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: doe and tachycardia major surgical or invasive procedure: - upper esophagogastroduodenoscopy (egd) history of present illness: mr. is a 51 year-old man no significant medical history presents from pcp appointment with dyspnea, tachycardia, back pain, to ed found to have new significant hct drop. pt is s/p ed visit for sudden onset sob. at that time he also c/o back pain for 10 days. in the ed, he was found to have mild leukocytosis, no left shift, neg trop x2, neg ddimer, cxr clear, nuclear stress test normal. ekg showed sinus tachycardia. pt was discharged for f/u. since discharge pt continued to experience sob. at this point could barely climb 2 flights of stairs or cross the street which is much more limited than his usual baseline. he denies orthopnea/pnd, but endorses mild chest discomfort in the subcostal areas bilaterally, exacerbated by movement but not by cough or positional changes. . on he noted dyspnea coinciding now with dark stools. no diarrhea or brbpr. no nausea/vomiting. pt denies any history - personal or familial - of gi problems ( discussed colon ca). pt is 51 years of age and has not had a colonoscopy. no history of liver disease or known varices. he denies alcohol or other drug use, no tattoos, and has not spent any time in prison. he does not use medications except that last week he did use nsaids for back pain; he only used 10 pills over the course of 3 days and stopped as he felt they may be causing some abdominal pain. of note, pt has had 15lb weight loss in the past 3 months . ros: denies headache fever, chill, cough, n/v/d, recent travel or sick contacts. . ed course: -initial vitals in the ed were 98.8 108 125/70 20 100%ra. on exam, marroon stool was noted in the rectal vault. -labs showed cbc: 12.3 > 23.6/7.8 < 212 on had h/h of 13.6/40.7 trop-t: <0.01 chemistry: 137/3.6 104/24 23/0.9 glu93 alt: 17 ap: 56 tbili: 0.3 alb: 3.7 ast: 19 lip: 31 probnp: 21 n:64.4 l:29.3 m:5.2 e:0.7 bas:0.5 pt: 11.6 ptt: 26.6 inr: 1.1 -imaging ctpa: 5/3/12prelim dictation no acute intrathoracic process cxr prelim dictation no acute cardiopulmonary process ekg: sr @ 110. twi in ii,avf, v4-v6. -interventions: pt was given asa, pantoprazole 40mg iv and admitted to the micu. on arrival to the micu, patient's vs were 105 112/69 99% ra past medical history: none (pilonidal abscess drained years ago without issues) social history: from originally, works at garage, is a priest. has not seen a doctor in 10 years. single, lives with roommates in a house. has one son, one daughter, both in 20s. not sexually active. denies smoking, etoh, illicit drug. family history: mother: leukemia, died at age 60s, hypertension father: prostate cancer, diet at age 70s physical exam: admission: vitals: hr 103 bp 125/75 98% ra general: overweight male. alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-distended, bowel sounds present, no organomegaly, no tenderness to palpation, no rebound or guarding gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: cnii-xii intact, 5/5 strength upper/lower extremities, grossly normal sensation, 2+ reflexes bilaterally, gait deferred. discharge: vs - 98.5=tmax 150/83 (122-150)/(68-83) 97p 18r 100%ra general - mr. is a pleasant and cooperative man in nad heent- mmm. no sclera icterus, jaundice, or pallor. oropharynx clear. heart - rrr, no m/r/g, no jvd lungs - ctab, no wheeze or rhonchi, unlabored, no accessory muscle use abdomen - protuberant, soft, non-tender, no organomegaly, hyperactive bowel sounds in 4 quadrants of the abdomen extremities - wwp, no clubbing, cyanosis, or edema. dp 2+ bilaterally. pt was not palpated bilaterally. neuro - awake, a&ox3, cns ii-xii grossly intact, sensation grossly intact in upper and lower extremity. pertinent results: 08:39pm blood wbc-12.3* rbc-2.72*# hgb-7.8*# hct-23.6*# mcv-90 mch-29.3 mchc-32.5 rdw-14.0 plt ct-212 08:39pm blood neuts-64.4 lymphs-29.3 monos-5.2 eos-0.7 baso-0.5 08:39pm blood pt-11.6 ptt-26.6 inr(pt)-1.1 08:39pm blood glucose-93 urean-23* creat-0.9 na-137 k-3.6 cl-104 hco3-24 angap-13 08:39pm blood alt-17 ast-19 alkphos-56 totbili-0.3 08:39pm blood probnp-21 08:39pm blood ctropnt-<0.01 08:39pm blood albumin-3.7 08:39pm blood tsh-4.0 08:39pm blood lipase-31 05:49am blood ck-mb-3 ctropnt-<0.01 11:43pm blood wbc-11.5* rbc-2.59* hgb-7.5* hct-23.2* mcv-90 mch-29.0 mchc-32.4 rdw-14.3 plt ct-189 05:49am blood wbc-11.7* rbc-3.11* hgb-9.3* hct-28.1* mcv-90 mch-29.8 mchc-33.0 rdw-14.6 plt ct-195 09:24am blood hct-27.2* 01:46pm blood hct-26.6* 06:15am blood wbc-8.5 rbc-2.99* hgb-8.9* hct-26.8* mcv-90 mch-29.8 mchc-33.2 rdw-15.0 plt ct-205 **final report ** helicobacter pylori antibody test (final ): positive by eia. (reference range-negative). - nuclear exercise stress test resting data ekg: sin.tach., lvh, repol. abn., lae heart rate: 100 blood pressure: 136/88 protocol modified - treadmill / stage time speed elevation heart blood rpp (min) (mph) (%) rate pressure 0 0-3 1.0 8 146 144/78 1 1.7 10 169 168/72 2 6-6.5 2.5 12 171 168/70 total exercise time: 6.5 % max hrt rate achieved: 101 symptoms: none interpretation: this 51 year old man was referred to the lab from the er following negative serial cardiac markers for evaluation of back pain as a possible anginal equivalent. the patient exercised for 6.5 minutes of a modified protocol and stopped for fatigue. the estimated peak met capacity was 4.8 which represents a poor functional capacity for his age. no arm, neck, back or chest discomfort was reported by the patient throughout the study. the baseline ekg showed lvh with repolarization abnormalities, lae and sinus tachycardia. the biphasic t waves normalized with exercise and returned to baseline in recovery. appropriate bp response to exercise with sinus tachycardia at rest. impression: uninterpretable st segments secondary to left ventricular hypertrophy in the absence of anginal type symptoms at a high cardiac demand and poor functional capacity. nuclear medicine report sent separately. radiopharmaceutical data: 11.0 mci tc-m sestamibi rest (); 32.6 mci tc-99m sestamibi stress (); history: 51 yo man referred for evaluation of back pain that was concerning as a possible anginal equivalent. summary of data from the exercise lab: exercise protocol: modified resting heart rate: 100 resting blood pressure: 136/88 exercise duration: 6.5 min peak heart rate: 171 percent maximum predicted heart rate obtained: 101% peak blood pressure: 168/72 symptoms during exercise: none reason exercise terminated: fatigue ecg findings: uninterpretable ecg for ischemia method: resting perfusion images were obtained with tc-m sestamibi. tracer was injected approximately 45 minutes prior to obtaining the resting images. at peak exercise, approximately three times the resting dose of tc-m sestamibi was administered iv. stress images were obtained approximately 45 minutes following tracer injection. imaging protocol: gated spect this study was interpreted using the 17-segment myocardial perfusion model. interpretation: the image quality is adequate but limited due to soft tissue attenuation. left ventricular cavity size is normal. resting and stress perfusion images reveal uniform tracer uptake throughout the left ventricular myocardium. gated images reveal septal hypokinesis with normal thickening, consistent with intraventricular conduction delay. overall left ventricular systolic function is normal with no concerning wall motion abnormalities. the calculated left ventricular ejection fraction is 61% with an edv of 61 ml. impression: 1. normal myocardial perfusion. 2. normal left ventricular cavity size and systolic dysfunction. - cta chest findings: there is no filling defect in the pulmonary arteries to the subsegmental level to suggest pulmonary embolus. tracheobronchial tree is patent to subsegmental levels. no significant mediastinal, hilar or axillary lymphadenopathy. great vessels appear unremarkable. aorta is normal in caliber throughout with no evidence of dissection or aneurysm. the left lung is clear. the right lung shows some very minimal areas of dependent atelectasis (3:37). below the diaphragm there are no gross abnormalities noted. no suspicious lytic or sclerotic lesions are seen. impression: no pulmonary embolus or other acute intrathoracic process. - egd erythema in the duodenal bulb compatible with duodenitis esophagitis in the ge junction compatible with mild esophagitis multiple ulcers were noted in the antrum. none had high risk features or stigmata of recent bleeding otherwise normal egd to third part of the duodenum brief hospital course: 51 y/o m unclear pmh presents with persistent back/chest pain, dyspnea and tachycardia in setting of black tarry stools, found to have significant hct drop over the last 2 days concerning for gi bleed. # upper gi bleed likely due to antral gastric ulcers: patient was noted to have significant hematocrit drop down to 23 from 40 over 2 days. initial chest discomfort was likely due to the gastric ulcers. stress test was negative. the initial tachycardia could also be acute blood loss. cta was negative for pe or dissection. he does not have liver disease or coagulopathy. he received 2 units of prbc during the hospital course. he received pantoprazole bolus then transitioned to an infusion. admitted to the micu and did not have further melena there. he underwent egd which revealed clean-based gastric antrum ulcers that were not bleeding, as well as esophagitis and duodenitis. his h. pylori ab was positive. patient was transitioned to 40 mg pantoprazole and started on clarithromycin and amoxicillin for a total of 14 days course to treat for h. pylori. he will continue with high dose ppi afterward. patient was transferred to the floor and maintained stable hct. his orthostatics were negative on the day of discharge. # weight loss. patient reports unintentional weight loss over 15 months. no clear etiology. ldh was within normal limits. no known history of smoking. he has not yet had screening colonoscopy. no other constitutional symptoms. he will need to have age appropriate cancer screening in the outpatient setting. transitional issues: f/u cbc with pcp routine screening colonoscopy please arrange for repeat egd in weeks per gi recommendation medications on admission: none discharge medications: 1. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day: take 30 minutes prior to breakfast and dinner. disp:*60 capsule, delayed release(e.c.)(s)* refills:*2* 2. amoxicillin 500 mg tablet sig: two (2) tablet po twice a day for 14 days. disp:*56 tablet(s)* refills:*0* 3. clarithromycin 500 mg tablet sig: one (1) tablet po twice a day for 14 days. disp:*28 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary diagnosis: - upper gastrointestinal bleed from gastric ulcer discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mr. , it was our pleasure to care for you in the hospital. you were admitted to because of gastrointestinal bleeding (gi bleeding). while in the hospital, you received 2 units of red blood cells transfusion for your low blood count. in addition, you also had an upper endoscopy of your esophagus, stomach, and part of the small intestines. you did not get a colonoscopy. the upper endoscopy showed that you have ulcers in your stomach, which explains some of the pain that you had before and the maroon colored stool. it was not bleeding anymore. we started a medication called omeprazole to control the acid in your stomach. you were found to have a bacterial infection in your stomach called h. pylori, which we are treating with antibiotics. you should not take any more pain medications such as ibuprofen, aspirin, aleve, advil, or similar medications known as nsaids. if you buy any over the counter medications, you should ask a pharmacist if they contain nsaids. you should avoid drinking alcohol. in addition, avoid coffee, citric food, chocolate, sweets, or oily food. you have an appointment with your primary care doctor to make sure that you are feeling good and that your blood counts are stable. please note the following changes in your medications: - start omeprazole (prilosec) 40 mg, 1 tab, twice a day. you should take this medication 30 minutes before eating breakfast and dinner. - start amoxicillin 500 mg tab, 2 tabs (total of 1 gram), by mouth, twice a day. - start clarithromycin 500 mg tab, 1 tab, by mouth, twice a day. followup instructions: department: when: thursday at 3:15 pm with: , md building: sc clinical ctr campus: east best parking: garage md procedure: other endoscopy of small intestine diagnoses: acute posthemorrhagic anemia loss of weight chronic or unspecified gastric ulcer with hemorrhage, without mention of obstruction duodenitis, without mention of hemorrhage helicobacter pylori [h. pylori] other esophagitis 

Answer: The patient is high likely exposed to