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: this is a 68-year-old man with minimal past medical history who presented to an outside hospital on with a chief complaint of nausea, vomiting and hematemesis. he complained of bright red blood times two. his initial hematocrit was 40 but hematocrit had been repeated twice and was 35. the patient was noted to be tachycardic and febrile. heart rate in the 120's to 130's and temperature maximum of 101.4 degrees. at the outside hospital he was given two liters of normal saline, protonix, xanax, phenergan and tylenol. his subsequent temperature was 100.3. he was subsequently transferred to the for a gastroenterological work-up. the patient complained on admission of mild chest pain and lightheadedness. his ekg was notable for st depressions in leads v5 and v6. an ng lavage was obtained, initially notable for bright red blood that would not clear. after significant lavage, coffee ground emesis had been noted. his repeat hematocrit was 34. review of systems: significant for fever and chest pain, palpitations, nausea, vomiting, gas, distention. it was notable for the absence of upper respiratory infection or symptoms, sick contacts, melena and urinary symptoms. past medical history: significant for a history of palpitations and a "heart murmur" with a normal echocardiogram. medications: the patient reported taking verapamil 180 mg and aspirin 81 mg q day. allergies: the patient denied known drug allergies, latex allergies or food allergies. social history: the patient reported occasional alcohol use. he denied tobacco use or iv drug use. the patient is currently employed as a psychiatrist and is married and lives with his wife. physical examination: examination on presentation to the was significant for vital signs with a heart rate of 108, blood pressure 146/64, respiratory rate 20 and he was satting 97% on room air. he appeared to be a caucasian man lying in bed in no apparent distress. his extraocular movements were intact, pupils were equal, round and reactive to light and accommodation. his mucus membranes were moist. oropharynx was clean without evidence of blood and he had no lymphadenopathy. his neck was soft and supple. his lungs were clear to auscultation bilaterally. his heart had a tachy rate but a regular rhythm. there were no murmurs, rubs or gallops. his abdomen was soft, nontender and non distended. there were no masses. his extremities were warm and well perfused. laboratory data: on admission, his laboratory studies were significant for a white blood count of 12.9, hematocrit 34.1 and platelet count 188,000. initial ck was 74. his amylase was 64, lipase was 31. his alt was 22, ast 19, alkaline phosphatase was pending and total bilirubin was 0.7. a urinalysis was significant for specific gravity 1.020. a kub which had been obtained at the outside hospital revealed air fluid levels consistent with small bowel obstruction. it was the opinion of the medical team that the patient had an upper gi bleed likely secondary to tear. hospital course: the patient was admitted to the and transferred to the micu. it was determined that a gi consult would be obtained and he would have an egd in the morning of hospital day #2. his hematocrit would be checked and he would be transfused if it continued to decline. he would be maintained npo with a nasogastric tube in place, two large iv's in place and on protonix 40 mg iv times two meaning . he would also be given d5 ?????? normal saline iv fluid, continue on aspirin and he would be cycled to rule out for mi. we also determined that the patient would be given ditropan with his foley and the patient would likely be discharged from the intensive care unit to the floor after his egd study. on hospital day #1 the patient was visited by his primary care physician, . . dr. had recommended the patient stay in the icu and agreed that he would follow closely in the patient's care. on hospital day #1, , the patient had an egd. the egd revealed tear, esophageal erosion, erythema, nodularity and friability in the stomach compatible with a diagnosis of gastritis. ulcers in the stomach body were also noted and the egd was otherwise normal to the third part of the duodenum. it was the opinion of the gi team that the patient would be maintained npo for 24 hours, his hematocrit would be checked serially, iv access would be maintained, he would be continued on iv protonix 40 mg , a pylori antibody would be checked and treated if positive, and aspirin would be held. on hospital day #2, , the patient continued to be evaluated in the medical icu. overnight he had sinus tachycardia with heart rates to the 120's to 140's. he was treated with verapamil and then changed to a diltiazem drip. the patient had also sustained foley trauma secondary to placement of the foley catheter at the outside hospital prior to his admission to . the patient had gross hematuria with numerous clots. a coude catheter was left in place and the plan was to leave it in place for at least three days. on exam the patient continued to be febrile, his t max was 100.9 with t current of 99.3. his vital signs were otherwise stable. his heart rate was 95-146, his blood pressure was 99-107/38-92, respiratory rate was 14-23 and he was satting 93-99% on room air. on physical exam he was awake and alert and in no apparent distress. his head and neck exam was unchanged. his lungs were clear to auscultation and his heart was tachy but had a regular rhythm. there were no murmurs, rubs or gallops. his abdomen was soft with mild epigastric tenderness. there was no rebound or guarding. there were bowel sounds. his extremities were warm and well perfused and there was no edema. neurologically he was alert and intact. his laboratory studies were significant for a white blood count of 12.6, hematocrit 29.6 and platelet count 174,000. his chemistries were significant for sodium 138, potassium 5.1, chloride 107, co2 22, bun 12, creatinine 0.9 and glucose 109. blood cultures, urine cultures and h. pylori antibody were all pending. his second ck was 67, his troponin was less than 0.3. in summary, on hospital day #2, it was determined that the patient was: 1) stable after an upper gi bleed with bloody emesis, likely due to tear. there were no active signs of bleeding at this time. he would be maintained npo, his hematocrit would be checked again, he would stay on iv protonix 40 mg iv q day and h. pylori antibodies were pending. 2) cardiovascular: he continued to have supraventricular tachycardia with heart rates in the 120's to 140's. he was maintained on a diltiazem drip and ekg was obtained. 3) from a urological standpoint there was blood at the meatus and his urine output was watched. the plan was to consult urology if bleeding or hematuria persisted. 4) he was maintained on iv fluids ?????? normal saline d5 at 125 cc per hour times three liters. his electrolytes were repleted. 5) pain control appeared to be adequate on morphine sulfate. 6) access: the patient had a right external jugular line. 7) disposition: when the patient was determined to be stable according to the medical icu team, he would be transferred to the floor. on hospital day #3, , the patient was advanced to clear liquids. he had one episode of atrial fibrillation in the morning which responded well to verapamil and was converted to a normal sinus rhythm. on physical exam his temperature maximum was 100.6. his temperature current was 100.1 degrees. his heart rate was 81, blood pressure was 91-126/39-56 and his respiratory rate was 19. on physical exam he was a man of stated age, lying in bed in no apparent distress. head and neck exam was unchanged. his lungs were clear to auscultation bilaterally. his heart was tachy but had a regular rhythm. there were no murmurs, rubs or gallops. his abdomen was soft, non distended and less tender to palpation. there were bowel sounds in all four quadrants. his extremities were warm, well perfused with no edema. neurologically he was intact and alert and oriented. his labs were significant for white blood count of 7.5, hematocrit 26.5, platelet count 118. his labs, chem 7, revealed sodium 131, chloride 104, co2 24, bun 9, creatinine 0.9, glucose 139. it was the opinion of the micu team that: 1) from a gi perspective after an upper gastrointestinal bleed with bloody emesis and an egd showing tear, that the patient had no active signs of bleeding at the time. his diet was advanced as tolerated and his protonix was changed from iv to po. 2) from a cardiovascular standpoint, his svt was being controlled on verapamil and his heart rate was to be monitored when the patient was ambulating. 3) the patient was requiring morphine sulfate for pain after foley trauma. the plan was to remove his foley catheter in the medical icu and monitor his urine output. 4) his diet was advanced as tolerated and his electrolytes were to be checked and repleted. 5) from a pain standpoint, he was being monitored on morphine sulfate. 6) he had a right external jugular line which was his line of access. 7) disposition: the bed facilitator was notified that the patient was stable and would be transferred to the floor. on the patient was visited by his primary care physician and was in stable condition. on the afternoon of the patient was also visited by the gi team. it was determined that because the patient was stable and his hematocrit was stable, he would be maintained on protonix 40 mg po bid for 6 weeks post discharge and then maintained on protonix 40 mg po q day. the patient would also require follow-up by gastroenterology and would need to have a conversation with them regarding the need to repeat egd. on the evening of the patient was transferred to the floor and to the care of the medical team. the patient continues to have bladder discomfort even after a straight cath of 300 cc of urine was obtained. shortly after the patient arrived on the floor, he continued to have persistent tachycardia. his heart rate was in the 150's. a 12 lead ekg was obtained. this was consistent with junctional tachycardia. there was no evidence of ischemic changes. the patient's rhythm reverted to normal sinus and his heart rate was in the 90's after a coude catheter was inserted. the patient immediately had a relief of severe abdominal discomfort and noticed deflation of the suprapubic region. 500 cc of urine output was drained initially and the urine was clear without signs of hematuria. the plan was to continue the patient on verapamil, recheck a hematocrit that evening and to maintain the foley in place. the patient understood that he would likely require to have the foley in place after discharge. on the morning of the patient was again visited by the gi team. it was determined that the patient would follow-up with gi within 1-2 weeks post discharge. he would be maintained on protonix 40 mg po bid for 6 weeks and then protonix 40 mg q day thereafter. on the afternoon of the patient was also visited by his primary care physician. was determined that the patient would be sent home that day with prescriptions for protonix and ditropan. ditropan will be prescribed as 5 mg tid while the foley was maintained in place. the primary care physician also requested the patient follow-up with him within approximately 7-10 days post discharge. on the early afternoon of it was the opinion of the medical team in conjunction with the gi team that the patient was stable for discharge. the patient was to be discharged with numerous instructions. prior to discharge the patient was visited by the learning care center in order to receive instructions on foley care and self removal. the patient was comfortable with the instructions provided to him and was eager to leave the hospital. condition on discharge: the patient was stable on discharge. discharge status: the patient was discharged to home. discharge diagnosis: 1. tear. discharge instructions: the patient was discharged successfully to home without services in the early afternoon of with numerous instructions. 1. the patient was given a prescription for protonix 40 mg po bid times 6 weeks and then protonix 40 mg po q day thereafter, dispense 100 tablets with three refills. 2. ditropan 5 mg po tid while the foley is in place, dispense 20 tablets, no refill. 3. the patient was given the phone number of the gi fellow and was instructed to follow-up with gi 7-10 days post discharge. 4. the patient was instructed to remove the foley catheter by himself on friday, or to wait the weekend if he felt more comfortable until the following monday, , at home. 5. the patient was also given the phone number to follow-up with dr. in order to have a urological follow-up 7-10 days post discharge. the patient was comfortable with the instructions provided to him and was eager to be discharged from the hospital. dr., 12-713 dictated by: medquist36 procedure: other endoscopy of small intestine diagnoses: diaphragmatic hernia without mention of obstruction or gangrene other specified cardiac dysrhythmias retention of urine, unspecified chronic or unspecified gastric ulcer with hemorrhage, without mention of obstruction injury to bladder and urethra, without mention of open wound into cavity urinary catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure esophagitis, unspecified gastroesophageal laceration-hemorrhage syndrome unspecified gastritis and gastroduodenitis, without mention of hemorrhage 

Answer: The patient is high likely exposed to