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 / bactrim attending: chief complaint: bright red blood per rectum major surgical or invasive procedure: colonoscopy femoral central venous catheter history of present illness: this is a 50 y/o male with a history of hiv/aids and hep c with cirrhosis/variceal bleeds/portal gastropathy/portal vein thromboses who was recently hospitalized from for a massive gi (rectal bleed), who now presents today with brbpr. per patient, he has not had any rectal bleeding since his last admission until 6pm this evening. patient reports increasing firmness to his stools recently and began haveing brbpr while having a bm this evening. unable to estimate amount of bleeding. no n/v/hematemesis/abdominal pain. no melena. no f/c/s. reports baseline lh/dizziness. no cp/sob/palpitations. per patient's girlfriend, patient began using cocaine recently again, last use yesterday. he presented to the ed tonight for further management. of note, the patient was due for injection of the rectal varices this thursday () with dr. . . during his last admission from - for a massive gi bleed (over 8 l in the first 24 hours) he required over 20 units of blood and >12 l ns. patient was also intubated during that time for airway protection. endoscopy revealed large rectal varices but tips was unsuccessful due to his portal vein thromboses. he received an embolization with dermabond injection on of his large rectal varices and his bleeding stopped. of note, this admission was preceded by a relapse of his drug use, particularly cocaine. he also developed bilateral dvts despite his massive bleed and an ivc filter was placed on as the risk of anticoagulation was too high. tips was again attempted but was unsuccessful. . in the ed tonight, vs t 97.4, bp 81-95/50-62, hr 80, rr 14, sao2 99%/2l nc. he was given 3 l ns and 2 u prbcs. exam was significant for large amount of brbpr. gi was called to see the patient and bleeding had resolved at that time. patient was admitted to the micu for further management. . ros - otherwise negative. of note, pt had a fall 5 days ago and resulting abrasion on forehead. denies any h/a. past medical history: # hiv/aids dx in , cd4 nadir 47 in - cd-4 119,viral load 175 copies - cd-4 47, viral load >100k copies. - cd -4 104, 4%, pvl 100 cd-4 144,14%, pvl 80. cd-4 83, 14%, pvl ud on kaletra, epzicom, and viread which had previously controlled his viral load. # hepatitis c, s/p varices, portal gastropathy, splenomegaly afp of 1.7 in 11/. +portal vein thromboses, rectal varices s/p embolization procedure . hepatitis c rna of 504,000 iu. his hep c genotype is 4a. esophageal varices that have been banded multiple times; receives regular egd through dr. . # ivc filter placed for bilateral dvts # leukopenia believed secondary to splenic sequetration (pet scan negative ) # renal insufficiency thought related to gi bleeds and possibly tenofovir. # h/o zoster # esophageal candidiasis (seen on egd most recently ) # h/o positive toxo igg in # h/o positive cmv igg in # h/o positive hep a ab in # h/o positive hep b core ab in (with neg sab, neg antigen) # h/o negative rpr in # negative ppd in # osteomyelitis l knee 10 years ago ivda # portal vein thrombosis seen on ct in # gout (dx age 18; hx of tophi removal; on allopurinol in the past. was seen in clinic .) # substance abuse (mostly iv heroin, benzos, cocaine) social history: lives with girlfriend, on . smoked 2ppd x 20-30 yrs, no etoh. h/o ivda. recent cocaine use (last use yesterday), with frequent d "binges." occasional bzd abuse. denies any etoh use. family history: nc physical exam: vs: tc 96.3, bp 112/78, hr 77, rr 18, sao2 100%/2 l nc general: cachectic-appearing male, slightly lethargic in nad heent: nc/at, perrl, eomi. no icterus. mm dry, op clear. small abrasion on forehead. neck: supple, no lad or jvd chest: cta-b anteriorly cv: rrr s1 s2 normal, no m/g/r abd: soft, nt/nd, nabs. +hepatosplenomegaly ext: no c/c/e, scars on left foot; right femoral line in place, c/d/i neuro: ao x 3, lethargic but arousable. no asterixis on exam. pertinent results: 07:17pm blood wbc-1.5* rbc-3.73* hgb-11.1* hct-33.4* mcv-90 mch-29.7 mchc-33.2 rdw-16.7* plt ct-73* 03:24am blood wbc-0.8* rbc-2.60*# hgb-7.9*# hct-23.3* mcv-89 mch-30.4 mchc-34.1 rdw-16.4* plt ct-68* gran ct-490* 01:03pm blood hct-26.5* 09:36am blood pt-14.7* ptt-28.0 inr(pt)-1.3* 07:17pm blood fibrino-163 03:24am blood glucose-126* urean-7 creat-0.9 na-140 k-3.6 cl-107 hco3-25 angap-12 12:22am blood hct-25.4* plt ct-50* 12:46am blood hct-26.2* plt ct-51* 03:24am blood wbc-0.8* rbc-2.60*# hgb-7.9*# hct-23.3* mcv-89 mch-30.4 mchc-34.1 rdw-16.4* plt ct-68* 09:36am blood hct-26.5* plt ct-62* 01:03pm blood hct-26.5* 05:06pm blood hct-28.4* 09:23pm blood hct-29.5* plt ct-67* 02:34am blood wbc-1.1* rbc-3.24* hgb-9.9*# hct-28.6* mcv-88 mch-30.5 mchc-34.6 rdw-16.6* plt ct-61* 11:18am blood hct-28.2* 06:47pm blood hct-28.2* 11:02pm blood hct-30.2* 05:33am blood wbc-0.9* rbc-3.30* hgb-10.0* hct-29.6* mcv-90 mch-30.2 mchc-33.7 rdw-16.5* plt ct-66* 09:18pm blood hct-28.9* plt ct-62* 03:21am blood wbc-0.7* rbc-3.06* hgb-9.2* hct-27.9* mcv-91 mch-30.1 mchc-33.0 rdw-16.2* plt ct-66* 10:01pm blood wbc-1.9* rbc-2.51* hgb-7.7* hct-21.9* mcv-87 mch-30.6 mchc-35.1* rdw-16.4* plt ct-59* 05:28am blood hct-18.5* 09:26am blood hct-22.5* 06:07pm blood hct-25.0* 05:00am blood wbc-1.2* rbc-2.57* hgb-7.9* hct-23.0* mcv-89 mch-30.8 mchc-34.4 rdw-16.9* plt ct-40* 03:16am blood glucose-130* urean-8 creat-0.8 na-135 k-3.7 cl-108 hco3-23 angap-8 02:34am blood alt-10 ast-21 ld(ldh)-142 alkphos-79 totbili-0.5 flex sig: findings: contents: clotted blood was seen in the colon. there was stool in the colon. other a large varix with central ulceration and stigmata of recent bleeding was seen in the rectum at approximately 5 cm. one, 2 cc. dermabond mixed 7:3 dermabond:ethadiol injection was applied for hemostasis with success. impression: stool in the colon blood in the colon a large varix with central ulceration and stigmata of recent bleeding was seen in the rectum at approximately 5 cm. (injection) recommendations: monitor in icu overnight clear liquid diet, may advance in am miralax prn titrated to 3 loose stools per day follow up sigmoidoscopy in 2 weeks. additional notes: the attending was present during the entire procedure. rectal varix was apparent source of bleeding, non-bleeding at time of procedure but with stigmata, injected with good hemostasis. flex sig: findings: contents: there was brown stool in the colon, no blood was seen other varix appeared improved with erythema and friability, no clot seen. area appeared firm. impression: stool in the colon varix appeared improved with erythema and friability, no clot seen. area appeared firm. flex sig: findings: mucosa: diffuse erythema was noted in the rectum. protruding lesions a single large external hemorrhoid was noted. other two strands of grade 1 rectal varices present. impression: a single large external hemorrhoid two strands of grade 1 rectal varices present. erythema in the rectum otherwise normal sigmoidoscopy to splenic flexure additional notes: the rectal varices have responded well to the glue therapy. brief hospital course: 50 y/o male with hep c cirrhosis, , hiv, recent massive rectal bleed, re-representing with brbpr . rectal bleeding - from rectal varices initially. received prbcs to keep hct>25, plts >50, ffp, cryo and started on an octreotide drip. continued to have brisk bleed. rectal foley placed and ballon inflated with 40cc h2o and bleeding tamponaded. colonoscopy showed a large varix with central ulceration and stigmata of recent bleeding and with dermabond:ethadiol injection with good hemostasis was achieved. his hct stayed stable after the procedure and was started on miralax prn to titrate stools to 3 per day. pt was called out to the floor on after stable hct for 24 hours. however, as soon as as pt arrived on the floor, he had brbpr after having a soft bowel movement which stopped spontaneously. pt was hemodynamically stable with stable hct, but was transferred back to the unit for further close monitor. liver team again put a foley and tamponaded the rectum. the following morning he again underwent another sigmoidoscopy which did not show any active bleeding. however, soon after flex sig, he rebled requiring more transfusion. bleeding stopped spontaneously. at this point, liver didn't think dermabond or any other therapy would help. he later rebled on the night of massively requiring more prbc, vasopressin gtt and dopamine gtt. hemostasis was not successful with a foley catheter, was placed to tamponade which achieved hemostasis. given his poor prognosis and no good medical options, multiple discussions regarding goals of care were made and even palliative consult was involved. however, given his clinical stability off pressors and no further rectal bleeding, comfort care was reversed on . he again underwent another flex sig on which only showed no active bleeding but large external hemorrhoids. pt was observed for 24 hours in the icu and then was discharged to home with services. his hct at d/c was 23 (transfusion >25 increases risk of rebleeding per liver, so pt was not transfused given no active bleeding). he'll follow up with his pcp 2 days after discharge from the icu and also with dr. in 2 weeks after d/c. . # - c/b encephalopathy, varices, portal gastropathy, splenomegaly, +portal vein thromboses, rectal varices s/p embolization. held lasix/propranolol/aldactone for now given low bp. . # hiv - followed by outpatient id/. recently was restarted on his haart medications but given his illness, haart was held. last cd4 count 24, vl pending. dapsone was held for neutropenia. azithromycin was continued for mac . . # leukopenia/thrombocytopenia/anemia - thought to be splenic sequestration and hiv. pt was kept on neutropenic precaution. held dapsone for neutropenia. platelets were transfused for plt<50 during active bleeding. . # addiction history - recent cocaine use, h/o heroin use. on methadone chronically. initially held methadone given his altered mental status but later was restarted. pt was on morphine gtt while he was heading towards cmo, but later was discontinued when comfort care was reversed. . # hyperglycemia - pt without previous history of diabetes, though he has been placed in insulin sliding scale over multiple admissions. recent hgb a1c <5. hyperglycemia was thought to be stress. pt was continued on insuling sliding scale. . # altered mental status: ct head was negative for bleed. his mental status returned to his baseline with resuscitation. # f/e/n - npo while massive bleeding. restarted neutropenic diet. . # - iv ppi, octreotide gtt, ivc (no pneumoboots given recent dvts, no anticoagulation) . # access - right femoral cordis --d/ced in icu, right radial a-line --d/ced in icu. rij d/ced on the day of discharge. . # code - dnr/dni (confirmed) . # communication - girlfriend, ; son medications on admission: kaletra epizcom viread allopurinol 300 mg qd dapsone 100 mg qd azithromycin 1200 mg q week (on sundays) omeprazole 20 mg qd spironolactone 50 mg qd lasix 20 mg qd rifaximin 200 mg tid propranolol 10 mg tid methadone 60 mg, oxycodone 30 prn breakthrough. discharge medications: 1. clonazepam 1 mg tablet sig: two (2) tablet po tid (3 times a day). 2. polyethylene glycol 3350 17 g (100%) powder in packet sig: one (1) powder in packet po tid (3 times a day). disp:*90 powder in packet(s)* refills:*2* 3. methadone 10 mg tablet sig: six (6) tablet po daily (daily). 4. azithromycin 600 mg tablet sig: two (2) tablet po qsun (every sunday). discharge disposition: home with service facility: homecare discharge diagnosis: primary diagnoses: rectal variceal bleeding secondary diagnoses: hiv/aids hepatitis c cirrhosis discharge condition: stable. no active rectal bleeding. discharge instructions: return to emergency room if you develop profuse rectal bleeding, chest pain, shortness of breath, abdominal pain, fevers, chills, or any other worrisome symptoms. please take medications as instructed and keep your follow up appointments. followup instructions: provider: , md phone: date/time: 11:45 provider: , , md. phone: ( date/time: 11:20 procedure: flexible sigmoidoscopy flexible sigmoidoscopy transfusion of packed cells injection of hemorrhoids diagnoses: cirrhosis of liver without mention of alcohol chronic hepatitis c without mention of hepatic coma gout, unspecified human immunodeficiency virus [hiv] disease opioid type dependence, continuous internal hemorrhoids with other complication 

Answer: The patient is high likely exposed to