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: bloody paracentesis, encephalopathy major surgical or invasive procedure: paracentesis history of present illness: 61yo man with h/o etoh cirrhosis, esld, ascites s/p frequent taps, ftt, who was admited for w/u of bloody ascites and management of ftt, who developed worsening ms compromise, transferred to micu for further w/u and management. has had marked weight loss continuing over past 3 months. when healthy his weight was 165-170, currently it is 138 lbs. he was recently () admitted for 4d for this ftt. pt underwent lvp (7l) on the day of admit , found to have bloody fluid that was concerning for tuberculous ascites. after his admission and the large volume tap, the patient was feeling "a little better". he had a ppd planted that has since come back negative. his wbc count was slightly elevated, but he had no fevers initially and his ascites were negative for sbp, so no abx were started. a nutrition consult was obtained, he was started on a po diet in addition to tf supplements. blood cultures have been neg to date. he had a cxr that showed l>r pleural effusion felt to be from his ascites, as well as a small ptx that was managed conservatively (no chest tube). . in the last several days, the patient developed leukocytosis and arf. his tube feeds were decreased distention, his sodium went down so his lasix/aldactone were held. a repeat cxr showed no enlargement of ptx. his wbc has remained elevated though he has been afebrile, and he was feeling well except for chronic low back pain. he underwent a diagnostic tap given his wbc and bandemia, with no evidence of sbp on gram stain and cell count. he had a repeat u/a, cxr that were unrevealing for infectious etiology. given his worsening renal function concerning for hrs, the pt was started on midodrine, octreotide, albumin. because of his worsening lbp, the patient's pain meds were increased this am to oxycodone 10mg. he had not had a bm since thursday despite lactulose, but a 90ml dose this am recently had the effect of a large loose bm. . the team found the pt to be withdrawn and lethargic later on this am, and called the icu team for evaluation. he was responding only to pain. his rate decreased, and an abg revealed normal ph but increased pco2. a repeat cxr is pending. pt is being transferred to the micu for further eval and management. prior to transfer, he received 2 doses of narcan and a new iv placement, with some mild improvement in his mental status and increase in his resp rate during this period. past medical history: etoh cirrhosis secondary to alcohol use recurrent ascites, negative cytology endoscopy with grade 2 varicies prior h/o htn gout history of pancreatitis, presumably etoh . s/p appendectomy, distant s/p hernia repair social history: patient lives with his wife currently. significant past etoh use for 30 years, drinking 4 drinks of hard liquor daily. per report from last discharge, quit etoh use 8 weeks ago. patient is a veteran. family history: no family history of colon or pancreatic ca. father with lung ca physical exam: vitals: tc 95.4 bp 105/63 hr 76 o2 sat 98% on nc o2 . gen: thin, cachetic, weak appearing male in nad heent: pupils equal and round, anicteric sclera, dry mm, hoarse voice neck: supple, no lad cv: soft s1 s2, rrr, with no m/r/g abd: abd soft, distended, moderate diffuse tenderness to palpation, + bs ext: no pedal edema, 2+ dp pulses neuro: + asterixis awake, a&o x 3 pertinent results: admission labs: . 02:00pm ascites tot prot-2.9 ld(ldh)-83 albumin-1.5 02:00pm ascites wbc-139* rbc-* polys-6* lymphs-62* monos-27* eos-1* other-4* 04:50am blood wbc-5.9 rbc-3.17* hgb-10.4* hct-31.1* mcv-98 mch-32.8* mchc-33.4 rdw-16.0* plt ct-271 04:50am blood neuts-73* bands-10* lymphs-10* monos-6 eos-1 baso-0 atyps-0 metas-0 myelos-0 04:50am blood pt-15.1* ptt-26.6 inr(pt)-1.4* 04:50am blood glucose-91 urean-66* creat-1.3* na-133 k-4.6 cl-93* hco3-30 angap-15 04:50am blood alt-14 ast-27 ld(ldh)-121 alkphos-136* amylase-54 totbili-0.9 04:50am blood lipase-101* 04:50am blood albumin-3.0* calcium-8.9 phos-3.2 mg-2.1 pertinent labs/studies: . 03:57pm blood cea-28* afp-3.7 04:50am blood lipase-101* 07:15am blood lipase-63* . 11:58am ascites wbc-500* rbc-* polys-5* lymphs-63* monos-32* 02:00pm ascites wbc-139* rbc-* polys-6* lymphs-62* monos-27* eos-1* other-4* 11:58am ascites totpro-2.9 albumin-1.5 02:00pm ascites totpro-2.9 ld(ldh)-83 albumin-1.5 . . . microbiology: blood cultures: : ngtd : ngtd . peritoneal fluid: : gram stain 1+ pmn culture - no growth, afb smear negative, no growth adenosine deaminase - adenosine deaminase,fluid <1.0 : no growth . . . . imaging: . chest pa/lat : a small right apical pneumothorax has developed. the right-sided pleural effusion has decreased in size. there has also been development of a moderate to large left-sided hydropneumothorax with decrease in the component of left-sided pleural effusion. the feeding tube remains in stable position. the lungs are otherwise clear. impression: development of bilateral pneumothoraces greater on the left side with decrease in bilateral effusions. . chest pa/lat : impression: essentially no significant interval change since the previous study in the bilateral hydropneumothoraces. . chest pa/lat : there is a feeding tube whose distal portion is not visualized. there is again seen a moderate left-sided hydropneumothorax. there has been no significant interval change in the size of the pneumothorax or the pleural fluid. there is a loculated right-sided pleural effusion, also unchanged. the small right apical pneumothorax seen previously is no longer visualized. consolidation at the lung bases, particularly at the right side cannot excluded due to the large amount of pleural fluid. impression: there has been resolution of the tiny right apical pneumothorax. otherwise unchanged. . portable chest : impression: 1. moderate-sized left-sided hydropneumothorax which is not significantly changed from the prior study, with a very tiny apical pneumothorax component. 2. moderate-sized right pleural effusion, unchanged. . : ct chest w/out contrast - 1. moderate-sized left-sided hydropneumothorax and moderate-sized right pleural effusion. 2. rounded opacity seen in the medial aspect of the right lung base, probably representing atelectasis, however, followup imaging is recommended to document resolution and to exclude mass. 3. no pathologically enlarged mediastinal or hilar lymphadenopathy is identified. 4. large amount of ascites. . : plain films l-spine - impression: old compression fracture of a low thoracic vertebral body accounting for less than 25% of the normal vertebral body height. thoracic and lumbar spondylosis without listhesis. . : portable chest - 1. moderate sized right pleural effusion, unchanged. 2. moderate sized left hydropneumothorax is stable with a persistent small apical pneumothorax component. . . . pathology: : cytology peritoneal fluid: negative for malignant cells. a few mesothelial cells, lymphocytes, and histiocytes. discharge labs: . 05:35am blood wbc-9.9 rbc-2.98* hgb-10.0* hct-29.5* mcv-99* mch-33.5* mchc-33.8 rdw-16.1* plt ct-210 05:35am blood glucose-110* urean-79* creat-1.7* na-137 k-4.1 cl-98 hco3-26 angap-17 05:35am blood alt-12 ast-25 alkphos-138* totbili-1.1 05:35am blood calcium-8.7 phos-3.7 mg-2.0 07:17am blood type-art o2 flow-2 po2-141* pco2-41 ph-7.45 calhco3-29 base xs-4 intubat-not intuba comment-nc 07:17am blood lactate-1.2 brief hospital course: a/p: 61 yo man with esld, presented with bloody ascites, ftt, encephalopathy. . . #. esld: on admission, patient was known to have a history of alcoholic cirrhosis with need for repeated paracentesis for recurrent ascites. as above, the patient has been noted to have bloody taps concerning for potential underlying malignancy or tuberculosis. the patient additionally had developed renal failure with concern for possible hepatorenal syndrome. it was the hope initially that the patient would be eligible for a liver transplant. however, as described in h+p, the patient was noted to have rapid decline in functional status with severe cachexia, concerning for potential secondary process such as malignancy, or possibly tuberculosis given bloody taps, although more likely the former. at time of admission, the patient was with such poor functional status that he was not considered eligible for a liver transplant. it was the hope that with improved nutritional status and treatment for encephalopathy patient may improve. workup was additionally underway for potential underlying condition such as malignancy or infection that was further compromising his health. unfortunately, the patient continued to decline rapidly clinically throughout the hospital course before further evaluation could be completed and the patient passed (see below). . #. depression/altered mental status: the patient was transferred to the micu because of somnolence thought to be secondary to underlying encephalopathy and med effect from narcotics with decreased hepatic clearance. the patient had an abg performed that revealed mild hypoxia, and hypercarbia with normal ph, possibly from increased oxycontin that was initiated for increasing back pain. the patient was observed in the micu without need for intubation or non-invasive ventilation and was subsequently transferred back to the floor. the patient was noted to have ongoing waxing and mental status with difficulty balancing comfort and pain control with maintaining mental status. the patient was noted again to grow somnolent for which a repeat abg was performed which revealed no significant acid/base disorder, hypercarbia or hypoxia. the patient's lactulose was up titrated and rifaximin added to his treatment regimen with hope to reverse potential underlying encephalopathy. narcotics were held without significant improvement in mental status. despite these efforts the patient continued to have ongoing worsening mental status with significant somnolence. code status was discussed with the patient's family where it was clarified that the patient definitely would not want to be aggressively resuscitated. given the patient's rapidly declining clinical status, it was discussed with the patient's family the treating team's concern that his short term prognosis may not be good. the patient's family understood this and additionally were in agreement that it would be better to treat the patient's pain (which he reported) than to hold pain meds so as to avoid further sedation. around 1:30 a.m. on the patient was noted to be developing increasing tachypnea and course upper airway sounds. for this, he was given a scopolamine patch and received ativan for distress. the patient was noted on telemetry to develop progressive bradycardia until asystolic. per the patient's and families wishes, no resuscitation efforts were made. the patient was reported to appear comfortable at the time of his passing with his family present. it was discussed with the patient's family the importance of performing a post-mortem exam to evaluate for possible underlying malignancy or infection, which they agreed to. . #. bloody paracentesis - the patient has had two paracentesis performed within the last 4 weeks that have bene demonstrated to be bloody by cell count without evidence of sbp. cytology on two samples did not reveal any malignant cells. given no evidence for malignancy by cytology, their was additional consideration of possible tuberculosis, particularly given the patient's history of 40 pound weight loss. however, despite the negative cytology, clinical suspicion for underling malignancy remained high. the patient did not have an elevated afp this admission but did have a mildly elevated cea of 28. afb smears from peritoneal fluid were negative for afb, cultures are all no growth to date, and adenosine deaminase levels from peritoneal fluid were < 1. a ppd was planted this admission which was negative. although suspicion for pulmonary tuberculosis was low, the patient was maintained on precautions as induced sputum was not possible secondary to sedation. the patient's family was instructed that they should be wearing tuberculosis barrier aerosol masks on entry to the room but declined to do so. throughout the patient's clinical course (see below) he continued to decline with depressed mental status, tachypnea, and hypotension. the patient passed away on after episode of bradycardia, progressing to asystole. the patient's family was agreeable to autopsy to determine underlying etiology for patient's rapid decline and cachexia, with concern for tuberculosis and malignancy as above. . #. arf: the patient developed acute renal failure during this hospitalization with consideration of pre-renal etiology of possibly hepatorenal syndrome. the patient was given a 1l fluid challenge while in the intensive care unit without any improvement in his renal function. the patient was maintained on octreotide and midodrine for ongoing blood pressure support. medications on admission: folic acid 1 mg po qd caco3 0.6 mg po qd aldactone 25 mg po qd lasix 40 mg po qd -> recently increased to 40 . lactulose 2 tspns qid mvi qd tube feeds discharge medications: none discharge disposition: extended care discharge diagnosis: primary: end stage liver disease renal failure failure to thrive bloody peritoneal effusion discharge condition: deceased discharge instructions: none followup instructions: none procedure: enteral infusion of concentrated nutritional substances percutaneous abdominal drainage diagnoses: alcoholic cirrhosis of liver acute kidney failure, unspecified other pulmonary insufficiency, not elsewhere classified portal hypertension gout, unspecified acute respiratory failure closed fracture of dorsal [thoracic] vertebra without mention of spinal cord injury hepatic encephalopathy dehydration peritoneal effusion (chronic) other and unspecified alcohol dependence, unspecified adult failure to thrive fracture, cause unspecified 

Answer: The patient is high likely exposed to