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: no known allergies / adverse drug reactions attending: chief complaint: transfer from osh for liver biopsy major surgical or invasive procedure: transjugular liver biopsy history of present illness: 30m with h/o etoh abuse and recent admission to micu at osh for alcoholic hepatitis who presented to osh on with jaundice, increasing abdominal distention, ble swelling and malaise x 2 days and rle erythema and drainage x 2 days. denies f/c/n/v/dysuria/cp/sob. denies sick contacts/recent travel. denies tylenol ingestion or h/o ivdu. also endorsed diarrhea soon after discharge which had stopped prior to presentation. in the ed, he was given lasix 40mg iv x1 and vancomycin iv x1. labs were notable for tbili 32, dbili >20, wbc 15.6 with 92%n, na 129, bun 44, cr 2.8, hct 33.3, plt 142, inr 4.2, ptt 34.6, pt 38.2, lipase 147, alk phos 242, ast 224, alt 89, etoh level <10, bnp 108 (uln 30), ammonia 64. utox positive for benzos and tylenol level was 15 (wnl). ua showed granular casts and bilirubin, trace leuks, wbc (no nitrites or bacteria). cxr showed moderate cardiomegaly without evidence of chf. lenis were negative for dvt b/l. he was admitted to the icu. . of note, the pt. was admitted to the osh micu from /11 with alcholic hepatitis. at that point, ast 128, alt 76, tbili 24, dbili 18, inr 2. ruq u/s showed increased liver echogenicity s/o fatty liver disease, moderate hepatosplenomegaly, and small ascites. hbsag and all other hepb serologies negative. negative, antimitochondrial ab wnl, actin igg and ige wnl. patient was discharged on pentoxifylline 400mg tid and prednisone 40mg daily for treatment of presumed alcoholic hepatitis. renal function was wnl during that admission. . since admission to the osh, the patient was placed on a ciwa scale but has not required any benzos for this. he has remained oriented and appropriate and has not shown signs of encephalopathy. he was started on solumedrol 40mg iv daily, nac gtt at 50 mg/kg, ns@125/hr, spironolactone, and continued on pentoxifylline. abdominal u/s performed, showed moderate ascites, hepatosplenomegaly, diffuse fatty liver. paracentesis not performed. he was started on po vitamin k 10mg daily. gi consultation was obtained and they recommended transfer for transjugular liver biopsy. he was thought to have a rle cellulitis and was started on vancomycin and ertapenem. ertapenem was changed to ceftriaxone for empiric coverage of possible sbp. his leukocytosis began to improve after initiation of antibiotics. blood cultures were obtained and have been ngtd. given the elevation in creatinine, there was also concern for hrs. he was started on albumin 50mg iv tid, octreotide 100mcg sc tid, midodrine 10mg po tid. renal ultrasound performed showing no hydronephrosis. creatinine trended down from 2.8 to 2.6. nephrology consultation was obtained and urine output was good throughout admission. . on the floor, he has no complaints. . review of systems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denies cough, shortness of breath, or wheezing. denies chest pain, chest pressure, palpitations, or weakness. denies nausea, vomiting, diarrhea, constipation, abdominal pain, or changes in bowel habits. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes. past medical history: past medical history: alcoholic hepatitis alcohol abuse morbid obesity social history: social history: single. works with autistic children. - tobacco: former smoker, quit 2 months ago, cigs/day x 7 yrs - alcohol: last drink prior to admission. endorses 4 screwdrivers daily x 10 years. - illicits: denies h/o ivdu or other illicits. family history: family history: father with fatty liver, mother with dm. maternal gf with cirrhosis. no known h/o hemochromatosis. physical exam: vitals: t: 96.5 bp: 129/70 p: 103 r: 23 o2: 96%ra general: alert, profoundly jaundiced, oriented, no acute distress heent: +scleral icterus, mmm, oropharynx clear, +frenular jaundice neck: supple, jvp not seen habitus, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, mildly distended, bowel sounds present, no rebound tenderness or guarding, no palpable organomegaly gu: no foley ext: warm, well perfused, palpable pulses, 3+ pitting edema b/l to knee skin: erythema overlying rle extending proximally to knee, mult striae noted on abdomen, patch of erythema on l foot, punctate 2mm lesion near r lateral malleolus with clear yellow drainage neuro: oriented x3, answering questions appropriately, no asterixis pertinent results: admission labs: 11:03pm blood wbc-17.4* rbc-3.34* hgb-12.8* hct-34.4* mcv-103* mch-38.4* mchc-37.3* rdw-14.8 plt ct-161 11:03pm blood pt-28.5* ptt-34.5 inr(pt)-2.8* 11:03pm blood glucose-165* urean-48* creat-2.1* na-132* k-4.3 cl-96 hco3-18* angap-22* 11:03pm blood alt-68* ast-93* ld(ldh)-334* alkphos-177* totbili-40.1* 11:03pm blood albumin-3.2* calcium-7.7* phos-5.7* mg-2.1 10:43am blood hbsag-negative hbsab-positive hbcab-negative igm hav-negative 05:55am blood igm hbc-negative 10:43am blood hcv ab-negative 10:43am blood acetmnp-neg 05:55am blood caltibc-68* ferritn-1328* trf-52* discharge labs: 05:25am blood wbc-23.1* rbc-3.00* hgb-11.5* hct-32.7* mcv-109* mch-38.4* mchc-35.3* rdw-14.3 plt ct-168 05:25am blood pt-21.6* ptt-35.0 inr(pt)-2.0* 05:25am blood glucose-111* urean-49* creat-1.7* na-139 k-3.6 cl-106 hco3-17* angap-20 05:25am blood alt-177* ast-166* alkphos-242* totbili-46.8* abd u/s : 1. diffuse echogenic liver, most consistent with fatty liver disease. however, more serious forms of liver disease such as significant cirrhosis/fibrosis cannot be excluded on this study. 2. patent portal veins with appropriate directional flow and hepatic veins with no evidence of thrombosis. 3. marked splenomegaly, 19.6 cm. 4. no evidence of hydronephrosis. 5. trace amount of perihepatic ascites. a spot was not marked for paracentesis given the lack of fluid. liver biopsy : 1) cirrhosis with prominent sinusoidal distribution of fibrosis (confirmed by trichrome stain) stage 4 fibrosis. 2) moderate macrovesicular steatosis with associated prominent foci of ballooning degeneration, abundant intracytoplasmic hyalin and lobular neutrophils. 3) moderate canalicular and hepatocellular cholestasis. 4) iron stain shows minimal iron deposition within kupffer cells. note: the findings are consistent with a toxic metabolic injury with advanced fibrosis (cirrhosis). abd u/s : survey of the abdomen demonstrates a small-to-moderate amount of ascites. given body habitus and patient positioning, a site suitable for safe paracentesis could not be marked. brief hospital course: 30 yo m with severe etoh hepatitis complicated by and also with rle cellulitis transferred from osh for further evaluation of hepatitis. . # hepatitis - assumed to be etoh related given patient's significant history of alcohol abuse. likely a component of fatty liver involvement as well. biopsy was initially deferred as the alcohol history was so prominent. steroids were continued from osh and when bilirubin did not respond, pentoxifylline was added to the regimen. a biopsy was eventually performed when liver function did not improve, and it was confirmed to be alcoholic hepatitis with underlying cirrhosis. bilirubin was ~40 on admission and continued to increase before stabilizing around 47. meld score was 45. he remained resistant to conversations relating to his prognosis and requested that all discussions be held with his father. as there were no further medical options, a family meeting was called and palliative care was consulted to offer advice on home hospice. though mr. remained a+o and without any complaints, with his severe liver disease his prognosis is poor. he was also discussed at transplant conference and it was decided that he was a poor candidate for transplant. he was discharged home on with home hospice services and on pentoxifylline. dr. agreed to be the contact for home hospice to discuss further complications of his liver disease as they arise. # cirrhosis - abdominal ultrasound was performed which showed no mass lesions in the liver, but confirmed cirrhosis and a small amount of ascites. he was initially treated with ceftriaxone empirically for sbp given his severe liver disease. a second ultrasound was performed but a suitable area for paracentesis was not identified. # acute kidney injury - assumed to be due to hepatorenal syndrome, though the diagnosis was unclear given his small amount of ascites and normal sodium. it may also have been due to prerenal azotemia as cr was as high as 2.4 at osh. albumin and octreotide/midodrine were given to treat prerenal vs. hrs. creatinine improved to about 1.5 on discharge. # leukocytosis - there was no evidence for an infection. high wbc count was assumed to be related to steroids and severe hepatitis. sbp was treated with ceftriaxone and cellulitis was treated with vancomycin. wbc did not improve and was still high on discharge. urine culture, blood culture and cxr all normal. # rle cellulitis: puncture wound on foot with drainage and erythema concerning for cellulitis. treated with vancomycin for five days with good resolution. blood cultures remained negative. wound care consult called. # anemia: remained chronically low with hct around 35. assumed to be related to alcohol given macrocytosis. also likely a chronic disease component given kidney function. # osa: remained stable on autoset cpap medications on admission: home medications: prednisone 40mg daily mvi 1 tab daily folic acid 1mg daily diazepam 2mg po bid:prn agitation pentoxifylline 400mg tid thiamine 100mg daily kcl 20 meq . transfer medications: octreotide 100mcg sc tid midodrine 10mg po tid nac gtt vit k 10mg po daily vancomycin 1.5g tid ceftriaxone 1 gram iv daily pentoxifylline 400mg po daily methylprednisolone 40mg iv daily spironolactone 25mg po daily heparin 5000 units sc tid protonix 40mg iv daily thiamine 100mg po daily folic acid 1mg daily mvi 1 tab daily albumin 50 grams iv tid discharge medications: 1. midodrine 10 mg tablet sig: one (1) tablet po three times a day. disp:*90 tablet(s)* refills:*2* 2. pentoxifylline 400 mg tablet extended release sig: one (1) tablet extended release po tid (3 times a day). disp:*90 tablet extended release(s)* refills:*2* 3. lorazepam 1 mg tablet sig: one (1) tablet po every 6-8 hours as needed for anxiety: please note that this medication can cause you to be drowsy. disp:*40 tablet(s)* refills:*0* 4. oxycodone 5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain: please note that this medication can cause you to be drowsy. disp:*40 tablet(s)* refills:*0* 5. ensure liquid sig: can po three times a day. disp:*90 cans* refills:*2* discharge disposition: home with service facility: hospice discharge diagnosis: primary diagnosis: alcoholic hepatitis cirrhosis cellulitis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: mr. , you were admitted to the hospital for alcoholic hepatitis. you had a liver biopsy which confirmed that this was the cause of your liver injury. you also had an infection in your foot that we treated with antibiotics. you were started on steroids and other medications to try to prevent worsening of your liver function. these treatments have not improved your liver function. you were evaluated by the surgery team who did not feel that you were a good candidate for a liver transplant. medications: # start midodrine 10mg three times daily # start pentoxyfilline 400mg three times daily # start oxycodone 5mg every 4 hours as needed for pain. # start ativan 1mg every 6 hours as needed for anxiety. these medications: ativan and oxycodone, are cleared by your liver and can cause you to become very sleepy if they build up in your system followup instructions: if you experience symptoms at home which are not adequately managed by your nurses, or if you have any questions related to your liver please call your hepatologist, dr. at ( department: hepatology who: dr. where: 4a when: at 12pm phone: procedure: closed (percutaneous) [needle] biopsy of liver non-invasive mechanical ventilation diagnoses: obstructive sleep apnea (adult)(pediatric) anemia, unspecified alcoholic cirrhosis of liver acute kidney failure, unspecified alcohol abuse, unspecified cellulitis and abscess of leg, except foot acute alcoholic hepatitis 

Answer: The patient is high likely exposed to