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 / clavulanic acid / oxycodone attending: chief complaint: bleeding, hypotension major surgical or invasive procedure: endoscopy history of present illness: this is an 81yo f pmhx esrd not on hd (lue fistula in place), copd, chf (ef unknown), cad on asa and plavix, recent rehab discharge who then presented to with lethargy, coffee ground emesis and dark stools. per family report, 3wks prior to admission, patient was admitted to hospital for lue fistula placement, and subsequently discharged to country manor at rehab facility. pt was discharged from rehab 1d prior to admission. since discharge, patient reported feeling progressively "very weak". on day of admission, she had 3-4 episodes of large coffee ground emesis, as well as multiple tarry black stools. as patient was becoming increasingly lethargic, she her family called 911. . per ems report, patient was found hypotensive in the field to 60/40. she was fluid resuscitated and stabilized with normal saline, brought to , where her labs were significant for wbc 5.8, hct 17.9, plt 150, cr 3.1. she was immediately transfused with 2 units prbcs, given a bolus of iv protonix, and trasferred to for further management. . in ed, initial vital signs were 97.7 55 135/42 15 97%ra. patient was alert and oriented, comfortable, able to give history. exam notable for nontender abdomen, rectal exam w melena. ekg demonstrated nsr at 53bpm w/o st/twave changes. labs were notable for hct 26.3, plt 144, lactate 1.3, cxr with prominent vascular markings, small l pleural effusion. ngl demonstrated coffee grounds that did not clear w 500cc fluid. case discussed with gi, who recommended platelet transfusion (not done given concern for fluid overload). patient was type and crossed x2 units and admitted to micu for further management. vitals prior to transfer were 145/47 61 16 100%ra. access was 18g x2, 20g x1. . on arrival to the micu, patient comfortable, sleepy, without complaint. vital signs were 97.8 60 128/34 16 98%ra. past medical history: past medical history: - esrd not on hd (rue fistula in place) - copd - chf (ef unknown) - htn - cad on asa and plavix - hld - oa - osteoporosis - back pain - gout - s/p ccy social history: lives by herself in ,ma; widowed, her son lives next door and takes care of her; she is able to walk around unassisted; 40pkyr history, denies etoh. . family history: no family history of gi bleeds physical exam: vs 97.8 60 128/34 16 98%ra general: elderly female, nad heent: +pallor, sclera anicteric, dry mm, perrl neck: supple, no jvd cv: rrr, ii/vi systolic murmur @ rusb lungs: sparse crackles, mild wheezing, no rales/ronchi abdomen: soft, obese, non-tender, nabs gu: + foley ext: wwp, 2+ dp/pt/radial pulses, no cyanosis or edema neuro: aox3, moving all extremities pertinent results: 02:05am blood wbc-5.9 rbc-2.60* hgb-8.1* hct-26.3* mcv-101* mch-31.3 mchc-30.9* rdw-18.0* plt ct-144* 10:40am blood wbc-6.2 rbc-2.75* hgb-8.6* hct-27.4* mcv-99* mch-31.4 mchc-31.6 rdw-18.8* plt ct-157 04:47pm blood hct-27.9* 07:48pm blood hct-26.3* 02:17am blood wbc-6.1 rbc-2.58* hgb-8.4* hct-25.8* mcv-100* mch-32.8* mchc-32.8 rdw-19.2* plt ct-131* 07:45am blood hct-23.3* 05:58pm blood hct-31.0*# 10:03pm blood hct-29.4* 06:32am blood wbc-5.1 rbc-3.19* hgb-10.2* hct-32.6* mcv-98 mch-32.0 mchc-32.6 rdw-19.1* plt ct-162# 10:54am blood hct-31.7* 02:05am blood neuts-75.3* lymphs-22.2 monos-2.0 eos-0.1 baso-0.4 02:07am blood neuts-67.5 lymphs-27.3 monos-3.5 eos-1.0 baso-0.7 06:32am blood neuts-71.3* lymphs-22.7 monos-4.7 eos-1.1 baso-0.2 02:05am blood plt ct-144* 10:40am blood pt-11.9 ptt-25.9 inr(pt)-1.1 10:40am blood plt ct-157 02:17am blood plt ct-131* 02:07am blood plt ct-100* 06:32am blood plt ct-162# 02:05am blood glucose-148* urean-152* creat-3.1* na-139 k-4.7 cl-102 hco3-24 angap-18 10:40am blood glucose-104* urean-140* creat-2.7* na-143 k-3.9 cl-105 hco3-25 angap-17 02:07am blood glucose-92 urean-82* creat-2.1* na-145 k-4.1 cl-107 hco3-29 angap-13 02:05am blood ck(cpk)-80 02:05am blood ck-mb-3 ctropnt-0.02* 02:17am blood calcium-9.2 phos-4.6* mg-2.1 02:07am blood calcium-9.4 phos-3.3 mg-2.2 08:17pm blood type- temp-37.1 ph-7.27* comment-green top 02:34am blood type- ph-7.35 comment-green top 08:17pm blood k-4.5 08:17pm blood freeca-1.16 02:34am blood freeca-1.18 12:09am urine 12:09am urine mucous-rare 12:09am urine rbc-9* wbc-31* bacteri-none yeast-none epi-0 . urine hematology general urine information type color appear sp 00:09 straw clear 1.010 source: catheter dipstick urinalysis blood nitrite protein glucose ketone bilirub urobiln ph leuks 00:09 mod neg 30 neg neg neg neg 5.0 mod source: catheter microscopic urine examination rbc wbc bacteri yeast epi transe renalep 00:09 9* 31* none none 0 source: catheter other urine findings mucous 00:09 rare source: catheter . microbiology urine urine culture-pending inpatient . mrsa screen mrsa screen-final inpatient no mrsa isolated . blood culture blood culture, routine-pending emergency . blood culture blood culture, routine-pending emergency . imaging . chest (portable ap) study date of 1:37 am impression: mild vascular congestion and small left pleural effusion. the study and the report were reviewed by the staff radiologist. . egd. saturday, old blood which was easily cleared without any evidence of active or or former bleeding fresh blood was seen in the duodenal sweep which was cleared. a small area of active bleeding was visualized, compatible with either a bleeding avm v. dieulafoy lesion (endoclip). otherwise normal egd to third part of the duodenum brief hospital course: 1. acute gi bleed - en endoscopy performed by gi on which showed a small area of active bleeding consistent with bleeding avm v. dieulafoy lesion. this was clipped. she was treated with iv pantoprazole which was transitioned to oral upon discharge. plan going forward: continue asa 325 as below hold plavix as discussed with cardiologist and pcp continue pantoprazole 2. acute blood loss anemia - related to #1. received a total of 3 units of prbc and 1 bag of platelets. at the time of discharge, hematocrit was 32.6 3. acute renal failure - cr was noted to be 3.1 on admission. unclear baseline. likely due to volume depletion/anemia. patient cr was trended while in micu and improved to 2.1 before transfer to floor in the setting of receiving blood. upon discharge the patient's cr was 1.7. 4. chf (unknown ef) / cad / hypertension - patient's cardiovascular status was monitored closely. she had one troponin of 0.02 in the setting of a cr of 3.1. her ckmb was not elevated. she had no chest pain or concerning ekg changes. the likelihood of a significant coronary event were felt to be very low. in the micu the patient's lopressor, isosorbide mononitrate, pravachol, niaspan, fenofibrate, asa, plavix, hydralazine, and isosorbide were initially held in setting of large gi bleed. after she was stabilized from a hemodynamic standpoint and could take oral medications she was restarted on metoprolol while in the micu. after she was transferred to the floor she remained on room air and was restarted on her home meds save for clopidogrel as above. 5. back pain. the patient's neurontin, tramadol, tylenol were initialyl held in the micu due to her gi bleed and npo status. on the floor they were restarted with good effect 6. copd. patient was placed on standing fluticasone and albuterol/ipratropium nebs. she was then transitioned to tiotropium and advair with as needed combivent nebs before transfer to the floor. she was dischareged on her home regimen 7. gout. the patient's allopurinol was initially held in the micu. on the floor it was restarted without issue transitional issues medication reconciliation-patient was unsure of all her medications, these were consolidated with her pharmacy medications on admission: - vitd2 units daily - mvi - lopressor 50mg - isosorbide mononitrate 15mg daily - neurontin 100mg tid - lasix 60mg qam - lasix 20mg qpm - tramadol 50mg - tylenol prn - symbicort - spiriva 18mcg daily - pravachol 40mg daily - plavix 75mg daily - niaspan 750mg daily - ferrous sulfate 325mg daily - fenofibrate 145mg daily - colace 200mg daily - asa 325mg daily - allopurinol 100mg daily - trazadone 25mg qhs - hydralazine 10mg tid discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). 3. niaspan extended-release 750 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po once a day. 4. gabapentin 100 mg capsule sig: one (1) capsule po tid (3 times a day). 5. isosorbide mononitrate 30 mg tablet extended release 24 hr sig: 0.5 tablet extended release 24 hr po daily (daily). 6. fenofibrate nanocrystallized 145 mg tablet sig: one (1) tablet po daily (). 7. pravastatin 20 mg tablet sig: two (2) tablet po daily (daily). 8. tramadol 50 mg tablet sig: 0.5 tablet po q6h (every 6 hours) as needed for pain. 9. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 10. cholecalciferol (vitamin d3) 1,000 unit tablet sig: two (2) tablet po daily (daily). 11. allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). 12. trazodone 50 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. 13. symbicort 160-4.5 mcg/actuation hfa aerosol inhaler sig: two (2) inhalation inhalation twice a day. 14. multivitamin capsule sig: one (1) capsule po once a day. 15. lasix 20 mg tablet sig: three (3) tablet po once a day. 16. lasix 20 mg tablet sig: one (1) tablet po at bedtime. 17. spiriva with handihaler 18 mcg capsule, w/inhalation device sig: one (1) daily inhalation once a day. 18. iron 325 mg (65 mg iron) tablet sig: one (1) tablet po once a day. 19. colace 100 mg capsule sig: two (2) capsule po once a day. discharge disposition: home with service facility: , discharge diagnosis: bleeding avm discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear ms. , it was a pleasure taking care of you at , you were admitted to the hospital with a bleeding blood vessel in your stomach. our gi experts were able to visualize it with a camera and clip the bleeding vessel. you stopped bleeding and were deemed safe for discharge home. . the follwing changes were made to your medication list: - stop taking plavix until dr. tells you otherwise - start taking protonix 40mg twice per day until dr. tells you otherwise followup instructions: name: , pa location: clipper cardiovascular associates address: 112a st, , phone: appt: at 1pm name: , j. location: medical associates address: , , phone: appt: at 2:45pm procedure: endoscopic control of gastric or duodenal bleeding diagnoses: obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery congestive heart failure, unspecified acute posthemorrhagic anemia acute kidney failure, unspecified chronic airway obstruction, not elsewhere classified chronic kidney disease, stage iv (severe) hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified gout, unspecified other and unspecified hyperlipidemia osteoporosis, unspecified chronic diastolic heart failure volume depletion, unspecified angiodysplasia of stomach and duodenum with hemorrhage 

Answer: The patient is high likely exposed to