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: fatigue/dyspnea major surgical or invasive procedure: esophagogastroduodenoscopy history of present illness: 76 y/o male w/ pmh copd, emphesema, nonerosive gastric reflux disease, diverticulosis & adenoma s/p polypectomy in presents with four days of dyspnea, fatigue, and melanotic stools. patient denies prior history of gi bleed. he has no abdominal pain, denies use of nsaids other than 81mg asa. of note, he had a recent foot surgery on , for which he took four "pain pills" on (unsure what kind, but doesn't believe it had ibuprofen/ asa product), and none after that time. on ros does note dull chest pressure w/ minimal exertion x 2 days, though not able to decide if it is similar to his heartburn. in the ed, admission vitals were: t 97 hr 108 bp 145/59 rr 17 po2 100%. he was noted to have black guaiac positive stool on rectal exam. ng lavage initially was clear, then noted to have a pink frothy color. ng lavage was then stopped, but upon speaking with gi, they requested a liter of fluid be lavaged. the ed resident then lavaged an additional 300cc of fluid, which was clear. ng has now been placed to intermittent suction. the patient had a ekg which was reportedly nsr at 96. cxr was normal. patient was given protonix 80mg iv x 1. also received 500cc normal saline, not transfused any blood. 2 18-gauge piv's were placed. he remained hemodynamically stable the entire time he was in the ed with systolic blood pressures ranging 130's to 150's. vital signs on transfer to the icu were: 97.3, 130/52, 94, 19, 98ra. past medical history: 1. emphysema with pleural plaques. 2. chronic obstructive pulmonary disease with some reversibility, as well as an indication of restrictive physiology. 3. lung nodules. 4. exertional dyspnea. 5. hypertension. 6. dyslipidemia. 7. nerd or nonerosive gastric reflux disease. 8. dysuria from benign prostatic hypertrophy. 9. history of asbestos exposure 10. hyperlipidemia 11. diverticulosis 12. sigmoid adenoma s/p polypectomy social history: the patient is a widower with 6 children and some grandchildren all whom live in the area. retired fireman. he had drunk moderately heavy in the past but quit drinking when he quit smoking 3 years ago (previously smoked 1 ppd x 50yrs). family history: father died at 40 from an mi. mother died at 76 from a pe after hip arthroplasty. sister is alive with a valve replacement and rectal cancer. brother died of a brain tumor in his 40s or 50s. physical exam: on admission: general: alert, oriented, no acute distress heent: sclera anicteric, mm dry, oropharynx clear 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: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema. l fifth toe w/ screw, lateral skin with blackened area around stitches. rectal: black guaiac positive stool in the vault, no hemorrhoids appreciated on discharge: vs: t96.7 bp134/67 hr 87 rr 20 100%ra. well appearing male, normal exam. no longer showing signs of dehydration. pertinent results: on admission: wbc-15.5*# hgb-8.0*# hct-24.4*# plt ct-546* neuts-71.2* lymphs-19.9 monos-6.2 eos-1.6 baso-1.1 pt-14.0* ptt-27.2 inr(pt)-1.2* fibrino-336 glucose-120* urean-30* creat-1.1 na-132* k-3.9 cl-102 hco3-22 angap-12 freeca-1.05* micro: hpylori ab positive on discharge: hct-29.5* glucose-98 urean-22* creat-1.2 na-137 k-3.7 cl-106 hco3-24 angap-11 imaging: portable cxr: no acute intrathoracic process. emphysema, calcified pleural plaque. second image demonstrates placement of an ng tube, though distal tip is not included in the imaged field. egd: hiatal hernia noted with small erosions at the site. no active bleeding visualized. erythema and erosion in the whole stomach compatible with erosive gastritis angioectasia in the duodenum (thermal therapy) otherwise normal egd to third part of the duodenum brief hospital course: 76 year-old man presented upper gib and significant blood loss. he was hemodynamically stable through his stay. however given the seemingly acute nature of his low hct he was transfused 3 units of prbcs. hct rose appropriately to 3 units and remained stable. egd demonstrated hiatal hernia with a small erosion making erosive gastritis the most likley source of bleeding. avms were also noted in the duodenum and potentially more distally. outpatient capsule endoscopy was recommended. he was started on treatment for positive hpylori antibody. he was monitored overnight with stable hematocrit. he was discharged the following day. incidentally he had atypical chest pain during his hosptialization and was ruled out of mi with two sets of negative cardiac markers. code status was discussed during this hospitalization. patient acknowledged that he did not want resucitation, but would be ok to intubate in setting of airway protection or if could preserve functional status, but would not want to be on a ventilator for a long period of time. his hcp is his son . medications on admission: fluticasone - 50 mcg spray 2 squirts daily fluticasone - 110 mcg/actuation aerosol - 2 puffs ipratropium-albuterol - 18 mcg-103 mcg (90 mcg)/actuation aerosol - 2 puffs qid lansoprazole - 30 mg daily lisinopril - 5 mg daily simvastatin - 40 mg daily tamsulosin - 0.4 mg q5pm aspirin - (otc) - 81 mg daily docusate sodium discharge medications: 1. fluticasone 50 mcg/actuation spray, suspension sig: two (2) spray nasal daily (daily). 2. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 3. gabapentin 300 mg capsule sig: one (1) capsule po once a day: then 200mg in the afternoon and bedtime. total of 700mg daily. 4. ipratropium-albuterol 18-103 mcg/actuation aerosol sig: puffs inhalation q6h (every 6 hours). 5. lisinopril 2.5 mg tablet sig: one (1) tablet po once a day. 6. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. disp:*60 capsule, delayed release(e.c.)(s)* refills:*2* 7. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po daily at 5pm. 8. amoxicillin 250 mg capsule sig: two (2) capsule po q8h (every 8 hours) for 13 days. disp:*78 capsule(s)* refills:*0* 9. clarithromycin 250 mg tablet sig: two (2) tablet po bid (2 times a day) for 13 days. disp:*52 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary diagnoses: - upper gastrointestinal bleeding - erosive gastritis - arteriovenous malformations in duodenum - hiatal hernia secondary diagnoses: - chronic obstructive pulmonary disease - hypertension. - dyslipidemia. discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: mr. it was a pleasure to care for you during your hospitalization. you were admitted for large amounts of bleeding from your stomach. you had an endoscopy which showed significant gastritis which is likely the cause of your bleeding. you were started on an acid suppressing medication and your symptoms improved. you should continue on this medication day as prescribed to allow healing of the stomach. it is likely that the reason for the gastritis is an infection caused by helicobacter pylori. you were started on an antibiotic regimen to treat this infection. please complete the treatment regimen as prescribed. do not take simvastatin for two weeks until the antibiotic course is complete due to drug interaction (risk of muscle breakdown). please make sure you set up an appointment this week to have the screw removed from your foot. medications changed during this hospitalization: start omeprazole for gastritis start clarythromycin for h.pylori infection start amoxicillin for h.pylori infection stop simvastatin until treatment for h.pylori is complete stop aspirin until your doctor advises you to restart. followup instructions: please call on monday (phone ) and set up an appointment with an available provider to have your blood count check. please call to set up an appointment with your podiatrist this week. division: gastroenterology provider: , m.d. date: 3:00pm location: , phone: department: radiology when: wednesday at 10:45 am with: cat scan building: campus: east best parking: garage department: pulmonary function lab when: tuesday at 7:30 am with: pulmonary function lab building: campus: east best parking: garage procedure: endoscopic excision or destruction of lesion of duodenum diagnoses: esophageal reflux acute posthemorrhagic anemia hyposmolality and/or hyponatremia other emphysema other chest pain angiodysplasia of stomach and duodenum without mention of hemorrhage helicobacter pylori [h. pylori] other specified gastritis, with hemorrhage 

Answer: The patient is high likely exposed to