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 attending: chief complaint: confusion major surgical or invasive procedure: therapeutic paracentesis history of present illness: admission h&p and micu course reviewed, please see for more details. briefly, the patient is a 60-yo man with esld etoh cirrhosis, cri 2/2 hrs vs iga nephropathy, and moderate as with preserved ef, discharged after a hospitalization for rhabdomyolysis, who presented to the ed on with acute onset of confusion at home. he had been taking his lactulose as prescribed with 2-3 bms daily, but awoke on feeling nauseated, lethargic, and tremulous, and became increasingly confused. he had never experienced this before, and has no h/o encephalopathy. he was brought to the ed by his wife, where he was afebrile with stable vs. he was unarousable and unable to protect his airway, so he was intubated for airway protection. ct head, cxr, ua, and ecg were negative and the pt did not respond to narcan, so he was given lactulose 30ml x1 and ctx 1g iv for concern for sbp, and admitted to the micu. ammonia was 170, and urine and serum tox screens were negative. . in the micu, he was started on lactulose and rifaximin for his encephalopathy. evaluation for an acute infection was negative, including cxr, ua, blood / urine / sputum cultures, and ascitic fluid from diagnostic paracentesis. stool c.diff is pending on transfer. he had a liver u/s that showed a clot of the small portal vein with no flow, and a ct abdomen/pelvis that showed a new 1.7cm right hepatic lesion highly suspicious for hcc, without evidence of portal vein thrombosis. he also received albumin given concern for hrs, with improvement of his creatinine to baseline. he was extubated on , and is currently a&ox3 with resolving asterixis, being transferred to the medical liver service for further care. past medical history: 1) etoh cirrhosis, diagnosed in ', candidate (may need liver-kidney), complicated by: - variceal bleeding in ', controlled with medications - ascites requiring periodic paracenteses - ? hrs - last egd : esophageal varices, portal hypertensive gastropathy - last colonoscopy : two 3mm benign-appearing polyps 2) recurrent arf with admissions and (? hrs vs iga nephropathy). no renal disease known prior to these admissions. 3) hx sepsis from dog bite in ' c/b multiorgan failure 4) l4-5 spinal fusion ' at hospital 5) as of uncertain severity - scheduled for lhc on fri 6) htn - stable off medications 7) hypercholesterolemia 8) hx aortic aneurysm, stable for last 20 yrs 9) l sided hernia repair 10) depression 11) r knee arthroscopy and meniscus repair 12) l knee open meniscus repair social history: pt born in , lived in , then mass for many years. retired school counselor and high school basketball coach. lives with wife and dog. drank ~2 drinks/day for appx 40 yrs, last drink for wife's birthday. used tob rarely for 8yrs, quit around . walks to mi daily. family history: father had cabg in 40s, also had 2 heart valve surgeries and 2 cvas. mom died at age . no fhx of liver or kidney disease. physical exam: vs - temp 98f, bp 125/75, hr 80, r 17, o2-sat 97% ra general - chronically ill-appearing man in nad, comfortable, pleasant, appropriate heent - +temporal wasting, +scleral icterus, conjunctiva clear, dry mm, op clear eyes - left pupil 5mm > right pupil 3mm, responsive to light bilaterally; eomi, no nystagmus neck - supple, no thyromegaly / lad / jvd lungs - cta bilat, no r/rh/wh, good air movement, resp unlabored, no accessory muscle use heart - pmi non-displaced, rrr, nl s1-s2, +3/6 sem throughout the precordium abdomen - nabs, soft/nt, +abd distension, +umbilical hernia, no palpable masses or hsm, no rebound/guarding extremities - wwp, 1+ pitting edema of ankles, 2+ dps skin - no rashes or lesions, +jaundice neuro - awake, a&ox3, non-focal, asterixis, able to name past presidents to . 4/5 strength equal bilaterally in elbow flex/ex, wrist extension, finger extension, finger grip. fnf intact. able to perform serial 7's pertinent results: ct head impression: no acute intracranial process. pansinus disease. abd doppler: echogenic clot of the small portal vein with no flow. the remainder of the study is unchanged since . multiphasic ct is helpful for further characterization ct abd/pelv: 1. 1.7-cm arterial phase enhancing right hepatic lesion highly suspicious for hcc. 2. no evidence of portal vein thrombosis. 3. cirrhosis. 4. ascites. 5. linear bibasilar consolidative changes, more likely atelectasis. 6. findings discussed with the surgery team. 12:52pm blood wbc-8.2 rbc-3.10* hgb-10.0* hct-30.4* mcv-98 mch-32.4* mchc-33.0 rdw-15.5 plt ct-160 05:50am blood wbc-5.3 rbc-2.37* hgb-7.8* hct-23.4* mcv-99* mch-32.9* mchc-33.2 rdw-15.6* plt ct-101* 12:52pm blood neuts-78.3* lymphs-12.9* monos-7.7 eos-0.9 baso-0.2 12:52pm blood pt-18.0* ptt-40.7* inr(pt)-1.6* 05:50am blood pt-22.2* ptt-56.3* inr(pt)-2.1* 12:52pm blood glucose-164* urean-59* creat-2.9* na-135 k-4.2 cl-102 hco3-21* angap-16 05:50am blood glucose-86 urean-35* creat-2.0* na-135 k-3.4 cl-107 hco3-21* angap-10 12:52pm blood alt-53* ast-80* alkphos-249* totbili-4.4* 05:50am blood alt-31 ast-53* ld(ldh)-214 alkphos-132* totbili-3.4* 12:52pm blood lipase-145* 04:22am blood albumin-2.9* calcium-9.1 phos-4.4 mg-2.3 05:50am blood albumin-3.2* calcium-8.8 phos-4.4 mg-1.9 12:52pm blood ammonia-170* 03:51am blood ammonia-61* 12:52pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 04:55pm blood type-art po2-334* pco2-42 ph-7.38 caltco2-26 base xs-0 10:51am blood type-art po2-62* pco2-44 ph-7.34* caltco2-25 base xs--2 brief hospital course: 60 yo m w/ cirrhosis, cri, as p/w hepatic encephalopathy and ascites. . #hepatic encephalopathy: pt. intially presented to osh and was transferred to for further care, at that time he was unable to protect his airway was intubated and admitted to the micu. he was given lactulose po q2 hours after insertion of rectal tube. after approximately 3 days he cleared and was extubated. he had a diagnostic tap of his ascites which was negative for sbp. he remained slightly lethargic and was transferred to the floor for several more days of lactulose/rifaximin. his lactulose was titrated down to 3 bms per day and he was discharge w/o asterixis. . #chronic renal failure: hrs vs. iga nephropathy. blood on ua c/w iga nephropathy. baseline cr is about 2.6, was elevated to 2.9 at time of admission. pt. recieved albumin and his cr decreased to 2.0 at the time of d/c. . #ascites: cirrhosis. pt. was tapped on admission concern for sbp, fluid culture and cell count were not suggestive of sbp. pt. had developed tense ascites by the day before d/c and was therapeutically tapped 5l. he reported feeling decreased abdominal pain afterward. results were not suggestive of sbp, the cultures were prelim negative at time of this writing. medications on admission: sertraline 50mg po daily - folic acid 1mg po daily - mvi 1tab po daily - pantoprazole 40mg po q12hrs - lactulose 30ml po 2-3x daily, titrate to loose stools daily - prochlorperazine 10mg po q6hrs prn nausea discharge medications: 1. sertraline 50 mg tablet sig: one (1) tablet po daily (daily). 2. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 3. multivitamin tablet sig: one (1) tablet po daily (daily). 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po every twelve (12) hours. 5. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po every 4-6 hours: titrate to >5 bowel movements daily. disp:*2 bottles* refills:*2* 6. compazine 10 mg tablet sig: one (1) tablet po every six (6) hours as needed for nausea. 7. thiamine hcl 100 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 8. rifaximin 200 mg tablet sig: two (2) tablet po three times a day. disp:*180 tablet(s)* refills:*2* discharge disposition: home with service facility: vna discharge diagnosis: primary dx: 1. hepatic encephalopathy 2. etoh cirrhosis . secondary dx: - chronic kidney disease hepato-renal syndrome vs. iga nephropathy - moderate aortic stenosis - hypertension - hypercholesterolemia - depression discharge condition: afebrile, vital signs stable discharge instructions: you were admitted to for encephalopathy. you were initially admitted to the micu and intubated for airway protection. you were given frequent doses of lactulose and rifaximin, and the encephalopathy improved. you also had a therapeutic paracentesis on to remove ascites. you did not have any infection. you are to have your valvuloplasty done by dr. next week. the cardiac catheterization lab will call you on monday with more information, but you will likely be admitted to the hospital on thursday with a plan for procedure on friday . in the meantime, you should continue taking your medications as prescribed. you should follow-up in clinic at the appointment scheduled below. . if you develop any worsening fevers, chills, abdominal pain, jaundice, nausea, vomiting, bleeding, or confusion, you should call your doctor or return to the emergency room for evaluation. followup instructions: provider: clinic phone: date/time: 3:40 pt. was also to follow up with cardiology dr. for elective left heart catheterization. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube percutaneous abdominal drainage percutaneous abdominal drainage diagnoses: pure hypercholesterolemia alcoholic cirrhosis of liver hepatorenal syndrome hyposmolality and/or hyponatremia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified aortic valve disorders depressive disorder, not elsewhere classified chronic kidney disease, unspecified acute respiratory failure other ascites hepatic encephalopathy nephritis and nephropathy, not specified as acute or chronic, with unspecified pathological lesion in kidney 

Answer: The patient is high likely exposed to