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: chief complaint: ugib reason for micu transfer: active ugib major surgical or invasive procedure: upper endoscopy intubation history of present illness: 53 year old woman with etoh and hcv (untreated) cirrhosis, actively drinking etoh, polysubstance abuse, history of pud , presented with hematemesis and melena since . she initially presented to hospital on where she was hemodynamically stable, but had witnessed hematemesis of 200cc of bright red blood in the osh ed. she had associated lightheadedness and was confused compared to baseline (per family). she denied abdominal pain, fever, sob or chest pain. she had been taking nabumetone prior to admission, denies other nsaids. at the osh she received 2u prbc, 3u ffp, 1 unit platelets, 10mg vit k, and ceftriaxone. egd showed oozing portal gastropathy and non-bleeding esophageal varices. she was placed on octreotide and ppi drips. she had signs of alcohol withdrawl and received ~100mg of iv valium. she was transferred to on for possible tips. labs prior to transfer from osh include hct 28.8, plt 48, inr 1.6, tbili 9.9, ast 117, alt 36, cr 0.4. etoh level on at 19:28 was 36. last drink was reportedly . on arrival to the micu, vitals were hr 118, bp 140/100 and 95% ra. she was encephalopathic and not answering questions, barely opening eyes to sternal rub. her ngt was draining maroon blood. she was continued on octreotide drip, transitioned to iv ppi given lack of ulcer disease seen on osh ed, and given ceftriaxone. she was intubated for airway protection for repeat egd and ongoing encephalopathy, sedated with propofol. gi was consulted for urgent egd. review of systems: unable to obtain past medical history: etoh abuse hcv untreated -seen at and cirrhosis due to above issues htn peptic ulcer disease with hematemesis gastric antrum vascular ectasias left ankle fracture social history: currently drinking, history of alcohol abuse. family history: noncontributory physical exam: admission exam: vitals: 99.6 122 152/84 21 94% general: obtunded, barely opening eyes to sternal rub heent: sclera icteric, oropharynx clear, perrl neck: supple cv: sinus tachycardia, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-tender, distended, ascites gu: foley ext: warm, well perfused, 2+ pulses neuro: obtunded, withdraws to pain bilaterally, perrl . discharge exam: general: aox3, appropriate, no asterixis heent: icteric sclera abd: soft, distended, +ttp over upper quadrants neuro: grossly intact otherwise as above pertinent results: admission labs: 10:47am blood wbc-4.9 rbc-3.15* hgb-10.9* hct-33.9* mcv-107* mch-34.7* mchc-32.3 rdw-17.1* plt ct-52* 10:47am blood neuts-84.3* lymphs-8.7* monos-5.2 eos-0.7 baso-1.0 10:47am blood pt-16.7* ptt-32.7 inr(pt)-1.6* 10:47am blood glucose-138* urean-11 creat-0.5 na-142 k-3.3 cl-104 hco3-27 angap-14 10:47am blood alt-27 ast-99* ld(ldh)-461* alkphos-70 totbili-7.6* 10:47am blood albumin-3.4* calcium-8.0* phos-1.9* mg-2.4 08:27pm blood type-art po2-122* pco2-39 ph-7.48* caltco2-30 base xs-6 discharge labs: 08:30am blood wbc-9.7 rbc-3.41* hgb-11.7* hct-36.7 mcv-108* mch-34.3* mchc-31.9 rdw-16.9* plt ct-181 08:30am blood pt-22.4* ptt-34.7 inr(pt)-2.1* 08:30am blood glucose-134* urean-4* creat-0.4 na-132* k-3.2* cl-99 hco3-26 angap-10 08:30am blood alt-40 ast-87* alkphos-99 totbili-16.9* 08:30am blood albumin-2.6* calcium-8.9 phos-3.2 mg-1.6 micro: blood: no growth urine: s.bovis, no growth hcv vl 88,614 hcv genotype pending egd: impression: esophageal varices (ligation) abnormal mucosa in the stomach blood in the whole stomach a lesion most consistent with a dieulafoy lesion was seen in the body of the stomach. there was an adherent clot. (endoclip) blood in the whole examined duodenum otherwise normal egd to third part of the duodenum liver ultrasound: impression: 1. hepatopetal flow seen in the main and right portal veins. slow flow which is possibly bidirectional is seen in the left portal vein on limited views. the hepatic veins and ivc are patent. 2. cirrhotic appearing liver with no focal liver lesion identified. 3. splenomegaly. a scant trace ascites in the right upper quadrant. cxr: impression: 1. ett in standard position, with overinflated cuff. 2. ngt in proximal stomach, and could be advanced a few centimeters. 3. mild pulmonary edema. echo; the left atrium is normal in size. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is moderate pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. impression: normal left ventricular cavity size and wall thickness with preserved global and regional biventricular systolic function. no clinically significant valvular disease. moderate pulmonary artery systolic pressure. egd findings: esophagus: excavated lesions a single non-bleeding 9 mm clean base ulcer with white exudates on top from prior banding was found in the lower third of the esophagus . other no evidence of barretts ro active bleeding was identified stomach: contents: white liquid fluid was seen in the entire stomach. a hemoclip was found in the fundus. where the dielofoy lesion was identified. no active signs of bleeding mucosa: localized discontinuous mosaic appearance of the mucosa with no bleeding was noted in the stomach body. these findings are compatible with mild portal gastropathy. other no evidence of active bleeding, ulcers or polyps duodenum: protruding lesions a sub-mucosal non-bleeding 1.5 cm mass of benign appearance was found at the second part of the duodenum. the scope traversed the lesion. other no active bleeding was identified in the duodenum brief hospital course: 53 year old woman with etoh, hcv cirrhosis, actively drinking etoh with evidence of alcoholic hepatitis on labs who presented with hematemesis and melena, s/p banding grade 3 esophageal varices and dieulafoy clipping. patient was admitted to icu for ugib. following egd patient remained hemodynamically stable, was sucessfully extubated and was transferred to medical floor. # upper gi bleeding: patient presented with ugib. received a total of 3 units prbcs and ffp at osh. bleeding resolved after dieulafoy clipping and variceal banding. tips is an option should bleeding recur. hct has been stable since clipping/banding. patient was continued on octreotide gtt for 72 hours after bleeding stopped. she received protonix 40 mg iv bid. she was started on ceftriaxone 1 g q24 for 5 days after bleed for sbp prophylaxis. patient was started on carafate slurry and nadolol 48 hrs after cessation of bleeding. she remained hemodynamically stable and was called out to medicine floor where she had no recurrence of her bleed. she was discharged on a ppi, nadolol and a fourteen day course of carafate. # encephalopathy: etiology likely hepatic encephalopathy triggered by gi bleed or alcoholic hepatitis although could be medication effect vs uti. no evidence of pvt/budd chiari or liver mass on ruq us. mental status improved with extubation and lactulose. patient was continued on lactulose and rifaxaimin with improvement in encephalopathy. she was oriented, appropriate and without asterixis at discharge. # alcoholic hepatitis: patient was actively drinking leading up to this admission and labs show evidence of alcoholic hep with elevated ast, tbili, inr. following extubation, encouraged aggressive nutrition with dobhoff tube but patient refused so she was encouraged to drink six ensures a day in addition to her regular meals. pentoxyfylline was started and her liver enzymes initially continued to trend up with discriminant factors > 50. repeat egd was performed to determine whether it would be safe to start steroids but this showed prominent ulceration and gastropathy that seemed susceptible to bleeding so steroids were not started. at discharge her lfts were stabilizing so she was discharged on a 28 day course of pentoxyfylline. she was encouraged to follow-up with her outpatient hepatologist. social work and the team expressed to her the importance of abstaining from alcohol and entering relapse prevention. # decompensated cirrhosis with encephalopathy: meld is 22. secondary to etoh and untreated hepatitis c. viral load was 88,000 and genotype was pending at discharge. patient continued on lactulose, rifaxamin, nadolol as above. # etoh abuse: patient had withdrawal at osh treated with iv diazepam. she was intubated on arrival as she was obtuned/required airway protection prior to procedures. patient was continued on ciwa scale, but this was discontinued in icu as she had no further withdrawal symptoms. patient was continued on multivitamin, thiamine, folate. social work was consulted and patient was given information regarding relapse prevention. . transitional issues - patient will require eus to biopsy submucosal mass in the duodenum found on repeat egd - hcv genotype was pending at discharge medications on admission: medications home: nabumetone medications on transfer: ocretotide drip pantoprazole drip ceftriaxone discharge medications: 1. folic acid 1 mg po daily rx *folic acid 1 mg daily disp #*30 tablet refills:*2 2. lactulose 30 ml po tid titrate to bowel movements/day rx *lactulose 20 gram/30 ml three times a day disp #*2700 milliliter refills:*2 3. multivitamins 1 tab po daily rx *multivitamin daily disp #*30 tablet refills:*2 4. nadolol 40 mg po daily hold if sys bp < 90 rx *nadolol 40 mg daily disp #*30 tablet refills:*2 5. pantoprazole 40 mg po q12h rx *pantoprazole 40 mg twice daily disp #*60 tablet refills:*2 6. pentoxifylline 400 mg po tid rx *pentoxifylline 400 mg three times a day disp #*63 tablet refills:*0 7. rifaximin 550 mg po bid rx *xifaxan 550 mg twice a day disp #*60 tablet refills:*2 8. sucralfate 1 gm po qid rx *sucralfate 1 gram/10 ml four times a day disp #*280 milliliter refills:*0 9. thiamine 100 mg po daily rx *thiamine hcl 100 mg daily disp #*30 tablet refills:*2 10. outpatient lab work please have cbc, inr, lfts, albumin drawn on and every monday for the next 3 weeks. please fax results to dr. at . discharge disposition: home discharge diagnosis: alcoholic cirrhosis alcoholic hepatitis variceal bleed dieulafoy lesion discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to the hospital with gi bleeding and confusion that was related to your liver cirrhosis. we performed an egd that isolated and treated the source of bleeding. you were transferred out to the medicine floor, where we continued treating your liver disease. your bilirubin continued to rise and we started a medicine called pentoxyphylline to decrease the inflammation in the liver which you will need to continue taking for the next month. this inflammation was due to your recent alcohol use. a repeat endoscopy showed no active bleeding but you still have ulcers that are very susceptible to bleeding. as our team and our social worker discussed with you, you must refrain from any future alcohol intake, otherwise you will get even more sick and may even die. since you refused to have a feeding tube placed, please remember to try to drink ensures a day to help with your nutrition as this will also help your liver heal. you will need to have your blood tests and liver function tests monitored each week to make sure you are doing well. followup instructions: -please call your pcp's office at on monday to set up an appointment in the next week. you should also get your blood counts and liver function tests performed every monday starting on and have these faxed to dr. office. -please call your liver doctor dr. office at ( on monday to schedule a follow-up appointment with him this week to discuss this hospitalization and your liver disease md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours endoscopic control of gastric or duodenal bleeding endoscopic excision or destruction of lesion or tissue of esophagus diagnoses: urinary tract infection, site not specified unspecified essential hypertension alcoholic cirrhosis of liver iron deficiency anemia secondary to blood loss (chronic) hyposmolality and/or hyponatremia unspecified viral hepatitis c without hepatic coma hypopotassemia esophageal varices in diseases classified elsewhere, with bleeding hepatic encephalopathy other and unspecified alcohol dependence, continuous acute alcoholic hepatitis dieulafoy lesion (hemorrhagic) of stomach and duodenum 

Answer: The patient is high likely exposed to