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: the patient is a 50 year-old male with history of hepatitis c cirrhosis, referred to dr. for transplant evaluation. he presented on the day prior to admission for pretransplant laboratories and was noted to have an elevated potassium of 6.1 and acute renal failure with a creatinine of 4.8. the patient had received a large volume 5 liter paracentesis the week prior to presentation. baseline creatinine was 1 to 1.3. he had been in his usual state of health but did note mild upper respiratory infection symptoms over the preceding days including rhinorrhea, cough that was productive, and general malaise. past medical history: significant for hepatitis c cirrhosis diagnosed in , etiology unknown. denied history of blood transfusion, iv drug use, or homosexual contacts. hiv negative, cmv igg positive, toxo negative and ebv/hsv that was pending. social history: lives in , mass with his mother and brother. tobacco. history of 2 to 3 beers per night, quit 5 years prior to admission when he was diagnosed with hepatitis c virus. family history: father died of bone cancer. mother recently diagnosed with lung cancer. physical examination: on admission temperature maximum 97.3, heart rate 62, blood pressure 89/66, respiratory rate 18, 96% on room air. patient appeared jaundiced, resting comfortably in bed. scleral icterus. dry mucous membranes. negative jugular venous distension. no lymphadenopathy. cardiac with distant heart sounds, regular rate and rhythm, no murmurs, regurgitation, gallop. lungs: scattered expiratory wheezes with coarse breath sounds. abdomen: positive bowel sounds, distended but tense. tender to palpation of the site of paracentesis in the left lower quadrant with ecchymosis at that site, no rebound, no guarding. extremities: no edema. neurologic: alert and oriented. answered questions appropriately. positive asterixis. over the course of this hospital stay his renal function worsened with creatinine up to 6. he was managed with octreotide and midodrine for the month of with slowly increasing creatinine. urine output was approximately 500 to 700 cc per day. diuretics were held in the setting of acute renal failure. he received lactulose t.i.d. and then underwent paracentesis approximately 4 to 5 days throughout the month of requiring fresh frozen plasma prior to each tap. the transplant service was consulted for transplant work up and on he was taken to the operating room for liver and kidney transplant from a deceased donor. surgeon was dr. . co-surgeon was dr. . assistant was dr. . estimated blood loss was 3.5 liters. please see operative reports for further details. he received induction and immunosuppression with 500 mg of solu-medrol, cellcept 1 gram intraoperatively. he received vancomycin and zosyn for prophylactic antibiotics. he was taken to the surgical intensive care unit for postoperative recovery. he was intubated. pathology report on the native liver demonstrated established cirrhosis, tricombed vein was evaluated. there was mild to moderate septal mononuclear cell inflammation with mild lobular component, grade 2 inflammation. no fatty changes were noted. negative vascular and biliary margins. autolyzed gallbladder with mild chronic inflammation with focal bile duct hamartoma and no iron seen on the special stain. postoperative day #1 renal ultrasound and liver ultrasound demonstrated hepatic and portal veins patent with normal directional flow. the inferior vena cava was patent as were the main, right and left hepatic arteries. the kidney transplant demonstrated unremarkable doppler ultrasound with resistive indices within normal limits. the nephrology service followed along closely making recommendations throughout this hospital course. he had 3 . liver function tests increased initially with an ast of 378, alt of 286 and alkaline phosphatase of 49 with a total bilirubin of 8.9. these trended down for the remainder of the hospital course to a low of ast of 52, alt of 154, alkaline phosphatase 120 and total bilirubin of 1.7. his creatinine preoperatively was 6.6. this decreased to 0.9 on postoperative day 4. he had excellent urine output of approximately 1500 cc of per day. two of the drains, the lateral and medial, were discontinued. the third remained in place for fairly large output of approximately 520 cc. the hematocrit decreased to 26.6 on postoperative day 3. he received 1 units of packed red blood cells. hematocrit remained fairly stable between 31.5 and 35.2. platelet count decreased to 56 on postoperative day 2 and gradually increased to 1.2 on postoperative day 9. prograf was started on postoperative day 2 to 2 mg b.i.d. the prograf level increased to 16.7. at this time the prograf was decreased to 1.5 mg p.o. b.i.d. and levels were monitored daily. on postoperative day 7 his prograf level increased to 13.5. prograf was held for 2 doses and then resumed at 1 mg p.o. b.i.d. vital signs were stable throughout this hospital course. he was afebrile. blood pressure ranged between 121/93 to 141/95. he had resolution of his generalized edema. his weight preoperatively was 81 kilos. this decreased down to 71.7 on postoperative day 9. on postoperative day 3 mr. complained of severe left ear pain and blockage that had started 2 days prior to his transplant surgery. he described the pain as being underwater in a pool. he also complained of tinnitus that was constant for the prior 4 days. he also noted diminished hearing for approximately 4 days and he felt somewhat dizzy. ear, nose and throat was consulted. findings included bilateral ear helix/tragus without evidence of inflammation or infection. there was no pain on palpation or retraction of the ears, no drainage from the ear canals. the left ear the external auditory canal had a small amount of ecchymosis at the 6 o'clock position but no evidence of cellulitis or obstruction. the tympanic membrane appeared grossly normal and was mobile. right ear was normal. was unreliable but possibly lateralized to the right. the was a graded and b on the right and b equaling a on the left. recommendations included afrin spray and sudafed to decongest. a sinus ct was done. non-contrast ct of the sinuses were done. this demonstrated opacification of the probably atelectatic left maxillary sinus. these findings were not felt to be the cause of the patient's left ear pain. he received sudafed with some relief and also afrin with fair relief of the left ear pain. vancomycin was stopped. it was felt that patient had left sided conductive hearing loss secondary to middle ear effusion, but a sensorineural hearing loss could not be ruled out at that time. patient had been receiving iv vancomycin and the possibility of a drug ototoxicity was raised. formal audiogram was recommended to test all frequency ranges. patient continued to complain of left ear pain and deafness for the remainder of the hospital course and he medicated with p.o. dilaudid with fairly acceptable relief of discomfort. the patient's blood sugars ranged between 122 to 149. consult was obtained and the patient received sliding scale insulin to achieve normalization of blood sugars. physical therapy followed the patient throughout the hospital course. patient was refusing to ambulate on some days given the left ear pain and generalized discomfort. he continued to receive p.o. dilaudid. physical therapy found the patient to have deconditioning and recommended daily physical therapy in anticipating independent function and mobility. they did not feel that patient would need physical therapy at home. the recommended treatment plan included balance and gait training and therapeutic exercises for general conditioning. postoperative day 4 liver function tests had increased slightly. ast 143, alt was 281 and alkaline phosphatase was 122, with a total bilirubin of 3.1. patient underwent a liver ultrasound that demonstrated patent main, right and left portal veins. the right middle and left hepatic veins were patent with normal directional flow. no flow was identified into the right hepatic artery. the main and left hepatic arteries were widely patent. findings were discussed with dr. at the time of this study. liver function tests were monitored. no further intervention was done. liver function tests gradually decreased. patient's diet was gradually advanced with fair p.o. intake. he was moving his bowels without difficulty. he is voiding clear yellow urine in small amounts. pain medication was changed to percocet. patient still complained of ear pain as well as right sided abdominal pain and distention. on postoperative day 7 the right side of the abdomen appeared somewhat edematous and tender. an ultrasound was done. this demonstrated no free fluid, pain in the right upper quadrant, a normal appearing transplant liver with normal arterial and venous color wave forms. a kidney ultrasound was done as well for complaints of right sided abdominal pain and small frequent urination. renal ultrasound demonstrated normal appearing transplanted liver with no hydronephrosis. resistive indices were 0.51, 0.75 and 0.56 in the upper, mid, and lower poles, respectively. normal arterial wave forms were noted. nutrition consult was obtained. patient was tolerating a regular diet. patient did not require supplements. iv fluids were hep-locked. he was tolerating adequate p.o. intake with excellent urine output of 2250. physical examination was unremarkable. he was ambulatory. blood glucoses ranged between 91 to 149. vital signs were stable. he was discharged home on in stable condition. discharge medications: included fluticasone-salmeterol 100/50 mcg disk with 1 inhalation b.i.d., epogen 10 units q week, calcium carbonate 500 mg p.o. t.i.d., pantoprazole 40 mg p.o. q.d., fluconazole 400 mg p.o. q.d., prednisone 20 mg p.o. daily, cellcept 1 gram p.o. b.i.d., bactrim single strength 1 tablet q.d., dilaudid 2 mg tablets p.o. p.r.n. q 4 hours, colace 100 mg p.o. b.i.d., prograf 1 mg p.o. b.i.d., magnesium oxide 400 mg p.o. b.i.d. and neutra-phos 1 packet p.o. t.i.d. for 3 days, valcyte 900 mg p.o. q.d. discharge diagnoses: hepatitis c cirrhosis. hepatorenal syndrome. bronchitis. anemia. status post liver and kidney transplant . discharge condition: stable. discharge instructions: patient was sent home with his #3 . he was instructed in care at home that included emptying the drain and recording output. he was instructed to have laboratories drawn every monday and thursday for cbc, chemi-10, ast, alt, alkaline phosphatase, total bilirubin, albumin and trough prograf levels. he is also instructed to call the transplant office if he develops fever, chills, nausea, vomiting, shortness of breath, inability to take medications, abdominal pain, vomiting, jaundice, or increase in drainage. patient also underwent an endoscopy during this hospital course pre- transplant. , procedure: other endoscopy of small intestine percutaneous abdominal drainage percutaneous abdominal drainage percutaneous abdominal drainage percutaneous abdominal drainage percutaneous abdominal drainage percutaneous abdominal drainage other transplant of liver arteriography of other intra-abdominal arteries other kidney transplantation transfusion of packed cells transfusion of other serum transfusion of platelets transfusion of coagulation factors other operations on lacrimal gland transplant from cadaver diagnoses: hyperpotassemia acute kidney failure with lesion of tubular necrosis acute and subacute necrosis of liver chronic hepatitis c with hepatic coma alcoholic cirrhosis of liver hepatorenal syndrome acquired coagulation factor deficiency portal hypertension candidiasis of other urogenital sites hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease retention of urine, unspecified pressure ulcer, lower back hypovolemia varices of other sites esophageal varices in diseases classified elsewhere, without mention of bleeding asthma, unspecified type, with (acute) exacerbation 

Answer: The patient is high likely exposed to