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: patient is a 46-year-old male status post liver transplant in for cryptogenic cirrhosis, hepatitis c, varices with recent admission for hyperkalemia now presents with fever of 103.2, decreased appetite, dehydration. patient has not eaten or had any fluid for a couple of days. past surgical and past medical history: liver transplant , nutcracker esophagus, elevated prolactin, end- stage renal disease, cryptogenic pneumonia, thoracotomy with right upper lobectomy secondary to cavitary lesion, gastroparesis. allergies: penicillin. medications at home: prograf 1 mg p.o. b.i.d., rapamune 2 mg p.o. daily, prednisone 5 mg daily, fluconazole 400 mg p.o. daily, protonix 40 mg b.i.d., valcyte 450 mg daily, nph insulin 28 units q.a.m., epogen 20,000 units every week, nifedipine 10 mg p.o. b.i.d., carafate 1 gram q.i.d., bactrim single strength 3 times a week. vital signs: temperature 103.7, heart rate 102, bp 101/78, 97% on room air, respiratory rate 18. labs: white count 1.6, hematocrit 25.3, platelet count 51. pt 14.2, ptt 30.7, inr 1.3. ua was negative. ast 62, alt 68, alkaline phosphatase 203, t bilirubin 0.6, amylase 12, lipase 8, creatinine 1.5 with a bun of 330. physical exam: in no acute distress, nonjaundiced. heart rate regular. lungs are clear to auscultation. abdomen: soft, nontender, nondistended. hospital course: patient was admitted to the transplant service and started on vancomycin and levofloxacin iv and given a dose of neupogen. blood cultures were sent off. duplex of the liver was done. this demonstrated patent hepatic veins and portal veins with appropriate direction of flow. patent extrahepatic veins, hepatic artery with improved wave forms. the intrahepatic right and left hepatic arteries were poorly visualized which suggested decreased flow. there was no evidence of hepatic ductal dilatation or ascites. chest x-ray on admission was stable; postoperative appearance of the right hemithorax. no evidence of acute pneumonia. blood and urine cultures were sent. blood cultures was less than 10,000 organisms. blood cultures demonstrated enterococcus faecium resistant to vancomycin, ampicillin, and penicillin, sensitive to linezolid. infectious disease was consulted. given pancytopenia, he was started on daptomycin in lieu of linezolid. weekly cks were monitored. these were normal. an abdominal ct was done. this demonstrated the main hepatic artery was not opacified beyond the origin of the gastroduodenal artery. no intrahepatic arterial flow was noted. the intrahepatic biliary ductal dilatation was noted more severe in the left than in the right lobe. several bile leaks were noted in the left hepatic lobe. there were patent portal and hepatic veins. moderate ascites was noted with stable severe splenomegaly and multiple varices. multiple subcentimeter hypodensities in the spleen was noted. this was felt to represent hemangiomas or other benign entities. a small right pleural effusion was noted. he was sent for a t-tube cholangiogram. there was no evidence of obstruction or leak noted. the biliary anastomosis was widely patent and there was normal contrast opacification of the intrahepatic bile ducts and small bowel. he was then sent on for a ptc cholangiogram which demonstrated dilated left-side intrahepatic bile ducts with nondilated right-sided intrahepatic bile ducts and irregularly marginated severe stricture of the extrahepatic common ducts with near complete occlusion was noted. this was angioplastied with an 8 mm x 4 cm angioplasty balloon and then a 10 french left-sided internal/external biliary drainage catheter was placed. his lfts improved. ast was 21, alt 43, alkaline phosphatase 129, total bilirubin 0.3. on , he underwent an angiogram by the cardiologist in the catheterization lab. this demonstrated completely occluded hepatic artery. his ptc drain was left to gravity drainage draining approximately 350- 575 cc of bilious drainage. his vital signs remained stable. he was afebrile. his white blood cell count remained on the low side in the range of 1.9-2.5. his hematocrit was stable on the low side ranging between 26.6-24.6. he continued on iv hydration as well as iv levaquin and daptomycin. he did receive 1 unit of packed red blood cells as well as neupogen again with slight improvement in his white blood cell count. he was medicated with oxycodone for discomfort in the right upper quadrant and right lateral abdomen. his ekg demonstrated an ectopic atrial rhythm with diffuse nonspecific st-wave abnormalities. heart rate was in the range of mid to high 80s. he underwent a transthoracic echocardiogram to assess for vegetation given bacteremia. it was noted that he had left ventricular wall thickness, cavity size and systolic function were normal with left ventricular ejection fraction of 55%. the regional left ventricular wall motion was normal and there was no evidence of endocarditis. a repeat chest x-ray demonstrated no significant interval change from the prior study. no pneumothorax. he was seen by podiatry service for toenail care. he stated that his left hallux nail was painful. he underwent sharp debridement of nails. pain diminished after this procedure. triple antibiotic was applied to the site without further problems. nutrition followed the patient throughout this hospital course making recommendations that included sugar-free shakes t.i.d. physical therapy cleared him to go home. dr. from infectious disease followed mr. recommending that fluconazole 200 mg be continued for 1 year given history of cryptococcal pneumonia. this was reinstituted. he was retransfused with 2 units of packed red blood cells for a hematocrit of 24 on . repeat hematocrit was 30. a repeat ptc cholangiogram was done that demonstrated nondilated intrahepatic biliary tree. there was narrowing of the common hepatic duct, but contrast slowed from the intrahepatic biliary tree to the bowel. his ptc drain was capped. he continued to have low-grade fevers of 100.4 up to 103.4 on . repeat blood cultures were drawn almost on a daily basis for surveillance. these blood cultures were negative. bioculture demonstrated enterococcus, 2 different species both resistant to vancomycin and both sensitive to linezolid. he remained on iv daptomycin and levaquin. his t-tube was uncapped for this febrile episode. he remained in the hospital for monitoring and iv daptomycin. for the remainder of the hospital course, he was running low grade temperatures and then he was afebrile. his t-tube was capped again and he tolerated this without further fevers. a repeat chest x-ray was done that demonstrated small right pleural effusion that was unchanged. no findings suggestive of pneumonia. of note, on , a picc line was placed at the cavoatrial junction anticipating that he would need iv daptomycin. on , his levofloxacin was stopped. he was started on cefepime 2 grams iv q.12h. flagyl was started 500 mg p.o. q.8., and the daptomycin was discontinued. a cmv viral load was done. this was not detected. cryptococcal antigen was negative. on , his picc line catheter was removed and the tip was cultured. there was no growth. repeat blood cultures on are still pending at this time. he was discharged home on on p.o. linezolid, p.o. levofloxacin was restarted, and fluconazole 200 mg daily. infectious disease recommended repeating an abdominal ct to rule out abscess or bilomas. of note, gram-positive cocci were noted in bottles on the blood culture likely representing contaminant. he was ambulatory. tolerating a regular diet. discharge condition: stable. medications on discharge: colace 100 mg p.o. b.i.d., fluconazole 200 mg p.o. daily, levofloxacin 500 mg p.o. daily, linezolid 600 mg p.o. b.i.d., nifedipine 10 mg p.o. b.i.d., oxycodone 5 mg p.o. p.r.n. q.6h. p.r.n. as needed, protonix 40 mg p.o. q.12h., bactrim single strength 1 p.o. daily, rapamune 3 mg p.o. daily, valcyte 450 mg p.o. daily, nph insulin 28 units subcutaneous daily, and regular insulin subcutaneous p.r.n. q.6h. discharge diagnoses: vancomycin resistant enterococci bacteremia, vancomycin resistant enterococci in bile, hepatic artery thrombosis status post liver transplant , stricture of extrahepatic common duct, and percutaneous transhepatic catheter placed. follow up: he was scheduled to followup in the outpatient transplant clinic on at 10:50 with dr. and on at 11:30 with dr. . , procedure: venous catheterization, not elsewhere classified diagnostic ultrasound of heart angioplasty of other non-coronary vessel(s) arteriography of other intra-abdominal arteries other percutaneous procedures on biliary tract percutaneous hepatic cholangiogram injection or infusion of oxazolidinone class of antibiotics procedure on single vessel diagnoses: bacteremia streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] complications of transplanted liver cholangitis obstruction of bile duct stricture of artery 

Answer: The patient is high likely exposed to