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: history of present illness: the patient is an 80-year-old woman with cryptogenic cirrhosis, known portal hypertension, history of hepatic coma, and coronary artery disease who presented to hospital on with a 2-day to 3- day history of melena. she was found to be guaiac-positive by examination, but since she was hemodynamically stable at the time, she was discharged home from the emergency department. she had a light dinner that evening, and shortly afterwards became diaphoretic, nauseous, and had one episode of hematemesis. she was brought back to the emergency department at hospital approximately three hours after she was initially discharged. at this time, she was found to be hypotensive, diaphoretic, and with a hematocrit drop to 26. an nasogastric lavage was performed in the emergency department and did not clear with 2 liters of normal saline. an emergent esophagogastroduodenoscopy was done which showed very large 10-cm varices crossing the gastroesophageal junction. sclerotherapy was used but unable to stop the bleeding. she was intubated and then sent to . past medical history: 1. cryptogenic cirrhosis diagnosed one year ago. 2. diverticulosis. 3. coronary artery disease. 4. history of ulcerative colitis. 5. hypertension. 6. portal hypertension. 7. question of diabetes mellitus. 8. gastroesophageal reflux disease. 9. status post cholecystectomy. 10. status post hysterectomy. 11. status post appendectomy. 12. cataracts. social history: the patient is married. she lives with her husband who is very supportive. she denies any history of alcohol, tobacco, or intravenous drug use. family history: family medical history was noncontributory. allergies: no known drug allergies. medications on admission: 1. isordil 30 mg p.o. q.d. 2. nadolol 40 mg p.o. q.d. 3. asacol 800 mg p.o. t.i.d. 4. captopril 25 mg p.o. t.i.d. 5. lactulose 20 g p.o. q.i.d. physical examination on presentation: vital signs on admission revealed temperature was 98.1, blood pressure was 118/56, heart rate was 64, oxygen saturation was 100% (intubated), respiratory rate was 10 to 14. physical examination in general revealed the patient was intubated and sedated. her pupils were equal, round, and reactive. her neck was supple with no lymphadenopathy appreciated. her sclerae were anicteric. her mucous membranes were moist. her chest was clear to auscultation bilaterally. her heart had a regular rate. normal first heart sound and second heart sound. a soft early peaking systolic murmur at the left upper sternal border. no third heart sound or fourth heart sound were appreciated. her abdomen was markedly distended with normal active bowel sounds. it was soft and nontender. no fluid wave was appreciated. three well-healed surgical scars were noted. the liver and spleen could not be palpated secondary to ascites. she had no cyanosis, clubbing, or edema. her lower extremities were in pneumo boots with 2+ dorsalis pedis and posterior tibialis pulses bilaterally. on skin examination, she had no rashes, palmar erythema, or prominent spider hemangiomas. pertinent laboratory data on presentation: laboratory values on admission revealed white blood cell count was 4, hemoglobin was 10, hematocrit was 29.1, platelets were 81. pt was 15.3, ptt was 27.2, inr was 1.6. chemistry panel revealed sodium was 139, potassium was 4.4, chloride was 112, bicarbonate was 17, blood urea nitrogen was 12, creatinine was 0.5, and blood glucose was 183. calcium was 6.1, magnesium was 1.4, phosphorous was 3.4. alt was 12, ast was 18, ldh was 188, alkaline phosphatase was 52, total bilirubin was 0.7. pertinent studies during hospitalization: 1. cardiac enzymes were cycled times three with a peak creatine kinase of 385, ck/mb was 11, and troponin was less than 0.3. 2. a chest x-ray on showed an opacity in the left lower lobe with minimal left pleural effusion. 3. a right upper quadrant ultrasound on showed a heterogenous liver consistent with cirrhosis, no intrahepatic or extrahepatic ductal dilatation. positive splenomegaly. positive small amount of ascites noted in perihepatic, perisplenic, and pelvic areas. 4. esophagogastroduodenoscopy done on revealed grade iii varices starting in the lower one-third of the esophagus with a stigmata of recent bleed and oozing from multiple areas. six and six injections sclerotherapy were performed with appropriate hemostasis. clotted blood was seen throughout the whole stomach. a large adherent clot was present in the fundus which prevented complete visualization. impression: this is an 80-year-old with cryptogenic cirrhosis and portal hypertension presenting with a gastrointestinal bleed secondary to a esophageal varices. hospital course: 1. gastrointestinal: upon admission, the patient was directly transferred to the medical intensive care unit where an nasogastric lavage was performed which did not clear after 5 liters of normal saline. an emergent esophagogastroduodenoscopy was performed which showed grade iii varices which were successfully sclerosed. no other sites of bleeding were noted. the patient was then started on octreotide on which she was continued for 72 hours without complications. a right upper quadrant ultrasound was performed which showed a small amount of ascites; however, the patient was started on ciprofloxacin for spontaneous bacterial peritonitis prophylaxis in the setting of a variceal bleed. the patient's cause for cirrhosis has been evaluated extensively; and per records from hospital, she is hepatitis negative and rapid plasma reagin nonreactive. she has a history of hepatic coma one year prior to this admission, at which time her cirrhosis was initially diagnosed. fortunately, alpha- fetoprotein has been negative over the past year. in addition to octreotide, the patient was restarted on her outpatient dose of nadolol 40 mg p.o. q.d. the patient's primary gastroenterologist, dr. at hospital was contact through dr. who performed the esophagogastroduodenoscopy at . 2. hematology: the patient with a baseline hematocrit of around 34. on presentation, hematocrit was 26 at the outside hospital and 29 on admission to . she received a total of 2 units of packed red blood cells with an appropriate hematocrit bump in the intensive care unit. after transfusion and sclerotherapy, the patient's hematocrit remained stable for greater than 48 hours prior to discharge. on admission, the patient's inr was elevated to 2.5 secondary to liver disease. she was given three doses of vitamin k with inr normalizing at 1.3. she was also noted to have thrombocytopenia which was thought secondary to her splenomegaly. 3. cardiovascular: the patient with a history of hypertension and coronary artery disease. given anemia, she was at high risk for demand ischemia; and therefore she was ruled out for myocardial infarction by cardiac enzymes. on admission, she was hypotensive; and therefore blood pressure medications were held on hospital day one. as her blood pressure normalized, her ace inhibitor and beta blocker were titrated up with no complications. she was to restart her long-acting nitrate upon discharge. 4. pulmonary: on admission, the patient was intubated and sent directly to the medical intensive care unit. after an emergent esophagogastroduodenoscopy, she was weaned off the ventilator and extubated the following morning without any difficulties. her oxygen saturation remained high for the remainder of her hospital course. 5. infectious disease: the patient was afebrile with a normal to slightly elevated white blood cell count throughout her hospitalization. given her portal hypertension and small amount of ascites, there was some concern for spontaneous bacterial peritonitis, and she was started on ciprofloxacin for prophylaxis. she was discharged with instructions to complete a 7-day course of ciprofloxacin. 6. endocrine: on presentation, the patient with a questionable history of diabetes mellitus; however, she was not on any outpatient medications for this diagnosis. her fingerstick glucose throughout this admission was consistently less than 200 and most in the 100 to 150 range. she was monitored on q.i.d. fingersticks and covered on a regular insulin sliding-scale. condition at discharge: condition on discharge was stable and improved. discharge diagnoses: 1. upper gastrointestinal bleed. 2. grade iii esophageal varices; status post sclerotherapy. 3. portal hypertension. 4. cryptogenic cirrhosis. 5. hypertension. 6. gastroesophageal reflux disease. medications on discharge: 1. nadolol 40 mg p.o. q.d. 2. asacol 800 mg p.o. t.i.d. 3. isordil 30 mg p.o. q.d. 4. captopril 25 mg p.o. t.i.d. 5. lactulose 20 g p.o. q.i.d. 6. ciprofloxacin 500 mg p.o. b.i.d. (times five days; to complete a 7-day course). discharge instructions: 1. the patient was to follow up with her primary care physician (dr. ) in approximately two to four weeks. 2. the patient was to follow up with her primary gastroenterologist (dr. at hospital for follow-up esophagogastroduodenoscopy with possible variceal banding. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube endoscopic excision or destruction of lesion or tissue of esophagus diagnoses: thrombocytopenia, unspecified esophageal reflux unspecified essential hypertension cirrhosis of liver without mention of alcohol acute posthemorrhagic anemia portal hypertension esophageal varices in diseases classified elsewhere, with bleeding 

Answer: The patient is high likely exposed to