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: history of present illness: this is a 71-year-old male with a past medical history of duodenal ulcer bleeding, who presented with a chief complaint of two days of orthostasis, fatigue and malaise with dark and tarry stools on to the emergency room. the patient reportedly denied nausea, vomiting, hematemesis, bright red blood per rectum, or syncope. the patient, however, did note fatigue, weakness and orthostasis. the patient reportedly contact dr. on , after realizing that his symptoms were consistent with a prior episode of duodenal ulcer bleeding. the patient was subsequently referred to the emergency room and admitted on , for workup of suspected upper gastrointestinal bleed. past medical history: polycythemia , coronary artery disease, hypertension, gout, depression, basal cell and squamous cell carcinoma, duodenal ulcer with repeated bleeds, status post splenectomy, status post right coronary artery stent, status post multiple skin biopsies, status post appendectomy. medications at home: protonix, aspirin, hydroxyurea, procardia, fexofenadine, allopurinol. allergies: tetracycline. physical examination: temperature 97.2, blood pressure 112/51, heart rate 57, respiratory rate 16, oxygen saturation 95% on room air. the patient was noted to be normocephalic, atraumatic, pupils equal, round and reactive to light and accommodation. the patient had moist mucous membranes and a clear oropharynx, no lymphadenopathy or jugular venous distention was noted, and no carotid bruits were noted bilaterally. heart examination demonstrated a regular rate and rhythm, normal s1 s2, and a ii/vi systolic murmur. respiratory examination demonstrated lungs clear to auscultation bilaterally, with diminished sounds at the bases. abdominal examination was soft, with minimal protuberance, nontender, no palpable masses. rectal examination demonstrated brown stool, strongly guaiac positive, no palpable masses, and normal tone. extremities were warm and well perfused, with no cyanosis, clubbing or edema. neurologic examination was alert and oriented x 3, appropriate. laboratory data: white blood cell count 9.1, hematocrit 23.6, platelet count 780. sodium 134, potassium 5.4, chloride 103, bicarbonate 20, bun 47, creatinine 1.6, glucose 46. a previously-drawn helicobacter pylori test was antibody negative. pt 12.7, ptt 29.2, inr 1.1. hospital course: the patient was admitted to the blue surgery service on , under the direction of dr. , with a presumptive diagnosis of upper gastrointestinal bleeding. the patient was admitted to the surgical intensive care unit for close hemodynamic monitoring, and was immediately transfused two units of packed red blood cells. an endoscopy conducted the evening of admission demonstrated a normal esophagus, melena in the antrum and stomach body, and a single acute cratered bleeding 7 mm ulcer in the distal bulb of the duodenum, with edema of the surrounding walls and a narrowing of the lumen. ten 1 cc epinephrine 1:10,000 injections were applied for hemostasis, with success. -cap electrocautery was applied for hemostasis successfully. the patient was followed with serial hematocrits every four hours through the evening of admission, into hospital day number one, during which time the patient required two additional units of packed red blood cells to be transfused, resulting in a hematocrit of 27.3 on the morning of hospital day number one. given this inappropriate response to four units of packed red blood cells transfused, the patient received continuous every four hour hematocrit checks through hospital day number three. the patient subsequently required two additional units of packed red blood cells and was noted to demonstrate a stable hematocrit of 31.8 on hospital day number three. given the stabilization, the patient was subsequently transferred out of the intensive care unit on the evening of hospital day number three, with instructions for continued hematocrit monitoring. serial studies conducted throughout the course of hospital day number three and four demonstrated stabilization of the patient's hematocrit at approximately 31.7. on hospital day number four, the patient was advanced to a regular diet. his intravenous fluids were discontinued, and he was transitioned to oral medications. a follow-up evaluation by the gastroenterology service noted the patient to be doing well, in stable condition, and advised continued oral protonix therapy twice daily for at least eight weeks, with once daily therapy thereafter. the patient was subsequently cleared for discharge to home, with instructions for follow up. condition at discharge: patient to be discharged to home, with instructions for follow up. discharge status: stable. discharge medications: 1. pantoprazole 40 mg by mouth twice a day 2. sucralfate 1 gram by mouth four times a day discharge instructions: the patient is to observe a planned non-acidic diet, sucralfate 1 gram by mouth four times a day, pantoprazole 40 mg by mouth every 12 hours. the patient is to limit physical exercise, no excessive exertion. the patient is to follow up with dr. in the outpatient surgical clinic three to four weeks following discharge. the patient is to call to schedule an appointment. , m.d. dictated by: medquist36 procedure: endoscopic control of gastric or duodenal bleeding endoscopic excision or destruction of lesion of duodenum diagnoses: coronary atherosclerosis of native coronary artery unspecified essential hypertension acute posthemorrhagic anemia gout, unspecified percutaneous transluminal coronary angioplasty status polycythemia vera acute duodenal ulcer with hemorrhage, without mention of obstruction 

Answer: The patient is high likely exposed to