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: weakness, confusion, hypotension major surgical or invasive procedure: none history of present illness: 74-year-old gentleman with multiple medical problems including esrd on hd (last dialysis on ), cryptogenic cirrhosis, history of pes, and chronically low bps who is brought in by his partner for 2-3 days of worsening confusion and weakness. patient was recently admitted to on for orthostatic symptoms; admission was complicated by an iatrogenic peritonitis (induced by paracentesis) for which the patient received a 14 day course of antibiotics. he has been feeling well since this time, though did present to his pcp recently for bilateral pitting edema (dvt ruled out at that time). pt currently denies weakness and reports that he would like coffee. he denies fever, chills, nausea, vomiting, constipation, urinary symtpoms, cough, chest pain, shortness of breath or palpitations. he does endorse recent anorexia for the past few days that he relates to fatigue. . in the ed, patient's temp was 97, bp was 67/47, hr of 96, and sp02 of 91% on ra. bibasilar crackles bilaterally and significant pedal edema. neuro exam was reportedly normal (a&ox3, no asterixis) and there was no ascites on abdominal exam. elevated white count, inr, and lfts. troponin of 0.25, which is higher than baseline. ekg with nsr in the 90s and no st changes. patient received vanc/zosyn and asa in ed. received 3l ns in ed, but still had an elevated lactate. at baseline pt is hypotensive, p 75-80, rr 18, 98% 2l nc. past medical history: 1. cryptogenic cirrhosis: a portal hypertension, splenomegaly, and ascites per mri of abdomen. portal vein thrombosis noted on mri from as well as more recent ultrasound. 2. chronic kidney disease stage iv-v currently undergoing hemodialysis, possibly due to chronic nephrolithiasis, in turn caused by a bowel surgery, possibly combined with chronic hypokalemia and nonsteroidal use. more recently suggested that the possibility of amyloidosis be explored. the patient has secondary hyperparathyroidism due to renal failure. 3. chronic secretory diarrhea: carcinoid syndrome, neuroendocrine tumors, pellagra, microscopic colitis, hyperthyroidism, and infectious etiologies have been ruled out with an extensive workup in 06/. currently, attributed to a history of ileal resection. 4. history of pe during hospitalization at . formerly on coumadin is stopped in 01/. 5. a history of likely gallstone pancreatitis with lipase greater than 900 during hospitalization in 06/. 6. h. pylori gastritis treated in . 7. mgus by spep. 8. a 1.2-cm hypoechoic nodule on the left thyroid lobe without enlargement on ultrasound, follow up in . tsh remains normal in 01/. 9. left inguinal hernia. 10. status post ileal resection in for possible crohn's disease. 11. status post surgical repair perforated ulcer in the . 12. status post surgical removal of renal stone in . 13. cataracts 14. paracentesis induced bowel perforation in social history: no tobacco, rare etoh. lives alone in . supportive family. his friend is a particularly important person in his life. family history: denies family history of liver or kidney disease. physical exam: vitals: t: bp: p: r: 18 o2: general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: admission labs: wbc-12.7*# rbc-5.37 hgb-13.1* hct-43.5 mcv-81* rdw-20.3* plt ct-57*# neuts-82.8* lymphs-13.1* monos-3.6 eos-0.2 baso-0.3 hypochr-normal anisocy-normal poiklo-1+ macrocy-normal microcy-normal polychr-occasional ovalocy-1+ target-1+ schisto-occasional tear dr1+ pt-17.4* ptt-33.5 inr(pt)-1.6* glucose-138* urean-15 creat-5.1*# na-143 k-4.3 cl-100 hco3-32 angap-15 alt-23 ast-53* ck(cpk)-92 alkphos-146* totbili-2.0* dirbili-0.3 indbili-1.7 lipase-22 albumin-2.4* calcium-8.7 phos-2.1* mg-1.4* . cardiac enzymes: 03:35pm blood ck-mb-notdone ctropnt-0.25* 01:38am blood ck-mb-3 ctropnt-0.24* 05:33pm blood ck-mb-3 ctropnt-0.21* 01:33am blood ck-mb-notdone ctropnt-0.23* . discharge labs: wbc-11.2* rbc-5.24 hgb-13.3* hct-41.5 mcv-79* rdw-20.9* plt ct-64* glucose-104* urean-18 creat-4.7* na-142 k-4.1 cl-103 hco3-30 angap-13 alt-17 ast-22 ld(ldh)-283* alkphos-180* totbili-1.7* calcium-8.4 phos-2.9 mg-1.9 . 5:00 pm stool consistency: formed received sample in lab on @ @1022. **final report ** cyclospora stain (final ): no cyclospora seen. microsporidia stain (final ): no microsporidium seen. clostridium difficile toxin a & b test (final ): feces negative for c.difficile toxin a & b by eia. (reference range-negative). cryptosporidium/giardia (dfa) (final ): no cryptosporidium or giardia seen. fecal culture (final ): no salmonella or shigella found. campylobacter culture (final ): no campylobacter found. . images/studies: cxr : findings: single ap upright portable view of the chest was obtained. bibasilar atelectasis/scarring is again seen. there is persistent elevation of the right hemidiaphragm. medial right base opacity may be summation of cardiac and diaphragmatic shadows, although appears more confluent than as compared to the prior examination. an underlying consolidation cannot be excluded. the aorta is tortuous. the cardiac silhouette is not enlarged. impression: 1. bibasilar atelectasis/scarring. persistent elevation of the right hemidiaphragm. 2. opacity seen in the medial right lung base, more confluent than on prior studies, underlying consolidation cannot be excluded. portable supine abdomen x-ray : supine abdomen: bowel gas pattern is nonobstructive with air seen in non-dilated loops of small and large bowel. there is no intraperitoneal air or pneumatosis. impression: no evidence of bowel obstruction. no free intraperitoneal air. abdominal us with doppler : impression: 1. cholelithiasis. 2. ascites. 3. vascular findings consistent with the prior ct appearance, including portal venous thrombosis with occlusion and development of collateral flow. 4. splenomegaly. echocardiogram : the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). regional left ventricular wall motion is normal. doppler parameters are most consistent with grade i (mild) left ventricular diastolic dysfunction. right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the ascending aorta is mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are structurally normal. there is mild pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. impression: mild symmetric left ventricular hypertrophy with normal global and regional biventricular systolic function. mild diastolic lv dysfunction. mild pulmonary hypertension. echocardiography is unable to exclude cardiac amyloidosis (ca), however classic ca features such as restrictive lv filling, polyvalvular regurgitation or very low/absent mitral annular e' waves are not present on this study. compared with the report of the prior study (images unavailable for review) of , findings appear similar. clavicle xray: superiorly displaced left distal clavicular fracture with subluxation of the humeral head and narrowing of the acromiohumeral space. brief hospital course: &4 year old man with of esrd on hd (last dialysis ), cryptogenic cirrhosis and ascites requiring paracentesis admitted with weakness and confusion. . # hypotension: it was not clear initially if the blood pressures (his systolics in the 70s measured in the patient's arm) were his baseline or relative hypotension. further investigation of records revealed that this was his baseline. he interemittently received fluid boluses for sbp<70. blood pressure was re-checked in his leg and was found to be ranging from 100-120 systolic. he remained afebrile with normal white count and lactate level. blood cultures to date have been negative. given his stable blood pressures midodrine was discontinued. of note, patient's baseline hr is in the 110s and he is asymptomatic at this heart rate. . # weakness/confusion: patient was brought into the ed by his partner who related a history of weakness and confusion for the past 3 days. patient states that he has had a lack of appetite for the past few days. possibilites for weakness and confusion in this patient include metabolic derangements (likely from liver failure and hepatic encephalopathy). albumin is significantly lower at 2.4 than it was in , malnutrition may be contributing to weakness. additionaly patient is at risk for hiv (partner is positive, but patient has historically refused testing). testing did not reveal any infectious etiology. patient's confusion improved prior to discharge. physical therapy evaluated him and recommended rehab for his weakness. . # clavicular fracture: patient had a fall prior to admission. xray shows displaced clavicular fracture. orthopedics evaluated him and recommened a sling for comfort. he has outpatient orthopedics follow up. pain control with tylenol. . # diarrhea: patient has had chronic diarrhea and extensive gi work up. gi feels like most like etiology is from illeal resection he had years ago. started cholestyramine and this decreased his stool output. patient to continue on loperamide. he also has follow up with gi as an outpatient. . # elevated troponin: he was found to have elevated troponins but normal ck. these were trended and given stable elevatation and unchanged ekg were thought to be due to his poor renal function. . # thrombocytopenia: patient has chronically low platelets splenic sequestration. platlet count was stable prior to discharge. . #esrd. the renal team was . he was continued on t/th/sat hemodialysis schedule. medications on admission: midodrine 10mg pre-hd xifaxan 200 mg tid nadolol 40 mg tid omeprazole 20 mg cap loperamide 2 mg q6h calcium acetate 667 mg cap, 2caps tid nephrocaps 1 mg cap once a day cipro 250 daily for sbp ppx discharge medications: 1. rifaximin 200 mg tablet sig: one (1) tablet po tid (3 times a day). 2. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. 3. loperamide 2 mg capsule sig: one (1) capsule po three times a day as needed for loose stool. 4. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 5. cholestyramine-sucrose 4 gram packet sig: one (1) packet po bid (2 times a day). discharge disposition: extended care facility: - discharge diagnosis: primary diagnosis: esrd on dialysis clavicle fracture chronic diarrhea . secondary diagnosis: cryptogenic cirrhosis cki h/o pe mgus on spep left inguinal hernia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you were admitted to the hospital with chronic diarrhea and after a fall. for your diarrhea the gi doctors . we believe that your diarrhea is chronic and related to the illeal surgery you had years ago. we have adjusted your medications, as written below, to help with manage this issue. for your history of falling physical therapy evaluated you and recommends a rehabiliatation program. you had a left clavicle fracture from your last fall. you should follow up with the orthopedics appointment listed below. you may use a sling for comfort if you need it. . we have made the following changes to your medications: 1. stop midodrine 2. stop nadolol 3. stop calcium acetate 4. stop ciprofloxacin 5. start cholestyramine 4mg by mouth twice a day followup instructions: department: orthopedics when: tuesday at 2:40 pm with: ortho xray (scc 2) building: sc clinical ctr campus: east best parking: garage department: orthopedics when: tuesday at 3:00 pm with: , md building: sc clinical ctr campus: east best parking: garage department: div. of gastroenterology when: wednesday at 4:00 pm with: , md building: ra (/ complex) campus: east best parking: main garage department: liver center when: monday at 9:30 am with: , md building: lm campus: west best parking: garage procedure: venous catheterization, not elsewhere classified hemodialysis diagnoses: thrombocytopenia, unspecified end stage renal disease renal dialysis status cirrhosis of liver without mention of alcohol unspecified protein-calorie malnutrition portal hypertension hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease hypotension, unspecified pressure ulcer, lower back calculus of gallbladder without mention of cholecystitis, without mention of obstruction personal history of venous thrombosis and embolism secondary hyperparathyroidism (of renal origin) other ascites diarrhea hepatic encephalopathy pressure ulcer, heel fall from other slipping, tripping, or stumbling closed fracture of clavicle, unspecified part pressure ulcer, stage ii inguinal hernia, without mention of obstruction or gangrene, unilateral or unspecified (not specified as recurrent) acquired absence of intestine (large) (small) monoclonal paraproteinemia 

Answer: The patient is high likely exposed to