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: patient recorded as having no known allergies to drugs attending: chief complaint: transfer from osh with hypercarbic respiratory failure and acute transaminitis major surgical or invasive procedure: intubated and extubated history of present illness: this is a 55 year old woman with a history of depression, hip replacement, etoh abuse, who presented to an osh ed with cp, sob, and nausea. patient is currently intubated and sedated, so history is obtained form osh records and her children. per patient's son and daughter, she was not feeling well for the last several days. she had complained of dizziness, lightheadedness, and nausea. she also may have fainted and had a fall 2 days prior to admission. for the last day, she has had shortness of breath and chest heaviness. the family do not believe that she had fevers, chills, or cough. they are not certain of any other symptoms. she went to an osh ed because of the sob and chest heaviness. . on arrival at the osh ed, hr was 82, bp 130/80. o2 sat was noted to be 81% on 4l nc and she was placed on nrb. sl ntg was given due to pt c/o chest heaviness. a dose of lovenox was also given. the patient's son called in to say that the patient had been taking multiple meds for hip and back pain, including darvocet, percocet, and vicodin, as well as ativan and etoh. for this reason, narcan was given. it does not appear that there was any improvement in her respiratory status. flumazenil was also given, with no improvement. abg was done: 7.094/90.9/73. the patient was intubated (etomidate and succinylcholine given). ngt was inserted. ativan was given for agitation with no effect, versed was given with better effect. propofol was then started. repeat abg was 7.41/35/171 on vent settings ac at 550x18, peep 5, fio2 100%. mucomyst 14g was given via ngt. she was noted to have about 350cc blood from ngt, then later vomited bloody brown material around ngt. 2u ffp were started as the patient was ready to be transferred. protonix 80mg iv and a dose of zosyn were also given (for t 101). by report, blood cultures were drawn. . the patient was then transferred to for icu level care. past medical history: htn s/p hip replacement in chronic back pain depression etoh abuse social history: lives with youngest daughter, currently in a hotel while apartment is being renovated. not working, on disability. quit smoking 7yrs ago. smoked 1/2ppd for 7 yrs. drinks 1 pint of vodka. no ivdu. family history: father had mi and peripheral nueropathy physical exam: vs: 99.5, 57, 174/72, 19, 100% (on ac vt 550, rr 18, peep 5, fio2 100%) gen: intubated and sedated heent: ett in place neck: unable to assess jvp lungs: coarse breath sounds b/l heart: bradycardic, regular, no m/r/g abd: hypoactive bs, soft, obese, nt/nd extrem: warm, dry, no edema pertinent results: 01:30am blood wbc-9.0 rbc-3.38* hgb-11.4* hct-32.4* mcv-96 mch-33.8* mchc-35.3* rdw-16.1* plt ct-97* 03:57am blood wbc-6.2 rbc-2.95* hgb-9.8* hct-28.4* mcv-96 mch-33.1* mchc-34.5 rdw-14.8 plt ct-113* 01:30am blood pt-17.4* ptt-32.8 inr(pt)-1.6* 03:57am blood glucose-73 urean-39* creat-5.8*# na-142 k-3.7 cl-99 hco3-21* 01:30am blood glucose-122* urean-25* creat-1.4* na-140 k-3.2* cl-101 hco3-24 angap-18 03:57am blood alt-415* ast-47* ld(ldh)-308* alkphos-132* amylase-316* totbili-1.6* 01:30am blood alt-5935* ast-* ld(ldh)-* ck(cpk)-213* alkphos-80 amylase-215* totbili-1.0 03:57am blood lipase-484* 04:08pm blood lipase-671* 01:30am blood lipase-192* 01:30am blood ck-mb-1 ctropnt-<0.01 probnp-4144* 03:57am blood albumin-3.0* calcium-9.4 phos-9.1*# mg-2.6 04:08pm blood hapto-68 01:30am blood caltibc-338 ferritn-greater th trf-260 12:18pm blood acetone-negative 01:30am blood tsh-0.99 01:30am blood hbsag-negative hbsab-negative hbcab-negative igm hav-negative 04:42pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 01:30am blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 01:30am blood hcv ab-negative 03:46am blood type-art temp-37.5 rates-18/ tidal v-550 peep-5 fio2-100 po2-456* pco2-31* ph-7.54* caltco2-27 base xs-5 aado2-251 req o2-48 -assist/con intubat-intubated 10:55am blood type-art temp-37.2 po2-125* pco2-47* ph-7.34* caltco2-26 base xs-0 intubat-intubated 03:46am blood lactate-2.0 12:50pm urine color-yellow appear-clear sp -1.013 12:50pm urine blood-lg nitrite-neg protein-30 glucose-tr ketone-15 bilirub-neg urobiln-neg ph-5.0 leuks-neg 12:50pm urine rbc-* wbc- bacteri-few yeast-few epi-0-2 12:50pm urine hours-random creat-42 na-53 12:50pm urine osmolal-315 05:58am urine bnzodzp-pos barbitr-neg opiates-pos cocaine-neg amphetm-neg mthdone-neg . bcx : no growth ucx : no growth . 3:44 pm sputum gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 4+ (>10 per 1000x field): multiple organisms consistent with oropharyngeal flora. respiratory culture (preliminary): due to mixed bacterial types ( >= 3 colony types) an abbreviated workup will be performed appropriate to the isolates recovered from this site. moderate growth oropharyngeal flora. gram negative rod(s). moderate growth. of two colonial morphologies. staph aureus coag +. heavy growth. . head ct : normal head ct . abd u/s :impression: 1. no biliary ductal dilatation or focal liver mass. 2. normal liver doppler. . cxr : heart size is top normal. pulmonary mediastinal vasculature is distended. ascending thoracic aorta may be significantly enlarged. nasogastric tube ends in the stomach. et tube in standard placement. no pneumothorax or pleural effusion. no evidence of pneumonia. . renal ultrasound : no obstructing stones or hydronephrosis. brief hospital course: this is a 55 year old woman with a history of depression, etoh abuse, back pain, s/p hip replacement, htn, who presents with hypercarbic respiratory failure and acute transaminitis. . # respiratory failure: initially hypercarbic respiratory failure and had significant ag metabolic acidosis which resolved with hd. etiology of resp failure likely to medications. ?hypoventilation vs dead-space. cns process ruled out with normal head ct. cxr not impressive for pna or chf. blood and urine cultures negative. serum tox repeat negative x2, urine positive for benzos and opiates-likely from ativan and darvon. echo : preserved regional/global biventricular systolic function. moderate tricuspid regurgitation. mild aortic regurgitation. mild mitral regurgitation. bnp elevated at 4,000, however cxr not impressive for volume overload, although heart size appears enlarged. extubation on , now doing well with no o2 requirments, no chest pain, and no sob. at time of discharge, patient's respiratory status resolved to her baseline prior to admission without symptoms of dyspnea and without o2 requirement. . # acute hepatitis/liver failure: transaminases initially rose to alt 6,000s and ast 16,000s. likely due to toxicity from darvon. received nac 14g at osh and continued her until . on admission, received activated charcoal and banana bag. synthetic function preserved (inr peaked at 1.6 and improved to 1.1, albumin 3.9). hepatitis panel negative. abdominal u/s w/dopplers unremarkable. hemolysis labs negative. liver function improved to normal lfts by time of discharge. . # acid/base: had significant ag metabolic acidosis (33)which improved with hd. likely to her renal failure and cell death from liver failure or toxin. renal u/s neg. has now had hd x 5 (as of ). u/a on had 30 protein and 15 ketones. on discharge her ag metabolic acidosis had resolved. . # arf: cr 1.4 on admission, baseline unknown. peaked at 7.9 during hospital course. renally dosed meds and nephrotoxins were avoided. renal u/s negative for hydronephrosis. renal failure was thought most likely secondary to atn. hemodialysis was initiated while inpatient with first session on and will follow up with hd as outpatient as well. she has been instructed on renal diet and will adhere to this as an outpatient. . # gi bleed: noted to have bloody ngt drainage and bloody brown emesis at osh. not clear if guaiac was checked from ngt. there was no further evidence of bleeding during her hospital stay. she remained guaiac negative from below. . # anemia: baseline hematocrit during this hospitalization has been in the low 30s. in osh was 42 and had ugib as above at osh. retic count 2.8. iron studies revealed iron 43, tibc 306, ferritin 305. ferrous sulfate was initiated at 325 mg po tid for iron deficiency anemia. she had drop in hct to 27s, with repeat checks stable and without a source of bleeding including gi. she will need hct monitoring as an outpatient to ensure stability. . # sinus bradycardia: was found to be bradycardic upon transfer, but bp stable. pt is on bb at home, but based on pill count did not appear to have overdosed. head ct negative for intracranial process. tte unremarkable. her beta blocker was held during her stay and its reinitiation should be reevaluated in follow up. . # peripheral neuropathy: she now has increased sensation in feet although it remains difficult to walk. normally takes darvon for pain. she was started on neurontin 100 which can be titrated up as appropriate in outpatient setting. . # etoh use/abuse: per patient's children, has at least drinks per day. did not show signs of withdrawal during her hospital stay. given her acute hepatitis, she was instructed to avoid etoh. she will likely need social work and or substance abuse counseling as outpatient as well. . # pancreatitis: amylase/lipase elevated on admission and had normalized by time of discharge. . # hypertension: her beta blocker was held due to bradycardia as above, and was held in the setting of renal failure. she was started on amlodipine for htn which she tolerated well, on which she will be discharged. . # depression: her home meds of wellbutrin and effexor were held given her renal and hepatic failure. if continued improvement, pcp may opt to reinitiate as an outpatient. even with their discontinuation, her mood has remained stable here. medications on admission: lasix 40mg qd toprol 50mg qd wellbutrin 100mg qd effexor 37.5g tid darvon 65mg tid diovan discharge medications: 1. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily): for high blood pressure. disp:*60 tablet(s)* refills:*2* 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 3. sevelamer 800 mg tablet sig: two (2) tablet po tid (3 times a day). disp:*180 tablet(s)* refills:*0* 4. gabapentin 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 5. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. bisacodyl 10 mg suppository sig: one (1) suppository rectal hs (at bedtime) as needed: for constipation. disp:*30 suppository(s)* refills:*0* 7. neomycin-polymyxin-hc 3.5-10,000-1 mg-unit/ml-% drops, suspension sig: five (5) drop otic tid (3 times a day) for 8 days. disp:*qs ml* refills:*0* 8. outpatient lab work please check hematocrit at next hemodialysis session on thursday . please phone result to patient's primary care doctor, dr. discharge disposition: home with service facility: vna of the discharge diagnosis: primary hypercarbic respiratory failure hepatitis acute renal failure . secondary hypertension peripheral neuropathy chronic back pain depression etoh abuse discharge condition: stable with no oxygen requirements, recovered liver function, and on hemodialysis for renal failure. discharge instructions: you were admitted to the hospital for respiratory and liver failure with subsequent renal failure. please return to the emergency room or call your doctor if you experience any of the following symptoms: fever > 101.5, intractable nausea/vomiting, dizziness or light-headedness, diarrhea, bleeding, rashes, swelling, increasing redness/pain at your dialysis catheter site, or any other concerning symptoms. . please take all medications as prescribed. you should avoid all alcholic beverages and avoid tylenol currently as your liver is recovering from significant damage. . please also adhere to the renal diet as outlined during your hospital stay. . please follow up as scheduled for hemodialysis on thursday , where you will be followed by a nephrologist . please follow-up with hepatology dr. at 8:30 am on . . please follow up with your pcp, . , post office square, , phone: ( on monday, at 10:45am. followup instructions: please follow up as scheduled for hemodialysis on thursday , where you will be followed by a nephrologist . please follow-up with the liver clinic, dr. at 8:30 am on . . please call your pcp, . , post office square, , phone: ( on monday, at 10:45am. procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more hemodialysis venous catheterization for renal dialysis venous catheterization for renal dialysis diagnoses: acidosis unspecified essential hypertension acute and subacute necrosis of liver acute kidney failure, unspecified depressive disorder, not elsewhere classified acute respiratory failure hemorrhage of gastrointestinal tract, unspecified hyperosmolality and/or hypernatremia unspecified hereditary and idiopathic peripheral neuropathy backache, unspecified alcohol abuse, continuous acute pancreatitis acute alcoholic hepatitis acute edema of lung, unspecified 

Answer: The patient is high likely exposed to