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: upper gastrointestinal bleed transfered from osh major surgical or invasive procedure: endoscopy history of present illness: this is a 52 f w/ h/o es liver dz from etoh cirrhosis, known esophageal varices found to have melanotic stools when presented to hospital today for l hip pain. incidentally described melanotic stools x 3 weeks. found to have inr 2.9, hct 26, plts 28. transfused 2 u prbc and transferred to er. . vitals on arrival to the er: 96.4, 94, 124/70, 14, 98% on 2l. 3 18g ivs. liver aware. vomited x 1 in ed, non-bloody. received vit k, octreotide. is ordered for plts, ffp. hd stable w/ sbp in 140s. not tachycardic but on a beta-blocker. melanotic stool in the rectal vault on exam. . on arrival to the floor, complained of feeling thirsty and tired. she thinks that she had a fever yesterday. + chronic cough but no sputum production. no dysuria. occasional sob. + left hip pain, worse on ambulation. she believes that while she usually has light stools, she has been having darker stools x 1 week but no bm x 1 day. no h/o gi bleed. fairly good appetite. no uri symptoms or dysuria. no chest pain. feels light-headed after getting morphine. nauseated after receiving morphine. past medical history: pmh: l hip avascular necrosis etoh cirrhosis w/ grade 3 varices and portal hypertension and encephalopathy alcoholism depression asthma hemorroids . psurgh: r breast lumpectomy for breast cancer (no radiation tx or chemo) social history: social history: remote h/o cocaine and current etoh abuse. + 3 pegs of vodka several times per week. lives in her own home and rents rooms to support herself. family history: nc physical exam: vitals: t: 96.5 p: 76 bp: 131/70 r: 10 sao2: 96% on 2l general: sleepy, but arrousable and able to answer questions although with slowed speech and delayed answers, cachectic heent: nc/at, perrl, eomi w/ a few beats of horiz nystagmus, + scleral icterus noted, dry mmm, no lesions noted in op, poor dentition neck: supple, jvd 9 cm pulmonary: lungs cta bilaterally cardiac: rrr, nl. s1s2, no m/r/g noted abdomen: soft, + hepatomegaly approx 4 cm below costal margin, no splenomegaly, nabs no fluid wave extremities: no c/c/e bilaterally, 2+ radial, dp and pt pulses b/l, no asterixis skin: erythematous macular rash on chest, larger blanching papules on upper back, + jaundice neurologic: -mental status: alert, oriented. able to relate history without difficulty although slow to respond. pertinent results: complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 04:55am 5.3 3.36* 11.8* 34.2* 102* 35.2* 34.6 18.0* 99* 04:56am 6.2 3.09* 11.0* 31.1* 100* 35.5* 35.4* 17.3* 88* 11:15pm 7.5 3.45* 12.1 33.6* 98 35.1* 36.0* 17.4* 38* . renal & glucose glucose urean creat na k cl hco3 04:55am 122* 9 0.5 132* 4.3 98 25 04:56am 131* 15 0.6 133 3.7 93* 26 11:15pm 124* 14 0.6 130* 3.0* 92* 24 . enzymes & bilirubin alt ast ld(ldh) alkphos totbili 04:55am 69* 122* 325* 149* 18.3* 06:10am 69* 152* 306* 152* 15.6* 04:56am 96* 290* 325* 169* 13.9* 11:15pm 114* 358* 203* 11.9* . egd :varices at the lower third of the esophagus and middle third of the esophagus. erythema, congestion and mosaic appearance in the antrum, stomach body and fundus compatible with portal hypertensive gastropathy . brief hospital course: 52 yo f with alcholic cirrhosis admitted with lower gi bleed. . 1. abdominal pain: developed while on steroids, however may be related to abdominal distention or bloating. high likelyhood of sbp given alcoholic cirrhosis and high discriminate factor but per ultrasound small ascites, hence no paracentesis. pt afebrile, less pain, stable abdominal bloating which patient associates with starting predisone therapy. patient received no additional benefit from lactulose 60ml tid; therefore, maintained on 30 ml tid. patient tolerated increased in furosemide to 40mg daily, home regimen 20mg 3x weekly. . 2. alcoholic hepatitis/cirrhosis: with associated complications including coagulopathy, encephalopathy. encephalopathy improved during stay, however total bilirubin was increasing after hematocrit had stabilized. prednisone 40mg started due to high discriminate factor. acute improvement of t.bili after initiation of steroids. continued patient on lactulose, nadolol and started ursodiol. continued furosemide & spironolactone daily. encouraged adequate nutrition with calorie counts x 3 days ~ 2000kcal daily. at time of discharge t. bili 10.1. -- patient discharged ama on prednisone taper starting -- to follow-up with dr. . . 3. gi bleed: in the setting of alcoholic hepatitis/cirrhosis. transferred from with melanic stools, underwent egd which showed grade i cords but no bleeding, also gastritis. transitioned from iv pantoprazole to oral daily dosing. hematocrit levels have remained stable ~ 30. continued nadolol. . 4. anemia: baseline 37 in but 27 in . likely a mixture from cirrhosis and blood-loss. b12 high, folate normal. patient did not require a packed red blood cell transfusion. edg did not show active bleeding. . 5. thrombocytopenia: most likely related to liver disease & splenic sequestration. required a bag of platelets and unit of fresh frozen plasma on admission . afterward patient stabilized. . 6. hyponatremia: most likely r/t liver disease, stable. pt mildly encephalopathic on admission, however improved daily with lactulose. no severe mental status changes. . 7. alcoholism: poor liver candidate due to continued alcoholism. on admission received one banana bag and placed on ciwa scale. required several doses of benzodiazepines initially, but no doses needed after 48 hours. patient last drink over one week prior to discontinuation of ciwa scale on . did not require any ativan after transfer from . continued on thiamine, folate, mvi. social work consulted to assist with addiction and therapy for alcohol abuse. patient not interested in any assistance with her addiction and would routinely deny that she had been drinking prior to admission. . 8. hypertension: well controlled on nadolol daily for esophageal prophylaxis . 9. left hip pain: left hip & back pain chronic, has seen orthopedics at and they have recommended a left hip replacement when the pain becomes severe. patient was told pain due to avascular necrosis by her primary care physician not by orthopedics. pain controlled with oxycodone as needed and neurontin. . 10. left leg swelling: complained of leg swelling lle leni negative for clot. suspect component of fluid retention due to prednisone. patient to follow-up with dr. on . . 11. breast cancer: s/p lumpectomy, no chemo/rads per pt, pt to f/u with oncologist at . had lumpectomy , recent mammogram showed densities that requires surgical biopsy. pt to reschedule surgery. oncologist at dr. . . 12. breast cancer: s/p lumpectomy, no chemo/rads per patient. recent mammogram showed densities that requires surgical biopsy. patient to schedule surgery. oncologist at is dr. . . 13. fen: patient fluid resusitated on admission, and electrolytes were aggressively repleted. . 14. communication: with the patient's brother (. she plans to stay with her brother on discharge on the mainland so that she can return to for her appointment with dr. . . 15. disposition: the patient left against medical advice. she was told that her alcoholic cirrhosis was severe and that her condition could become critical at any moment. it was felt that it was essential that she remain in the hospital for further care and monitoring. the patient declined and stated she wanted to return home. she was informed of the risk of leaving including death. she signed out against medical advice. she agreed to return for close outpatient follow-up with dr. on , . medications on admission: spironolactone 25 mg nadolol 20 mg thiamine 100 mg folate 1 mg daily lasix 20 mg 3x per week neurontin 100 mg po bid mvi calcium lactulose discharge medications: 1. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po tid w/ meals (). disp:*90 tablet, chewable(s)* refills:*2* 2. gabapentin 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 3. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 4. nadolol 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. spironolactone 25 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po tid (3 times a day). disp:*2700 ml(s)* refills:*2* 8. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 9. ursodiol 300 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 10. oxycodone 5 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. disp:*30 tablet(s)* refills:*0* 11. prednisone 10 mg tablet sig: 1-4 tablets po once a day for 17 days: please take 40mg (4 tablets) 10/23,, , than decrease your dose to 30 mg (3 tablets) for 7 days - then decrease your dose to 20 mg ( 2 tablet) for 7 days - , then decrease your dose to 10 mg (1 tablet) for another 7 days . disp:*57 tablet(s)* refills:*0* 12. thiamine hcl 100 mg tablet sig: one (1) tablet po once a day. 13. folic acid 1 mg tablet sig: one (1) tablet po once a day. discharge disposition: home discharge diagnosis: primary: alcoholism with alcohol withdrawl alcoholic hepatitis alcoholic encephalopathy acute on chronic liver failure hypertension secondary depression left hip pain hemorrhoids discharge condition: stable, afebrile, pain under control discharge instructions: ms. you were admitted due to a concern for a bleed from your stomach/esophagus. you were given blood and underwent an upper endoscopy which showed no evidence of bleeding. you were started on protonix to help prevent future episodes of gi bleeding. . while in the hospital you were treated for alcohol withdrawal and alcoholic hepatitis. the hepatitis was treated with steroids with improvement in your liver function. you liver remains very sick. it is recommended that you continue to stay in the hospital for further treatment. . you have signed out against medical advice and you will need to follow-up with liver clinic at for continued care. it is recommended strongly that you never drink again. . if you develop any fever, chills, nausea, vomiting, bloody stool or vomit, or other concerning symptom please call 911, go to the local emergency room or call your liver doctor. . medicine reconsiliation spironolactone 25 mg daily - continue nadolol 20 mg daily - continue thiamine 100 mg - continue folate 1 mg daily - continue lasix - increased to 40 mg daily neurontin 100 mg po bid - continue mvi - continue calcium - continue lactulose - continue at 30 mg three times day . new medications pantoprazole 40 mg daily - for your stomach urosdiol 300 mg twice a day - because of your liver disease oxycodone 5 mg every 6 hours as needed for pain vitamin d3 800 mg daily - because of your liver disease prednisone taper -for your liver 40 mg daily 30 mg daily 20 mg daily 10 mg daily followup instructions: please follow up with dr. on . you will be called with an appointment time. provider: , . . please follow-up with dr. at for further work-up of new densities seen on mammography. please call to make this appointment. md procedure: other endoscopy of small intestine diagnoses: thrombocytopenia, unspecified unspecified essential hypertension alcoholic cirrhosis of liver hyposmolality and/or hyponatremia asthma, unspecified type, unspecified personal history of malignant neoplasm of breast depressive disorder, not elsewhere classified pain in joint, pelvic region and thigh other and unspecified alcohol dependence, continuous acute alcoholic hepatitis alcohol withdrawal other specified gastritis, with hemorrhage 

Answer: The patient is high likely exposed to