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: osh transfer in shock major surgical or invasive procedure: cardiac catheterization arterial line tracheal entubation history of present illness: 49m with dm1, alcoholic cardiomyopathy, and a recent admission at for dka and rapid afib presented to with palpitations, was found to be in afib with rvr, developed progressive hypotension followed by a junctional rhythm, went into pea, was resuscitated, and was sent to for balloon pump. at the time of presentation to goodsam, he was found to be in afib with heart rates in the 150s-160s. iv metoprolol failed to provide sufficient rate control. he was noted to be in chf (edema on cxr and bnp of 993), so he was given furosemide 40mg iv, producing 300ml of urine. to achieve better rate control, an amiodarone drip was initiated, and following this his bp dropped to the 70's, so he was started on a phenylephrine drip and placed on a nrb-mask. he was then transferred to the icu where, for increasing hypotension and respiratory distress, he was intubated and started on propofol. after the intubation he first converted to sinus rhythm but then dropped his p waves, went to a junctional rhythm, then pea arrested. he was resuscitated with cpr, 1mg each of epinephrine and atropine, and bicarb infusions; his post-resuscitation rhythm was sinus. given his ongoing pressor requirements and the feeling that he was in cardiogenic shock, he was transferred to for a balloon pump. at the time of transfer, his vitals were t 101.3, bp 105/p, hr 60's (on 36mcg of norepi gtt), rr 18, and spo2 mid-high 90's on a/c 700/18/80/5. his transfer labs were signficant for a wbc of 17.6 (up from 10), hct of 41, plt of 419, bicarb of 18, bun of 20, cr of 1.1, and abg of 7.45/24/315/16. . micu course: spontaneously converted to sinus from afib. altered ms ? etoh withd but now ok. weaned off pressors on . extubated . diuresed. vanc and aztreonam continued for ? sepsis. dig started. . past medical history: -dm2(insulin dependent, but had dka in /06) -alcoholic cardiomyopathy (ef 15-20%, , ) -atrial fibrillation social history: he has a history of heavy etoh, cocaine abuse and tobacco abuse (states pack/wk). lived with mother prior to this admission. works as a mechanic. family history: no premature coronary disease physical exam: pe: middle aged man, intubated and sedated vs: t 98.6, hr89, bp 112/69 (83), rr 14, 99% sato2 vent setting: 99% on ac 550 x 14 peep 5 fio2 100% pressors: dobutamine 5 and levophed 0.24 skin: pale heent: anicteric, op clear with sl dry mucosa lungs: moves air well, coarse, no wheezes or rales cardiac: rrr, s1s2, no m/r/g abd: soft, nt, nd, decr but present bs, hepatomegaly 3-4cm below costal margin extremities: dopplerable dp and pt pulses, trace edema over feet, cool/dry neuro: sedated, perrl, moves all extrm to pain pertinent results: tachy, a fib, normal axis, low voltage in limb leads, normal voltage in precordium, poor r wave progression, twi in i, ii, tw flattening in iii, avr, avl, avf, st elevation (<1mm) in v3, st depression (1mm) in v5, v6. 06:04am blood wbc-10.1 rbc-4.29* hgb-13.4* hct-37.8* mcv-88 mch-31.1 mchc-35.3* rdw-14.5 plt ct-198 03:37am blood neuts-74.0* lymphs-23.1 monos-1.8* eos-0.9 baso-0.2 06:04am blood pt-13.2* ptt-30.2 inr(pt)-1.2* 06:04am blood glucose-140* urean-12 creat-0.8 na-139 k-4.5 cl-102 hco3-25 angap-17 06:08am blood alt-238* ast-30 alkphos-114 totbili-0.9 05:23am blood alt-2274* ast-765* ld(ldh)-405* alkphos-155* totbili-3.3* 05:16am blood alt-3892* ast-2496* ld(ldh)-1302* ck(cpk)-42 alkphos-180* totbili-2.0* 06:04am blood calcium-8.8 phos-4.1 mg-2.1 05:16am blood ck-mb-notdone ctropnt-<0.01 04:21pm blood ck-mb-notdone ctropnt-0.03* 03:37am blood ck-mb-notdone ctropnt-0.07* 02:15pm blood ctropnt-0.12* 02:15pm blood %hba1c-9.9* -done -done 07:55am blood triglyc-207* hdl-26 chol/hd-7.2 ldlcalc-119 05:23am blood tsh-3.5 02:15pm blood hbsag-negative hbsab-negative hbcab-negative hav ab-negative 06:44pm blood -negative 03:37am blood igg-665* 05:03pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 04:36pm blood type-art fio2-94 po2-77* pco2-36 ph-7.50* caltco2-29 base xs-4 aado2-588 req o2-92 intubat-not intuba . ecg sinus rhythm. since the previous tracing of sinus rhythm is new. . echo: conclusions: the left atrium is elongated. left ventricular wall thicknesses are normal. the left ventricular cavity size is top normal/borderline dilated. there is severe global left ventricular hypokinesis. no masses or thrombi are seen in the left ventricle. the right ventricular cavity is mildly dilated with severe global free wall hypokinesis. the aortic valve leaflets (3) are mildly thickened. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. physiologic mitral regurgitation is seen (within normal limits). the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. impression: mild biventricular cavity enlargement with severe global biventricular hypokinesis c/w diffuse process (toxin, metabolic, etc. the low heart rate raises the suspicion for hypothyroidism - though he does not have a pericardial effusion). . port cxr: impression: no significant change in the appearance of the cardiac enlargement or bilateral pleural effusions. mild pulmonary vascular congestion persists. . impression: partially occlusive clot in the lower internal jugular vein. . cath\ final diagnosis: 1. single vessel coronary artery disease as manifest by 70% proximal stenosis of a moderate sized ramus branch. there is otherwise noncritical, but diffuse, disease of the left and right coronary arteries. 2. severely reduced left ventricular systolic function with elevated left ventricular filling pressures. brief hospital course: a/p: 49m with dm2, likely alcoholic cardiomyopathy who presented to goodsam with afib-rvr, developed shock of presumed cardiogenic etiology, and had a pea arrest. here to continue to eval etiology of cardiomyopathy. . #shock -- now resolved. multifactorial with septic vs cardiogenic. by ecg he did not seem to have a major ischemic event to account for the shock. alternatively, given his wbc and fever, this could have been a septic picture. - lipids with low hdl but, ldl 119 and total chol 186 . # sepsis -- wbc normalized and afebrile. unclear etiology. wbc and fever could both be insetting of infection or pea arrest. continued abx for a total of 7 day course which was discontinued on . - discontinued ceftaz in ccu - continued vanco for a total 7-day course - continued broad abx with aztreonam for in place of ceftaz for a total 7-day course - f/u cultures here negative - was afebrile x 4 days with normal wbc count on discharge . # chf: ddx alchoholic vs myopathy afib vs viral. ef 15-20% at goodsam. cxr and vent/abg were consistent with pulm edema, likely secondary to chf-ef 15-18%. will need repeat outpt echo (in 3 months) for evaluation of cardiomyopathy and possible primary prevention with icd. - continue lasix with potassium supplementation - cath with moderate 3vd, plan for stress in future - will recommend he get hiv testing as outpatient . # afib -- paf. another episode of afib with rvr during hospital course on medical floor to hr 200s now in nsr on amio taper. he was asymptomatic during this episode. - goal hr < 80 - dig d/c'd on - continue toprol xl - lmwh, coumadin started (sent home on coumadin alone and inr will be checked on ) . # elevated lfts -- resolved by discharge. with transaminases this elevated and only modestly elevated alk phos and t bili, the most plausible diagnosis is shock liver. this is occuring in the background of likely underlying alcholic liver disease. hepatitis serologies all negative. -ruq u/s was normal . #respiratory failure -- resolved. now satting 94% on ra. bilateral pleural effusion vs atelectasis vs infiltrate on cxr. - diuresis for pulm edema - is to bedside . #rue- erythema and edema. all lines removed from this arm. has a r ij non-occlusive dvt - already on lmwh/coumadin . #acute renal failure -- resolved. likely a septic atn (with additional contribution from ischemic atn during pea) potentially exacerbated by the pressor use. - renal ultrasound normal . #hilar mass -- seen on one cxr at goodsam. ct chest without findings c/w hilar mass. . #dm2 -- - continue , glargine - hgalc 9.9 . #alcoholism -- ciwa scale with po valium and iv ativan. thiamine, folate, mvi. supposedly quit alcohol in . -agitation in icu seemed more like icu psychosis rather than withdrawl. no additional signs of withdrawal during hospital course. . #fen -- diabetic/cardiac diet, goal 500 cc neg today . #ppx -- heparin gtt, ppi . #code -- full . #contact -- mother, , at . sister, , . . #dispo: to home with outpatient pcp and cardiology medications on admission: meds at home: none . meds on transfer: metoprolol xl 200mg qam, 100 qpm coumadin md digitalis 0.375mg qd glargine 26u qhs aspart 6utid riss lorazepam gtt thiamine ceftriaxone 1g q24 - not given discharge medications: 1. to employer mr. has been hospitalized through and may be discharged on . he will not be able to work for at least 4 weeks. 2. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily): for coronary artery disease. disp:*30 tablet(s)* refills:*2* 3. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. hexavitamin tablet sig: one (1) cap po daily (daily). disp:*30 cap(s)* refills:*2* 5. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). disp:*30 tablet, chewable(s)* refills:*2* 7. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. warfarin 1 mg tablet sig: five (5) tablet po once a day: or as directed by your doctor to keep inr . disp:*150 tablet(s)* refills:*2* 10. metoprolol succinate 100 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po daily (daily). disp:*30 tablet sustained release 24hr(s)* refills:*2* 11. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day): 400 mg 2x/day through ; 400 mg 1x/day through ; 200 mg 1x/day through then stop. disp:*80 tablet(s)* refills:*0* 12. insulin glargine 100 unit/ml solution sig: five (5) u subcutaneous at bedtime. disp:*200 u* refills:*2* 13. insulin lispro (human) 100 unit/ml solution sig: per sliding scale subcutaneous four times a day. disp:*300 u* refills:*2* 14. outpatient lab work inr check on . please call result to dr. . 15. k-dur 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day. disp:*30 tab sust.rel. particle/crystal(s)* refills:*2* discharge disposition: home discharge diagnosis: cardiogenic shock sepsis chf (ef <20%) paroxysmal atrial fibrilation shock liver respiratory failure rue dvt acute renal failure dm2 discharge condition: hemodynamically stable. ambulatory. discharge instructions: please take all medications as instructed. there were several changes made to your current medications regimen. . please check your heart rate 2 times per day. your heart rate should not be more than 100 unless you are up and walking around. if your heart rates stays in the 120 range for more than one hour and you are resting, go to the er. . if you experience any nausea, vomiting, lightheadedness, chest pain, shortness of breath, or any other concerning symptoms please seek medical attention immediately. followup instructions: please make a follow-up appointment with dr. within the next week. tel (. . please make an appointment with dr. (cardiology) within the next 2 weeks tel (. . an appointment has already been made for you with dr. (cardiology) on at 1:00 pm. bldg, . . procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures diagnoses: coronary atherosclerosis of native coronary artery acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute and subacute necrosis of liver unspecified septicemia atrial fibrillation acute respiratory failure other shock without mention of trauma other complications due to other vascular device, implant, and graft alcoholic cardiomyopathy 

Answer: The patient is high likely exposed to