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: patient recorded as having no known allergies to drugs attending: chief complaint: hematemesis major surgical or invasive procedure: none history of present illness: 52 yo m with a history of alcohol abuse, s/p l sided nephrectomy who presented on complaining of 4 days of hematemesis and anuria. patient began having nausea and vomiting one week ago. four days ago patient has been having red emesis, blood clots and bloody tissue in his emesis. patient has had epigastric pain relieved by vomiting. also patient mentions that he has been anuric x4 days, and hasn't had a bm in one week. he has been trying to eat, but would vomit even when drinking water. as a result he hasn't eaten at all for the last 4 days. of note he has not had aspirin or ibuprofen. has been drinking 2 40oz bottles of beer per day. in the ed, initial vs: t 97 hr 92 bp 119/58 rr 16 o2 99% on ra. patient was tender in the epigastrium. patient was guaiac positive. ng lavage yielded 0.6l dark brown fluid with coffee grounds. a foley catheter was placed, and patient was given 2l iv fluids. while in the ed, systolic bps were 80s-90s. on transfer, vitals were bp 95/55, hr 80 94% on ra. ros: denies fever, chills, night sweats, headache, vision changes, rhinorrhea, congestion, sore throat, cough, shortness of breath, chest pain, diarrhea, constipation, brbpr, melena, hematochezia, dysuria, hematuria. past medical history: left-sided nephrectomy from a hemangioma hypertension tobacco abuse chronic lower back and lower extremity pain from a traumatic fall in rheumatic fever as a child depression social history: home: the patient lives alone in in an apartment complex. tobacco: one pack per day x 40 years. etoh - two 40 oz beers per day. drugs: intermittent marijuana use (1 joint per month). denies any other iv, illicit, or herbal drug use. sex: not currently sexually active, was hiv negative in . family history: notable for diabetes and hypertension. physical exam: vitals - t: bp: 102/58 hr: 88 rr:16 02 sat: 97% on ra general: nad heent: ncat. perrl. oropharynx clear, no plaques or exudates. neck supple. no lad. cardiac: rrr. no murmurs. lung: ctab. no wheezes or crackles. abdomen: soft, mild tenderness to palpation over epigastrium. non distended. no fluid wave. no rebound or guarding. ext: wwp. no le edema. neuro: a+o x3. grossly non focal. derm: no rashes. pertinent results: admission labs: 10:00am blood wbc-12.8*# rbc-5.00 hgb-14.4 hct-40.0 mcv-80*# mch-28.8 mchc-35.9* rdw-14.4 plt ct-180 10:00am blood neuts-73.8* lymphs-20.5 monos-4.5 eos-0.1 baso-1.2 10:46am blood pt-13.2 ptt-24.1 inr(pt)-1.1 10:00am blood glucose-134* urean-97* creat-15.5*# na-133 k-3.8 cl-74* hco3-25 angap-38* 10:00am blood alt-38 ast-131* ck(cpk)-7399* alkphos-91 totbili-0.3 04:09pm blood ck(cpk)-5982* 10:00am blood lipase-100* 04:09pm blood totprot-6.2* calcium-6.0* phos-11.7*# mg-2.5 04:09pm blood c3-150 c4-24 discharge labs: . . . microbiology: blood cx x 2 pending blood cx pending urine cx pending cdiff toxin pending studies: ekg: sinus rhythm with atrial premature beats. increased precordial voltage. consider left ventricular hypertrophy. since the previous tracing of the rate is faster and atrial premature beats are new. precordial st-t wave abnormalities are less prominent. clinical correlation is suggested. cxr: no acute intrathoracic process. renal ultrasound 1. no hydronephrosis. 2. 2.6 cm hypodense right lower pole renal lesion likely representing a complex cyst. an mri of the kidney is recommended for further characterization of this lesion. 3. status post left nephrectomy. portable cxr - severe pulmonary edema echo - ef > 75%; mild concentric left ventricular hypertrophy. hyperdynamic global and regional biventricular systolic function. tachycardia. mild aortic dilation. moderate pulmonary hypertension. cxr interval worsening in left lower lobe opacity. this could be due to atelectasis, but pneumonia cannot be totally excluded. right lower lobe atelectasis has worsened. interstitial edema has improved. small left pleural effusion is stable. cardiomediastinal contours are unchanged, with cardiac size top normal. egd findings esophagus: mucosa: grade 4 esophagitis and ulceration with stigmata of recent bleeding was seen in the gastroesophageal junction, compatible with esophagitis. stomach: contents: coffee ground heme was seen in the stomach body. mucosa: localized erythema of the mucosa with no bleeding was noted in the antrum. these findings are compatible with gastritis. duodenum: contents: clotted blood was seen in the second part of the duodenum. mucosa: localized erythema of the mucosa with no bleeding was noted in the duodenal bulb compatible with duodenitis. other findings: the source of bleeding is most likely the esophagitis and ulceration. impression: grade 4 esophagitis in the gastroesophageal junction compatible with esophagitis. erythema in the antrum compatible with gastritis. blood in the stomach body. erythema in the duodenal bulb compatible with duodenitis. blood in the second part of the duodenum. the source of bleeding is most likely the esophagitis and ulceration. brief hospital course: 52 yo male with a history of alcohol abuse presented with hematemesis, nausea, vomiting, anuria x4 days, and acute renal failure. each of the problems addressed during this hospitalization are described in detail below: 1. hypotension on presentation, the patient was tranienently hypotensive likely secondary to hematemesis and hypovolemia. abg consistent with contraction alkalosis. the patient has remained hemodynamically stable and not needed pressors. aggressive rehydration with iv fluid was started to maintain map>65. hypotension resolved shortly thereafter. 2. acute renal failure on admission, the patient was found to be in arf with cr 15.5, baseline 1.0. anion gap was 25, likely secondary to uremia. electrolytes were within normal limits. the patient was not fluid overloaded. contraction alakalosis likely secondary to vomiting. foley was placed in ed. ck was found to be 7399. etiology of arf was not clear, but possibilities may include (1) nephrolithiasis given single kidney in this patient with a recently passed kidney stone, (2) pre-renal cause given intoxication and hypovolemia (3) rhabdomyolysis. on presentation, aggressive diuresis with iv fluids was initiated. per renal recs, spep, upep, c3, c4 were checked and were wnl. given a finding of a renal cyst on renal u/s, there was concern of obstruction. urology was consulted and the patient underwent cystopscopy and retrograde pyelogram, which revealed no obsruction. over the next two days, creatinine and ck trended down. the patient responded to ivf with a large uop. he never required dialysis. prior to discharge, cr = 1.3 and stable at this level. 3. hematemesis this was believed to be secondary to severe esophagitis and resolved on presentation. gi was consulted and performed emergent egd. egd demonstrated severe esophagitis. his hematocrit was 40 on presentation but then declined to 33. he received 2 units of packed rbcs with improvement in his hematocrit to 38-40. ppi iv bid and carafate slurry were given. the patient was maintained npo initially and diet was slowly advanced. the patient has not had any further episodes of hemaemesis during this admission. he is discharged on ppi and sulcrafate. 4. alcohol abuse the patient was maintained on ciwa scale to watch for signs of alcohol withdrawal, but did not actively withdraw. toxicology screen was only positive for opiates. he was referred by social work to outpatient addiction treatment day program at . 5. transaminitis ratio of mildly elevated ast to alt suggested transaminitis is seconday to alcohol abuse. hepatitis panel was performed and were notable for hepatitis a antibody being positive, suggestive of prior infection. 6. elevated lipase on presentation, lipase was 100, suggesting mild alcoholic pancreatitis. the patient had mild epigastric pain that resolved shortly thereafter with no intervention. there were no aigns of symptoms concerning for fulminant pancreatitis. the patient was initially maintained npo and received iv fluids for hypotension and renal failure. pain resolved. 7. hypertension: hctz and lisinopril were transiently held given hypotension. as blood pressure improved, hctz was resumed on discharge. he will need to have the lisinopril re-added at his upcoming appointment with his pcp as needed. 8. chronic pain: outpatient morphine was initially held due to hypotension, but was later re-started. the patient tolerated 15mg prn morphine. 9. depression and schizoaffective disorder according to discussion with outpatient mental health providers, the patient was restarted on risperdal and elavil. given that patient was receiving multiple sedating medications, seroquel was held with plans to restart as an outpatient. medications on admission: 1. hctz 25mg po daily 2. lisinopril 5mg po daily 3. morphine ir 15mg po bid prn pain 4. ms contin 30mg po bid 5. risperdal 3mg po daily 6. elavil 50mg po qhs 7. seroquel 100-200mg po qhs discharge medications: 1. sucralfate 1 gram tablet sig: one (1) tablet po qid (4 times a day). 2. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily). 3. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 4. risperidone 1 mg tablet sig: three (3) tablet po hs (at bedtime). 5. amitriptyline 50 mg tablet sig: one (1) tablet po hs (at bedtime). 6. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 7. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 8. hydrochlorothiazide 25 mg tablet sig: one (1) tablet po once a day. 9. levofloxacin 250 mg tablet sig: three (3) tablet po daily (daily): until . disp:*6 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary diagnosis: 1. hematemesis - vomiting blood 2. acute renal failure 3. pneumonia secondary diagnosis: 1. alcohol abuse 2. depression 3. schizoaffective disorder discharge condition: improved. discharge instructions: you were admitted to the hospital for treatment of vomiting blood and urinary problems. were found to have bleeding in your gastrointestinal tract and this improved with medications. for your urinary problems, you were found to have acute renal failure likely due to vomiting, dehydration, and muscle damage. your kidney function improved with rehydration. you also developed a fever and pneumonia, which improved with antibiotics. you should complete your antibiotic course. we have made the following changes to your medications: - hctz and lisinopril - hctz to be restarted on discharge, f/u with your pcp regarding the lisinopril - seroquel - this was discontinued due to interactions with your other medications. we recommend that you follow-up with your outpatient providers about when to restart this medication. - lidocaine patch - this is a pain medication to treat your back pain. - pantoprazole and sucralfate- these are medications to help treat your stomach irritation. - levofloxacin - this is an antibiotic to treat your pneumonia. you should complete this antibiotic on . please seek immediate medical attention if you develop fevers, shaking chills, night sweats, nausea, vomiting, change in urination, vomiting blood, dark or black stools, bright red blood per rectum, light-headedness, dizziness, or passing out. you should discontinue and refrain from drinking alcohol. you have been provided outpatient counselling information by the social worker to help you toward this end. please discuss you plans at your next outpatient appointment with you care provider. followup instructions: provider: , md phone: date/time: 2:10 procedure: other endoscopy of small intestine transfusion of packed cells retrograde pyelogram other irrigation of (naso-)gastric tube diagnoses: pneumonia, organism unspecified acute posthemorrhagic anemia acute kidney failure, unspecified obstructive chronic bronchitis with (acute) exacerbation depressive disorder, not elsewhere classified pulmonary collapse dehydration chronic pancreatitis rhabdomyolysis other esophagitis mixed acid-base balance disorder ulcer of esophagus with bleeding schizoaffective disorder, unspecified acute alcoholic intoxication in alcoholism, continuous 

Answer: The patient is high likely exposed to