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: cephalexin / heparin agents attending: chief complaint: gi bleed major surgical or invasive procedure: egd history of present illness: 67 year old male with alcoholic cirrhosis who was admitted in to for alcoholic hepatitis treated with prednsione 40 mg po qdaily for five days. . he reports having progressive shortness of breath for past few days with inability to even walk to block from unlimited activity a week ago. he reports no abdominal pain, nausea, vomiting, hematemesis, brbpr, dark stools, dysuria, fever, cough, chest pain, dizziness, palpatations or alcohol use (last drink 3 weeks ago). . he presented to osh today where he as noted to have dark bloody stool and hematocrit of 15 along with elevated lfts. unfortunately he refused ng lavage. he was transfused one unit of prbc and 2 units of ffp. he was given 750 mg levaquin emperically and transferred to ed with octreotide and protonix started. . in the ed, his intial vitals were 99.0 94 118/76 18 98% ra. he had guiaic positive but not grossly bloody stool in the vault in the ed. he was continued on his octreotide and protonix gtt while switched to ceftriaxone 1 gm q24. his labs were significant for hct of 15.4, inr of 2.1, t.bili of 8.7, lactate of 7.1, wbc of 17.2, creatinine of 1.6 and sodium of 131. he was transferred to micu for futher evaluation and management. . in the micu, he reports feeling well except for right shoulder pain which hurts with movement. past medical history: alcoholic cirrhosis social history: last alcoholic beverage was 3 weeks ago. he stopped smoking twenty years ago. no illicit drug use. lives alone at home. separated from his wife. retired. family history: no family history of liver disease physical exam: admission exam gen: male in no acute distress vitals: 98.7 128/59 120 100%ra heent: normocephalic. nontraumatic. icteric. chest: clear to auscultation bilaterally. no crackles or wheezing noted heart: regular rate and rhythm. systolic murmur heard throughout abdomen: soft and distended. tenderness to deep palpation. shifting dullness to percussion noted. external: 1+ pitting edema to the knee neuro: alert and oriented to person, place and time. mild confusion with recall. could not tell me who the current president is. cn 2-12 intact. muscles strength throughout except r shoulder strength which was limited due to pain. skin: jaundiced. b/l upper extremity bruises discharge exam vitals: tm/tc 99.4/97.5, bp 150/85 (135-155)/(65-85), hr 85 (80-90), rr 20, sao2 96-100%ra in: 1560 po, 100 iv ... out: 2450, bm x0 (net fluid bal -800) gen: nad chest: clear to auscultation bilaterally. no crackles or wheezing. heart: regular rate and rhythm. systolic murmur heard throughout. abdomen: soft and distended. tenderness to deep palpation. shifting dullness to percussion noted. extrem: 2+ pitting edema to the knee bilaterally; rue now symmetrical to the lue but with limited rom pain neuro: alert and oriented to person, place and time. muscle strength throughout except r shoulder strength which was limited due to pain. skin: jaundiced. b/l upper extremity bruises. pertinent results: admission exam 08:30pm blood wbc-17.2* rbc-1.57*# hgb-5.2*# hct-15.4*# mcv-98# mch-33.2* mchc-34.0 rdw-16.3* plt ct-124* 08:30pm blood neuts-90.2* lymphs-6.8* monos-2.2 eos-0.3 baso-0.4 08:30pm blood pt-22.1* ptt-43.9* inr(pt)-2.1* 11:35pm blood ret aut-4.5* 08:30pm blood glucose-160* urean-48* creat-1.6* na-131* k-4.8 cl-101 hco3-18* angap-17 08:30pm blood alt-17 ast-27 alkphos-77 totbili-8.7* 08:30pm blood lipase-22 11:35pm blood albumin-2.0* calcium-8.1* phos-4.1# mg-1.6 iron-123 11:35pm blood caltibc-135* vitb12-greater th folate-14.9 hapto-30 ferritn-250 trf-104* 08:30pm blood ammonia-43 05:25am blood afp-3.6 11:46pm blood lactate-5.2* 08:39pm blood lactate-7.1* discharge labs 05:48am blood wbc-6.9 rbc-3.21* hgb-10.0* hct-29.6* mcv-92 mch-31.1 mchc-33.7 rdw-17.0* plt ct-70* 05:48am blood pt-23.3* ptt-45.2* inr(pt)-2.2* 05:48am blood glucose-100 urean-13 creat-0.8 na-133 k-3.7 cl-101 hco3-30 angap-6* 05:48am blood alt-20 ast-38 alkphos-117 totbili-7.2* 05:48am blood albumin-1.9* calcium-7.9* phos-2.1* mg-1.8 ekg normal sinus rhythm with low limb lead voltage. non-specific st-t wave abnormalities. no previous tracing available for comparison. cxr no active disease. shoulder x-ray mild degenerative arthritic change. rue ultrasound no evidence of dvt in the right upper extremity. ruq ultrasound 1. fatty liver with no focal lesions seen. additionally, there is a reversal of portal venous flow in the right and left system as seen on prior. 2. there is mild intra-abdominal ascites around the liver as well is in bilateral lower quadrants, right greater than left. 3. gallstone with no evidence of cholecystitis. the common bile duct is normal in caliber. 4. splenomegaly. ct head w/o contrast 1. no hemorrhage, edema, or evidence of other acute process. 2. global atrophy, greater than expected for patient's age, likely related to history of ethanol abuse, and sequelae of chronic small vessel ischemic disease. tte no vegetations seen egd impression: ulcer in the first part of the duodenum (thermal therapy) otherwise normal egd to third part of the duodenum brief hospital course: brief hospital course: mr. is a 67y/o gentleman with alcoholic cirrhosis who was admitted with dark stools/anemia and was found to have duodenal ulcer that was treated with gold probe, with stable hct. his course was complicated by strep viridans bacteremia for which he was treated with antibiotics and he was discharged home. . active issues . # gi bleed: duodenal ulcer, hct stable now. egd revealed duodenal ulcer which was treated with gold probe. h. pylori negative. he was treated with ppi, sucralfate, and prophylactic ceftriaxone. his hct remained stable and he had no more signs of active bleeding. . # strep viridans bacteremia: unclear source. he had 1 positive blood culture on , the day of admission. he was initially started on vanc but after speciation and sensitivities returned, he was kept on ceftriaxone (which he was on for prophylaxis in the setting of gi bleed anyway). id consult was obtained; his access at the time was a right ij which was pulled (and cultured), and when blood cultures were cleared, a picc line was placed for outpatient antibiotics. tte was negative for vegetation and he remained afebrile without any other psitive culture data. the plan is to treat with ceftriaxone for 2 weeks (last day is ). he was discharged home with vna and he will follow up with his pcp and hepatologist. . # alcohlic cirrhosis with ascites and total body volume overload: meld 27. his diuretics had been held in the icu and on arrival to the floor he was total body volume overloaded. he was continued on his home dose of diuretics: lasix 40 daily, aldactone 100 daily with very good urine output. he will continue on this dose and follow up with his hepatologist. . # hyponatremia: likely hypervolemic as well as hypovolemic. while holding home lasix and aldactone, his hyponatremia improved slightly, but it was still stable in the setting of adding back diuretics. sodium at the time of discharge was 133. . # thrombocytopenia: due to esld his platelets were monitored and were 60-100 throughout admission; level was 70 at the time of discharge. . # acute kidney injury: resolved. cr peaked at 1.6, likely was due to prerenal state from volume depletion vs. ischemic atn. his cr was monitored and up to 1.6 but was 0.8 at the time of discharge. . # right shoulder pain: seems to be rotator cuff in nature but unable to do an exam limited by pain. x-ray revealed just arthritic changes. he was seen by pt and was cleared to go home with pt. he may benefit from an outpatient mri to assess for rotator cuff injury. medications on admission: lasix 40 mg po qdaily aldosterone 100 mg po qdaily discharge medications: 1. furosemide 40 mg tablet sig: one (1) tablet po qam. 2. spironolactone 100 mg tablet sig: one (1) tablet po qam. 3. sodium chloride 0.9% flush 10 ml iv prn line flush picc, non-heparin dependent: flush with 10 ml normal saline daily and prn per lumen. 4. ceftriaxone in dextrose,iso-os 2 gram/50 ml piggyback sig: one (1) pack intravenous q24h (every 24 hours) for 2 weeks: total 2 week course (last day is ). disp:*14 pack* refills:*0* 5. 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* 6. sucralfate 1 gram tablet sig: one (1) tablet po qpm: (please take this separately from your other medications because it can affect the absorption of other medications. disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: discharge diagnosis: gi bleed (duodenal ulcer) alcohol cirrhosis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted due to bloody stools, and you were found to have an intestinal ulcer that was treated. we restarted your diuretics (lasix and aldactone) and the extra fluid in your body is being removed well. . during the admission, you had right shoulder pain, which you had before admission as well. x-ray showed that you do not have a fracture. please follow up with your pcp to discuss this (appointment listed below). . we made the following changes to your medications: -start sucralfate -start pantoprazole -start ceftriaxone (last day is ) followup instructions: primary care name: , . . location: medical center address: 1 dr, , phone: appt: at 2pm hepatology department: liver center when: friday at 9:00 am with: , md building: lm bldg () campus: west best parking: garage procedure: venous catheterization, not elsewhere classified endoscopic control of gastric or duodenal bleeding diagnoses: thrombocytopenia, unspecified abnormal coagulation profile alcoholic cirrhosis of liver acute kidney failure, unspecified unspecified protein-calorie malnutrition hyposmolality and/or hyponatremia portal hypertension bacteremia hepatic encephalopathy chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction varices of other sites streptococcus infection in conditions classified elsewhere and of unspecified site, other streptococcus other specified disorders of stomach and duodenum precipitous drop in hematocrit other and unspecified alcohol dependence, continuous edema 

Answer: The patient is high likely exposed to