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: history of present illness: ms. is a 66-year-old woman with a past medical history significant for end-stage renal disease (on hemodialysis), type 2 diabetes, and a history of endocarditis; who, on the evening of , developed nausea, abdominal cramping, and vomiting at approximately 10 p.m. she noted some vomitus of dark fluid which her daughter reported as appearing like coffee-grounds. she vomited three times on the night prior to admission, and the crampy pain was relieved status post vomiting. she also notes weakness, being lightheaded, and transient dizziness on the morning of admission while standing. she also noticed diarrhea on and has been constipated since then, until the time of admission. her last bowel movement was the night prior to admission. it was hard, and she has not noticed any bright red blood per rectum. she has had some black stools for about one week. she denies any fevers, chills, short of breath, chest pain, dysuria, and lower extremity edema. she has noticed some mild dyspnea on exertion for the last two to three days. no paroxysmal nocturnal dyspnea. no orthopnea. her exercise tolerance consists of two to three flights of steps; after which she has to stop to rest. she has no history of every having a gastrointestinal bleed. in the emergency department, her initial vital signs were a heart rate of 92, blood pressure was 82/palpation, and oxygen saturation was 71% on room air. her blood pressure was remeasured at 123/80 with a heart rate of 82 without any intervention. she received several volumes of normal saline in the emergency department, and her blood pressure remained low at 106/42. an nasogastric lavage in the emergency department revealed coffee-grounds emesis but cleared. she was guaiac-positive in the emergency department. she received 2 units of packed red blood cells in the emergency department as well as desmopressin acetate. ms. also has a left ring finger ulcer for which she has been taking a significant amount of naprosyn for over the last several weeks. this ulcer was thought secondary to a shunt for dialysis and a steel phenomena. past medical history: 1. native mitral valve endocarditis; for which she was ampicillin-sensitive. she was treated with eight weeks of antibiotics in . 2. end-stage renal disease (on hemodialysis since ). 3. anemia. 4. hypertension. 5. obesity. 6. gastroparesis. 7. cataracts. 8. type 2 diabetes (times three years). 9. left finger ulcer. 10. hypercholesterolemia. 11. history of superior vena cava clot (with perm-a-cath). 12. vestibular toxicity (secondary to gentamicin). 13. second-degree heart block in a wenckebach pattern. 14. echocardiogram in showed mild mitral regurgitation, moderate tricuspid regurgitation, and a normal ejection fraction of greater than 55%. 15. cardiac catheterization in revealed 50% stenosis of the left circumflex. medications on admission: (medications at home included) 1. lipitor 10 mg p.o. q.d. 2. ativan. 3. phos-lo 2 mg p.o. t.i.d. 4. tylenol. 5. oxycodone. 6. insulin 70/30. 7. naprosyn (times three weeks). 8. prilosec. 9. aspirin. 10. nephrocaps. 11. zestril 10 mg p.o. q.d. 12. imdur 30 mg p.o. q.d. 13. subcutaneous heparin. 14. calcitriol. 15. timolol eyedrops. allergies: codeine and percocet (cause nausea and vomiting). social history: she denies any drug use, alcohol use, or tobacco use. she lives with her son at home. physical examination on presentation: physical examination on admission revealed temperature was 97.9, heart rate was 72, blood pressure was 97/42, respiratory rate was 26, oxygen saturation was 99% on 4 liters. in general, alert and oriented times three. in no acute distress. pupils were status post cataract surgery. extraocular movements were intact. conjunctivae were pale. neck examination revealed no jugular venous distention. heart had a regular rate and rhythm. normal first heart sound and second heart sound. a 2/6 systolic ejection murmur. the lungs were clear to auscultation bilaterally. the abdomen was soft, obese, nontender to deep palpation. rectal examination revealed normal tone. no masses. heme-positive. lower extremity without any clubbing, cyanosis, or edema. pertinent laboratory values on presentation: laboratories on admission revealed white blood cell count was 13.6, hematocrit was 22.3 (last hematocrit was on and was 30; in her hematocrit was 39), and platelets were 337. sodium was 140, potassium was 4.4, chloride was 96, bicarbonate was 23, blood urea nitrogen was 73, creatinine was 7.8, and blood glucose was 199. inr was 1.4 and ptt was 35. hematocrit on discharge was 35.1. hospital course: 1. anemia and gastrointestinal bleed: given ms. significant hematocrit drop and history of coffee-grounds emesis (also verified on a nasogastric lavage) and guaiac-positivity, it was felt that she had a significant upper gastrointestinal bleed; most likely secondary to recent nonsteroidal antiinflammatory therapy for her finger ulcer. she was admitted to the medical intensive care unit for careful observation, and they proceeded with an upper endoscopy on . the findings on endoscopy showed a medium-sized hiatal hernia. the mucosa in the stomach had localized continuous friability with erythema and congestion of the mucosa with contact bleeding noted in the antrum. these findings were compatible with gastritis. there was some patchy erythema, friability, and erosion of the mucosa with no bleeding noted in the stomach body or fundus. there were two acute stellate crated nonbleeding ulcers ranging in size from 5 mm to 15 mm found in the fundus. the ulcers were white-based with no visible vessel and no stigmata of bleeding or suggesting of bleeding. the duodenum had diffuse discontinuous erythema and friability of the mucosa with contact bleeding compatible with duodenitis. following the upper endoscopy, ms. was transferred to the floor, and her hematocrits were followed serially. her hematocrit stayed stable. she was transfused 2 units of blood in dialysis on , and her hematocrit on discharge was 35.1 (up from 22 on the day of admission, status post a blood transfusion of 4 units). at the time of discharge, it was felt that her upper gastrointestinal bleed had been stopped. she was initially maintained on intravenous protonix q.12h. she was then switched to oral protonix q.12h. after endoscopy, she was maintained on ice chips and was eventually advanced to a regular diabetic diet. 2. finger ulcer: the finger ulcer was thought secondary to a steel phenomena related to her dialysis shunt in her left arm. on , the transplant service took ms. to the operating room and ligated the shunt. she was to follow up with the plastic surgery/hand clinic on at 9 a.m. to re-evaluate further treatment for the ulcerated finger. 3. renal system: given the loss of dialysis access from the shunt, ms. also received a right internal jugular perm-a-cath which was changed over while in the operating room by the transplant surgery team at the time of ligation of her dialysis shunt. ms. received dialysis on and on prior to discharge; as regularly scheduled. 4. hypertension: ms. has had her blood pressure medications held during her acute gastrointestinal bleed and were restarted at the time of discharge. 5. pain: given a history of nonsteroidal antiinflammatory drugs use leading to a gastrointestinal bleed, ms. was continued on oxycodone and tylenol to help her with pain control, and she was instructed to avoid nonsteroidal antiinflammatory drugs if at all possible. 6. endocrine system: ms. was maintained on a sliding-scale of insulin, and her fingersticks were well controlled during her hospital stay. discharge disposition: ms. was to be discharged back to home. discharge instructions/followup: 1. the patient to follow up with dr. as previously scheduled in the next one to two weeks. 2. ms. had an appointment with the plastic surgery/hand clinic on at 9 a.m. in the building of () to evaluate her finger ulcer. medications on discharge: the patient was to continue all medications previously taken except for naprosyn. avoid any nonsteroidal antiinflammatory drugs (including naprosyn, advil, ibuprofen, and motrin). 1. oxycodone 5 mg to 10 mg p.o. every four to six hours as needed (for pain). 2. protonix 40 mg p.o. q.d. 3. lipitor 10 mg p.o. q.d. 4. ativan. 5. phos-lo 2 mg p.o. t.i.d. 6. tylenol. 7. insulin 70/30. 8. aspirin. 9. nephrocaps. 10. zestril 10 mg p.o. q.d. 11. imdur 30 mg p.o. q.d. 12. subcutaneous heparin. 13. calcitriol. 14. timolol eyedrops. condition at discharge: condition on discharge was good. discharge status: discharge status was to home. , m.d. dictated by: medquist36 procedure: other endoscopy of small intestine hemodialysis insertion of totally implantable vascular access device [vad] revision of arteriovenous shunt for renal dialysis diagnoses: anemia, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease obesity, unspecified other complications due to renal dialysis device, implant, and graft gangrene home accidents unspecified analgesic and antipyretic causing adverse effects in therapeutic use other specified gastritis, with hemorrhage 

Answer: The patient is high likely exposed to