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: penicillins / fentanyl attending: chief complaint: hematemesis major surgical or invasive procedure: egd history of present illness: 51f with etoh cirrhosis with varices, chronic pancreatitis, asthma, presented with hematemesis. of note, she was recently admitted with abdominal pain and etoh intoxication and subsequent withdrawal. subsequently she was admitted for abdominal pain but patient signed out ama on the same day after iv narcotics were not given. she was at on for domestic abuse by a friend but appears to have left there ama. she then started drinking vodka. she developed symptoms of nausea, vomiting, and abdominal pain. she devoped hematemesis which she describes as bright red blood mixed with the vomit. she called for an ambulance and was taken to . in ed vs 98.9, 105, 108/74, 18, 96%ra. pt was intoxicated with etoh 333. she was admitted to initially on octreotide gtt given concern for hematemesis. however the hct was 32.7, stable from 32.8 several days prior. hct dropped to 28.8 the following morning after hematemesis and roughly 3l ivf. she has required no transfusions and hct has remained roughly stable since. egd showed 4 cords of grade i varices at the lower third of the esophagus with portal hypertensive gastropathy and 2 small nonbleeding ulcers in duodenum. past medical history: - alcoholic cirrhosis (dx: )- complicated by varices, ascites, encephalopathy - chronic pancreatitis (dx: ) - on pancrease - etoh abuse - history of dt - low back pain (dx: ) - degenerating l4-6 discs, seen in pain clinic 8 years ago and received fentanyl patch and oxycodone - asthma (since birth) - history of intubation in the past - uterine and cervical ca s/p hysterectomy () social history: she is a former nurse who lives in apt in subsidized housing in alone. divorced x2. she has one son, 30yo who lives in . she is disabled from severe low back pain. she smokes ppd and recent heavy alcohol use, up to a gallon of vodka at a time. has tried aa. no illicit drug use family history: mother died at age 72 from a gib, "blood clot in stomach" ; father died in mid-70s from cancer, possibly mesothelioma (worked in shipping). mother, father, paternal grandfather have history of alcoholism. physical exam: vs: temp: 98.4 bp: 108/70 hr: 72 rr: 18 o2sat: 96 3l . gen: in awake, in bed, nad heent: perrl, eomi. no scleral icterus. neck: supple, no lad, no jvp elevation. ej peripheral iv lungs: mild occasional wheezes cv: rrr, no murmurs, rubs, gallops. abdomen: soft, nt, nd, nabs extremities: warm and well perfused, no cyanosis, clubbing, edema. neurological: alert and oriented x 3, skin: bruising noted on shoulders and neck psychiatric: appropriate. pertinent results: 09:45pm urine hours-random 08:58pm glucose-90 urea n-17 creat-0.6 sodium-142 potassium-3.3 chloride-103 total co2-22 anion gap-20 08:58pm glucose-90 urea n-17 creat-0.6 sodium-142 potassium-3.3 chloride-103 total co2-22 anion gap-20 08:58pm alt(sgpt)-66* ast(sgot)-227* ck(cpk)-111 alk phos-121* tot bili-4.2* 08:58pm lipase-77* 08:58pm ctropnt-<0.01 08:58pm ck-mb-3 ctropnt-<0.01 08:58pm asa-neg ethanol-333* acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 08:58pm wbc-7.0 rbc-3.47* hgb-11.4* hct-32.7* mcv-94 mch-33.0* mchc-35.0 rdw-18.5* 08:58pm neuts-59.1 lymphs-30.1 monos-5.1 eos-5.3* basos-0.3 08:58pm plt count-39*# 06:48pm urine hours-random 06:48pm urine gr hold-hold 06:48pm urine color-amber appear-hazy sp -1.027 06:48pm urine blood-neg nitrite-pos protein-tr glucose-neg ketone-50 bilirubin-sm urobilngn-12* ph-6.5 leuk-tr 06:48pm urine rbc-0 wbc-0-2 bacteria-few yeast-none epi-0-2 06:48pm urine mucous-mod . egd: protruding lesions 4 cords of grade i varices were seen in the lower third of the esophagus. stomach: mucosa: erythema, congestion and mosaic appearance of the mucosa were noted in the whole stomach. these findings are compatible with portal hypertensive gastropathy. duodenum: mucosa: 2 small nonbleeding ulcers were seen. impression: varices at the lower third of the esophagus erythema, congestion and mosaic appearance in the whole stomach compatible with portal hypertensive gastropathy abnormal mucosa in the duodenum otherwise normal egd to third part of the duodenum recommendations: avoid all nsaids and -2 inhibitors. take tylenol for pain (max dose of 2 grams per day). d/c octreotide. continue iv ppi . carafate 1 gm po four times per day. continue cipro 400 mg iv bid for total of 3 days. clear liquid diet this pm. brief hospital course: this is a 51 yo f with h/o etoh cirrhosis with varices, chronic pancreatitis, and asthma, who presented with hematemesis after binge drinking. she was initially admitted to the icu, stabilized, and then called out to the general medicine floor. the following is her course by problem. . # upper gi bleed: initially admitted to the icu and started on octreotide gtt. admission hct was 32.7, stable from 32.8 several days prior. hct dropped to 28.8 the following morning after hematemesis and roughly 3l ivf. the hct has remained roughly stable since without transfusion. egd showed 4 cords of grade i varices at the lower third of the esophagus with portal hypertensive gastropathy and 2 small nonbleeding ulcers in duodenum. she was continued on ppi, carafate, and prophylaxis with cipro for a 3 day course. hct remained stable at 30 at discharge. . # alcoholic cirrhosis: the patient has met with sw during previous admissions and attempts have been made to arrange for detox and patient has had difficulty with compliance with recurrent etoh use and missed appointments. t bili and lfts elevated mildly above baseline on admission. she has remained off lasix/aldactone over past month due to numerous binges/poor po intake. lactulose and nadolol were continued. hepatology followed the pt while in house, and the pt has follow up with hepatology in . . # etoh abuse/withdrawl: pt has a history of dts in the past. she was treated here with valium per ciwa scale, thiamine, and folate. . # abdominal pain/chronic pancreatitis: pt had epigastric pain with guarding on exam. likely due to both vomiting, ulcers, gastropathy, and chronic pancreatitis. patient treated briefly with iv narcotics, changed to po and then discharged off opiates due to her well-documented history of opiate abuse. on multiple occasions, she attempted to manipulate the medical staff to maintain iv opiates for pain or to increase her pain med doses. her complaints of pain were out of proportion with her functional status. she threatened to leave ama when her narcotics were changed from iv to oral. however, this was still done and she backed down and stayed in hospital. . # asthma: noted mild wheezes on exam. advair was started and pt received albuterol nebs prn. . # pancytopenia: likely due to marrow suppression from etoh abuse as well as splenic sequestration. platelets in 30s, hct stable at 28. last iron studies were borderline, and b12/folate were wnl. . # tobacco abuse: written for nicotine patch . # coagulopathy: secondary to cirrhosis. . medications on admission: 1. albuterol 90 two (2) puff q4h prn 2. sucralfate 1 gram po qid 3. amylase-lipase-protease 20,000-4,500- 25,000 unit capsule, delayed release(e.c.) sig: one (1) cap po qidwmhs 4. lactulose thirty (30) ml po tid 5. docusate sodium 100 mg po bid 6. senna 8.6 mg po daily as needed. 7. nadolol 20 mg po once a day. 9. thiamine hcl 100 mg po once a day. 10. omeprazole 20 mg po twice a day. discharge medications: 1. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. 2. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po tid (3 times a day). disp:*1 bottle* refills:*2* 3. nadolol 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. sucralfate 1 gram tablet sig: one (1) tablet po qid (4 times a day). disp:*120 tablet(s)* refills:*2* 5. amylase-lipase-protease 20,000-4,500- 25,000 unit capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po qidmwhs. 6. nicotine 14 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily): do not use if you are smoking!!. disp:*30 patch 24 hr(s)* refills:*0* discharge disposition: home discharge diagnosis: hematemesis anemia of acute gi bleed duodenal ulcers grade 1 esophageal varices pancreatitis, etoh etoh abuse severe thrombocytopenia discharge condition: vital signs stable discharge instructions: patient should return to the ed if hse is vomiting blood, has large amounts of blood in her stool, has persistent high fevers. you have been repeatedly counselled and strongly instructed to stop drinking alcohol completely. alcohol is causing many of your medical issues. without stopping drinking alcohol, these medical issues will worsen and your abdominal pain will worsen. followup instructions: provider: , md phone: date/time: 11:00 provider: , md phone: date/time: 9:30 procedure: other endoscopy of small intestine diagnoses: thrombocytopenia, unspecified tobacco use disorder acute posthemorrhagic anemia alcoholic cirrhosis of liver portal hypertension asthma, unspecified type, unspecified hemorrhage of gastrointestinal tract, unspecified esophageal varices in diseases classified elsewhere, without mention of bleeding other specified disorders of stomach and duodenum chronic pancreatitis other and unspecified coagulation defects acute alcoholic intoxication in alcoholism, continuous duodenal ulcer, unspecified as acute or chronic, without hemorrhage or perforation, without mention of obstruction 

Answer: The patient is high likely exposed to