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: hematemasis major surgical or invasive procedure: egd s/p banding intubation history of present illness: this is a 46 year old male with a history variceal bleeds who woke up this morning in a pool of blood and then proceeded to have hematemasis x2. he reports he drank about 6 beers and a few mixed drinks for the fourth of . prior to that his last drink had been a few weeks ago. his last variceal bleed was in and his last endoscopy was in . at that time he had " four cords of grade ii varices were seen in the upper third of the esophagus, lower third of the esophagus and middle third of the esophagus. one band was placed successfully at 3 cm above gej". . prior to last night he did not report any fevers/chills, n/v/c/d, ab pain, rashes, jaundice. ros otherwise negative. . his mother found him early this morning in a pool of blood. after some more hematemasis he was sent to . from there he was sent to ed. . in the ed initial vitals were 98.5 98 111/60 18 96. he was given protonix 80mg iv at and started on ppi gtt and octreotide gtt. he recieved 1 u prbc and crossed for two more. his hct was noted to be 22.3 23 at (b/l 27-32). pt had guaiac pos exam. he has a 20 and 18 piv. . on the floor, he is currently asymptomatic. no further hematemasis. he does not complain of any pain. past medical history: -etoh hepatitis/cirrhosis, portal hypertension, esophageal varices. no history of hep ancephalopathy, no hx of sbp. -subacute pancreatitis -hypertension -appendectomy -repeated surgeries for facial trauma -unknown surgery on bilateral shoulders social history: heavy etoh abuse with binge drinking episodes. previously drinking 6 pack per day +/- whiskey. now has binge drinking with his friends. smokes 1pack per week. no ivda. family history: cad, father deceased at 64, grandfather deceased at 61, both from mi physical exam: general appearance: well nourished, no acute distress, thin eyes / conjunctiva: perrl, conjunctiva pale head, ears, nose, throat: normocephalic lymphatic: cervical wnl cardiovascular: (s1: normal), (s2: normal) peripheral vascular: (right radial pulse: present), (left radial pulse: present), (right dp pulse: present), (left dp pulse: present) respiratory / chest: (expansion: symmetric), (breath sounds: clear : b/l) abdominal: soft, non-tender, bowel sounds present extremities: right lower extremity edema: absent, left lower extremity edema: absent skin: not assessed, bruising neurologic: responds to: not assessed, movement: not assessed, tone: not assessed pertinent results: admission labs: 08:00am blood wbc-3.2* rbc-2.69*# hgb-7.0*# hct-22.3*# mcv-83 mch-25.8* mchc-31.2 rdw-19.7* plt ct-74* 08:00am blood neuts-70.1* lymphs-12.9* monos-13.3* eos-1.9 baso-1.8 04:04am blood hypochr-1+ anisocy-normal poiklo-1+ macrocy-normal microcy-normal polychr-normal ovalocy-1+ tear dr1+ 08:00am blood pt-19.1* ptt-31.3 inr(pt)-1.7* 08:00am blood glucose-141* urean-13 creat-0.8 na-144 k-3.7 cl-108 hco3-22 angap-18 08:00am blood alt-17 ast-57* alkphos-127 totbili-2.7* 02:44pm blood calcium-7.3* phos-4.1 mg-1.4* ruq u/s - impression: 1. cirrhotic liver with patent vasculature demonstrating appropriate flow. 2. splenomegaly and trace ascites. cxr - impression: small right pleural effusion. egd: - 5 bands were successfully placed in the lower third of the esophagus. - 1 band was could not be placed in the lower third of the esophagus. - impression: varices at the lower third of the esophagus and middle third of the esophagus. blood in the stomach body. no gastric verices were seen. there was an episode of hypotension during the procedure with systolic bp to 70mmhg for less that 3 minutes. this was responsive to fluid bolus. otherwise normal egd to third part of the duodenum. brief hospital course: this is a 46-yo man with etoh abuse, cirrhosis c/b portal hypertension & esophageal varices, p/w hematemesis and found to have evidence of esophageal variceal hemorrhage now s/p banding. . #. acute blood loss anemia: the patient was admitted to the icu. he was intubated and egd was performed which demonstrated 4 cords of grade iii varices seen in the lower third and middle third of the esophagus. there were stigmata of recent bleeding. there was one varicx at 32cm that had a blister consistent with recent hemorrhage. he recieved one unit of prbc prior to the icu and two in the icu for tachycardia. he was extubated after his egd. he was started on prophylatic ciprofloxacin. he remained on a protonix and octreotide drip overnight. a social work consult was initiated. his hct initially remained somewhat low but then began to increase appropriately. he received a total of 4 units of prbcs while in the icu. octreotide was stopped upon transfer from the icu to the floor. sucralfate was initiated and his nadolol was restarted. he did not have any further episodes of gi bleeding. his hematocrit continued to trend upwards and was 30 the morning of his discharge. his vital signs remained stable and his diet was advanced to regular. he was discharged home with instructions to complete a 7 day course of his cipro regimen, and to continue taking his nadolol, ppi, and sucralfate. . . #. etoh abuse: patient had minimal anxiety his last night in the micu and was well controlled with iv valium. a ciwa protocol was in place and he had no further triggers for the rest of his stay. he admits that he has a problem and seems to have insight into this problem. at his request, social work provided him with information on addiction counseling services. he received thiamine, folate, and mvi while in house and was discharged home with scripts for all three. . . #. cirrhosis: this patient has known cirrhosis and portal hypertension. based on labs, there was no evidence of acute decompensation from his liver. his leukopenia and thrombocytopenia consistent with cirrhosis. liver us confirmed cirrhosis. he did not have encephalopathy nor did he develop ascites. he is to follow up with dr. on . medications on admission: - lactulose 30ml po bid-tid - nadolol 20mg po daily - omeprazole 40mg po bid - sucralfate 10mg po bid - folic acid po daily - multivitamin po daily - thiamine po daily discharge medications: 1. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po tid (3 times a day) as needed for constipation. disp:*qs * refills:*0* 2. nadolol 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 3. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. disp:*60 capsule, delayed release(e.c.)(s)* refills:*2* 4. sucralfate 100 mg/ml suspension sig: ten (10) ml po four times a day. disp:*qs * refills:*2* 5. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. multivitamin tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 4 days. disp:*8 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary diagnosis: upper gi variceal bleed. . secondary diagnosis: - cirrhosis c/b portal hypertension, esophageal varices, and variceal bleeding - hypertension discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to for further evaluation of vomiting bright red blood and were found to have an upper gastrointestinal bleed related to your previously known esophageal varices. while you were here you had an endoscopy that identified the source of the bleeding in your esophagus and had a banding procedure to stop it. you should stop drinking alcohol altogether to help prevent this from happening again in the future. while you were here, you met with social work who provided you with several phone numbers to call for alcohol rehabilitation. . we changed your medications in the following ways: -you should take ciprofloxacin twice a day for 4 more days. -you should increase your home sucralfate to 1 gram four times daily. followup instructions: you should follow-up at all of the medical appointments listed below: . 1. provider: (h3) general 2 radiology phone: date/time: 8:00 . 2. provider: (st-3) gi rooms date/time: 10:00 . 3. provider: , md phone: date/time: 10:00 md procedure: endoscopic excision or destruction of lesion or tissue of esophagus alcohol detoxification diagnoses: other iatrogenic hypotension tobacco use disorder acute posthemorrhagic anemia alcoholic cirrhosis of liver portal hypertension hemorrhage complicating a procedure esophageal varices in diseases classified elsewhere, with bleeding acute pancreatitis leukocytopenia, unspecified other sedatives and hypnotics causing adverse effects in therapeutic use acute alcoholic intoxication in alcoholism, continuous 

Answer: The patient is high likely exposed to