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: hematemasis major surgical or invasive procedure: intubation, egd history of present illness: this is a 67 year old male with a history of hypertension and heavy alcohol use who presents from home with hematemasis and melena. patient was in his usual state of health until the morning of presentation. he woke up at 3 am and vomited bright red blood into his sink. he went back to sleep and woke back up at 6 am and had a dark red bowel movement and vomited blood again. he called an ambulance. he was not experiencing any lightheadedness, dizziness, chest pain, difficulty breathing, abdominal pain. he was experiencing nausea and vomiting as above. he was brought to emergency room. there are no records available from his visit to but per er reports he had an ngt placed which was draining frank blood. he received iv protonix and received one unit of prbcs and was transferred to this hospital for further management. . in the ed, initial vs were: t: 97.8 p: 106 bp: 120/90 r: 16 o2 sat 96% on 2l. he had 1 liter normal saline. he was started on an octreotide drip and admitted to the micu. . on arrival to the micu he denies lightheadedness, dizziness, chest pain, difficulty breathing, nausea, vomiting, abdominal pain, dysuria, hematuria, leg pain. he endorses a history of dyspnea on exertion which is chronic for which he was recently started on advair. he denies a personal history of heart disease but has a strong family history of coronary disease. he endorses heavy drinking but has not had a drink for one week. he endorses a recent upper respiratory tract infection one week ago but symptoms have resolved. he endorses mild lower extremity edema and orthopnea without paroxysmal nocturnal dyspnea. he has had minimal hematemasis before but this is his first significant gastrointestinal bleeding. he has no known history of liver disease. he takes aspirin 81 mg daily but denies heavy nsaid use. all other review of systems is negative in detail. past medical history: hypertension dyspnea on exertion alcohol abuse social history: lives with his grandaughter. he has a 90 pack year smoking history but quit 20 years ago. gallon of hard alcohol per week, last drink 6 days ago. no history of hospitalizations for alcohol abuse or withdrawal. no other illicit drug use. family history: two brothers who died of coronary disease in 50s and 60s. father died of coronary disease in his 70s. no history of gastrointestinal bleeding or malignancies. physical exam: on presentation to the micu: t: 99.7 bp: 163/79 p: 107 r: 22 o2: 96% on 2l general: alert, oriented, no acute distress heent: sclera anicteric, mmm, ngt in place draining blood neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: obese, soft, non-tender, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: foley draining clear yellow urine ext: warm, well perfused, 2+ pulses, trace pitting edema to shins . . on transfer to the floor: vitals: t: 99.6 bp: 150/70 p: 93 r: 22 o2: 92% on 2l general: alert, oriented, no acute distress heent: sclera anicteric, mmm, ngt in place draining blood neck: supple, jvp not elevated, no lad lungs: wheezing bilaterally. cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: obese, soft, non-tender, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused, 2+ pulses, trace pitting edema to shins pertinent results: labs on admission: ......13.9 16.7 ------ 238 ......40.7 . n:82.4 l:13.3 m:3.9 e:0 bas:0.4 . pt: 14.4 ptt: 25.0 inr: 1.2 . 142 108 33 -------------------glucose 107 5.0 26 0.7 . ca 8.1 mg 2.0 phos 3.2 . alt 22 ast 17 alkp 60 tbili 0.6 lipase 13 . ua negative for blood, infxn, trace ketones, glucose neg . hpylori pending 7:58 am sputum site: endotracheal source: endotracheal. gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 1+ (<1 per 1000x field): gram negative diplococci. 1+ (<1 per 1000x field): gram positive cocci. in pairs. respiratory culture (preliminary): further incubation required to determine the presence or absence of commensal respiratory flora. moraxella catarrhalis. moderate growth. bcx negative to date x2 . . ekg sinus tachycardia. otherwise, normal tracing. no previous tracing available for comparison. . cxr impression: left basilar opacification may be atelectasis although pneumonia cannot be completely excluded. consider repeat pa and lateral with encouraged inspiration. repeat lateral may help locate the tip of the og tube which is only seen to the level of the distal esophagus. . cxr findings: as compared to the previous radiograph, the patient has been extubated. the nasogastric tube has also been removed. the size of the cardiac silhouette is unchanged. there is unchanged atelectasis at the left lung base. no evidence of pneumothorax, no newly appeared focal parenchymal opacity. an older very subtle opacity at the bases of the right upper lobe is slightly better seen than on the previous examination. brief hospital course: assessment and plan: 67 hypertension and heavy alcohol use who presents from home with hematemasis and melena. upper gastrointestinal bleeding: on admission to the micu patient was tachycardic with stable blood pressure. he was started on iv pantoprazole, an octreotide drip, and 3 large bore ivs were placed. upper endoscopy showed ulcer in stomach with nearby vessels suspicious for recent bleed, which was injected with epinephrine and electrocautery was performed. patient was intubated during procedure due to difficulty tolerating procedure (not due to hypoxia or respiratory distress). hct's were serially checked and stable. no further episodes of bleeding. he was transfered to the floor on . on arrival to the floor her was asymptomatic and hemodynamically stable. his diet was advanced and he was switched to oral medications. h. pylori serology was positive and he was treated with pantoprazole, clarithromycin and ammoxicillin. he had an epsiode of melena with some bright red blood on . serial hematocrits were stable between 28 at 31% and he had no repeat episodes of melena or hematochezia. pneumonia: patient had l sided infiltrate on cxr, subjective productive cough, and temperature of 100.3 and a sputum gram stain was positve for moraxella. he was started on a five day course of levofloxacin. once h. pylori serologies were positive, he was started on triple therapy and levofloxacin was stopped as amoxicillin and clarithromycin provided adequate cap coverage. wheezing/hypoxia: on arrival to the floor, patient had significant bilateral wheezing and was dependent on supplemental oxygen, with an oxygen saturation of 95% on 3l nc. of note, he describes becoming short of breath at home walking up one flight of stairs, and that this has been a chronic problem for many years. he was treated with his home dose of salmeterol/fluticasone, and given albuterol/ipratropium nebulizer treatments. his breathing improved substantially, and was able to ambulate with assistance and supplemental oxygen on the floor. he will likely require pulmonary function tests and further treatment for possible copd as an outpatient. he was discharged with supplemental oxygen and home physical therapy. hypertension: patient was hypertensive on arrival to the floor with sbp 140-170. he was restarted on his home dose of lisinopril 40mg po daily, and his blood pressure decreased to a sbp of 110-140. history of alcohol abuse: no history of withdrawal. last drink per report . started on valium ciwa scale, and thiamine, folate, multivitamin, but never developed any withdrawal symptoms or required valium. patient was counseled extensively about the risk of repeated gi bleeding with alcohol use, more generally about the health benefits of alcohol cessation. medications on admission: lisinopril 40 mg daily advair 250/50 1 puff aspirin 81 mg daily discharge medications: 1. lisinopril 40 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 2. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: two (2) disk with device inhalation (2 times a day). disp:*120 disk with device(s)* refills:*2* 3. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po twice a day. disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 4. oxygen oxygen 2-3l/min, continuous for portability, pulse dose system. dx: copd 5. amoxicillin 250 mg capsule sig: four (4) capsule po q12h (every 12 hours) for 7 days. disp:*56 capsule(s)* refills:*0* 6. clarithromycin 250 mg tablet sig: two (2) tablet po bid (2 times a day) for 7 days. disp:*28 tablet(s)* refills:*0* 7. multivitamin tablet sig: one (1) tablet po once a day. 8. hydrochlorothiazide 25 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 9. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: puff inhalation twice a day as needed for shortness of breath or wheezing. disp:*1 inhaler* refills:*2* discharge disposition: home with service facility: allcare vna discharge diagnosis: upper gi bleed hypertension history of alcohol abuse discharge condition: vitals stable, ambulating without difficulty. discharge instructions: you were admitted for bleeding in your stomach to the icu. there you had an endoscopy that showed an ulcer which was injected with medication to stop the bleeding. this ulcer and bleeding are likely from long-term alcohol use. it is very important to stop drinking. the following medication changes were made: 1. stopped: aspirin. because of the bleeding in your stomach, you should stop taking your aspirin as it can worsen bleeding. your primary care doctor will determine when and if you should restart it. 2. started: pantoprazole 40mg once a day. you were started on this medication which helps to heal ulcers. you should continue taking this at home indefintely. 3. started: amoxicillin 1000mg by mouth, twice daily for 7 days. and clarithromycin 500mg by mouth twice daily for 7 days. you tested positive for the bacteria helicobacter pylori, which can cuase ulcers. these two antibiotics will treat this. 4. added: mulitvitamin. because of your alcohol abuse, you were started on a multivitamin. you should continue taking one tablet once a day indefinitely. 5. added: albuterol inhaler, please use inhaler twice daily as needed for shortness of breath of wheezing 6. added: hydrochlorothiazide 25mg take once daily. for blood pressure. 6. oxygen: please use supplemental oxygen, set at 2l/min no other medication changes were made, you should continue all your other home medications as directed. please review all medication changes with your primary physician. several appointments were made for you as listed below. it is extremely important for you to keep these appointments. additionally, you will need a repeat endoscopy in 8 weeks. the gi doctor you have an appointment with will schedule that with you when you see him. if you cough up or thrown up any blood, have blood in your stool, chest pain, shortness of breath, abdominal pain, high fever or any other concerning symptoms, please seek medical care immediately. it was a pleasure meeting you and participating in your care. followup instructions: you have an appointment with your primary care doctor, dr. , , , on at 1pm. it is very important that you keep this appointment. if you need to change the appointment, please call . you were also scheduled for an appointment with the dr. on 1pm in gastroentrology here at . if you need to change this appointment, please call . procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube endoscopic control of gastric or duodenal bleeding diagnoses: pneumonia due to other gram-negative bacteria pure hypercholesterolemia unspecified essential hypertension acute posthemorrhagic anemia obstructive chronic bronchitis with (acute) exacerbation personal history of tobacco use hypopotassemia chronic or unspecified gastric ulcer with hemorrhage, without mention of obstruction other and unspecified alcohol dependence, unspecified unspecified gastritis and gastroduodenitis, without mention of hemorrhage helicobacter pylori [h. pylori] cardiomegaly 

Answer: The patient is high likely exposed to