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: penicillins attending: chief complaint: acute renal failure major surgical or invasive procedure: none history of present illness: pt is a 53 year old man with hcv cirrhosis, complicated by recurrent ascites, sbp, encephalopathy, and portal hypertensive gastropathy who is being sent in by the liver center after yesterday's labs showed an elevated creatinine. unfortuantely, the lab work is not available in our system. . he has had multiple admissions in the past six months for acute on chronic renal failure. his urine lytes are usually c/w with pre-renal azotemia. renal u/s have showed no hydronephrosis. he typically improves with fluids, midodrine and octreotide. with renal failure, he has also had several episodes of hyperkalemia. . his most recent admission was from for arf, hyperkalemia, and refractory ascites. he had 9 l paracentesis on . pt has no complaints since his discharge on friday. he denies any change in urine output, dysuria. he has not been taking any medications other than prescribed--no nsaids. his wife only noticed his tremors worsened today. . ros: (+) diarrhea with lactulose (-) denies fever, chills, night sweats. denies headache, sinus tenderness, rhinorrhea or congestion. denied cough, shortness of breath. denied chest pain or tightness, palpitations. denied nausea, vomiting, constipation or abdominal pain. no recent change in bowel or bladder habits. no dysuria. past medical history: hepatitis c diagnosed - viral load 335k - recurrent/refractory ascites requiring frequent paracenteses - history of hepatic encephalopathy - portal gastropathy without esophageal varices hepb coreab positive, surface ag negative low back pain s/p disc surgery , radial right wrist fx at the end of after fall hemachromatosis, heterozygous for the c282y mutation spur cell hemolytic anemia - piggyback liver transplant social history: he is married and lives with his wife. is not working currently. stopped smoking 6-7 months ago. smoked 1 ppd since age 15. no alcohol in 2 years. multiple tattoos. his wife organizes his medications. family history: his father had etoh cirrhosis. no history of kidney problems. physical exam: vitals: t: 98.1, p: 87, bp: 119/75, r: 18, sao2: 100ra general: awake, alert and oriented x3, refused to do moyb but did them forwards, nad. heent: nc/at, no scleral icterus noted, mmm neck: supple, no lad pulmonary: lungs cta bilaterally cardiac: rrr, nl. s1s2, no m noted abdomen: positive bowel sounds, soft, nontender, distended but not tense. extremities: 1+ pedal edema to knees bilaterally skin: spider angiomas on chest, maculopapular rash on abdomen neurologic: sl asterixis pertinent results: 06:30am blood wbc-9.0 rbc-3.19* hgb-9.8* hct-30.1* mcv-95 mch-30.7 mchc-32.5 rdw-16.4* plt ct-232 06:30am blood pt-11.7 ptt-26.7 inr(pt)-1.0 06:30am blood glucose-79 urean-42* creat-2.0* na-137 k-5.4* cl-111* hco3-19* angap-12 06:30am blood alt-30 ast-21 alkphos-346* totbili-2.4* 06:30am blood calcium-9.3 phos-4.6* mg-1.6 brief hospital course: 53 y.o. man with hcv cirrhosis, complicated by recurrent ascites, sbp, encephalopathy, and portal hypertensive gastropathy was admitted with recurrent acute on chronic renal failure that was managed with albumin, midodrine, and octreotide after paracentesis. cr slightly improved to 2.6. lactulose and rifaxamin were continued. cipro was continued for sbp prophylaxis. on , a liver donor became available and he underwent piggyback liver transplant. surgeon was dr. . induction immunosuppression was given (solumedrola and cellcept). five liters of ascites were removed. there was a size mismatch between the donor (smaller)and recipient bile duct. this was adjusted for by cutting a slit on top of the donor liver, using interrupted 5-0 pds to accomplish a biliary anastomosis. two drains were placed in the usual locations (posterior to liver and hilar area). postop, he was transferred to the sicu for management. vre rectal screen was positive. he experienced a lot of pain on top of his chronic back pain and required large amounts of narcotics. on postop day 1, he was extubated and resumed his home doses of oxycontin. re-intubation for pulmonary edema was required on postop day 4. he was also found to have myocardial stunning from the stress of surgery. bnp was 39,512. cardiology was consulted. cardiac enzymes were negative. diuresis and metoprolol were given. no cardiac event occurred and he was eventually extubated. chest ct was negative for pe and notation was made of bilateral pleural effusions. hepatic vasculature was patent. on , tte demonstrated ef of 30%. there was moderate regional left ventricular systolic dysfunction with infero-lateral and apical akinesis, trace mr and borderline pulmonary artery systolic htn. he was extubated on . of note, jp drains had large bilious outputs requiring albumin and fluid replacement. lfts increased initially with t. bilirubin peaking at 12 then decreasing. liver duplex demonstrated patent hepatic vasculature, but suboptimal visualization of the inferior vena cava, no intrahepatic biliary ductal dilation and a small amount of ascites. on , ercp was performed noting extravasation of contrast from the biliary anastomosis was seen, with contrast tracking along the jp drain. a 10cm 8 french stent was placed. lfts then continued to improve with jp drain outputs dropping and appearing non-bilious. he was transferred out of the sicu on to the med- unit where he continued to do well. diet was advanced and tolerated. glucoses were elevated requiring nph daily with intermittent sliding scale regular insulin. lateral jp was removed on . lateral jp creatinine was 2.3 with serum bili of 2.7. the medial jp remained in place. pt worked with him noting impulsivity and need for a rolling walker. he was cleared for home with home pt thru vna. medication teaching was done and he did fairly well with reinforcement. insulin administration and glucoses checks were reviewed. he required assist from his wife for management of this. this plan was for vna services to provide monitoring/instruction. immunosuppression consisted of cellcept 1 gram that was well tolerated. steroids were tapered to 20mg daily per protocol and prograf which was started on postop day 0 was adjusted per trough levels. on the day of discharge, prograf trough was 10.9. prograf was decreased to 4mg . creatinine increased postop to 3.6 after ct, but gradually decreased to 1.8. on the day of discharge, creatinine was 2.0 and potassium was 5.4. he was instructed to follow a carbohydrate consistent, 2gram potassium diet. he was discharged to home with vna of southeastern ma (). he had resumed his home dose of oxycontin 80mg tid with prn oxycodone 10mg approximately 3-4 times a day for breakthru pain. medications on admission: oxycodone 40 mg tablet sustained release 12 hr sig: two (2) tablet sustained release 12 hr po q8h (every 8 hours). oxycodone 5 mg tablet sig: two (2) tablet po q6h as needed for pain. lactulose 10 gram/15 ml syrup sig: 30-60 mls po tid midodrine 5 mg tablet sig: one (1) tablet po tid ciprofloxacin 250 mg tablet sig: one (1) tablet po q24h rifaximin 200 mg tablet sig: two (2) tablet po tid acetaminophen 325 mg tablet sig: two (2) tablet po bid magnesium oxide 400 mg tablet daily sucralfate 1 gram tablet sig: one (1) tablet po bid pantoprazole 40 mg tablet, delayed release daily daily folic acid 1 mg tablet sig: one (1) tablet po daily (daily). multivitamin tablet sig: one (1) tablet po daily (daily). thiamine 100 daily ergocalciferol (vitamin d2) 50,000 unit capsule sig: one (1) capsule po 1x/week (sa). clotrimazole 10 mg 5 times a day discharge medications: 1. prednisone 5 mg tablet sig: four (4) tablet po daily (daily): follow taper. 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 4. fluconazole 200 mg tablet sig: one (1) tablet po q24h (every 24 hours). 5. oxycodone 40 mg tablet sustained release 12 hr sig: two (2) tablet sustained release 12 hr po q8h (every 8 hours). 6. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 7. ursodiol 300 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 8. oxycodone 5 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*42 tablet(s)* refills:*0* 9. valganciclovir 450 mg tablet sig: one (1) tablet po daily (daily). 10. mycophenolate mofetil 500 mg tablet sig: two (2) tablet po bid (2 times a day). 11. sulfamethoxazole-trimethoprim 400-80 mg tablet sig: one (1) tablet po daily (daily). 12. tacrolimus 5 mg capsule sig: one (1) capsule po q12h (every 12 hours). 13. nph insulin human recomb 100 unit/ml suspension sig: ten (10) units subcutaneous once a day. disp:*1 bottle* refills:*2* 14. insulin regular human 100 unit/ml solution sig: follow printed scale injection four times a day. disp:*1 bottle* refills:*2* 15. outpatient lab work stat labs: cbc, chem 10, alt, ast, alk phos, t.bili, trough prograf fax results to attention rn 16. insulin syringes nph qd and prn sliding scale regular low dose syringe with 25-26 gauge needle supply: 1 box refill: 1 discharge disposition: home with service facility: vna of southeastern mass. discharge diagnosis: hcv cirrhosis s/p liver transplant pulmonary edema, resolved myocardial stunning, resolved hyperglycemia on steroids chronic back pain discharge condition: mental status: clear and coherent level of consciousness: alert and interactive activity status: ambulatory - requires assistance or aid (walker or cane)-impulsive with activities/walking discharge instructions: please call the transplant office if you have any of the warning signs listed below you will need to get labs drawn every monday and thursday empty and write down drain output. bring record of drain outputs to next transplant office appointment apply dry gauze to your drain daily check your blood sugars prior to meals and give insulin as directed on sliding scale no driving while taking pain medication you may shower no heavy /straining followup instructions: provider: , md phone: date/time: 8:00 provider: , md phone: date/time: 10:30 provider: , md phone: date/time: 10:00 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more diagnostic ultrasound of heart insertion of endotracheal tube enteral infusion of concentrated nutritional substances endoscopic sphincterotomy and papillotomy endoscopic insertion of stent (tube) into bile duct other transplant of liver other operations on lacrimal gland transplant from cadaver diagnoses: other chronic pain acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified adrenal cortical steroids causing adverse effects in therapeutic use chronic hepatitis c without mention of hepatic coma hepatorenal syndrome portal hypertension cardiac complications, not elsewhere classified chronic kidney disease, unspecified defibrination syndrome surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation infection with microorganisms without mention of resistance to multiple drugs other ascites hypovolemia other specified disorders of stomach and duodenum backache, unspecified chronic viral hepatitis b without mention of hepatic coma without mention of hepatitis delta unspecified vitamin d deficiency other acute and subacute forms of ischemic heart disease, other other non-autoimmune hemolytic anemias carrier or suspected carrier of other specified bacterial diseases secondary diabetes mellitus without mention of complication, not stated as uncontrolled, or unspecified 

Answer: The patient is high likely exposed to