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: compazine / phenobarbital / nsaids / aspirin / dilantin / heparin agents attending: chief complaint: transferred for biliary sepsis/acalculous cholecystitis major surgical or invasive procedure: subclavian line placement history of present illness: this is a 56yo m who was transferred for acalculous cholecystitis. he had prolonged recent hospitalization with recent c diff with toxic megacolon in (surgery deferred because patient refused ostomy), sepsis with pseudomonas from urine, respiratory failure secondary to pneumonia requiring intubation, fungal septicemia. peg tube was palced at that time. he was eventually discharged to rehabilitation after one month of hospitalization on . he developed abdominal discomfort in rehab and was sent to outpatient ct scan raised suspiciaon of cholecystitis. patient had alp and direct bili elevation since . ultrasound demonstarted sludge in gb, ct showed ??cholecystitis with some pericholecystic fluid and hida scan abnormal. he was given cefotetan and zosyn. he was in icu and given ivf for mild hypotension. he was also given ivf for mild hypotention (per d/c summary). transferred to for futher care and ? biliary drainage. past medical history: major depression with recent hospitalization under section 12 seizure disorder osteoporosis c diff colitis vre from rectal swab anemia chronic constipation colonic polyp osteoporosis bilateral pneumonia social history: he denies smoking/etoh, prior to all this he was living home alone physical exam: gen-sleepy, nad, a+o x3 heent-anicteric, oral mucosa dry, neck supple cv-rrr, no r/m/g resp-ctab from anterior exam -mild tenderness on right side, no rebound, no guarding, active bowel sounds, soft, peg tube site clean ext-1+pitting edema pertinent results: ct pelvis: limited portable exam demonstrating no gross evidence of left hip fracture or dislocation. dedicated radiographs of the hip within the department may be helpful for more comprehensive assessment given concern for fracture. . mrcp: 1) minimal central intrahepatic biliary ductal dilatation, with a normal appearing common bile duct. there is no evidence of intraductal filling defects or central obstructing lesions. 2) gallbladder sludge with a small amount of gallbladder wall edema. given the presence of abdominal ascites and third spacing of fluid within the visualized subcutaneous soft tissues, the significance of this gallbladder wall edema is non-specific. clinical correlation is recommended. 3) bibasilar consolidations, consistent with the patient's stated history of aspiration pneumonia. 4) gynecomastia. . liver u/s: 1) gallbladder sludge, without calculi or evidence of acute cholecytitis. 2) no evidence of biliary tract obstruction to explain cholestasis. . cxr: increased opacity at the right lung base likely represents developing pneumonia versus aspiration. increased atelectasis at the left lung base. . ct head: no evidence of acute intracranial hemorrhage or mass effect. . mr : there is an acute compression fracture of the l2 vertebral body, which likely represents an insufficiency fracture, though a pathologic fracture cannot be entirely excluded. a chronic compression fracture of l1 is also noted. there is no evidence of cord impingement . mr : chronic compression fracture of t10 vertebral body. no epidural abscesses are seen . liver core biopsy: the specimen is small and fragmented but shows changes consistent with submassive hepatic necrosis. the changes include parenchymal collapse, bile duct proliferation with portal mixed inflammatory cell infiltrate and cholestasis. no fatty change is seen. trichrome stain shows mild portal fibrosis and collapse. the etiology of these changes includes a drug reaction, among others. . knee plain film - pa and lateral views of the left knee show mild degree of degenerative changes involving the left knee manifested by mild degree of joint space narrowing involving the medial and the patellofemoral compartments. there is no evidence of joint effusion. there is mild degree of hypertrophic changes involving the superior aspect of the patella.the bony structures show normal bone density and no evidence of fractures or destructive changes or erosions . 11:47pm lactate-1.8 11:37pm glucose-151* urea n-11 creat-0.4* sodium-142 potassium-3.9 chloride-107 total co2-29 anion gap-10 11:37pm alt(sgpt)-736* ast(sgot)-1850* ld(ldh)-451* alk phos-1752* amylase-107* tot bili-4.6* 11:37pm lipase-139* 11:37pm albumin-2.3* calcium-8.4 phosphate-3.2 magnesium-1.6 11:37pm hbsag-negative hbs ab-negative hbc ab-negative hav ab-negative 11:37pm hcv ab-negative 11:37pm wbc-11.3* rbc-3.85* hgb-12.9* hct-40.3 mcv-105* mch-33.5* mchc-32.0 rdw-16.5* 11:37pm neuts-79.7* lymphs-13.6* monos-5.9 eos-0.1 basos-0.6 11:37pm anisocyt-1+ macrocyt-3+ 11:37pm plt count-354 11:37pm pt-16.3* ptt-33.0 inr(pt)-1.7 brief hospital course: c diff colitis - the patient was initially placed on metronidazole due to his prior history of prolonged c diff colitis. this was stopped after three days after it was determined that the he had completed a full course of metronidazole at the outside hospital. on hospital day 15 the patient spiked to 104 w/ rigors and tachycardia to the 170's. he was transferred to the micu for a second time for further monitoring. his white count rose to 33. he was pancultured and emprically started on vancomycin, levaquin, and flagyl. his stool eventually came back positive for c difficile. vancomycin and levaquin were stopped and the patient was maintained on flagyl and po vancomycin. his white count returned to and he was no longer febrile. the patient was eventually given a 14 day course of flagyl for c diff colitis. since the patient had a prior history of c diff toxic megacolon and a history of prior c diff infections was unknown he was treated as a second relapse. he will be d/c on pulsed taper of po vancomycin for a total six week course. . elevated lfts - the patient was initially admitted to the icu for sepsis. he was started on broad spectrum abx due to concern for cholecystitis. pt had ruq us and mrcp that illustrated sludging withing the gallbladder but no evidence for acute cholecystitis. since the patient did not have a fever and no cholecystitis zosyn was stopped after five days. due to concern for hepatotoxicity of his regular anticonvulsants lamictal and valproate, both known to be hepatotoxic, and conversation with neurology the patients regular anticonvulsants were held and he was started on keppra. his lfts then began to normalize. however, after the patient was called out of the micu for a second time for a recurrence of his c diff colitis, his lfts began to rise again. hepatology was re-consulted and recommended ruling out fungal infections. fungal isolator blood cx were sent and found to be negative. the patient also had a negative hiv test. the patient eventually had a transjugular liver biopsy that showed submassive hepatic necrosis that was most consistent with a drug reaction. the patient was not on any hepatotoxic medications during his second episode of transaminitis, however this will felt to represent a residual finding from his anti-epileptic medications. his lfts again began to trend down at the time of d/c and the patient was instructed to follow up with hepatology in the next month. . atrial tachycardia - the patient was noted on telemetry to have intermittent bursts of tachycardia to the 120's and then he would slowly return to a rhythm in the 80's. ecg p waves of a different morphology than his baseline when he became tachycardic. on one occasion the patient experienced bradycardia to the 30's. ep was called to see the patient. they felt the patient had an episodic atrial atchycardia that emerged due to his acute illness. they felt his bradycardia was due to a vagal episode. as a result he was placed on a beta blocker for prophylaxis against other vagal episodes as well as a tachycardia induced cardiomyopathy. . seizures - depakote, lemectil and zonegram was discontinued due to concern of hepatotpxicity. per conversation with neurology the patient was started on keppra for prophylaxis and prn ativan. the patient was noted to have a generalized shaking of all extremities which lasted for 1-2 minutes and resolved with the administration of ativan. neurology was consulted and advised that the patient's keppra dose be increased. on the morning of the patient had a staring spell and had decreased responsiveness. this was felt to be another seizure and neurology advised to increase the keppra again. neurology also felt that the patient should be given a sleep aid as abnormal sleep cycles could contribute to breakthrough seizures. neurontin was recommended as an additional if needed but was not started as the patient did not have another episode at the time of d/c. right foot ischemia - on hospital day # 7, the pt was noted to have a cold right foot with nonpalpable pulse. pulse was present by doppler. he was started on heparin drip. vascular surgery was consulted. per their recommendation, workup was initiated to rule out source of emboli. echocardiogram showed normal ef with no thrombus, duplex fem/ arteries was negative for aneurysm, abd u/s to r/o aaa was negative. heparin was eventually changed to lovenox and the patient was started on coumadin with anticipated treatment for six months. the patient's platelet count began to steadily decline. as a result all heparin products were stopped and a heparin induced thrombocytopenia (hit) antibody was sent and was found to be positive. the patient was placed on lepirudin for his hit. this was stopped temporarily for liver biopsy and then started again. once the patient's coumadin was therapeutic () lepirudin was stopped. he was instructed to see vascular surgery in 3 months time. serotonin release antibody ultimately returned negative so this anticoagulation can likely be discontinued. this information was communicated with the rehabilitation facility. . tube feeds - the patient was given resplor tube feeds and encouraged to take po's as tolerated. . lower extremity weakness - the patient was felt to be deconditioned due to prolonged hospitalization. neurology was consulted and recommended an mri spine to evaluate for epidural abscess. he was found to have a lumbar compression fracture with no cord compression and no abscess. the patient was given calcium and vitamin d. medications on admission: cymbalta lamictal 50 q8 zonegran flagyl vanco 250 q6 valproic acid 375 qid hydrocortisone 5 qd sc heparin cymbalta 60 qam zantac potassium 20 lidoderm for left hip morphine prn guainefesin all:compazine, aspirin, dilantin, phenobarbital, nsaids, tricyclics, tegretol, succinylcholine discharge medications: 1. atenolol 50 mg tablet sig: one (1) tablet po daily (daily). 2. ursodiol 300 mg capsule sig: one (1) capsule po bid (2 times a day). 3. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical q24h (every 24 hours): right hip. 4. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical q24 (): left hip. 5. miconazole nitrate 2 % powder sig: one (1) appl topical tid (3 times a day). 6. lansoprazole 30 mg susp,delayed release for recon sig: one (1) po daily (daily). 7. levetiracetam 500 mg tablet sig: three (3) tablet po qam (once a day (in the morning)). 8. levetiracetam 500 mg tablet sig: four (4) tablet po qpm (once a day (in the evening)). 9. trazodone hcl 50 mg tablet sig: 0.5 tablet po hs (at bedtime) as needed. 10. aluminum-magnesium hydroxide 225-200 mg/5 ml suspension sig: 15-30 mls po qid (4 times a day) as needed. 11. zinc oxide-cod liver oil 40 % ointment sig: one (1) appl topical qd (). 12. oxycodone hcl 5 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. 13. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). 14. calcium carbonate 1,250 mg tablet sig: one (1) tablet po tid (3 times a day). 15. lorazepam 2 mg/ml syringe sig: 1-2 mg injection q4h (every 4 hours) as needed for seizure activity. 16. vancomycin hcl 125 mg capsule sig: one (1) capsule po see instructions: 1 pill x 2 days 1 pill qd x 7 days 1 pill qod x 7 days 1 pill q 3 days x 14 days. 17. warfarin sodium 5 mg tablet sig: one (1) tablet po once a day for 6 months: please start again when inr between . discharge disposition: extended care facility: - discharge diagnosis: drug induced hepatitis heparin induced thrombocytopenia seizures c diff colitis atrial tachycardia depression ischemic foot discharge condition: fair discharge instructions: please notify a physician or return to the emergency room if you experience fevers, chills, uncontrolled nausea or vomiting, continuous foul smelling diarrhea, limb shaking, shortness of breath, chest pain, abdominal pain, bloody stool, confusion. . you will take coumadin for the next six months and then follow up with dr. of vascular surgery in 3 months time. your coumadin is being held for two days until your inr returns between . . you should have your lfts checked daily in rehab to make sure they normalize. followup instructions: please follow up with dr. of vascular surgery in 3 months for your ischemic foot - ( . please make an appointment to be seen in the hepatology clinic in the next month ( . please make an appointment to see your neurologist dr. within a week of discharge from rehab. procedure: enteral infusion of concentrated nutritional substances closed (percutaneous) [needle] biopsy of liver diagnoses: acquired coagulation factor deficiency unspecified septicemia unspecified protein-calorie malnutrition other convulsions hypopotassemia other specified cardiac dysrhythmias intestinal infection due to clostridium difficile major depressive affective disorder, single episode, unspecified pain in joint, pelvic region and thigh unspecified accident anticoagulants causing adverse effects in therapeutic use closed fracture of lumbar vertebra without mention of spinal cord injury systemic inflammatory response syndrome due to noninfectious process with acute organ dysfunction hepatitis, unspecified arterial embolism and thrombosis of lower extremity critical illness polyneuropathy hydantoin derivatives causing adverse effects in therapeutic use other and unspecified anticonvulsants causing adverse effects in therapeutic use hypertrophy of breast 

Answer: The patient is high likely exposed to