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: sulfatrim / sulfa (sulfonamide antibiotics) / tape "x10yd attending: chief complaint: bright red blood per rectum major surgical or invasive procedure: colonoscopy/egd ij cvl intubation history of present illness: 56 y.o female with pmhx of hcv/etoh cirrhosis decompensated in the past with grade 1 varices in , small amount of ascites, and encephalopathy with recent diagnosis of metastatic adenocarcinoma ( thought to be a pancreaticobilliary source) who recieved a eus with fna and now presenting with hematochezia and altered mental status. the husband accompanies the patient reports that she seemed to be more confused the last 2 days. yesterday they noted that she had dark-colored stools that appeared to be like blood. the patient is uncooperative with exam right now and has no specific complaints. . initial vitals in the ed was 97.3 92 97/76 16 97% and she was given octreotide drip, pantoprazole drip and ceftriaxone. patient was noted to have sbp's into the 80's, given iv ns and bp stablized with sbp at approx. 110. patient had 1 20 g piv and left io placed because of difficult access. on arrival to the micu, the patient is sleeping and does not want to answer questions. she denies pain, and says she has noticed dark blood in her stools for a couple of "days." she refuses to answer further questions and denies confusion. "just leave me alone." review of systems: patient will not answer, could not be fully obtained (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, 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, abdominal pain, or changes in bowel habits. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes or skin changes. past medical history: hep c etoh abuse depression cirrhosis l humerus fracture s/p orif ; s/p removal of hardware and repair of left humerus nonunion w/ bone graft and locking plate s/p washout and debridement on and . social history: did not drink alcohol for 3 years until a recent admission in 6/. smokes abou5-6 cigarettes/day. lives with her husband in . family history: nc physical exam: admission vitals: t:99.0 bp:110/80 p:95 r:12 18 o2:87% ra general: sleeping, oriented x2-3, no acute distress. does not want to answer questions, wants to sleep heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: does not comply with neurologic exam. spontaneously moving all limbs.no asterxis rectal: dark red/maroon blood in the rectal vault . discharge exam: general: lethargic, one word responses, appeared to be in no acute distress. oriented x0 heent: sclera anicteric, mm moist, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, 2/6 sem heard best at lusb lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly pertinent results: admission labs 07:06pm hgb-9.3* calchct-28 06:57pm glucose-85 urea n-17 creat-0.7 sodium-137 potassium-3.8 chloride-104 total co2-24 anion gap-13 06:57pm alt(sgpt)-41* ast(sgot)-81* alk phos-122* tot bili-2.7* 06:57pm albumin-3.0* 06:57pm asa-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 06:57pm wbc-7.7 rbc-2.84* hgb-9.1* hct-27.5* mcv-97 mch-31.9 mchc-33.0 rdw-16.1* 06:57pm neuts-74.9* lymphs-17.2* monos-4.8 eos-2.8 basos-0.4 06:57pm plt count-103* 06:57pm pt-17.5* ptt-32.1 inr(pt)-1.6* 05:25pm glucose-88 urea n-19 creat-0.7 sodium-129* potassium-greater th chloride-105 total co2-23 05:25pm glucose-88 urea n-19 creat-0.7 sodium-129* potassium-greater th chloride-105 total co2-23 05:25pm alt(sgpt)-65* ast(sgot)-213* alk phos-117* tot bili-2.7* 05:25pm albumin-3.2* 05:25pm wbc-11.2*# rbc-3.05* hgb-9.8* hct-29.6* mcv-97 mch-32.3* mchc-33.2 rdw-16.0* 05:25pm neuts-74.9* lymphs-17.2* monos-4.8 eos-2.9 basos-0.2 05:25pm plt count-148*# . studies: egd : 4 cords of grade iii large esophageal varices were seen starting at 20 cm from the incisors in the upper third of the esophagus and gastroesophageal junction. the junctional varix had red whale signs. the varices were not bleeding. severe portal hypertensive gastropathy seen throughout the stomach with cherry red spots without signs of active bleeding or oozing. retroflexed revealed small hiatal hernia with small gastric varices on lesser curvature left undisturbed. normal duodenal bulb and second portion . colonoscopy : moderate left sided diverticulosis without signs of active bleeding, otherwise normal colonoscopy to the cecum. retroflexion in the rectum revealed hyertrophy of anal papila and one cord of rectal varices without signs of active or recent bleed, moderate internal hemorrhoids left undisturbed. . micro: urine culture-neg urine culture-neg brief hospital course: 56 y.o female with pmhx of hcv/etoh cirrhosis decompensated in the past with grade 1 varices in , small amount of ascites, and encephalopathy with recent diagnosis of metastatic adenocarcinoma ( thought to be a pancreaticobilliary source) who received a eus with fna and who presented with hematochezia and altered mental status. . active issues #hematochezia- rectum revealed maroon stools. patient placed on octreotide, pantoprazole drips and started on ceftriaxone ppx. differential included variceal bleed, diverticulosis. hct dropped from 35 to 28. intubated without complication and underwent egd which revealed severe esophageal and gastric varices with diverticulosis on colonoscopy. no role in tips per hepatology given underlying malignancy. ct torso also carried out which verified malignancy metastases, with enlarged nodes by liver and pancreas unknown primary. pt was transferred to the floor, where her symptoms were controlled with oral morphine for pain and sl zydas for agitation. there was no blood noted . pain: see above. after being transferred to the floor, patient was controlled on iv and po morphine. eventually switched to all po meds. standing morphine has had to be uptitrated, and at discharge she was receiving 7.5mg of concentrated sl ms q2h, with an additional q1h:breakthrough pain. it is difficult to assess patient as she is usually sedated, however, she can become anxious/agitated in the morning and when prompted, will occasionally report that she has abdominal pain. . #confusion-thought to be multifactorial including hepatic encephalopathy and delirium post sedation. was extubated on and patient remained agitated and delirious pulling out her central line placement. a family meeting took place with the patient's sister and husband who were health care proxies. poor prognosis due to underlying malignancy and cirrhosis were explained to them. reported that she has weeks to months to live. systemic chemo was offered but cons outweighed pros given that the main concern for the health care proxies were the comfort of the patient. therefore, on she was placed as comfort care only and lactulose, rifaximin,ceftriaxone, ppi, lab draws were stopped. . #adenocarcinoma- thought to be from pancreatic- biliary source. . transitional issues: #stymptom control: pt has been transitioned to all po meds. will need to uptitrate po morphine and sl zydas as needed medications on admission: 1. albuterol inhaler 2 puff ih q6h:prn sob 2. fluoxetine 20 mg po daily 3. gabapentin 600 mg po tid 4. lactulose 30 ml po tid 5. oxycodone (immediate release) 5-10 mg po q8h:prn pain 6. pantoprazole 40 mg po q24h 7.alprazolam 0.25 mg tablet 1 tablet(s) qhs 8.cholestyramine-aspartame 4 gram packet 1 packet by mouth qdaily discharge disposition: extended care facility: nursing care center discharge diagnosis: primary diagnosis: metastatic pancreatic adenocarcinoma anemia gastrointestinal bleed chronic pain discharge condition: mental status: confused - always. level of consciousness: lethargic but arousable. activity status: bedbound. discharge instructions: you were admitted to the icu because you had blood in your stool and you were confused. you were treated with blood transfusions and medicine to make you stop bleeding. a camera was used to look at your esophagus, stomach, and your colon. this showed many areas that could potentially bleed, though none were bleeding at the time. when your blood count was stable, you were transferred to the service. your pain was well controlled while you were here. you were comfortable and your symptoms were controlled. we are sending you on medication to take by mouth for your pain, and a seperte medication for any confusion/anxiety or agitation. medications to start: morphine concentrate 7.5mg q2h morphine concentrate 5-10mg q1h prn:pain olanzapine 5mg q8h olanzapine followup instructions: none md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours other endoscopy of small intestine colonoscopy diagnoses: esophageal reflux acute posthemorrhagic anemia alcoholic cirrhosis of liver portal hypertension unspecified viral hepatitis c without hepatic coma asthma, unspecified type, unspecified depressive disorder, not elsewhere classified acute respiratory failure encounter for palliative care hepatic encephalopathy hemorrhage of gastrointestinal tract, unspecified varices of other sites esophageal varices in diseases classified elsewhere, without mention of bleeding other and unspecified alcohol dependence, unspecified diverticulosis of colon (without mention of hemorrhage) other alteration of consciousness secondary and unspecified malignant neoplasm of intra-abdominal lymph nodes malignant neoplasm of other specified sites of pancreas 

Answer: The patient is high likely exposed to