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: the patient is an 87 year old man in a rehabilitation facility, who was observed to have bright red blood per rectum. he was seen to have a large bowel movement with bright red blood as well as blood clots. the patient felt dizzy and his blood pressure was taken as 90/40. he was given 250 cc of normal saline and transferred to , where his hematocrit was found to be 19.9. his baseline hematocrit is around 29. past medical history: 1. dementia. 2. frequent falls. 3. coronary artery disease, status post coronary artery bypass grafting in and myocardial infarction in . 4. congestive heart failure with a left ventricular ejection fraction of 25% in . 5. intermittent atrial fibrillation, not anticoagulated because of fall risk. 6. anemia. 7. type 2 diabetes mellitus. 8. hypertension. 9. hyperlipidemia. 10. hypothyroidism. 11. most recently admitted from for diuresis for congestive heart failure exacerbation. medications on admission: digoxin 0.125 mg p.o.q. monday, 0.25 mg p.o.q. wednesday, lasix 80 mg p.o.b.i.d., spironolactone 25 mg p.o.q.d., cozaar 50 mg p.o.b.i.d., glyburide 5 mg p.o.b.i.d., aspirin 81 mg p.o.t.i.d., isordil 40 mg p.o.t.i.d., colace, metformin 1,000 mg p.o.b.i.d., iron sulfate 160 mg p.o.q.d., lipitor 10 mg p.o.q.d., casodex (bicalutamide) 50 mg p.o.q.d., synthroid 0.15 mg p.o.q.d., ranitidine 150 mg p.o.q.d., toprol xl 50 mg p.o.q.d., hydralazine mg p.o.q. a.m./afternoon/p.m. physical examination: on physical examination on admission, the patient was afebrile with a pulse of 72 to 80, blood pressure 116/34, respiratory rate 15 and oxygen saturation 100%. general: pale elderly gentleman in no acute distress. head, eyes, ears, nose and throat: pupils equal, round, and reactive to light and accommodation, fundi with sharp disks, no hemorrhage, oropharynx without discharge, mucous membranes dry. neck: supple, no bruits. chest: clear to auscultation bilaterally, no wheezes, rales or rhonchi. cardiovascular: regular rate and rhythm, normal s1 and s2, no murmur. abdomen: soft, nontender, nondistended, positive bowel sounds. rectal: normal tone, dark stool, guaiac positive. musculoskeletal: 5/5 strength in upper and lower extremities. neurologic examination: alert and oriented times three, poor short term memory. physical examination on discharge showed crackles to one-half way up lungs, left greater than right, and 1+ edema to mid-calves. cardiovascular: regular rate and rhythm. nasogastric lavage: negative for blood. laboratory data: admission white blood cell count was 11.5 with 79.8 neutrophils, 0 bands, 12.6 lymphocytes, 5.9 monocytes, 1.1 eosinophils and 0.6 basophils, hemoglobin 6.7, hematocrit 19.9, platelet count 329,000, sodium 132, potassium 5, chloride 96, bicarbonate 29, bun 63, creatinine 1.1, prothrombin time 12.9 and inr 1.1. serial ck were 60, 45 and 24. : white blood cell count 14.2, hemoglobin 11.8, hematocrit 33.4. : white blood cell count 13, hemoglobin 11.3, hematocrit 33.9. : white blood cell count 12.4, hemoglobin 12.1, hematocrit 36.4. : white blood cell count 11.7, hemoglobin 12.1, hematocrit 35.4. : white blood cell count 14, hemoglobin 12.1, hematocrit 34.8. : white blood cell count 12.2, hemoglobin 9.8, hematocrit 28.3. : sodium 138, potassium 3.9, chloride 103, bicarbonate 25, bun 23, creatinine 1.1 and glucose 129. : helicobacter pylori antibody positive. : urinalysis (straight catheterization), greater than 50 red blood cells, greater than 50 white blood cells, few bacteria, no epithelial cells. radiologic data: tagged red blood cell scan, : blood flow images show increased diffuse activity in the left side of the abdomen, delayed blood pool images obtained over one hour show no increased activity in the region of the gastrointestinal tract, delayed blood pool images obtained over a third half-hour show a brief focus of increased activity in the left mid-abdomen, the activity moves up into the left and diffuses out over one-half hour; impression, (1) increased diffuse activity over the left side of the abdomen could represent a region of hyperemia which can be seen with diverticulitis, (2) brief focus of activity over the left mid-upper quadrant of the abdomen could represent a small bleed which disperses in the bowel, its location is difficult to identify but could represent bleeding in the transverse colon. chest x-ray: increased pulmonary vascularity with associated perihilar haziness in a bilateral lower lobe interstitial pattern; there are probably small pleural effusions bilaterally; impression, congestive heart failure with interstitial edema and probable small bilateral pleural effusions. , chest x-ray (unofficial read): left lower lobe infiltrate, small nodular opacity in the right lung at level between fifth and sixth ribs. , small bowel follow-through: several air filled loops with small and large bowel throughout the abdomen; the patient was given barium to drink and this reached the cecum over three to four hours; no intrinsic mass effect or filling defects are seen over 1 cm in size; the terminal ileum was normal in appearance; impression, no obvious mass or mass effect is identified. , upper gastrointestinal endoscopy: reducible small sized hiatal hernia in the esophagus, stomach with diffuse continuous erythema of the mucosa with no bleeding noted in the antrum; these findings are compatible with gastritis; duodenum, multiple cratered nonbleeding ulcers ranging in size from 2 to 5 mm were found in the duodenal bulb. hospital course: the patient felt asymptomatic during his hospital stay. he himself did not complain of shortness of breath, weakness or dizziness, although he is a poor historian. he was admitted to the medical intensive care unit initially, where two large bore intravenous lines were placed. he received three times daily hematocrit checks and was transfused with four units of packed red blood cells, with appropriate hematocrit bump to 29. the patient was then transferred to the floor and given two more units. his hematocrit was 31.5 afterwards. he had no further transfusions and his hematocrit was 34.4 on discharge. his stool was guaiac negative on discharge. his antihypertensive medications, besides losartan, were held for most of the hospitalization because of the concern of risk for hypotension, especially given his likely recent bleed. he was restarted on toprol xl 50 mg daily and lasix 80 mg twice a day on . he had a systolic blood pressure of approximately 130 and pulse approximately 75 on these medications. he will be discharged with his baseline antihypertensive regimen, which includes isordil 40 mg three times a day and hydralazine mg in the morning, noon and evening, with hold parameters applied. he usually had a regular rate and rhythm but occasionally was in atrial fibrillation. as evaluated on previous admission, the patient is a poor candidate for anticoagulation given that he has a history of frequent falls. on , the patient underwent an upper gastrointestinal endoscopy which showed multiple, 2 to 5 mm, nonbleeding duodenal ulcers. colonoscopy was attempted on , but failed because the patient had too much residual stool despite having consumed one gallon of golytely. a colonoscopy was successfully performed after he drank another gallon. the colonoscopy revealed nonbleeding, grade ii, internal hemorrhoids and diffuse continuous melanosis. otherwise, he had a normal colonoscopy with no evidence of bleeding. a small bowel follow-through, performed on , also was normal and did not yield a source of bleeding. the source of the patient's gastrointestinal bleed, therefore, was most likely his duodenal ulcers. he was found to be helicobacter pylori positive and was started on triple therapy as well as a proton pump inhibitor twice a day for life. he had been receiving 81 mg of aspirin three times a day prior to admission. because of his ulcers, yet his multiple cardiac risk factors, it was decided to continue him on aspirin but only on 81 mg per day. a chest x-ray on revealed a possible small nodule in the left lung at the level between the fifth and six ribs. this could potentially be followed up with an outpatient ct scan. however, given the patient's age and his co-morbidities, as well as his being an extremely poor candidate for chemotherapy or surgery, this workup may not be necessary. the chest x-ray also revealed a left lower lobe infiltrate. the patient had been afebrile and without cough during his hospitalization. he will be started on levofloxacin 250 mg per day for ten days. his urinalysis on showed a possible urinary tract infection, which levofloxacin would cover. he did have red blood cells in his urine and it is unclear whether this is due to trauma from catheter insertion. he should have a repeat urinalysis as an outpatient. condition at discharge: guarded, owing to the patient's baseline health with multiple co-morbidities. discharge status: full code. discharge diagnoses: gastrointestinal bleed, likely from duodenal ulcers. positive for helicobacter pylori. discharge medications: digoxin 0.125 mg p.o.q. monday, 0.25 mg p.o.q. wednesday. lasix 80 mg p.o.b.i.d. spironolactone 25 mg p.o.q.d. cozaar 50 mg p.o.b.i.d. glyburide 5 mg p.o.b.i.d. aspirin 81 mg p.o.q.d. isordil 40 mg p.o.t.i.d. colace one to two tablets p.o.b.i.d.p.r.n. constipation. metformin 1,000 mg p.o.b.i.d. iron sulfate 160 mg p.o.q.d. lipitor 10 mg p.o.q.d. casodex (bicalutamide) 50 mg p.o.q.d. synthroid 0.15 mg p.o.q.d. omeprazole 30 mg p.o.b.i.d. toprol xl 50 mg p.o.q.d. hydralazine mg p.o.q. a.m./afternoon/p.m., hold for systolic blood pressure less than 100. levofloxacin 250 mg p.o.q.d., last day . clarithromycin 500 mg p.o.b.i.d., last day . amoxicillin 1 gm p.o.b.i.d., last day . disposition: the patient was discharged to a rehabilitation facility for work on his ambulation. his wife should contact dr. to schedule a follow-up appointment in about three weeks. dr. is at . mrs. is at . , m.d. dictated by: medquist36 procedure: other endoscopy of small intestine colonoscopy diagnoses: pneumonia, organism unspecified urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism atrial fibrillation aortocoronary bypass status chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction 

Answer: The patient is high likely exposed to