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: altered mental status major surgical or invasive procedure: intubation with mechanical ventilation extubated history of present illness: mr. is a 38 y.o. man w/ an unknown pmh who was transferred from w/ altered mental status. he was reportedly observed trying to enter a bar, after which he flashed a taxi, and then he hid under a park bench. the police/ems were called. he was screaming, spitting, and biting himself, requiring sedation and restraints. in the ed, vs: t97.7, hr 103, bp 144/58, rr 18, o2 sat unable to assess. he was anxious, uncooperative, and hostile. alt 34, ast 51, alk phos 49, tbili 0.2, albumin 4.7. etoh 384. serum osmolality 407. u/a negative for ketones. he received haldol, lorazepam, cogentin, as well as midazolam and succinylcholine for intubation to receive a ct head. ct head was negative for an intracranial process. he was transferred to the ed for further evaluation. in the ed, vs: t 97.6, hr 61, bp 91/43, rr 16, 100% on 100% fio2. exam was significant for no sign of traumatic injury. na was found to be 152. etoh 377. 4l of ns were given. 400cc urine emptied in the ed. on arrival to the micu, t 98.3, hr 70, bp 87/44, rr 20, 98% intubated on cmv tv 550, rr 20, fio2 40%, peep 5. his na was still elevated to 146. he was sedated on fentanyl/midazolam. he was given iv thiamine, folate, mv, and 1l ns bolus. he was also started on d5 1/2 ns + 20 meq k at 150 cc/hr. past medical history: alcoholism s/p splenectomy 16 years ago for car accident anxiety social history: single and lives alone in ?????? . he is a bartender. in aa for alcoholism ?????? has been hospitalized for etoh 5x. has a history of delirium tremens. started drinking 1.5 mo ago. he used cocaine and ecstacy 2 mo ago. he also used 1 adderall pill yesterday. family history: non-contributory physical exam: admission physical vitals: t98.3, hr 70, bp 87/44, rr 20, 98% intubated fio2 40% general: sedated, not diaphoretic heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: jvp not elevated, no lad cv: rrr, nl s1/s2, no murmurs, rubs, gallops lungs: ctab, no wheezes, rales, ronchi abdomen: midline abdominal incision, soft, nt, nd, bs+, no organomegaly ext: wwp, no cyanosis, clubbing, edema neuro: sedated, pupils round and minimally reactive, minimally reflexic in ue and le, downgoing babinski b/l, rest of exam deferred due to sedation . discharge physical vs 97.8, 120/62, p58, r20, 96%ra gen: alert. cooperative. in no apparent distress. appears comfortable heent/neck: perrla. eomi. mucous membranes pink/moist. no icterus or pallor. lungs: clear to auscultation b/l. no wheezes or crackles. cv: s1, s2. regular rate and rhythm. no murmurs/gallops/rubs appreciated. no jvd. abdomen: bs present. soft. musculoskeletal tenderness to palpation over lower abdomen. nondistended. no organomegaly noted. well healed midline surgical scar c/w old splecectomy extremities: no gross deformities, clubbing, or cyanosis. no edema neuro: cnii-xii intact, motor and sensory grossly normal. no tremors. pertinent results: admission labs: 11:45pm type- ph-7.33* comments-green top 11:45pm lactate-1.5 k+-5.1 11:45pm freeca-0.99* 11:17pm glucose-95 urea n-11 creat-1.0 sodium-146* potassium-5.4* chloride-116* total co2-22 anion gap-13 11:17pm calcium-7.1* phosphate-4.5 magnesium-2.1 11:17pm wbc-6.2 rbc-3.63* hgb-11.4* hct-34.2* mcv-94 mch-31.5 mchc-33.3 rdw-13.4 11:17pm plt count-301 11:17pm pt-11.7 ptt-29.7 inr(pt)-1.1 09:42pm type-art tidal vol-500 peep-5 o2-100 po2-449* pco2-54* ph-7.29* total co2-27 base xs--1 aado2-208 req o2-43 -assist/con intubated-intubated 08:20pm urine hours-random 08:20pm urine bnzodzpn-pos barbitrt-neg opiates-neg cocaine-neg amphetmn-pos mthdone-neg 08:20pm urine color-yellow appear-hazy sp -1.015 08:20pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 08:14pm glucose-104 na+-152* k+-3.7 cl--113* tco2-25 08:08pm urea n-12 creat-1.0 08:08pm estgfr-using this 08:08pm lipase-55 08:08pm asa-neg ethanol-377* acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 08:08pm wbc-5.3 rbc-3.80* hgb-11.8* hct-35.6* mcv-94 mch-31.1 mchc-33.2 rdw-13.4 08:08pm plt count-308 08:08pm pt-11.2 ptt-30.1 inr(pt)-1.0 08:08pm fibrinoge-180 . ph 7.29/pco2 54/po2 449/hco3 27/basexs -1 type:art; intubated; fio2%:100; aado2:208; req:43; tv:500; peep:5; mode:assist/control . micro: none . imaging: cxr wet read: no evidence of acute disease. et tube terminating 5 cm above carina, could be advanced slightly. og tube terminating barely in stomach with sidehole in esophagus; advancing the tube by 10-12 cm suggested. . ct head (osh) wet read: no evidence of intracranial mass lesion, acute infarction, or acute intracranial hemorrhage. the brain parenchyma appears normal. the ventricles, sulci, and cisterns are unremarkable. there is no extra-axial collection. there is no mass effect or midline shift. . ekg: ekg: nsr, t wave inversion and rsr' in v1, borderline elevated qrs. discharge labs: 07:10am blood wbc-10.4# rbc-3.98* hgb-12.5* hct-37.1* mcv-93 mch-31.3 mchc-33.6 rdw-13.1 plt ct-306 07:10am blood glucose-84 urean-12 creat-0.8 na-142 k-3.9 cl-108 hco3-29 angap-9 07:10am blood calcium-8.6 phos-3.3 mg-1.8 07:10am blood alt-45* ast-88* ck(cpk)-1807* alkphos-41 totbili-0.7 brief hospital course: 38 year old male with history of alcohol use/abuse, depression and anxiety who presented with altered mental status secondary to alcohol intoxication. the patient arrived as an outside hospital transfer intubated. he was admitted to the micu and extubated once his mental status improved. he was transferred to the general medicine floor for further monitoring, and stable by day of discharge. . active problems: 1) intoxication/altered mental status: the patient's alcohol level was 377, which was high enough alone to be responsible for stupor, loss of consciousness, and airway depression. he was initially intubated at outside hospital but extubated shortly after arriving to the icu as mental status improved. urine tox screen was also positive for amphetamines,(the patient reports using one tablet of adderall the day before admission) and benzodiazepines. however, sedation involved benzodiazepine use, and he denied illicit use of this class of medication. he presented w/ hypertension and tachycardia. acute intracranial process such as hemorrhage was ruled-out w/ head ct. he remained afebrile, and infectious etiology for his altered mental status was unlikely. mental status improved after iv fluids. there were no seizures/tremors, or other signs of withdrawal throughout his hospital course. . 2) history of alcohol use vs abuse - the patient stated he would like to be sober again and plans on returning to aa and, when allowed, his sober house. he was seen by social work during his stay. of note, patient stated that he works as a bartender, and had been sober for 6 weeks prior to this episode (of which he has no recollection of even his first drink). 3) hypernatremia of 146-149 early in admission, likely due to dehydration. the patient's free water deficit was calculated to be ~3l and he was treated with iv fluids with good response. by day of discharge, his electrolytes were within normal limits. . 4) mild transamnitis, which ast 88, alt 45 - the patient's liver enzyme pattern follows a probable alcoholic induced cause. the patient was counseled on alcohol induced liver injury and was advised to follow up with his pcp. . 5) elevated creatine-kinase - likely secondary to time down on ground or secondary to restraints during period of agitation. his ck initially increased from 1753 to 2437 but began trending downwards after treatment with iv fluids. he did not present with any muscle weakness or hematuria and there were no other signs of rhabdomyolysis. . 6) neck and abdominal muscle soreness- likely musculoskeletal, secondary to mechanical ventilation verses straining against restraints or during intubation. the patient's symptoms were controlled with ibuprofen during his stay. . 7)hypotension on presentation to the micu. this was likely in the setting of sedation with midazolam and fentanyl. he was hypertensive in the ed in the setting of agitation before being sedated and intubated. since he is a young, fit man, he may have a low bp at baseline. his hypotension resolved during his stay and he was stable by discharge. . 8)normocytic anemia of unknown etiology. the patient's hb/hct was between 11.4-12.5/34.2-37.1, possibly secondary to alcohol abuse combined with aggressive iv fluid resuscitation. the patient was advised to follow up with his primary care physician. remained clinically stable with no evidence of active bleeding during his stay. . chronic issues: 1) history of depression/anxiety - the patient remained clinically stable throughout his stay and his home celexa 30mg was reinitiated on transfer from the micu to the floor. . 2) history of insomnia - the patient reported trouble sleeping but did not receive or ask for his prn written medication in his overnight stay on the general medicine floor . transitional issues: 1) alcohol use/abuse: the patient was advised to discuss this admission with his pcp and to return to aa for recovery 2) the patient was advised to followup with his pcp regarding his elevated liver enzymes. medications on admission: celexa 30 mg discharge medications: 1. citalopram 30 mg po daily 2. ibuprofen 400-600 mg po q8h:prn pain discharge disposition: home discharge diagnosis: primary: alcohol intoxication, altered mental status, hypernatremia, elevated ck enzymes secondary: depression, anxiety discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mr. , it was a pleasure caring for you at . you were admitted because you had an altered mental status secondary to your use of alcohol and amphetamines. you were sedated and ventilated with a breathing tube at an outside hospital before being transferred here for further care. we noticed that you had high sodium, probably secondary to losing too much water (dehydration) and also that some blood values relating to muscle breakdown were also elevated (possibly due to an extended period laying down or from being in restraints). we treated you for these with iv-fluids and you responded well. we also noticed elevations of your liver enzymes, indication some damage most likely related to your alcohol use. as a precaution, we monitored you for any signs of withdrawal. you sore throat and muscle aches are likely related to the breathing tube and mechanical ventilation. the aches may also be related to injury while you were intoxicated. we strongly urge you to continue aa and stop drinking alcohol, and you should followup with your primary care physician regarding your liver and other care. we also recommend you stop smoking. . please note the following changes to your medications: you may start taking ibuprofen for pain, as needed you may continue your home medications as previously prescribed. followup instructions: please followup with your primary care physician. have made you the following appointment: name: np when: wednesday at 9:15am where:island health , ma phone:( procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours diagnoses: acidosis other iatrogenic hypotension hypocalcemia anemia, unspecified depressive disorder, not elsewhere classified other opiates and related narcotics causing adverse effects in therapeutic use alcohol abuse, unspecified anxiety state, unspecified acute respiratory failure other acquired absence of organ hyperosmolality and/or hypernatremia rhabdomyolysis acute alcoholic hepatitis amphetamine or related acting sympathomimetic abuse, unspecified benzodiazepine-based tranquilizers causing adverse effects in therapeutic use physical restraints status 

Answer: The patient is high likely exposed to