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: nafcillin attending: chief complaint: hematemesis major surgical or invasive procedure: diagnostic paracentesis history of present illness: the patient is a 31 y/o female with history of autoimmune hepatitis complicated by cirrhosis and recurrent ascites presenting with intermittent episodes of hematemesis over 3 days duration. she describes the blood as coffe-ground in color and reports that it "dribbles" out of her mouth when she lies backwards. amount is estimated to be ~ teaspoons per episode. the patient also endorses crampy, diffuse, nonradiating abdominal pain over 2 days that is unchanged by food or positioning. does take approximately 2g of tylenol daily for this pain and occasional ha. denies any nsaid use. she further reports having melena x2 days duration. otherwise no changes in bowel/bladder habits. appetite unchanged. no back or cp. no sob. no recent fevers or uri sx. does describe episode of ?thrush 1 week ago, tx'ed by pcp believed to be abx during last hospital admission. . the patient was recently admitted for ugib. she has a + ng lavage at osh and was txfered here where an egd revealed grade 1 varices. she had no further episodes of bleeding during that admission. . in the ed, vs 98. 109 133/84 18 100% ra. her hct was 31.6, inr 1.6 and she remained hd stable. she was started on pantoprazole gtt and octreotide gtt and given ctx 1 g, odansetron 2 mg and morphine 4 mg. her vs prior to transfer were t 98.7 hr 84 bp 127/80 100% on ra. transferred to the micu for furthr mgmt. . on arrival in the micu, the patient is hd stable. initial vs 96.8 85 158/86 17 97%. . review of systems: (+) per hpi, also with new c/o intermittent ha (-) denies fever, chills, night sweats, recent weight loss or gain. denies sinus tenderness, rhinorrhea or congestion. denies cough, shortness of breath, or wheezing. denies chest pain, chest pressure, palpitations, or weakness. denies nausea, vomiting, diarrhea, constipation. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes or skin changes. past medical history: # autoimmune hepatitis: +, ama-, + # cirrhosis: # rheumatoid arthritis: # hep c: genotype 3. most recent viral load undetectable. # mulitple liver biopsies # compartment syndrome in r arm s/p surgical decompression # herpes zoster # c section in # osteomyelitis social history: lives with mother and two children (ages 3 and 11)in . smokes 5 cig/day (down from before) x 15 yrs. has h/o etoh and drug abuse (heroin and cocaine) but clean since . one episode of heroin use in 9/. has a 11 year old son and a 3 year old daughter ( ). mom is point person. family history: aunt w/ ca breast, no other h/o autoimmune hepatitis, early colon ca, or crohn/uc. physical exam: on admission to micu: vitals: 96.8 85 158/86 17 97% general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, mildly distended, moderately tender diffusely, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema discharge exam: 98.2, tm 98.7, 131/87, 78, 18, 100ra general: alert, oriented, no acute distress heent: eomi, sclera anicteric, mmm, oropharynx clear lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, mildly distended, moderately tender diffusely, bowel sounds present, no guarding gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema skin: multiple ulcerating excoriations over the ue and le bilat. some lesions scabbed over. pertinent results: admission labs: wbc-6.1 rbc-2.89* hgb-11.1* hct-31.6* mcv-109* mch-38.4* mchc-35.2* rdw-18.7* plt ct-65* neuts-69.2 lymphs-24.5 monos-3.7 eos-2.1 baso-0.4 pt-17.8* ptt-30.2 inr(pt)-1.6* fibrino-135* glucose-145* urean-20 creat-0.7 na-136 k-4.2 cl-107 hco3-23 angap-10 alt-76* ast-107* alkphos-127* lipase-78* calcium-7.8* phos-3.3 mg-1.7 lactate-1.2 imaging: egd: varices at the lower third of the esophagus erythema and erosion in the antrum and stomach body compatible with gastritis congestion in the whole stomach compatible with portal hypertensive gastropathy there was no blood or coffee-ground material in the stomach otherwise normal egd to third part of the duodenum mri abd:1. cirrhosis, portal hypertension, and ascites. 2. no focal liver lesion seen. 3. the portal vein is patent. assessment of the hepatic veins is difficult due to distortion by the extensive fibrosis and cirrhosis. no definite intravascular thrombus is seen. 4. prominant portal-systemic shunting from portal confluence through large duodenal varices to the ivc. discharge labs: 04:25am blood wbc-3.2* rbc-2.61* hgb-9.8* hct-28.4* mcv-109* mch-37.7* mchc-34.7 rdw-18.8* plt ct-41* 04:25am blood pt-17.2* ptt-33.5 inr(pt)-1.5* 04:25am blood glucose-228* urean-13 creat-0.4 na-135 k-3.7 cl-104 hco3-26 angap-9 04:25am blood alt-58* ast-58* ld(ldh)-229 alkphos-109* totbili-1.5 04:45am blood lipase-66* 04:25am blood calcium-8.2* phos-2.0*# mg-1.8 04:25am blood hcg-<5 brief hospital course: patient is a 31 yo f with ai hepatitis, cirrhosis and previously seen grade 1 varices who presented with hematemesis and melena. #. ugib: she reported hematemesis and melena on admission to the micu but ng lavage was negative. egd the following morning showed grade 1 non-bleeding varices and signs of gastritis and portal gastropathy. she was transitioned from ppi drip to iv bid and octreotide was stopped. her hematocrit responded to one unit of packed red cells appropriately and did not further drop. she was transitioned to the floor where she continued to remain stable. she was started on nadolol and continued on the ppi as an outpatient. #. abdominal pain: she complained of diffuse, crampy abdominal pain of 3 days duration on admission, however, she later reported that the pain had been occurring for weeks and had recently increased in intensity and duration. she described it as "like labor pains." this was possibly due to liver inflammation or pancreatitis. her lipase was mildly elevated to 78 on admission and remained elevated in the 60s throughout admission, however, this could be attributed to her advanced liver disease and she had no other s/s suggestive of pancreatitis besides abdominal pain. ruq ultrasound with doppler showed cirrhosis, patent portal veins, and no evidence of pancreatitis. it also did not visualize the echogenic focus seen on a previous ultrasound. diagnostic paracentesis was performed which showed no sbp. pt got an mri/mrv of abdomen to further eval pain, because she was already scheduled for it as an outpatient prior ultrasound being unable to visualize flow to left lobe of liver. in house u/s showed patent vasculature, however, and mri showed no definite area of thrombus. mri also showed large duodenal varices. later in her hospital course, pt noticed a bulging sensation in her upper pelvis, which could be palpated on physical exam. upon further questioning she admitted that she had seen a gynecologist s few months ago who noted an abnormality on her bimanual exam and suggested she follow up with a transvaginal ultrasound, which she had not done yet. pt also admitted she no longer gets her period, so a pregnancy test was done and was negative. pt was stable so she was discharged and encouraged to follow up with her gynecologist for the transvaginal ultrasound to rule out gynecologic causes of abdominal pain or masses, such as fibroids. #. thrombocytopenia: she has chronic thromobocytopenia from her cirrhosis. her platelets were within her baseline. # cirrhosis: her furosemide was continued but imuran was held. pt was placed on ceftriaxone for sbp ppx while in house and switched to ciprofloxacin to complete the 5d course after discharge. medications on admission: imuran 50 mg once a day, budesonide 3 mg one p.o. t.i.d. vitamin d 50,000 units once a week furosemide 20 mg once a day spironolactone 100 mg once a day iron 325 one three times a day clotrimazole troches five times a day magnesium discharge medications: 1. budesonide 3 mg capsule, ext release 24 hr sig: one (1) capsule, ext release 24 hr po tid (3 times a day). 2. ergocalciferol (vitamin d2) 50,000 unit capsule sig: one (1) capsule po 1x/week (th): please resume according to your previous schedule. 3. spironolactone 100 mg tablet sig: one (1) tablet po daily (daily). 4. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). 5. ciprofloxacin 250 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 2 days: please take on and . disp:*2 tablet(s)* refills:*0* 6. nadolol 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po twice a day. disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 8. imuran 50 mg tablet sig: one (1) tablet po once a day. 9. iron (ferrous sulfate) 325 mg (65 mg iron) tablet sig: one (1) tablet po three times a day. 10. clotrimazole 10 mg troche sig: one (1) troche mucous membrane five times a day as needed for yeast infection. discharge disposition: home discharge diagnosis: primary diagnosis autoimmune hepatitis gi bleed discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: thank you for allowing us to take part in your care. you were admitted to after vomiting what looked like blood. you got a blood transfusion of 2 units. you also had a procedure which looked in your stomach to see if you had any active bleeding, which you did not. you had an mri to evaluate your abdominal pain, and it did not show a reason why you were having pain, or any evidence of blood clots in your abdomen. you should follow up with dr. in one week. we made the following changes to your medications: we restarted nadolol 20 mg once a day. we started ciprofloxacin (an antibiotic) for two more days. we started pantoprazole (an acid suppression medication). all of your other medications remain the same. followup instructions: you need to follow up in the liver center next week. please call tomorrow morning to confirm your appointment time and day. you have the following appointment already scheduled: department: transplant when: wednesday at 1:20 pm with: transplant clinic building: lm campus: west best parking: garage we recommend that you follow up with your gynecologist as they recommended. please call them for an appointment. procedure: other endoscopy of small intestine diagnoses: cirrhosis of liver without mention of alcohol portal hypertension hemorrhage of gastrointestinal tract, unspecified esophageal varices without mention of bleeding cannabis abuse, unspecified autoimmune hepatitis other, mixed, or unspecified drug abuse, in remission 

Answer: The patient is high likely exposed to