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: no allergies/adrs on file attending: chief complaint: gi bleed major surgical or invasive procedure: upper endoscopy central line placement arterial line placement intubation bronchoscopy history of present illness: this is a 42-year-old male with known alcoholism who presents from -n with gi bleed. per reports patient was taken into protective custody for section 35 for involuntary detox. while in the holding chamber, patient was noted to have a seizure and fell to the ground. he was found to be post-ictal with head laceration and was taken to -n for further evaluation of head injuries. while at -n patient was found to have projectile coffee ground emesis. patient was intubated for airway protection. of note patient had a prolonged, traumatic intubation requiring several attempts. patient was started on octreotide and protonix and given 6lns along with 2 units of prbcs and ffps. he was then sent to for further evaluation. per police recrods, patient on told father that he was "going to drink himself to death." father advised patient to call police however when patient did not, he did himself. police then placed patient in protective custody. on , patient was placed on section 35 for mandatory detox. on sw note, patient was noted to be very tremulous and patient had blood on shirt. in the ed, initial vs were: -patient was continued protonix and octreotide drip -there is a cuff leak and the et tube will likely need to be replaced. given that this was an extremely difficult intubation, and that he has ventilating and oxygenating very well it is safest to be done in the icu with anesthesia. -ctx was given for sbp prophylaxis -et tube was moved 4 cm -ng tube hooked to wall suction and put out coffee-grounds -liver and gi were consulted patient was then admitted to icu for further management. vs prior to transfer were hr 100 o2 sat 100% bp 94/52. . on arrival to the micu, patient was sedated and intubated. past medical history: - "liver disease" with "borderline ascites" - alcoholism - told he had 5 "spots" on lungs - recurrent epistaxis x 1 year - dysphagia social history: most details are unknown and except that is an alcoholic. per police records, was homeless as of . heavy drinking for the last 7 days. heavy tobacco use. recently evicted from apartment. family history: unknown physical exam: admission exam vitals: afebrile 91/65 96 97% on cmv 100% peep 5 500x14 general: intubated and sedated heent: pupils 1-2mm b/l og in place, putting coffee grounds, occipital laceration with 4 staples in place neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly gu: foley in place back: scattered ecchymoses ext: warm, well perfused, 2+ pulses, trace to 1+ edema b/l, scattered ecchymoses neuro: sedated physical examination: vs: 98.2 119/63 93 18 99%ra general: awake, alert, oriented x3 heent: sclera icteric. perrl, eomi. cardiac: rrr, s1 s2 no mrg lungs: ctab anteriorly, no crackles, wheezes or rhonchi. abdomen: nabs, soft, non-tender to palpation. no hsm or tenderness. extremities: warm and well perfused, no clubbing, cyanosis or edema. neuro: alert, oriented x3, no longer dysarthric, not agitated. pertinent results: 01:04am blood wbc-4.4 rbc-3.12* hgb-11.1* hct-33.3* mcv-107* mch-35.5* mchc-33.2 rdw-14.8 plt ct-33* 05:37am blood wbc-3.9* rbc-2.60* hgb-9.2* hct-27.9* mcv-107* mch-33.2* mchc-31.2 rdw-14.8 plt ct-82*# 12:13pm blood hct-29.8* 05:40pm blood hct-30.1* plt ct-36*# 09:29pm blood hct-31.1* plt ct-50* 01:04am blood wbc-4.2 rbc-2.69* hgb-9.1* hct-28.3* mcv-105* mch-33.9* mchc-32.2 rdw-14.7 plt ct-56* 05:15am blood hct-29.1* plt ct-50* 08:42am blood hct-28.0* plt ct-60* 01:25pm blood hct-25.7* plt ct-51* 04:56pm blood hct-26.1* 08:34pm blood hct-24.2* plt ct-53* 12:20am blood hct-27.2* plt ct-50* 04:16am blood wbc-3.9* rbc-2.48* hgb-8.5* hct-26.5* mcv-107* mch-34.3* mchc-32.2 rdw-15.3 plt ct-55* 11:40am blood wbc-4.1 rbc-2.53* hgb-8.9* hct-27.0* mcv-107* mch-35.3* mchc-33.1 rdw-15.3 plt ct-59* 04:31pm blood wbc-3.3* rbc-2.46* hgb-8.5* hct-26.4* mcv-107* mch-34.6* mchc-32.3 rdw-15.7* plt ct-67* 03:20am blood wbc-3.8* rbc-2.56* hgb-8.8* hct-27.4* mcv-107* mch-34.4* mchc-32.1 rdw-15.3 plt ct-73* 03:35pm blood wbc-2.9* rbc-2.68* hgb-9.2* hct-28.9* mcv-108* mch-34.3* mchc-31.8 rdw-15.5 plt ct-77* 04:00am blood wbc-3.3* rbc-2.91* hgb-9.8* hct-31.2* mcv-107* mch-33.6* mchc-31.3 rdw-15.0 plt ct-88* 03:55am blood wbc-4.3 rbc-2.93* hgb-10.0* hct-30.8* mcv-105* mch-34.1* mchc-32.5 rdw-14.9 plt ct-106* 04:13am blood wbc-4.9 rbc-2.99* hgb-10.1* hct-31.8* mcv-106* mch-34.0* mchc-31.9 rdw-15.1 plt ct-134* 04:43am blood wbc-5.6 rbc-3.09* hgb-10.7* hct-33.4* mcv-108* mch-34.5* mchc-31.9 rdw-15.3 plt ct-161 12:53pm blood wbc-6.7 rbc-3.18* hgb-10.9* hct-34.3* mcv-108* mch-34.3* mchc-31.8 rdw-15.0 plt ct-204 05:45am blood wbc-8.0 rbc-3.16* hgb-10.9* hct-34.3* mcv-109* mch-34.6* mchc-31.8 rdw-15.4 plt ct-217 05:55am blood wbc-8.5 rbc-3.08* hgb-10.5* hct-33.4* mcv-108* mch-34.0* mchc-31.4 rdw-15.5 plt ct-226 05:55am blood wbc-9.7 rbc-3.06* hgb-10.4* hct-33.3* mcv-109* mch-34.0* mchc-31.3 rdw-15.5 plt ct-249 09:40am blood wbc-9.8 rbc-3.11* hgb-10.8* hct-34.0* mcv-109* mch-34.6* mchc-31.7 rdw-15.4 plt ct-251 06:00am blood wbc-9.8 rbc-3.14* hgb-10.6* hct-34.5* mcv-110* mch-33.9* mchc-30.8* rdw-15.1 plt ct-264 06:28am blood wbc-8.9 rbc-2.79* hgb-9.4* hct-29.8* mcv-107* mch-33.8* mchc-31.6 rdw-15.3 plt ct-241 01:00pm blood wbc-9.5 rbc-3.08* hgb-10.4* hct-33.1* mcv-108* mch-33.9* mchc-31.5 rdw-15.5 plt ct-246 05:45am blood wbc-7.9 rbc-2.80* hgb-9.6* hct-29.8* mcv-107* mch-34.4* mchc-32.2 rdw-15.7* plt ct-216 05:45am blood wbc-8.6 rbc-2.68* hgb-9.3* hct-28.6* mcv-107* mch-34.6* mchc-32.5 rdw-15.8* plt ct-210 05:35am blood wbc-7.8 rbc-2.74* hgb-9.4* hct-29.3* mcv-107* mch-34.2* mchc-32.0 rdw-15.8* plt ct-206 02:12am blood pt-14.6* ptt-32.6 inr(pt)-1.4* 06:38pm blood pt-15.0* inr(pt)-1.4* 01:04am blood pt-16.2* ptt-34.6 inr(pt)-1.5* 03:20am blood pt-15.5* ptt-33.7 inr(pt)-1.5* 10:56am blood pt-16.1* ptt-34.0 inr(pt)-1.5* 03:55am blood pt-17.1* ptt-35.5 inr(pt)-1.6* 04:13am blood pt-17.5* ptt-34.0 inr(pt)-1.6* 04:43am blood pt-16.3* ptt-33.7 inr(pt)-1.5* 05:45am blood pt-16.0* ptt-36.0 inr(pt)-1.5* 05:55am blood pt-15.0* ptt-39.3* inr(pt)-1.4* 05:55am blood pt-15.4* ptt-35.6 inr(pt)-1.4* 09:40am blood pt-15.8* ptt-38.7* inr(pt)-1.5* 06:00am blood pt-15.7* ptt-41.2* inr(pt)-1.5* 06:28am blood pt-15.9* ptt-40.4* inr(pt)-1.5* 05:45am blood pt-16.3* ptt-48.0* inr(pt)-1.5* 05:45am blood pt-16.7* inr(pt)-1.6* 05:35am blood pt-15.5* ptt-37.7* inr(pt)-1.5* 05:35am blood pt-15.5* ptt-37.7* inr(pt)-1.5* 02:12am blood glucose-104* urean-5* creat-0.6 na-140 k-3.2* cl-103 hco3-30 angap-10 12:13pm blood glucose-78 urean-8 creat-0.9 na-140 k-3.1* cl-104 hco3-29 angap-10 09:29pm blood urean-10 creat-0.8 na-141 k-3.5 cl-109* hco3-25 angap-11 01:04am blood glucose-79 urean-10 creat-0.8 na-142 k-4.0 cl-110* hco3-24 angap-12 01:25pm blood glucose-62* urean-13 creat-0.8 na-142 k-3.5 cl-112* hco3-22 angap-12 04:16am blood glucose-72 urean-17 creat-1.0 na-138 k-3.7 cl-108 hco3-21* angap-13 04:31pm blood glucose-96 urean-19 creat-1.1 na-140 k-3.5 cl-108 hco3-23 angap-13 03:20am blood glucose-101* urean-20 creat-1.3* na-144 k-3.8 cl-109* hco3-24 angap-15 03:35pm blood glucose-125* urean-19 creat-1.3* na-145 k-3.6 cl-110* hco3-26 angap-13 04:00am blood glucose-135* urean-20 creat-1.2 na-145 k-3.6 cl-106 hco3-27 angap-16 04:26pm blood glucose-120* urean-20 creat-1.2 na-145 k-3.6 cl-105 hco3-30 angap-14 03:55am blood glucose-114* urean-18 creat-1.1 na-145 k-3.2* cl-102 hco3-32 angap-14 02:41pm blood glucose-123* urean-19 creat-1.2 na-146* k-3.4 cl-104 hco3-31 angap-14 04:13am blood glucose-121* urean-18 creat-1.1 na-147* k-3.6 cl-106 hco3-30 angap-15 04:43am blood glucose-112* urean-22* creat-0.9 na-146* k-3.9 cl-108 hco3-26 angap-16 05:45am blood glucose-106* urean-30* creat-1.3* na-148* k-3.7 cl-108 hco3-25 angap-19 05:55am blood glucose-100 urean-30* creat-1.3* na-148* k-3.6 cl-110* hco3-25 angap-17 05:55am blood glucose-96 urean-24* creat-1.1 na-148* k-3.4 cl-110* hco3-23 angap-18 09:40am blood glucose-143* urean-20 creat-1.1 na-144 k-3.4 cl-108 hco3-26 angap-13 06:00am blood glucose-104* urean-24* creat-1.2 na-145 k-3.9 cl-108 hco3-24 angap-17 06:28am blood glucose-101* urean-26* creat-1.1 na-140 k-3.6 cl-105 hco3-21* angap-18 05:45am blood glucose-101* urean-21* creat-0.9 na-137 k-3.6 cl-104 hco3-21* angap-16 05:45am blood glucose-98 urean-18 creat-1.0 na-137 k-3.7 cl-104 hco3-20* angap-17 05:35am blood glucose-96 urean-16 creat-0.9 na-133 k-3.7 cl-102 hco3-20* angap-15 02:12am blood alt-31 ast-191* alkphos-128 totbili-4.2* 06:38pm blood ld(ldh)-282* 01:04am blood alt-26 ast-162* alkphos-104 totbili-4.9* 04:16am blood alt-24 ast-129* ld(ldh)-228 alkphos-101 totbili-6.4* 03:20am blood alt-23 ast-118* alkphos-100 totbili-7.6* 04:00am blood alt-26 ast-116* ld(ldh)-250 alkphos-114 totbili-8.1* 03:55am blood alt-27 ast-121* ld(ldh)-278* alkphos-117 totbili-9.4* 04:13am blood alt-29 ast-124* alkphos-138* totbili-10.8* 04:43am blood alt-33 ast-131* alkphos-144* totbili-9.6* 05:45am blood alt-32 ast-131* alkphos-136* totbili-9.8* 05:55am blood alt-35 ast-135* alkphos-132* totbili-9.6* 05:55am blood alt-37 ast-130* alkphos-117 totbili-10.0* 09:40am blood alt-40 ast-146* alkphos-121 totbili-11.0* 06:00am blood alt-40 ast-157* alkphos-142* totbili-10.7* 06:28am blood alt-36 ast-143* alkphos-129 totbili-9.6* 05:45am blood alt-35 ast-142* alkphos-138* totbili-9.5* 05:45am blood alt-35 ast-147* alkphos-132* totbili-9.8* 05:35am blood alt-34 ast-141* alkphos-136* totbili-9.2* 05:35am blood albumin-3.4* 06:38pm blood hapto-10* 06:38pm blood d-dimer-1761* 06:00am blood vitb12-1257* folate-7.1 06:00am blood tsh-3.9 02:12am blood hbsag-negative hbsab-borderline hbcab-negative 03:42pm blood smooth-negative 09:34am blood ama-negative 09:34am blood -negative 03:42pm blood igg-1170 igm-52 12:20am blood vanco-12.5 05:14am blood vanco-10.9 02:12am blood hcv ab-negative ceruloplasmin test result reference range/units ceruloplasmin 26 18-36 mg/dl this test was performed at: - , , md comment: chem # 62442e alpha-1-antitrypsin test result reference range/units alpha-1-antitrypsin qn 159 83-199 mg/dl this test was performed at: - , , md comment: chem # 62442e 04:45am urine blood-lg nitrite-neg protein-30 glucose-neg ketone-neg bilirub-sm urobiln-2* ph-6.0 leuks-mod 08:51pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-6.0 leuks-neg 09:16am urine blood-neg nitrite-neg protein-30 glucose-neg ketone-neg bilirub-mod urobiln-neg ph-6.0 leuks-neg 04:45am urine rbc-26* wbc-32* bacteri-few yeast-none epi-1 09:16am urine rbc-1 wbc-5 bacteri-few yeast-none epi-0 nonsqep-<1 7:54 pm sputum source: endotracheal. **final report ** gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 1+ (<1 per 1000x field): gram positive cocci. in pairs and clusters. respiratory culture (final ): commensal respiratory flora absent. staph aureus coag +. sparse growth of two colonial morphologies. staphylococcus species may develop resistance during prolonged therapy with quinolones. therefore, isolates that are initially susceptible may become resistant within three to four days after initiation of therapy. testing of repeat isolates may be warranted. sensitivities: mic expressed in mcg/ml _________________________________________________________ staph aureus coag + | clindamycin-----------<=0.25 s erythromycin----------<=0.25 s gentamicin------------ <=0.5 s levofloxacin----------<=0.12 s oxacillin-------------<=0.25 s trimethoprim/sulfa---- <=0.5 s ruq u/s : impression: 1. echogenic liver compatible with fatty infiltration, although other forms of cirrhosis/fibrosis are favored. 2. non-distended gallbladder with wall edema likely reflecting sequelae of hepatic disease. 3. patent hepatic vasculature, but reversal of left portal vein flow, suggesting a degree of portal hypertension. 4. splenomegaly. egd : findings: esophagus: other a dark flat spot was noted in the lower esophagus, extending 2 cm above the ge junction to the ge junction. there was no apparent clot, ulceration, tear, or varix at this location. as the lesion was not bleeding, no therapy was applied. no esophageal varices. stomach: contents: coffee ground heme was seen in the whole stomach. mucosa: diffuse granularity and mosaic appearance of the mucosa were noted in the stomach. these findings are compatible with portal hypertensive gastropathy. flat lesions three red spots with adherent clots were noted in the stomach cardia and fundus. these had the appearance of visible vessels. the clots were removed by washing and suctioning, for visualization of the underlying lesions. there were no gastric varices or ulcerations seen. a gold probe was successfully applied to each of these spots successfully for hemostasis. other no gastric varices. duodenum: mucosa: localized erythema and granularity of the mucosa with no bleeding were noted in the duodenal bulb compatible with bulbar duodenitis. impression: coffee ground heme in the stomach. portal hypertensive gastropathy. three flat red spots in the stomach cardia and fundus, with adherent clots, treated with cautery. (thermal therapy) bulbar duodenitis. single dark flat spot in the lower esophagus to the ge junction, without clot, ulceration, tear, or varix. no esophageal varices. no gastric varices. otherwise normal egd to third part of the duodenum brief hospital course: primary reason for hospitalization: patient is a 42yo male with known alcoholism on section 35 for involuntary detox presenting s/p fall found to have coffee ground emesis transferred for management of gi bleed and alcoholic liver disease. # gi bleed: patient presented with coffee ground emesis and upper gi bleed suspected. he underwent egd without evidence of varices, but found to have 3 ulcers. he required 2 units of prbcs and 3 units of platelets during admission. he was initially started on octreotide, ppi, and sucralfate. octreotide was discontinued given no varices. he completed 5 days of abx for sbp prophylaxis. he was also found to be h. pylori positive and was started on triple therapy. # airway management/respiratory status: patient intubated at osh for airway protection in the setting of altered mental status and ugib. he was extubated successfully on . his fluid overload was treated with lasix . # pna: cxr concerning for bilateral lower lobe consolidations. repeat cxr on showed increased retrocardiac opacity. patient was initially started on ceftriaxone for sbp prophylaxis which was changed to vanc/cefepime/flagyl on . this was subsequently changed to vanc/zosyn and then vanc d/c on and zosyn d/c on . his sputum grew mssa. spiked no further fevers throughout the hospitalization. # alcoholic cirrhosis/etoh abuse: patient presented without known history of liver disease, however imaging suggestive of cirrhosis. given etoh history, ast>alt with rising tbili likely related to etoh vs decompensation secondary to gi bleed. hepatitis serologies negative. , ama, smooth negative, alpha antitrypsin, ceruloplasmin negative. he was started on lactulose and rifaxamin. he was not treated for alcoholic hepatitis with steroids due to recent gi bleed but was started on pentoxyphylline as his discriminant function score was 36. lfts plateaued and began to downtrend a few days prior to discharge. his nutritional status was supported initially with tube feeds, multivitamin, thiamine, folate. # head laceration/head strike: prior to presentation patient fell and hit head with +loc. he had ct head and neck which were negative for acute process. he was placed in a c-collar which was cleared after patient was extubated. patient underwent laceration repair with 4 staples in ed which were removed on . # altered mental status: patient arrived intubed and sedated. he required large amounts of benzos for sedation and withdrawal purposes. his midazolam was switched to precedex prior to extubation and his ciwa scale was discontinued on day 5 to avoid additional benzo administration. after extubated patient continued to remain altered. this was likely multifactorial from excessive benzo administration taking time to clear, hepatic encephalopathy, and icu delirium. patient was continued on lactulose and was started on standing olanzapine, which ultimately was discontinued after psych consultation as it caused him to be dysarthric. # section 35/depression: patient was apparently saying he??????s going to ??????drink himself to death??????. when mental status cleared, he no longer expressed these symptoms. he was initiatially under section 35 (involuntary detox) per his father, however since he was admitted to the hospital and underwent detox here, the section 35 was suspended. the patient was discharged into the care of his mother temporarily, however there was nothing further to be done to prevent him from drinking as his father would have to go back to court to have the section 35 reinstated. transitional issues: - needs pcp (provided # to ) - needs hepatologist (provided # to liver here) - needs enrollement in relapse prevention program medications on admission: none discharge medications: 1. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po q6h (every 6 hours). disp:*3600 ml(s)* refills:*2* 2. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. pentoxifylline 400 mg tablet extended release sig: one (1) tablet extended release po tid (3 times a day). disp:*63 tablet extended release(s)* refills:*0* 5. amoxicillin 500 mg tablet sig: two (2) tablet po twice a day for 3 days. disp:*12 tablet(s)* refills:*0* 6. clarithromycin 500 mg tablet sig: one (1) tablet po twice a day for 3 days. disp:*6 tablet(s)* refills:*0* 7. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day for 3 days. disp:*3 capsule, delayed release(e.c.)(s)* refills:*0* 8. rifaximin 550 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 9. epipen 0.3 mg/0.3 ml pen injector sig: one (1) 1 injection intramuscular as needed: as needed for bee stings. disp:*1 pen* refills:*0* discharge disposition: home discharge diagnosis: alcohol withdrawal seizure upper gastrointestinal bleed aspiration pneumonia h.pylori infection alcoholic hepatitis alcoholic cirrhosis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. you are able to walk but are not safe to be out on your own. for this reason you are being discharged into the care of your mother for the time being till you recover further. discharge instructions: you were admitted for seizure, gastrointestinal bleeding, severe alcohol withdrawal, cirrhosis of the liver and alcoholic hepatitis. you were treated for 16 days with resolution of most of your medical issues. your alcoholic hepatitis (liver inflammation from alcohol) has improved but is not 100% better. if you drink again, you risk severe liver injury and death, including "sips" of alcohol; there is no "safe" amount of alcohol for you to drink from now on. please note that you are being discharged on new medications for your liver disease. please take them as prescribed. followup instructions: please call clinic here to establish care with a new primary care doctor at . with a hepatologist of your choice, call and make an appointment to be seen in weeks. you have advanced liver disease and will need to be followed for this in the future. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube enteral infusion of concentrated nutritional substances other bronchoscopy arterial catheterization endoscopic control of gastric or duodenal bleeding diagnoses: toxic encephalopathy alcoholic cirrhosis of liver acute kidney failure, unspecified unspecified septicemia severe sepsis portal hypertension other convulsions unspecified fall open wound of forehead, without mention of complication acute respiratory failure defibrination syndrome pneumonitis due to inhalation of food or vomitus methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site septic shock hepatic encephalopathy duodenitis, without mention of hemorrhage hemorrhage of gastrointestinal tract, unspecified hyperosmolality and/or hypernatremia other specified disorders of stomach and duodenum helicobacter pylori [h. pylori] other and unspecified alcohol dependence, continuous acute alcoholic hepatitis alcohol withdrawal benzodiazepine-based tranquilizers causing adverse effects in therapeutic use other diuretics causing adverse effects in therapeutic use physical restraints status 

Answer: The patient is high likely exposed to