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: found down / altered mental status major surgical or invasive procedure: orif of anterior mandibular fracture tracheal intubation mechanical ventilation history of present illness: patient is a 51 year-old woman found down in the rain by ems, some report of whether she had visited another er previously today (by speaking to other medics). altered mental status, moaning not answering questions. several empty bottles of listerine nearby. . inital vitas on the ed were 120 20 110/70 99%. on arrival to the ed, she spontaneously opened her eyes, moaning, intermittently following commands. she was found to have increase secretions with a gcs 13 and was not protecting her airway, thus she was intubated for airway protection. labs in the ed were notable for an alcohol level 423, lactate of 4.4, wbc 14.4 w/ 72% pmns, anion gap 16, osm gap 106 that is explained by etoh level of 423, and negative ua/utox. ct head did not identify acute intracranial process or crainal fracture and ct c-spine identified possible mandibular fracture and anterior subluxation of right mandibular condyle. the decision made to admit the patient to the micu. vs on transfer were 31.1c, 59, 103/70, 18, 100% ventilated. . on arrival to the micu, patient is intubated and sedated. she open eyes and follows commands. past medical history: depression with prior suicide attempts anxiety etoh abuse social history: recently moved back to us from with husband etoh: endorses heavy use since age 29, when she had her first son, with first use in teenage years. current use as above. denies h/o dt or withdrawal seizure, but frequently has tremor. tob: none current other: denies illicits social history: from mn, oldest of 3 children in intact family. completed college and worked as a corporate trainer. married x25 years and now is a housewife, mother of 3 children (youngest is 17). has lived in cities around the world with her husband, who works internationally, and most recently moved to from . forensics history notable for 2 past , does not currently drive. family history: father with likely depression, no formal treatment. no fh or suicide or substance use disorders. physical exam: admission physical exam: general: intubated and sedated, comfortable and following commands heent: sclera anicteric, pupils 4mm to 3mm bl neck: jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs lungs: symmetric breath sounds bilaterally, no wheezes or rales abdomen: soft, non-distended, bowel sounds present, no organomegaly ext: well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: cnii-xii intact, 5/5 strength upper/lower extremities, grossly normal sensation, 2+ reflexes bilaterally, gait deferred, finger-to-nose intact pertinent results: admission labs 06:39am urine ucg-negative 05:17am blood asa-neg ethanol-423* acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 05:17am blood osmolal-408* 06:33am blood type-art temp-30.9 rates-/18 tidal v-500 fio2-100 po2-294* pco2-22* ph-7.47* caltco2-16* base xs--4 aado2-401 req o2-70 -assist/con intubat-intubated 05:28am blood glucose-161* lactate-4.4* na-146* k-4.4 cl-110* calhco3-17* 05:28am blood hgb-14.3 calchct-43 o2 sat-96 cohgb-2 methgb-0 05:28am blood freeca-0.99* 05:42am blood glucose-85 urean-5* creat-0.4 na-141 k-3.0* cl-104 hco3-27 angap-13 05:17am blood wbc-14.4* rbc-4.24 hgb-13.6 hct-40.7 mcv-96 mch-32.0 mchc-33.3 rdw-13.3 plt ct-302 05:42am blood wbc-5.3# rbc-3.78* hgb-12.1 hct-36.1 mcv-95 mch-32.1* mchc-33.7 rdw-13.5 plt ct-198 05:17am blood neuts-72.0* lymphs-24.2 monos-2.4 eos-0.5 baso-0.8 . discharge labs: . imaging: cxr ]: findings: the et tube ends 6.1 cm above the level of the carina. an ng tube ends near the level of the ge junction. a trauma board slightly limits evaluation of this radiograph. the lungs are clear. lung volumes are low. the cardiac and mediastinal contours are normal. there are no pleural effusions. no pneumothorax is seen. the bony thorax is grossly intact. impression: 1. no acute cardiac or pulmonary process. 2. appropriately positioned endotracheal tube. 3. ng tube ends near the level of the ge junction. recommend advancing. . ct cspine ]: findings: there is no acute fracture of the cervical spinal or malalignment, although there is slight loss of the normal cervical lordosis. multilevel degenerative changes of the cervical spine include small anterior osteophytes and mild posterior disc bulging at c5-6 with minimal associated narrowing of the spinal canal. a lucency through the right paramedian portion of the mandible (3:29) could be a non-displaced fracture, but is incompletely evaluated on the present study (3:28). the right mandibular condyle is subluxed anteriorly. there are no pathologically enlarged cervical lymph nodes. the orogastric tube is coiled within the pharynx. an et tube is present. the visualized portions of the lung apices are unremarkable aside from biapical pleuroparenchymal thickening/scarring. there is minimal left maxillary sinus mucosal thickening. the remainder of the visualized portions of the paranasal sinuses and mastoid air cells are well aerated. impression: 1. no acute cervical fracture or malalignment. 2. possible fracture through the body of the mandible is incompletely assessed on the present study. further evaluation with a dedicated maxillofacial ct could be performed. 3. anterior subluxation of the right mandibular condyle. 4. orogastric tube is looped within the oropharynx. recommend repositioning. . ct head ]: findings: there is no evidence of intracranial hemorrhage, edema, shift of normally midline structures, hydrocephalus, or acute large vascular territorial infarction. aside from minimal left maxillary sinus mucosal thickening, the visualized portions of the paranasal sinuses and mastoid air cells are well aerated. no fractures are identified. the left mandibular condyle is subluxed slightly anteriorly, of uncertain chronicity. note is made of a right parietal subgaleal hematoma. impression: 1. no acute intracranial process. 2. slight anterior subluxation of the right mandibular condyle, of uncertain chronicity. 3. right parietal subgaleal hematoma. . ct sinus ]: findings: there is an acute comminuted and nondisplaced fracture of the anterior body of the right mandible. this extends to, but does not appear to involve, the roots of the right central and lateral incisors. the right mental foramen is spared. there is no significant surrounding fat stranding or large fluid collections. the submandibular and sublingual glands appear symmetric. tmuscles of the floor of mouth appear intact. cervical lymph nodes are not pathologically enlarged. the right mandibular condyle is anteriorly and inferiorly subluxed from the right glenoid fossa. it appears irregularly enlarged and dystrophic, suggesting prior trauma and/or degenerative changes. mild mucosal thickening is noted throughout the ethmoid and maxillary sinuses. there is mild rightward deviation of the nasal septum, with a broad-based bony spur that does not contact the middle meatus. the ostiomeatal units are widely patent. the lamina papyracea are intact. note is made of type 2 olfactory fossae bilaterally. imaged frontal calvarium, nasal bones, facial bones, and maxilla appear intact. upper cervical spine is within normal limits. the airway is widely patent. impression: 1. comminuted nondisplaced fracture of the right anterior mandibular body. 2. dystrophic right mandibular condyle, with anterior and inferior subluxation. . micro: 9:45 am sputum source: endotracheal. **final report ** gram stain (final ): <10 pmns and >10 epithelial cells/100x field. gram stain indicates extensive contamination with upper respiratory secretions. bacterial culture results are invalid. please submit another specimen. blood culture - pending mrsa screen - final urine culture - final brief hospital course: 51 year-old woman with unknown medical history presenting with ams after being found down in the rain by ems found to have a etoh level of 423 and intubated for airway protection admitted for alcohol intoxication found to have comminuted jaw fracture. . active issues: # jaw fracture: patient was taken to the or on for orif of mandible. pt recovered in pacu and was then transferred to general medicine floors. pain was controlled oxycodone and tylenol for adjunctive therapy. oral surgery followed pain and recommended a soft/pureed diet and will follow up with patient in clinic. oral surgery will arrange for follup. # etoh intoxication/altered mental status: patient was initially found down outside and was hypothermic on arrival to ed. serum etoh level was 423. pt was intubated for airway protection in ed. after admission the icu, patient was extubated. after extubation patient alert and oriented x 3. initial altered state was attributed to etoh intoxication. psychiatry and social work saw patient who felt that she was not at harm to herself. however after discussion with patient and husband, patient decided to go home first and then enter a program. pt was given information of several dual diagnosis programs in the area. pt was monitored closely for withdrawal symptoms and required minimal support. # elevated ck: patient arrived to ed with elevated ck likely in setting of being found down. this value normalized with aggressive fluid hydration. # depression/anxiety: patient with long standing depression/anxiety with prior suicide attempts. patient was clear that current admission was not a result of intentional self harm. pt currently not any psychotropic agents. psychiatry was consulted who recommended dual diagnosis program of which the patient was amenable to attending. transitional issues 1) patient was need further outpatient psychiatric support for dual diagnosis. 2) pending: blood cultures from are pending at discharge. call to obtain final results 3) code status: full code (confirmed) medications on admission: none discharge medications: 1. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 2. thiamine hcl 100 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 3. acetaminophen 325 mg tablet sig: two (2) tablet po tid (3 times a day) as needed for pain. 4. oxycodone 5 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain: do not take more than prescribed. do not combine with alcohol. disp:*30 tablet(s)* refills:*0* 5. amoxicillin-pot clavulanate 875-125 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 7 days. disp:*13 tablet(s)* refills:*0* 6. multivitamin capsule sig: one (1) capsule po once a day. discharge disposition: home discharge diagnosis: comminuted jaw fracture anxiety depression alcohol abuse discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted because you were found unconscious outdoors and had a very low body temperature. because you were unable to follow commands completely, you had a breathing tube placed to help protect your airways. this was removed after admission. you were found to have a complex jaw fracture which was fixed by oral surgery. you will need to follow up with as an outpatient. they will call you with an appointment. while you were here, we had the psychiatrists see you who recommended a dual diagnosis program to help your anxiety and alcohol dependence. the social work team has given you information for several programs in the area. it is very important that you seek help for your addiction. the following changes were made to your medications: - started augmentin 875mg twice a day, last day will be on - started oxycodone 5mg, take 1-2 tabs every 4-6 hours as needed for pain. do not combine with alcohol or take more than prescribed. - started folate 1mg once a day - started thiamine 100mg once a day - started multivitamin daily - please obtain over the counter followup instructions: please call at to make an appointment with a new primary care physician. the oral surgery team will call you with an appointment in the next week. procedure: open reduction of mandibular fracture diagnoses: unspecified fall dysthymic disorder acute alcoholic intoxication in alcoholism, continuous closed fracture of mandible, symphysis of body 

Answer: The patient is high likely exposed to