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: penicillins / bactrim attending: chief complaint: hematemesis major surgical or invasive procedure: thoracentesis endoscopy x2 history of present illness: mr. is a 64 year-old man with a history of esophageal cancer, s/p resection, neoesophagus, radiation, and chemotherapy who presents with gib. . most recently admitted with dyspnea and suboptimal stress test. cardiac catheterization revealed moderate mr and two vessel cad. he underwent a pericardectomy only as he had severe constrictive pericarditis related to his esophageal radiation. . reports feeling well until evening prior to admission when he began to vomit blood. no nausea or vomiting before initial hemetemesis. over the evening he vomited ~5 times, once with "jellyfish" appearance. also with concurrent black stools (~5). last episode of hemetemesis was at 7am on day of admission. . initially presented to an osh where bp was 109/68 with hr 129. hct found to ve 22.1. 2 units of prbc were given. . in the ed, initial bp 116/79 with hr 120, rr 20 and 100% on room air. bp fell to as low as 95/70 with hr in the 120s. recieved 1+ liters of ivf. . ros: (+) weight loss of 22lbs since ; thinks this is water weight (+) fatigue (-) fevers/chills (-) chest pain (+) sob with exertion (noted since before ) (-) nausea/abdominal pain (-) dysphagia/odynophagia denies use of nsaids or other otc meds past medical history: 1. esophageal cancer - s/p resection () - s/p radiation, chemotherapy and neoesophagus 2. coronary artery disease - cardiac cath () with --lmca: eccentric 40% ulcerated plaquing with slight contrast staining --lad: 50% stenosis just after a large d1; 50% mid lad stenosis after a smaller d2; 60% distal lad stenosis; slightly slow flow in the lad consistent with microvascular dysfunction --lcx: mild diffuse plaquing, and supplied a tortuous lpl; distal av groove lcx was occluded after the lpl and filled slightly by antegrade vasa and right-to-left collaterals; proximal lpl 40% stenosis --rca: mild diffuse plaquing throughout --rca-rv fistula 3. hypertension social history: married with two grown children. does not smoke and drinks glasses of wine 3-4 times per week. works as an insurance . family history: father had heart disease and a mi at age 59. physical exam: vitals: bp 111/79, hr 126, rr 14, 100% on ra gen: lying in bed. in no distress. heent: mild conjuctival pallor; no icterus cv: tachycardic; no murmurs. pulm: clear. abd: soft. nt/nd ext: warm. mild edema. neuro: pupils 4mm-->2mm cn ii-xii intact. strength 5/5 in all four extremities; sensation grossly intact pertinent results: admission labs: 12:15pm blood wbc-7.4 rbc-3.45* hgb-8.7* hct-27.3* mcv-79* mch-25.1* mchc-31.8 rdw-16.5* plt ct-194 12:15pm blood neuts-77.5* lymphs-16.5* monos-5.1 eos-0.6 baso-0.2 12:15pm blood pt-16.8* ptt-27.2 inr(pt)-1.5* 12:15pm blood glucose-112* urean-41* creat-0.8 na-141 k-4.3 cl-107 hco3-28 angap-10 12:15pm blood alt-20 ast-24 alkphos-81 totbili-1.1 12:15pm blood lipase-16 12:15pm blood albumin-3.6 02:18pm blood calcium-8.3* phos-3.1 mg-2.0 12:30pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-5.0 leuks-neg . studies: cxr - impression: increased right-sided pleural effusion and possible infiltrate in the right lower lung. interval decrease in left-sided pleural effusion compared to . the study and the report were reviewed by the staff radiologist. . endoscopy - findings: esophagus: lumen: evidence of a previous esophago-gastric anastomosis was seen at 23 cm from the incisors. there was no visible bleeding site in the esophagus or at the esophageal gastric anastomosis. however, there was sdherent coffee ground material not all of which could be washed away. stomach: contents: clotted blood was seen in the stomach body and antrum. this obscured the greater curve of the antarl area and could not be completely cleared as the clots could not be suctioned. other the stomach was s shaped. duodenum: other normal to d3 with out a bleeding site found impression: previous esophago-gastric of the esophagus blood in the stomach body and antrum normal to d3 with out a bleeding site found the stomach was s shaped. otherwise normal egd to second part of the duodenum recommendations: if any questions or you need to schedule an or email at the patient's bleeding site could not be ascertained due to blood in the stomach. plan keep hct above or at 27. he has already received two units prbc. npo except for meds. iv protonix. we will reavaluate patient in am and likely rescope tomorrow. discharge labs: 05:58am blood wbc-6.5 rbc-3.76* hgb-10.5* hct-31.2* mcv-83 mch-27.9 mchc-33.6 rdw-18.2* plt ct-193 05:58am blood glucose-113* urean-12 creat-0.7 na-138 k-4.1 cl-102 hco3-31 angap-9 05:50am blood ld(ldh)-203 05:50am blood totprot-6.0* brief hospital course: 64m with history of esophageal cancer, s/p resection and radiation, now with upper gib. # upper gib: pt had several episodes of hematemesis and was found to have hct 22 at osh. hct increased to 27.3 after 2 units packed rbc's; overall down from 31 two weeks prior. he was initially admitted to micu for management. gi scope upon arrival to icu showed evidence of recent bleeding but no clear etiology and no active bleeding; no interventions were performed. he was continued on iv ppi and metoprolol, aspirin and plavix were held. he continued to have melanotic stools with gradually decreasing hematocrit. gi attempted repeat egd however he spontaneously went into an svt in the 220s. this resolved with iv lopressor, but the procedure was deferred until the following day. the following day however, his oxygen saturations in low 90's at rest and decreased below 90% while laying flat therefore the procedure was again postponed for gentle diuresis to improve oxygenation. eventually after several days of slowing decreasing hematocrit but no overt bleeding events, he udnerwent repeat egd with no evidence of active bleeding. he was discharged on ppi with gi follow-up. # acute blood loss anemia: as above, gi bleed which responded appropriately to blood tranfusion . # coronary artery disease: patient denied any chest pain though continued to have doe. his aspirin and plavix were held given gi bleed. aspirin was scheduled to be restarted after discharge and patient will discuss with his primary cardiologist risks vs benefits of restarting plavix # tachycardia: patient had persistent tachycardia despite adequate fluid and blood replacement. this was thought to be a physiological response from his known restrictive pcardiomyopathy. after remaining hemodynamically stable with no evidence of re-bleed, he was restarted on metoprolol with heart rate stable around 100. he diud have an episode of svt as described above. # acute chf: patient developed decreasing oxygen saturations, worsening dyspnea and orthopnea after initial volume and blood resuscitation. he has chronic bilateral pleural effusions that have not responded to diuresis and have required thoracentesis previously therefore it was decided to proceed with thoracentesis to improve oxygenation. patient was symptomatically drastically improved after unilateral thoracentesis and was able to tolerate repeat egd. pleural fluid was sent for cytology and was negative for evidence of malignant cells. he was scheduled for outpatient appointment with interventional pulmonary to discuss utility of right-sided thoracentesis. # hypertension: anti-hypertensives were held initially and restarted as above. # history of esophageal cancer: presentation initially concerning for recurrence given that he initially presented with hematemesis. no evidence of recurrence on repeat egd. thoracentesis with negative cytology. he will follow-up with outpatient providers as scheduled medications on admission: 1. aspirin 81 mg daily 2. clopidogrel 75 mg daily 3. metoprolol 25 mg daily (used to take ) 4. lasix 40 mg daily 5. spironolactone 12.5 mg daily 6. simvastatin 40 mg daily 7. omeprazole 20 mg daily discharge medications: 1. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). disp:*60 tablet, delayed release (e.c.)(s)* refills:*0* 2. furosemide 40 mg tablet sig: one (1) tablet po daily (daily): take twice daily on , , , then resume once daily dosing. 3. spironolactone 25 mg tablet sig: 0.5 tablet po daily (daily). 4. metoprolol tartrate 50 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary: hematemesis acute blood loss anemia supraventricular tachycardia diastolic congestive heart failure bilateral pleural effusion . secondary: restricive pericarditis discharge condition: good. hemodynamically stable and afebrile. blood counts stable with no evidence of active bleeding. discharge instructions: you were admitted to the hospital after an episode of vomiting blood. you received several blood tranfusions and your blood counts remained stable. we did a procedure called an endoscopy but did not find the source of the bleeding. you also some shortness of breath and low oxygen levels, likely related to the fluid in your lungs, so we did a procedure called a throacentesis to remove the fluid. the following changes were made to your medications: 1) hold aspirin for 7 days then restart on 2) stop plavix and discuss with your cardiologist whether this should be restarted 3) increase pantoprazole to 40mg twice daily 4) increase lasix to 40mg twice daily for 5 days, then resume 40mg daily until you see dr. 5) increase metoprolol to 50mg twice daily please return to the emergency department if you experience an episode of bleeding, either vomiting blood or defecating, black or tarry stools, shortness of breath or any other symptoms that are concerning to you. regarding your heart failure, please weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet followup instructions: the following appointments are scheduled after discharge: interventional pulmonary, dr. for right sided thoracentesis on friday at 2pm. please report to chest disease center in building, room 116. call with questions. . you have an appointment with dr. from gastroenterology on at 3:10 pm. please call with questions. . you have an appointment with your caridologist dr. on at 4:40pm. please call with questions there are still some test results pending including fluid from your lungs that is being evaluated for cancer cells. please follow-up your pcp weeks for these results. procedure: other endoscopy of small intestine other endoscopy of small intestine thoracentesis diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux unspecified pleural effusion congestive heart failure, unspecified unspecified essential hypertension acute posthemorrhagic anemia acute on chronic diastolic heart failure hematemesis constrictive pericarditis personal history of antineoplastic chemotherapy personal history of irradiation, presenting hazards to health paroxysmal supraventricular tachycardia personal history of malignant neoplasm of esophagus personal history of surgery to other organs 

Answer: The patient is high likely exposed to