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: compazine attending: chief complaint: transfer from with bright red blood per ileostomy major surgical or invasive procedure: ligation of bleeding varix at ostomy site history of present illness: 62 yo f h/o hypothyroid, uc s/p colectomy and colostomy 20 yrs ago, tx from for blood per r sided ileostomy. she first noticed some increased bleeding from her ileostomy about a week pta. on friday , she noticed a large amount of bleeding and had to empty her bag of red blood and clots x 3. + loc at that time and admitted by ambulance to osh - hct 19. at osh, intermittent blood in ostomy and tx x 5u. abd ct reportedly showed no masses but moderate ascites. egd showed no evidence of bleeding. scope through her ileostomy limited by blood. on she was tx'd here after she put out 1.2liters of blood through her ostomy. in total she got 9u prbc at the osh. . . past medical history: past medical history hypothyroidism ulcerative colitis . social history: social history pt admits to drinking "several" (approx ) glasses of white wine daily. her last drink was 3days prior to presenting at . she does not smoke but her husband smokes 3ppd so is exposed to a lot of second hand smoke. per her daughter, she has been under a lot of stress lately. her daughter also reports greater etoh intake (2 bottles wine per day). . she is under a lot of stress at home regarding grandchildren custody issues. physical exam: vs: 99.0 (tm=tc), 93/47 (75-100/33-68), 86 (81-93), sat 94-99% 3l i/o: 24hr: 4.6l/1.4l (los: +3.3l) bg: 168, 146 gen: nad, interactive, often vague answers. heent: op clear, no sclera under tongue, mmm, perrl, sclerae anicteric. cv: normal s1/s2, rrr, no m/r/g pul: lungs with decreased breath sounds at bases to halfway up lungs, no wheezes. some crackles at bases. abd: soft, nt, midline scar, ileostomy in rlq without bleeding. ext: no edema, dp full, rp full neuro: a&ox3, speech fluent, voice without fluctuations in tone/strength. cn intact with lateraly nystagmus on extreme gaze. moves all extremities. no tremor pertinent results: admission labs: 11:07pm blood wbc-8.9 rbc-3.52* hgb-11.1* hct-31.0* mcv-88 mch-31.6 mchc-36.0* rdw-17.0* plt ct-126* 02:49am blood hct-25.3* 09:45am blood hct-27.6* 03:42pm blood hct-27.3* 11:07pm blood neuts-68.3 lymphs-23.4 monos-4.8 eos-3.0 baso-0.4 11:07pm blood pt-16.2* ptt-32.5 inr(pt)-1.5* 11:07pm blood plt ct-126* 11:07pm blood glucose-134* urean-3* creat-0.6 na-141 k-3.3 cl-111* hco3-22 angap-11 11:07pm blood alt-13 ast-41* ld(ldh)-135 ck(cpk)-68 alkphos-77 amylase-19 totbili-2.3* 09:45am blood dirbili-1.3* 11:07pm blood lipase-18 11:07pm blood ck-mb-2 ctropnt-<0.01 11:07pm blood albumin-2.3* calcium-6.8* phos-2.5* mg-1.5* 11:07pm blood tsh-0.59 . studies (pt has had recent blood tx): : 29 caltibc: 148 ferritn: 97 trf: 114 . peritoneal fluid: albumin < 1 (saag ~ 1.4) protein 0.8 glucose 93 ldh 44 wbc 23, rbc 2611 n17, l 38, m 10, mesothelial 12, macroph 23 gram stain negative . culture data negative throughout hospital stay . abd u/s : 1 coarsened liver echotexture consistent with fatty infiltration. more advanced forms of liver disease such as fibrosis/cirrhosis cannot be excluded. 2. small amount of perihepatic ascites. 3 distended gallbladder containing sludge and wall edema, likely related to underlying liver disease. 4 slow velocity but hepatopetal flow within the portal vein. 5 small right pleural effusion. . cxr : findings consistent with pulmonary edema from fluid overload with associated pleural effusions. . tagged rbc scan : no active gi bleeding at the time of study. . echo : conclusions: the left atrium is mildly dilated. the interatrial septum is aneurysmal. left ventricular wall thickness, cavity size, and systolic function are normal (lvef>55%). regional left ventricular wall motion is normal. tissue velocity imaging demonstrates an e/e' <8 suggesting a normal left ventricular filling pressure. right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is an anterior fat pad. . ct abd : findings are consistent with cirrhosis, decompensation as evidenced by ascites and varices. (liver with nodularity and irregularity, no splenomegaly, paraumbilical vein recannulization, bibasilar effusions, gb with stones/sludge.) . chest ap : there is stable appearance of the vascular engorgement, perihilar haziness and diffuse bilateral interstitial opacities representing fluid overload along with small bilateral pleural effusions. . egd: impression: small hiatal hernia erythema, congestion and mosaic appearance in the antrum and stomach body compatible with portal gastropathy erythema in the gastroesophageal junction varices at the lower third of the esophagus otherwise normal egd to second part of the duodenum recommendations: follow-up biopsy results continue protonix. hold nadolol given low bp and minimal varices. repeat egd in 2years. f/u in liver ctr upon discharge from hospital. . leni : negative for dvt. . cta chest : 1. no pulmonary embolism. 2. pulmonary edema with moderately bilateral pleural effusion. 3. large amount of intra-abdominal ascites. . brief hospital course: icu course: in the icu she continued to have intermittent bleeding from her ostomy. sbp has remained in the 90s with pt mentating and stable. ng lavage (~500cc) was negative, the patient did not tolerate the procedure well so a complete liter could not be administered. surgery and gi saw the pt. surgery put vicryl and one silk suture in an actively bleeding vessel at the ostomy site on with subsequent hemostasis. afterward, a tagged rbc scan failed to reveal any extravazation of blood and hct remained stable. gi scoped the ostomy and found no further sites of bleeding (superficial scope, not extensive). ultrasound showed an enlarged liver with fatty infiltration and sluggish portal vein flow with peri-hepatic ascites. the pt was then felt to be stable to tx to the floor. hospital course by problem: . # sob: the patient developed shortness of breath during her hospital stay. cxr suggested volume overload, but because of the acuity of onset, the patient was sent for le dopplers and, eventually, a cta. she ruled out for pe/dvt and was treated with lasix. her sob improved with lasix treatment. the volume overload was thought to be due to her multiple blood transfusions and ivf support while in the icu. echo showed no systolic dysfunction and was not suggestive of diastolic dysfunction. . # gi bleed: when the patient was transferred out of the icu, sutures were in place. and there was no further bleeding. she was seen by the ostomy nurse and follow-up with surgery was established for after the patient's discharge. . # anemia - though the patient's studies were unreliable due to recent bleed and transfusions, they were suggestive of deficiency, and the pt was started on . . # cirrhosis - during the workup for her gi bleed, imaging repeatedly revealed small to moderate ascites, and liver silhouette suggestive of cirrhosis. the pt has a history of etoh abuse that she was reluctant to talk about. per her family, she drinks 1-2 bottles of wine each evening. this was thought to be the most likely cause of hepatic dysfunction. psc was entertained given her history of uc, however there was no ductal change on liver us. there was no sign of overload suggestive of hemachromatosis. sm muscle antibody for pbc was weakly positive and not suggestive of this entity. the hepatology service was consulted and suggested nadolol, aldactone, and lasix qd. hepatitis panel was negative for hep b, hep c, and hep a. egd revealed no esophogeal varices. therefore the nadolol was discontinued. . # etoh abuse: the pt was not forthcoming regarding her etoh use. it was an obviously emotional topic for pt and family. she stated she had wine with dinner. per her daughter she had been drinking heavily (bottles of wine per night) for years. recent family stresses relating to custody have caused her to escalate her drinking recently per the daughter. family members also give a history of daily vomiting and shakes if she did not drink. she required very little benzodiazapines per ciwa. she was treted with iv thiamine and po folic acid. she was seen by sw for etoh abuse counselling and took information regarding rehab, but stated that she did not want to become involved and she would be able to quit drinking on her own. . # hypotension - the pt had a low blood pressure throughout the hospitalization but was stable. it was felt that this baseline low bp was likely due to cirrhosis. . # h/o hypothyroidism: - tsh was checked and was wnl. continued prior dose of synthroid 75mcg . # prurigo nodularis: the pt had a chronic skin finding over her exposed skin. she had been told in the past that it was due to her nervous habit of scratching her skin. ddx could include dermatitis herpetiformis, though it would be an odd presentation of this. she was treated with sarna lotion and the skin remained stable to improved over her hospital course. . # uc - the pt had curative colectomy for her dz. no extra-gi symptoms were apparent. she received ostomy care per ostomy nurse as noted above. . # ppx: the patient did receive heparin sq at this hospitalization. . # code: remained full, confirmed with patient, family. . # communication: home: , cell: . pcp: (). medications on admission: meds on transfer octreotide drip nexium 40mg twice daily ativan prn bannana bag discharge medications: 1. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 2. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. multivitamin capsule sig: one (1) cap po daily (daily). disp:*30 cap(s)* refills:*2* 4. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. spironolactone 25 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 7. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: vna discharge diagnosis: primary: gi bleed: bleeding vessel at ostomy new diagnosis of cirrhosis hypotension anemia of blood loss and deficiency secondary: ulcerative colitis s/p colostomy hypothyroid discharge condition: stable hct x >48 hours, no orthostatic symptoms, o2 saturation on ra while ambulating > 90%, no symptoms of sob discharge instructions: you were admitted with bleeding from your ostomy site. this was caused by dilation of the blood vessels in this area. the dilation was likely caused by your liver disease. your liver disease may be related to alcohol. you should not drink any alcohol anymore. if you need help as you stop drinking all alcohol, please contact the hospital or the contact alcoholics anonymous directly. you will have a number of follow up to ensure you are treated properly for your liver disease and to prevent further bleeding. please do not miss : dr. (colorectal surgery) - he will need to examine your ostomy and the stitches that were placed at this hospitalization. your appointment is for: at 1:15pm at the (facing the er). it is , . please bring ostomy supplies as he will want to remove your current ostomy bag. you should make an appointment to see your primary care physician, . , within 2 weeks. you should follow up with the liver team in the next 1-2 weeks. please call for an appointment with dr. : (. if you develop recurrent bleeding, light headedness, fevers, chills, severe nausea or vomiting or other worrisome symptoms please seek immediate medical attention. followup instructions: provider: , md date/time: 1:15 dr. (pcp) - pt to call. pt to call for hepatology follow up: dr. : (. md, procedure: percutaneous abdominal drainage control of hemorrhage, not otherwise specified esophagogastroduodenoscopy [egd] with closed biopsy transfusion of packed cells transfusion of other serum diagnoses: unspecified pleural effusion intestinal bypass or anastomosis status acute posthemorrhagic anemia alcoholic cirrhosis of liver acquired coagulation factor deficiency portal hypertension unspecified acquired hypothyroidism pulmonary collapse iron deficiency anemia, unspecified hypoxemia varices of other sites other and unspecified alcohol dependence, continuous lichenification and lichen simplex chronicus attention to ileostomy other colostomy and enterostomy complication 

Answer: The patient is high likely exposed to