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: history of present illness: is a 74 year old woman with an extensive past medical history including a history of atrial fibrillation and flutter, seizure disorder, dementia secondary to alcohol abuse and a history of lower gi bleed with recently diagnosed diabetes mellitus who presents to from after she was found to be passing large amounts of dark stool with clots of blood. the patient, upon presentation to the emergency department denies abdominal pain or any other pain, nausea, vomiting, diarrhea, or constipation. she denies fever or chills or dysuria. she denies hematochezia. at baseline, the patient is quite demented and most of her history is thus obtained from the emergency department and from paperwork from the nursing home. in the emergency room, the patient was ng lavaged with no coffee ground or bright red blood noted. it was not documented whether ng lavage revealed any bilious material. the ng tube was subsequently removed. the patient was noted to be orthostatic. she was typed and crossed and one unit of packed red blood cells was given in the emergency department as well as normal saline at 150 cc per hour. the patient is admitted to medicine at this point for further treatment. past medical history: 1. seizure disorder. 2. history of atrial fibrillation/flutter. 3. osteoarthritis. 4. osteoporosis. 5. dementia felt to be secondary to alcohol abuse. 6. history of lower gi bleed from diverticula. 7. diabetes mellitus, type 2, diagnosed in . 8. cerebrovascular accident of the left frontal lobe with resulting ataxia and right hemi-cva. 9. history of falls. 10. cataracts. 11. history of decubitus ulcer in the right buttock. 12. history of hyponatremia. medications: 1. folate. 2. mvi. 3. vitamin d. 4. glyburide 2.5 mg q. day. 5. tums. 6. milk of magnesia. 7. colace. 8. celebrex 200 mg twice a day. 9. dilantin 150 mg twice a day. 10. trazodone 12.5 mg/37.5 mg. 11. phenobarbital 75 mg q. day. 12. diltiazem sr 120 mg q. day. 13. aspirin 325 mg q. day. social history: the patient is a resident of . does not smoke. has a history of alcohol abuse (used to drink one pint of vodka per day). son is involved in care. family history: noncontributory. physical examination: in the emergency department, temperature 98.6 f.; blood pressure 140/60; pulse 73, respiratory rate 20; o2 saturation 99% on room air. in general, this is an elderly female, alert, in bed, in no acute distress. normocephalic, atraumatic. pupils surgical. extraocular muscles are intact. sclerae anicteric. mucous membranes slightly dry. neck is supple with no lymphadenopathy and no jugular venous distention. chest is clear to auscultation bilaterally with scattered crackles which clear with cough. cardiovascular: regular rhythm with ii/vi systolic ejection murmur. abdomen is soft, nontender, nondistended. normoactive bowel sounds. no palpable masses noted with heme positive stool. extremities: no cyanosis, clubbing or edema. thready peripheral pulses with well healed scar on the lateral surface of the right leg. neurological: alert, confused, knows name only. moves all four extremities and follows commands. laboratory: notable labs upon admission are white blood cell count of 10,000, hematocrit of 30.8 down from baseline of 38, platelets 337,000. alt 20, ast 25, ldh 249, alkaline phosphatase of 161. potassium of 6.4 and upon repeat 5.7. ekg is sinus at 75 beats per minute, intervals with pr interval at 220; otherwise intervals within normal limits; depressions in v3, but no acute st-t wave changes. hospital course: 1. gastrointestinal: the patient was admitted to the medical wards for further management of her gi bleeding. over the next 12 hours, the patient was noted to have two more episodes of dark magenta stools with clots and had been transfused a total of two units of packed red blood cells. on the morning of , her hematocrit was 27.0, down from 30 the evening before. an upper endoscopy was performed and a 1 cm antral ulcer was identified without any active bleeding which was felt to the be the source of the patient's bleeding (upper endoscopy was performed as the patient's bun was elevated and it was felt that an upper source of bleeding may be possible). the patient returned to the floor but continued to have multiple episodes of magenta stools per rectum, which progressively became more bright and red in quality, concerning for a lower gi source of bleeding. the patient received two more units of packed red blood cells and her hematocrit remained stable at 27 to 28. the patient's converted to atrial fibrillation and her blood pressures began to drop into the 90s and she was transferred to the medical intensive care unit for further evaluation. a tagged red blood cell scan did not demonstrate any active bleeding on the evening of . a colonoscopy the next day was non-diagnostic as the patient still had significant amounts of stool in her colon. the patient received two more units of red blood cells and the output of bright red blood per rectum began to decrease. on the morning of , the patient had a repeat colonoscopy which demonstrated multiple diverticula throughout the course of the colon, but did not show signs of any active bleeding. on the afternoon of , the patient was transferred back to the medical floor where she remained until discharge with a blood pressure stable in the 120s to 140s systolic over 60s to 70s diastolic, a heart rate which was variable between normal sinus rhythm and atrial fibrillation in the 120s to 130s, and with no further episodes of bright red blood per rectum. the patient was maintained on high-dose intravenous protonix for the first several days of her hospitalization, but will continue protonix 40 mg p.o. q. day as an outpatient. the patient also tested positive for h. pylori and will undergo a course of eradication of this organism. she will continue colace 100 mg p.o. twice a day to soften her stools. 2. cardiovascular: the patient was noted to be in paroxysmal atrial fibrillation after returning to the floor on . her atrial fibrillation is well controlled on diltiazem and she will be discharged on an increased dosage of 180 mg of cardizem cd p.o. q. day. pulmonary: the patient was noted to be in some slight fluid overload, having been positive about eight liters from the intensive care unit upon presentation to the floor with some bilateral rales noted on examination. the patient auto-diuresed over the next 24 hours and was then given 20 mg of lasix with good urine output. upon discharge, the patient was having good oxygen saturation on room air. 3. infectious disease: the patient was noted to have a urinary tract infection by urinalysis and was treated with three days of bactrim while in hospital with good results. 4. neurology: the patient was continued on her regular doses of dilantin and phenobarbital for her history of seizure disorder. her levels were noted to be within normal limits and she was continued on the same dose with no complications. 5. fluids, electrolytes, nutrition: the patient was maintained on a clear liquid diet throughout much of her hospitalization and upon transfer to the floor tolerated an american diabetic association diet very well. disposition: the patient is discharged on the evening of , back to on the medications listed below. discharge diagnoses: 1. peptic ulcer disease. 2. diverticulosis. 3. anemia. 4. dementia. 5. diabetes mellitus. 6. paroxysmal atrial fibrillation. 7. urinary tract infection. 8. seizure disorder. discharge medications: 1. diltiazem cd, (cardizem cd), 180 mg p.o. q. day. 2. colace 100 mg p.o. twice a day. 3. multivitamins one tablet p.o. q. day. 4. folate 1 mg p.o. q. day. 5. trazodone 37.5 mg p.o. q. h.s. p.r.n. insomnia. 6. vitamin d 800 iu p.o. q. day. 7. tums 500 mg p.o. twice a day. 8. protonix 40 mg p.o. twice a day times 14 days and then q. day. 9. dilantin phenytoin 150 mg p.o. twice a day. 10. phenobarbital 75 mg p.o. q. day. 11. glyburide 2.5 mg p.o. q. day. 12. clarithromycin 500 mg p.o. twice a day times 14 days. 13. amoxicillin 1 gram p.o. twice a day times 14 days. (please note that aspirin and celebrex have been discontinued secondary to the patient's gi bleed). 14. tylenol 650 mg p.o. q. four to six hours p.r.n. pain. dr., 11-500 dictated by: medquist36 procedure: other endoscopy of small intestine colonoscopy colonoscopy diagnoses: urinary tract infection, site not specified acute posthemorrhagic anemia hyposmolality and/or hyponatremia atrial fibrillation other convulsions chronic or unspecified gastric ulcer with hemorrhage, without mention of obstruction diverticulosis of colon with hemorrhage helicobacter pylori [h. pylori] personal history of alcoholism 

Answer: The patient is high likely exposed to