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: patient recorded as having no known allergies to drugs attending: chief complaint: left hip arthritis major surgical or invasive procedure: left tha history of present illness: 64 y/o with oa of right hip,presents for surgical management of pain. his hematology team was consulted for pre and post operative care. infusion, high risk bleeding, high risk thrombosis . history of present illness: 64 y/o male with chronic hepatitis b infection with grade cirrhosis (presently suppressed), antithrombin iii deficiency and superior mesenteric thrombosis (managed by dr. , on coumadin), thrombocytopenia/macrocytosis, esophageal varices, and hypertension who is pod #0 s/p left total hip replacement with dr. . . from surgical perspective, blood loss estimated to be 750 cc and procedure was uncomplicated. patient received 3l lr, 50 ml 25% albumin, 2 mg versed, 8 mg decadron, 250 mcg fentanyl, total of 6 mg dilaudid, 4 g cefazolin. uop was 240 cc during procedure. . from hematology perspective, patient presented with several days of abdominal pain and bloating in . he underwent a ct can at on , which demonstrated a nonocculusive endoluminal thrombus within the superior mesenteric vein with extension into more distal branches and extending into the main portal vein. work up at the time revealed low protein c and antithrombin iii levels (antithrombin iii 48%, normal range 80 to 120%; protein c antigen 31%, protein c functional 46%). on , the antithrombin iii levels were determined was 54% and the antithrombin antigen was 65%, both below the range of normal. further testing revealed he was negative for prothrombin gene mutation, factor v leiden, and anticardiolipin. he was placed on coumadin therapy indefinitely with goal inr of . . in anticipation of his upcoming surgery, he was recently seen in clinic on . at that time he was informed that hip replacement surgery is associated with a very high risk of developing thrombotic complications. for this reason, he was recommended to stop coumadin 5 days prior to surgery and start a lovenox bridge (150 mg daily) until the day before his surgery. he had low antithrombin iii levels on (66%), although these levels were all checked while he was still on coumadin. for this reason, he was recommended to receive atiii repletion therapy to correct the deficiency prior to having the procedure. ivc filter was also considered for dvt prophylaxis, but he had a relatively contraindication to its use with a prior history of smv thrombosis, and it was felt that collateral thrombosis could further put that vascular tree at risk. . with regard to his at3 deficiency, patient received 1 dose before surgery to keep level > 100%. level at baseline is approximately 55%. . prior to transfer, hr 84 and bp 144/89. access 2 piv - 16 guage x 2. unable to obtain a-line as catheter would not thread. past medical history: 1. superior mesenteric vein thrombosis () secondary to atiii deficiency, on coumadin 2. macrocytosis/thrombocytopenia (thrombocytopenia and macrocytosis were thought liver disease from hepatitis b. he was ruled out for myelodysplastic because his smear lacked characteristic pelger cells, ovalomacrocytes or microcytic anemia) 3. splenomegaly (per u/s in ) 4. hepatic cirrhosis (grade iii/iv) 5. htn on naldolol 6. esopageal varicies (an egd done in showed grade 1 and 2 esophageal varicies) 7. gall bladder polyps 8. hepatitis b, unknown source of exposure(genotype d, with precore and bcp mutations (basal core promoter mutation) on tenofovir 9. oral hsv on valcyclovir 10. hematuria-one episode as a childhood of unclear etiology 11. colonic adenoma --> s/p polypectomy. repeat negative colonoscopy in . social history: nc family history: nc physical exam: well appearing, well nourished 64 year old male alert and oriented no acute distress lle: -dressing-c/d/i -incision-c/d/i -> no erythema or drainage. diffuse ecchymosis throughout entire lle. mild edema -+at, fhl, -silt -brisk cap refill -calf-soft, nontender -nvi distally pertinent results: 07:12pm blood wbc-11.2*# rbc-3.94* hgb-13.7* hct-39.7* mcv-101* mch-34.8* mchc-34.5 rdw-13.7 plt ct-118* 04:52am blood wbc-9.4 rbc-3.53* hgb-12.6* hct-35.6* mcv-101* mch-35.7* mchc-35.4* rdw-14.6 plt ct-127* 03:12pm blood hct-33.7* 08:40pm blood wbc-12.1* rbc-3.13* hgb-10.6* hct-31.8* mcv-102* mch-34.0* mchc-33.4 rdw-13.5 plt ct-113* 08:10am blood wbc-8.6 rbc-2.75* hgb-9.8* hct-28.4* mcv-103* mch-35.8* mchc-34.6 rdw-14.8 plt ct-109* 06:15am blood wbc-7.4 rbc-2.41* hgb-8.4* hct-24.2* mcv-100* mch-34.8* mchc-34.7 rdw-13.7 plt ct-104* 05:55am blood wbc-5.2 rbc-2.16* hgb-7.8* hct-22.3* mcv-103* mch-36.0* mchc-34.9 rdw-14.7 plt ct-115* 01:56am blood wbc-6.0 rbc-2.65* hgb-9.3* hct-26.4* mcv-100* mch-35.1* mchc-35.2* rdw-16.2* plt ct-120* 06:10am blood wbc-5.4 rbc-2.58* hgb-8.9* hct-25.4* mcv-98 mch-34.6* mchc-35.2* rdw-15.8* plt ct-108* 07:33pm blood hct-28.6* 06:30am blood wbc-6.4 rbc-2.75* hgb-9.6* hct-27.9* mcv-101* mch-34.9* mchc-34.5 rdw-16.7* plt ct-161 07:12pm blood neuts-86.8* lymphs-9.6* monos-2.3 eos-0.9 baso-0.3 04:52am blood neuts-78.1* lymphs-14.4* monos-7.0 eos-0.2 baso-0.3 01:40pm blood pt-16.7* ptt-31.7 inr(pt)-1.5* 06:30am blood pt-16.9* ptt-29.2 inr(pt)-1.5* 12:21pm blood lmwh-0.28 01:59pm blood at-118 04:52am blood at-91 08:10am blood at-72 06:15am blood at-73 05:55am blood at-95 07:12pm blood glucose-146* urean-16 creat-0.8 na-137 k-4.8 cl-105 hco3-24 angap-13 04:52am blood glucose-162* urean-18 creat-0.7 na-135 k-4.2 cl-104 hco3-24 angap-11 08:10am blood glucose-130* urean-19 creat-0.8 na-136 k-3.5 cl-103 hco3-28 angap-9 12:21pm blood glucose-163* urean-17 creat-0.7 na-138 k-3.9 cl-106 hco3-26 angap-10 brief hospital course: the patient was admitted to the orthopaedic surgery service and was taken to the operating room for above described procedure. please see separately dictated operative report for details. the surgery was uncomplicated and the patient tolerated the procedure well. patient received perioperative iv antibiotics. postoperative course was remarkable for the following: 1. please see below 2. heme consulted for antithrombin iii deficiency. follows with dr otherwise, pain was initially controlled with a pca followed by a transition to oral pain medications on pod#1. the patient received lovenox for dvt prophylaxis starting on the morning of pod#1. the foley was removed on pod#2 and the patient was voiding independently thereafter. the surgical dressing was changed on pod#2 and the surgical incision was found to be clean and intact without erythema or abnormal drainage. the patient was seen daily by physical therapy. labs were checked throughout the hospital course and repleted accordingly. at the time of discharge the patient was tolerating a regular diet and feeling well. the patient was afebrile with stable vital signs. the patient's hematocrit was acceptable and pain was adequately controlled on an oral regimen. the operative extremity was neurovascularly intact and the wound was benign. the patient's weight-bearing status is weight bearing as tolerated on the operative extremity with posterior hip precautions. mr is discharged to home with services in stable condition. assessment and plan mr. is a 64-year-old male with history of liver cirrhosis, hepatitis b, smv/pv thrombosis and antithrombin iii deficiency (on coumadin), who is s/p left total hip replacement and pod day 0. admitted to for administration of at-3 # s/p left total hip replacement: pod #1. uncomplicated surgery per discussion with orthopedics, with estimated blood loss 750 cc. pain well controlled currently. - cefazolin per orthopedics recs (total of 3 doses) - pain control with standing naproxen, tylenol and prn morphine - written for dilaudid pca per orthopedics, which can be consolidated to morphine iv or po regimen in next 24-48 hours - monitor hct for now and can transition to daily once stable - hip plain film per ortho on and - rom restictions post surgical hip precautions per ortho . # at iii deficiency: hip replacement surgery is associated with a very high risk of developing thrombotic complications. given mr. atiii deficiency, underlying liver disease, and previous history of venous thromboses, he is at high risk for perioperative thrombosis. prior to the or, he received thrombate (antithrombin iii) at a dose of 3864u iv x1 and his at level rose to 118%. - appreciate hematology/oncology recommendations - per heme/onc goal is an at level >75% (ideally 80-120). this morning??????s level was 91 so will get dose of 1656 u today - he should have levels checked daily for at least the next three days and will be dosed with additional thrombate prn (at a dose of 1656u iv daily). - for dvt prophylaxis, has satarted lovenox 30mg sc bid 12 hours after surgery (orthopedics team aware). currently not on treatment dose heparin bridge per heme recs. will touch base about when to formally bridge to coumadin - continue coumadin # anemia: hct 39.7--> 35.6 with baseline of 46-47. unlikely to be dilutional given lack of dilution of platelets. other possibility includes surgical site bleeding. less likely b12, folate, fe deficiency, or anemia of chronic disease. - trend with hcts - b12, folate, iron studies all pending - will guaiac stool # hepatitis b: unknown source of exposure(genotype d, with precore and bcp mutations (basal core promoter mutation) on tenofovir. - continue tenofovir per home regimen # oral hsv - continue valacyclovir per home regimen # htn: bp currently stable. - continue nadalol per home regimen # thrombocytopenia: stable and at baseline, per review of omr and per discussion with hematology. - trend daily medications on admission: nadolol - 20 mg tablet - one tablet(s) by mouth daily tenofovir disoproxil fumarate - 300 mg tablet - 1 tablet(s) by mouth daily valacyclovir - (prescribed by other provider) - 500 mg tablet - 1 tablet(s) by mouth once a day warfarin - 5 mg tablet - 1-1.5 tablet(s) by mouth once a day patient to take 7.5 mg daily 6 days per week and 5 mg daily 1 day per week (sunday). medications - otc glucosamine sulfate - (prescribed by other provider) - dosage uncertain omega-3 fatty acids - (otc) - dosage uncertain discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 2. lovenox 30 mg/0.3 ml syringe sig: one (1) subcutaneous twice a day: until inr 2.0 -2.5. disp:*10 * refills:*0* 3. oxycodone 5 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for pain. disp:*80 tablet(s)* refills:*0* 4. coumadin 7.5 mg tablet sig: one (1) tablet po once a day: goal inr . follow by . disp:*30 tablet(s)* refills:*2* 5. multivitamin tablet sig: one (1) tablet po daily (daily). 6. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours). 7. valacyclovir 500 mg tablet sig: one (1) tablet po daily (daily). 8. tenofovir disoproxil fumarate 300 mg tablet sig: one (1) tablet po daily (daily). 9. nadolol 20 mg tablet sig: one (1) tablet po daily (daily). discharge disposition: home with service facility: homecare discharge diagnosis: left hip osteoarthritis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: 1. please return to the emergency department or notify your physician if you experience any of the following: severe pain not relieved by medication, increased swelling, decreased sensation, difficulty with movement, fevers greater than 101.5, shaking chills, increasing redness or drainage from the incision site, chest pain, shortness of breath or any other concerns. 2. please follow up with your primary physician regarding this admission and any new medications and refills. 3. resume your home medications unless otherwise instructed. 4. you have been given medications for pain control. please do not drive, operate heavy machinery, or drink alcohol while taking these medications. as your pain decreases, take fewer tablets and increase the time between doses. this medication can cause constipation, so you should drink plenty of water daily and take a stool softener (such as colace) as needed to prevent this side effect. 5. you may not drive a car until cleared to do so by your surgeon or your primary physician. 6. please keep your wounds clean. you may shower starting five days after surgery, but no tub baths or swimming for at least four weeks. no dressing is needed if wound continues to be non-draining. any stitches or staples that need to be removed will be taken out by the visiting nurse or rehab facility two weeks after your surgery. 7. please call your surgeon's office to schedule or confirm your follow-up appointment in four weeks. 8. please do not take any non-steroidal anti-inflammatory medications (nsaids such as celebrex, ibuprofen, advil, aleve, motrin, etc). 9. anticoagulation: please continue your lovenox twice a day and coumadin 7.5 until your inr is therapeutic to help prevent deep vein thrombosis (blood clots). after your inr is therapeutic () you may stop lovenox injections. please follow up with on friday. 10. wound care: please keep your incision clean and dry. it is okay to shower five days after surgery but no tub baths, swimming, or submerging your incision until after your four week checkup. please place a dry sterile dressing on the wound each day if there is drainage, otherwise leave it open to air. check wound regularly for signs of infection such as redness or thick yellow drainage. staples will be removed by the visiting nurse or rehab facility in two weeks. 11. vna (once at home): home pt/ot, dressing changes as instructed, wound checks, and staple removal at two weeks after surgery. 12. activity: weight bearing as tolerated on the operative extremity. posterior precautions. mobilize frequently. no strenuous exercise or heavy lifting until follow up appointment. physical therapy: post hip precautions wbat treatments frequency: daily dressing changes as needed ice as tolerated staples out 2 weeks from surgery followup instructions: provider: , : date/time: 12:40 provider: phone: date/time: 10:20 provider: phone: date/time: 8:30 procedure: total hip replacement hip bearing surface, ceramic-on-polyethylene diagnoses: thrombocytopenia, unspecified anemia, unspecified unspecified essential hypertension cirrhosis of liver without mention of alcohol long-term (current) use of anticoagulants personal history of venous thrombosis and embolism primary hypercoagulable state chronic viral hepatitis b without mention of hepatic coma without mention of hepatitis delta herpes simplex without mention of complication osteoarthrosis, localized, not specified whether primary or secondary, pelvic region and thigh 

Answer: The patient is high likely exposed to