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: mercaptopurine attending: chief complaint: esld, esrd on hd major surgical or invasive procedure: : piggyback liver with removal of the portal stent and duct-to-duct hepaticojejunostomy. : cadaveric renal left kidney to right iliac fossa. : liver biopsy 11/9/10l ercp with pancreatinc and biliary stent placement : kidney biopsy : arteriogram with 6x18 mm stent to hepatic artery : ercp: pancreatic stent removal : tunneled dialysis line placement : ercp 2 biliary stents to common bile duct (previous had migrated) : picc line placement history of present illness: mr. is a 66 year-old man with a history of nonalcoholic steatohepatitis complicated by cirrhosis with a prior meld score of 18. he is status post tips procedure after decompensation . he is currently listed for at . this summer, the patient had a routine uri which resulted in esrd secondary to post-streptococcus glomerulonephritis. he is on hd m/w/f. he was subsequently listed for a kidney . today, mr. was offered a liver and kidney and was admitted in anticipation for transplantation. he has been healthy since his most recent admission to the hospital. he mentioned that he did have a tooth pulled for a cavity 2 days ago. he is not on any antibiotics. ros: the patient denies: weight changes, fevers/chills, chest pain, sob, cough, recent illnesses or hospitalizations, sick contacts, new skin lesions/rashes, dysuria, nausea/vomiting. lactulose gives him diarrhea at baseline. past medical history: - nash cirrhosis - diagnosed by biopsy in , c/b ascites, s/p tips and redo and s/p ablation of three grade i esophageal varices - piggyback liver with removal of the portal stent and duct-to-duct hepaticojejunostomy. - ulcerative colitis diagnosed in - htn - iddm - s/p tonsillectomy - : esrd secondary to post-streptococcal glomerulonephritis - cadaveric renal left kidney to right iliac fossa. social history: lives alone, wife died in . smoked for 33 yrs x 1ppd and quit in . does not drink alcohol, no drugs. he has two daughters who visit him frequently. retired in , formerly a vice president in manufacturing. family history: htn, pancreatic ca. physical exam: vs t 97.1 hr 62 bp 179/74 rr 26 sat 97%ra gen: a and o x 3, nad. wdwn card: rrr no m/r/g/c pulm: cta b. decreased breathsounds in the bilateral bases abd: soft, non-tender, non-distended. no hsm. no masses ext: venous stasis changes. palpable pt/dp, popliteal, femoral pulses bilaterally. palpable radial and brachial pulses bilaterally. pertinent results: at admission: wbc-3.2* rbc-3.63* hgb-11.9* hct-36.0* mcv-99* mch-32.7* mchc-33.0 rdw-16.4* plt ct-50* pt-16.9* ptt-29.6 inr(pt)-1.5* glucose-291* urean-28* creat-4.0* na-138 k-4.3 cl-101 hco3-31 angap-10 alt-18 ast-35 alkphos-117 totbili-2.0* albumin-3.2* calcium-8.5 phos-4.9*# mg-3.0* glucose-146* lactate-1.5 na-136 k-4.0 cl-102 caltibc-260 ferritn-4327* trf-200 pth-59 pt-14.6* ptt-24.5 inr(pt)-1.3* glucose-67* urean-46* creat-4.8*# na-133 k-4.7 cl-93* hco3-24 angap-21* alt-107* ast-97* alkphos-812* totbili-23.3* albumin-2.7* calcium-8.6 phos-2.8 mg-2.3 at discharge: wbc-4.3 rbc-2.89* hgb-8.7* hct-26.9* mcv-93 mch-30.1 mchc-32.4 rdw-21.0* plt ct-172 pt-14.3* ptt-22.7 inr(pt)-1.2* glucose-147* urean-45* creat-5.0* na-134 k-3.7 cl-96 hco3-26 angap-16 alt-70* ast-46* alkphos-528* amylase-174* totbili-6.9* calcium-8.7 phos-6.3* mg-2.1 tacrofk-8.4 brief hospital course: on , he underwent piggyback liver with removal of the portal stent and duct-to-duct hepaticojejunostomy and cadaveric renal left kidney to right iliac fossa. surgeon was dr. . a ureteral stent was placed as well as 2 drains around the liver and 1 drain around the kidney . postop, he was sent to the sicu intubated for management. lfts increased and creatinine remained the same. urine output was 190-240cc/day range. liver duplex demonstrated patent vasculare flow. renal duplex vasculature was patent and normal. he was weaned and extubated. diet was slowly advanced. he was transferred out of the sicu on psopt day 4. lfts continued to increase. liver duplex on demonstrated patent and normal venous/arterial flow. a liver biopsy was performed on noting mild to focally moderate zone 3 cholestasis with focal feathery degeneration of hepatocytes, consistent with preservation/reperfusion injury. on , repeat liver duplex showed patent hepatic vasculature. no biliary dilatation and no collections were identified. splenomegaly was noted. an ercp was performed on . findings were as follows: 1. no anastomotic stricture. 2. diffuse beaded contour of intrahepatic ducts. diagnostic considerations include changes related to arterial ischemia or primary sclerosing cholangitis. 3. removal of sludge-like filling defect. on , ir performed the following: celiac axis, sma, and common hepatic artery arteriograms demonstrating common hepatic artery (70% plus) stenosis of the common hepatic artery, possibly at the point of anastomosis. placement of 6 mm x 18 mm balloon-expandable stent within the common hepatic artery and deployment of 6 french angio-seal device to the left common femoral artery access point. he was on iv heparin for 24 hours then was started on asa and plavix. renal function did not improve. dialysis was initiated via a right ij line. a renal biopsy was performed on showing considerable donor chronic vascular changes and some of the findings raise the possibility of (donor) diabetic nephropathy. hemodialysis was continued. given poor graft function, he was relisted for liver and kidney . during the remainder of hospital course, he was dialyzed. drains were removed. diet was tolerated. was following throughout for blood sugar management. on he had another ercp for pancreatic stent removal. on his wbc was noted to be going up, and blood cultures were sent. he was never febrile. the blood cultures came back postive for vre, and although he was initially started on vanco, he was changed to daptomycin quickly once the culture data was returned. he will continue the daptomycin through . subsequent blood cultures were taken daily, and none have been positive since . final cultures should be followed up as an outpatient. once the cultures had cleared, on a tunneled dialysis line placement was done for patient to receive outpatient hemodialysis. on because alk phos and bilirubin remained significantly elevated, he underwent another ercp, the previous stent was noted to have migrated, so 2 biliary stents to the common bile duct were placed. on the same day he also had picc line placement for home antibiotic therapy to be completed . medications on admission: albuterol neb q6h prn, amlodipine 10, balsalazide 1.5g"', avodart 0.5, ergocalciferol qthurs, clotrimazole 10"", advair 250-50", lactulose 20 g"", rifaximin 400"', ursodiol 300", ascorbic 250", calcium 500", vitamin d 400, multivitamin, ferrous sulfate 300", propranolol 40", sevelamer hcl 800"', lisinopril 5, nephrocaps 1 discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. fluconazole 200 mg tablet sig: one (1) tablet po q24h (every 24 hours). 3. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 4. valganciclovir 450 mg tablet sig: one (1) tablet po 2x/week (tu,fr). 5. oxycodone 5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*20 tablet(s)* refills:*0* 6. mycophenolate mofetil 500 mg tablet sig: one (1) tablet po four times a day. 7. sulfamethoxazole-trimethoprim 400-80 mg tablet sig: one (1) tablet po daily (daily). 8. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 9. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 10. ursodiol 300 mg capsule sig: two (2) capsule po tid (3 times a day). disp:*180 capsule(s)* refills:*2* 11. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 12. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 13. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po tid (3 times a day). 14. ranitidine hcl 150 mg tablet sig: one (1) tablet po once a day. 15. rifaximin 200 mg tablet sig: three (3) tablet po twice a day. 16. novolog 100 unit/ml solution sig: follow printed sliding scale subcutaneous four times a day. 17. tacrolimus 1 mg capsule sig: three (3) capsule po q12h (every 12 hours). 18. daptomycin 500 mg recon soln sig: eight hundred (800) mg intravenous q48h (every 48 hours) for 4 doses: give after dialysis on then at home, and at home. disp:*3 doses* refills:*0* 19. prednisone 5 mg tablet sig: three (3) tablet po daily (daily): started . 20. heparin, porcine (pf) 10 unit/ml syringe sig: two (2) ml intravenous prn (as needed) as needed for line flush. 21. insulin glargine 100 unit/ml solution sig: twelve (12) units subcutaneous at bedtime. discharge disposition: home with service facility: vna of southeastern mass. discharge diagnosis: esrd nash cirrhosis dm s/p liver/kidney extensive kidney donor disease hepatic artery stenosis with ischemic liver disease discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: please call the office if you have any of the warning signs: fever, chills, nausea, vomiting, increased jaundice, increased abdominal pain/bloating, incision redness/drainage, confusion, shortness of breath or increased fluid retention you will need to have lab work every monday and thursday (starting ) at quest lab in . do not take your prograf on those mornings until your labwork is done. resume hemodialysis at kidney center on you will have a repeat ercp on tues at the . do not eat anything that morning. no heavy lifting no driving until notified you may do so. daptomycin, iv antibiotic will be given at dialysis on , you will have the medication at home on sunday , on tuesday while you are here for ercp you will receive a dose, and then on thursday you will have your last dose of daptomycin at home. followup instructions: you will receive a call re: time to come to on for repeat ercp, which is at the , , center (nhb) phone: date/time: 9:30 , md phone: date/time: 10:00 dr. phone: date/time: 8:30 procedure: venous catheterization, not elsewhere classified hemodialysis closed (percutaneous) [needle] biopsy of liver venous catheterization for renal dialysis endoscopic insertion of stent (tube) into bile duct endoscopic insertion of stent (tube) into bile duct closed [percutaneous] [needle] biopsy of kidney other transplant of liver arteriography of other intra-abdominal arteries other kidney transplantation other endovascular procedures on other vessels endoscopic retrograde cholangiopancreatography [ercp] removal of pancreatic tube or drain other operations on lacrimal gland transplant from cadaver other operations on lacrimal gland transplant from cadaver endoscopic insertion of stent (tube) into pancreatic duct diagnoses: end stage renal disease renal dialysis status anemia, unspecified cirrhosis of liver without mention of alcohol diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease bacteremia infection with microorganisms without mention of resistance to multiple drugs streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] ulcerative colitis, unspecified complications of transplanted liver complications of transplanted kidney 

Answer: The patient is high likely exposed to