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: atenolol / serax / neurontin attending: chief complaint: gi bleed major surgical or invasive procedure: egd () history of present illness: 40 year old man with pmh of alcohol abuse, withdrawal, dt, alcoholic pancreatitis, pancreatic pseudocyst, htn, depression, polysubstance abuse, gerd, tobacco abuse, and withdrawal seizures from stopping xanax presents with sudden onset of chest and abdominal pain at 3 am yesterday am waking him from sleep, with associated nausea and dry heaves. ultimately, he had two episodes of vomiting bright red blood, as well as having some watery diarrhea. he denied any blood int he stools or black stools, and endorsed feeling week or dizzy. he also endorsed some mild sob. . his ros at that time notable for a rash on the bilateral lower extremities. . his admission labs were notable for a glucose of 175 and a bun of 20. lfts showed ast 106 alt 80, amylase 239 and lipase 1309. his wbc was 44.8 with 88% n, 5% bands, 3% lymphs. his osh imaging showed a cxr with no acute disease, a ct of the abdomen and pelvis showing some gallbladder wall thickening, hyperemia and inflammatory changes suspicious for acute cholecystitis, as well as some mild fat stranding around the pancreatitis head, with a stable pseudocyst in the region of the pancreatic tail. ruq u/s showed thickening gallbladder wall up to 1 cm with a small amount of pericholecystic fluid. no cholethiasis and no definite son sign. normal caliber cbd and possible minimal intrahepatic biliary ductal dilatation. ekg at osh showed sinus rhythm 70, no st changes. . for his ugib, gi was consulted, and scoped him, finding as below. for his acute pancreatitis, his alcohol level was undetectable, and his was kept npo. from his elevated wbc count, e was started on unasyn and flagyl, and ultimately sent here on vancomycin, metronidazole, and meropenem. he was placed on bcd. . his blood gas at 7 pm on was 7.29/40.3/111 on smv12x500,. . repeat abg on psv 5/5 7.38/38/94. . ont he floor, he is sedated and unable to answer questions. . review of systems: unable to answer past medical history: alcohol abuse alcohol withdrawal delirium tremens alcohol pancreatitis pancreatic pseudocyst anxiety and depression hypertension polysubstance abuse gerd tobacco abuse withdrawal seizures from stopping xanax social history: the patient lives at home with his girlfriend. referred he stopped drinking alcohol a year ago. smokes marijuana. denies other illicit. denies iv drugs. continues to smoke tobacco on a daily basis. family history: noncontributory physical exam: admission physical exam: vitals: t: 97.3 bp: 136/93 p: 76 r: 21 o2: 94% intubated 50% fio2. general: sedated heent: nasal passageways with clot in the nares bilaterally neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: mild ttp in the epigastrium, without rebound, without hard surgical abdomen. ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema . discharge physical exam: pertinent results: admission labs: 12:54am blood wbc-32.8* rbc-4.95 hgb-15.9 hct-48.1 mcv-97 mch-32.0 mchc-33.0 rdw-14.3 plt ct-20* 12:54am blood neuts-88.1* lymphs-6.9* monos-4.3 eos-0.5 baso-0.2 12:54am blood pt-15.0* ptt-27.8 inr(pt)-1.3* 12:54am blood fibrino-475* 08:10am blood fdp-40-80* 03:00am blood ret aut-1.5 12:54am blood glucose-207* urean-29* creat-0.8 na-141 k-4.7 cl-112* hco3-21* angap-13 12:54am blood alt-51* ast-124* ld(ldh)-1754* alkphos-49 amylase-218* totbili-1.5 12:54am blood alt-51* ast-124* ld(ldh)-1754* alkphos-49 amylase-218* totbili-1.5 12:54am blood lipase-214* 12:54am blood calcium-7.1* phos-2.8 mg-1.7 12:54am blood hapto-<5* 03:50am blood type-art po2-94 pco2-38 ph-7.38 caltco2-23 base xs--1 03:50am blood lactate-1.4 discharge labs: imaging: axr () the right side up decubitus view of the abdomen (limited) was reviewed. the imaged portion of the abdomen does not reveal the presence of free air. cxr () the et tube tip is 5.5 cm above the carina, slightly eccentric. the ng tube tip is in the stomach. heart size and mediastinum are unremarkable. there is mild interstitial pulmonary edema. left lower lobe consolidation is associated with pleural effusion. ct abd and pelvis () 1. findings consistent with worsening pancreatitis including increased peripancreatic stranding and increased small volume ascites. 2. slight increase in size of the pancreatic tail pseudocyst, now measuring 6.0 x 4.6 cm. 3. wedge-shaped region of hypoenhancement involving the inferior aspect of the spleen with adjacent smaller regions of splenic hypoenhancement are not significantly changed compared to the prior study and are concerning for impeding infarction; recommend attention on follow-up imaging. note is again made of marked narrowing of the splenic vein. 4. new small bilateral pleural effusions with associated compressive atelectasis. 5. wall thickening of the second and third portions of the duodenum are likely reactive. 6. bilateral renal hypodensities, some of which are simple cysts and others that are too small to characterize. 7. 1 cm hypodensity in the right hepatic lobe adjacent to the gallbladder fossa is likely a region of focal fat deposition versus a perfusional anomaly. abdominal us () 1. gallbladder sludge. 2. small segment v liver hemangioma. 3. splenic infarct. 4. pancreatic tail pseudocyst. 5. trace ascites seen on ct two days prior not evident on ultrasound. edg () -blood in the esophagus -ulcers in the middle third of the esophagus and lower third of the esophagus -- tear -diffuse ulceration and fibrin deposition was seen in the stomach. there were innumerable ulcers. the fundus had a large diffuse area of ulceration, adherent clot and fibrin deposition. there were some areas that appeared to resemble a mass although it was not possible to distinguish a mass from inflammatory tissue and fibrin deposition. -ulcers in the antrum, pylorus and stomach body -ulcers in the duodenal bulb, second part of the duodenum and third part of the duodenum -the etiology of the diffuse, severe ulceration is unclear and could represent a malignant process (ze syndrome), ischemic event or caustic intake. repeat egd severe gastropathy consistent with portal hypertensive gastropathy large areas of superficial serpiginous ulceration were noted in the body and fundus. there was a large area with dusky-black appearance with thickening of the mucosal folds noted in the fundus - differential diagnosis necrosis of gastric mucosa, gastric varices or an underlying infiltrative process. cold forceps biopsies were performed for histology at the stomach. mild duodenitis in the duodenal bulb. otherwise normal egd to third part of the duodenum 03:19am blood wbc-29.9* rbc-4.00* hgb-13.3* hct-37.8* mcv-94 mch-33.3* mchc-35.2* rdw-15.2 plt ct-15*# 11:24pm blood wbc-31.5* rbc-3.76* hgb-11.8* hct-34.6* mcv-92 mch-31.4 mchc-34.1 rdw-15.2 plt ct-25* 07:30pm blood wbc-31.5* rbc-3.75* hgb-11.9* hct-34.8* mcv-93 mch-31.7 mchc-34.1 rdw-15.5 plt ct-33* 07:00am blood wbc-30.8* rbc-3.59* hgb-11.6* hct-33.7* mcv-94 mch-32.3* mchc-34.5 rdw-15.3 plt ct-49* 07:35am blood wbc-31.4* rbc-3.47* hgb-10.8* hct-32.9* mcv-95 mch-31.3 mchc-33.0 rdw-15.7* plt ct-132*# 07:00am blood glucose-123* urean-16 creat-0.6 na-137 k-3.4 cl-101 hco3-27 angap-12 03:19am blood alt-36 ast-67* ld(ldh)-1454* alkphos-44 totbili-1.8* dirbili-0.5* indbili-1.3 03:00am blood ld(ldh)-1255* totbili-1.7* dirbili-0.6* indbili-1.1 07:00am blood ld(ldh)-1100* totbili-1.1 03:30pm blood hapto-28* 03:00am blood vitb12-535 folate-7.6 hapto-28* 07:00am blood hapto-51 02:00pm blood adamts13 activity evaluation = normal 10:42am blood gastrin-test 11 (normal) 07:15am blood wbc-29.0* rbc-3.42* hgb-10.9* hct-31.3* mcv-92 mch-31.9 mchc-34.8 rdw-15.7* plt ct-214# egd bx are pending. brief hospital course: 40 year m with pmh alcohol abuse, withdrawal, dt, alcoholic pancreatitis, pancreatic pseudocyst who presents with upper gi bleed after chronic nsaid and energy drink (monster) intake. he required intubation for airway protection. # gi bleed patient was evaluated by gi and underwent a egd which revealed diffusely eroded edematous gastric mucosa with central black membranes v. clot in the fundus but no definitive bleeding site. he had erosive esophagitis, esophageal/gastric/duodenal ulcers to the 3rd part of duodenum, and tear. no bx were done initially b/c of low platelet. he received 2u prbc and 3u platelet transfusions. he was started on a ppi drip which was later transitioned to a ppi po bid. he was initially kept npo and advanced to full diet upon transfer from the icu. gastrin levels were normal. egd was repeated with biopsies. there was still erosive changes seen. he will need high dose ppi x at least 6-8 weeks, and have a 3rd repeat egd at that time. h. pylori serology was negative. he was instructed on nsaid/asa and monster/other energy drink avoidance. # airway protection pt was intubated in the setting of hemoptysis for airway protection. he was successfully extubated the following morning as he was no longer actively bleeding. he did not have an oxygen requirement upon transfer to the general medicine floor. # abnormal cbc (thrombocytopenia, anemia, possible hemolysis): the patient was noted to have a leukocytosis, anemia and thrombocytopenia. no blasts were seen in his wbc differential, but there were bands at the outside hospital, and the elevated counts were attributed a possible infection v. pancreatitis. he was initially started on antibiotics, but these were discontinued as he clinically improved. hematology was called regarding his thrombocytopenia and undetectable haptoglobin on admission (suggesting a consumptive/hemolytic process). upon review of his smear, they saw evidence of few schistocytes which raised their concern for possible ttp. they felt his case was not entirely clear as the smear was made on a post-transfusion blood, which may have been the etiology of the schistocytes. upon further discussion, it was decided not to initiate plasmapheresis and to monitor the patient closely. given his low platelet counts, there was also concern for possible itp and the patient was started on steroid therapy. the platelet count rose, permitting repeat egd w/ biopsy, and the haptoglobin rose to within normal counts. on discharge the plt count had normalized to >200. adamts13 activity was normal. an hiv ab test is pending at time of discharge and will be followed up at his hematology follow-up appointment next week with dr. . he will complete a rapid taper of prednisone for the next 5 days after discharge. # pancreatitis and pseudocyst: the exact etiology of his pancreatitis was unclear, though nsaids were high on the differential. his ruq u/s demonstrated no gallstones, though there was presence of biliary sludge (which can also cause pancreatitis). the patient denies current alcohol use and his etoh level was negative as per osh report. he was given iv hydration and no antibiotics were administered as the patient did not appear to be infected. he clinically improved and is tolerating enteric meals. he has a pseudocyst that will need to be followed by gi/pancreas team, who will contact him with appointment information (dr. ). given the sludge, it is recommended he undergo elective cholecystectomy when he recovers from this hospitalization. . # tobacco use: he was placed on nicotine patch and encouraged to stop smoking to allow his gi ulcers faster healing. he should continue nicotine patch taper prolonged. discharge medications: 1. nicotine 21 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily): use 21mg patch daily for 4-6 weeks, then 14mg patch daily for 2-4 weeks, then 7 mg patch for weeks. do not smoke while using this med. disp:*28 patch 24 hr(s)* refills:*0* 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours) for 8 weeks. disp:*112 tablet, delayed release (e.c.)(s)* refills:*0* 3. trazodone 50 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. disp:*30 tablet(s)* refills:*0* 4. prednisone 20 mg tablet sig: two (2) tablet po daily (daily): starting , take 2 tablet once x 1 day, then 1 tablet once x 2 days, then half tablet once x 2 days. disp:*5 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: gi bleed -- erosive esophagitis, esophageal/stomach/duodenal ulcers. severe pancreatitis pancreatic pseudocyst thrombocytopenia, unspecified discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to icu with bleeding from the upper intestinal tract (including esophagus, stomach and duodenum). you required mechanical ventilation for a short period. you were given 2 units of blood. you underwent 2 endoscopies which showed irregularity of the stomach wall. biopsies were taken and these results are pending. you will need to follow up with the gi/pancreas specialist. you were found to have low platelets (blood cell involved in clotting) of unclear etiology and were treated empirically with steroid medication under hematology consultation. your platelet level began to normalize. you need to complete a rapid taper with prednisone as prescribed, and have follow up blood counts with your pcp in one week. you were found to have pancreatitis and a pancreatic pseudocyst. biliary sludge was seen on imaging studies. you were seen by the gi and surgical specialists. the pseudocyst will need to be monitored, and it is recommended you have your gallbladder removed in the future when you have recovered from this hospitalization. please continue to refrain from alcohol, tobacco use, caffeine use, use of any ibuprofen, motrin, advil, naproxen/naprosyn, or aspirin containing products in order to promote healing of your gi ulcers. please stop drinking monster drinks, or any similarly marketed energy drink. followup instructions: gi physician: gi team will call you with appointment information. if you do not hear from them by end of next monday, please call operator to have dr. (gi fellow) paged. he is arranging follow up. department: hematology/oncology when: friday at 10:00 am with: , md building: sc clinical ctr campus: east best parking: garage name: , md specialty: internal medicine when: monday at 4pm address: , , phone: procedure: other endoscopy of small intestine esophagogastroduodenoscopy [egd] with closed biopsy diagnoses: thrombocytopenia, unspecified esophageal reflux tobacco use disorder unspecified essential hypertension acute posthemorrhagic anemia chronic or unspecified gastric ulcer with hemorrhage, without mention of obstruction chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction hemorrhage of gastrointestinal tract, unspecified other specified disorders of stomach and duodenum gastroesophageal laceration-hemorrhage syndrome acute pancreatitis cyst and pseudocyst of pancreas other esophagitis ulcer of esophagus with bleeding other diseases of spleen salicylates causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to