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: gi bleed major surgical or invasive procedure: endoscopy history of present illness: the pt is a 57 yo female with h/o etoh abuse and depression who presented to hospital earlier today reporting 2 days of bloody emesis and black tarry stools. vitals on arrival to osh were p 96 hr 137/62 rr22 100% 4l. labs were notable for hct 24.8 (hct in .6), mcv 101, plts 127, t bili 2.6, d bili 1.2, i bili 1.4, ast 74 and nl alt of 27, nl alk ph 125. chem 7 only remarkable for bun of 24 (creatinine 1). inr was 1.46 and she received 2 units of ffp. ciwa at osh was 9 and she received ativan 2mg iv x1. she was started on an octreotide gtt at 50mcg/hr and given protonix 40 iv x1. ekg showed st juntional depression in v4-v5 and qtc of 530. vitals prior to transfer were p126 bp 133/63 rr20 98% ra. . on arrival to the ed vitals were t96.7 bp 141/67 hr 127 rr20 97% on 2l. the patient received protonix gtt at 8mg/hr, octreotide at 50mcg/hr, valium total 20mg iv based on ciwa scale for tremors and anxiety. hct was 20.7, inr 1.5, plts 132, ast 70, alt 27, tbili 2.1, serum tox negative. the pt was guaiac + for melena on rectal exam. an ng tube was placed and dk maroon colored gastric contents were suctioned back. she received a total of 1.5l of ivf and blood was ordered but not administered prior to transfer. she was t & c 5 units. her hr improved to the 90s with the valium. vitals prior to transfer were t99.5 hr 95 bp 132/65 rr27 o2 sat 98% ra. . in the icu she reports feeling weak but otherwise fine. she says her last drink was 2 days ago and that at home she had bloody emesis x3 yesterday and x2 today. she also reports black tarry stools since yesterday. she denies nausea or abd pain at home. she reports she has not been to a doctor for 15 yrs until this summer. . (+) per hpi , + mild cough non productive cough and weakness, + for pain in her left leg and her feet which was being worked up by a neurologist this summer (-) denies fever, chills, headache, congestion. denies cough, shortness of breath, or wheezing. denies chest pain, chest pressure, palpitations,. denies nausea, vomiting. denies dysuria, frequency, or urgency. denies arthralgias or myalgias except as above. denies rashes or skin changes. . past medical history: alcoholism depression cholelithiasis h/o splenomegaly anemia hl left foot drop fracture left ulna social history: social history: drinks bottle of wine a day and 8 ounces of vodka. married. never smoker. denies h/o other illicits. son with schizoaffective d/o. they had to sell their home and husband has gone out of business and started working for another company secondary to their son having schizoaffective disorder. family history: mother with alzheimer's. sister with h/o etoh abuse. physical exam: physical exam on discharge: vs: t 99.6 bp 137/64 hr 93 rr 17 98% ra gen: pleasant, nad heent: brusing on forehead, around eyes, perrl, eomi, mildly dry mm resp: ctab, 1 spider on chest cv: rrr, s1 and s2 wnl, no m/r/g abd: + bs, liver palpable to 2 fingers below margin, no splenomegaly ext: + erythema, no c/c/e skin: no rashes/no jaundice/no splinters neuro: aaox3. cn ii-xii intact. 5/5 strength throughout. no pass-pointing on finger to nose. 2+ ue reflexes back: large bruise over coccyx pertinent results: 1. labs on admission: 03:30pm blood wbc-8.6 rbc-2.05* hgb-6.7* hct-20.7* mcv-101* mch-32.5* mchc-32.2 rdw-18.3* plt ct-132* 03:30pm blood pt-17.2* ptt-26.5 inr(pt)-1.5* 03:30pm blood glucose-98 urean-22* creat-1.0 na-144 k-3.5 cl-108 hco3-24 angap-16 03:30pm blood alt-27 ast-70* alkphos-113* totbili-2.1* 03:30pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg . 2. labs on discharge; 03:42am blood tsh-0.46 03:42am blood hbsag-negative hbsab-negative hbcab-negative igm hav-negative 03:42am blood -negative 03:42am blood hcv ab-negative 06:00am blood wbc-6.1 rbc-3.11* hgb-10.0* hct-29.8* mcv-96 mch-32.1* mchc-33.5 rdw-17.5* plt ct-103* 06:00am blood pt-18.4* ptt-30.6 inr(pt)-1.7* 06:00am blood alt-33 ast-88* alkphos-121* totbili-3.3* 06:00am blood calcium-8.8 phos-3.6 mg-1.6 06:00am blood glucose-110* urean-6 creat-0.8 na-139 k-3.5 cl-105 hco3-26 angap-12 . 3. imaging/diagnostics: - osh ct c-spine: mild degenrative disk dz most pronounced at c5/6 and c6/7. straightening of the normal cervical lordosis as can be seen in the setting of muscle spasm. . - ct head : small subgaleal hematoma along the right aspect of the frontal bone without evidence of an underlying fracture. no intracranial mass, hemorrhage, or evidence of an acute territorial infarct. diffuse tissue loss, slightly more than expected for the patient's age, perhaps related to chronic alcoholism. small vessel ischemic dz. atheroschlerosis. . - cxr at : wet read, no cardiopulm process . - abdominal ultrasound : 1. heterogeneous hepatic architecture with no solid focal liver lesion identified. small simple right hepatic cyst. 2. focal area of segmental intrahepatic biliary dilatation of unknown etiology. an mrcp is recommended for further characterization. 3. patent portal vein. small midline varices identified. 4. borderline splenomegaly. 5. layer of sludge and within the gallbladder. 6. no ascites. . - mrcp : 1. fatty and cirrhotic liver, with recanalized paraumbilical vein and hepatogastric and esophageal varices. trace perihepatic ascites. no evidence of worrisome hepatic lesions. 2. mild central intrahepatic biliary dilatation without extrahepatic biliary dilatation, similar to prior ultrasound. 3. gallbladder sludge. 4. pancreatic divisum. 5. 1.6 cm left adnexal cystic lesion, likely left ovarian cyst. as the patient is post-menopausal, a follow up ultrasound is recommended in 1 year. brief hospital course: 57 yo female with h/o alcohol abuse and depression presenting with upper gi bleed and alcohol withdrawal. . #. upper gi bleed: given significant etoh abuse history there was concern for possible esophageal/gastric varices causing the bleed. she was given 3 units prbc. endoscopy showed diffuse hemorrhagic gastritis with possible portal gastropathy. no intervention was done. she was briefly on a ppi gtt and this was then transitioned to . she was started on 3-day course of octreotide drip. ceftriaxone was started and discontinued after hematocrit stabilized. she did not require any more blood transfusions for the remainder of the hospitalization. . #. likely alcoholic cirrhosis: transaminitis work-up included tsh, iron studies, hepatitis panel, ck, autoimmune serologies, which were all unremarkable. most likely etiology from chronic alcohol abuse. ruq ultrasound showed midline varices, splenomegaly, heterogeneous liver with no overt lesion, focal area of biliary dilation located centrally within liver, sludge/ within gallbladder, and no ascites. mrcp was performed which was negative for intrahepatic or extrahepatic biliary dilatation. finished course of ceftriazone for gib. . #. etoh withdrawal: drinks 1-2 bottles of wine + 8 oz of vodka daily. required total of valium 20mg iv while in the ed based on ciwa scale. pt states she normally gets anxious and has tremors when stopping etoh but denies any h/o seizure. she was given a banana bag, valium per ciwa, mostly for anxiety and tremors. she was also given mvi, thiamine, folate. patient was consoled regarding the importance of absolute abstinence. she was advised by attending and social worker to go to inpatient detox program, but adamantly refused. patient plans to follow-up with outpatient therapist and psychiatrist after discharge. . ====================================== for primary care doctor: ====================================== patient was given hepatitis a and hepatitis b vaccination on . she will need the second and third dose of hepatitis b vaccination at 4 to 6 month interval. medications on admission: medications at home: lorazepam 0.5mg po bid prn anxiety vitamin b1 100mg twice a day . meds on transfer: octreotide gtt at 50mcg/hr protonix 40 iv x1 discharge medications: 1. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. multivitamin tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. 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* 5. lorazepam 0.5 mg tablet sig: one (1) tablet po twice a day as needed for anxiety. disp:*14 tablet(s)* refills:*0* discharge disposition: home with service facility: discharge diagnosis: severe gastritis alcohol withdrawal 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 for treatment of your vomitting. you were found to have bleeding from your stomach. you recieved a blood transfusion to replace the blood you lost. due to your alcohol history, your were monitored very closely for withdrawal and given medication as needed. you are being discharged home with follow-up appointments with your primary care doctor and a new hepatologist. . we made the following changes to your medications: started: - folic acid 1 mg by mouth daily - thiamine hcl 100 mg by mouth daily - multivitamin 1 tablet by mouth daily - pantoprazole (delayed release) 40 mg by mouth twice a day start folate, thiamine, multivitamin followup instructions: name: , n location: address: 2 center dr., , phone: appt: the office is working on an appt for you within the next week. they will call you at home with an appt. if you dont hear from them within 48 hours of your discharge, please call the office directly to book. department: liver center when: monday at 11:30 am with: , md building: lm campus: west best parking: garage procedure: other endoscopy of small intestine diagnoses: thrombocytopenia, unspecified acute posthemorrhagic anemia alcoholic cirrhosis of liver acquired coagulation factor deficiency depressive disorder, not elsewhere classified accidental fall on or from other stairs or steps other specified disorders of stomach and duodenum other and unspecified alcohol dependence, continuous alcohol withdrawal contusion of face, scalp, and neck except eye(s) alcoholic gastritis, with hemorrhage 

Answer: The patient is high likely exposed to