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: hematemesis major surgical or invasive procedure: egd history of present illness: 49 yo f with h/o heavy etoh use now with hematemesis. states her father's funeral was thursday and she drank her normal 3 glasses of wine that evening. the whole day she had only eaten a platter. at 3 a.m. on friday she started having intense abd cramps and started vomiting blood. at the same time she started having copious black diarrhea. states throughout the day she vomited and had diarrhea approx 20 times. states she briefly felt better around 2 p.m. and had a rum and coke but then had more vomiting. had more rum and coke at 11 p.m. and hematemesis continued and her sister convinced her to go to the ed. states she has had light-headedness but has not passed out. pt states before this she has never had hematemesis or black stools. denies knowledge of liver disease. . at hct was 28.2, plt 23, blood etoh 103. pt was given 1l ns, zofran 4mg iv, protonix 40mg iv, one unit prbc's, vitamin k 10mg im and was transfered to where she vomited once in the ed with dark brown emesis. at hct was 30.6, inr was 1.6. she was given anzemet 25mg iv, octreotide 50mcg iv, and phenergan 12.5mg iv. . past medical history: htn hypothyroidism torticolis "spasms" diagnosed by neurologist several years ago social history: lives with her husband in , ma. her eldest son died last year. she has 2 other grown children. used to work as a cook but is now retired. states she and her husband drink approx glasses of wine each evening and have occasional hard alcohol on the weekends (x 30 years). states that when she doesn't drink she gets more shakey and doesn't feel well but has never had seizures. she smokes - 1 ppd. denies any cocaine, marijuana, heroin, or other substances. family history: denies knowledge of liver disease. physical exam: 101.2, 118, 130/67, 18, 98% on ra gen: appears slightly anxious, in nad heent: op clear, dry. no petechiae or evidence of bleeding. skin: no palmar erythema or spider angiomata. cv: tachy, regular, no m/r/g abd: s/nt/slightly distended but no obvious fluid wave. +bs. lungs: ctab ext: no c/c/e. rectal: guaiac positive black stool. neuro: a&ox3, no focal abnormalities. pertinent results: chest single view on history: oxygen requirement, question pneumonia or fluid overload. there are no old films available for comparison. there is an area of increased opacity in the left lower lobe consistent with left lower lobe pneumonia. there is a small left pleural effusion. the heart is upper limits normal in size. the bony thorax is normal. impression: left lower lobe pneumonia. . brief hospital course: 1. gi bleed: at admission, the patient underwent banding of grade 2 varices. her hematocrit remained stable and she was transferred to the floor. she had a repeat endoscopy during the admission with repeat banding of the varices. she was on sucralfate and ppi. she will have subsequent endoscopies and banding as an outpatient. . 2. alcoholic liver disease: the patient had a new diagnosis of alcoholic liver disease and likely cirrhosis. she did not undergo liver biopsy during this admission. she has marked hepatomegaly and splenomegaly, ascites and esophageal varices. her course was complicated by alcoholic hepatitis. her discriminate function was 36, however, she was not a candidate for steroids given the recent gi bleed and infection (see below). she had prolonged abdominal distention and pain (see below) despite improvement in her lfts. she underwent three paracenteses and was started on diuretics to control her fluid accumulation. there was no evidence of sbp. her relatively low blood pressure limited the dose of diuretics. she will have liver center follow up as an outpatient. the patient was actively drinking prior to admission. hbsab neg, hav neg, anti smooth muscle antibody neg, igg 1406. iga 540 (elevated). ceruloplasmin negative. . 3. pain: the patient suffered from chronic abdominal pain which was difficult to control. her pain was severe despite resolution of her alcoholic hepatitis. ct scan did not have evidence of liver bleed or abscess or other anatomic reason for her pain. she required high doses of narcotics for pain control, and denied (repeatedly) ever using narcotics before. it was suspected that her pain was from capsular stretch from hepatomegaly. ultimately, pain service was involved and she was put on 30 mg oxycontin twice daily with oxycodone for breakthrough and neurontin. this regimen provided improved pain control. the patient has an addiction (alcohol) history and attempts to wean her narcotics were unsuccessful. at discharge, the patient was given oxycontin 40 mg and prn oxycodone for breakthrough and neurontin. she was given 2 weeks of narcotics and was told she needs to see her pcp for chronic narcotic management. . 4. community acquired pneumonia: the patient was diagnosed with pneumonia at admission. she completed 10 days of levoquin and 7 days of flagyl. the patient continued to spike fevers during her prolonged hospitalization. repeat xray showed no infiltrate. . 5. uti: group a strep urinary infection treated with four days of augmentin with subsequent clean culture. the patient continued to spike fevers and ceftriaxone was added to her regimen to complete at 10 day course for the uti in this patient with liver disease. the patient was transferred to cefpodoxime at discharge. . 6. alcohol abuse/addiction: the patient was actively drinking prior to admission. she has a long history of alcohol use with drinks of wine daily. she was seen by addiction services and social work during this hospitalization and was given material regarding alcoholics annonymous and other abstinence programs. there was also a strong suspicion of outpatient vicodin abuse given overheard conversations between the patient and her husband, however, this was denied repeatedly on direct questioning. the patient displayed drug-seeking behaviors while inpatient. she was repeatedly informed that she can no longer drink alcohol and verbalized understanding. . 7. hypertension: the patient had a history of hypertension prior to admission, but her blood pressure tended to run low during this hospitalization. it is likely that this is related to lack of alcohol while hospitalized and pain medication. the patient also was started on nadolol for her varices, but was unable to tolerate this in addition to the doses of lasix and aldactone needed to control her abdominal distention. . 8. hypothyroidism: continued outpatient levoxyl. . 9. disposition: the patient was discharged home to complete a 10 day course of cefpodoxime. she was given a prescription for 2 weeks of narcotics and will follow up with her pcp. has close liver center follow up. she had been cleared by pt for going home. she requires daily magnesium repletion. she was full code. medications on admission: lisinopril 5mg daily levoxyl 5 mg daily discharge medications: 1. levothyroxine 50 mcg tablet sig: one (1) tablet po daily (daily). 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 3. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 4. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. spironolactone 100 mg tablet sig: 1.5 tablets po daily (daily). disp:*90 tablet(s)* refills:*2* 6. furosemide 40 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 7. oxycodone 5 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed for pain. disp:*30 tablet(s)* refills:*0* 8. oxycontin 20 mg tablet sustained release 12 hr sig: two (2) tablet sustained release 12 hr po twice a day. disp:*60 tablet sustained release 12 hr(s)* refills:*0* 9. gabapentin 300 mg capsule sig: one (1) capsule po q8h (every 8 hours). disp:*90 capsule(s)* refills:*1* 10. magnesium oxide 400 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 11. cefpodoxime 200 mg tablet sig: one (1) tablet po twice a day for 6 days. disp:*12 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary: alcoholic liver disease variceal bleed alcoholic hepatitis ascites secondary esophageal varices thrombocytopenia hypothyroidism hypertension abdominal pain discharge condition: stable. tolerating a regular diet. pain improved. able to walk with walker. discharge instructions: you were admitted with bleeding from your gi tract and then treated for alcoholic hepatitis. please call your doctor or come to the ed if you develop vomiting blood, blood per rectum, dark tarry stools, nausea, vomiting, uncontrollable pain, inability to take your medications, increase size of your abdomen, worsening lower extremity swelling, chest pain or shortness of breath. . there are several new medications for you to take daily: 1. lasix (diuretic) 80 mg daily 2. spironolactone (diuretic) 150 mg daily 3. oxycontin 40 mg twice a day 4. oxycodone 5 mg every 4-6 hours as needed for pain 5. protonix (acid blocker) 40 mg twice a day 6. folate (vitamin) 1 mg daily 7. thiamine (vitamin) 100 mg daily 8. neurontin (pain medication) 300 mg three times daily 9. magnesium oxide (electrolyte replacement) 400 mg daily 10. cefpodoxime 200 mg twice daily for 6 days (antibiotic, start ). followup instructions: repeat endoscopy: provider: west,room five gi rooms date/time: 8:30 provider: , md phone: date/time: 8:30 liver center follow up: provider: , md phone: date/time: 8:30 . primary care provider: , call to schedule appointment procedure: percutaneous abdominal drainage endoscopic excision or destruction of lesion or tissue of esophagus diagnoses: pneumonia, organism unspecified urinary tract infection, site not specified unspecified essential hypertension alcoholic cirrhosis of liver unspecified acquired hypothyroidism esophageal varices in diseases classified elsewhere, with bleeding alcohol abuse, continuous acute alcoholic hepatitis alcohol withdrawal 

Answer: The patient is high likely exposed to