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: esophagogastroduodenoscopy (egd) history of present illness: mr. is a 67 year-old man with a history of dm, cad, large infrarenal aaa with bilateral large common iliac aneurysms, s/p right hypogastric coiled embolization on , who presents with hematemesis and is admitted to the micu for further management. . he was recently discharged on after presenting with arf and after presenting with fournier's gangrene/periurethral abscesses requiring operative debridment. during this hospitalization, he also underwent coil embolization of the right hypogastric artery. he was doing well at home until today when he had an episode of bright red hematemsis with clots this morning. he also had a 3 bowel movements with bright red blood and associated with light-headedness but no abdominal pain or chest pain. he presented to his pcp and was referred to the ed. . in the ed, vital signs were initially: 86 87/46 20 100%ra. hct on arrival was 22 from a baseline of 30. bps improved with 4l ivfs and he was transfused 2u prbc, 2u ffp, and 1 unit of platelets. ng lavage positive for dark blood but no coffee grounds and he had brb per rectum. he was also given pantoprazole 80 iv x 1 and a gtt was started. he complained of cp initially which improved with morphine 2mg iv x 2 and blood transfusion. his ekg demonstrated anterior-lateral precordial tw flattening consistent with ischemic changes per cardiology. abd ct was negative for aorto-enteric fistula and he was admitted to the micu for further management. past medical history: - large infrarenal aaa with b/l large common iliac aneurysms - urethral abscess - dm - htn - cad s/p pci - r hypogastric coiled embolization on - suprapubic urinary catheter placement - per pt has hx of "stenting" of vessel after left arm pain, but does not believe stent in heart, thinks in arm. social history: lives at home with wife and is retired. quit smoking two months ago; previously 1 ppd x 50 years. no drugs. family history: colon cancer in father physical exam: vs: 98 96 107/65 100%2l gen:the patient is in no distress and appears comfortable skin:no rashes or skin changes noted heent:no jvd, neck supple, no lymphadenopathy in cervical, posterior, or supraclavicular chains noted. chest:lungs are clear without wheeze, rales, or rhonchi. cardiac: regular rhythm; no murmurs, rubs, or gallops. abdomen: no apparent scars. non-distended, and soft without tenderness extremities:no peripheral edema, warm without cyanosis neurologic: alert and appropriate. cn ii-xii grossly intact. bue , and ble both proximally and distally. no pronator drift. reflexes were symmetric. downward going toes. pertinent results: admission labs: 02:30pm blood wbc-12.1*# rbc-2.39*# hgb-7.1*# hct-22.0*# mcv-92 mch-29.7 mchc-32.3 rdw-16.2* plt ct-205 02:30pm blood urean-47* creat-1.6* na-138 k-5.6* cl-109* hco3-21* angap-14 09:29pm blood ck-mb-notdone ctropnt-<0.01 05:38am blood ck-mb-4 ctropnt-0.03* 06:07pm blood ck-mb-notdone ctropnt-0.03* 09:29pm blood ck(cpk)-35* 06:07pm blood ck(cpk)-22* 09:29pm blood calcium-7.6* phos-3.9 mg-1.7 . discharge labs: 12:06pm blood wbc-10.9 rbc-4.31* hgb-12.4* hct-36.9* mcv-86 mch-28.7 mchc-33.5 rdw-15.4 plt ct-145* 12:06pm blood glucose-285* urean-24* creat-1.4* na-137 k-4.3 cl-99 hco3-29 angap-13 09:55am blood calcium-8.6 phos-3.3 mg-1.7 ecg : sinus rhythm. tracing may be within normal limits but unstable baseline makes assessment difficult. since the previous tracing of there is probably no significant change. intervals axes rate pr qrs qt/qtc p qrs t 81 144 70 356/392 72 42 86 ct abdomen/pelvis : ct abdomen with contrast: the imaged portions of the lung bases reveal a 7-mm subpleural nodule in the right lower lobe (3:11). additionally, note is made of scattered nodules in the left lower lobe, though these latter show indistinct margins suggesting that they may be inflammatory or infectious in etiology. the imaged cardiac apex is notable for mitral annular calcification. the spleen, adjacent splenule, pancreas, gallbladder, adrenal glands, kidneys, liver are unremarkable. the stomach contains a nasogastric tube. there is no retroperitoneal or mesenteric lymphadenopathy. ct pelvis with contrast: a suprapubic catheter ends the urinary bladder is unchanged. the prostate is notable for diffuse calcifications which are also unchanged. the rectum and colon are unremarkable. there is no free gas or fluid in the pelvis. there is no pelvic or inguinal lymphadenopathy. ct angiogram: the suprarenal aorta is normal in caliber. the infrarenal aorta is notable for diffuse aneurysmal dilation. a small intimal flap is seen in the proximal part of the suprarenal aorta (3:70). more distally, just above the level of the aortic bifurcation, the aorta measures 74 x 69 mm in cross-sectional area and is notable for a large amount of mural thrombus. aneurysmal dilation with thrombus is also present in the common iliac arteries bilaterally, the most severe on the right with a total dimension of the vessels 91 x 83 mm, similar to that seen previously. the patient is status post embolization of the right internal iliac artery, a finding which is unchanged from the recent comparison ct. both external iliac arteries opacify normally with arterial contrast. there is no evidence of aortoenteric fistula. osseous findings: there is no suspicious sclerotic or lytic lesion. degenerative changes are present throughout the lumbar spine. there is also mild degenerative change in the sacroiliac joints bilaterally. impression: 1. large infrarenal and bilateral common iliac arterial aneurysms, appearing similar to those characterized recently. there is no evidence of aortoenteric fistula. 2. focal nodule in the right lower lobe and inflammatory appearing nodules in the left lower lobe. in the absence of high risk for pulmonary malignancy, would recommend followup with a dedicated ct of the chest in six months. in the presence of these risk factors, would recommend followup with a dedicated ct of the chest in three months. cxr : findings: interval extubation and removal of nasogastric tube and central line with no evidence of pneumothorax. mild pulmonary vascular congestion. no new areas of consolidation to suggest an acute infectious pneumonia. egd : findings: esophagus: excavated lesions: a single non-bleeding 5 mm ulcer was found in the gastroesophageal junction. stomach: mucosa: mosaic appearance of the mucosa was noted in the fundus and stomach body. these findings are compatible with possible portal hypertensive gastropathy. duodenum: excavated lesions: a single acute cratered 3 cm ulcer was found in the proximal bulb and anterior bulb. a clot suggested recent bleeding and there were two vissible vessels. 2 2.5 cc.epinephrine 1/ injections were applied for hemostasis with success. a gold probe was applied for hemostasis successfully to anterior vissible vessel. two endoclips were successfully applied for the purpose of hemostasis to posterior vissible vessel. impression: mosaic appearance in the fundus and stomach body compatible with possible portal hypertensive gastropathy ulcer in the proximal bulb and anterior bulb (injection, thermal therapy, endoclip) ulcer in the gastroesophageal junction otherwise normal egd to second part of the duodenum brief hospital course: mr. is a 67 year-old man with a history of a large infrarenal aaa with bilateral large common iliac aneurysms, s/p right hypogastric coiled embolization on , who presents with hematemesis. . # gi bleed: on arrival to the icu patient was hemodynamically stable. an urgent egd was performed with intubation and anesthesia. this demonstrated two large bleeding duodenal ulcers which were injected with epinephrine, cauterized and endoclips were applied. he received an additional 4 units of prbc before, during and after the procedure. general surgery and interventional radiology were consulted regarding management of his ugib, and did not recommend further intervention as hemostasis was achieved by egd. he was kept in the unit for close clinical monitoring. he continued to have melena, but it was thought this represented residual blood from his initial bleed. his hematocrit was 22 on arrival to the micu, after a total of seven units prbc, his repeat hematocrit was 29. he was called out to the medical floor on . his ppi was converted from a drip, to dosing iv to dosing orally. his diet was gradually advanced. he experienced no further episodes of bleeding, and his hematocrit remained stable. on discharge, he was prescribed treatment for h. pylori, as well as a ppi. . # cad s/p pci: patient initially experienced chest pain, it was considered likely that this represented demand ischemia in the setting of anemia. myocardial infarction was ruled out by ekg and serial troponins and cardiac enzymes. patient was continued on his statin, but aspirin was held in the setting of an active bleed. . # infrarenal aaa with b/l common iliac aneurysms: ct scan demonstrated no evidence of aorto-enteric fistula. vascular surgery was consulted and followed throughout his stay. patient has a scheduled intervention for his aaa with vascular surgery. . # periurethral abscesses: patient had recent periurethral abscesses requiring operative debridement and suprapubic urinary catheter placement . he was continued on his outpatient 10 day course of levofloxacin, which he completed . his suprapubic catheter functioned appropriately well, and the surgical site was healing well. . # hypertension: blood pressure medications were initially held in the setting of an acute bleed. on discharge, he was restarted on his home dose of metoprolol. . # diabetes mellitus: patient was treated with a humalog sliding scale throughout his hospitalization. . # lung nodule: focal nodule in the right lower lobe and inflammatory appearing nodules in the left lower lobe. in the absence of high risk for pulmonary malignancy, would recommend followup with a dedicated ct of the chest in six months. in the presence of these risk factors, would recommend followup with a dedicated ct of the chest in three months. medications on admission: 1. metoprolol succinate 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). 2. simvastatin 10 mg tablet sig: two (2) tablet po daily 3. aspirin 81 mg tablet, chewable sig: one (1) tablet daily 4. levofloxacin 250 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 10 days. disp:*10 tablet(s)* refills:*0* 5. glyburide 2.5 mg tablet sig: one (1) tablet po once a day. 6. lisinopril 5 mg tablet sig: one (1) tablet po once a day. 7. hyoscyamine sulfate 0.125 mg tablet sig: one (1) tablet po four times a day: prn for bladder spasms. discharge medications: 1. simvastatin 10 mg tablet sig: two (2) 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): please begin taking pantoprazole once you have finished the . disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 3. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 4. metoprolol succinate 25 mg po daily 5. 500-500-30 mg combo pack sig: one (1) po twice a day for 14 days. disp:*qs pack* refills:*0* 6. glyburide 2.5 mg tablet sig: one (1) tablet po once a day. discharge disposition: home with service facility: homecare discharge diagnosis: duodenal ulcer upper gastrointestinal bleed abdominal aortic aneurysm discharge condition: stable, alert and oriented to person, place and time, ambulating without assistance. discharge instructions: you were admitted for bloody stools. upper endoscopy (esophagogastroduodenoscopy or egd) was performed and found a bleeding ulcer in your stomach. injections, cauterization and clips were placed to stop the bleeding. you were given 8 units of packed red blood cells. since this procedure, your blood count levels have remained stable. the following changes were made in your medications: - please start , take as directed on the package, twice daily for 14 days. - while taking the , not take protonix (pantoprozole). once you are finished with the , you can continue taking the pantoprazole as prescribed. - please stop taking aspirin until you speak with dr. , or dr. . please continue with all other medications as you were before. please review all changes in your medications with your primary care physician. followup instructions: please follow up with the following appointments: md: dr. specialty: internal medicine-primary care date/ time: 1:30pm location: , ma phone number: provider: rm 2 -preadmission testing date/time: 10:00 you are scheduled for surgery for your abdominal aortic aneuurysm: provider: , time: 10:00 am, date vascular surgery provider: , md specialty: gastroenterology - - . , ma phone: date/time: 1:30 provider: unit phone: date/time: 10:00 procedure: endoscopic control of gastric or duodenal bleeding diagnoses: acidosis thrombocytopenia, unspecified coronary atherosclerosis of native coronary artery acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled portal hypertension hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified percutaneous transluminal coronary angioplasty status chronic kidney disease, stage iii (moderate) vascular disorders of male genital organs other diseases of lung, not elsewhere classified gastric ulcer, unspecified as acute or chronic, without mention of hemorrhage or perforation, without mention of obstruction chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction abdominal aneurysm without mention of rupture other specified disorders of stomach and duodenum urethral abscess 

Answer: The patient is high likely exposed to