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: endoscopy x 2 dobhoff placement x 2 tunneled line placement hemodialysis history of present illness: 43m with etoh cirrhosis transferred from osh with hematemesis. pt had been hospitalized at from after having been admitted for seizure in the setting of heavy alcohol consumption. per the patient, he had been kept in the hospital for detox and for liver biopsy which was recommended for ferritin of 691 and iron of 232 concerning for hemachromatosis. unfortunately, he was unable to have the biopsy while in-house and was discharged home with vna and home pt on tuesday. pt states that things had been going fine until last night when he had 3 episodes of hematemesis. the first large, the second medium, and final large as well. the patient states that his vomitus was maroon, denies any bright red blood. he presented to hospital where cr 4.5, hct 28.5, inr 2.9. transferred to for further evaluation and management. . in the ed, initial vs 98.4 72 116/80 18 100%. no further episodes of bleeding since prior to arrival at the osh. wbc# 30.3 82% pmn hct 27.1 plts 357 bun 35 cr 4.4 lactate 2.3 ptt 45 inr 2.5 tbili 33.3. serum tox screen negative. cxr showed no acute process. blood cultures drawn. given vanc 1 g iv, ceftriaxone 2 iv, 1u prbc, 2u ffp, 2l ns. started protonix and octreotide gtt. paracentesis deferred given elevated inr. vital signs prior to transfer 91/48 92 19 100%ra. . on arrival to the icu, 97 97/54 28 97%. pt had no specific complaints. denies headache, shortness of breath, chest pain, abdominal pain, nausea, vomiting since home, diarrhea (except after lactulose), constipation. last bm around 10pm last night, non-bloody. has noticed that he has been peeing less. has minimal dry cough since coming to the hospital. denies history of hepatitis. stool on arrival, guaiac positive. past medical history: etoh liver disease alcohol dependence complicated by seizures (first ) gastroesophageal reflux disease seizures in setting of heavy alcohol consumption, seen by a neurologist who did not feel that it was a primary seizure disorder mva - right femur fracture with placement, pelvic fracture social history: never smoker, drank vodka daily until 3 weeks ago. never has used iv drugs. lives with girlfriend, . has 2 children, daughter 17, son, 16 who live with their mother who the patient is still very close to. pt formerly worked at mass electric. family history: mother - deceased alcoholic liver disease father - deceased cancer, diagnosed in his 40s. no other family history of cancer. physical exam: medications on admission from osh: - pentoxifylline sr 400mg tid - spironolactone 25mg - kcl 20meq - metoprolol tartrate 12.5mg - lactulose 30ml tid - ativan 0.5mg tid prn - mvi daily - thiamine 100mg daily - folic acid 1mg daily - magnesium oxide 400mg - fish oil 1 capsule daily . medications upon transfer from micu: octreotide acetate 50 mcg/hr iv gtt albuterol 0.083% neb soln 1 neb ih q2h:prn sob / wheeze oxycodone liquid 2.5 mg po/ng q8h:prn pain albuterol 0.083% neb soln 1 neb ih q4 hours pantoprazole 8 mg/hr iv infusion amoxicillin 500 mg po q24h - 7 day course, day 1 , end day pentoxifylline 200 mg po daily (please give after hd on dialysis days) folic acid 1 mg po/ng daily ipratropium bromide neb 1 neb ih q4h lactulose 30 ml po/ng tid sucralfate 1 gm po qid miconazole 2% cream 1 appl tp to soles of feet thiamine 100 mg po/ng daily nephrocaps 1 cap po daily pertinent results: admission labs: =============== 04:40am wbc-30.3* rbc-2.94* hgb-9.1* hct-27.1* mcv-92 mch-31.1 mchc-33.8 rdw-22.1* 04:40am neuts-82* bands-2 lymphs-6* monos-8 eos-1 basos-0 atyps-0 metas-1* myelos-0 04:40am hypochrom-1+ anisocyt-1+ poikilocy-1+ macrocyt-normal microcyt-normal polychrom-normal target-occasional schistocy-occasional burr-occasional 04:40am plt count-357 04:40am pt-26.1* ptt-45.1* inr(pt)-2.5* 04:40am hcv ab-negative 04:40am asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 04:40am hbsag-negative hbs ab-negative hav ab-negative 04:40am ferritin-187 04:40am albumin-2.2* calcium-7.9* phosphate-4.2 magnesium-3.0* 04:40am lipase-6 04:40am alt(sgpt)-19 ast(sgot)-109* alk phos-208* tot bili-33.3* dir bili-25.5* indir bil-7.8 04:40am glucose-116* urea n-35* creat-4.4* sodium-137 potassium-4.9 chloride-108 total co2-19* anion gap-15 04:51am lactate-2.3* studies: ======== portable cxr impression: no acute intrathoracic process. abdominal u/s conclusion: 1. fatty liver without focal lesions. 2. biliary sludge, but no stones. 3. patent intrahepatic portal and hepatic venous systems. extrahepatic portal venous system cannot be assessed due to gas. 4. trivial perisplenic ascites, insufficient to mark for tap. egd: esophagitis in the middle third of the esophagus, lower third of the esophagus and gastroesophageal junction compatible with severe erosive esophagitis. islands of denuded mucosa seen. mosaic appearance, abnormal vascularity, erythema and congestion in the whole stomach compatible with portal hypertensive gastropathy otherwise normal egd to second part of the duodenum egd: esophagus: mucosa: multiple ulcerations and significant erythema of the lower esophagus consistent with severe esophagitis. no varices noted. likely cause of upper gi bleeding. stomach: normal stomach. duodenum: normal duodenum. impression: abnormal mucosa in the esophagus otherwise normal egd to third part of the duodenum pa & lateral cxr impression: persistent bilateral small amounts of pleural effusions, no acute pulmonary infiltrates, no pneumothorax, unchanged position of previously described right internal jugular approach central venous line. brief hospital course: #. acute alcoholic hepatitis: the patient presented with very elevated bilirubin, leukocytosis in the setting of heavy alcohol consumption/abuse history. the meld score was in the 40's and discriminant function was in the 160's. viral, auto-immune, vascular and toxic workup were negative. the patient was told that he had a very poor prognosis. he was not started on corticosteroids due to gi bleed, uti and . the patient was started on pentoxyphyline to prevent hrs with a planned 4 week course from (last day ). a feeding tube was placed for nutrition. . #. renal failure: the patient presented with elevated creatinine. the likely diagnosis was atn (given nsaid use and hypotension) but hrs was not entirely ruled out. the patient was started on dialysis due to volume status and increased bun. the patient was anuric as of discharge and he is being maintained on pentoxyphyline to prevent hrs. he had a tunneled hd line placed and is on m,w,f dialsysis. . #. hematemesis: the patient presented to on for hematemesis. an egd at that time showed erosive esophagitis without evidence of esophageal varices. he eventually left ama. on he represented to with hematemesis. he was transferred to the micu. he was started on octreotide, ppi, sucralfate and iv vancomycin and ceftriaxone. he was transfused and given ffp as well. his presenting hct was 27.1. he had no further episodes of bleeding in the micu. he had an egd on which again showed severe erosive esophagitis. the patient was stable and sent to the floor. on the floor he had two episodes of hematemesis and was transfered back to the micu. a repeat egd was done on which again showed erosive esophagitis without varices. the patient was transferred back to the floor and was without hematemesis, signs of gi bleed and had stable vitals. . #. melena: the patient had two episodes of melena following his hematemesis. it was likely related to his erosive esophagitis. his hct remained stable and his hct was stable. . #. urinary tract infection: the patient had a positive ua with urine culture growing enterococcus. he was treated with a 7 day course of antibiotics (amoxicillin) . #. alcohol abuse: the patient was started on folate, thiamine and a multivitamin. he was counseled on the importance of abstaining from alcohol. . #. nutrition: feeding tube was placed and nutren 2.0 full strength formula was started. . . . to do for rehab: hd m,w,f lft, cbc, chem-10 if abdnormal labs, increase in bilirubin or wbc please contact dr. - pt/ot cont tube feeds medications on admission: folic acid 1mg daily spironolactone 25mg metoprolol tartrate 12.5 mg kcl 20meq lactulose 30ml tid pentoxyfylline sr 400mg tid mag oxide 400mg ativan .5mg tid prn thiamine 100mg daily fish oil 1 capsule daily mvi daily discharge medications: 1. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po tid (3 times a day). 2. miconazole nitrate 2 % cream sig: one (1) appl topical (2 times a day). 3. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 4. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 5. sucralfate 1 gram tablet sig: one (1) tablet po qid (4 times a day). 6. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q2h (every 2 hours) as needed for sob / wheeze. 7. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 8. pentoxifylline 400 mg tablet sustained release sig: 0.5 tablet sustained release po daily (daily). 9. midodrine 2.5 mg tablet sig: three (3) tablet po tid (3 times a day). 10. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q4h (every 4 hours) as needed for wheezing/sob. 11. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours) as needed for wheezing/sob. 12. heparin (porcine) 5,000 unit/ml solution sig: 4000- unit dwell injection prn (as needed) as needed for line flush: for dialysis nurse: withdraw 4 ml prior to flushing with 10 ml ns followed by heparin as above according to volume per lumen. 13. oxycodone 5 mg/5 ml solution sig: 2.5 mg po q8h (every 8 hours) as needed for pain: hold for oversedation or rr<16. 14. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po twice a day. discharge disposition: extended care facility: medical center - discharge diagnosis: primary diagnosis: 1. acute alcoholic hepatitis 2. hematemesis secondary to erosive esophagitis 3. acute renal failure 4. urinary tract infection secondary diagnosis: 1. alcohol abuse discharge condition: stable. tolerating tube feeds. discharge instructions: you were transferred from an outside hospital to for bloody emesis. you were initially admitted to the intensive care unit for emergent endoscopy, which showed that your likely bleeding was due to erosive esophagitis. you were given blood transfusions and stabilized. you were transferred to the liver service for further management. you were diagnosed with acute alcoholic hepatitis. you were started on medications to help with this diagnosis. you were initiated on hemodialysis for your kidney failure and tolerated this well. you were given nutrition through a small tube in your nose. please keep all your medical appointments. you must see a liver doctor in the near future to continue to help manage your liver disease. please do not drink any alcohol. please continue all medications as directed. if you have any of the following symptoms, please call your doctor or go to the nearest er: fever>101, chest pain, shortness of breath, abdominal pain, black stools, bright red blood per rectum, vomiting blood, or any other concerning symptoms. followup instructions: please follow up with a hepatologist in the liver center. for future reference, the phone number is . we will set up this appointment and contact you with your appointment date and time. please follow up with your primary care physician. procedure: other endoscopy of small intestine other endoscopy of small intestine enteral infusion of concentrated nutritional substances hemodialysis venous catheterization for renal dialysis venous catheterization for renal dialysis diagnoses: esophageal reflux urinary tract infection, site not specified alcoholic cirrhosis of liver acute kidney failure, unspecified portal hypertension other specified disorders of stomach and duodenum other and unspecified alcohol dependence, continuous esophageal hemorrhage acute alcoholic hepatitis other esophagitis 

Answer: The patient is high likely exposed to