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: vicodin / penicillins attending: chief complaint: gib major surgical or invasive procedure: egd history of present illness: 57 year old male with chronic af on coumadin, diastolic dysfunction with lvef 55%, chf, past htn, cirrhosis with portal htn & cll in remission who was sent into cardiologist noted a hct drop to 18 from baseline in mid-30s during routine labs. inr 3.5 . 10 days pta, he was noted to have a 15 lb. weight gain with 3-4+ leg edema with more sob & fatigue while at heart failure clinic. lasix increased to 80mg at that time. his routine labs were drawn today and when hct drop, he was instructed by cardiologist to go to ed. . in ed, vitals were 97.9 86 102/40 18 100%2lnc. he was transfused 2uprbc, 2 units ffp, guaiac positive, but ng lavage negative. gi was notified. he has varices in the middle third of the esophagus and normal c-scope recently. given his history of cll, hemolysis was also assessed. . upon arrival in micu, he denies any pain, but does note fatigue. he reports increased lethargy, lhd, dizzyness over past 5 days. his weight is 14 pounds above his dry weight, but denies any dietary indiscretion, chest pain, changes in meds. past medical history: 1. hypertension 2. atrial fibrillation after coumadin 3. seasonal allergies 4. shingles 5. dental abscess 6. peptic ulcer disease 7. cll: in remission social history: significant for no tobacco usage, significant alcohol usage. he used to drink heavily in thepast, with no history of any withdrawals or delirium tremens. he drinks about glasses of wine 3-4 times a week family history: diabetes, cancer and stroke. physical exam: vitals: 98.3 94 103/46 17 100%3lnc general: awake, alert, nad. heent: + jvd, no lad, moist oral mucose. pulmonary: lungs cta bilaterally cardiac: irregular rate and rhytm, holosystolic murmur abdomen: obese, soft, nt/nd, normoactive bowel sounds, liver ~ 2 cm below costal border; no asterixis back: no pain on palpation extremities: 2+ edema le neuro: slightly flat affect skin: mild scleral icterus, mild jaundice pertinent results: ekg: afib, nl axis, nl intervals, twi i, ii, l, f,v3-6 (old); more pronounced st depression in ii, v4-6 compared to prior in . egd: 1 cords of grade ii varix was seen in the middle third of the esophagus.there was scarring from previous banding in the lower esophagus but no significant varices in lower esophagus. . c-scope: normal colon to cecum and terminal ileum. brief hospital course: hospital course by problem: # anemia: suspect gib as guaiac positive on exam and has hx of varices. egd performed showed no active bleeding but grade 2 varices banded just in case. received 2u ffp, 5u prbcs and hct from 17 - 24. ct abd showed no rp bleed. no clear evidence of hemolysis. his hematocrit remained stable stable until discharge. poor marrow response was noted and heme/onc was consulted. they felt his anemia was due to a combination of splenic sequestration, alcoholic bone marrow suppression and possibly a very small chronic gi bleed. after discharge from the micu, his hematocrit was monitored and remained stable. he was advised to stop drinking immediately. . # cll: followed by dr. , who had been aware of anemia and mentioned possiblity of hemolysis or marrow infiltration. previous hemolysis w/u has been negative and remained so now. per heme/onc, there was no indication for a bone marrow biopsy at this time as it would not change management. he will follow up with his pcp for further monitoring. . # diastolic dysfunction/chf: appeared volume overloaded on presentation with an increase in his weight and increased le edema. his chf meds were held initially in the setting of a gi bleed but then restarted after the normal egd with good response. a repeat echo showed mild lvh, preserved ef. he began diuresing appropriately on his home dose of lasix 80mg po bid and spironolactone to the point were he was able to ambulate normally without significant desaturation upon discharge. he will follow up with his cardiologist for further management. . # etoh cirrhosis: his etoh level was 29 on admission. he stated his last drink was earlier that pm. his spironolactone and nadolol were initially held out of concern for a gib but were restarted after the egd. he was told to quit drinking immediately, a plan to which he agrees. he will follow up with his hepatologist for further management. . # afib on coumadin: his coumadin was initially held and reversed with ffp prior to the egd but was then restarted after no bleeding was found. his inr was therapeutic prior to discharge. he was well rate controlled with his nadolol and digoxin. . # cad: his asa was initially held but then restarted after the egd. he will discuss with his primary care physician the utility of being on both asa and coumadin given his risk for gi bleed. he was continued on his pravastatin. . # arf: his creatinine was 1.9 on admission with a baseline of 0.9. likely due to prerenal azotemia, especially after it resolved after fluid resucitation with blood. full code medications on admission: asa 81 coumadin 6 mg every other day; 5 mg other days lasix 80 (increaased 10 days ago from 40 ) lisinopril 2.5 daily digoxin 0.25 daily ppi nadolol 20 daily pravastatin 10 daily aldactone 50 mg daily discharge medications: 1. pravastatin 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 q24h (every 24 hours). 3. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 5. furosemide 80 mg tablet sig: one (1) tablet po bid (2 times a day). 6. digoxin 250 mcg tablet sig: one (1) tablet po daily (daily). 7. nadolol 20 mg tablet sig: one (1) tablet po daily (daily). 8. spironolactone 25 mg tablet sig: two (2) tablet po daily (daily). 9. warfarin 5 mg tablet sig: one (1) tablet po daily (daily). 10. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). 11. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. discharge disposition: home discharge diagnosis: primary: anemia secondary: cirrhosis chronic lymphocytic leukemia hypertension atrial fibrillation discharge condition: hematocrit stable. all other vital signs stable. discharge instructions: you were admitted because your blood count was very low. this may have been due to a small amount of bleeding, your current alcohol use and your chronic lymphocytic leukemia. you received blood transfusions, and your blood count was stable therefater. in addition, you had an upper endoscopy and had some veins in your esophagus blocked off. we did not make any changes to your medications. you should stop drinking alcohol altogether. it is worsening your liver disease and affecting your ability to produce red blood cells. you should follow up with your primary care doctor, hepatologist and hematologist. weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet fluid restriction: followup instructions: please schedule appointments with your primary care doctor and your hematologist/oncologist as soon as possible. you should call to schedule an appointment with the clinic. dr. (hepatology) will contact you soon about setting up a follow up appointment soon. you should also have your inr checked early this week. provider: . phone: date/time: 3:00 md procedure: transfusion of packed cells transfusion of other serum diagnoses: congestive heart failure, unspecified alcoholic cirrhosis of liver acute kidney failure, unspecified iron deficiency anemia secondary to blood loss (chronic) portal hypertension atrial fibrillation blood in stool diastolic heart failure, unspecified other and unspecified alcohol dependence, continuous chronic lymphoid leukemia, in remission 

Answer: The patient is high likely exposed to