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: patient is an 81-year-old man with past medical history of polycythemia , coronary artery disease status post myocardial infarction on , deep venous thrombosis/pulmonary embolus on coumadin, and aspirin now presenting with black-tarry stools x2 days, one was yesterday and one this morning. the patient denies any bright red blood per rectum, chest pain, shortness of breath, abdominal pain, nausea, vomiting, lightheadedness, dizziness, fevers, chills, history of gastrointestinal bleed in the past. review of systems: remarkable only for one week history of direct cough, fatigue, chronic constipation, and three month history of anorexia with decreased po intake. he has had routine colonoscopies in the past, one of which had a positive polyp, the most recent one per note was negative. in the emergency room, hematocrit was found to be 17, blood pressure 74/30. patient was given 2 units of packed red blood cells and 1 liter of normal saline with good response. nasogastric lavage was negative. two large boar ivt were placed. gi was consulted. past medical history: 1. polycythemia in . 2. benign prostatic hypertrophy. 3. left deep venous thrombosis complicated by pulmonary embolus . 4. coronary artery disease status post myocardial infarction with catheterization showing 80% left anterior descending artery stenosis, stented. 5. left total knee replacement . 6. splenic infarct with fluid collection with negative cultures. 7. osteoarthritis. medications: 1. lisinopril 5 mg q day. 2. aspirin 325 mg q day. 3. metoprolol 12.5 mg . 4. hydroxyurea 500 mg q day. 5. flomax 0.4 mg q day. 6. coumadin 5/2.5 qod. allergies: no known drug allergies. family history: no coronary artery disease. brother with prostate cancer. sister with breast cancer. no colon cancer. social history: the patient is a retired truck driver. he lived with his wife for 48 years. the patient had a five pack year history of smoking, quit 5 years ago. the patient has a history of social alcohol, no drug use. physical examination: on admission, his physical examination was temperature 95.3, blood pressure 120/47, pulse 76, respiratory rate of 22, and sating 100% on room air. the patient is a pale-elderly man appearing fatigued, alert and oriented times three, conversant in no acute distress. heent: pupils are equal, round, and reactive to light. pale conjunctivae. mucous membranes slightly dry, poor dentition. neck had no jugular venous distention and no lad. lungs had bibasilar crackles left greater than right. cardiovascular: regular, rate, and rhythm, 1/6 systolic ejection murmur at left lower sternal border. abdomen was soft, nontender, nondistended, normoactive bowel sounds. no masses or hepatosplenomegaly. extremities: no edema, no calf tenderness, warm. neurologic: the patient was alert and oriented, nonfocal, 2+ patellar reflexes bilaterally, downgoing toes. rectal had red-brown stool, guaiac positive in the emergency department. laboratories on admission: white blood cell count 19.3, hematocrit 17, platelets 988. his baseline hematocrit is between 33-37. differential was 92% neutrophils, 1 band, 1 lymphocyte, 5% monocytes, and 1% eosinophils. his coags were pt 21.4, inr of 3.0, ptt 31.8. sodium 140, potassium 4.7, chloride 105, bicarb 22, bun 69, creatinine 1.5, glucose 255. creatinine at baseline is 1.1-1.3. urinalysis showed trace blood, negative nitrate, trace protein, small bilirubin, white blood cells, moderate bacteria, squamous epithelial cells. alt was 22, ast 17, alkaline phosphatase 54, total bilirubin 0.4, amylase 37, lipase 35. chest x-ray showed left basilar pna versus atelectasis. electrocardiogram showed normal sinus rhythm at 70 beats per minute, left axis deviation, normal intervals, no st changes. t-wave flattening in inferior leads, left atrial hypertrophy. hospital course: patient was transferred to the micu on . he was started on transfusions of red blood cells. he received 5 units of packed red blood cells, 5 units of fresh-frozen plasma, vitamin k to reverse the inr. gi was consulted. a colonoscopy was performed the next day and it was negative. egd upper endoscopy revealed a nonbleeding 10 cm ulcer in the duodenum. patient's hydroxyurea, aspirin, and coumadin were discontinued. the patient was started on levofloxacin and clindamycin for questionable aspiration. the patient received a five day course of levofloxacin, two day course of clindamycin. post-transfusion, the patient developed congestive heart failure which was treated with lasix with improvement. the patient was felt to be stable and transferred to the floor. the patient had a swallow evaluation which was negative. patient was feeling better on the floor. he was evaluated by pt and felt that he did not require rehab stay, and was able to go home with vna and home pt. hematology/oncology was consulted, who felt that his hydroxyurea could be withheld until his hematocrit returned to 35. patient's white blood cell count was noted to trend up. this was questionably due to infection versus . according to hematology/oncology, it is possible that caused elevated white blood cell count. patient will follow up with his hematology/oncology doctor, dr. as an outpatient at which time restarting hydroxyurea will be addressed. patient had no complaints. he had no cough, fevers, or chills. it was felt that it was unlikely that he had pneumonia, so levofloxacin was discontinued. on discharge, the patient was started on amoxicillin for 14 days and clarithromycin for 10 days to treat presumed h. pylori. at time of discharge, the results from the h. pylori were still pending. status post endoscopy, the patient was started on proton-pump inhibitor, which he should continue for a few months. aspirin will continue to be withheld for three weeks following endoscopy to allow for time for ulcer to heal since patient has a history of coronary artery disease with recent myocardial infarction. aspirin should be restarted in the future. patient will be discharged to home with vna services and pt home evaluation. discharge diagnoses: 1. gastrointestinal bleed status post endoscopy which revealed nonbleeding duodenal ulcer. 2. polycythemia . 3. coronary artery disease status post myocardial infarction. 4. deep venous thrombosis/pulmonary embolus . discharge medications: 1. lisinopril 5 mg po q day. 2. metoprolol 12.5 mg po bid. 3. protonix 40 mg po q day x2 months. 4. flomax 0.4 mg po q day. 5. amoxicillin 1 gram po bid x14 days. 6. clarithromycin 500 mg po bid x10 days. followup: the patient is to follow up with dr. at number and with dr. . it was discussed with the primary care physician and hematology/oncology, who feels that the patient has been on coumadin for six months for his deep venous thrombosis/pe, and there is no reason to continue the anticoagulation therapy further at this time. the patient is to followup with his primary care physician in the next week at which time his bun, creatinine can be rechecked along with his complete blood count to ensure that his hematocrit and white blood cell count remains stable. , m.d. dictated by: medquist36 procedure: other endoscopy of small intestine colonoscopy diagnoses: pneumonia, organism unspecified acute posthemorrhagic anemia long-term (current) use of anticoagulants personal history of venous thrombosis and embolism subendocardial infarction, subsequent episode of care other specified hypotension polycythemia vera acute duodenal ulcer with hemorrhage, without mention of obstruction personal history of thrombophlebitis 

Answer: The patient is high likely exposed to