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: melena and coffee ground emesis major surgical or invasive procedure: upper endoscopy with injection of epinephrine history of present illness: 53 year old male, vietnamese speaking with chronic hbv and recent diagnosis of hcc with invading ivc and right atrium and recent hx of right multifocal lobal pe who was discharge on on lovenox. pt presents today with complains of melena and coffee ground emesis since last night. pt states that he has occ. black stools in the last 5 days ranging from yellow to black stools 2-3 times per day. last night he developed severe epigastric and overall diffused abd pain. he than had small loose black bowel movement total of 7 stools last night. he also had small amount of coffee ground emesis overnight and this morning had 2-3 episodes of large amounts (almost filling up toilet bowel) coffee ground emesis. he came to ed for further evaluation. he denies having any chills, fever, any prior nausea or vomiting. he was having loose bm per day for the past "few" wks and most recently for the last 5 days, it has ranged from yellow to black. his urine has been dark yellow, but he denies any other gu symptoms. he denies having any sob or doe. in the ed, his vitals were 97.1 f, bp 117/81, hr 118, rr 22, sats 99% on ra. he ng tube placed and he had 800ml of coffee ground fluid. he had rectal exam and was guaiac positive. he was given 80mg of protonix, 50 mcg of octreotide, 30mg protamine and 2 l of ns. he was typed and crossed. hepatology was also consulted since they were following pt during last admission for hcc. . of note pt was evaluated by onc team chemotherapy was offered, but pt decided that he did not wanted to received any treatment for his malignancy with invasion to ivc and right atrium, as well as multiple blood clots in the liver and lungs. he understands that if he does not get treatment that his disease is terminal. he has met with palliative care and was transitioning to hospices, although he still full code for now. . on arrival to the floor, pt appears comfortable. he is alert and conversing. vs: temp 99.4f, hr 121,118/79, 21, 97% on ra. . review of systems: (+) per hpi (-) denies fever, chills, night sweats. denies headache, sinus tenderness, rhinorrhea or congestion. denied cough, shortness of breath. denied chest pain or tightness, palpitations. no recent change in bladder habits. no dysuria. denied arthralgias or myalgias. past medical history: chronic hepatitis b, hepb serologies on social history: pt works as a machinist, used to smoke cigarettes a day for 30+ years, quit 2 weeks ago. endorses only occasional etoh, denies recreational drug use. pt emigrated to the us from in the early 80s. lives at home with wife and two children, aged 8,11. family history: denies any family history of cancers. physical exam: vitals - temp 99.4f, hr 121,118/79, 21, 97% on ra. general: thin man in nad heent: eomi, perrl slight scleral icterus, mmm, 7cm jvd (non-elevated) pulmonary: lungs cta bilaterally, no wheezes, ronchi or rales cardiac: rr, nl s1 s2, no murmurs, rubs or gallops appreciated abdomen: distended, mildly tender to deep palpation over the ruq, hepatomegaly noted 3-4 cm beneath subcostal margin + bs x 4 extremities: no edema or asterixis noted neurologic: alert, oriented x 3. able to relate history without difficulty. cranial nerves ii-xii intact, 7 deferred. strength noted diffusely. sensation intact to light touch. pertinent results: labs on admission: 09:10am blood wbc-9.5 rbc-4.14* hgb-10.7* hct-33.0* mcv-80* mch-25.8* mchc-32.4 rdw-18.1* plt ct-246 09:10am blood neuts-80.6* lymphs-14.2* monos-4.3 eos-0.5 baso-0.5 09:10am blood pt-16.9* ptt-35.7* inr(pt)-1.5* 09:10am blood glucose-185* urean-28* creat-0.7 na-132* k-6.0* cl-95* hco3-26 angap-17 09:43pm blood alt-275* ast-434* ld(ldh)-904* alkphos-615* amylase-30 totbili-9.1* 09:43pm blood albumin-2.3* calcium-7.3* phos-2.9 mg-1.9 09:23am blood hgb-11.7* calchct-35 chest x ray : portable ap chest radiograph was compared to . the ng tube has been inserted with its tip being in the proximal/mid stomach. cardiomediastinal silhouette is stable. the previously demonstrated small areas of atelectasis on the ct torso have improved in the interim. there is no appreciable pleural effusion or pneumothorax. endoscopy : findings: esophagus: normal esophagus. stomach: other fresh blood clots noted. duodenum: excavated lesions a samll single cratered non-bleeding ulcer was found in the duodenal bulb, possible ulcers in the duodenal bulb. other active bleeding noted. 5 cc.epinephrine 1/ hemostasis with success. impression: fresh blood clots noted. active bleeding noted. (injection) ulcer in the duodenal bulb otherwise normal egd to third part of the duodenum recommendations: c/w ppi and octreotide gtt f/u hct and transfusion as needed. brief hospital course: micu course: 53 year old male with hep b, new diagnosis of hcc with invasion to ivc and right atrium and right multifocal pe previously lovenox who is admitted to micu with gi bleed. # gi bleed: gi was consulted and egd revealed bleeding duodenal ulcer, s/p epinephrine injection. no eseophageal varices were seen. h. pylori positive on ab test. lovanox was held in setting of gi bleed. he was given a total of 5 uprbc, ffp and vit k. he continued to have episodes of melena but hct stabalized at 26 suggesting no further bleeding. based on a detailed discussion of the risks and benefits and benefits of treating his h pylori with hepatology a decision was made to start him antibiotic therapy. #hcc: the patient has a recent diagnosis of hcc. disease is extensive infiltrating ivc and right atrium. pt was offered chemo, but has refused at this time given extent of disease. he was in the process of being transferred to hospice care. he was scheduled to see dr. , onc as outpatient on the day of admission. he was seen by palliative care and although he wished to treat his acute gi bleed, he decided not want to pursue treatment for his hcc. his goals included getting home to be with his family. #multifocal pulmonary emboli: given malignancy infiltration into ivc and right atrium, uncertain if the embolies are due to cancer infiltration or thrombus. he was started on lovenox recently, but now presented with gi bleed. his anticoagulation was held in the setting of bleeding. it was not thought that an ivc filter would be helpful in this case give that malignancy is infiltrating into right atrium. he was kept on pneumoboots for prophylaxis. # dm: recent hga1c of 8.6% on insulin at home (as per family 6 units at home) he was continued on insulin sliding scale. # pain: diffuse abd pain, tx with morphine prn with some effect, it was changed to dilaudid with improved affect. pt c/o pain in the ruq which is similar to chronic pain. he was encouraged to ask for pain medications as needed so that his requirement could be estimated. abd pain improved during micu stay. palliative care followed. patient was changed to a po regimen sl morphine in order to prepare him for potential hospice transfer. # code status: dnr/dni - 90 min family meeting held upon arrival to the floor. hcp did not want agressive meausures c/w with note of on . . disposition: hospice/ in should patient become stable. ===================== summary since arriving to general medical floor: 53 year old male with metastatic hccv and chronic hep b with pes presents with ugib s/p 6 u prbcs, egd and cautery. goals of care to focus mainly on comfort/palliation. had an ir guided diagnostic paracentesis without evidence for sbp. a permanent pleurex catheter was placed for palliation. given his significant ascites and scrotal edema, he was started onlasix/aldactone . palliative care and hospice worked together with the team and family to coordinate a discharge plan that was in keeping with the patient's goals of care. . the triple antibiotic regimen was discontinued for the h. pylori given the complexity of the regimen, the patient's overall prognosis and his appetite/ability to tolerate po's. . dr. updated dr. via telephone re: the discharge plan of care. medications on admission: lovenox 60 mg/0.6 ml syringe subcutaneous every twelve (12) hours vicodin prn pain insulin u 100 discharge medications: 1. morphine concentrate 20 mg/ml solution sig: five (5) mg po q2h (every 2 hours) as needed for pain. :*qs mg* refills:*0* 2. spironolactone 25 mg tablet sig: one (1) tablet po every other day. :*30 tablet(s)* refills:*0* 3. furosemide 20 mg tablet sig: one (1) tablet po every other day. :*30 tablet(s)* refills:*0* 4. prilosec 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. :*60 capsule, delayed release(e.c.)(s)* refills:*0* 5. lorazepam 1 mg tablet sig: one (1) tablet po four times a day as needed for nausea, anxeity, breathing problems, sleep. :*100 tablet(s)* refills:*0* 6. fentanyl 12 mcg/hr patch 72 hr sig: one (1) transdermal every three days. :*10 * refills:*0* 7. drain care please drain pleurex catheter daily (up to 2 liters each day) if this offers the patient comfort. discharge disposition: home with service facility: hospice care discharge diagnosis: primary: metastatic hepatocellular carcinoma duodenal ulcer secondary: pulmonary embolus- off anticoagulation discharge condition: mental status: confused - sometimes. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: you were admitted with a gastrointestinal bleed. you underwent an endoscopy which demonstrated an ulcer. you were also found to be h pylori positive. this was treated with some antibiotics and a proton pump inhibitor. we stopped the three antibiotics at discharge because it's not clear that they will be that helpful to you in the long-term. you were also started on two medications to decrease your swelling, lasix and spironolactone. . we also drained some fluid from your abdomen and put in a pleurex catheter to allow your caregivers to continue to drain fluid from your abdomen for comfort. followup instructions: dr. is aware of your situation and that you have gone home with hospice. procedure: percutaneous abdominal drainage percutaneous abdominal drainage endoscopic control of gastric or duodenal bleeding other irrigation of (naso-)gastric tube diagnoses: other chronic pain acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hyposmolality and/or hyponatremia secondary malignant neoplasm of other specified sites long-term (current) use of anticoagulants personal history of venous thrombosis and embolism abdominal pain, other specified site encounter for palliative care malignant neoplasm of liver, primary other and unspecified coagulation defects chronic viral hepatitis b without mention of hepatic coma without mention of hepatitis delta other pulmonary embolism and infarction leukocytosis, unspecified helicobacter pylori [h. pylori] acute duodenal ulcer with hemorrhage, without mention of obstruction edema pain in limb malignant ascites 

Answer: The patient is high likely exposed to