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: hydrochlorothiazide / allopurinol attending: chief complaint: chief complaint: back pain reason for micu admission: lower gi bleed major surgical or invasive procedure: upper endoscopy history of present illness: mr. is a 76 year old gentleman discharged from the service earlier this month on aspirin, plavix and warfarin that was recently discharged from rehab within the past 7 days. during that time, per his daughter, he did not take zantac or as prescribed because he did not have any stomach upset. he reports some dry heaves without true vomiting or abdominal pain and black stools for the past 4-5 days. he denies chest pain, dyspnea or lightheadedness/falls, but does report some thoracic and lumber back pain which have been of variable chronicity depending on his interviewer. . in the ed, initial vs: 97.2 58 114/39 18. the patient was evaluated by surgery, surgery, cardiac surgery and gi and a decision was made to admit to the micu for endoscopy, and that the patient was not have a cause of back pain (dissection, aortoenteric fistula). ng lavage with coffee ground emesis, did not clear. he was given 1 unit of prbcs and 2l of fluid. his k was noted to be elevated but without ekg changes, and so this was addressed only with fluids given his "other major issues." he is transfered with a left hand 20 gauge peripheral and an 18 gauge external jugular iv, t&x and on ppi/erythromycin & zofran for anti-emetic control. he was never tachycardic or hypotensive. . on arrival the micu, the patient denies any back or abdominal pain. gi is present and performed an urgent endoscopy, with full report . ros: denies fever, chills, night sweats, headache, vision changes, rhinorrhea, congestion, sore throat, cough, shortness of breath, chest pain, abdominal pain, constipation, melena, dysuria, hematuria. past medical history: -pvd: s/p peripheral angiography & angioplasty l peroneal and anterior tibial -cad s/p cabg on -right le cellulitis at vein harvest site (admission ), cx grew pseudomonas, on cipro and linezolid until -diabetes mellitus -hypertension -peripheral disease -chronic renal insufficency -chronic anemia -hyperlipidemia -gangrene of l foot (tips of 4th and 5th digits) -gout -osteoarthritis -cataracts -carotid stenosis - s/p l cea social history: daughter lives with patient in his appt, ~60pkyr history, quit family history: father: stroke, died in his late 70s mother: pulmonary embolism after hip fracture, died at age 88 physical exam: admission exam: vitals - t: 96.3 bp: 126/54 hr: 71 rr: 16 02 sat: 100 general: comfortable appearing gentleman heent: no lad, oropharnyx clear cardiac: s1 & s2 regular without murmur lung: b cta abdomen: nontender/nondistended ext: no edema, necrotic toes, poor distal pulses neuro: aaox3, cnii-xii intact pertinent results: admission labs & studies: labs: 2:06p na:139 k:5.9 glu:117 hgb:6.4 calchct:19 lactate:5.9 . 2:00p ck: 53 mb: notdone trop-t: 0.08 . 139 111 132 --------------<124 6.2 10 4.1 estgfr: 14/17 (click for details) ca: 8.7 mg: 2.2 p: 4.5 . alt: 16 ap: 77 tbili: 0.1 alb: 3.4 ast: 23 lip: 92 . 6.2 13.3>----<296 19.9 (baseline: 25-35) microbiology: none . studies: ct ab/pelvis: (wetread) -extensive calc of ao, chest/abd branch vessels, cor arteries. stable infrarenal aaa up to 3.0 cm in true diameter, borderline bilat common iliac aneurysms up to 1.5 cm. no evidence for rupture/hematoma. -mild pulm emphysema. calc gallstones. nonobstructing r renal stones. sigmoid diverticulosis. -unchanged t11, l2 compression fx and grade 1 l5-s1 anterolisthesis. . endoscopy: impression: -erythema and scarring in the duodenum compatible with duodenitis -erythema and multiple erosions in the antrum and fundus -ulcers in the stomach body (injection, endoclip) -esophagitis in the lower third of the esophagus and gastroesophageal junction -otherwise normal egd to second part of the duodenum . recommendations: -high dose (40mf iv twice daily). -start 1 g sucralfate four times a day. -clarify if h.pylori eradication was ever attempted. if not, eradicate as he was previously positive. -repeat endoscopy in weeks. . ekg: sr @ 56, rbbb, nl axis. no stemi . cxr: (wetread): prominent mediastinum, which may relate to ap, portable technique with tortuous aorta. but recommend dedicated pa and lateral views for further/better evaluation or ct as clinically indicated. brief hospital course: #. gastric bleed: bled slowly to a hct of 19, baseline~30s. currently clipped by gi, no evidence of continuing bleed. hemodynamically stable (likely due to beta blockade and slow bleed), no further bleeding or brisk bleeding. it is possible that there is another souce of bleeding. he was transfused 3 units to hct in high 20s, which stabilized for 24 hours. he was started on ppis and h. pylori eradication. the patient was stable on the day of discharge and was sent home with vna follow-up. . #. lactic/anion gap acidosis: likely from underperfusion/hemorrhagic shock. resolved with rescusitation. #. cad/pvd: patient with significant disease, both central and peripheral. vsurg following. no evidence of ischemia or clot at this time. inr 2.9 seen by in house who clarified that the patient must be on all three forms of anticoagulation. they saw and documented the wound on this leg did not think it was an abscess. his warfarin was restarted as an outpatient. #. hyperkalemia: patient admitted hyperkalemic to 5.9, resolved to 5.4 without ekg changes or symptoms. #. acute vs. chronic renal failure: currently at or near recent baseline. patient states that he is not interested in hd. medications on admission: amlodipine 10mg po daily aspirin 325mg po daily clopidogrel 75mg po daily x30 days (until ) epoetin alfa units mwf furosemide 20mg po daily glipizide 2.5mg po daily metoprolol tartrate 50mg po bid oxycodone 5mg po q4 prn pain pantoprazole 40mg po daily simvastatin 40mg po daily warfarin 5mg po daily discharge medications: 1. sucralfate 1 gram tablet sig: one (1) tablet po qid (4 times a day). disp:*120 tablet(s)* refills:*2* 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 3. epoetin alfa 2,000 unit/ml solution sig: () units injection qmowefr (monday -wednesday-friday). 4. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 5. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical qid (4 times a day) as needed for itching. 6. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 7. warfarin 2 mg tablet sig: two (2) tablet po once daily at 4 pm. 8. amoxicillin 250 mg capsule sig: two (2) capsule po q24h (every 24 hours) for 13 days. disp:*26 capsule(s)* refills:*0* 9. clarithromycin 250 mg tablet sig: one (1) tablet po bid (2 times a day) for 13 days. disp:*26 tablet(s)* refills:*0* 10. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day for 13 days. disp:*26 capsule, delayed release(e.c.)(s)* refills:*0* 11. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day: start after 13 days of twice daily omeprazole. disp:*30 capsule, delayed release(e.c.)(s)* refills:*2* discharge disposition: home with service facility: homecare discharge diagnosis: gi bleed gastritis dualfoy's lesion discharge condition: mental status: clear and coherent level of consciousness: alert and interactive activity status: ambulatory - independent discharge instructions: you were admitted to the hospital with a gi bleed. you were taken to the micu where you underwent endoscopy and were found to have several ulcers and a bleeding blood vessel which had to be clipped. please note that we feel that stopping your antacid medication contributed to this. you must take all of your medications as prescribed: . the following changes were made to your home medications: your must be increased to 40mg twice daily for the next 13 days, then can be returned to daily you were started on clarithromycin 250mg twice daily for the next 13 days. you were started on amoxicillin 250mg twice daily for the next 13 days. you were started on sucralfate 1 gram four times per day you must take all of the above medicines as prescribed or you will bleed again. . . your warfarin should be 4mg daily. your lasix was held and should be restarted when you see dr . followup instructions: provider: , md phone: date/time: 11:00 provider: lab phone: date/time: 1:45 provider: , md phone: date/time: 2:45 procedure: endoscopic control of gastric or duodenal bleeding diagnoses: acidosis hyperpotassemia acute posthemorrhagic anemia acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified gout, unspecified coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status chronic kidney disease, unspecified other shock without mention of trauma chronic or unspecified gastric ulcer with hemorrhage, without mention of obstruction esophagitis, unspecified atherosclerosis of native arteries of the extremities, unspecified 

Answer: The patient is high likely exposed to