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: decadron / shellfish derived / coconut flavor attending: chief complaint: gi bleed major surgical or invasive procedure: - egd history of present illness: 56 year old male with a history of hepc cirrhosis, pancytopenia, presents w/ brbpr this am and epistaxis. one week ago, he developed fevers, chills, myalgias and a cough. two days ago, he developed some crampy left-sided abdominal pain. he had nausea and dry heaves, but no emeisis or constipation. his flu symptoms were improving. yesterday, when he was going to the bathroom, he found bloody stool in the toilet. he also has had 2 episodes of nosebleeding, including this am. he gets these episodes every few weeks. . in the ed, initial vs: 98.3 92 146/74 18 97. rectal exam with bloody mucous, not gross. no current nose bleeding. plt 33. he remained hd stable and was 90 137/68 prior to transfer. he got a fs of 68 got amp d50. he was started on protonix plus gtt, octreatide, and ceftriaxone. he was given nac vs. placebo per a research protocol and morphine per pan. he was seen by gi who deferred scoping until admitted to the icu and holding on ct scan until after egd. he did not get fluid or blood products. he had a ct scan en route. . currently, he is confortable except for some mild abdominal pain. he denies further bleeding. . ros: denies headache, vision changes, rhinorrhea, congestion, sore throat, shortness of breath, chest pain, dysuria, hematuria. past medical history: diabetes ii - most recent a1c 6.7% . hep c cirrhosis, followed by bipolar disease asthma social history: denies alcohol and tobacco use. lives with his wife and children. he is currently unemployed. denies ivdu. family history: sister with chronic pancreatitis physical exam: vs- t: 96.8 bp 156/89 hr 80 rr 18 sao2 97% ra general: pleasant gentleman in nad, conversant, comfortable. heent: dry mucous membranes. nares without visible blood or clot. anicteric sclera. eomi, perrla skin: no palmar erythema or spider angiomas noted. cardiac: rrr nl s1, s2, no murmurs appreciated lung: clear to auscultation bilaterally abdomen: soft, obese, minimal luq tenderness. normoactive bowel sounds. no rebound or guarding. no fluid wave appreciated. ext: wwp, no edema, 1+ dp pulses. neuro: no asterixis noted. alert and oriented x3 pertinent results: repeat plt 27; hct 30.9 lactate:1.1; ph:7.39 |111 |14 -------------< 125 4.0 | 23 |0.9 mg: 1.8 alt: 42 ap: 59 tbili: 1.9 ast: 57 ldh: 255 mcv 88 10.1 1.4 >-------< 29 28.8 n:63.7 l:25.4 m:8.1 e:2.1 bas:0.5 pt: 16.5 ptt: 36.6 inr: 1.5 . studies: . egd (): scar present lower third of the esophagus at site of obliterated varices. no varices noted. erythema, congestion, abnormal vascularity and mosaic appearance in the whole stomach compatible with portal hypertensive gastropathy. erosions in the stomach body and antrum. otherwise normal egd to second part of the duodenum . ct scan (): (prelim) cirrhosis, splenomegaly, varices. small hypodense liver lesions, too small to characterize, close f/u recommended. no evidence of diverticulitis. called by ed with report of: swelling around c/w vasculitis worse than prior. . mri abdomen (): no evidence of hepatoma. cirrhotic liver with evidence of portal hypertension. marked splenomegaly brief hospital course: mr. is a 56 year-old gentleman w/ hcv cirrhosis complicated by recurrent varices s/p banding and thrombocytopenia who presented with bright red blood per rectum in the setting of 2 episodes of epistaxis. due to his history of esophageal varices, he was initially admitted to the icu given concern for variceal bleed. 1. gi bleed- patient was hemodynamically stable throughout hospital course and did not require transfusion of blood products. he had upper endoscopy while in the icu which showed no evidence of variceal bleed, but showed portal hypertensive gastropathy and erosions in the stomach body and antrum. there was no definitive source of upper gi bleeding found. since his hematocrit was stable and there were no further episodes of bleeding, he was discharged with close gi follow-up. from dr. office was notified of his admission and will set up closer follow-up and discussion on whether colonoscopy would be beneficial to identify possible lower source of gi bleed such as hemorrhoids. of note, patient's last colonoscopy was in and was normal. 2. luq abdominal pain- the patient describes a vague luq abdominal pain similar to what he has experienced on and off in the past. given a negative egd, this most likely represents recurrent discomfort secondary to splenomegaly or perhaps due to vasculitis as evidenced by swelling on ct-he will plan to follow this up in outpatient clinic. medications on admission: albuterol 90 mcg 1 neb inhaled via nebulizaiton once a day as needed for asthma fluticasone 50 mcg in each nostril twice a day as needed for allergies fluticasone-salmeterol 250 mcg-50 mcg/dose 1 puff po twice daily furosemide 40 mg by mouth once a day as needed for swelling insulin glargine 50 u twice a day am and pm insulin lispro 25 in am, 20 at lunch, and 20 at supper lactulose 30 cc by mouth daily lisinopril 20 mg by mouth daily lithium carbonate 600 mg by mouth twice a day omeprazole 20 mg by mouth twice a day (not taking) oxycodone-acetaminophen 5 mg-325 mg by mouth twice a day quetiapine 1200 mg by mouth q hs (dose confirmed) discharge medications: 1. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 1-2 puffs inhalation every 4-6 hours as needed for shortness of breath or wheezing. 2. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 3. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po once a day as needed for constipation. 4. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po bid (2 times a day). 5. insulin glargine 100 unit/ml solution sig: five (5) units subcutaneous twice a day: take 50u in the morning and 50 u in the evening . 6. humalog 100 unit/ml solution sig: twenty five (25) units subcutaneous w/ meals: take 25 units in the morning, 20 units w lunch and 20 with dinner. 7. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. 8. quetiapine 200 mg tablet sig: six (6) tablet po hs (at bedtime). 9. lisinopril 20 mg tablet sig: one (1) tablet po once a day. 10. lasix 40 mg tablet sig: one (1) tablet po once a day. 11. fluticasone 50 mcg/actuation spray, suspension sig: one (1) spray nasal twice a day as needed for allergy symptoms: in each nostril twice a day as needed for allergies . 12. lithium carbonate 600 mg capsule sig: one (1) capsule po once a day. discharge disposition: home discharge diagnosis: primary: gi bleed secondary: hcv cirrhosis, esophageal varices discharge condition: mental status:clear and coherent level of consciousness:alert and interactive activity status:ambulatory - independent discharge instructions: it was a pleasure being involved in your care, mr. . you were admitted to the intensive care unit with bright red bloody bowel movements. due to concern for variceal bleed, you underwent endoscopy which showed no active bleeding. you were discharged in stable condition with outpatient follow-up. your medications have not changed. please continue to take your current medications as indicated. please call your physician 911 if you experience crushing chest pain, intractable nausea or vomiting, difficulty breathing, fevers/chills, large amounts of blood in your urine vomit or stool or any other concerning medical problem. followup instructions: ** please call at dr. office to schedule an earlier follow-up appointment!! 1. , : date/time: 9:00 2. gi (st-3) gi rooms date/time: 8:30 3. , md phone: date/time: 8:30 please make an appointment to see your primary care doctor, md at your earliest convenience for a post-hospitalization follow-up. call to set up an appointment with him. procedure: other endoscopy of small intestine diagnoses: cirrhosis of liver without mention of alcohol diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified viral hepatitis c without hepatic coma asthma, unspecified type, unspecified hemorrhage of gastrointestinal tract, unspecified other specified disorders of stomach and duodenum bipolar disorder, unspecified epistaxis esophageal varices without mention of bleeding abdominal pain, left upper quadrant 

Answer: The patient is high likely exposed to