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: this is a 62 year-old female with a history of cirrhosis, diverticulitis, colovesicular fistula who presents with three episodes of melena. the patient was in her usual state of health until when a relative noted her to be jaundice. she made an appointment to see her primary care physician . on she had two episodes of melena. it was not associated with n-v-c-b-abdominal pain, easy bruising, bleeding with brushing teeth, bright red blood per rectum, fever, headache, chest pain, shortness of breath, dysphagia, odynophagia, visual changes, travel or unusual foods. she had mild lightheadedness and had lost four pounds intentionally over the past two weeks. she had mild gas and bloating for two days. no prior episodes of black stool or bright red blood per rectum were reported. she had been taking one aspirin per day for two weeks for aches and pains as well as one to two aleve per day for joint pain. she denies ingesting spinach, pepto-bismol or iron. she had an additional episode of melena on the a.m. of and her primary care physician instructed to go directly to the emergency department where she had a systolic blood pressure in the 80s and black stool that was guaiac positive. in the emergency department nasogastric lavage was performed and was negative. access was obtained and the patient was given 2 units of packed red blood cells and 2 liters of normal saline. from there she was transferred to the micu for further management. past medical history: 1. cirrhosis (unclear diagnostic criteria). 2. hypertension. 3. diverticulitis and colovesicular fistula status post partial colectomy in with dr. . colonoscopy with multiple diverticula in 4/. 4. cesarean section times three. 5. fibroids status post or. 6. right knee arthroscopy in . 7. obesity. social history: the patient lives with her husband. she reports alcohol abuse for 40 years. she has been sober for the past two weeks. when she does drink she drinks six drinks per day for a week at a time and then will abstain for a period of weeks. she smoked in her 20s, but has had no smoking since then. she denies intravenous drug use or occupational exposure. her hepatitis status is unknown. family history: mother with myocardial infarction at age 67. paternal grandmother with diabetes mellitus. allergies: no known drug allergies. medications on admission: 1. atenolol 50 mg q day. 2. accupril 20 mg q day. 3. hydrochlorothiazide 25 mg q day. 4. lipitor 10 mg every other day. 5. st. aspirin times two weeks. 6. aleve b.i.d. 7. vitamin b-12. 8. echinacea. physical examination: examination on admission revealed temperature of 97.7. blood pressure 85/54. heart rate 70. respiratory rate 16. oxygen saturation of 100% on room air. general, the patient is pale in no acute distress, alert and oriented times three. appearing stated age and obese. heent examination revealed no jaundice, pale appearance and nonicteric sclera. neck was supple without masses or thyromegaly. there was no lymphadenopathy. chest revealed lungs were clear to auscultation bilaterally. cardiovascular examination revealed a nondisplaced point of maximal impulse. s1 and s2. no murmurs, rubs or gallops. no carotid bruits. abdominal examination the patient was soft, nontender, nondistended. there was no hepatosplenomegaly, masses or bruits. rectal examination was positive for guaiac positive stool. the extremity examination showed no cords, clubbing or edema. there was 2+ dorsalis pedis pulses and radial pulses bilaterally. there was mild pallor at the nail beds and dupuytren's contracture in the right hand. skin examination showed no rashes or bruits. on neurological examination motor was 5 out of 5 in all extremities and sensation was grossly intact to light touch. patellar and brachial radialis reflexes were intact and symmetric. cranial nerves ii through xii were grossly intact. laboratories and studies: laboratory results revealed a white blood cell count of 17.5, hematocrit 33.0 down from 43 in in the computer system. platelets 351. chem 7 revealed sodium of 137, potassium 4.1, chloride 98, bicarb 25, bun 68, creatinine 1.3, and an inr was 1.1. liver enzymes testing showed an alt of 86, ast of 60, amylase of 37, total bilirubin of 1.6. troponin was sent and came back less than asa. hospital course: after access was established nasogastric lavage was performed and the patient was given 2 units of packed red blood cells and 2 liters of normal saline. she was transferred to the medical intensive care unit for further management. 1. gastrointestinal bleed: gastrointestinal consult was obtained. hematocrits were check q six hours. two peripheral ivs were maintained at all times. the patient's goal hematocrit was greater then 26. proton pump inhibitor was started. on the patient had an esophagogastroduodenoscopy to further investigate the source of her bleeding. findings on that esophagogastroduodenoscopy were schatzki's ring, erosions in the antrum and also in the antrum the erosions and the ulcer were nonbleeding at the time of the examination, otherwise the esophagogastroduodenoscopy was normal to the third part of the duodenum. recommendations were to rule out h-pylori, continue protonix 40 mg po q day times six weeks and for repeat esophagogastroduodenoscopy in eight weeks to ensure healing of ulcers and also for possible esophageal dilation. h-pylori asa was sent and came back negative. protonix treatment was continued and the patient was scheduled for a follow up esophagogastroduodenoscopy in eight weeks. 2. cirrhosis: it was unclear how the diagnosis of cirrhosis was made in this patient and a cirrhosis workup was undertaken. right upper quadrant ultrasound showed an echogenic liver. hepatitis serologies were sent. hepatitis b surface antigen returned negative. surface antibody is pending at the time of this dictation. hepatitis c asa was negative. ama and were also negative. the patient was also found to have an elevated ferritin, but was unclear whether this was due to blood transfusion or the patient's baseline level. the patient will follow up in the liver clinic for further evaluation of her cirrhosis. 3. hypertension: the patient's antihypertension medications were titrated to her blood pressure given her acute bleed. 4. alcohol: the patient stated she was sober times two weeks and was without signs of dts or withdraw. thiamine, folate and mvi were started. the patient was seen by social work consult to discuss her alcoholism and provide support and resources for her. on the night of the patient was deemed stable to be discharged from the medical intensive care unit to the floor team. the patient came out to the floor and maintained good blood pressure and stable vital signs overnight. on the patient was deemed to be clear for discharge to home. there was no further evidence of bleeding by physical examination. discharge medications: same as admission with exception of the aspirin and the non-steroidal anti-inflammatory drugs, which were discontinued and the protonix 40 mg q day that was started and will be continued for six weeks. disposition: to home. discharge status: at the time of discharge the patient was ambulating comfortably without lightheadedness or other symptoms of hypovolemia. she was feeling well. all her questions had been answered and her follow up appointments both for workup of her cirrhosis and upper gastrointestinal bleed and for her repeat esophagogastroduodenoscopy had been made. discharge diagnoses: 1. gastrointestinal bleed requiring transfusion of 2 units of packed red blood cells secondary to erosions and ulcerations in the antrum. 2. cirrhosis of yet undetermined etiology. 3. hypertension. 4. alcohol abuse. 5. obesity. discharge follow up: the patient had an appointment for repeat esophagogastroduodenoscopy six weeks from the time of discharge. she will also follow up with her primary care physician as well as the liver clinic for further workup of her cirrhosis and upper gastrointestinal bleed. , m.d. dictated by: medquist36 procedure: other endoscopy of small intestine transfusion of packed cells diagnoses: unspecified essential hypertension alcoholic cirrhosis of liver hemorrhage of gastrointestinal tract, unspecified other and unspecified alcohol dependence, continuous stricture and stenosis of esophagus orthostatic hypotension chronic gastric ulcer without mention of hemorrhage or perforation, without mention of obstruction 

Answer: The patient is high likely exposed to