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: liver failure hypotentsion refractory ascites major surgical or invasive procedure: placement of arterial line. placement of r internal jugular central line. history of present illness: 64m with h/o etoh cirrhosis, htn, dm2 who presented to hospital on with increasing abdom distension refractory to direutics (increased by pcp) and increasing lethargy. increasing abdom distension x several months but had been working full time until ~3 wks ago. had been admitted to hosp ~1 wk prior to this admission for a febrile episode. pt was d/ced on levoflox, and d/ced w/o clear source. upon presentation to on , he had mild sob & mild nausea believed related to his abdom distention. no f/c, cp, cough, diarrhea/constipation, melena, brbpr, or other sx. at , further diuresis was attempted but limited by declining serum na+. s/p paracentesis on , with 6l removed that showed no evidence of sbp (wbc 290, 21% pmn's). serum wbc was elevated at 17, and empiric levoflox/flagyl were initiated. became hypotensive to 70s/40s on which improved w/500cc ns. also noted to have l-arm weakness w/hypotn & ct head done but w/o evid of stroke. transferred to for further care on . pt was directly admitted to the medicine service & upon arrival was tired, thirsty, & c/o l-arm weakness. ct head showed possible l-pons lesion and mri/a () showed watershed ischemia in r hemisphere. inr also elevated at 11->8. sbp initially 115s but became hypotensive to 80s/50s & transferred to icu for closer monitoring & pressure support. past medical history: -etoh cirrhosis: first dx ~ yrs ago. no etoh since then. liver bx at osh c/w this dx. -htn: on lisinopril at home -dm2: controlled w/diet & exercise -diverticulsosis -encephalitis in tx w/acyclovir social history: former salesman who quit drinking years ago. no tobacco or ivdu. family history: no hx of strokes. physical exam: exam on admisson: vs: 96.1 112/71 102 28 93% 2 l gen: sleepy heent: pupils equal, mm dry. neck: supple without carotid bruits cv: rrr, nl s1 and s2, no murmurs/gallops/rubs lung: clear to auscultation bilaterally + asterixis. neuro: pt was alert but drowsy. oriented x3. pertinent results: 09:14pm pt-42.2* ptt-60.7* inr(pt)-11.2 09:06pm urine hours-random urea n-229 creat-85 sodium-77 09:06pm urine osmolal-339 09:06pm urine color-amber appear-clear sp -1.015 09:06pm urine blood-lg nitrite-neg protein-30 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-sm 09:06pm urine rbc->50 wbc-0-2 bacteria-few yeast-none epi-0 trans epi-0-2 09:06pm urine hyaline-0-2 05:45pm glucose-162* urea n-81* creat-2.1* sodium-128* potassium-5.5* chloride-94* total co2-19* anion gap-21* 05:45pm alt(sgpt)-101* ast(sgot)-122* ld(ldh)-337* alk phos-232* tot bili-3.6* 05:45pm alt(sgpt)-101* ast(sgot)-122* ld(ldh)-337* alk phos-232* tot bili-3.6* 05:45pm albumin-2.5* calcium-9.0 phosphate-5.4* magnesium-2.7* 05:45pm osmolal-306 05:45pm afp-4.0 05:45pm wbc-29.9* rbc-5.92 hgb-19.7* hct-57.2* mcv-97 mch-33.2* mchc-34.4 rdw-14.8 05:45pm neuts-88.0* bands-0 lymphs-4.6* monos-7.0 eos-0.1 basos-0.2 05:45pm plt smr-low plt count-99* head ct: findings: there is no intra- or extra-axial hemorrhage, midline shift, or mass effect. the /white matter differentiation remains intact. the ventricles and sulci are prominent, consistent with atrophy. there is calcification within the right basal ganglia. there is a question of low density in the left side of the pons on image 9 but this is indefinite. there are no acute fractures. the paranasal sinuses are well- aerated. impression: no intracranial hemorrhage or mass effect. possible abnormality of pons. if clinically indicated, further evaluation with mri could be performed. mri: findings: there is abnormal diffusion in the right hemisphere in a patchy fashion some of which is in a location suspicious for a watershed distribution and infarction, some of which may represent embolic infarcts in the occipital lobe. there is some abnormal signal in some of these areas especially in the posterior frontal and parietal region on the flair sequence to indicate that some of these may be subacute in nature. there is no evidence of hemorrhage or mass effect. there is no evidence of a focal extra-axial lesion or fluid collection. there is no evidence of abnormality relative to the brain stem. impression: abnormal signal on diffusion weighted and t2w sequences in the right hemisphere as discussed above consistent with watershed and/or embolic infarction. mra of the circle of and its major tributaries: findings: there is no evidence of aneurysm or flow abnormality. the a1 portion of the anterior cerebral artery on the right is diminutive, though probably is present. the p1 portion of the left posterior cerebral artery is probably not patent and is associated with a fetal type left posterior communicating artery. impression: no evidence of aneurysm or flow abnormality abd u/s: abdomen ultrasound: the liver is nodular and echogenic consistent with the history of cirrhosis. there is free fluid in the abdomen adjacent to the liver and extending into both lower quadrants. the left lobe of the liver and the left hepatic veins, portal vein, and hepatic arteries are not visualized due to overlying bowel gas. the right kidney measures 10.8 cm. there is no hydronephrosis within the right kidney. there is a small 7 mm exophytic lower attenuation area within the kidney, most likely a simple cyst. the left kidney measures 10 cm and also does not contain hydronephrosis. the spleen is enlarged with multiple echogenic foci consistent with granulomas. the gallbladder is collapsed, and is without stones. the common bile duct is not dilated. there is no intrahepatic biliary ductal dilatation. the right and middle hepatic veins are patent and have the appropriate direction of flow. the middle and right hepatic arteries are patent, but contain elevated resistive indices ranging from 0.74 to 0.85. the ivc is patent and has the appropriate direction of flow. there is no flow seen within the main portal vein or right portal vein branches. the splenic vein is not visualized due to overlying gas. the extrahepatic extension of the portal vein is also not visualized. impression: 1. absence of flow within the portal vein. this could be secondary to a portal vein thrombus, although an infiltrative process cannot be excluded. 2. ascites. 3. splenomegaly with probable splenic granulomas. torso ct: ct of the chest without iv contrast: the soft tissue window images reveal no significant axillary, mediastinal or hilar lymphadenopathy. there is calcification of the aortic arch. the tip of the right ij line is in mid-svc. there are no pleural effusions. there is a moderate sized right pleural effusion. small left effusion is also present. the lung window images reveal bibasilar atelectasis, right greater than left. there are at least three small (ranging from 2-5 mm) lung nodules at the right base. the airways appear patent. ct of the abdomen without iv contrast: the study is limited due to the lack of iv contrast. a nodular liver is visualized. a 1.8 x 2 cm area of low attenuation is visualized near segment 6 of the liver. there is a large amount of ascites present. multiple splenic granulomas are visualized. the kidneys and the adrenals appear unremarkable. the pancreas appears normal. the abdominal loops of small and large bowel appear unremarkable. a feeding tube is visualized in the stomach. there are multiple para-aortic lymph nodes present. the largest one measures about 1.3 cm. ct of the pelvis with iv contrast: a large amount of free fluid is present. the urinary bladder appears unremarkable. there is no pelvic or inguinal lymphadenopathy. a rectal tear was present. there is no suspicious lytic or blastic lesion in the osseous structures. impression: limited study due to lack of iv contrast. shrunken nodular liver consistent with cirrhosis. 1.8 x 2 cm area of low attenuation present in segment 6 of the liver. this cannot be further characterized on this study. further evaluation is recommended. multiple right lung nodules. follow up is recommended. multiple para-aortic lymph nodes. brief hospital course: by problem: * * 1) cirrhosis/ascites: 64 yo man with etoh cirrhosis dx'd 11-12y ago, stable for years, then presented with 1 week worsening ascites to osh . was put on empiric levo/flagyl. ascites tapped , c/w transudate: 290 wbc, 21% p, cx neg on levo. had major fluid shifts and hypotension after tap (was 6l) and developed stroke, worsened renal failure, worsening hepatic failure. pt was transfered to on . pt presented from osh with w/elev lfts, elev inr, arf. - abdom u/s () showed nodular liver c/w cirrhosis; r & middle hepatic arteries w/elevated resistive indices; no flow in r or main portal veins that could be c/w portal vein thrombosis or infiltrative dz; r & middle hepatic veins wnl; l-side of liver & l-sided vasculature not visualized due to bowel gas & distention. spleen w/nodules c/w granulomas. ascites. us cannot rule out hcc in worsening liver failure and pv thrombosis. pt developed worsening abd distension and elevated bladder pressure on . a large volume paracentesis was performed and 3.8 liters of fluid was removed with decreased in bladder pressure from 27 to 17. pt developed refractory ascites likely portal vein thrombosus. pt was not an operative candidate. 2) arf: thought to be hypotension and atn vs. hepatorenal syndomr. +muddy brown casts so most likely atn from hypotn. initial fena 1.5%, feurea 7%. repeat urine lytes w/<10 na. ?hypoperfusion ?hepatorenal. no hydro seen on ultrasound. low uop. pt was started on octreotide & midodrine for potential hepato-renal syndrome. pt continued to have worsening urine output starting . urine output was not improving after 3.8 liter tap on . 3)id: pt developed increased leukocytosis which became persistent. on w/250 wbc, 21% polys so not c/w sbp. pt was on levo/flagyl on floor; changed levoflox to zosyn for gram neg coverage; continue vanco (started ); continued flagyl; also empirically started fluconazole . a ct scan of the thorax was done on w/o contrast which showed small pulm nodules; moderate r pleural eff; cirrhotic liver; large ascites; pancreas & bowel unremarkable. a repeat showed 750 wbc, 64% polys; gram stain neg. - cdiff neg x1, checking 2nd. - id consulted given parecentesis results while on abx. recommended continuing with current antibiotics (vanc by levels, zosyn, flagyl, fluconazole). 4) pancreatitis: /lip checked on markedly elevated. unclear if predated portal vein thrombosis & worsening ascities or not (cirrhosis & pancreatitis both predispose to portal vein thrombosis). 5) previous hypotn: diffdx incl sepsis, dehydration (from aggressive diuresis)or poor perfusion from worsening cirrhosis. elev lactate 11.2->8->9 could be due to sepsis, hypoperfusion, or decreased breakdown due to cirrhosis. started neo on for increasing lactate. 5) ischemic stroke: likely due to hypotn post-paracentesis at osh as l-arm weakness began acutely then; ct & mri/a as above. per neuro, goal map>90 so was started on neo . carotid dopplers () notable for 60-69%r ica occlusion and l-vertebral not visualized (so could be occulded or hypoplastic) 6) coagulopathy: likely from cirrhosis. fibrinogen wnl. reversed w/ffp for central line (fem) on & . no active bleeding, cont to trend up indicating worsening liver failure. rec'd vit k x 3 days. 6) elevated hct: hct in high 50s at osh; unclear etiology (expect anemia in this chronically ill pt). patient with relative and also with worsening thrombocytopenia. 7) hyponatremia: likely related to fluid status -holding diuretics, free water restrict 8) cv: increased ectopy on tele ; an episode of paf starting on with hr up to 130-140s. intermittently goes in and out but and became more frequent. unable to cardiovert due to other medical probs. pt inr already elevated and beta-blockers contraindicated due to hypotension. 9) fen: fluid restrict to 1l. tried boost but w/pancreatitis, ordered ir placement of post-pyloric tube. tube feeds started . 10) ppx: autoanticoagulated; ppi; physical therapy to consult 11) communication: with wife and daughter who were very involved in the patients care. * * pt's condition continued to worsen with worening multiorgan failure. pt was still alert and oriented though mental status began to wax and wane on . family meeting was held and family and patient decided to make pt comfort measures only. pt was transfered to the floor and received morphine for shortness of breath prn. the patient expired on . medications on admission: insulin sliding scale nystatin phenergan prn discharge medications: none discharge disposition: expired discharge diagnosis: liver failure discharge condition: expired discharge instructions: none followup instructions: none procedure: venous catheterization, not elsewhere classified enteral infusion of concentrated nutritional substances percutaneous abdominal drainage transfusion of other serum diagnoses: acute kidney failure with lesion of tubular necrosis unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute and subacute necrosis of liver alcoholic cirrhosis of liver hepatorenal syndrome acquired coagulation factor deficiency unspecified septicemia hyposmolality and/or hyponatremia severe sepsis other and unspecified alcohol dependence, in remission atrial fibrillation acute, but ill-defined, cerebrovascular disease acute pancreatitis iatrogenic cerebrovascular infarction or hemorrhage portal vein thrombosis polycythemia vera 

Answer: The patient is high likely exposed to