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: colchicine / protein powder attending: chief complaint: hematemesis. major surgical or invasive procedure: upper endoscopy with cauterization of bleeding esophageal cancer. ivc filter placement. radiation therapy to esophageal cancer. history of present illness: mr. is a 53 year-old man with history of stage iv esophageal ca, pud, esrd with live donor transplant, pe and dvt on lovenox who presents with hematemesis since this morning. note, receiving palliative radiation therapy to t-spine with last dose . . first noticed early today, vomiting bright red blood at home. the patient reports that at approximately midnight, he felt nauseous, went to the bathroom, began coughing and then vomited up a toilet bowl full of bright red blood, some clots and food. his wife drove him to the hospital where he had further episodes. there is some question whether this is emesis or sputum with blood. no prior episodes and no new sob or leg swelling. reports chest wall pain similar to chronic discomfort for which radiation therapy is being administered to palliate his symptoms. last dose of lovenox was 6pm. he presented to ed for evaluation. . in the ed, his vitals were t 99.5, hr 107, bp 138/67, satting 99%ra. labs notable for nl coag, hct 31 up from baseline 26-28. guaiac positive. cxr negative. ng lavage not performed due to esophageal stent. gi consulted and recommended ppi , serial hct, and close monitoring. he remained hd stable but concern for potential for worsening of hematemesis. admitted to micu. . of note, he had one episode of coffee ground emesis in the ed on last admission in the setting of heparin bolus for pe. past medical history: # esophageal ca stage iv (metastatic to bones, liver, lung; diagnosed after esophageal mass discovered; progressive dysphagia s/p palliative esophageal stent ), has been on cisplatin and irinotecan therapy as first line treatment, currently receiving palliative radiation therapy to chest wall and spine, plan for initiating high-dose taxotere following completion of his palliative radiation therapy # dvt # pe # remote hx of gastric ulcer not seen on recent egds. # esrd to iga nephropathy s/p kidney transplant and # status post right arm avf # avascular necrosis of the bilateral hips # htn # hyperlipidemia # cataracts status post extraction, # gout # squamous cell carcinoma of the face x3 # status post umbilical hernia repair # status post ventral hernia repair mass social history: lifetime nonsmoker. he is a civil engineer working in tunnel building. he lives with his wife and three children. he drinks occasionally and notes no exposure to asbestos or radiation. family history: mother had a cva, father had chf, had a grandfather with gastric cancer. physical exam: t 100.0 hr104 bp 124/80 rr15 sao2 97%ra general: wdwn, in pain heent: perrl, eomi, anicteric sclera, conjunctivae pink neck: supple, trachea midline, no thyromegaly or masses, no lad cardiac: tachycardic, s1s2 normal, no m/r/g, no jvd pulmonary: ctab abdomen: tender at epigastrium, non-distended. extremities: warm, 2+ dp pulses, no edema neuro: a&ox3, speech clear and logical, cnii-xii intact, moves all extremities pertinent results: labs at admission 08:20pm hct-26.8* 05:30pm ck(cpk)-56 05:30pm ck-mb-notdone ctropnt-0.02* 12:30pm hct-27.4* 07:25am glucose-85 urea n-17 creat-0.9 sodium-137 potassium-4.1 chloride-100 total co2-29 anion gap-12 07:25am estgfr-using this 07:25am ck(cpk)-50 07:25am calcium-9.1 phosphate-3.7 magnesium-1.5* 07:25am ck-mb-2 ctropnt-0.02* 07:25am wbc-6.7 rbc-3.41* hgb-10.4* hct-31.9* mcv-94 mch-30.5 mchc-32.6 rdw-16.4* 07:25am neuts-80.0* lymphs-15.6* monos-4.0 eos-0.3 basos-0.1 07:25am plt count-300 07:25am pt-12.6 ptt-35.0 inr(pt)-1.1 .. studies ct c/a/p (): impression: 1. apparent mild wall thickening of the descending and sigmoid colon may be due to underdistension. however, given change in appearance from prior study and mild stranding around the ascending and left colon, a focal/segmental colitis secondary to diverticulitis, or other infectious or ischemic etiologies could be considered in the appropriate clinical setting. 2. increased size of large hepatic metastases, many of which bulge the liver capsule, though there is no sign of capsular rupture. two new lesions are also noted. 3. new small bilateral pleural effusions. 4. interval partial resorption of right lower lobe pulmonary emboli. 5. no significant change in bilateral pulmonary nodules and metastatic lymphadenopathy in the chest. brief hospital course: in summary a 53 year-old man with history of stage iv esophageal ca (mets to lungs and spine) s/p esophageal stenting, recent pe and dvt on lovenox, esrd s/p transplant presents with hematemesis due to bleeding at site of esophageal cancer. . # hematemesis egd was performed that showed bleeding at the site of known esophageal mass, which was cauterized to one area. following the procedure, his hematocrit remained stable and he did not require any transfusions. he was put on iv proton-pump inhibitor at twice daily dosing. once stabilized several days post-procedure this was switched back to ppi in the morning and h2 blocker at night. . in addition to the cauterization, he had xrt to his esophageal lesion on the day prior to discharge. this therapy was completed without complication. . # esophageal ca stage iv with distant metastasis. he is followed by dr. in oncology clinic. at time of admission he was undergoing palliative xrt to his t-spine. during this hospitalization, xrt was administered to his esophageal mass in order to stabilize the site and prevent further bleeding. prior to discharge, he reported mild abdominal pain and a ct was performed that showed increasing size of liver metastases with stretching of the hepatic capsule. the full report is provided above. . he was continued on long acting morphine with oxycodone for breakthrough pain. at time of discharge, his pain was well-controlled on regimen of ms contin and oxycodone. he will proceed with two more weeks of xrt followed by systemic chemotherapy. . # history of pulmonary embolism he has recent a diagnosis of dvt and pe and had been on lovenox. however, due to his hematemesis at admission, the lovenox was held. gi was consulted and recommended stopping anticoagulation altogether given his high risk of re-bleeding from the esophageal tumor. an ivc filter was therefore placed. at time of discharge, he is no longer on anticoagulation. . # end-stage renal disease he is status post living donor transplant and was followed by the renal transplant service. he was continued on tacrolimus and bactrim ss during hospitalization. . although initially npo, his diet was slowly advanced as tolerated, careful to avoid hot foots and liquids. dvt prophylaxis was achieved with pneumoboots; he was kept on ppi and bowel prophylaxis throughout hospital course. code status is full. medications on admission: emend 125 mg (1)-80 mg (1)-80 mg (1) capsule, dose pack 1 capsule(s) by mouth once a day atorvastatin 40 mg once a day dexamethasone 8 mg po bid for 3 days beginning a day before chemo ?4mg daily ativan 0.5 mg by mouth every 6 hours as needed for nausea lovenox 80mg q12h ms contin 30 mg by mouth twice a day zofran 8 mg tablet by mouth every 8 hours as needed for nausea oxycodone 5 mg by mouth every 4 - 6 hours as needed percocet 5 mg-325 mg 1-2 tabs po every 4-6 hours as needed for pain protonix 40 mg by mouth once a day ?tid prochlorperazine 10 mg po every 4-6hours as needed for nausea ranitidine 300 mg po qhs ?150mg sirolimus 4 mg po daily bactrim ss 1 tab daily docusate sodium 100 mg capsule prn discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 3. acetaminophen 325 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed. 4. prochlorperazine maleate 10 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for nausea. 5. trimethoprim-sulfamethoxazole 80-400 mg tablet sig: one (1) tablet po daily (daily). 6. tacrolimus 1 mg capsule sig: four (4) capsule po q12h (every 12 hours) as needed for transplant. 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 8. simethicone 80 mg tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day) as needed. 9. morphine 30 mg tablet sustained release sig: one (1) tablet sustained release po q12h (every 12 hours). disp:*40 tablet sustained release(s)* refills:*0* 10. oxycodone 5 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed. disp:*120 tablet(s)* refills:*0* 11. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. disp:*30 capsule, delayed release(e.c.)(s)* refills:*2* 12. ranitidine hcl 300 mg capsule sig: one (1) capsule po at bedtime. 13. zofran 8 mg tablet sig: one (1) tablet po three times a day. 14. ativan 0.5 mg tablet sig: one (1) tablet po q6h prn. 15. atorvastatin 40 mg tablet sig: one (1) tablet po at bedtime. 16. emend 125 mg capsule sig: one (1) capsule po once a day. discharge disposition: home discharge diagnosis: primary diagnosis bleeding from metastatic esophageal cancer . secondary diagnoses history of deep venous thrombosis s/p ivc filter placement end stage renal disease s/p kidney transplant discharge condition: vital signs stable. pain adequately controlled. discharge instructions: you were hospitalized for treatment of bleeding from your esophagus. you underwent endoscopy and the bleeding mass was cauterized. you subsequently underwent radiation therapy treatment. . you will continue to have radiation therapy for your esophageal cancer for the next two weeks. after this, you will follow-up with dr. in clinic to discuss beginning chemotherapy. . due to your history of pulmonary embolism (blood clot to the lungs), a filter was placed in one of you veins to prevent blood clots from traveling to your lungs. due to the risk of bleeding associated with anticoagulation therapy, we have decided not to treat you with anticoagulation. please stop taking the lovenox. . we have added one new medicine to your medications. it is called omeprazole and should be taken in the morning to prevent gastrointestinal bleeding. this should be taken in addition to the ranitidine you are already taking. please stop taking the lovenox. . please return to the emergency department or call your doctor if you experience any new or worsening pain, any fever, or any other symptoms that are concerning to you. followup instructions: provider , rn phone: date/time: 9:00 . provider , rn phone: date/time: 9:00 . provider , md, phd: date/time: 1:30 md, procedure: other endoscopy of small intestine interruption of the vena cava transfusion of packed cells other radiotherapeutic procedure diagnoses: end stage renal disease malignant neoplasm of liver, secondary iron deficiency anemia secondary to blood loss (chronic) hyposmolality and/or hyponatremia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease constipation, unspecified other and unspecified hyperlipidemia long-term (current) use of anticoagulants personal history of venous thrombosis and embolism secondary malignant neoplasm of lung other pulmonary embolism and infarction secondary malignant neoplasm of bone and bone marrow malignant neoplasm of other specified part of esophagus esophageal hemorrhage kidney replaced by transplant diverticulitis of colon (without mention of hemorrhage) acute venous embolism and thrombosis of unspecified deep vessels of lower extremity 

Answer: The patient is high likely exposed to