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: the patient is a 53 year-old man with a history of hepatic cirrhosis secondary to chronic alcohol abuse as well as a history of esophageal varices who presented to the emergency department at the on with a chief complaint of one cup full of hematemesis. the patient had previously been admitted to the in with a similar complaint of hematemesis. he stated he had no subsequent episodes of hematemesis following his discharge from the hospital in , but on the day of admission the patient began feeling nauseous and then vomited up approximately one cup full of bright red blood. the patient states he had been particularly depressed of late, and that he had been "bingeing on vodka." the patient also complains of severe insomnia, which he states is only helped by etoh. the patient also admits to recent fatigue, malaise, and a general lack of interest in pursuing his daily activities. he states that over this time while he again resumed drinking alcohol that he also was noncompliant with his medications. past medical history: 1. hepatic cirrhosis secondary to chronic alcohol abuse. 2. history of upper gastrointestinal bleed. 3. esophageal varices. 4. status post partial colectomy secondary to colonic polyps. 5. history of abdominal herniorrhaphy and repair. 6. rosacea. 7. gallstones. 8. splenomegaly. allergies: percocet. medications: 1. furosemide 40 mg po q.d. 2. spironolactone 100 mg po q day. 3. nadolol 20 mg po b.i.d. 4. pantoprazole 40 mg po q.d. 5. thiamine. 6. folate. 7. multivitamins. social history: the patient is currently receiving disability benefits. he previously worked as priest. continues to drink alcohol, and he has occasional episodes of binge drinking. he denies any tobacco or recreational drug abuse. family history: the patient has an extensive family history of alcohol abuse. while in the emergency department the patient continued to vomit bright red blood as well as have coffee ground emesis. her remained hemodynamically stable with a stable blood pressure and a heart rate in the 120s. he refused a nasogastric tube. two large bore peripheral intravenous were placed. the patient was started on octreotide drip administered, pantoprazole intravenously administered 2 to 3 liters of ivf and was also given 2 units of fresh frozen platelets. a esophagogastroduodenoscopy done in the emergency department demonstrated grade 2 varices at the gastroesophageal junction and lower third of the esophagus. injections of sodium morrhuate were made in six of these sites in the distal esophagus. hemostasis was achieved. there was also evidence of blood in the stomach as well as a small hiatal hernia. the esophagogastroduodenoscopy was otherwise normal to the third part of the duodenum. the patient was then transferred from the emergency department to the micu where an initial physical examination was performed. this examination demonstrated a temperature of 98.4 degrees fahrenheit, heart rate 82, blood pressure 149/89, respiratory rate 13, oxygen saturation was 97% on 2 liters of nasal cannula. in general, the patient smelled of liquor and had slurred speech, was alert, oriented, calm and in no acute distress. the patient was vomiting clear liquid with flecks of blood clots. heent examination pupils are equal, round, and reactive to light and accommodation. extraocular movements intact. his sclera were anicteric and his mucous membranes were dry. his neck was supple. there was no lymphadenopathy and there was no jvd. the patient had bibasilar crackles that did not clear with cough. his heart was a regular rate and rhythm. there were normal s1 and s2 heart sounds, and there were no murmurs, rubs or gallops. his abdomen was soft, nontender, nondistended and there were normoactive bowel sounds. he had no peripheral edema. the patient was found to have multiple ecchymoses on his upper extremities. cranial nerves ii through xii were grossly intact. there were no tremors, no evidence of anxiety and no evidence of agitation. laboratory: initial laboratory evaluation demonstrated a white blood cell count of 15.9, hematocrit 37.4, platelets of 167. initial serum chemistries demonstrated sodium of 138, potassium of 4.1, chloride 97, bicarbonate 25, bun 19, creatinine 0.8, and glucose 189. his coagulation studies demonstrated a pt of 14.8, ptt 29 and an inr of 1.5. the differential on his white blood cell count demonstrated 84.5 neutrophils, 7 lymphocytes, 8 monocytes, 0.1% eosinophils and 0.2% basophils. hospital course: 1. gastrointestinal: the patient was started on intravenous ceftriaxone on admission given data that indicated improvement in morbidity and mortality in patient's who receive antibiotics in the setting of an acute upper gastrointestinal bleed. a right upper quadrant ultrasound done on hospital day one demonstrated a diffusely echogenic and nodular liver, ascites surrounding the liver, normal flow in hepatic veins, normal direction of flow and patency of the portal vein and its main branches and enlargement of the spleen. these findings were consistent with the patient's history of cirrhosis. following administration of ivf, the patient's hematocrit initially dropped to 30.5 followed by a drop to 24.7. given this precipitous drop the patient was transfused 2 units of packed red blood cells on hospital day one. his hematocrit subsequently increased appropriately to a level of 30.9 and then remained stable throughout the remainder of his hospitalization. given the drop in hematocrit noted above a repeat esophagogastroduodenoscopy was done on hospital day two. this study demonstrated grade two varices starting at 35 cm from the incisors in the lower third of the esophagus and middle third of the esophagus. these varices were not bleeding. reinjections of sodium morrhuate were applied for hemostasis with success. there was also evidence of thickened nodular gastric folds as well as erythema and granularity in the fundus compatible with gastropathy. the esophagogastroduodenoscopy was otherwise normal to the third part of the duodenum. following this procedure, the patient was given oral clear liquids for the first time during this hospitalization. he tolerated these liquids without complications. on hospital day three the patient was started on a regular oral diet, which he also tolerated without difficulty. he was continued on an octreotide drip for a total duration of 72 hours. he was continued on intravenous antibiotics as noted above throughout his hospitalization. he was given a seven day course of ciprofloxacin to be completed following discharge. he was also restarted on nadolol 20 mg po b.i.d. on hospital day two. once his hematocrit stabilized, he was switched from intravenous pantoprazole twice a day to 40 mg po q.d. the patient's liver function tests were checked on admission. they demonstrated an elevated ldh to 400, low albumin at 3.4 and elevated total bilirubin at 3.0. his ast was also mildly elevated at 51. these elevated values gradually began to decline throughout his admission, although his serum albumin continued to drop and was 3.1 on the day prior to discharge. he should continue to have his liver function tests monitored as deemed necessary by the gi service as an outpatient. the patient is scheduled for a repeat esophagogastroduodenoscopy with banding on with dr. and dr. on the at 12:00 p.m. the patient should report to the lobby/gi unit at noon for the procedure. he will be instructed to be npo after midnight for the procedure. he was also given instructions to scheduled an outpatient follow up with dr. two to three weeks after discharge from the hospital. 2. hematology: as noted above the patient was transfused 2 units of packed red blood cells on hospital day one for a drop in hematocrit. his hematocrit remained stable throughout the remainder of his hospitalization. in addition, the patient presented with a coagulopathy with an admission inr of 1.5. he was subsequently transfused 2 units of fresh frozen platelets and was started on subq phytonadione given his coagulopathy. on the day prior to discharge the patient's platelet count was 66,000. a serum haptoglobin level was checked and found to be in the normal range, therefore providing no evidence for hemolysis. along with his gastrointestinal follow up the patient should continue to have his blood counts monitored on an outpatient basis. 3. pulmonary: the patient had a chest x-ray performed in the emergency department on admission. this radiograph demonstrated a cardiomediastinal silhouette that was normal in appearance. the lungs were clear and there was no evidence of pleural effusions. there was no evidence of pneumonia on this film. 4. psychiatry: as noted in the history of present illness, the patient presented with complaints of decreased mood, loneliness, depression, insomnia and persistent alcohol abuse in the setting of chronic liver disease. he denied suicidal or homicidal ideations at any point. the patient was started on a ciwa protocol to prevent alcohol withdraw. no benzodiazepines were administered at any point throughout the hospitalization. given the patient's depression and persistent alcohol abuse, a psychiatry consult was obtained. the psychiatry service recommended the addition of an anti-depressant (mirtazapine) for mood, anxiety and improved sleep. they also recommended an inpatient alcohol rehabilitation program. while the patient agreed with the need for inpatient alcohol rehabilitation, he stated that he was unable to commit to this plan at the current time, given pending familial obligations. given this impass, the addictions service sought outpatient treatment for the patient and began the process of a referral to the bayridge partial hospitalization substance program. the patient was accepted into this plan and arrangements were made for the program to contact the patient following his discharge from the hospital. the patient agreed with this plan. 5. endocrine: as part of the evaluation of the patient's depression a tsh test was sent. this tes demonstrated a low tsh value and therefore a t4 and t3 level was ordered. these values also came back low. however, review of the literature demonstrated that patients with acute nonthyroidal illness may have low tsh, t4 and t3 values. given these laboratory abnormalities on this admission, the patient should have outpatient follow up of his thyroid function tests. discharge condition: stable. discharge placement: home. discharge diagnoses: 1. upper gastrointestinal bleed secondary to esophageal varices. 2. esophageal varices. 3. blood loss anemia. 4. alcohol abuse. 5. hepatic cirrhosis secondary to long standing alcohol abuse. 6. thrombocytopenia. 7. perihepatic ascites. 8. status post partial colectomy for colonic polyps. 9. status post abdominal hernia repair. 10. history of rosacea. 11. history of cholelithiasis. 12. history of splenomegaly. 13. dorsalis pedis pulse. discharge medications: 1. nadolol 20 mg po b.i.d. 2. furosemide 40 mg po q.d. 3. spironolactone 100 mg po q.d. 4. pantoprazole 40 mg po q.d. 5. ciprofloxacin 500 mg po b.i.d. times seven days. 6. mirtazapine 7.5 mg po q.h.s. 7. mvi one cap po q.d. 8. folate 1 mg po q.d. 9. thiamine 100 mg po q.d. the patient was instructed that he was scheduled for esophagogastroduodenoscopy with banding on with dr. and dr. . he should be npo after midnight on the night prior to the procedure. he should report to the lobby/gi unit on the at noon on the day of the procedure. he was instructed to avoid all etoh. he was also instructed to schedule an outpatient follow up appointment with dr. two to three weeks after discharge. the remainder of the discharge plan is outlined above. , m.d. dictated by: medquist36 procedure: other endoscopy of small intestine endoscopic excision or destruction of lesion or tissue of esophagus endoscopic excision or destruction of lesion or tissue of esophagus diagnoses: thrombocytopenia, unspecified acute posthemorrhagic anemia alcoholic cirrhosis of liver esophageal varices in diseases classified elsewhere, with bleeding other and unspecified alcohol dependence, continuous 

Answer: The patient is high likely exposed to