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: no known allergies / adverse drug reactions attending: chief complaint: hematemesis major surgical or invasive procedure: egd history of present illness: mr. is a 46 year-old male with end-stage liver disease secondary to alcohol abuse and chronic hepatitis c, never treated due to ongoing etoh use, previously complicated by bleeding esophageal varices status post banding, portal hypertension, non-bleeding gastric varices, portal vein thrombus (not anticoagulated because of compliance issues and continued alcohol use). he developed abdominal pain yesterday morning which was followed by about 3 episodes of bright red vomitus, which he quantifies at a half . he also had several episodes of melena daily starting yesterday. on the morning of presentation, he had 3 episodes of bright red blood per rectum with continued diffuse abdominal pain. he endorses chills but denies cough, dysuria or headache/confusion. he has been lightheaded at times but denies chest pain or palpitations. his last egd showed portal gastropathy and gastric fundal varix. he has been compliant with his nadolol. . upon presentation to the ed, his initial vs were t 99.3, hr82, bp133/76, rr16, sat100ra. on exam, he had diffuse abdominal pain worse in the rll (s/p appendectomy). also with g+ black stool, no ascites, mild baseline tremor, w/ mild asterixis, oriented x 3. he was found to have a hematocrit to 27 from a baseline in the low to mid 30s. he refused ngt. he received 2lns, iv ppi bolus and gtt, along with octreotide gtt, 10unit vitamin k, and ciprofloxacin. he was crossmatched 4 units, got a unit of platelets for plt 40, a unit of ffp (inr 2.1), and will be sent with a prbcs. lactate elevated to 2.4. prior to transfer to the micu, his vs were t98.6 p83 bp107/65 rr14 99ra. . on arrival to the micu, his initial vs were:t100.2 p91 bp105/68 rr15 sat98ra. he was comfortable in no acute distress, noting only diffuse abdominal pain. no recent hematemesis since arriving from the micu. states that he has been drinking nightly, with last drink on friday. otherwise denying fevers, chills, dysuria, hematuria, malaise, weakness, weight gain, increased girth. no recent nsaids or anticoagulants. he's been compliant with nadolol. . of note, he was admitted for consideration of tips in after routine hcc screening ct revealed a portal vein thrombus. the decision was made not to proceed with either tips or anticoagulation due to ongoing etoh abuse and suspected inabiltiy to comply with coumadin. . review of systems: (+) 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: -cirrhosis c/b esophageal varices, no h/o ascites -hcv, chronic -etoh abuse, ongoing -portal vein thrombosis , not anticoagulated social history: lives w son. facilities . etoh: 6-8 nightly smoking: 30py, now cigarettes per day drugs: h/o iv use (heroin), denies recent use family history: noncontributory physical exam: on admission: vitals: t100.2 p91 bp105/68 rr15 sat98ra general: jaundice, alert, orientedx3, resting comfortably, no acute distress heent: mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: mild tenderness to palpation diffusely, but soft, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: answering questions appropriately, aaox3, moving all extremities . discharge pe: vitals: 99.0, 94/56, 70, 99%ra general: alert, orientedx3, resting comfortably, no acute distress heent: mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, nontender, nondistended, +bs gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: answering questions appropriately, aaox3, moving all extremities . pertinent results: admission labs: 01:40pm blood wbc-3.6* rbc-2.74* hgb-9.0* hct-27.1* mcv-99* mch-32.7* mchc-33.1 rdw-19.6* plt ct-40* 08:00pm blood wbc-2.3* rbc-2.03*# hgb-6.5*# hct-20.1*# mcv-99* mch-31.9 mchc-32.2 rdw-20.1* plt ct-44* 12:50am blood hct-25.0* 01:40pm blood pt-22.2* ptt-37.8* inr(pt)-2.1* 08:00pm blood pt-22.4* ptt-40.4* inr(pt)-2.1* 05:51am blood pt-20.2* ptt-36.2* inr(pt)-1.8* 01:40pm blood glucose-107* urean-11 creat-0.6 na-138 k-3.9 cl-104 hco3-29 angap-9 05:51am blood glucose-77 urean-8 creat-0.7 na-140 k-3.3 cl-108 hco3-25 angap-10 03:03pm blood glucose-97 urean-7 creat-0.6 na-138 k-3.0* cl-103 hco3-25 angap-13 01:40pm blood alt-33 ast-102* ld(ldh)-284* alkphos-134* totbili-5.4* dirbili-2.5* indbili-2.9 05:51am blood alt-23 ast-68* alkphos-86 totbili-4.3* 05:13am blood alt-27 ast-78* alkphos-88 totbili-4.7* 01:40pm blood albumin-2.4* calcium-8.1* phos-2.8 mg-1.5* 05:51am blood calcium-7.0* phos-3.2 mg-1.2* 03:03pm blood calcium-7.3* phos-3.6 mg-2.2 . discharge labs: 06:05am blood wbc-2.5* rbc-3.24* hgb-10.1* hct-30.9* mcv-95 mch-31.2 mchc-32.8 rdw-20.4* plt ct-51* 06:00am blood wbc-3.3* rbc-3.15* hgb-10.1* hct-30.5* mcv-97 mch-32.0 mchc-33.1 rdw-20.9* plt ct-44* 07:00am blood wbc-3.6* rbc-3.12* hgb-9.7* hct-30.2* mcv-97 mch-31.2 mchc-32.3 rdw-20.6* plt ct-45* 06:05am blood pt-23.7* inr(pt)-2.2* 06:00am blood pt-24.9* ptt-38.6* inr(pt)-2.4* 07:00am blood pt-25.9* inr(pt)-2.5* 05:13am blood glucose-105* urean-10 creat-0.7 na-137 k-3.0* cl-102 hco3-28 angap-10 06:05am blood glucose-80 urean-5* creat-0.5 na-130* k-3.1* cl-96 hco3-26 angap-11 06:00am blood glucose-75 urean-6 creat-0.6 na-132* k-3.4 cl-101 hco3-24 angap-10 07:00am blood glucose-88 urean-7 creat-0.6 na-133 k-3.5 cl-102 hco3-25 angap-10 05:13am blood alt-27 ast-78* alkphos-88 totbili-4.7* 06:05am blood alt-29 ast-83* alkphos-87 totbili-4.6* 07:00am blood alt-28 ast-72* alkphos-116 totbili-3.3* 06:05am blood albumin-2.4* calcium-7.2* phos-2.6* mg-1.4* 06:00am blood calcium-7.3* phos-2.3* mg-1.6 07:00am blood albumin-2.5* calcium-7.3* phos-3.4 mg-1.5* . abdomenal us: (prelim) portal veins are patent, however there is reversal of flow throughout the portal system and of the splenic vein. left lobe lesion stable in size c/w . cirrhosis, no sig ascites. gallstones in gb neck, borderline gb thickness likely cirrhosis. no son murphys, cbd normal caliber. no bil dil. . egd: esophagus: other scar from prior banding seen in lower esophagus. stomach: lumen: a small size hiatal hernia was seen. mucosa: erythema and congestion of the mucosa were noted in the whole stomach. these findings are compatible with portal gastropathy. protruding lesions a single large varix was was seen in the stomach fundus. there were no stigmata of recent bleeding, however given the amount of blood and lack of other findings, decision made to inject with glue. 3 cc glue injected for hemostasis with success. other blood and clots seen in the stomach fundus and body. it was too thick to suction. duodenum: normal duodenum. impression: small hiatal hernia scar from prior banding seen in lower esophagus. blood and clots seen in the stomach fundus and body. it was too thick to suction. erythema and congestion in the whole stomach compatible with portal gastropathy gastric varices (injection) otherwise normal egd to third part of the duodenum brief hospital course: mr. is a 46yo m with end stage liver disease due to chronic hepatitis c and etoh intake, portal hypertension, portal vein thrombosis, here with upper gib of likely variceal origin. . # upper gi bleed: patient presented after several episodes of bloody hematemesis and melena. admission hct below baseline at 27 from 30-35. in the micu, received 2unit plt and 2ffp. urgent egd demonstrated a single large varix was was seen in the stomach fundus. there were no stigmata of recent bleeding, however given the amount of blood and lack of other findings, decision made to inject with 3 cc glue for hemostasis with success. patient monitored in the micu for goal hct~25, inr<2, plt>50 on octreotide and ppi ggt. patient continued on abx for ppx. per liver, if instability ensue, next step would be tips. the patient was transferred to the et service, and while on the floor, his vital signs and crit were stable. the patient was continued on nadolol and upon discharge, the patient's ceftriaxone for ugib ppx was discontinued. the patient was instructed how important it is to stop drinking alcohol. he was seen by social work and given information for outpatient resources to help him to stop drinking. . # end stage liver disease. related to chronic hepatitis c and etoh. abd us with evidence of stable cirrhosis. dopplers with reversal of flow secondary to cirrhosis rather than clot. nadolol was initially held, but once patient was on the - service, the patient was restarted on nadolol. the patient was instructed about the importance of stopping drinking, as his liver disease is continuing to progress. while in the unit, the patient was showing some signs of encephalopathy, as he was becoming confused. he was started on lactulose while in the unit. however, on transfer to the floor, the patient's mental status had cleared up and returned to baseline. the patient was discharged on lactulose prn for confusion. . # etoh abuse: patient with 6-8nightly drinks; he was initially started on ciwa protocol for etoh withdrawal. he was also continued on iv folate, thiamine, and multivitamin. the patient was seen by social work regarding his alcohol abuse. the importance of alcohol cessation was reiterated. . # portal vein thrombosis: never anticoagulated due to noncompliance and ongoing etoh abuse. please continued to follow this as an outpatient. . transitional issues: . # outpatient follow-up: the patient is scheduled for an outpatient colonoscopy and egd. he also has follow up at the liver center, as well as with his pcp. medications on admission: nadolol 40 mg daily omeprazole daily mvt daily discharge medications: 1. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po tid:prn as needed for confusion. disp:*3 bottles* refills:*0* 2. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 3. nadolol 20 mg tablet sig: two (2) tablet po daily (daily). 4. folic acid 1 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 5. thiamine hcl 50 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary diagnosis: upper gastrointestinal bleed alcholic cirrhosis hepatitis c infection discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mr. , . it was a pleasure taking care of you while you were hospitalized at . you were admitted to the hospital because you were vomiting blood. you were taken to the intensive care unit and an emergent scope was done and a camera was out down into your stomach. we found that you had a bleed blood vessel (varix) that was causing you to vomit up blood. we injected your varix with glue and the bleeding has stopped. . you have been stable since the procedure and you have not bled. . it is very important that you stop drinking. the reason you have your varix and these dilated blood vessels is because your heavy alcohol drinking has caused your liver to become sick. the more you drink, the sicker your liver is going to get and the more likely you will have another bleed. . it is also very important that you follow up in the liver clinic and with your primary care doctor. you also are scheduled for for a colonoscopy and upper endoscopy on tuesday, a 8 am in the building, . . we made the following changes to your medications: start lactulose 30 ml as needed for when you are confused followup instructions: name: , l. location: address: , , phone: appointment: thursday at 11:45am . department: liver center when: wednesday at 11:20 am with: dr. building: lm campus: west best parking: garage . colonoscopy/egd tuesday, at 8am building, , please call with any questions . department: liver center when: wednesday at 12:20 pm with: dr. building: lm campus: west best parking: garage md procedure: endoscopic control of gastric or duodenal bleeding diagnoses: chronic hepatitis c without mention of hepatic coma acute posthemorrhagic anemia alcoholic cirrhosis of liver alcohol abuse, unspecified other sequelae of chronic liver disease hematemesis varices of other sites other and unspecified alcohol dependence, unspecified portal vein thrombosis 

Answer: The patient is high likely exposed to