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: penicillins / adhesive tape attending: chief complaint: melena major surgical or invasive procedure: right internal jugular triple lumen catheter endoscopy colonoscopy capsule endoscopy blood transfusion x3 history of present illness: 55 year-old male with hepatitis c cirrhosis s/p liver with recurrent hepatitis c complicated by ascites/ encephalopathy/ varices/ chronic portal and splenic venous thrombosis. with melena. seen in dr. office today, found to have bp 90/50. reports dark stools x3 days, with frank blood mixed with stool at 3:00am morning preceding admission. of note, egd () showed 3 cords grade i varices, portal gastropathy. in the ed, 98.6 66 102/58 16 99%ra. noted to have dark brown stool mixed with bloody mucous. ng lavage not performed. laboratory data significant for hematocrit 25.9 (baseline 31) with tbili 1.7, alk phos 258. written for 2 units prbcs, has not received yet. hemodynamically stable. notified, but have not seen the patient. received protonix, ceftriaxione, octreotide. on transfer to micu, 68, 102/57, 18, 100% 2l. on the floor, reports feeling well. denies fever, chills, lightheadedness. reports nonproductive cough, longstanding. denies chest pain, shortness of breath, palpitations. reports occasional cramping in lower abdomen. denies nausea, vomiting, dysuria, hematuria, bruising. past medical history: past medical history: -itp -svt last episode approximately , medically managed at this time -hepatitis c -esld s/p liver tx , s/p revision ; complicated with rejection and steroid use since to present; also complicated with hepatitis c recurrence and restarted peg interferon . hep c possibly contracted from tatoo . -thoracic compression fractures: -cognitive disorders: h/o post hypoxic encephalopathy . -depression /anxiety -neutropenia and infections including c. diff x3, streptococcal septicemia, anal fistula -history of fistula in anus s/p fistulectomy -chronic pain especially rectal pain -diabetes : steroid induced, managed at clinic, recent hba1c 5.1 % (had received blood transfusions with splenectomy ), insulin requirements decreased -s/p appy -s/p tonsillectomy -bilateral inguinal hernia -s/p hernia repair which has failed -s/p umbilical hernia repair and right inguinal hernia repair -s/p ccy -left sided hydronephrosis due to obstruction from splenomegaly, s/p left ureteral stent placement . -secondary hyperparathyroidism due to ckd managed by dr. at . -splenectomy, distal pancreatectomy, c/w fistula, s/p spent and then removal social history: lives with mother in and they both help with ther health issues. he has a sister that lives in that is very involved in his care. patient sates he smoked in highschool socially (only in parties), but quit since then. he denies any current or past alcohol intake. he also denies at thit time any illegal substance use, however, he also is denying any past illegal substance use. family history: mother has dm2 and htn. uncle with cancer in his 80s (unknown site). denies any family history of mi, sudden cardiac death, stroke and lung diseases has dm2 physical exam: 98.2, 72, 113/55, 17, 95% ra general: alert, oriented, comfortable heent: sclera anicteric, dry mucous membranes neck: jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, ii/vi early systolic murmur lusb abdomen: normoactive bowel sounds, prior incision scars noted, soft, non-tender gu: no foley rectal: per ed, guaiac positive brown stool ext: thin; warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: no asterixis pertinent results: admission labs: 01:48pm wbc-6.8 rbc-2.36* hgb-8.5* hct-25.9* mcv-110* plt ct-166 01:48pm neuts-52 bands-0 lymphs-33 monos-11 eos-4 baso-0 atyps-0 metas-0 myelos-0 01:48pm hypochr-1+ anisocy-normal poiklo-1+ macrocy-3+ microcy-normal polychr-normal ovalocy-1+ target-2+ schisto-occasional burr-occasional acantho-1+ 01:48pm pt-13.8* ptt-33.9 inr(pt)-1.2* 01:48pm glucose-97 urean-31 cr-1.0 na-138 k-4.9 cl-110* hco3-20* 01:48pm alt-39 ast-64* alkphos-258* totbili-1.7* 01:48pm lipase-157* 01:48pm albumin-3.0* 04:04pm lactate-0.9 urine: 03:50pm color-yellow appear-clear sp -1.016 03:50pm blood-neg nitrite-neg protein-25 glucose-neg ketone-neg bilirub-neg urobiln-neg ph-5.0 leuks-neg 03:50pm rbc-0 wbc-0 bacteri-rare yeast-none epi-0-2 03:50pm sulf x-mod micro: bcx: ngtd studies: ekg: normal sinus rhythm. tracing is within normal limits. compared to the previous tracing of no diagnostic interval change. egd: - varices at the lower third of the esophagus and gastroesophageal junction erythema, congestion, abnormal vascularity and mosaic appearance in the stomach compatible with portal hypertensive gastropathy - polyp in the proximal body (injection) - beyond pylorus, 8 mm non bleeding polyp adjacent to hepatico-jejunostomy. - otherwise normal egd to second part of the duodenum recommendations: grade i esophageal varix. no stigmata of bleeding. no gastric varices noted. bleeding polyp noted in proximal body of stomach injected with epi with hemostasis. polyp adjacent to hepatico-jejonostomy which needs biopsy as outpatient. potential source of bleeding from gastric polyp. continue iv ppi. continue abx. dc octreotide gtt. trend hct. cxr: right ij catheter tip extends to the lower portion of the svc. no evidence of pneumothorax. the far left portion of the chest has been eliminated from the image, but there is no evidence of acute cardiopulmonary disease. colonoscopy: - normal mucosa in the colon - old blood mixed with bowel prep throughout the colon. - area of ? flat lesion noted in the transverse colon. - otherwise normal colonoscopy to cecum recommendations: please keep pt on clears and proceed with capsule endoscopy capsule endoscopy: several nonbleeding ulcers in the small bowel. the differential diagnosis includes asa/nsaid induced damage, ibd, ulcerative jejunoileitis or infectious etiologies (possibly viral in nature) discharge labs: hct 29.2 brief hospital course: mr. is a 55m with hepatitis c cirrhosis s/p liver with recurrent hepatitis c cirrhosis complicated by ascites/encephalopathy who was admitted with gib/melena. #. lgib: initial immediate concern was for ugib, particularly variceal bleeding or portal gastropathy in this patient with decompensated liver disease. differential also included gastritis and lgi sources, including hemorrhoids, diverticulosis, avm. the patient immediately received 2u prbcs post transfusion hct decreased from 25.9 in the ed to 25.8. protonix gtt, octreotide gtt and ceftriaxone daily were started. egd was performed upon arrival to the icu which showed non-bleeding esphageal and gastric varices as well as an oozing gastric polyp which was injected with epinephrine- nothing to suggest the cause of patients relatively decrease in hematocrit. colonoscopy was performed on hd2 which again did not show any obvious cause of bleeding. dark old blood was noted to be transiting through the colon. hct trended down gently on hd2 and another 1u prbc transfusion was given. the patient underwent capsule endoscopy on hd2 which showed several small ulcers in the small bowel. #. hepatitis c cirrhosis s/p liver : tbili slightly elevated from baseline although ast, alt, alk phos improved from baseline. patient was not clinically encephalopathic while in the icu. surgery was consulted and aware of patient. tacrolimus 0.5mg po bid, lamivudine 100mg po daily (donor was hbcab positive) and ursodiol 300mg po bid were continued. #. duodenal polyp- a non-bleeding duodenal polyp was seen on egd that should be biopsied as an outpatient at a later date. medications on admission: alendronate - 70 mg tablet - 1 tablet(s) by mouth weekly take 30 minutes before other meds or food. take w/ 8 oz water & remain upright for 30 min. after dose. atenolol - 25 mg tablet - 1 tablet(s) by mouth once a day clindamycin hcl - 300 mg capsule - 2 capsule(s) by mouth x 1 1 hour before dental work or cleanings. ergocalciferol (vitamin d2) - 50,000 unit capsule - 1 capsule(s) by mouth weekly lamivudine - 100 mg tablet - 1 tablet(s) by mouth once a day latanoprost - 0.005 % drops - 1 drops(s) in each eye hs (at bedtime) both eyes lipase-protease-amylase - 20,000 unit-,500 unit-,000 unit capsule, delayed release(e.c.) - 2 capsule(s) by mouth three times a day with meals omeprazole - 20 mg capsule, delayed release(e.c.) - 2 capsule(s) by mouth twice a day sertraline - 50 mg tablet - 1 tablet(s) by mouth once a day sulfamethoxazole-trimethoprim - 800 mg-160 mg tablet - 1 tablet(s) by mouth three times a day tacrolimus - 0.5 mg capsule - 1 capsule(s) by mouth twice a day testosterone - 50 mg/5 gram (1 %) gel in packet - apply one packet per day daily (patient should get 5 gram per day) - no substitution trazodone - 100 mg tablet - 1 tablet(s) by mouth hs (at bedtime) as needed for insomnia ursodiol - 300 mg capsule - 1 capsule(s) by mouth twice a day acetaminophen - 325 mg tablet - 2 tablet(s) by mouth three times daily calcium citrate-vitamin d3 - 315 mg-200 unit tablet - 1 tablet(s) by mouth twice a day simethicone - 80 mg tablet, chewable - 40 mg by mouth three times a day zinc oxide - 16 % paste - apply topically three times daily as needed discharge medications: 1. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime). 2. sertraline 50 mg tablet sig: one (1) tablet po daily (daily). 3. tacrolimus 0.5 mg capsule sig: one (1) capsule po q12h (every 12 hours). 4. trazodone 100 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. 5. lamivudine 100 mg tablet sig: one (1) tablet po daily (daily). 6. menthol-cetylpyridinium 3 mg lozenge sig: one (1) lozenge mucous membrane prn (as needed) as needed for cough. 7. sulfamethoxazole-trimethoprim 800-160 mg tablet sig: one (1) tablet po tid (3 times a day). 8. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po tid (3 times a day): titrate to 3 bowel movements per day. 9. rifaximin 200 mg tablet sig: two (2) tablet po tid (3 times a day). *** of note, patient on neomycin at home due to lack of insurance coverage of rifaximin 10. lipase-protease-amylase 16,000-48,000 -48,000 unit capsule, delayed release(e.c.) sig: two (2) cap po tid w/meals (3 times a day with meals). 11. cefpodoxime 200 mg tablet sig: one (1) tablet po twice a day for 2 doses. disp:*2 tablet(s)* refills:*0* 12. calcium citrate + 315-200 mg-unit tablet sig: one (1) tablet po twice a day. 13. vitamin d 50,000 unit capsule sig: one (1) capsule po 1x/week (). 14. acetaminophen 325 mg tablet sig: two (2) tablet po three times a day as needed for pain. 15. androgel 1 %(50 mg/5 gram) gel in packet sig: one (1) packet transdermal once a day. 16. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po bid (2 times a day). disp:*60 capsule, delayed release(e.c.)(s)* refills:*2* 17. ursodiol 300 mg capsule sig: one (1) capsule po bid (2 times a day). 18. simethicone 80 mg tablet, chewable sig: 0.5-1 tablet, chewable po tid (3 times a day). 19. atenolol 25 mg tablet sig: one (1) tablet po once a day. discharge disposition: home with service facility: homecare discharge diagnosis: lower gastrointestinal bleed acute blood loss anemia compenstated end-stage liver disease chronic pancreatitis discharge condition: hemodynamically stable with brown stools, ambulating the unit independently. alert, oriented x3. eating a regualr diet. discharge instructions: you were admitted with bleeding from your gastrointestinal tract. the bleeding has stopped and you required 3 blood transfusions during your stay. you underwent an endoscopy and a colonoscopy that did not show a clear source for your bleeding so a capsule study was performed prior to your discharge which you will need follow up for as an outpatient. also, a polyp just past your stomach was found on the endoscopy that needs to be biopsied as an outpatient. please resume a regular diet and all of your home medications. please follow up with dr. as scheduled. please call the liver clinic if you develop any further signs of bleeding in your stool, feel lightheaded, have chest pain, or any other new concerns. followup instructions: you have the following appointments scheduled: provider: , md phone: date/time: 10:00 provider: clinic phone: date/time: 8:40 provider: clinic (sb) phone: date/time: 1:00 procedure: venous catheterization, not elsewhere classified other endoscopy of small intestine colonoscopy endoscopic control of gastric or duodenal bleeding diagnoses: other iatrogenic hypotension adrenal cortical steroids causing adverse effects in therapeutic use cirrhosis of liver without mention of alcohol acute posthemorrhagic anemia unspecified viral hepatitis c without hepatic coma hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified chronic kidney disease, unspecified dysthymic disorder other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other specified cardiac dysrhythmias osteoporosis, unspecified other sequelae of chronic liver disease secondary hyperparathyroidism (of renal origin) hemorrhage of gastrointestinal tract, unspecified complications of transplanted liver esophageal varices in diseases classified elsewhere, without mention of bleeding surgical operation with transplant of whole organ causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation other specified disorders of stomach and duodenum accidents occurring in residential institution chronic pancreatitis immune thrombocytopenic purpura other specified disorders of intestine benign neoplasm of stomach benign neoplasm of duodenum, jejunum, and ileum secondary diabetes mellitus without mention of complication, not stated as uncontrolled, or unspecified 

Answer: The patient is high likely exposed to