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: a.c.e inhibitors / aspirin / valsartan attending: chief complaint: coffee ground emesis major surgical or invasive procedure: esophagogastroduodenoscopy history of present illness: patient is a 76 y/o m with a pmh of htn, dm, cri, and hyperlipidemia who presents from home with emesis. the patient reports that he was in his usoh yesterday until around 9pm when he suddenly felt nauseated and vomited x1. he reports that he had not eated anything since lunch time when he had two sausages that he prepared at home. he reports that the emesis looked like coffee grounds. per the ed the patient's daughter felt that her father "did not look good" and ems was called. the patient had another episode of coffee ground emesis in the ambulance. he denies any fevers, chills, diarrhea or abdominal pain. he does not know if he has had any melena as he "stopped looking at his stools since he stopped taking iron 1 year ago". he denies any h/o hematochezia. the patient denies any history of gi bleeding in the past. he denies taking ibuprofen, however he did take one aspirin yesterday for some l-sided neck pain despite being told he should not take it. . in the emergency department initial vs were t 97.4 bp 125/64 hr 116 rr 20 o2 sat: 100% 4l. hct was checked and was 31.6. he had a melanic stool, guaiac positive. gi evaluated the patient in the ed. an ngl was performed after long discussion with patient which showed small flecks of old blood and no active bleeding. bp remained stable. 2 pivs were placed. he received 40mg protonix iv and 1l ns. he was admitted to the icu for close monitoring and egd in am. . currently the patient feels well but states he does not want to be in the hospital. he denies any further nausea, emesis, diarrhea or abdominal pain. he also denies chest pain, lh, sob, palpitations or other complaints. . ros is otherwise negative for le swelling, pnd, orthopnea, dysuria or difficulty urinating. past medical history: ckd, baseline cr 3-3.5, followed by dr. dm2, last a1c 7.2 in htn elevated psa followed by dr. , s/p bx in showing chronic inflammation and no malignancy hyperlipidemia ? osa chronic anemia, baseline hct 35-38 depression, not treated l cerebellar cva erectile dysfunction central vestibular vertigo social history: lives with his daughter. widower, lost his wife 4 years ago. independant in adls, ambulates with cane. smoked for 40 years, quit 20 years ago. retired post office worker. denies etoh. family history: father had cva in 50s mother had dm and ? colon ca, died in 80s brother cva age 31 physical exam: general: pleasant, alert, comfortable, well appearing, in nad heent: normocephalic, atraumatic. no conjunctival pallor. no scleral icterus. perrla/eomi. mmm. op clear. neck supple, no lad, no thyromegaly. cardiac: tachy, regular, normal s1, s2. no murmurs, rubs or . jvp= 6cm lungs: ctab, good air movement biaterally, no wheezes or rales abdomen: nabs. soft, nt, nd. no hsm extremities: no edema or calf pain, ext. warm and well-perfused skin: no rashes, hyperpigmentation in upper anterior chest. neuro: a&ox3. appropriate. cn 2-12 grossly intact. preserved sensation throughout. 5/5 strength throughout. + reflexes, equal bl. gait assessment deferred psych: listens and responds to questions appropriately, pleasant pertinent results: labs on admission: 10:52pm ck(cpk)-153 10:52pm ck-mb-8 ctropnt-0.21* 10:52pm hct-29.0* 10:52pm pt-14.2* ptt-22.4 inr(pt)-1.2* 06:00pm urine hours-random urea n-726 creat-103 sodium-34 06:00pm urine osmolal-436 06:00pm urine color-yellow appear-clear sp -1.012 06:00pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 03:05pm glucose-216* urea n-111* creat-4.1* sodium-146* potassium-4.1 chloride-107 total co2-25 anion gap-18 03:05pm estgfr-using this 03:05pm alt(sgpt)-18 ast(sgot)-16 ld(ldh)-232 ck(cpk)-148 alk phos-72 tot bili-0.1 03:05pm ck-mb-9 ctropnt-0.15* 03:05pm albumin-3.2* calcium-8.1* phosphate-4.0 magnesium-2.1 03:05pm wbc-8.5 rbc-3.03* hgb-9.0* hct-26.9* mcv-89 mch-29.7 mchc-33.4 rdw-14.0 03:05pm plt count-191 10:31am glucose-232* na+-144 k+-4.5 cl--101 tco2-23 10:30am wbc-9.5# rbc-3.48* hgb-10.7* hct-31.6* mcv-91 mch-30.8 mchc-33.9 rdw-13.9 10:30am neuts-76.5* lymphs-17.1* monos-5.6 eos-0.4 basos-0.3 10:30am plt count-248 . labs on discharge: 05:25am blood wbc-7.3 rbc-3.08* hgb-9.4* hct-27.7* mcv-90 mch-30.4 mchc-33.8 rdw-14.2 plt ct-139* 05:25am blood glucose-159* urean-87* creat-3.7* na-146* k-4.3 cl-113* hco3-24 angap-13 . microbiology: mrsa screen - negative h pylori serology - pending . imaging: echo: the left atrium and right atrium are normal in cavity size. there is mild symmetric left ventricular hypertrophy with normal cavity size and global systolic function (lvef>55%). due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. right ventricular chamber size and free wall motion are normal. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets are mildly thickened (?#). there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. impression: technically suboptimal study. mild symmetric left ventricular hypertrophy with preserved global biventricular systolic function. . egd: -erosions in the gastroesophageal junction -nodularity and erythema in the fundus and stomach body compatible with gastritis -ulcers in the pre-pyloric region -congestion in the duodenal bulb compatible with duodenitis -otherwise normal egd to second part of the duodenum brief hospital course: patient is a 76 year old man with history of hypertension, dm type 2, hyperlipidemia and chronic renal insufficiency who presented from home with coffee ground emesis. . 1.) anemia/coffee ground emesis: egd demonstrated several pre-pyloric ulcers, likely etiology of presentation. received a total of 1 unit packed red blood cells, and was treated with pantoprazole with stabilization of his hematocrit in the high 20's on discharge. h pylori serology was sent and is pending on discharge, to be followed up as an outpatient and treated if positive. otherwise patient was discharged on pantoprazole with instructions to follow up with gastroenterology in weeks time. . 2.) hypertension, benign: medications initially held on admission, but all were restarted on discharge. . 3.) tachycardia: on presentation, now resolved with iv fluid hydration. . 4.) abnormal ekg: patient with noted new twi on ekg, likely from tachycardia above. ruled out for mi. echo essentially unremarkable. . 5.) hyperlipidemia: continued statin . 6.) diabetes: held outpatient regimen while npo but restarted on discharge. . 7.) chronic renal insufficiency: baseline creatnine labs appears to be 3-3.5. cr 4.1 on admission, decreased to baseline by time of discharge. . 8.) bph: continued tamsulosin . 9.) history of cva: ticlid held on admission, restarted on discharge. medications on admission: amlodipine - 5 mg daily atorvastatin - 40 mg daily diltiazem hcl - 360 mg sust. release daily doxercalciferol - 0.5 mcg capsule - 1 (one) capsule(s) by mouth twice a day to maintain level of vitamin d furosemide - 40 mg, once a day on odd days, 2 tablets daily on even days insulin glargine - 8 units sc once a day metoprolol succinate - 50 mg daily repaglinide - 1 mg twice a day tamsulosin - 0.4 mg daily ticlopidine - 250 mg twice a day discharge medications: 1. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 2. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 3. diltia xt 120 mg capsule,degradable cnt release sig: three (3) capsule,degradable cnt release po once a day. 4. doxercalciferol 0.5 mcg capsule sig: one (1) capsule po bid (2 times a day). 5. lasix 40 mg tablet sig: two (2) tablet po on even days. 6. lantus 100 unit/ml solution sig: eight (8) units subcutaneous once a day. 7. metoprolol succinate 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). 8. repaglinide 1 mg tablet sig: one (1) tablet po twice a day. 9. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po hs (at bedtime). 10. ticlopidine 250 mg tablet sig: one (1) tablet po twice a day. 11. 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:*2* discharge disposition: home discharge diagnosis: primary - acute blood loss anemia, resolved - upper gastrointestinal bleed, stable secondary - hypertension - diabetes, type ii discharge condition: afebrile, vitals stable discharge instructions: you were hosptialized because you had vomited blood. after a thorough work up, the cause of your vomiting was from several ulcers that have stopped bleeding. you recieved one unit of blood and your hematocrit has been stable. you have been started on a new medication called protonix. please take this medication twice daily until you follow up with gastroenterology. please avoid a class of medications called non steroidal anti-inflammatory medications and do not take them without first discussing with your doctor. this includes ibuprofen, motrin, aspirin. please contact physician if develop more blood in vomit, blood in stool, black colored stools or vomit, lightheadedness/dizziness, chest pain/pressure, shortness of , other questions or concerns. followup instructions: please follow up with gastroenterology dr. in weeks to arrange for a repeat endoscopy. can call to schedule appointment. please follow up with these previously scheduled appointmentsp: provider: , m.d. date/time: 1:30 . provider: , dpm phone: date/time: 11:40 . provider: , : date/time: 11:00 procedure: esophagogastroduodenoscopy [egd] with closed biopsy transfusion of packed cells diagnoses: acute posthemorrhagic anemia 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 i through stage iv, or unspecified depressive disorder, not elsewhere classified hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) chronic kidney disease, unspecified other and unspecified hyperlipidemia chronic or unspecified gastric ulcer with hemorrhage, without mention of obstruction personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits duodenitis, without mention of hemorrhage tachycardia, unspecified helicobacter pylori [h. pylori] impotence of organic origin vertigo of central origin 

Answer: The patient is high likely exposed to