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: morphine attending: chief complaint: n/v/abdominal pain major surgical or invasive procedure: egd intubation history of present illness: 47 yo male presents to ed with 1 mo h/o abdominal pain, nausea and vomiting with an increase in severity over the past days. pt denies any association of the pain with food, but does admit to n/v after eating. patient denies any diarrhea or constipation, but does recall one episode of dark black loose stool 2 days ago, no brbpr, no use of iron or pepto bismol. he admits to 1-3 episodes of bloody emesis, approximately "half gallon" at a time. without any lightheadedness or dizziness. he describes his abdominal pain as "25/10" sharp, stabbing pain, with no radiation. . he reports decreased po intake, increased urination, inability to take po meds and poorly controlled dm with "400lbs wt loss". . in the ed the patient received anzemet, insulin, and dilaudid 2mg x2. after the second dose of dilaudid the patient became extremely itchy, improved with diphenhydramine. no urticaria noted in ed. denies f/c, cp, sob past medical history: diabetes leg amputation (post-trauma) neuropathy esophagitis on egd seizures - stated his most recent seizure was 2 days ago, has been vomiting his dilantin for the past few days pvd htn s/p appy h/o dvt social history: lives with his wife and two children. has worked on a hog farm for 25 years. smokes 1 ppd for past 3 years. heavy etoh use 3+ years ago. heavy drug use 25+ years ago. family history: sister with disease physical exam: vit: 98.1 92 138/68 16 95% ra gen: middle aged male, scratching furiously throughout interview, twisting and turning in no apparent pain, very drowsy once he stopped scratching for more than one minute, no respiratory distress heent: nc/at, eomi, no nystagmus, sclera nonicteric, perrla, mm dry, op clear neck: no jvd cv: tachycardic, regular rhythm, nl s1, s2, no mgr pulm: ctab, no w/c/r abd: + bs, soft, nt to light and deep palpation with distraction, no guarding gu: normal rectal tone, brown stool in vault, guaiac neg (per ed) ext: r bka, removal of multiple digits on left foot, no peripheral edema, 2+ radial pulses neuro: very agitated, moving all extremities equally skin: several bleeding excoriations and 1-2 cm ulcerations on extremities, abdomen, back, buttocks, and legs. pertinent results: : supine and left lateral decubitus abdomen: an inferior vena cava filter is noted, with the apex angle to the patient's right. the configuration is unchanged compared to the scout view of the ct of the abdomen in . air and stool are seen throughout the colon and within the rectum. air is noted within a couple of nondilated small bowel loops. no soft tissue masses or calcifications are noted. no free air is visualized on the left lateral decubitus view. impression: no evidence of obstruction, with air and stool throughout the colon and in the rectum. . : repeat ab films: impression: no evidence of free air. nonspecific small bowel gas pattern. . ekg: ns, rate 90, left axis, qrs 0.88, pr and qt interval nl, no ste or std, twi in i and avr . eeg: impression: abnormal portable eeg due to the low-voltage, slow background. this indicates a wide-spread encephalopathy affecting both cortical and subcortical structures. medications, infections, and metabolic disturbances are among the most common causes. the superimposed faster alpha frequency suggests a medication effect. there were no areas of prominent focal slowing, but encephalopathies may obscure focal findings. there were no epileptiform features. . egd: linear erosions with exudate in the lower third of the esophagus compatible with erosive esophagitis. fluids in stomach. mass in the cardia. mass in the gastroesophageal junction. otherwise normal egd to second part of the duodenum . admission labs: 04:20pm blood wbc-11.5*# rbc-4.30* hgb-10.8* hct-32.4* mcv-76* mch-25.1* mchc-33.2 rdw-16.6* plt ct-383# 04:20pm blood neuts-70.2* bands-0 lymphs-26.0 monos-3.0 eos-0.6 baso-0.2 04:20pm blood pt-12.3 ptt-21.1* inr(pt)-1.0 04:20pm blood glucose-319* urean-7 creat-0.7 na-134 k-4.1 cl-97 hco3-23 angap-18 04:20pm blood alt-9 ast-19 alkphos-112 amylase-52 totbili-0.3 04:20pm blood lipase-32 04:20pm blood ck(cpk)-24* ck-mb-notdone ctropnt-<0.01 03:15am blood calcium-8.9 phos-4.3 mg-1.4* 04:20pm blood phenyto-<0.6* 05:29am blood phenyto-11.6 04:05am blood phenyto-9.6* 05:00am blood phenyto-6.7* . microbio: blood cx - no growth urine cx - no growth sputum cx gram stain >25 pmns and <10 epithelial cells/100x field. 4+ (>10 per 1000x field): gpc in pairs, chains, and clusters. respiratory culture (final ): sparse growth oropharyngeal flora. gram negative rod(s). sparse growth. brief hospital course: # n/v/abdominal pain/gib - pt was admitted to medicine for treament of n/v and abdominal pain, attributed to gastroparesis and esophagitis (nl amylase and lipase, normal cardiac enzymes, no sbo on kub). the night of admission he had an episode of coffee ground emesis, but refused ng lavage. the following morning the patient became hypotensive, developed tonic clonic seizures, and was transferred to the micu for further evaluation. in the micu his hct continued to trend down 32->29->27->23 but bumped to 28 after 2u. pt was electively intubated for an egd which showed esophagitis but no active bleeding and possible masses at the ge junction, no biopsies taken. patient was extubated, returned to floor, diet advanced, and pt was discharged to home with plans to follow up with dr. for repeat egd and possible peg placement in the future given poor nutritional status secondary to recurrent abdominal pain/gastroparesis. . # hypotension: pt became hypotensive on the morning of hd#2. etiology was felt to be multifactorial including, dehydration from n/v, volume loss from hematemesis, and multiple medications for pain and seizure control, in the setting of betablockade. during the repeated tonic-clonic seizures his bp dropped to 60/p with hr in the 50's. he required ivf and levophed to maintain sbp 70-80's. he was transferred to the micu, received 2 units prbcs, ivf, and was able to be weaned from the levophed with stable bp prior to returning to the floor. . # seizures: the pt has a known history of grand mal seizures, most recent had been 2 days prior to admission. due to n/v he had been unable to hold down his medications. dilantin level on admission was <0.6. he was loaded with iv phenytoin 1000mg and then started on 100 mg iv q8hrs. however on hd#2 despite his phenytoin level of 11.6, he had a series of tonic clonic seizures requiring ativan iv. neurology was consulted and pt was reloaded on phenytoin after transfer to the micu. ct head showed unchanged old infarction of the left cerebellar hemisphere and no acute changes. eeg did not show any epileptiform activity. pt had no further seizures while hospitalized. patient was eventually restarted on 300 mg dilantin po qd. would recommend follow up of dilantin level as outpatient as pt may require further dose titration to maintain therapeutic level. . # fever: patient had a mild fever during his hospitalization and mild leukocytosis on admission to 11.5. no localizaing symptoms. urine cx and blood cx negative. cxr clear. sputum grew oral flora and sparse gnr. no treatment given as wbc and fever resolved. . # dm: continued insulin ss with fs qid. had patient return to outpatient regimen at discharge. . # neuropathy - due to dm and pvd. continued pain control with oxycodone po or dilaudid iv in house. returned to outpatient regimen with oxycodone and oxycontin at discharge. . # fen: pt was tolerating a regular diet at d/c. . # psych: prior to discharge patient was cleared by psychiatry as competent to make the decision to go home, and understood the risks of completing further work up as an outpatient. . # dispo: he was very anxious to leave the hospital so that he would be able to smoke (left the floor once against medical advice to smoke outside and became very dizzy upon returning to floor, all vss). ultimately the patient was discharged to home with his wife after his dizziness had resolved. medications on admission: meds (per list from his wife): 2 pills atenolol 20 mg qd po captopril 25 mg po bid oxycontin 80 mg po bid dilantin 300 mg po qd seroquel 300 mg po qhs maalox prn benadryl prn discharge medications: 1. metoclopramide 10 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for gastroparesis. disp:*60 tablet(s)* refills:*0* 2. multivitamin capsule sig: one (1) cap po daily (daily). 3. 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:*0* 4. oxycodone 5 mg tablet sig: two (2) tablet po q8h (every 8 hours) as needed for for pain. disp:*6 tablet(s)* refills:*0* 5. dilantin 100 mg capsule sig: three (3) capsule po once a day. 6. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 7. tegaserod hydrogen maleate 6 mg tablet sig: one (1) tablet po bid () as needed for gastroparesis. disp:*30 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary: gastroparesis upper gi bleed seizure disorder diabetes discharge condition: fair discharge instructions: if you develop worsening abdominal pain, nausea/vomiting, dizziness, bloody stool or if you start vomiting blood, return to the emergency room immediately. followup instructions: please call your pcp (, m ) tomorrow for follow up on either monday or tuesday of this coming week. you will need follow up on for your pain management and diabetes control. . please call 1- to make a follow up appt with dr. in the gastroenterology department. md procedure: venous catheterization, not elsewhere classified other endoscopy of small intestine transfusion of packed cells diagnoses: unspecified essential hypertension acute posthemorrhagic anemia other convulsions diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes other and unspecified hyperlipidemia long-term (current) use of insulin old myocardial infarction below knee amputation status esophageal hemorrhage gastroparesis other esophagitis 

Answer: The patient is high likely exposed to