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: patient is a 78-year-old male with history of gastritis with one prior episode of melena a few years ago which was not worked up and a history of alcohol abuse transferred from to medical intensive care unit with diagnosis of gastrointestinal bleed status post four units of packed red blood cells. patient received an additional one unit of packed red blood cells at . patient was diagnosed with a dieulafoy's lesion in . egd here on revealed a short segment of barrett's esophagus, erythema, and friability of the body of stomach and duodenum and angiectasia of the body of the stomach treated with thermal therapy in addition to the second part of the duodenum, which was also treated with thermal therapy. on presentation patient was vomiting blood and nearly passed out. he states that he has not been feeling good and has been extremely tired for the past couple months. he is unsure if he has had black stools in the past. he denies history of peptic ulcer disease or nonsteroidal anti-inflammatory drugs use, positive increased stress secondary to losing his wife less than a year ago. past medical history: 1. gastritis with history of one episode of melena a few years ago not worked up followed by dr. of . 2. atrial fibrillation on coumadin. 3. chronic obstructive pulmonary disease diagnosed five years ago. 4. abdominal aortic aneurysm diagnosed two years ago. 5. hypertension. 6. alcohol abuse. 7. left wrist fracture following a motor vehicle accident three weeks ago. patient is currently in cast. allergies: no known drug allergies. social history: positive tobacco, two packs per day, times 50 years. alcohol: four to six beers per day times 50 years. positive history of withdrawal seizures in the hospital. no history of drug use. patient is widowed. he has two daughters who accompany him today. he is a retired maintenance supervisor. physical examination: temperature 99.3, heart rate 66, blood pressure 144/78, respiratory rate of 20, satting 95% on room air. in general, he is in no apparent distress. heent: sclerae anicteric; pupils equally reactive to light and accommodation; extraocular movements intact; oropharynx is clear except for break down in lesion noted on the buccal mucosa. neck: no lymphadenopathy or jugular venous distention. pulmonary: diffuse inspiratory wheeze; no rhonchi or rales. cardiovascular: irregular irregular; no murmurs, rubs, or gallops appreciated. abdomen: normoactive bowel sounds; soft but appears distended; nontender; no hepatosplenomegaly. extremities: no clubbing, cyanosis, or edema except the left fingers appear cyanotic distal to the left wrist cast but are warm to touch. neuro: alert, oriented times three; cranial nerves ii-xii grossly intact. laboratory and diagnostic data: admission hematocrit 29.2, inr 1.2, alt 80, ast 97. blood cultures no growth. troponin t 0.16, 0.10, 0.05, ck-mb ranged from 2 to 6. tsh 1.2, sodium 129, serum osmolality 263, urine osmolality 570, urine sodium 30. ekg: atrial fibrillation at a rate of 77 beats per minute; no st elevation or t-wave inversion. chest x-ray: stable cardiomegaly; no failure or infiltrate. urinalysis: negative nitrate, leukocyte esterase, 3 to 5 white blood cells, 0 white blood cells, no bacteria. hospital course: patient is a 78-year-old male with history of gastritis with gastrointestinal bleed in status post a total of five units packed red blood cells with egd here showing two angiectasias treated with thermal therapy, also with stomach and duodenal erosion. hematocrit stable but slowly trending down. 1. gastrointestinal bleed: patient status post one unit packed red blood cells during his stay in the medical intensive care unit. patient bumped appropriately to this transfusion; however, his hematocrit again decreased the following day. patient was continued on a q. day proton pump inhibitor. his hematocrit remained stable on the floor; however, he continued to have black bowel movements, and this was followed for an additional 24 hours. his hematocrit remained stable for a total of 48 hours. he was thus discharged with plan for follow-up egd in six weeks. 2. cardiovascular: patient noted to have troponin leak in the context of a significant gastrointestinal bleed. this was likely thought to be secondary to demand ischemia in the context of a decreased hematocrit requiring increased cardiac output. no ischemic changes were noted on ekg, and patient ruled out by serial cardiac enzymes. patient was continued on restarted beta blocker. initiated this at admission. no indication for angiotensin-converting enzyme inhibitor. patient did not receive daily aspirin secondary to the context of a gastrointestinal bleed. patient instructed to seek outpatient follow up for lipid panel and further management of his cardiac health. 3. chronic obstructive pulmonary disease: patient unaware of diagnosis. he was managed with albuterol p.r.n. wheezing. he maintained his oxygen saturation on room air with little intervention. 4. history of alcohol abuse: patient maintained on the ciwi scale; however, no evidence of tremulousness, anxiety, diaphoresis, or palpitations. repeated reinforcement was given for absence of alcohol in the context of a gastrointestinal bleed as this will increase his risk for occurrence. patient was maintained on thiamine and folate. 5. hyponatremia: patient noted to have hyponatremia. urine and serum osmolality in addition to urine sodium consistent with syndrome of inappropriate antidiuretic hormone possibly secondary to pulmonary disease versus stress. patient was maintained on a 1.5 liter fluid restriction. his sodium remained stable. 6. atrial fibrillation: tsh was noted to be within normal limits. patient's risk factors for atrial fibrillation include copd and alcohol use. no anticoagulation was initiated secondary to his gastrointestinal bleed. 7. persistent low-grade fever with bandemia: concern for pneumonia considering patient developed an oxygen requirement. a pa and lateral chest x-ray was obtained. no infiltrate was noted. likely, his fevers are secondary to atelectasis. patient was discharged without instructions or prescription for antibiotics. urinalysis and blood cultures were negative this admission. 8. smoking cessation: patient counseled regarding the importance of smoking cessation in the context of a gastrointestinal bleed. he was started on bupropion for aid with his attempt to quit tobacco. discharge diagnoses: 1. gastrointestinal bleed. 2. syndrome of inappropriate antidiuretic hormone. discharge condition: good; hematocrit stable for past 48 hours; satting well on room air; sodium stable. disposition: discharged to home with services. discharge medications: 1. colace 100 mg p.o. b.i.d. 2. folate 1 mg p.o. q. day. 3. multivitamin one q.d. 4. thiamine 100 mg p.o. q. day. 5. protonix 40 mg p.o. q. day. 6. albuterol one to two puffs inhaled q. 6 hours p.r.n. 7. metoprolol 25 mg p.o. b.i.d. 8. atrovent two puffs q.i.d. 9. bupropion 150 mg p.o. q. a.m. discharge instructions: 1. patient is to follow up with his primary care provider, . , within one week to check his blood count and sodium and for further management of copd and aid with quitting alcohol and tobacco in addition to restarting his coumadin. 2. patient is to follow up for repeat egd . 3. patient is to follow up with his cardiologist, dr. , regarding the stress to his heart in the context of his gastrointestinal bleed. dr., 12-735 dictated by: medquist36 procedure: other endoscopy of small intestine endoscopic control of gastric or duodenal bleeding transfusion of packed cells diagnoses: tobacco use disorder unspecified essential hypertension chronic airway obstruction, not elsewhere classified atrial fibrillation alcohol abuse, unspecified long-term (current) use of anticoagulants chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction other disorders of neurohypophysis barrett's esophagus 

Answer: The patient is high likely exposed to