospital on when he was able to reach his pcp. presented to where he was found to have bili >10 and ast/alt >900. he was admitted and ct of the abdomen was performed and per, report, showed gallbladder thickening. cxr was wnl. pt was offered further inpatient w/u however elected to f/u with his pcp who /u with hepatitis serologies (negative) and advised ercp which was performed on , and was normal other than a large peri-ampullar diverticulum. at that time, labs were notable for a bili of 20, alt/ast> 900 and elevated ap to 196. inr was 1.4. he was scheduled to f/u with dr. in clinic today. . in clinic today, labs bp was low at 90/60 and the pt appeared dry. labs were sent and were pending on admission to the floor. pt was admitted for further w/u of his liver failure. . on arrival to the floor pt confirms the above history and denies any new complaints. he denies fevers (took temp at home and no greater than 100), n/v/d, abd pain. he states that he has no hx of drug/etoh abuse or tatoos. he has not traveled outside the the country in 15 yrs, denies new food exposures (including wild mushrooms) and has not been around children or in daycare centers recently. he has no fam hx of liver disease. he has not ever used tylenol and has not recently started any medications. past medical history: tubulovillous adenoma rotator cuff syndrome, s/p repair x2 inguinal hernia repair , osteoarthritis hypertension social history: small amount of chemical exposure as a worker in an instrumention lab smoking: former smoker (quit ) 1 ppd, 55 pack-years alcohol: social family history: father deceased cad/pvd mother deceased cad/pvd sisters: diabetes - type ii; ms, stroke denies family history of liver disease physical exam: admission physical examination: vs: 114/76 76 18 wt 101.4 kgs general: well appearing 70 yo m who appears stated age. comfortable, appropriate and in good humor. diffusely jaundiced heent: sclera icteric. perrl, eomi. neck: supple with nl jvp, no lad cardiac: pmi located in 5th intercostal space, midclavicular line. rrr, s1 s2 clear and of good quality without murmurs, rubs or gallops. no s3 or s4 appreciated. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use, moving air well and symmetrically. ctab, no crackles, wheezes or rhonchi. abdomen: mildly distended but soft, non-tender to palpation except over the liver edge where there is mild ttp. no fluid wave or shifting dulness. liver edge palpable 2 cm below the costal margin, no splenomegaly. extremities: warm and well perfused, no clubbing or cyanosis. mild bilaterally to knees. 2+ dp/pt pulses neuro: aao x3, cns intact, strength and sensation grossly intact. pertinent results: on admission: wbc-11.4*# rbc-3.06*# hgb-10.6*# hct-25.0*# mcv-76*# mch-34.6*# mchc-45.8*# rdw-19.9* plt ct-343# pt-15.6* inr(pt)-1.5* glucose-141* urean-38* creat-1.7* na-135 k-4.3 cl-101 hco3-20* angap-18 alt-1293* ast-858* alkphos-165* totbili-60.5* albumin-3.2* iron-224* calcium-9.0 phos-4.8* mg-2.1 hbsag-negative hbsab-negative hbcab-negative igm hbc-negative igm hav-negative ama-negative smooth-positive a hiv ab-negative . 08:31am blood alt-208* ast-178* ld(ldh)-2680* alkphos-67 totbili-82.2* transplant at discharge wbc-6.6 rbc-3.08* hgb-10.0* hct-30.2* mcv-98 mch-32.4* mchc-33.0 rdw-17.8* plt ct-248 pt-9.4 ptt-27.4 inr(pt)-0.9 glucose-126* urean-86* creat-6.0*# na-137 k-5.5* cl-96 hco3-29 angap-18 alt-32 ast-23 alkphos-183* totbili-1.4 albumin-2.6* calcium-8.5 phos-5.2* mg-2.5 tacrofk-5.8 brief hospital course: 70 yo male admitted with jaundice with abnormal lfts. etiology unknown and extensive workup undertaken. liver biopsy was done to evaluate for autoimmune vs malignant etiology. steroid treatment with prednisone was initiated pending diagnosis. on , the patient rapidly decompensated and was in fulminant liver failure. tbili rose to 70, hct dropped to 18, and inr rose to 9. he was emergently treated with ffp, prbcs, and steroids. he was transferred to the sicu for management transvenous biopsy was done. wbc was 31.4 on , elevated from 16.6. he was afebrile with no clear etiology. empiric treatment with ceftriaxone was started. mental status worsened. on , dr. placed a right-sided high frontal intracranial pressure bolt placement. renal function declined and cvvhd was started for worsening renal function. liver biopsy was notable for histologic features in keeping with an acute, fulminant hepatitis with a clinical differential of acute viral or immune-mediated injury (either primary autoimmune hepatitis or immune-mediated drug reaction). no infiltrative neoplasm was identified. a transplant work up was completed and he was listed for liver transplant. on , a liver donor offer became available and was accepted. he was taken to the or with dr . he received an orthotopic deceased donor liver transplant (piggyback), portal vein-portal vein anastomosis, common bile duct to common bile duct anastomosis without a t-tube, and celiac patch of the donor to the common hepatic artery of the recipient. of note, his native liver was reported as firm but without evidence of cirrhosis. he tolerated the procedure without complication and was transferred to the sicu in stable condition. in the post operative period, his recovery was very slow, and he remained intubated through pod 10. his mental status had initially been very slow to improve. additionally, the patient had elevated wbc into the mid 20's. although he was not febrile, infectious disease was consulted and culture data was closely followed. on pod 3 a bal was performed which yielded yeast and haemophilus influenzae. prior to transplant had been on vanco and zosyn due to his rapid decompensation, however once the culture data was retuned he was started on meropenem. all antibiotics have been off since pod10, wbc has returned to and he has remained afebrile. prior to transplant, the patient was in acute kidney failure, and was started on cvvhd while in the icu prior to the transplant. there has yet to be return of kidney function. cvvh was done until pod 11, and then he was started on intermittent hd, with the first hd treatment done in the icu with good tolerance of fluid removal. however, he was transferred to 10, and his first attempt at intermittent hd outside of the icu caused hypotension, and he was returned to the sicu, and cvvh was once again resumed. once he was more stable, intermittent hd was tried again, and since that time he has continued on intermittent hd every monday, wednesday, friday with typical fluid removal from 1-2 liters as tolerated. urine output has been zero until about pod 27 when he has started to make about 100 to 200 cc's daily. his weight has decreased from a maximum 112 kg around pod 3 to about 95 kg at discharge. the patient had transferred out of the icu on pod 15, returned to the icu with hypotension on dialysis, spent another 8 days in the icu and has been on 10, with routine surgical care since pod 24. the patient has been receiving tube feeds via a post pyloric feeding tube with good tolerance. his appetite is poor at this time. the patient underwent routine induction immunosuppression at time of transplant to include solumedrol with taper, cellcept, prednisone taper per protocol once solumedrol was completed, and prograf which was started on the evening of pod 1. levels have been monitored daily with adjustments per level. total bilirubin was 75.6 on day of transplant, and has decreased over the course of the hospitalization to 1.4 on day of discharge. ast and alt are wnl. alk phos was 65 on day of transplant, and although initially was trending down, by pod 11 was noted to be trending back up and was 397 on pod 14. on he underwent liver biopsy which showed cholestasis and bile duct proliferation, so on he underwent an ercp which showed a mis-match in the diameter of the donor and native duct. . no strictures were noted. the anastomosis was patent. no resistance to flow of contrast or passage of 5 mm balloon was noted. no extravasation was contrast was noted. both right and left hepatic ducts filled normally. the alk phos has started to trend back towards normal and was 183 on day of discharge. the patient has been evaluated by physical therapy and will require extensive rehab. he receives hemodialysis via right tunneled hd line every monday, weds, friday, is taking tube feeds via ppft, and has poor appetite, appears to be tolerating the tube feeds, and has had normalization of bowel function. medications on admission: -metoprolol succinate 25 mg oral tablet extended release 24 hr take 1 tablet daily pt dc'd the following medications 2 days pta out of concern for aes in the setting of new jaundice: -omeprazole 20 mg oral capsule, delayed release(e.c.) take 1 capsule 30 minutes before first meal of day -naproxen sodium 220 mg oral tablet 2 tabs po bid prn -aspirin 81 mg oral tablet -vitamin discharge medications: 1. glucagon (human recombinant) 1 mg recon soln sig: one (1) recon soln injection q15min () as needed for hypoglycemia protocol. 2. fluconazole 200 mg tablet sig: one (1) tablet po q24h (every 24 hours). 3. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) puff inhalation q4h (every 4 hours) as needed for wheezing. 4. sodium chloride 0.65 % aerosol, spray sig: sprays nasal qid (4 times a day) as needed for dry nose. 5. midodrine 5 mg tablet sig: 2.5 tablets po tid (3 times a day). 6. oxycodone 5 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 8. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 9. dextrose 50% in water (d50w) syringe sig: one (1) intravenous prn (as needed) as needed for hypoglycemia protocol. 10. ondansetron hcl (pf) 4 mg/2 ml solution sig: one (1) injection q8h (every 8 hours) as needed for nausea/vomiting. 11. valganciclovir 450 mg tablet sig: one (1) tablet po 2x/week (tu,fr). 12. mycophenolate mofetil 500 mg tablet sig: two (2) tablet po bid (2 times a day). 13. sulfamethoxazole-trimethoprim 400-80 mg tablet sig: one (1) tablet po daily (daily). 14. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily): for and then decrease to every other day for 1 week then stop on . 15. ergocalciferol (vitamin d2) 50,000 unit capsule sig: one (1) capsule po 1x/week (tu) for 4 weeks. 16. prednisone 5 mg tablet sig: three (3) tablet po daily (daily): follow taper. 17. insulin lispro 100 unit/ml solution sig: follow sliding scale units subcutaneous four times a day. 18. nph insulin human recomb 100 unit/ml suspension sig: fifteen (15) units subcutaneous once a day: am dose. 19. nph insulin human recomb 100 unit/ml suspension sig: twenty (20) units subcutaneous once a day: suppertime dose. 20. tacrolimus 1 mg capsule sig: two (2) capsule po twice a day: check trough level friday . discharge disposition: extended care facility: - discharge diagnosis: fuliminant hepatic failure of unknown etiology malnutrition discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: for this week only, please draw labs on friday . cbc, chem 10, ast, alt, t bili, alk phos, trough prograf, fax results to , then resume monday/thursday labs you will be transferring to rehab in you will continue to receive hemodialysis 3 times per week labs will be drawn every monday and thursday starting week of tube feeds will continue until you are able to take in sufficient calories to meet your body's needs followup instructions: provider: , md, phd: date/time: 1:20 provider: , md, phd: date/time: 9:40 provider: , phone: date/time: 10:30 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances enteral infusion of concentrated nutritional substances hemodialysis closed (percutaneous) [needle] biopsy of liver closed (percutaneous) [needle] biopsy of liver venous catheterization for renal dialysis atrial cardioversion closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus other transplant of liver incision with removal of foreign body or device from skin and subcutaneous tissue insertion of totally implantable vascular access device [vad] endoscopic retrograde cholangiopancreatography [ercp] other operations on lacrimal gland transplant from cadaver intracranial pressure monitoring magnetic removal of embedded foreign body from cornea central venous catheter placement with guidance diagnoses: acidosis acute kidney failure with lesion of tubular necrosis other postoperative infection unspecified essential hypertension adrenal cortical steroids causing adverse effects in therapeutic use acute and subacute necrosis of liver unspecified septicemia severe sepsis hematoma complicating a procedure personal history of tobacco use atrial flutter acute respiratory failure defibrination syndrome pneumonitis due to inhalation of food or vomitus septic shock osteoarthrosis, unspecified whether generalized or localized, site unspecified hepatic encephalopathy surgical operation with transplant of whole organ causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation delirium due to conditions classified elsewhere leukocytosis, unspecified hypotension of hemodialysis autoimmune hemolytic anemias personal history of colonic polyps other fluid overload hemophilus influenzae [h. influenzae] infection in conditions classified elsewhere and of unspecified site other secondary thrombocytopenia autoimmune hepatitis secondary diabetes mellitus without mention of complication, uncontrolled 

Answer: The patient is high likely exposed to