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: melena major surgical or invasive procedure: esophagogastroduodenoscopy (egd) history of present illness: mr. is a 51yo m with history of dm and prior bleeding duodenal ulcer who presents with 3 days of melena. he has had three days of feeling fatigued, flushed, nauseated and dizzy with some mild, crampy diffuse abdominal pain. these symptoms were similar to those he felt with a bleeding duodenal ulcer about 9-10 years ago so he presented to his pcp. syncope and appetite has been normal. he does not regularly take nsaids and has also stopped taking his usual medications including metformin and lisinopril. has been taking chewable antacids and maalox. at his pcp's office, his hemoglobin was 10 from 13 in so he was sent to the er. in the er, initial vitals were 99.2, 99, 136/92, 16, 100% ra. he had guaiac positive brown stool. gi was consulted and recommended ppi drip with admission to the icu for egd. patient received 2l ns with bolus and drip ppi. vitals on transfer were 83, 144/89, 13, 99% ra. in the micu, he had a new burning, heartburn sensation that is worse when supine and not affected by food or exercise. he denies sob but endorses some doe and constant headache for the past couple days. patient typically has bowel movement daily, but has had loose movements twice daily for the past couple days. past medical history: dm type 2 hypertension insomnia duodenal peptic ulcer disease, ?endoscopic repair social history: he does not smoke or use illicit drugs. patient drinks alcoholic drinks/day family history: uncle with bleeding ulcers physical exam: admission: vitals: t: 36.3 ??????c hr: 56 bp: 111/53(67) rr: 21 spo2: 99% general: alert, oriented, no acute distress heent: nc/at, sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi 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 gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema discharge: vitals: t: 97.9f hr: 75 bp: 137/96 rr: 20 spo2: 99% ra general: alert, oriented, no acute distress heent: nc/at, sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi 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 gu: no foley ext: warm, well perfused, 2+ pulses pertinent results: hematocrit trend: 27.6 --> 24.4 (received 2 units prbcs) -->27.9 --> 26.9--> 29.0 studies: egd : medium hiatal hernia. erythema, friability and nodularity in the z-line compatible with possible ulceration or barrett's esophagus. otherwise normal egd to third part of the duodenum brief hospital course: 51-year-old man with history of bleeding duodenal ulcer admitted with melena, likely secondary to erosive esophagitis. . #melena: the patient presented to his pcp 3 days of melena. associated symptoms were fatigue, nausea and dizziness with some mild, crampy diffuse abdominal pain. the pcp noted drop in hgb from 13 to 10 and patient was sent to the ed. gi was consulted and the patient was placed on a ppi drip. he was transfused 2 units of packed red blood cells and was transferred to the icu for egd. on an egd revealed erosive esophagitis with friable tissue that was believed to be the cause of bleeding. there was no evidence for bleed or ulceration in the stomach or duodenum. hematocrit remained stable in the micu and the patient was transferred to the internal medicine floor on . melena, nausea, heart burn and abdominal pain resolved with an iv ppi and sucralfate. the patient tolerated an advancing diet without difficulty. hematocrit remained stable on the floor. patient was discharged on omeprazole 40mg po bid and sucralfate qid. he will follow up with dr. in gi in weeks for repeat egd with biopsies. . # type ii diabetes mellitus: home metformin held, and patient was placed on insulin sliding scale. blood sugars remained stable without intervention. of note, patient states that he recently stopped taking his home metformin. he was encouraged to discuss his medications with his primary care physician at his visit. . # htn: home lisinopril held in light of gi bleed. blood pressure remained stable throughout admission. of note, patient states that he recently stopped taking his home lisinopril. he was encouraged to discuss his medications with his primary care physician at his visit. medications on admission: lorazepam 0.5 mg prn prior to flight albuterol sulfate (ventolin hfa) 90 mcg 1-2 puffs q6 prn lisinopril 10 mg daily metformin 500 mg maalox prn discharge medications: 1. sucralfate 1 gram tablet sig: one (1) tablet po qid (4 times a day). disp:*120 tablet(s)* refills:*2* 2. 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* 3. ventolin hfa 90 mcg/actuation hfa aerosol inhaler sig: inhalation every six (6) hours as needed for shortness of breath or wheezing. 4. metformin 500 mg tablet sig: one (1) tablet po twice a day: . 5. lisinopril 10 mg tablet sig: one (1) tablet po once a day: . discharge disposition: home discharge diagnosis: primary diagnosis: upper gi bleed from erosive esophagitis secondary diagnoses: hypertension, type ii dm on metformin discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: mr. , you were admitted to the intensive care unit with 3 days of dark black stools, worsening heartburn, and nausea. in the intensive care unit, you underwent an upper endoscopy, where you were found to have an enflamed, bleeding esophagus at the site where your esophagus meets your stomach. you were started on a medication to prevent the backwash of acid from your stomach into your esophagus, as this is the likely source of irritation. during your stay in the intensive care unit, your blood counts dropped and you were transfused 2 units of red blood cells. since your transfusion, your blood counts have been stable. you were transferred to the internal medicine floor. gi has recommended that you follow up with them in weeks for a repeat upper endoscopy and biopsies. you should remain on omeprazole 40 mg twice daily to prevent backwash of acid from your stomach into your esophagus. we have added 2 medications to your home regimen: start omeprazole 40 mg by mouth twice a day start sucralfate one tablet 4 times a day followup instructions: follow up with dr. , your primary care physician, at 9:40am. please follow-up on wednesday at 12:30 with dr. for an upper endoscopy with biopsies on of , 3. a confirmation will be mailed to you at home. follow up with dr. on wednesday at 10:00am to review the results of your upper endoscopy biopsies. procedure: other endoscopy of small intestine diagnoses: esophageal reflux unspecified essential hypertension acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled diaphragmatic hernia without mention of obstruction or gangrene blood in stool other esophagitis 

Answer: The patient is high likely exposed to