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: this is a 63-year-old male with multiple medical problems including cad status post cabg, end-stage renal disease, status post crt in , history of hypertension, diabetes, upper gi bleed x2, extensive right upper extremity dvt complicated by melena and hypotension in the setting of anticoagulation. patient was admitted for cabg from to , and underwent cabg on , and then readmitted on with shortness of breath and found to have hemothorax, upper gi bleed, acute renal failure on chronic renal insufficiency. egd revealed acute gastritis, nonbleeding duodenal bulb ulcers. plavix was held. aspirin was started. patient returned on with right upper extremity swelling. ultrasound revealed a dvt from the right subclavian to right axillary and brachial veins. patient was started on heparin gtt. on . had three episodes of melena with hematocrit dropping from 32.5 to 26.3, received 2 units of packed red blood cells with hematocrit decreasing to 23.8. patient taken for egd revealed gastritis and duodenal bulb ulcers and a single bleeding proximal duodenal ulcer, which was cauterized. post ercp, patient became hypotensive with systolic blood pressure dropping to the 80s, and was tachycardic to the 100s. he received 1 liter of normal saline, 1 unit of packed red blood cells with blood pressure 133/57, heart rate 94, and saturating at 100% on room air. a left groin triple lumen was placed. patient was taken to the fenard icu. in the , patient received multiple transfusions of packed red blood cells, was diuresed with lasix and was maintained on cyclosporin, prednisone, and allopurinol. he was hypertensive which was controlled with the addition of beta blocker. the patient had hyperkalemic metabolic acidosis, which improved with intravenous fluids and bicitra. patient had repeat egd on , which was significant for no rebleeding, but friable tissue. patient was started on p.o. diet, diuresed, and was found to have stable hematocrit x2 days since patient was called out. past medical history: 1. cri with end-stage renal disease status post cadaveric renal transplant in complicated by chronic allograft nephropathy confirmed by renal biopsy. baseline creatinines are 1.5-2.8. 2. cad status post cabg x3 in ascending thoracic aorta to om-1, pl left circ two segments, reverse saphenous vein, lad to left internal mammary. 3. history of gi bleed with ulcer in with guaiac-positive stool. 4. colonoscopy with sigmoid diverticulosis, ascending colon with polyps and sigmoid transverse colon. 5. hypertension. 6. type 2 diabetes. 7. depression. 8. anemia with baseline hematocrit of 30. 9. history of bk virus in blood and urine. 10. tuberculosis as child. 11. gout. 12. status post appendectomy. medications on transfer: 1. cyclosporin 100 q.d. and 75 q.h.s. 2. prednisone 5 mg one p.o. q.d. 3. pantoprazole 40 mg one p.o. b.i.d. 4. allopurinol 100 mg one p.o. q.d. 5. bicitra 30 mg one p.o. b.i.d. 6. hydralazine 75 mg q.i.d. 7. sodium bicarb 650 b.i.d. 8. metoprolol 50 mg b.i.d. 9. ativan prn. physical exam: patient's vitals on physical exam were temperature 97.8, blood pressure is 160/80, respiratory rate is 16, pulse is 78, saturating 98% on room air. generally, the patient is in no acute distress, alert and oriented times three. heent is normocephalic, atraumatic. extraocular movements are intact. the oropharynx is clear, moist mucous membranes are noted. there is positive jvd. lungs are clear with decreased breath sounds at the bases bilaterally. abdomen is obese, positive bowel sounds, soft, nontender, and nondistended. a left ij is in place and stable, and there is no clubbing, cyanosis, and only trace edema. right upper extremity with 2+ pitting edema. normal distal pulses. data: white count 9.1, hematocrit 32.9, platelet count is 193. inr is 1.2, ptt 30, pt 13.5. sodium 144, potassium 4.0, chloride 113, bicarb 24, bun is 45, creatinine is 1.7, glucose 105, calcium is 8.1, magnesium is 1.8, and phosphorus is 3.2. hospital course by systems: 1. gi bleed secondary to bleeding duodenal ulcer: patient's hematocrit while on the floor was stable from 32 to 34. patient had no more transfusion requirements. he was maintained on b.i.d. protonix. his aspirin, plavix, and heparin were held. patient was h. pylori negative. the plan was that patient would have repeat egd in two months, and patient was to remain off of aspirin and plavix for at least the next two weeks until he has an appointment with his cardiologist. 2. dvt in the right upper extremity: patient had no increase in swelling from his baseline. his pulses were intact. no anticoagulation was continued on the floor. 3. chronic renal insufficiency: patient was continued on prednisone, cyclosporin. his bicitra was discontinued. his creatinines remained from 1.7 to 2.0. 4. coronary artery disease: again, patient was not maintained on aspirin and plavix given his recent bleed. patient can likely restart aspirin and plavix within the next two weeks after he has had an appointment with a cardiologist and has had stable hematocrit with no further evidence of bleeding. 5. hypertension: patient remained hypertensive throughout his hospitalization. this is complicated by the fact that his blood pressures had to be taken in his thigh and an appropriate size cuff was difficult to obtain. however, his blood pressures were persistently 150-220 systolic. patient was maintained on beta blocker, hydralazine, and amlodipine as amlodipine and hydralazine were maxed out and his beta blocker was increased to 125 mg t.i.d. by time of discharge. patient on exam was also noted to be fluid overloaded given his decreased breath sounds at the bases, elevated jvd, and was maintained on lasix, and he went anywhere from 40-80 iv and his goal was -1 liter per day. by the time of discharge, the patient was approximately 1.7 kg down from his baseline. patient's exam clinically improved with resolution of jvd as well as improvement in breath sounds at the lung bases. patient was discharged with an addition of 40 mg of lasix a day. 6. for prophylaxis, patient was maintained on proton-pump inhibitor b.i.d. was ambulating without difficulty. patient is a full code. discharge condition: stable. his right upper extremity dvt is stable. he is having no tachypnea, tachycardia, oxygen desaturation or any other evidence of pulmonary embolus. he is able to ambulate without desaturating. he has good distal pulses. patient is tolerating a regular diet. his hematocrits have remained stable. discharge status: he will be discharged to home. medications on discharge: 1. prednisone 5 mg one p.o. q.d. 2. cyclosporin 100 mg p.o. q.a.m. and 75 mg one p.o. q.h.s. 3. allopurinol 100 mg one p.o. q.d. 4. lorazepam 1 mg tablet one p.o. t.i.d. 5. pantoprazole 40 mg one p.o. b.i.d. 6. hydralazine 75 mg one p.o. q.6h. q.d. 7. amlodipine 10 mg one p.o. q.d. 8. metoprolol 125 mg one p.o. t.i.d. 9. avandia 4 mg one p.o. q.d. 10. lasix 40 mg one p.o. q.d. 11. double strength bactrim one on monday, wednesday, and friday. discharge plans: 1. dr. at the internal clinic on at 3:30. patient should have his cbc and chem-10 checked at that time. 2. cardiac surgery, dr. on at 1:30 p.m. 3. dr. , cardiology services at at 8 a.m. at that time, the patient will need to discuss resumption of aspirin as well as plavix. he should also have his hematocrit checked at that time and if stable, that consideration can be taken by dr. . 4. dr. from the clinic on at 10:30 a.m. in the egd suite for repeat egd. 5. clinic. the clinic was called on two occasions, however, have not heard back from them. hence, patient is given the phone number and told that if he does not hear from the clinic within two days with an appointment date and time, that he should call the clinic. 6. clinic was also , and the voice mail was reached. patient was advised that if he should not hear back from the clinic within two days, that he should call the clinic himself. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified other endoscopy of small intestine endoscopic control of gastric or duodenal bleeding endoscopic control of gastric or duodenal bleeding transfusion of packed cells diagnoses: hyperpotassemia anemia, unspecified congestive heart failure, unspecified atrial flutter hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction other vascular complications of medical care, not elsewhere classified complications of transplanted kidney 

Answer: The patient is high likely exposed to