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: history of present illness: mr. is a 57-year-old male who presented to hospital on with hematemesis. the patient was treated with transfusions and octreotide. esophagogastroduodenoscopy was done with unsuccessful therapeutic treatment of upper gastrointestinal bleed. the patient was transferred to , with for transjugular intrahepatic portosystemic shunt procedure. indications included gastric variceal bleed that was refractory to endoscopic treatment. the patient was electively intubated prior to transfer. on , the patient had a transjugular intrahepatic portosystemic shunt procedure complicated by innominate vein perforation right internal mammary artery bleed with hemothorax. the patient was taken to the operating room for sternotomy with repair of vascular lesions. the patient was stabilized, and a chest tube placed. the patient required 12 units of packed red blood cells, and 4 units of platelets, and 4 units of fresh frozen plasma. after initial period of stability, the patient became increasingly hypotensive from to requiring pressor support. a swan-ganz catheter was placed and his systemic vascular resistance was decreased, and the cardiac output and index were increased. the patient was transferred to the fernard intensive care unit for further care given picture of sepsis. of note, his packed red blood cell requirement has been 3 units per day over three days and has stopped bleeding clinically. there was no nasogastric tube output. the patient still had tube in place. the patient is paralyzed due to difficulty with ventilation postoperatively. in the operating room on , the patient had an episode of hypotension for about one to three minutes. past medical history: 1. cirrhosis. 2. status post esophageal variceal bleed. 3. status post transjugular intrahepatic portosystemic shunt which was unsuccessful. 4. status post innominate vein and right internal mammary artery laceration with resultant hemothorax. 5. status post sternotomy as described. allergies: no known drug allergies. medications on transfer: medications on transfer from surgical intensive care unit were octreotide 50 mcg q.d., insulin drip, dilaudid drip, ativan drip, oxacillin 2 g q.6h., levofloxacin 500 mg intravenously q.d., flagyl 500 mg intravenously t.i.d., protonix 40 mg intravenously b.i.d., cisatracurium 80 mcg/kg per hour, neo-synephrine drip. physical examination on presentation: blood pressure was 110/50, pulse was 80, temperature was 37. the patient was on ventilatory support on ac 550 x 12 with an fio2 of 60%, and positive end-expiratory pressure of 20. swan-ganz catheter readings as follows: central venous pressure 22, pulmonary artery pressure 44/19, cardiac output of 7.8, cardiac index was 3.95, systemic vascular resistance was 522. ins-and-outs 2700 in and 1800 out; 1300 of that urine. in general, the patient was intubated and sedated. pupils were small and reactive. neck revealed left internal jugular in place; the site looks clean. the oropharynx was clear. was in place; some purulent green discharge noted. chest revealed fair breath sounds bilaterally, positive rhonchi throughout. cardiovascular had a regular rate and rhythm. no murmurs, rubs or gallops. abdomen was soft, decreased bowel sounds. extremities were warm with fair pulses distally. skin had no rash. right radial and femoral lines with no purulent discharge noted from either line. pertinent laboratory data on presentation: white blood cell count was 13.4 (decreased from 19.6), hematocrit was 33.4, platelets were 146. pt was 15.4, ptt was 42.2, inr was 1.7. chemistry-7 significant for a creatinine of 1.5 (increased from baseline of 1). albumin was 2.7, phosphate was 4.5, magnesium was 2.1. alt was 19, ast was 32, alkaline phosphatase was 108, total bilirubin was 13.1 (increased from admission of 6). urine sodium was 19 on . arterial blood gas revealed 7.4, pco2 was 34, po2 was 135, unknown fio2, lactate was 3. blood cultures revealed no growth to date so far. sputum was positive for methicillin-sensitive staphylococcus aureus. radiology/imaging: a chest x-ray revealed bilateral infiltrates suggestive of congestive heart failure. hospital course: in summary, this is a 57-year-old male with recent gastric variceal bleed, status post unsuccessful transjugular intrahepatic portosystemic shunt complicated by hemothorax and innominate vein injury requiring thoracotomy, now hypotensive on pressors requiring increased fio2 and positive end-expiratory pressure to maintain oxygenation. his swan-ganz catheter numbers and physical with complete blood count and increased white blood cell count with left shift were suggestive of sepsis. the patient was paralyzed due to difficulty with ventilation postoperatively. the patient seemed to no longer bleeding from his varices. 1. pulmonary: given decreased blood pressure we tried to decrease the positive end-expiratory pressure as tolerated and tried to wean off the paralytics. the patient was also given fluid to maintain his blood pressure. diuresis was not an option given decreased blood pressure. a swan-ganz catheter was placed perioperatively and was subsequently discontinued. 2. cardiovascular: the patient was requiring neo-synephrine to increase his blood pressure. we tried to wean the neo-synephrine and add vasopressin; however, this was unsuccessful. 3. gastrointestinal: the patient had a stable hematocrit and no longer had a transfusion requirement. the patient was continued on protonix, and the tube continued to be left in. the patient had hyperbilirubinemia; most likely thought secondary to shocked liver given episode of hypotension. 4. renal: creatinine had increased to 1.5 and continued to increase during the hospitalization. it was thought most likely secondary to hepatorenal syndrome. the patient continued to maintain a good urine output. on , the patient was started on octreotide and midodrine given the possibility of hepatorenal syndrome; however, his creatinine continued to increase. 5. endocrine: the patient was maintained on an insulin drip which was later changed to subcutaneous. 6. hematology: the patient's hematocrit remained stable. his coagulopathy was most likely secondary to his liver disease. 7. infectious disease: oxacillin was changed to vancomycin given that the patient continued to be febrile. it was also thought that the patient may have a sinusitis secondary to the tube; however, gastroenterology felt that the tube should be kept in given his recent episode of upper gastrointestinal bleed. the patient was continued on vancomycin, levofloxacin, and flagyl for general sepsis to cover for sinusitis, and mediastinitis, and staphylococcus aureus in the sputum. 8. fluids/electrolytes/nutrition: the patient was initiated on total parenteral nutrition. the patient did not significantly improve, and given worsening renal function, it was thought that the patient's prognosis was very poor. after a family meeting, the patient was made do not resuscitate. on , given the poor prognosis, the family decided to make the patient comfort measures only. at 11:58, the patient expired. condition at discharge: expired. discharge diagnoses: 1. gastric variceal bleed secondary to cirrhosis. 2. cirrhosis; most likely secondary to ethanol use. 3. hemothorax secondary to transjugular intrahepatic portosystemic shunt procedure; status post sternotomy and stabilization of perforations. 4. sepsis. 5. acute respiratory distress syndrome (ards). , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances insertion of endotracheal tube suture of vein suture of artery exploratory thoracotomy diagnoses: alcoholic cirrhosis of liver acute kidney failure, unspecified accidental puncture or laceration during a procedure, not elsewhere classified hemorrhage complicating a procedure acute respiratory failure hemorrhage of gastrointestinal tract, unspecified varices of other sites traumatic hemothorax without mention of open wound into thorax 

Answer: The patient is high likely exposed to