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: compazine / unasyn attending: chief complaint: etoh intox / abdominal pain major surgical or invasive procedure: intubation/extubation rij central venous line placement evacuation of r femoral vein hematoma by vascular surgery paracentesis history of present illness: 53m w/ h/o ivda, hcv cirrhosis, current etoh abuse presents with epigastric pain in the setting of alcohol intoxication. pt reports epigastric pain. unable to get more detailed history due to pt's somnolence. per last d/c note, the patient has a history of chronic pancreatitis and polysubstance abuse and has had multiple admissions in the past for nausea, vomiting, and abdominal pain. during these admissions he has been treated for alcohol withdrawal and possible chronic pancreatitis (though no evidence of such). past medical history: -hepatitis c cirrhosis, incompletely tx with ifn (dr. , hepatology ) -self-reported chronic pancreatitis (not documented and does not require home narcotics) - hx hx drug seeking behavior, confirmed with clinic (health care for the homeless) - per osh records, hx ivdu - hx grade i esophageal varices per records - hx bilateral varicoceles by scrotal u/s s/p cholecystectomy s/p splenectomy after mva -polysubstance abuse (alcohol with history of dts, tobacco, narcotic seeking behavior, past ivda) -depression with suicide attempts -asthma -s/p cholecystectomy -s/p splenectomy -s/p spinal fusion surgeries social history: + history of ivda, etoh, and tobacco. he was formerly employed as a painter but per last d/c summary disabled due to back and stomach problems for >5 years. son, a computer programmer, and daughter, a nurse, live in . in the past, has lived in and houses family history: mother died of mi age 57. father, a bar owner, died at 47 of stomach cancer. parents not alcoholics. physical exam: vs: t 97.1, bp 160/108, hr 112, rr 20, sao2 89%/ra -> 90%/2l, 94%/3l gen: somnolent, nad, arousable but falls back asleep heent: perrl, eomi, dry mm neck: supple, no lad, blood posteriorly chest: diffusely rhonchorous +wheezes cv: rrr, nl s1, s2, no murmurs/rubs/gallops abd: soft, tender in ruq, no rebound or guarding, +distension, + decreased bs ext: no peripheral edema neuro: unable to assess as pt somnolent, not following commands well pertinent results: labs: . serum etoh 225 serum benzo pos serum asa, acetmnphn, barb, tricyc negative . 143 / 105 / 7 gluc 101 agap=17 -------------------- 3.8 / 25 / 0.8 . ca: 8.1 mg: 1.7 p: 2.6 . alt: 80 ap: tbili: 1.2 ast: 166 : 55 lip: 31 . wbc 8.8 hct 27.1 plt 253 n:56 band:0 l:23 m:17 e:0 bas:0 atyps: 2 metas: 2 hypochr: 1+ poiklo: 2+ target: 2+ . pt: 15.3 ptt: 28.3 inr: 1.4 . studies: tib fib & ankle films: no acute fracture. . abd u/s: evaluation of the right upper, right lower, left upper and left lower quadrants of the abdomen demonstrated a small amount of ascites in the right upper quadrant. the quantity was not sufficient to mark a spot for paracentesis. . cta chest: 1. no evidence of pulmonary embolism. no consolidation within the lungs. 2. old compression deformity of a mid thoracic vertebral body. 3. nodular liver consistent with a cirrhotic liver, associated small amount of ascites, and likely reactive lymph node at the gastroesophageal junction. 4. calcification along the right pectoralis major muscle is suggestive of a prior hematoma in this region. . ct head: no evidence of intracranial hemorrhage. likely old small infarct in the right cerebellar hemisphere. . ct abd/pelvis: 1. cirrhosis with small amount of perihepatic ascites tracking into the right paracolic gutter. 2. extensive wall thickening of the ascending and transverse colon indicating colitis of indeterminant etiology, possibly secondary to liver failure. 3. no evidence of pancreatitis. . femoral vascular u/s: findings most consistent with av fistula at the site of the femoral puncture. . ct abd/pelvis: 1. fatty cirrhotic liver without enhancing lesions identified. perihepatic ascites. 2. bilateral tiny pleural effusions. . cxr: left basilar opacity since . . cxr: left lower lobe collapse, unchanged since , accompanied by increasing moderate left pleural effusion. no pneumothorax. tip of the right pic catheter projects over the superior cavoatrial junction. no mediastinal widening. the right lung clear. mild cardiomegaly stable. dilated azygos vein suggests elevated central venous pressure or volume. . ruq u/s: 1. nodular liver consistent with cirrhosis. 2. moderate amount of ascites. brief hospital course: # abdominal pain: according to past records from and from , the patient has a long history of admissions and ed visits for abdominal pain, as well as a history of narcotic-seeking behavior. he has a history of hcv cirrhosis. the differential diagnosis of his pain was broad, and included pancreatitis (although amylase, lipase, and ct findings argue against this), sbp (paracentesis results were negative), colitis (some chronic changes noted on ct, no change from prior), and gastritis. the patient did have an elevated bilirubin, but ruq ultrasound was unrevealing, other than his known cirrhosis. chronic mild elevation of lfts was felt to be secondary to hcv and etoh. the patient was initially kept npo and given iv fluids and ppi. due to his somnolence on admission, narcotics were initially avoided. later in the hospital course, the patient was given po opiates only, due to his hypercarbic respiratory failure (see below). the patient was very demanding and constantly requested iv pain medications. he also frequently refused all po medications. at time of discharge he was on tramadol po only and is eating well without significant abdominal pain. the patient does claim to have a history of chronic pancreatitis as the etiology of his pain, so to make a definitive diagnosis he could be referred for a secretin test. this can be consider as an outpatient. . # groin hematoma: following placement of a femoral venous catheter for iv access, the patient developed a hematoma and became hypotensive. he was taken to the or on given concern for an avm. no avm was found, but a large hematoma was evacuated. a jp was left in place, but on the patient pulled this out. at that time the had still been draining 600-700cc/day. serosanguinous fluid continued to from the site of the jp , vascular surgery recommended placement of an ostomy bag over the site to collect the fluid and monitor its volume, as well as to protect the patient's skin. the patient's hematocrit remained stable. lasix was also restarted in the hopes that treating the patient's peripheral edema would help to prevent reaccumulation of fluid in the groin site. (though albumin is quite low so this may not be successful) the patient had apparently been on diuretics as an outpatient as well, but adherence was not certain. needs follow up with vascular surgery. . #hcv/etoh cirrohsis - now closer to euvolemic. continue on lasix 40 po bid and spironolactone. also on lactulose and rifimaxin with improvement of mental status. will restart bactrium sbp prophylaxis. paracentesis neg for sbp. . #scrotal cellulitis - has prior hx of scrotal edema and bilateral varicoceles per records from . this admission was noted to have scrotal erythema and ttp. started on treated with levofloxacin and vancomycin when not taking po. now will take a 10d course of cipro. . # hypercarbic respiratory failure: the patient was first noted to be somnolent in the pacu following evacuation of his groin hematoma on . abgs over time were 7.19/69/135 -> 7.23/55/170. he received 2 doses of narcan with some response, but the response waned quickly. he was re-intubated in the pacu and transferred to the micu for further management. he was extubated on and transferred back to the floor. however, overnight he again became somnolent with a decreased rr and abg 7.15/63/80. he had received morphine 2mg iv ~12 hours earlier. he was again given narcan, after which his rr increased to 24 and he became acutely wheezy and tachycardic to the 140s. he was transferred to the micu, but did not need to be re-intubated at that time. no further intervention was needed, and he was again transferred to the floor. from that time onward, sedating medications were kept to a minimum, and iv opiates were avoided entirely. as mentioned above, the patient tended to refuse po medications, so he received relatively small amounts of narcotics. he was noted to have a persistent lll opacity on serial cxr, but as he was afebrile and it was not felt that he had a pneumonia clinicially, he was not treated with antibiotics. . # altered mental status: on admission this was secondary to etoh withdrawal/intoxication (see below). there was also concern for a head bleed given a history of possible head trauma, but head ct was negative for bleed. etoh abuse was treated as below. the patient remained very agitated, combative, and uncooperative throughout his admission. as above, he pulled out a jp from his groin following hematoma evacuation, and at another time he pulled out a r ij central venous line. he required a 1:1 sitter for his own safety and that of others, as he threatened to harm staff members and to jump out a window. at the time of discharge mental status has cleared and he had no active suicidal ideation. . # etoh abuse: the patient was intoxicated on admission, and he does have a history of withdrawal and dts. he was kept on a ciwa scale with ativan. he was given a banana bag on admission and was also continued on po thiamine, folate, mvi. there was no evidence for acute alcoholic hepatitis on admission. . # hypoxia: on admission the patient was found to be hypoxic. as mentioned above, it was not felt that he had pneumonia. given that he was also tachycardia, there was also concern for pe. this was ruled out with cta of the chest. he was give albuterol and atrovent nebs as well, given his history of asthma/copd his hypoxia has now resolved. . # leg pain: the patient had this complaint on admissin. x-rays were negative for fracture. medications on admission: (on last discharge ): 1.amylase-lipase-protease 20,000-4,500- 25,000 unit capsule, delayed release(e.c.) sig: two (2) cap po tid w/meals (3 times a day with meals). 2.nicotine 21 mg/24 hr patch 24hr sig: one (1) patch 24hr transdermal daily (daily). 3.albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h (every 6 hours) as needed. 4.fluticasone propionate 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 5.folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 6.multivitamin capsule sig: one (1) cap po daily (daily). 7.thiamine hcl 100 mg tablet sig: one (1) tablet po daily discharge medications: 1. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 2. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 3. multivitamin capsule sig: one (1) cap po daily (daily). 4. amylase-lipase-protease 20,000-4,500- 25,000 unit capsule, delayed release(e.c.) sig: two (2) cap po tid w/meals (3 times a day with meals). 5. albuterol 90 mcg/actuation aerosol sig: two (2) puffs inhalation every 4-6 hours as needed for shortness of breath or wheezing. 6. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 7. trimethoprim-sulfamethoxazole 160-800 mg tablet sig: one (1) tablet po daily (daily). 8. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 9. tramadol 50 mg tablet sig: one (1) tablet po q 12h (every 12 hours) as needed for pain. 10. acetaminophen 500 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed. 11. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed. 12. nadolol 20 mg tablet sig: one (1) tablet po daily (daily). 13. spironolactone 25 mg tablet sig: two (2) tablet po daily (daily). 14. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 15. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 16. lactulose 10 g/15 ml syrup sig: thirty (30) ml po qid (4 times a day). 17. rifaximin 200 mg tablet sig: one (1) tablet po tid (3 times a day). 18. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 19. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day). 20. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 10 days. 21. bactrim ds 160-800 mg tablet sig: one (1) tablet po once a day. 1. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. multivitamin capsule sig: three (3) cap po daily (daily). disp:*30 caps* refills:*2* 4. amylase-lipase-protease 20,000-4,500- 25,000 unit capsule, delayed release(e.c.) sig: two (2) cap po tid w/meals (3 times a day with meals). disp:*180 cap* refills:*2* 5. albuterol 90 mcg/actuation aerosol sig: two (2) puffs inhalation every 4-6 hours as needed for shortness of breath or wheezing. disp:*1 mdi* refills:*2* 6. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 7. 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* 8. acetaminophen 500 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed. 9. nadolol 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 10. spironolactone 25 mg tablet sig: two (2) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 11. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 12. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 13. lactulose 10 g/15 ml syrup sig: thirty (30) ml po qid (4 times a day). disp:*1 bottle* refills:*2* 14. rifaximin 200 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 15. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 16. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day). 17. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 10 days. 18. bactrim ds 160-800 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: primary diagnoses: abdominal pain etoh intoxication hypercarbic respiratory failure secondary to opiates right groin hematoma, secondary to right femoral central venous line . secondary diagnoses: hcv cirrhosis polysubstance abuse depression asthma discharge condition: good discharge instructions: if you experience fever, chills, nausea, vomiting, abdominal pain, or any other new or concerning symptoms, please call your doctor or return to the emergency room for evaluation. . please take all medications as prescribed. . please attend all followup appointments. your pcp should make sure you follwo up with the vascular surgery clinic for your groin hemoatoma (bruise). you also need to follow up with a liver specialist. followup instructions: you should follow up with your primary care doctor (dr. ) in the next week. you have an appointment with dr. , your vascular surgeon, on at 10:30 am. his office is on the of the . their phone number is . md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube percutaneous abdominal drainage other incision with drainage of skin and subcutaneous tissue incision and drainage of scrotum and tunica vaginalis diagnoses: tobacco use disorder unspecified essential hypertension alcoholic cirrhosis of liver other, mixed, or unspecified drug abuse, unspecified unspecified viral hepatitis c without hepatic coma hematoma complicating a procedure asthma, unspecified type, unspecified acute respiratory failure other inflammatory disorders of male genital organs retention of urine, unspecified personal history of noncompliance with medical treatment, presenting hazards to health unspecified sedatives and hypnotics causing adverse effects in therapeutic use abdominal pain, epigastric lack of housing alcohol withdrawal delirium acute alcoholic intoxication in alcoholism, unspecified edema of male genital organs 

Answer: The patient is high likely exposed to