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: vicodin / penicillins attending: chief complaint: abdominal pain major surgical or invasive procedure: paracentesis transfusion of packed red blood cells and fresh frozen plasma upper endoscopy history of present illness: 57yom with h/o etoh cirrhosis, ugib, cll, a fib on coumadin p/w abdominal pain (mid abdominal) since this morning. at worst the abdominal pain was and was worse with bumps in car ride to ed. sharp in nature and perhaps transiently better after bm. he also notes increased lethargy over the past few days. he has had softer/loose brown stool; denies black stool or brbpr. reports chronic, intermittent diarrhea x many years, however noted 4 loose stools (more frequent than normal during these episodes). has noted perhaps slightly increased abdominal distention, but no significant increase in le edema from recent baseline. no fevers/chills. no dysuria/hematuria. denies n/v/hematemesis. has been taking po, but "not as much as usual" and he reports feeling dehydrated. . of note, he was hospitalized for chf and hct drop at which time egd was performed showing grade 2 varices which were banded. hct at time of discharge was 24.3 at time of discharge. . in the ed, initial vitals were 98.8 112 81/45 18 96%ra. ngl was negative for blood. he had guaiac positive brown stool. ct abd/pelvis was performed which showed moderate loculated ascitic fluid without other clear bowel pathology. he received levofloxacin 750mg iv, flagyl 500mg iv, and ceftriaxone 1g iv. he also received zofran 4mg iv x1 for nausea after ngl. additionally he was noted to have transient sbps to 70s (normally 90s); central line (right ij) was placed and he received 3l ns to which his bp improved to high 80s-90s systolic. . ros: no f/chills. no lightheadedness/dizziness. no ha/changes in vision. no sob/cough/pnd/orthopnea. no dysuria/hematuria. +chronic le edema which he denies being worse than baseline. no rashes. +jaundice. no joint pain. past medical history: # etoh cirrhosis -portal htn -varices with h/o ugib -ascites -no h/o sbp -no h/o hepatic encephalopathy # hypertension # diastolic chf # atrial fibrillation on coumadin # seasonal allergies # shingles # dental abscess # peptic ulcer disease # cll social history: significant for no tobacco usage, significant alcohol usage. he used to drink heavily in the past, with no history of any withdrawals or delirium tremens. he reports previously was drinking about glasses of wine 3-4 times a week, but reports has stopped currently. family history: diabetes, cancer and stroke. physical exam: vs: temp: 97.2 bp: 85/48 hr: 90 a.fib rr: 19 o2sat 99% ra gen: pleasant, comfortable, nad heent: left pupul 3->2.5mm, right pupil 2.5->2mm, eomi, + scleral icterus, mm dry, op without lesions neck: no supraclavicular or cervical lymphadenopathy appreciated, no jvd, no carotid bruits, no thyromegaly or thyroid nodules resp: no increased wob, bibasilar rales l>r ( up on left), no rhonchi nor wheezes cv: irregularly irregular, s1 and s2 wnl, no m/r/g appreciated abd: +mild distention, +b/s, soft, mildly tender mid abdomen just superior to umbilicus, + hepatosplenomegaly, no rebound/guarding ext: + left lower extremity edema, 2+right lower extremity edema (reports asymmetry as chronic), warm, good pulses skin: no rashes, +jaundice neuro: aaox3. cn ii-xii grossly intact. 5/5 strength throughout. no sensory deficits to light touch appreciated. no asterixis. . pertinent results: labs on admission: 11:22pm lactate-1.3 02:37pm lactate-3.1* 02:37pm hgb-9.1* calchct-27 02:25pm glucose-151* urea n-21* creat-1.3* sodium-135 potassium-4.1 chloride-101 total co2-28 anion gap-10 02:25pm estgfr-using this 02:25pm alt(sgpt)-21 ast(sgot)-41* alk phos-109 amylase-74 tot bili-5.5* 02:25pm lipase-28 02:25pm calcium-8.3* magnesium-2.0 02:25pm ammonia-57* 02:25pm digoxin-2.5* 02:25pm wbc-31.0* rbc-2.50* hgb-8.8* hct-25.7* mcv-103* mch-35.2* mchc-34.3 rdw-24.7* 02:25pm neuts-15* bands-2 lymphs-79* monos-4 eos-0 basos-0 atyps-0 metas-0 myelos-0 02:25pm plt count-243 02:25pm pt-21.2* ptt-34.8 inr(pt)-2.1* . labs on discharge: 05:51am blood wbc-13.2* rbc-2.61* hgb-8.7* hct-25.1* mcv-96 mch-33.5* mchc-34.8 rdw-22.5* plt ct-121* 05:51am blood pt-20.0* ptt-50.8* inr(pt)-1.9* 05:51am blood glucose-83 urean-24* creat-1.0 na-140 k-3.9 cl-105 hco3-24 angap-15 05:51am blood calcium-8.9 phos-3.5 mg-2.1 . ekg: a. fib at rate 86. normal axis and intervals. biphasic tw in v2, twi v3-v6 (old), twi ii, iii, avf (both old) . microbiology: blood cx - negative urine cx - < 100k enterococcus blood cx - negative peritoneal fluid cx - gram stain 4+ pmns, no microorganisms, cx negative . imaging: . cxr: wet read: pleural plaques, bilateral haziness and cephalization c/w pulmonary edema vs. overlying pleural disease. . ct abd/pelvis: 1. increasing ascites within the abdomen, layering non-dependently with some areas of partial loculation and mild rim enhancement--these findings raise the possibility of peritonitis. 2. stigmata of portal hypertension including splenomegaly, paraesophageal varices, and a large recanalized umbilical vein. . abd u/s: impression: 1. poor visualization of the left hepatic lobe, left hepatic vein, and left portal vein. 2. patent main portal, right portal, and right and middle hepatic veins. 3. findings consistent with cirrhosis and portal hypertension. 4. moderate to large volume ascites. . ct abd/pelvis: impression: 1. markedly decreased amount of ascites. no evidence of hematoma or intraperitoneal hemorrhage. 2. stigmata of portal hypertension including splenomegaly, periesophageal varices, gastric varices, and large recanalized umbilical vein are unchanged. . egd: impression: varices at the lower third of the esophagus erythema in the gastroesophageal junction compatible with esophagitis otherwise normal egd to third part of the duodenum brief hospital course: 57 year old man with history of alcoholic cirrhosis and portal hypertension with grade 2 varices status post banding in , cll, diastolic chf presents with increase in loose bowel movements and abdominal pain. initially admitted to micu for transient hypotension, stable throughout admission. . hospital course by problem: . # abdominal pain/spontaneous bacterial peritonitis: due to spontaneous bacterial peritonitis given loculated ascites and peritoneal enhancement on ct, as well as diagnostic paracentesis demonstrating greater than 250 pmns. peritoneal culture with no growth. patient was treated with levofloxacin with resolution of abdominal pain. discharged with instructions to complete 7 day course of levofloxacin, then to start on ciprofloxacin for sbp prophylaxis. . # hypotension: normal sbps run in the 90s per patient, but bp on presentation was below this, off of normal anti-hypertensives. therefore felt to be relative hypotension. was initially admitted to the micu due to this, but bp stabilized with ivf. no more episodes of hypotension throughout hospital course. . # alcohollic cirrhosis: patient with known alcoholic cirrhosis, with esophageal varices. on furosemide, aldactone, nadolol as outpatient. these were initially held due to hypotension above, but then were added back (although furosemide and nadolol added at lower dose that on admission). otherwise, treatement of sbp as above, and treatment of anemia as below. the patient will follow up with hepatology as an outpatient. . # anemia: patient presented with hct of 25.7, trended to low of 18.5. etiology of patient's anemia felt to be likely multifactorial - due to history of cll, perhaps some low grade hemolysis (50% indirect bili, low haptoglobin, but normal ldh, and in setting of transfusions and cirrhosis, so difficult to interpret), as well as perhaps low grade bleed from esophageal varices. he is on coumadin for afib and aspirin as an outpatient, which were held on admission. patient received 6 units prbc, 7 units ffp, vitamin k po x 1 during hospital course. egd demonstrated non-bleeding varices, no intervention done. he was discharged with stable hct, off of his coumadin and aspirin, on protonix, with follow up with his pcp to check hematocrit as outpatient to ensure remains stable. re-starting anticoagulation will also be addressed by his pcp as outpatient. . # acute renal failure: creatinine 1.3 from previously normal baseline of 0.8-1.0. resolved with ivf, blood. . # rhythm: patient has a history of atrial fibrillation on coumadin. as above, coumadin held on admission due to decreased hct. digoxin also held on admission, and was held on discharge, to be addressed as an outpatient. otherwise remained rate controlled on nadolol during hospital course. . # pump: patient with known diastolic chf, preserved ef followed by dr. in outpatient setting. patient was given iv lasix with blood transfusions, and as above, was discharged on lower dose of lasix than presented on. appeared euvolemic during hospital course. will follow up as outpatient. . # cll: followed by dr. as outpatient. to be followed up as outpatient. medications on admission: 1. pravastatin 10 mg po daily 2. omeprazole 40 mg po daily 3. furosemide 80 mg po bid 4. digoxin 250 mcg po daily 5. nadolol 40 mg po daily 6. spironolactone 50 mg po daily 7. warfarin 6 mg alternating with 5 mg po (alternating dose qod) 8. lisinopril 2.5 mg po daily 9. aspirin 81 mg daily 10. testosterone patch (50mg/5gram td) discharge medications: 1. pravastatin 10 mg tablet sig: one (1) tablet po daily (daily). 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 3. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. spironolactone 25 mg tablet sig: two (2) tablet po daily (daily). 5. nadolol 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). 7. levofloxacin 500 mg tablet sig: one (1) tablet po once a day for 4 days. disp:*4 tablet(s)* refills:*0* 8. ciprofloxacin 250 mg tablet sig: one (1) tablet po once a day: please start this after you have completed your course of levofloxacin. disp:*30 tablet(s)* refills:*2* 9. outpatient lab work please check cbc (including hematocrit), and inr (please bring this lab slip with you to your doctor's office on thursday, ) discharge disposition: home discharge diagnosis: primary: spontaneous bacterial peritonitis anemia secondary: cirrhosis hypertension diastolic congestive heart failure atrial fibrillation on coumadin cll peptic ulcer disease discharge condition: good. hematocrit stable, patient ambulatory. discharge instructions: you were admitted to the hospital with abdominal pain and found to have a spontaneous bacterial peritonitis (infection in the peritoneum of your abdomen). this was treated with antibiotics. you also had low blood counts requiring transfusions, and therefore underwent an endoscopy for further evaluation, which demonstrated non bleeding esophageal varices. you were discharged with instructions to follow up with your primary care physician, well as hepatology. . please take medications as directed. please note that medication changes include: - new medications include levofloxacin (antibiotics) to complete a 7 day course, and after this is completed, you will need to be on prophylactic ciprofloxaciin (a similar antibiotic) continually. - you had your dose of furosemide decreased from 80mg twice daily to 40mg daily. - you had your dose of nadolol decreased from 40mg daily to 20mg daily. - we have also discontinued your coumadin due to your bleeding for now - this will be re-addressed by your physician after discharge. - we have also discontinued your aspirin due to your bleeding for now - this will be re-addressed by your physician after discharge - we also have discontinued your digoxin due to your low blood pressure - this will be re-addressed by your physician after discharge as well. . please follow up with appointments as directed. . please contact physician if develop weakness/dizziness, blood in stool, black colored stools, abdominal pain, fevers, any other complaints. followup instructions: please make a follow up appointment with your primary care physician, . ( in the next 1 week. at this visit, you will need to have your blood counts checked. you will also have to re-address starting back on your coumadin. (please bring the printed lab slip with you so that your physician knows which labs need to be checked). if your doctor cannot see you in his office this week, please go in anyways on thursday to have your blood drawn (bring in the slip) and your primary care doctor will follow up on the results. . please follow up with hepatology, dr. at ( as directed. please call him to make a follow up appointment in the next 2-4 weeks. . the following appointments had already been scheduled, prior to your hospitalization: provider: , : date/time: 1:00 procedure: venous catheterization, not elsewhere classified esophagogastroduodenoscopy [egd] with closed biopsy transfusion of packed cells transfusion of other serum diagnoses: anemia, unspecified congestive heart failure, unspecified unspecified essential hypertension alcoholic cirrhosis of liver acute kidney failure, unspecified portal hypertension atrial fibrillation long-term (current) use of anticoagulants gastric ulcer, unspecified as acute or chronic, without mention of hemorrhage or perforation, without mention of obstruction esophageal varices in diseases classified elsewhere, without mention of bleeding chronic diastolic heart failure chronic lymphoid leukemia, without mention of having achieved remission spontaneous bacterial peritonitis 

Answer: The patient is high likely exposed to