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: no known allergies / adverse drug reactions attending: chief complaint: acute renal failure major surgical or invasive procedure: liver transplant splenectomy and closure ex lap, washout ercp x4 thoracentesis tunneled hd line, l trache history of present illness: ms. is a 69yo f with pmh hep c cirrhosis currently on the tranplant list recently admitted for sbp who is being admitted after her cr in clinic was found to be 2.8 from 1.9. of note, pt has been on diuretic as well as a fluid restriction since her last admission. . she was recently discharged on after an 11-day hospitalization for ischemic bowel and sbp, responsive antibiotics and volume resuscitation. she also had a urine culture that initially grew vre and was treated with a 3-day course of linezolid. upon discharge, her diuretic doses were doubled (lasix 20mg --> 40mg and spironolactone 50mg --> 100mg). baseline creatinine appears to be 1.8-2.0. . she has been very compliant with her fluid restriction of 1l + ensure, but her appetite continues to be poor. she denies any issues with medication compliance. she feels well overall, without any acute concerns. her abdomen has not increased in size lately. past medical history: chronic c hepatitis genotype 1 and cirrhosis as above cirrhosis - complicated by volume overload, grade 1 esophageal varaces, never had encephalopathy or ascites requiring paracentisis. history of positive ppd - evaluated by transplant id and will undergo inh/b6 therapy post-transplant. osteopenia - dexa hypothyroidism vitamin d deficiency orthotopic liver transplant exploratory laparotomy, splenectomy, and choledochocholedochostomy social history: she does not smoke. she does not drink. denies drug use. she is married with five children. she used to works as a nurse, but hasn't been able to work for 3 years. she misses being a nurse and being active. family history: non-contributory. physical exam: admission physical exam: vitals: 98.1, 136/87, 85, 18 and 98% on ra general: nad, pleasant and conversant heent: nc/at, perrl, eomi, mild scleral icterus, oropharynx clear without sublingual jaundice neck: supple, no appreciable jvd heart: rrr, nl s1/s2, no m/r/g lungs: crackles at right base, otherwise cta abdomen: distended but soft, non-tender; + fluid wave and shifting dullness extremities: 2+ radial and dp pulses, 1+ edema in le bilaterally; no cyanosis/clubbing; no palmar erythema neurological: aaox3, no asterixis, cn ii-xii grossly intact, in ue and le bilaterally, gait deferred skin: no e/o spider angiomata, no rashes pertinent results: 10:47am blood wbc-11.4* rbc-3.22*# hgb-9.7*# hct-32.9* mcv-102* mch-30.0 mchc-29.4* rdw-20.0* plt ct-468* 05:35am blood wbc-10.6 rbc-3.01* hgb-9.1* hct-30.4* mcv-101* mch-30.1 mchc-29.8* rdw-18.9* plt ct-395 12:45pm blood glucose-145* urean-72* creat-5.1*# na-139 k-4.4 cl-97 hco3-23 angap-23* 10:47am blood glucose-134* urean-93* creat-6.4*# na-141 k-5.0 cl-98 hco3-20* angap-28* 05:35am blood glucose-132* urean-51* creat-3.9*# na-138 k-4.7 cl-99 hco3-22 angap-22* 05:25am blood alt-9 ast-32 alkphos-362* totbili-0.4 10:47am blood alt-9 ast-31 alkphos-361* totbili-0.5 05:35am blood alt-14 ast-61* alkphos-393* totbili-0.4 05:35am blood calcium-9.5 phos-3.5 mg-2.2 12:45pm blood tsh-1.1 06:12am blood tacrofk-10.4 05:25am blood tacrofk-10.3 05:35am blood tacrofk-8.5 brief hospital course: 69f with hcv cirrhosis recently admitted with acute on chronic kidney injury concerning for hrs and hyponatremia. hyponatremia resolved with hydration. she became oliguric with rising cr despite this octreotide/midodrine and was initiated on dialysis . lfts worsened. liver ultrasound revealed new non-occlusive portal vein thrombosis. liver function continued to worsen. heparin drip was started after an egd was performed to establish risk of bleeding varices. grade varices with no signs of bleeding were noted. on , an abo incompatible donor liver offer was accepted and she underwent orthotopic liver transplant from donor with blood type a (she is type b). plasmapheresis was done prior to or. she had a significant coagulopathy and abdomen was unable to be closed. surgeon was dr. . please refer to operative notes for complete details. she was sent intubated to the sicu for management postop. plasmapheresis was performed on postop day 1. liver duplex exam was limited, but demonstrated patent vasculature within the right lobe of liver. left lobe hepatic vasculature and extrahepatic vessels could not be assessed. lfts increased. jp drainage was bilious. anti a titers were in the 1-4 range and plasmapheresis was stopped. a total of 7 doses of atg were given. immunosuppression consisted of cellcept, solumedrol and prograf per trough levels. she was taken back to the or on , for exploratory laparotomy, splenectomy, and choledochocholedochostomy. blood cultures were sent for serum wbc elevation. enterococcus faecium was isolated from blood on . vancomycin was initially started then switched to daptomycin when sensitivities isolated vre. dapto continued until then was switched to linezolid on . lfts improved, but bilirubin remained elevated. on , a liver duplex was done to evaluate for hyperbilirubinemia noting large peri- and subhepatic collection which appeared to be a partially liquefied and partially organized. on , an ercp was performed for evaluation of bacteremia in setting of large peri-hepatic / subhepatic fluid collection seen on ultrasound. the biliary anastomosis was angulated but appeared patent. no intervention was done. alk phos increased and liver biopsy was done on which showed bile duct proliferation. bilious drainage was noted in jp. on , she was taken to the or for liver transplant for exploratory laparotomy, evacuation of hematoma and washout liver biopsy. a tracheostomy was also performed as she had been intubated for 15 days. she remained vented and repeat ercp was performed on with finding of anastomotic stricture in the mid bile duct and moderate bile extravasation of the level of the stricture confirming bile leak. a sphincterotomy was performed with placement of a 7cm by 10fr biliary stent. good bile flow was noted after stent placement. feeding tube was placed and feeds were continued. she transferred out of the sicu after 26 days. she was febrile on and was transferred back to the sicu for hypotension. blood cultures isolated fairly resistant klebsiella. cvl tip culture isolated vre. zosyn was started then was switched to colistin after 3 days. colistin continued for 4 more days when sensitivities revealed sensitivity. meropenum was started on and continued for a total of 2 weeks. repeat blood cultures were negative. bilious jp output diminished. however, this increased again as well as serum wbc. ercp was done again on . extravasation was noted at the main biliary tree, at or just below the anastomosis. otherwise, biliary tree was normal. two 7cm by 10fr plastic stents biliary stents and -gastric feeding tube were placed under fluoro. she remained in the sicu for 10 days. she was anuric and cvvhd continued until when she was switched to intermittent hd. on thoracentesis was done for large pleural effusion with 1200cc removed. culture was negative. a pigtail catheter was placed on for re accumulation. pigtail was removed on . on , cxr demonstrated recurrent right pleural effusion. interventional pulmonary performed a thoracentesis and placed a pigtail that was placed suction for small apical pneumothorax. subsequently, daily cxr s showed near resolution of pneumothorax. pigtail was removed. for most of her postoperative course, she was delirious/paranoid. delirium was felt to be multifactorial (uremia, bacteremia, prograf, sleep deprivation and steroids). psyche was consulted and recommended low dose haldol. scheduled hs haldol seemed to be beneficial with less confusion and paranoia. she became oriented, but had intermittent episodes of anxiety. episodes of anxiety resolved. speech evaluated and declared her safe for diet. tube feeds continued secondary to inability to consume enough kcals to meet needs. trache cannula was down sized to a # 5 with intermittent use of passy muir valve. she had episodes of feeling like she was suffocating. this seemed to occur with passy muir valve. a 24 hour trial of cuff deflation was done demonstrating appropriate oxygenation. she was decannulated on and continued to do well from a respiratory stand point. on , a left tunneled line was placed for hemodialysis. hd continued on a tues-thurs-sat schedule as she remained anuric. bladder scan was negative on multiple occasions. physical therapy found her to be extremely debilitated requiring lift and max assist. rehab was recommended. however, discharge to rehab was suspended given lack of approval for ltac coverage from her insurer. she remained in hospital. physical stamina improved over subsequent weeks to where she was able to stand and walk with assist with walker. abdominal jp drain remained in place with outputs decreasing to a low of 11cc/day. incision was intact with small area at apex that had been opened and a 2x2 gauze was placed. of note, she had persistent vaginal bleeding over most of hospital stay. this was worked up in admission with endometrial bx with finding of no-malignancy, but showed increased endometrial stripe. she continued to have vaginal spotting. eventually, this stopped. she should f/u with gyn. on , she was hypotensive and felt unwell. blood cultures were drawn and were positive for daptomycin resistant vre. she was initially started on dapto, but then switched to linezolid. surveillance cultures remained negative. she completed a 2 week course. on , f/u ercp was done (last ercp with biliary stent placement for leak). no leak was noted and stent was removed. over subsequent days, she had malaise with intermittent nausea and small amount of vomiting. tube feeds were held. blood cultures were sent on and have remained negative to date. on , she desat'd while ambulating. cxr revealed a moderate sized right pleural effusion. on , ip performed a right thoracentesis draining 800 ml. pleural culture was negative . post procedure cxr revealed a small apical pneumothorax. she became hypotensive with decreased right breath sounds. chest pigtail catheter was placed to a pleura vac and attached to suction. it became obvious that she had an air leak. on , chest pigtail catheter was removed and cxr demonstrated small right-sided pleural effusion. of note, feeding tube was noted to be in stomach. hemodialysis schedule was switched to monday-wednesday-friday. she recquired low dose midodrine 2.5mg 1 hour prior to hd for on going hypotension during hd. last hd was which she tolerated well. code: full emergency contact: (husband, ) . transitional issues: - gyn follow-up for h/o vaginal bleeding medications on admission: - ciprofloxacin 500 mg tablet 1 tablet(s) by mouth every twenty-four(24) hours - furosemide 40 mg tablet 1 tablet(s) by mouth once a day - lactulose 10 gram/15 ml solution 15-30 ml(s) by mouth three times a day - levothyroxine 50 mcg tablet 1 tablet(s) by mouth daily - megestrol 400 mg/10 ml (40 mg/ml) suspension 20 ml by mouth once a day - rifaximin 550 mg tablet 1 tablet(s) by mouth twice a day - spironolactone 100 mg tablet 1 tablet(s) by mouth q am - calcium carbonate-vitamin d3 600 mg (1,500 mg)-400 unit tablet 1 tablet(s) by mouth twice a day - cholecalciferol (vitamin d3) 400 unit tablet 2 tablet(s) by mouth once a day discharge medications: 1. levothyroxine 50 mcg tablet sig: one (1) tablet po daily (daily). 2. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q6h (every 6 hours) as needed for sob/wheeze. 3. acetaminophen 325 mg tablet sig: two (2) tablet po q8h (every 8 hours) as needed for pain: no more than 2000mg per day. 4. docusate sodium 50 mg/5 ml liquid sig: ten (10) ml po bid (2 times a day). 5. ursodiol 300 mg capsule sig: one (1) capsule po bid (2 times a day). 6. insulin regular human 100 unit/ml solution sig: follow printed scale units injection asdir (as directed). 7. glucagon (human recombinant) 1 mg recon soln sig: one (1) recon soln injection q15min () as needed for hypoglycemia protocol. 8. ipratropium bromide 0.02 % solution sig: one (1) inh inhalation q6h (every 6 hours) as needed for wheezing. 9. famotidine 20 mg tablet sig: one (1) tablet po q24h (every 24 hours). 10. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 11. prednisone 10 mg tablet sig: one (1) tablet po daily (daily): decrease to 7.5mg on x 10 days then decrease to 5 mg x10. 12. sulfamethoxazole-trimethoprim 200-40 mg/5 ml suspension sig: ten (10) ml po daily (daily). 13. tacrolimus 1 mg capsule sig: two (2) capsule po q12h (every 12 hours): provide elixer. 14. outpatient lab work stat labs every monday and thursday for cbc, chem 10, ast, alt, alk phos, t.bili, albumin and trough prograf with results faxed to transplant coordinator 15. mycophenolate mofetil 200 mg/ml suspension for reconstitution sig: five (5) ml po bid (2 times a day). 16. isoniazid 100 mg tablet sig: 1.5 tablets po daily (daily). 17. pyridoxine 50 mg tablet sig: four (4) tablet po daily (daily): while taking inh. 18. midodrine 5 mg tablet sig: 0.5 tablet po 3x/week (mo,we,fr): give 1 hour prior to dialysis. 19. b-complex with vitamin c tablet sig: one (1) tablet po daily (daily). 20. mirtazapine 15 mg tablet sig: 1.5 tablets po hs (at bedtime). 21. senna 8.8 mg/5 ml syrup sig: one (1) tablet po bid (2 times a day). 22. tacrolimus 2 mg po q12h (every 12 hours). takes as elixir 23. ondansetron hcl (pf) 4 mg/2 ml solution sig: four (4) mg injection q8h (every 8 hours) as needed for nausea. discharge disposition: extended care facility: for the aged - macu discharge diagnosis: acute on chronic kidney injury hcv cirrhosis s/p liver transplant, splenectomy biliary anastomoses stricture, leak malnutrition vre catheter tip/vre bacteremia right pleural effusion s/p thoracentesis x2 pneumothorax h/o +ppd on inh delirium hypothyroin vaginal bleeding discharge condition: mental status: confused - sometimes. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. fall risk discharge instructions: you will be transferring to rehab hemodialysis will continue 3 times per week blood work will be drawn every monday and thursday for lab monitoring tube feedings will continue followup instructions: provider: , md phone: date/time: 11:30 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more other endoscopy of small intestine enteral infusion of concentrated nutritional substances venous catheterization for renal dialysis endoscopic sphincterotomy and papillotomy temporary tracheostomy endoscopic insertion of stent (tube) into bile duct endoscopic insertion of stent (tube) into bile duct other transplant of liver total splenectomy therapeutic plasmapheresis open biopsy of liver endoscopic retrograde cholangiopancreatography [ercp] endoscopic retrograde cholangiopancreatography [ercp] hepatotomy choledochoenterostomy other operations on lacrimal gland transplant from cadaver diagnoses: pneumonia, organism unspecified end stage renal disease renal dialysis status other postoperative infection unspecified pleural effusion cirrhosis of liver without mention of alcohol chronic hepatitis c without mention of hepatic coma acute kidney failure, unspecified hepatorenal syndrome unspecified septicemia unspecified protein-calorie malnutrition severe sepsis other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure iatrogenic pneumothorax paralytic ileus hepatic encephalopathy complications of transplanted liver other and unspecified coagulation defects portal vein thrombosis 

Answer: The patient is high likely exposed to