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: tetanus antitoxin / aspirin attending: chief complaint: gi bleed and decreased po intake major surgical or invasive procedure: percutaneous g- tube placement history of present illness: 85 yo m w/ hx ad, diverticulosis, recently diagnosed colon ca, status post hemicolectomy on presents with dark stools. hcts have trended down from 30 at nh --> 26--> 23. in the ed, vs: t 99.2 hr 67 bp 146/69 rr 18 99% ra. ng lavage was negative. patient was transferred to for further monitoring with plan for egd in am. past medical history: 1) colon ca s/p r colectomy - mucinous adenocarcinoma with 1 out of three lymph nodes positive 2) diverticulosis 3) right knee and shoulder surgery 4) benign prostatic hypertrophy s/p turp with history of arf attributed to post-obstructive uropathy, requiring transient indwelling foley 5) nephrolithiasis 6) alzheimer's 7) chronic anemia 8) depression social history: lives in nursing house. no smoking. minimal alcohol use. formerly in the navy, worked as a tailgunner during ww2. family history: 2 brothers died of lung cancer, one brother died of colon cancer physical exam: vs: afebrile, hr 70, bp 140/76, 98%ra gen: elderly man, pleasant, in nad heent: eomi, perrl neck: supple, jvp at clavicle cv: rrr, s1s2, no m/r/g abd: soft/ nt/ nd, +bs ext: warm, no cyanosis or edema skin: no rashes neuro: aao x 2: hospital (); cn ii-xii intact pertinent results: 10:30am blood wbc-9.0 rbc-4.12* hgb-10.6* hct-33.4* mcv-81* mch-25.8* mchc-31.7 rdw-17.1* plt ct-474* 10:30am blood glucose-115* urean-6 creat-0.8 na-144 k-4.0 cl-112* hco3-24 angap-12 12:15am blood alt-8 ast-19 alkphos-73 amylase-81 totbili-0.5 10:30am blood tsh-1.5 <b> ct abdomen<b/> indication: recent percutaneous gastrostomy placement. evaluate placement. <br> comparison: ct torso of and abdomen radiograph of . <br> technique: contiguous axial images from the mid chest through the abdomen were obtained without iv contrast. coronal and sagittal reformatted images were generated. <br> preliminary report: gastrostomy tube terminates in the esophagus, repositioning is recommended. filling defect in the mid esophagus. bilateral pleural effusions, right greater than left. small right lung base consolidation. large bilateral renal cysts. . <br> ct abdomen without iv contrast: there is a moderate right pleural effusion and small left pleural effusion, simple in attenuation. there is adjacent atelectasis and/or consolidation within a portion of the posterior right lung base. there is a small pericardial effusion. all effusions are increased since . there are coarse coronary artery calcifications, particularly involving the lad. <br> in the epigastric region, a percutaneous gastrostomy has been placed into the gastric antrum. the tube courses cephalad through the body of the stomach, through the gastroesophageal junction, and with the tip into the lowermost esophagus. oral contrast has been administered via the gastrostomy tube, which opacifies the lower esophagus. within the lumen of the uppermost imaged esophagus (at the level of the carina), there is a round soft tissue attenuation structure with air, which may represent retained food. small amounts of oral contrast are seen within the gastric lumen. <br> the non-contrast appearance of the liver is unremarkable except for the occasional calcified granuloma. minimal high-density material is seen dependently within the gallbladder, possibly representing layering stones. multiple calcified granulomas are seen in the spleen. a splenule is noted. the non-contrast appearance of the pancreas is unremarkable. the adrenal glands are minimally bulky, without a focal mass lesion, unchanged. there is no hydronephrosis of the kidneys. bilateral renal cysts are noted, which are unchanged in appearance. the previously described hyperenhancing focus in the lower pole of the right kidney is not apparent on non-contrast imaging. <br> the abdominal aorta is normal in caliber, with moderately-severe atherosclerotic calcification, particularly involving the origin of the sma. <br> the patient is post-right hemicolectomy. oral contrast opacifies the remaining portion of the colon, or several diverticula are seen. visualized small bowel loops also contains some oral contrast, but are otherwise unremarkable. there is no free air in the abdomen. there is no free fluid. small retroperitoneal nodes are seen adjacent to the ivc measuring up to about 7 cm size (2:36). these are not markedly changed from the prior examination. <br> no concerning osseous lesions are seen. <br> impression: 1. the gastrostomy tube has been placed percutaneously into the gastric antrum, but the tube is oriented cephalad, with the tip in the lowermost esophagus. oral contrast is seen within the lower half of the esophagus, and a rounded structure within the lumen of the mid esophagus at the level of the carina likely represents retained food. 2. increased size of bilateral pleural effusions, right greater than left, and there is a small pericardial effusion. 3. diffuse atherosclerotic disease as described. findings reviewed with the gi fellow on . the study and the report were reviewed by the staff radiologist. dr. dr. approved: tue 2:44 am <br> <br> <b>egd from admission:<b/> findings: esophagus: normal esophagus. stomach: mucosa: atrophy of the mucosa was noted in the antrum. duodenum: protruding lesions there was a question of a small sub-mucosal mass of benign appearance at the duodenal bulb. excavated lesions a few ulcers were found in the duodenal bulb as well as duodenitis. these were considered low risk for bleeding. other procedures: as ulcers and duodenitis were considered low risk, decision was made to proceed with peg placement. a 20fr percutaneous gastrostomy tube (peg) was placed successfully using standard techniques at the stomach body. <br> impression: atrophy in the antrum low risk ulcers and duodenitis in the duodenal bulb successful peg placement (peg) question of small submucosal mass in duodenal bulb. otherwise normal egd to third part of the duodenum recommendations: high dose protonix 40 mg twice a day please check h. pylori serology and treat if positive no further intervention for now for question of submucosal mass unless symptomatic or further bleeding. use tube for essential meds if needed tonight. can start tube feeding tomorrow. duodenitis and ulcer may have accounted for slow hct decline. <br> brief hospital course: mr. is a 85 year old man with a history of alzheimer's, diverticulosis, recently diagnosed colon ca, status post hemicolectomy on presented with dark stools and acute blood loss anemia and malnutrition from the . in the , ng lavage was negative by report. he was initially admitted to the medical icu, and given 2 units of prbcs. he was hemodynamically stable and underwent egd, revealing: "atrophy in the antrum, low risk ulcers and duodenitis in the duodenal bulb, successful peg placement (peg), question of small submucosal mass in duodenal bulb, otherwise normal egd to third part of the duodenum." it was felt these ulcers were likely accounting for the blood loss and occult blood positive stools. h. pylori ab was positive and he was started on antimicrobial therapy as well as twice daily ppi treatment. <br> mr. was called out of the unit to the general medical floor. once on the general medical floor, he had trouble tolerating his tfs initially with emesis and nausea. ct scan revealed the g tube curled up proximally into the esophagus. the gi fellow pulled the tube back and abdominal x-ray showed it no longer in the esophagus. tfs were resumed and the patient had no difficuties thereafter. <br> alzheimer's dementia and depression: pt oriented to self, but not place or time. he was continued on namenda and aricept per home regimen. he was continued on his mirtazapine and his tsh was normal. <br> submucosal mass seen on egd: unclear if this requires follow-up. see egd report attached. <br> remaining open surgical wound: minimal opening, excellent granulation tissue, no evidence for infection, appears to be healing well. continue conservative care as directed. <br> mucinous adenocarcinoma with 1/3 positive lymph nodes, adenopathy seen on ct scan: consider outpatient follow up with gi oncology if patient/family desire. i personally discussed the above findings and recommendations with the patient's hcp and son and his questions were answered to his apparent satisfaction. <br> during the patient's admission, he was a full code. you may consider readdressing this in the future. <br> please note, the patient may have some dark stools given his recent gi bleed, but this should resolve over time. you may consider checking a hct if you are concerned that he is bleeding again, though the suspicion that his duodenal ulcers will bleed any more is small as he is on treatment for h. pylori and a high dose ppi. medications on admission: remeron 15mg qhs omeprazole 20 mg po bid celexa 20mg daily aricept 10mg daily namenda 10mg daily senna ferrous sulfate discharge medications: 1. donepezil 5 mg tablet sig: two (2) tablet po hs (at bedtime). 2. memantine 5 mg tablet sig: two (2) tablet po daily (). 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed: hold for loose stools. 4. acetaminophen 500 mg capsule sig: capsules po q 8 hours as needed. 5. mirtazapine 15 mg tablet sig: one (1) tablet po hs (at bedtime). 6. amoxicillin 250 mg capsule sig: four (4) capsule po q12h (every 12 hours) for 10 days. 7. clarithromycin 250 mg tablet sig: two (2) tablet po bid (2 times a day) for 10 days. 8. protonix 40 mg susp,delayed release for recon sig: forty (40) mg po twice a day. 9. ferrous sulfate 300 mg (60 mg iron)/5 ml liquid sig: three hundred (300) mg po daily (daily). discharge disposition: extended care facility: - discharge diagnosis: primary: 1) acute blood loss anemia - likely secondary to duodenal ulcerations, h. pylori ab positive 2) malnutrition, s/p g tube placement secondary: --adenocarcinoma s/p hemicolectomy in , metastatic to 1 out of three lymph nodes, ct report from this admission, showed "small retroperitoneal nodes are seen adjacent to the ivc measuring up to about 7 cm size (2:36). these are not markedly changed from the prior examination." --alzheimer's dementia --possible depression --history of renal failure secondary to obstructive uropathy discharge condition: good discharge instructions: please md if mr. is unable to tolerate his tube feeds, develops respiratory distress, pain, fever, or other concerning symptoms. followup instructions: please ensure patient has transporation to see his urologist, dr. phone: date/time: 10:30 please ensure patient has transportation to see his colonic surgeon , md phone: date/time: 11:15 consider oncologic evaluation for adjuvant therapy for his advanced mucinous adenocarcinoma procedure: enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] transfusion of packed cells diagnoses: acute posthemorrhagic anemia unspecified protein-calorie malnutrition chronic kidney disease, unspecified alzheimer's disease dementia in conditions classified elsewhere without behavioral disturbance chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction diverticulosis of colon (without mention of hemorrhage) helicobacter pylori [h. pylori] secondary and unspecified malignant neoplasm of intra-abdominal lymph nodes malignant neoplasm of rectosigmoid junction body mass index between 19-24, adult 

Answer: The patient is high likely exposed to