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: no known allergies / adverse drug reactions attending: chief complaint: hematemesis major surgical or invasive procedure: egd - banding of 2 varices endotracheal intubation, mechanical ventilation history of present illness: mr. is a 60 year old man with h/o hcc, s/p tace x3, recent egd showing esophageal varices, who presents with tarry stool x1 and dark bloody hematemesis x2. patient notes having "coffee ground" material in his diarrhea yesterday x1. he then had 2-3 episodes of dark bloody hematemesis today. he has had several gibs in the past. patient notes that he was drinking etoh this am (2 beers and some wine), last drink at noon. in the ed, initial vs: 99.3 129 136/78 16 99%. rectal exam with guaiac positive brown stool. labs notable for hct 30 (down from baseline mid30s), plt 117, inr 1.6, ast 240, alt 97, etoh 157, lactate 5.7. ekg showed sinus tachycardia. gi was consulted and recommended octreotide and ppi gtt's, iv ctx. he refused ng lavage. given no ivf. patient has 2 pivs. vitals prior to transfer hr 125, 96%ra, rr 18, bp 156/78. on the floor, patient is currently comfortable. no nausea, abdominal pain, shortness of breath, chest pain, palpitations, lightheadedness, fevers, chills. he is very concerned regarding being intubated for the egd. review of systems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denies cough, shortness of breath, or wheezing. denies chest pain, chest pressure, palpitations, or weakness. denies constipation, abdominal pain. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes or skin changes. past medical history: hcc s/p tace x3 alcoholic cirrhosis with signs of portal hypertension with grade 1 varices and one episode of jaundice. gerd with erosive gastritis htn mgus social history: lives alone. has a brother and sister that live nearby. originally from . - tobacco: none - alcohol: currently drinking every few days, 2-3beers/day, no h/o withdrawal or seizures - illicits: none family history: he had a father with prostate cancer. no other cancer history in the family. physical exam: admission exam: vitals: t: 98.1 bp: 167/87 p: 112 rr: 20 o2: 95%ra general: alert, oriented, no acute distress -> intubated for egd heent: sclera mildly icteric, dry mm, oropharynx clear, poor dentition neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi cv: tachycardic, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, distended, bowel sounds present, no rebound tenderness or guarding gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: aaox3, cns intact, strength and sensation grossly nl. discharge exam: vs tm 99.7, tc 98.1, 124-159/73-95, 63-80, 18-20, 98% ra gen: well appearing man in no acute distress heent: no lad heart: rrr, normal s1, s2, no mrg lungs: ctab, no wheezes, crackles abd: soft, nontender, slightly distended, + bs, no rebound or guarding ext: no edema neuro: cn2-12 intact, no tremors, no asteryxis pertinent results: admission labs: 08:44pm blood wbc-5.6# rbc-3.27* hgb-10.0* hct-30.3* mcv-93 mch-30.5 mchc-32.9 rdw-16.4* plt ct-117* 08:44pm blood neuts-54.0 lymphs-36.6 monos-5.3 eos-3.2 baso-0.9 08:44pm blood pt-17.8* ptt-31.3 inr(pt)-1.6* 08:44pm blood glucose-158* urean-20 creat-0.8 na-142 k-3.9 cl-103 hco3-22 angap-21* 08:44pm blood alt-97* ast-240* alkphos-238* totbili-1.4 08:44pm blood lipase-39 08:44pm blood ctropnt-<0.01 08:44pm blood albumin-3.0* 08:44pm blood asa-neg ethanol-157* acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 10:00pm blood lactate-5.7* micro: bcx: no growth to date studies: cxr: no acute cardiopulmonary process. radiology wrist(3 + views) left findings: fiberglass splint obscures the bony detail. no definite acute fracture. no dislocation. unchanged mild radiocarpal joint space narrowing and sclerosis. unchanged widening of the scapholunate interval. unchanged mild degenerative changes at the capitate-lunate and capitate-scaphoid articulations with some sclerosis. unchanged degenerative changes of the thumb cmc joint with joint space narrowing, sclerosis, and osteophytosis. unchanged degenerative changes of the druj with joint space narrowing and osseous spurring. no change in alignment. unchanged lunatotriquetral coalition. impression: no change as described above. egd: - 2 cords of grade ii varices were seen in the lower third of the esophagus. there were stigmata of recent bleeding - 2 bands were successfully placed in the lower third of the esophagus. - blood in the stomach body - blood in the duodenum discharge labs: 06:15am blood wbc-2.3* rbc-2.91* hgb-9.0* hct-27.7* mcv-95 mch-30.9 mchc-32.4 rdw-17.7* plt ct-73* 06:15am blood pt-14.7* ptt-30.2 inr(pt)-1.3* 06:15am blood glucose-123* urean-14 creat-0.9 na-140 k-3.4 cl-109* hco3-25 angap-9 06:15am blood albumin-2.6* calcium-7.5* phos-2.9 mg-1.7 brief hospital course: mr. is a 60 year old man with h/o etoh cirrhosis, hcc s/p tace, known esophageal varices s/p banding, gastritis, and duodenal ulcer, who presents with gib. #. gib: patient with h/o etoh cirrhosis and hcc s/p tace, known esophageal varices s/p banding in , and , gastritis, and duodenal ulcer. presenting with heme positive brown stool and 2 episodes of dark bloody hematemesis, so likely source is upper. patient is tachycardic, but o/w hemodynamically stable. egd done by liver ?????? banded 2 varices. pt was treated with octreotide drip for 72 hours and ppi iv bid. he was also started on ctx 1g iv daily -> ciprofloxacin 500mg po bid ending for total treatment course of 7 days. pt's nadolol was increased to 60mg po daily. pt was also started on sucralfate given his recent banding procedure. #. elevated lactate: likely to bleed and etoh use. decreased from 5.7 on admission to 2.3 the following morning. #. etoh cirrhosis: patient with etoh cirrhosis, known esophageal varices, prior gibs, now decompensated with recurrent bleed. patient continues to drink and presents with etoh level 157. last drink at noon on . pt's nadolol was initially held given acute bleed but then restarted after pt was monitored and stable, taking pos. it was increased to 60mg daily (see above). pt was also written for ciwa scale but required very little benzo treatment. pt was supplemented w/ mvi/thiamine/folate daily and had a social work consult. pt was repeatedly instructed on the severe dangers of continuing alcohol consumption. pt states that he understands. pt was started on lactulose tid titrated to loose bm daily because he had some mild confusion and significant distortion of his sleep/wake schedule. pt states that his thinking and nocturnal sleeping both improved significantly on lactulose, and this medication was continued on discharge. #. hcc: s/p tace x3. lesions stable on recent imaging. pt is due for repeat outpatient mri in . #. ?wrist fx: patient seen in ed and for wrist pain after bike accident. no fractures seen on xr, but splint was placed for possible scaphoid fracture. supposed to see hand / ortho in , but missed his appointment. only mild pain at this time. have rescheduled his appointment for 1 wk after discharge. #. htn: lisinopril/hctz were held in the setting of acute bleed. pt's nadolol was up-titrated given his hr and bp to 60mg po daily. his discharge bp was ~125/75 and hr ~65. his lisinopril/hctz may need to be restarted at a lower dose if his bp increases. transitional issues: -lisinopril/hctz held given normotensive on increased nadolol; may need to be restarted at a lower dose if his bp increases -hcc - pt will need repeat mri to visualize mass in -continue vigorous counseling efforts to discourage recidivism medications on admission: mvi 1tab po daily nadolol 40mg po daily sucralfate 30cc po bid x 14d (prescribed , to end ) esomeprazole 20mg po bid lisinopril-hctz 20-25mg 2 tabs po daily folate 1mg po daily iron supplementation discharge medications: 1. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po tid (3 times a day): please adjust the amount as needed for a goal of loose bowel movements daily. disp:*3000 ml(s)* refills:*2* 2. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 4 days. disp:*8 tablet(s)* refills:*0* 3. nadolol 20 mg tablet sig: three (3) tablet po daily (daily). disp:*90 tablet(s)* refills:*2* 4. multivitamin oral 5. sucralfate 100 mg/ml suspension sig: thirty (30) ml po twice a day for 1 months. disp:*qs for 1 month ml* refills:*0* 6. folic acid 1 mg tablet sig: one (1) tablet po once a day. 7. iron oral 8. esomeprazole magnesium 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. discharge disposition: home discharge diagnosis: primary: variceal bleed secondary: etoh cirrhosis - portal htn, esophageal varices hcc gerd with erosive gastritis htn discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: mr. , you came to the hospital because you were vomiting blood. you had an emergent upper endoscopy, which showed that you had bleeding from varices (dilated blood vessels) at the bottom of your esophagus. two bands were placed during your procedure and you were started on medications to help control the bleeding. you did not have any evidence of any further bleeding. you were also started on preventative antibiotics, which you will need to continue as an outpatient. we believe that most of your symptoms are related to your continued drinking. you must stop drinking alcohol. we have made the following changes to your medications: -start ciprofloxacin 500mg tablets, 1 tab every 12 hrs until . -start taking lactulose syrup. start with 30 ml by mouth 3 times a day. please adjust the amount as needed for a goal of loose bowel movements daily. -start taking sucralfate 30ml by mouth twice daily for 1 month. -increase your nadolol to 20mg tablets, 3 tabs by mouth daily -stop taking your lisinopril-hctz until you speak with dr. . please continue to take your other medications as previously prescribed. followup instructions: name: , c. location: --primary care address: , , phone: appt: at 10am name: , pa location: --orthopedics/hand clinic address: , , phone: appt: at 2:40pm department: liver center when: friday at 9:00 am with: , md building: lm bldg () campus: west best parking: garage procedure: endoscopic excision or destruction of lesion or tissue of esophagus central venous catheter placement with guidance diagnoses: unspecified essential hypertension acute posthemorrhagic anemia alcoholic cirrhosis of liver malignant neoplasm of liver, primary esophageal varices in diseases classified elsewhere, with bleeding other and unspecified alcohol dependence, unspecified 

Answer: The patient is high likely exposed to