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: portal vein thrombosis major surgical or invasive procedure: picc line placement, removed on day of d/c history of present illness: 45 year old male without no known past medical history presents with portal vein thrombosis. the patient presented to the hospital ed on with complaints of marked abdominal pain. he reports that the pain began approximately 5 days prior to admission here as a dull ache in his lower back with diffuse pain in the abdomen that was sharper in nature. he reports it was constant, not worse with eating or movement. he reports nausea, but no vomiting. he notes he had chills, but denies fevers. he reports constipation, no other changes in his stools. he was initially seen on pm in the ed at which time he received ivfs and was discharged with percocet for pain. his condition worsened, and he went to his pcp who believed that this might be viral hepatitis and thus sent hepatitis serologies and additional labs, which were significant for mild transaminitis. his pcp ordered for further evaluation which, per the admit note to hospital, revealed mild edema and infiltration in the mesentery and the retroperitoneum with pericolic gutter ascites suggestive of pancreatitis (he does not come with official report). also noted on ct were splenic varices suggestive of portal hypertension with a question on ct of portal vein thrombosis. he was scheduled for an outpatient ruq ultrasound to further evaluate the portal vein flow, but his pain became too severe so he presented to hospital ed for further evaluation. at hospital, ruq ultrasound doppler revealed main portal vein, right and left branch portal vein thromboses. although not explicitly noted in the ultrasound report, it is noted on the hospital admission note that there was concern for smv thrombosis, although further information was not available and the physician requesting transfer did not state this concern. he received 100mg sc lovenox. he had progressive difficulty eating/drinking due to worsening nausea along with gastric distension. a nasogastric tube was placed for with relief; initial output was 500cc and admission notes greenish/brown fluid which was guaiac positive, although he was guaiac negative from below. his abdominal pain remained significant so he was started on a dilaudid pca with some mild improvement in his pain. vascular surgery was consulted and recommended transfer to for ir portal vein thrombolysis procedure along with hepatology consultation. past medical history: adhd depression anxiety low testosterone obesity social history: he is the director of economic development for and lives with his partner. is a nonsmoker and denies etoh and other illicits. over 20 years ago, he would drink etoh heavily on weekends, but none since. no h/o ivdu. family history: no family history of liver disease. no history of autoimmune disease or ibd. no history of thromboses. mother did not have miscarriages. father and with mis in their 50s, mother with type 2 dm physical exam: ros: gen: - fevers, + chills, - weight loss eyes: - photophobia, - visual changes heent: - oral/gum bleeding cardiac: - chest pain, - palpitations, - edema gi: + nausea, - vomitting, - diarhea, + abdominal pain, + constipation, - hematochezia pulm: - dyspnea, - cough, - hemoptysis heme: - bleeding, - lymphadenopathy gu: - dysuria, - hematuria, - incontinence skin: - rash endo: - heat/cold intolerance msk: - myalgia, - arthralgia, - back pain neuro: - numbness, - weakness, - vertigo, - headache physical exam: vss: 97.5, 147/85, 100, 18, 96% gen: uncomfortable pain: heent: eomi, dry mm, - op lesions pul: cta b/l cor: tachycardic, rrr, s1/s2, - mrg abd: tender to deep palpation (greatest in ruq), - rebound, - guarding, +bs, - cvat ext: - cce neuro: caox3, non-focal derm: - telangectasia, - spider angiomata, - jaundice, - rash pertinent results: admission labs: wbc-11.1* rbc-4.93 hgb-14.4 hct-42.7 mcv-87 mch-29.1 mchc-33.6 rdw-13.7 plt ct-176 neuts-84.8* lymphs-9.9* monos-4.8 eos-0.3 baso-0.1 pt-14.7* ptt-25.0 inr(pt)-1.3* glucose-120* urean-16 creat-0.6 na-141 k-3.9 cl-106 hco3-25 angap-14 alt-56* ast-21 alkphos-53 amylase-61 totbili-1.1 lipase-145* albumin-3.4 calcium-7.9* phos-2.0* mg-2.0 lactate-1.4 on discharge: wbc-3.8* rbc-4.05* hgb-12.3* hct-35.6* mcv-88 mch-30.5 mchc-34.7 rdw-14.6 plt ct-174 pt-14.8* ptt-65.5* inr(pt)-1.3* glucose-104 urean-11 creat-0.6 na-139 k-4.4 cl-105 hco3-28 angap-10 . imaging ruq u/s: 1. limited ultrasound examination given poor acoustic window and habitus. the main portal vein is thrombosed, with extent into the superior mesenteric vein difficult given overlying bowel gas. a cta abdomen be performed for further evaluation. 2. diffusely echogenic liver consistent with fatty infiltration. however, other forms of diffuse fibrosis/cirrhosis cannot be excluded. 3. splenomegaly. 4. small-to-moderate amount of ascitic fluid in the right upper quadrant. . ct abdomen/pelvis: . 1. chronic portal vein occlusion with cavernous transformation, extending to smv, most notably in the left mid abdomen, where there is venous and mesenteric edema and a focally thick-walled segment of jejunum in keeping with mesenteric ischemia. 2. heterogeneous perfusion of the liver without focal lesion. early changes of cirrhotic liver disease are present including ascites, splenomegaly, and left hepatic atrophy. . repeat ct a/p on : 1. portal, splenic, and superior mesenteric venous thrombosis, as on prior examination. cavernous transformation as noted. 2. multiple mildly dilated loops of small bowel. given the aforementioned venous thrombosis, likely differential considerations do include mesenteric ischemia. 3. heterogeneous attenuation of the liver suggesting abnormality in perfusion related to portal venous thrombosis. 4. moderate ascites. 5. right-sided pleural effusion. brief hospital course: a/p: 45yo previously healthy man presented to osh with abdominal pain, found to have portal vein thrombosis, transferred to for potential intervention, hct was trending down with blood in transferred to the icu for closer monitoring, now s/p egd with no significant findings, retransferred to floor. . #) portal vein thrombosis: etiology not entirely clear. differential includes hypercoagulability, malignancy, pancreatitis, cirrhosis. appears to be acute on chronic given splenomegaly and collaterals seen on imaging. ct showed chronic protal vein occlusion extending into smv with thickened jejunum suggesting mesenteric ischemia. extensive liver workup negative thus far. lipase trended down. #) ugib- patient initially had brb and coffee grounds in ngt. hematocrit dropped from 43.8--> 38 but remained stable thereafter. patient remained hd stable. pt used nsaids occasionally once per week and no etoh to suggest pub. no vomiting to suggest boerhaves or tear. not brisk enough to suggest variceal bleed. egd on without any significant findings, also no portal gastropathy. #) depression/anxiety: patient currently npo and ngt to intermittent suction so will not be able to administer po antidepressant. patient was transferred to the surgical service and followed with abdominal exams. he was started on a heparin drip for the pv thrombus and began coumadin on . despite having to reinsert the ngt following a large meal, he remained stable and without indication that this was indeed a small bowel obstruction. he was passing flatus and had several bms. in addition after removal of the ngt the second time and very cautious reinstatement of clears and then low residue diet, he tolerated this very well withour further nausea or vomiting. in the interim he received several days of tpn for nutritional support. no surgical intervention was performed. in response to the finding of portal vein thrombus he will bridge as an outpatient on lovenox and coumadin until inr therapeutic in the 2-3 range. inr and coumadin dosing will be followed by patients pcp dr at his primary clinic in . medications on admission: home meds: percocet 2 tabs po q6h prn pain zoloft 100mg po daily ritalin 10mg po bid androgel pseudoephedrine prn meds on transfer: dilaudid pca (continuous rate of 0.1mg with 5min lockout, total 1.2mg/hour) protonix 40mg iv daily zofran 4mg iv q6h discharge medications: 1. sertraline 100 mg tablet sig: one (1) tablet po daily (daily). 2. methylphenidate 5 mg tablet sig: one (1) tablet po bid (2 times a day). 3. testosterone 2.5 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal q24h (every 24 hours). 4. enoxaparin 100 mg/ml syringe sig: one (1) subcutaneous (2 times a day). disp:*10 syringes* refills:*1* 5. pseudoephedrine hcl 30 mg tablet sig: one (1) tablet po prn as needed for allergy symptoms. 6. multivitamin tablet sig: one (1) tablet po once a day: do not get a tablet with iron. 7. outpatient lab work draw pt/inr on friday and fax results to attn dr 8. coumadin 5 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 9. coumadin 1 mg tablet sig: two (2) tablet po once a day: take as directed. disp:*60 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: portal vein thrombus discharge condition: good discharge instructions: please call dr office at if you develop fever > 101, chills, nausea, vomiting, diarrhea or have no stool for more than 2 days. call or return to er if you develop abdominal pain. watch for signs of bleeding to include nosebleed, rectal bleeding or easy bruising. have pt/inr checked on friday and have results faxed to . lovenox injections to continue until coumadin level is therapeutic continue low residue diet goal inr followup instructions: call dr office at to arrange follow up appointment follow up with dr . he will be monitoring coumadin dosing as an outpatient. procedure: venous catheterization, not elsewhere classified diagnoses: dysthymic disorder obesity, unspecified hemorrhage of gastrointestinal tract, unspecified acute vascular insufficiency of intestine attention deficit disorder with hyperactivity nonspecific elevation of levels of transaminase or lactic acid dehydrogenase [ldh] portal vein thrombosis unspecified endocrine disorder 

Answer: The patient is high likely exposed to