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: patient recorded as having no known allergies to drugs attending: chief complaint: gi bleed and hypotension major surgical or invasive procedure: upper endoscopy colonoscopy sigmoidoscopy history of present illness: this is a 48 year-old male with a history of esld and variceal bleed who is transferred from osh with gi bleed and hypotension. . osh course: per pt history and partial osh record (full records not available on admission) the patient was admitted on with melana and syncope. an egd was performed in osh ed revealing grade 1 distal esophageal varices, portal gastropathy, fresh heme in the stomach without active bleed. he remained stable until the day of transfer. . on the day of transfer, a 3 l paracentesis was performed. sortly thereafter he was noted to be hypotensive with an sbp in the 60s. he was transferred to the icu. he had several episodes of large volume melanotic bms. labs revealed hct of 17 (was 33 earlier that day). a tlc femoral line was placed. he was transfused 3 units prbcs, 2 units ffp, 2 units platelets. he was started on levophed 12 mcg/min, protonix gtt and octreotide gtt at 50 ml/hr. rn report, he also spiked to f today, and was therefore given a dose of ceftriaxone 2g/vanco 1g/flagyl 500. he was transferred to via for further evaluation and management. . on arrival to the icu: he immediatly passed >300 cc's of melanotic/bloody liquid bm. sbp 90 (on levophed), hr 60s. he complained of mild epigastric pain, +chronic low back pain, unchanged from baseline. no nausea/vomiting/sob/chest pain/lightheadedness. he denies cough, urinary frequency, urgency, dysuria, focal weakness, vision changes, headache, rash or skin changes. . he was continued on levophed, given a ns bolus and transfused 2 units emergency release prbcs. the liver team was consulted for ? emergent egd. past medical history: -cirrhosis: from hcv infection. complicated by variceal bleed () w/p egd and banding last in , ascites on diuretics, hyponatremia, and hepatic encephalopathy. had been listed for at , but removed after psychiatric hospitalization for si/hi. last colonoscopy in . reported baseline coagulopathy, with inr between . -hypertension -pancytopenia -depression, anxiety, psychosis: s/p admissions (most recently ) for homicidal ideation -gerd -chronic lower back pain social history: married with 1 adult daughter, smokes 1.5 ppd. + h/o etoh (sober x 3 years) and drugs (h/o intranasal cocaine, ivda), but apparently quit in . on disability. family history: denies liver disease in family. physical exam: vitals: t: 97.6 bp:96/55 (on levo) hr:61 rr: 13 o2sat:100% 4l nc gen: ill appearing, pale, lethargic. heent: jaundiced. eomi, sclera anicteric, no epistaxis or rhinorrhea, mm dry , op clear neck: neck veins flat, carotid pulses brisk, no bruits, no cervical lymphadenopathy, trachea midline cor: rrr, hsm normal s1 s2, radial pulses +2 pulm: lungs ctab, but diminished bs b/l bases abd: distended but soft, +fluid wave, +umbilical hernia, mild epigastric tenderness ext: no c/c/e, no palpable cords neuro: alert, oriented to person, place, and time. cn ii ?????? xii grossly intact. moves all 4 extremities. strength 5/5 in upper and lower extremities skin: + jaundice, +multiple spider angiomas. ecchymosis over r ant chest wall. pertinent results: admission labs: 11:52pm wbc-11.9*# rbc-2.67* hgb-8.3* hct-23.3*# mcv-88# mch-31.2 mchc-35.7* rdw-17.8* 11:52pm neuts-89* bands-6* lymphs-1* monos-4 eos-0 basos-0 atyps-0 metas-0 myelos-0 11:52pm plt smr-low plt count-147*# 11:52pm glucose-166* urea n-15 creat-1.1 sodium-134 potassium-4.8 chloride-100 total co2-25 anion gap-14 11:52pm albumin-2.5* calcium-7.2* phosphate-3.2 magnesium-1.6 11:52pm alt(sgpt)-25 alk phos-63 tot bili-4.1* 11:52pm pt-19.7* ptt-45.2* inr(pt)-1.8* . discharge labs: 06:25am blood wbc-4.4 rbc-3.53* hgb-10.8* hct-31.6* mcv-90 mch-30.7 mchc-34.3 rdw-17.5* plt ct-42* 06:25am blood pt-20.3* ptt-44.1* inr(pt)-1.9* 06:25am blood glucose-61* urean-14 creat-0.6 na-131* k-4.0 cl-98 hco3-29 angap-8 12:27am blood calcium-8.2* phos-1.9* mg-1.9 06:25am blood alt-42* ast-117* alkphos-70 totbili-5.5* . studies: gi bleeding study impression: negative gi bleed scan. . liver or gallbladder us (single organ) impression: 1. stigmata of longstanding liver disease including cirrhosis, large amount of ascites, and splenomegaly. 2. sludge within the gallbladder, however no evidence of cholecystitis. . egd, findings: esophagus: protruding lesions 3 cords of grade i varices were seen in the esophagus. the varices were not bleeding. stomach: mucosa: granularity and mosaic appearance of the mucosa were noted in the whole stomach. these findings are compatible with portal hypertensive gastropathy. duodenum: mucosa: granularity and friability of the mucosa with no bleeding were noted in the duodenal bulb compatible with portal hypertensive duodenopathy. other findings: no evidence of upper gi bleed. impression: esophageal varices granularity and mosaic appearance in the whole stomach compatible with portal hypertensive gastropathy granularity and friability in the duodenal bulb compatible with portal hypertensive duodenopathy no evidence of upper gi bleed. otherwise normal egd to proximal jejunum recommendations: 1) proceed with flexible sigmoidoscopy . sigmoidoscopy, findings: contents: clotted blood was seen in the rectum, sigmoid colon and distal descending colon. it was not possible to get above the blood. the site of bleeding was not identified. impression: blood in the rectum, sigmoid colon and distal descending colon otherwise normal sigmoidoscopy to descending colon recommendations: 1) transfuse 2u prbcs. 2) correct coagulopathy/ thrombocytopenia. 3) needs mesenteric angiography +/- embolization. . colonoscopy, impression: ulceration, friability and abnormal vascularity in the proximal ascending colon compatible with ischemic bowel (biopsy) otherwise normal colonoscopy to cecum recommendations: 1) avoid hypotension. 2) continue antibiotics. 3) transfuse as required. 4) follow histology. . specimen submitted: proximal ascending colon...1 jar. procedure date diagnosis: colon, ascending, mucosal biopsy: a. necrotic mucosa. see note. b. fibrinopurulent exudate with bacterial colonies. note: the findings are consistent with (the endoscopic finding of) ischemia. brief hospital course: 48 year-old man with a history of esld and prior variceal bleed who presents to osh with gi bleed and hypotension, transferred to for further treatment. . plan: #gi bleed/ischemic colitis: pt had sig. melanotic stool concerning for upper gi bleed, esp. given his history of variceal bleed. he was initially started on an octreotide gtt as well as protonix iv bid. however, egd did not reveal a bleeding source; sigmoidoscopy could not locate the source due to the extent of blood in the colon. initial bleeding scan was also unrevealing. the following day, a colonoscopy was performed and findings suggested ischemia, as did the colon biopsy. he was transfused a total of 7 units of prbcs, 3 units of ffp, and 4 units of platelets. his hct stabilized at 31, and he had no further episodes of sig. bleeding. he was discharged on protonix. . #acute blood loss anemia: as above. . #hemorrhagic/hypovolemic hypotension: this was likely hemorrhagic in the setting of gib. on arrival, he required levophed for 1 day in the micu. his sbp returned to baseline of 90s with aggressive ivf resuscitation and transfusion of blood products as above. sepsis was also considered. he received vanc, ceftraixone, and flagyl at the osh prior to transfer. pt was continued on ceftriaxone given high risk of sbp (no paracentesis was performed prior to initiation of abx) and discharged on cipro for ppx. pt was pancultured without any growth. . #hepatitis c virus cirrhosis. after pt was stabilized, he was restarted on lactulose, rifaxamin, nadolol, lasix, spironolactone. he was continued on ceftriaxone given high risk of sbp though no paracentesis was performed prior to initiation of abx) . #h/o psychosis, depression: pt was continued on citalopram and risperdone. . #chronic back pain: pt was cont on home regimen of oxycontin. . # code: full medications on admission: meds on transfer: levophed gtt octreotide gtt flagyl day 1 vanco day 1 ceftriaxone day 1 albumin 50 g x1 lasix 40 mg/day protonix propranolol 10 mg daily oxycontin 20 mg risperidone 2 g citalopram 20 spironolactone 25 lactulose tid ondansetron prn . meds at home: (per discharge summary) rifaximin 400 mg tid pantoprazole 40 mg citalopram 20 mg oxycontin 20 mg nadolol 20 mg qhs furosemide 40 mg spironolactone 100 mg ibuprofen 400 mg tablet sig: 1-2 tablets po q8h prn lactulose 45 ml q4 titrate to 4 bm/day risperidone 2 mg discharge medications: 1. rifaximin 200 mg tablet sig: two (2) tablet po tid (3 times a day). 2. lactulose 10 gram/15 ml syrup sig: forty five (45) ml po tid (3 times a day). 3. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 4. nadolol 20 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 5. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 6. spironolactone 100 mg tablet sig: one (1) tablet po daily (daily). 7. risperidone 2 mg tablet sig: one (1) tablet po twice a day. 8. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 9. oxycodone 20 mg tablet sustained release 12 hr sig: one (1) tablet sustained release 12 hr po q12h (every 12 hours). 10. ciprofloxacin 250 mg tablet sig: two (2) tablet po twice a day: please take 2 tablets (500 mg) twice a day for 2 more days. then take 1 tablet (250 mg) once a day for 1 month. disp:*40 tablet(s)* refills:*0* 11. acetaminophen 325 mg tablet sig: 1-2 tablets po every six (6) hours as needed for fever or pain: please do not take more than 2 gm per day. discharge disposition: home discharge diagnosis: primary: gastrointestinal bleed, upper and lower ischemic colitis acute blood loss anemia hypovolemic shock . secondary: hepatitis c virus cirrhosis discharge condition: stable discharge instructions: you were admitted for bleeding from your gastrointestinal tract. you required several blood transfusions. upper endoscopy looking into your stomach showed no signs of bleeding. there was, however, bleeding noted in your colon. the bleeding seems to have resolved. your blood counts have been stable. . please continue to take your medications as needed. for a possible infection in your abdomen, you were started on antibiotics. please continue to the antibiotic ciprofloxacin 500 mg twice a day for 2 more days. then you need to take ciprofloxacin 250 mg once a day for at least a month to prevent return of the infection. you should follow up with dr. to see if you should continue ciprofloxacin longer than that. please avoid ibuprofen or naproxen. you may take acetaminophen (tylenol) up to 2 grams per day. . if you develop a fever, worsening abdominal pain, nausea/vomiting, blood in the stool or vomitus, lightheadedness/dizziness, or any other concerning symptoms, please call dr. at . followup instructions: please keep the following appointments: provider: clinic phone: date/time: 2:00 procedure: other endoscopy of small intestine closed [endoscopic] biopsy of large intestine flexible sigmoidoscopy diagnoses: anemia, unspecified esophageal reflux tobacco use disorder unspecified essential hypertension cirrhosis of liver without mention of alcohol chronic hepatitis c without mention of hepatic coma hyposmolality and/or hyponatremia portal hypertension dysthymic disorder other shock without mention of trauma other ascites esophageal varices in diseases classified elsewhere, without mention of bleeding other specified disorders of stomach and duodenum acute vascular insufficiency of intestine backache, unspecified unspecified psychosis 

Answer: The patient is high likely exposed to