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 44-year-old gentleman with a history of alcohol abuse and alcohol-induced cirrhosis, atrial fibrillation, and upper gastrointestinal bleed secondary to nonsteroidal antiinflammatory drugs who was admitted to an outside hospital on with atrial fibrillation and a rapid ventricular response. it was thought at this time that he was in acute alcohol withdrawal. he was treated with diltiazem given by intravenous bolus and by drip for rate control and ativan with withdrawals. he subsequently developed facial edema and airway edema requiring emergent intubation for airway protection. it is unclear at this time what the initial precipitant was for possible angioedema. he also received protonix at one point during hs hospitalization there. the patient was transferred from to the intensive care unit on for further management. at , the hospital course was significant for group g streptococcus sepsis; possibly from a cellulitic skin source which has been treated with ceftriaxone. he developed hypotension and required a short course of neo-synephrine. his atrial fibrillation with a rapid ventricular response was eventually treated with digoxin with good rate control. he spontaneously converted into a normal sinus rhythm during his hospital course. his intensive care unit course was also notable for delta multiple sclerosis thought to be secondary to hepatic encephalopathy with a minimal response to rectal lactulose. he also developed a left lung collapse secondary to mucous plugging. the patient received bronchoscopy two times with aggressive suctioning on and with eventual re-expansion of his left lower lobe. he failed a speech and swallow evaluation after he was extubated on . he was also noted to have some trouble with his cough and had a hoarse voice after extubation, thought to be residual from his angioedema. past medical history: 1. alcohol abuse with a history of alcohol withdrawal seizures and hallucinosis. 2. atrial fibrillation. 3. upper gastrointestinal bleed thought secondary to nonsteroidal antiinflammatory drug use. 4. chronic back pain. 5. anxiety. 6. alcohol-induced cirrhosis. 7. interatrial septal aneurysms. 8. chronic deep venous thrombosis with collaterals. 9. hepatitis b and hepatitis c negative at outside hospital. medications on transfer: (from intensive care unit) 1. digoxin 0.1 mg by mouth once per day 2. pepcid 20 mg by mouth twice per day. 3. lactulose 300 mg per rectum twice per day. 4. albuterol as needed. 5. miconazole powder. 6. ceftriaxone (day 10 as of ). 7. tylenol. 8. vitamin k times three. allergies: aspirin, diltiazem, and ativan are questioned for anaphylaxis. social history: the patient is homeless. he lives in a shelter. his cousin is his health care proximally, and he has a sister who lives in with whom he is not in communication. family history: family history was unknown. physical examination on presentation: on physical examination, vital signs were stable with a temperature of 98.4 degrees fahrenheit, his blood pressure was 92/38, his respiratory rate was 22, and his oxygen saturation was 95% on 2 liters nasal cannula. in general, the patient was a middle-aged gentleman who was alert. he had some garbled speech and was nonsensical at times. he had a hoarse voice. the lungs had rhonchi bilaterally but greater on the right than on the left. he had 1+ pedal edema and proximal muscle wasting. he had some dilated veins of his upper thorax. pertinent laboratory values on presentation: significant laboratory data revealed the patient's platelet count was 42 (which was stable during his hospitalization). his mean cell volume was 101. his chemistry-7 was normal. his inr was 1.7, prothrombin time was 15.9, and partial thromboplastin time was 29.9. pertinent radiology/imaging: an echocardiogram from showed an ejection fraction of 60% to 70%. no interatrial septal defects. normal left ventricular and right ventricular function. mitral regurgitation of 2+ and 1+ tricuspid regurgitation. trace pericardial effusions. no vegetations were seen on transesophageal echocardiogram. on , a right upper quadrant ultrasound showed an echogenic liver consistent with cirrhosis and a hyperechoic lesion in the posterior right lobe. there was small free fluid around the liver and some cholelithiasis. no ductal dilatation or gallbladder wall thickening was seen on ultrasound. a chest x-ray from showed a patchy retrocardiac density and a slight increase in atelectasis. on , an upper extremity ultrasound showed a chronic occlusion of right internal jugular with collateralization. acute thrombus about the brachial vein with normal flow through the second brachial vein. concise summary of hospital course by issue/system: in brief, the patient is a 44-year-old gentleman with a history of alcohol abuse, cirrhosis, and a prolonged admission to the medical intensive care unit for alcohol withdrawal, complicated by anaphylaxis to possibly diltiazem versus ativan or protonix, and group b streptococcus sepsis. he also had atrial fibrillation with a rapid ventricular response, hypotension, and mucous plugging. the patient was transferred to the regular medical floor on . 1. hypoxia issues: the patient's cough continued to improve during his hospital stay. he had no further episodes of desaturations, and he was able to clear his secretions. a chest x-ray on showed interval improvement of the left lower lobe collapse and consolidation with clear lung fields. 2. delta multiple sclerosis issues: the patient was noted to have some delirium status post his intensive care unit stay. this continued to clear each day and was thought to be multifactorial with an element of hypoxia, hepatic encephalopathy, and alcohol-induced encephalopathy causing his change in mental status. he had a head computed tomography that was negative for any acute bleed or mass; although there was note of a calcification in the left frontoparafalcine region measuring 6 mm in its greatest dimension which was thought to be related to angioma, although of unclear etiology. he also was noted to have mild brain atrophy on a head computed tomography. by the time of discharge, the patient was able to engage in conversation appropriately and follow commands. 3. angioedema issues: since the angioedema was not witnessed during this hospitalization, it was unclear at this time whether he actually had an episode of angioedema. the allergy service was consulted and they suggested that the patient have a re-challenge of ativan an diltiazem as an outpatient. thyroid studies were sent here which showed a normal thyroid-stimulating hormone and a free t4. his c4 level was within normal limits, and his c1 level was an out of hospital study which was still pending. it appeared highly unlikely that the patient developed angioedema secondary to ativan since he has received ativan multiple times in the past without any adverse reactions. 4. group b streptococcus sepsis issues: the patient was to complete a 21-day course of intravenous ceftriaxone as per infectious disease consultation. as of today's dictation, the patient was on day 16/21. all surveillance cultures have been negative thus far. after the patient has completed his course of antibiotics, he should have surveillance cultures drawn as an outpatient. 5. paroxysmal atrial fibrillation issues: the patient is now in a sinus rhythm; although, it appears that he is at high risk for having recurrent atrial fibrillation given that his left atrium was enlarged on an echocardiogram done at this institution. however, given his alcohol abuse and current unsteady gait, the patient was at a high risk for falls. will continue digoxin for rate control for now, and would reconsider whether the patient would be able to be compliant with outpatient anticoagulation. he was not started on any oral anticoagulation during this hospitalization. 6. cirrhosis issues: the patient has thrombocytopenia which was most likely due to cirrhosis and splenic sequestration. he also had an elevated inr which was most likely due to liver failure. the patient has a history of portal vein thrombosis which is currently stable. from an ultrasound done on , there was no reversal of flow noted. it was unclear at this time whether the patient has had an evaluation for varies; however, this should be done as an outpatient. in terms of his hepatic encephalopathy, he was continued on lactulose 30 mg by mouth three times per day with good effect. he should have an outpatient hepatology appointment once his rehabilitation stay has finished. 7. speech and swallow issues: the patient passed a speech and swallow test several days after his medical intensive care unit stay. he was able to tolerate a full diet without any difficulties and no longer had to remain nothing by mouth. he was not longer at risk for aspiration. discharge diagnoses: 1. paroxysmal atrial fibrillation. 2. alcohol withdrawal. 3. cirrhosis. 4. angioedema of unclear etiology. 5. aspiration pneumonia and mucous plugging causing respiratory failure. 6. group b streptococcus sepsis. 7. hepatic encephalopathy. 8. anemia and thrombocytopenia secondary to cirrhosis and alcohol bone marrow suppression. condition at discharge: condition on discharge was stable. discharge status: to a rehabilitation facility. medications on discharge: 1. ceftriaxone 2 g intravenously q.24h. 2. albuterol inhaler as needed. 3. famotidine 20 mg by mouth once per day. 4. digoxin 0.125 mg by mouth once per day. 5. multivitamin one tablet by mouth once per day. 6. lactulose 30 mg by mouth three times per day. discharge instructions/followup: 1. the patient was to have a peripherally inserted central catheter line placed on to complete his antibiotic course. 2. the patient was to observe a regular diet with aspiration precautions. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified diagnostic ultrasound of heart enteral infusion of concentrated nutritional substances other bronchoscopy other intubation of respiratory tract diagnoses: congestive heart failure, unspecified acquired coagulation factor deficiency atrial fibrillation acute respiratory failure pneumonitis due to inhalation of food or vomitus angioneurotic edema, not elsewhere classified pneumococcal pneumonia [streptococcus pneumoniae pneumonia] hepatic encephalopathy streptococcal septicemia 

Answer: The patient is high likely exposed to