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: piperacillin sodium/tazobactam attending: chief complaint: found down major surgical or invasive procedure: diagnostic paracentesis. therapeutic paracentesis history of present illness: 49m w/ polysubstance abuse, hcv, hbv, aids, autonomic dysfunction, and cirrhosis admitted after being found down at the t stop. at the scene he was felt to have falled down the stairs and was brought to the ed. here he was hypothermic with an elevated lactate and spb ~70 and started on vancomycin/zosyn for presumed sepsis. diagnostic tap of his ascites was negative. ct showed a small sah (later thought to be artifact on repeat) and he was dilantin/keppra loaded. a l1/2 compression fx was seen and orthopedics evaluated him as well. his initial labs were significant for a coagulopathy w/ inr=1.8 and plt=53 and he was given 1u plt, 2u rbc, and 1u ffp and sent to the micu for further w/u. of note, he was recently admitted to in for progressive ascites and had a therapeutic tap there and was diuresed with lasix/aldactone. . in the micu, his bp was stable in a normal range and he had a cxr showing a probable infiltrate along w/ ? r rib fractures and his antibiotics were switched to levaquin/flagyl. his mental status was slightly impaired on arrival (aaox2) and this was felt to be secondary to intoxication and chronic liver failure. his labs were initially thought to be c/w a picture of dic (low haptoglobin, low plt, low fibrinogen) but his osh labs were eventually obtained and showed a chronic picture of liver failure (alt 71, ast 130, alp 719, tbili 1.2, alb 2.1, inr 1.6) along w/ pancytopenia (hct 24.8 and plt 53). given this information, his hematologic abnormalities were thought to be close to his baseline and he was called out to the floor. past medical history: 1. polysubstance abuse (etoh, cocaine, heroin) 2. hep b 3. hep c 4. hiv/aids with h/o pcp (cd4-23, vl 140k on ; on viracept/combavir changed to truvata/reyataz/norovir then to atrepla ) 5. etoh cirrhosis 6. recurrent retropharyngeal abscess w/ gbs bacteremia and sepsis 7. autonomic dysfx requiring wheelchair use 8. cachexia 9. recurrent pancreatitis social history: homelessness, etoh abuse. followed at healthcare for the homeless, and . physical exam: pe: 97.6, 141/73, 92, 20, 98% (50% blowby mask), 5138/1237 gen: sedated but arousable to voice and cooperative w/ exam heent: mm dry, o/p w/ hard palate patches of erythema, pupils reactive to light cv: rrr, no m/r/g lungs: l basilar crackles but otherwise cta abd: distended and moderately tense. mild diffuse tenderness but no rebound or guarding ext: 2+ le edema to thighs, scrotal edema, erythema of r ankle shin w/out evident skin breakdown neuro: oriented to self, city, year, and president. cooperative w/ exam and answers questions appropriately. moving all extremities spontaneously. pupils reactive at 2.5mm. pertinent results: 03:55am blood wbc-6.9 rbc-2.41* hgb-9.2* hct-27.8* mcv-115* mch-38.1* mchc-33.0 rdw-17.3* plt ct-52*# 05:22am blood wbc-5.8 rbc-2.77* hgb-9.8* hct-30.0* mcv-108* mch-35.3* mchc-32.6 rdw-17.2* plt ct-41* 06:55am blood pt-18.7* ptt-36.3* inr(pt)-1.8* 04:12am blood wbc-7.5 lymph-8* abs -600 cd3%-87 abs cd3-524* cd4%-13 abs cd4-79* cd8%-69 abs cd8-412 cd4/cd8-0.2* 03:55am blood urean-19 creat-1.5* 11:15am blood glucose-157* urean-17 creat-1.1 na-138 k-4.5 cl-111* hco3-14* angap-18 06:55am blood glucose-83 urean-13 creat-0.7 na-135 k-3.8 cl-110* hco3-19* angap-10 05:22am blood glucose-120* urean-21* creat-1.3* na-131* k-3.5 cl-107 hco3-19* angap-9 03:55am blood alt-101* ast-266* ld(ldh)-777* ck(cpk)-126 alkphos-606* amylase-193* totbili-1.2 05:22am blood alt-27 ast-50* ld(ldh)-267* alkphos-305* totbili-1.6* 02:42pm blood calcium-7.6* phos-3.7 mg-1.4* 06:55am blood albumin-2.1* calcium-7.7* phos-1.9* mg-1.7 02:42pm blood hbsag-positive hbsab-negative hbcab-positive hav ab-positive 03:55am blood asa-neg ethanol-176* acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 02:42pm blood hcv ab-positive 11:57am blood type-art temp-35.7 po2-71* pco2-27* ph-7.48* caltco2-21 base xs--1 mri c-spine findings: alignment of the cervical spine is normal. there are degenerative changes with intervertebral osteophyte formation at c4-5. this causes severe narrowing of the spinal canal and flattening of the spinal cord. uncovertebral osteophytes narrow the neural foramina bilaterally at this level. the involvement is more severe on the right and left. small osteophytes at c5-6 narrow the spinal canal and produce mild narrowing of the neural foramina. the signal intensity of the spinal cord appears normal. rib x-ray nondisplaced fractures of the right posterolateral eighth, ninth, and tenth ribs with callous formation. the findings represent subacute versus remote injury. no pneumothorax. interval worsening of bilateral airspace opacities, worse in the left mid lung. diagnostic considerations include pneumonia ct head : likely a small focus of subarachnoid blood in the left parietal occipital lobe. scalp hematoma of the left scalp. no evidence for skull fracture. . ct spine : no evidence for cervical spine fracture or malalignment. degenerative changes at c4-5 . ct abd/pelvis: 1. large volume of ascites throughout the abdomen and pelvis. small liver and few small varices suggest liver disease. 2. distended gallbladder without gallbladder wall thickening or gallstones. 3. distended stomach containing solid and liquid material. 4. pancreatic calcifications suggest prior pancreatitis. no pancreatic inflammation or peripancreatic fluid collections. 5. anasarca. 6. probe/instrument within the rectum. 7. compression deformity of l1 vertebral body of indeterminate age. . cxr (): 1. stable multifocal consolidations, most consistent with pneumonia. 2. stable appearance of right-sided rib fractures without evidence for pneumothorax. kub (): 1) mild gaseous distention to loops of small bowel, with probable large bowel ileus affecting transverse colon. 2) re-identification of known ascites. kub (): slightly decreased distention to loops of small bowel with unchanged dilatation of the transverse colon measuring up to 8 cm suggestive of an ileus. no evidence of obstruction. kub ():dilated transverse colon with interval development of a single loop of dilated small bowel within the left lower quadrant. these findings are again most suggestive of an ileus. continued radiographic surveillance is recommended. 11:41 am sputum source: expectorated. **final report ** gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 4+ (>10 per 1000x field): gram positive cocci. in pairs and clusters. 2+ (1-5 per 1000x field): budding yeast. 1+ (<1 per 1000x field): gram positive rod(s). respiratory culture (final ): oropharyngeal flora absent. staph aureus coag +. heavy growth. oxacillin resistant staphylococci must be reported as also resistant to other penicillins, cephalosporins, carbacephems, carbapenems, and beta-lactamase inhibitor combinations. rifampin should not be used alone for therapy. yeast. moderate growth. brief hospital course: on arrival to the floor on , the patient was complaining of breathing difficulty and increased back, chest pain. his blood pressure ranged from 95-110, and he had minimal urine output. imaging had previously revealed right rib and l1 fractures. lidocaine patchs were placed on the patient's right chest, and lumbar spine, and he was administered oxycodone. ortho saw the patient, and recommended tlso as soon as the patient could ambulate out of bed. neurosurgery was consulted regarding the patient's neck ct showing possible spinal cord compression. they felt the compression was a result of chronic degenerative changes, and that the patient's only clinical manifestation was mild proximal weakness. they recommended a soft collar and outpatient follow-up. hepatology consulted on the patient, and they recommended increased diuretic administration. on , a therapeutic paracentesis was performed, draining 4800cc of fluid. the patient was administered 37.5g albumin after the paracentesis. on , the patient was reporting improved breathing and pain, however, he experienced further diminished urine output and his blood pressure dropped to 90-100. his creatinine also increased from .7 to 1.3, from . hepatology initially diagnosed him with hepatorenal syndrome and recommended to discontinue the diuretics, and to add 25g of 25% albunmin . since pt responded so well with ivfs and discontinuation of diuretics, the diagnosis was later changed to renal failure. on the patient's chemistries portrayed a picture of possible dic. in addition, his left arm was found to be cyanotic, with nonpalpable radial pulse and poor capillary refill. iv fluida at 125cc/ hour were administered. vascular surgery consulted on the patient several hours later, and by then the patient's arm was no longer cyanotic appearing and he had a palpable radial pulse. no intervention was suggested atthis time. later in the day the patient triggered with a temperature of 94.0, down from his baseline of 96-97. he was given a warming blanket, and had blood cultures drawn. heme/onc was cnsulted and they were not certain if the patient had dic or hit, reporting the patient's chemistries are difficult to interpret because he received blood products in the micu prior to arrival on the floor, and the recent trends in coagulation studies may simply be the patient's return to his baseline values as opposed to a consumptive coagulopathy. in addition, they observed only few schistocytes on the smear. eventually it was decided this was most likely merely a manifestation of trending down to his baseline and but dic to some extent and not hit. id was also consulted regarding the role for haart. the patient was not on haart on presentation to the hospital, and was instead begun without id approval by a different medicine team. they recommended discontinuing haart and adding zosyn (to vancomycin), given the fact that the patient just triggered with hypothermia and may be septic. as pt developed a lower extremity rash zosyn was discontinued and aztreonam and flagyl was used instead. . from this point on the patients renal, and respiratory function steadily improved, was not requring oxygen, and diuretics was added on with good effect. however, on pt was found to have a possible ileus on a kub (done b/c had mild epigartic pain). patient was temporarily placed npo but had bm and was passing gas without nausea and vomiting; therefore his diet was advanced while ambulation was ecouraged. on patient looked great and was able to eat regular meals, ambulating with a walker in his brace and was ready for placement; however no beds were found for him in rehab. in addition, his amylase and lipase started to rise despite not having any s/s of pancreatitis (no abd pain, no nausea, vomiting). the thinking was that this was a drug-induced biochemical pancreatitis. the patient had no s/s of pancreatits (no abd. pain, nausea, vomiting etc). the most likely culprit initially was robutussin which was d/c'd on . on vancomycin and aztreonam were also d/c'd after id had ok'd this from their perspective. on , the amylase and lipase increase had begun to taper and the patient was ambulating, taking adequate po, voiding on own. he was discharged on with close follow-up with ortho, hepatolgy follow-ups as well as an appt with dr. for his hiv/aids case as well as his general medical care. medications on admission: mvi thiamine folate bactrim ds qd spironolactone 100qd lasix 80 azithromycin qwk discharge disposition: extended care facility: - discharge diagnosis: renal failure mrsa pneumonia l1 compression fracture cervical stenossi with cord compression cirrhosis hep a hep b hep c hiv/aids polysubstance abuse discharge condition: stable discharge instructions: - if you develop a fever >38.5 c, intractible nausea and vomiting, blood in your vomitus, bleeding per rectum, severe abdominal swelling (ascites), fatigue, severe abdominal pain, or if you at any time become concerned about your medical condition please contact at , dr. or present at the nearest hospital. - please go to your scheduled follow-up visits with dr. , orthopedic surgery and hepatology. followup instructions: - dr. on monday at 9:30 am for your hiv/aids and general medical care - , 01:30p , (liver center), lm , liver center (sb). pt needs to start antiretroviral therapy for hepatitis b once amylase and lipase have normalized. - , 12:30p ,ortho spec, , clinic (sb) - , 12:10p x-ray ortho scc2, , , x-ray ortho scc2 -important contact info: healthcare for the homeless. , pa (pager) pcp: . , health group, ; ; fax - pt needs to start antiretroviral therapy for hepatitis b once amylase and lipase have normalized. - pt needs to have potassium monitored in the close follow-up with his pcp since he is on a high dose of spironolactone which may cause hyperkalemia - pt may need to be re-stared on hiv/ais antiretroviral therapy procedure: percutaneous abdominal drainage transfusion of packed cells transfusion of other serum transfusion of platelets diagnoses: cirrhosis of liver without mention of alcohol chronic hepatitis c without mention of hepatic coma acute kidney failure, unspecified unspecified septicemia unspecified protein-calorie malnutrition sepsis human immunodeficiency virus [hiv] disease accidental fall on or from other stairs or steps paralytic ileus methicillin susceptible pneumonia due to staphylococcus aureus closed fracture of dorsal [thoracic] vertebra without mention of spinal cord injury dermatitis due to drugs and medicines taken internally chronic viral hepatitis b without mention of hepatic coma without mention of hepatitis delta lack of housing acute pancreatitis acute alcoholic hepatitis contusion of face, scalp, and neck except eye(s) cervical spondylosis with myelopathy closed fracture of four ribs unspecified disorder of autonomic nervous system penicillins causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to