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: upper gi bleed major surgical or invasive procedure: egd , history of present illness: 68 y/o f with pmhx as below, otherwise significant for recurrent sigmoid diverticulitis and severe copd, admitted to osh on with sob, malaise, and elevated wbc. a cxr showed an infiltrate in the rml c/w pneumonitis. a ct abd/pelvis showed rml infiltrate, no evid of diverticulitis. her vs were sig for mild hypoxia to 91% on ra -> 96% 2l nc. she was admitted to their medical floor and treated with zosyn for cap due to her recent hospitalization. she was also placed on iv solumedrol & nebulizers to cover a possible copd exacerbation. a chest ct obtained on showed a large hiatal hernia (old) with large amt of food impaction and ? chronic aspiration (patchy rml and lll infiltrates). gi was consulted who performed an egd on which revealed esophagitis and fresh blood at the distal end of the esphoagus which was injected twice with epi. a large amt of clots were seen in the stomach without other etiology. a repeat hct showed a hct of 27 (36 on admission?) and 1u prbc was given. 10mg sc vit k was given for an inr of 1.7. hct bumped to 34, then back down to 27. a repeat egd on again demonstrated showed active bleeding in the distal esophagus with large amt of clots in the stomach. due to poor visibility, no further action was taken. an addt'l unit of prbc was given, protonix gtt was started, and pt was transferred to for repeat egd/intervention. given her gib her steroids were returned to her home dose of 5mg of prednisone. . on arrival, pt c/o epigastric abd pain, radiating to the luq. she denies any recent n/v, hematemesis, brbpr, or hematochezia. last bm today was reportedly guiaic (-). she otherwise denies any f/chills, productive cough, chest pain, dysuria, or any other symptom. past medical history: 1) recurrent sigmoid diverticulitis s/p sigmoid resection 12/. c/b mild wound infection. 2) severe copd on chronic steroids. fev1 30% per report. uses home oxygen intermittently. 3) insulin dependent dm 4) htn 5) gerd 6) dysphagia 7) esophageal stricture s/p resection in . 8) pud/gastritis/esophagitis 9) hx of hiatal hernia 10) ? gastroparesis 11) chronic anemia 12) osteoporosis social history: heavy etoh use, "couple of pints on the weekend." quit 1 yr ago. former tob user, 25 pk-yr hx, quit 8 mo ago. no drug use. recieved pneumonvax, flu vaccine this year. lives at home alone - no family members. family history: non-contributory physical exam: physical exam on micu admission: vs: temp:98.6 bp:121/65 hr:97 rr:16 o2sat: 92% on 1.5l nc gen: pleasant, in mild discomofort due to pain heent: perrl, eomi, anicteric, mm dry, op without lesions neck: no supraclavicular or cervical lymphadenopathy, no jvd, no carotid bruits, no thyromegaly or thyroid nodules resp: mild end-expiratory wheezing but otherwise good air movement throughout. no rales or crackles noted. cv: rr, s1 and s2 wnl, no m/r/g. + r subclavian in place abd: ttp over epigastrium radiating into luq. no ruq tenderness. no rebound or guarding. no masses or hepatosplenomegaly ext: no c/c/e, warm, good pulses skin: no rashes/no jaundice neuro: aaox3. cn ii-xii intact. 5/5 strength throughout. no sensory deficits to light touch appreciated. pertinent results: complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 09:31am 26.5* 06:10am 8.2 2.61* 8.1* 24.8* 95 30.9 32.6 15.5 399 . 05:26am 16.7* 3.03* 9.1* 28.7* 95 30.2 31.8 16.4* 432 07:24pm 17.8* 3.21* 10.1* 29.9* 93 31.4 33.7 15.4 391 . renal & glucose glucose urean creat na k cl hco3 06:29am 85 4* 0.5 145 3.6 110* 30 05:23am 79 4* 0.5 143 4.0 109* 30 . 05:26am 64* 27* 0.5 142 4.5 111* 26 07:24pm 87 30* 0.6 142 4.4 111* 27 . enzymes & bilirubin alt ast ld(ldh) alkphos totbili 07:24pm 13 12 177 100 0.2 . esophageal biopsy squamous mucosa with focal mild active esophagitis. no glandular mucosa seen. . portable cxr left effusion and airspace disease, the latter slightly progressed versus prior. again, pneumonia and atelectasis are possible. brief hospital course: 68 y/o f with pmhx as below, otherwise significant for recurrent sigmoid diverticulitis and severe copd, admitted to osh on with cap, found to have ugib . # ugib: has long-standing history of severe gerd and esophagitis however no h/o gib; had prior esophageal resection for dysphagia, found to have stricture. s/p egd x 2 during admission, no evidence of active bleeding seen however initial egd showed blood in stomach; and biopsy showed esophagitis. hematocrit remained stable during admission, she did not require any blood transfusions here although she received 2u at osh. h.pylori serology negative. continued pantoprazole daily, however also added carafate prior to discharge for abdominal pain. . # abdominal pain: localized to luq & epigastric area. unclear etiology, improved during pt's stay. etiology still unclear as egd done unrevealing, however biopsy showed esophagitis. pain control with dilaudid prn, pain improved during stay. pt to f/u with pcp for further evaluation. . # copd: pt with significant copd, on oxygen as needed at home. had initially been treated at osh hospital with high dose steroids, tapered down to home regimen prednisone 5mg po daily. her o2sats were adequate here, did not require oxygen. we continued her on home regeimn advair, spiriva and nebs as needed. . # dm: well controlled on admission, held lantus 7u at bedtime while on clear liquid diet. resumed prior to discharge. . # htn: restarted pt on home regimen of furosemide 20mg po daily prior to discharge. had been held on admission due to ugib. . # osteoporosis: continued pt on home regimen evista. . # leukocytosis: resolved prior to discharge, had been treated for cap at osh with 10day course of zosyn, also ?leukemoid reation from steroids. no evidence of active infection as afebrile without leukocytosis. no antibiotics. . pt reached maximal hospital benefit and was discharged home to follow up with gastroeneterology as well as pcp. medications on admission: home meds: lantus 7u qhs asa 81' trazadone 100 qhs evista 60' protonix 40" advair 250/50 spiriva zocor 20' lasix 20' pred 5' . meds on transfer: protonix gtt 8mg/hr advair spiriva prednisone 5mg dilaudid prn zinc 220'/vit c 500" thiamine 100' kdur 10' zocor 20' evista 60' trazadone 100 qhs zosyn 3.375 iv q6 senna/colace benadryl insulin ss xopenex zofran prn . allergies: nkda discharge medications: 1. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 2. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). 3. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 4. prednisone 5 mg tablet sig: one (1) tablet po daily (daily). 5. raloxifene 60 mg tablet sig: one (1) tablet po qdaily (). 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 7. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 8. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 9. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 10. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). 11. trazodone 100 mg tablet sig: one (1) tablet po hs (at bedtime). 12. insulin glargine 100 unit/ml solution sig: seven (7) units subcutaneous at bedtime. 13. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed. 14. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. disp:*30 tablet(s)* refills:*0* 15. sucralfate 1 gram tablet sig: one (1) tablet po qid (4 times a day). disp:*120 tablet(s)* refills:*2* discharge disposition: home with service facility: vna discharge diagnosis: upper gi bleed severe copd insulin dependent diabetes discharge condition: stable discharge instructions: you were transferred from for egd and further management of upper gi bleed. egd showed some inflammation of the lining of your stomach and no further bleeding. . we have not made any changes to your medications, we have added carafate which coats your abdomen and may help with abdominal pain. we recommend that you do not drink alcohol or use aspirin as this may affect bleeding in your stomach & esophagus. . call your pcp or come to the emergency room if you develop chestpain, shortness of breath, fatigue, blood in your stools or black stools. followup instructions: you have an appointment with your pcp . on @ 10am. office# . you will need to have a repeat cxr by your pcp to evaluate resolution of your pneumonia, please discuss this with her. . gastroenterology f/u with dr on @ 430pm. office # . you will need to have your hematocrit checked at that time. procedure: other endoscopy of small intestine esophagogastroduodenoscopy [egd] with closed biopsy transfusion of packed cells diagnoses: other and unspecified noninfectious gastroenteritis and colitis esophageal reflux unspecified essential hypertension adrenal cortical steroids causing adverse effects in therapeutic use acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled chronic airway obstruction, not elsewhere classified alcohol abuse, unspecified long-term (current) use of insulin osteoporosis, unspecified other postprocedural status hemorrhage of gastrointestinal tract, unspecified esophagitis, unspecified abdominal pain, generalized leukocytosis, unspecified gastroparesis other dependence on machines, supplemental oxygen 

Answer: The patient is high likely exposed to