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 known allergies / adverse drug reactions attending: chief complaint: pancreatitis major surgical or invasive procedure: intubation history of present illness: 43 yo m with etoh abuse, chronic low back pain, who presented to osh with severe lower abdominal pain, back pain and alcohol withdrawal. lab testing showed an elevated lipase and amylase suggestive of acute pancreatitis. he reportedly received a total of 15.5 mg iv dilaudid prior to icu transfer at the osh. the patient's mental status deteriorated with increasing agitation and confusion, and patient became tachycardic and hypertensive (180s/110s), thought to be due to alcohol withdrawal. upon arrival to the icu, he was administered a dose of narcan for increased somnolence, with some improvement in mental status. patient was intubated for airway protection. labs were significnat for hematocrit 47-->50, wbc count 6.6k-->12k with no left shift, creatinine 0.7, anion gap 8, calcium 8.8, albumin 4.2-->3.3, lipase 599. abdominal x-ray was unremarkable. ct abdomen showed moderate pancreatitis, with slight enhancement of uncinate process, with overall uniform pancreas enhancement. there were no organized collections. abdominal ultrasound showed no evidence of cholelithiasis, choledocholithiasis, or biliary ductal dilation. patient was started on meropenem. central venous line was placed, and there was no pressor requirement. patient was also on a lorazepam infusion up to 10 mg/hr. bladder pressure was initially 18, rising to 22 in transit via , now 27. patient reportedly received 9 liters ivf before transfer. plateau pressure was noted be 27 during transfer, pip>30. lactate was 2.7. uop was reportedly poor with concentrated urine. systolic blood pressure on transfer to 110s-120s, and patient was tachycardic to the 130s. past medical history: alcohol abuse with ?withdrawal seizures chronic low back pain social history: patient works in construction. he has drunk heavily for many years. possible history of withdrawal seizures. he has been hospitalized previously for alcohol intoxication and withdrawal, including in the icu. he has undergone inpatient detoxification several times. history of crack abuse and possible amphetamine use, unknown when last. patient has smoking history of unknown duration. lives in . he is not married. family history: cva in father. physical exam: exam on admission: general: intubated and sedated, unresponsive to sternal rub, no acute distress heent: sclera anicteric, perrl neck: supple, jvp not elevated cv: tachycardic but regular, normal s1 + s2, no murmurs, rubs, gallops appreciated lungs: diminished bilaterally, scattered expiratory wheezes abdomen: tense, distended, hypoactive bowel sounds, no organomegaly, no rebound or guarding, no ecchymoses gu: foley in place ext: warm, 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. exam at discharge: general - well-appearing in nad. lungs - l basilar crackles, clearing to cough, no r/rh/wh, good air movement, resp unlabored, no accessory muscle use. heart - rrr, no mrg, nl s1-s2 abdomen - nabs, soft/nt/nd, no masses or hsm, no rebound/guarding extremities - wwp, no c/c/e, 2+ peripheral pulses (radials, dps) neuro - aox3, cns ii-xii grossly intact, overall nonfocal pertinent results: admission labs: 05:25pm wbc-10.1 rbc-4.94 hgb-15.0 hct-46.8 mcv-95 mch-30.4 mchc-32.0 rdw-13.7 05:25pm blood pt-12.2 ptt-37.1* inr(pt)-1.1 05:25pm blood glucose-159* urean-30* creat-1.4* na-134 k-4.6 cl-103 hco3-26 angap-10 05:25pm blood lipase-941* 05:25pm blood calcium-7.3* phos-3.4 mg-1.8 01:14am blood asa-neg ethanol-neg acetmnp-neg bnzodzp-pos barbitr-neg tricycl-neg 05:38pm blood type- temp-38.7 rates-20/ peep-5 po2-44* pco2-65* ph-7.30* caltco2-33* base xs-3 -assist/con intubat-intubated 05:38pm blood lactate-2.4* 05:38pm blood freeca-1.09* discharge labs: 06:00am blood wbc-10.3 rbc-3.67* hgb-10.8* hct-33.8* mcv-92 mch-29.5 mchc-32.0 rdw-14.2 plt ct-773* 06:00am blood glucose-229* urean-14 creat-0.8 na-135 k-4.2 cl-93* hco3-32 angap-14 06:00am blood glucose-229* urean-14 creat-0.8 na-135 k-4.2 cl-93* hco3-32 angap-14 06:00am blood alt-16 ast-16 ld(ldh)-324* alkphos-66 totbili-0.3 06:00am blood alt-16 ast-16 ld(ldh)-324* alkphos-66 totbili-0.3 06:00am blood calcium-9.3 phos-4.1 mg-2.0 sputum cx gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 4+ (>10 per 1000x field): gram positive cocci. in pairs and clusters. 4+ (>10 per 1000x field): gram negative rod(s). 1+ (<1 per 1000x field): gram negative diplococci. respiratory culture (final ): commensal respiratory flora absent. staph aureus coag +. moderate growth. sensitivities performed on culture # 350-5665k . haemophilus influenzae, beta-lactamase negative. identification and sensitivities performed on culture # 350-6885k . cxr: as compared to the previous radiograph, the monitoring and support devices are in constant position. the left pleural effusion with left basal atelectasis is unchanged in extent and severity. on the right, the pre-existing pleural effusion has slightly decreased, but the right basolateral atelectasis is still present and better visible, given the absence of right pleural effusion. unchanged moderate cardiomegaly. monitoring and support devices are constant. cxr there is some perihilar prominence. this could reflect some mild elevation of pulmonary venous pressure or, in the appropriate clinical setting, raise the possibility of developing superimposed consolidation ct abd with contrast: impression: 1. significant interval worsening. necrotizing pancreatitis with early pseudocyst formation. nonvisualization of splenic vein. 2. bilateral pleural effusions, small on the right and moderate on the left with adjacent airspace atelectasis. 3. nodular parenchymal densities on the right likely infectious or related to aspiration. brief hospital course: 43 yo m with etoh abuse, chronic low back pain, who presented to osh with pancreatitis and alcohol withdrawal. # pancreatitis: pancreatitis was characterized as moderate without fluid collection or necrosis based on osh ct abdomen. most likely is to alcohol use. abdominal ultrasound without evidence of stones or ductal dilation making gallstone pancreatitis less likely. aggressive fluid resuscitation was limited by increasing intrabdominal pressures, see below for more details. he was placed on an insulin gtt, and his electrolytes were monitored and subsequently replaced as necessary. he was on tpn and nj tube was placed by ir. his tubefeeds were advanced slowly to goal as he clinically improved. a ct scan was obtained on which showed concern for necrotizing pancreatitis with early pseudocyst formation. throughout his micu course he was febrile to 102/103 daily, but his fever curve trended downwards as he clinically improved. once he was transferred to the floor, he eventually tolerated food po, and the ng tube was pulled on . # abdominal compartment syndrome: he presented with tense distended abdomen with rapidly rising bladder pressures, increasing plateau pressures, with poor urine output, rising creatinine, and lactate. surgery consult was obtained and recommended continual monitoring. during the first day of his icu course, his intra-abdominal pressures decreased, as evidenced by decreasing bladder pressures, downtrending lactate and creatinine, as well as increasing urine output. with his clinical improvement, abdominal decompression was deemed unnecessary. # respiratory distress: patient was intubated for airway protection initially, with likely hypoventilation due to abdominal distention as evidenced by increased peak and plateau pressures requiring high amounts of peep. additionally pt was found to have pneumonia (see below). patient was successfully extubated and did not require tracheostomy or peg tube. he was weaned to room air with stable oxygen saturations. # pneumonia: pt was spiking fevers, cxr evidence and sputum cx growing mssa + h. influenzae. he was started on unasyn based on sensitivities and completed an 8 day course. subsequently in his course, he had increasing oxygen requirement and sputum cx grew mssa. he was treated with naficillin for 8 days and eventually weaned from supplemental o2. # hyperglycemia: patient without h/o dm with new insulin requirement due to systemic inflamation, tube feeds, and poor pancreas function. fsbgs corrected to 100s-200s at the time of discharge on 25 units lantus qhs and humalog ss. # sinus tachycardia: patient with mild sinus tachycardia (90s-100s) in the setting of diuresis (60 mg iv lasix qd-) following aggressive fluid resuscitation for pancreatitis, with likely contribution from anxiety. he remained afebrile/hd stable without leukocytosis or other evidence of infection at that time. # alcohol withdrawal: patient required high doses of lorazepam at osh, and required high doses of midazolam and fentanyl for sedation. liver function tests normal. after extubation, he was treated with prn ativan per ciwa scale, and did not have evidence of active withdrawal. # acute kidney injury: unknown baseline, but creatinine of 0.7 on arrival to osh, during icu course, his cr was downtrending. initial rise in cr, most likely secondary to increasing intra-abdominal pressures. resolved. # hypernatremia: resolved after free water repletion. # dropping hematocrit: likely dilutional s/p 10l of fluids combined with anemia of chronic disease. stabilized at 26. fe labs consistent with anemia of chronic disease. #transitional issues: -hyperglycemia: patient discharged on insulin due to persistent hyperglycemia in the hospital; likely will require downtitration on pcp as pancreatic function recovers. -sinus tachycardia: patient with mildly elevated hr (90s-100s) in the setting of aggressive diuresis following fluid resuscitation, as well as anxiety; may require further investigation if persistent on pcp . -chronic pain: patient discharged with limited supply of oxycodone for chronic low back pain; may wish to resume home vicodin on pcp . medications on admission: 1. oxycodone-acetaminophen (5mg-325mg) dose is unknown po frequency is unknown discharge medications: 1. glargine 25 units bedtime insulin sc sliding scale using hum insulin rx *freestyle lite strips please check your blood sugar at meals and in the evening at bedtime. four times a day disp #*120 each refills:*0 rx *lantus 100 unit/ml please inject 25 units before bedtime each day 25 units before bed; disp #*30 each refills:*0 rx *lantus 100 unit/ml please take 25 units before bed each night 25 units before bed; disp #*750 unit refills:*0 rx *humalog 100 unit/ml up to 24 units per sliding scale four times a day disp #*2250 unit refills:*0 rx *freestyle lancets please check your blood sugar at meals and in the evening before bed please check four times a day disp #*120 unit refills:*0 rx *insulin syringe 30 gauge x " please use to inject insulin up to five times a day (humalog at meals and bedtime if needed and glargine at bedtime as intructed) disp #*120 unit refills:*0 2. oxycodone (immediate release) 10 mg po q4h:prn pain hold for sedation, rr<12 rx *oxycodone 5 mg 2 capsule(s) by mouth every four hours disp #*12 tablet refills:*0 discharge disposition: home with service facility: vna discharge diagnosis: pancreatitis alcohol withdrawal ventilator-associated pneumonia acute respiratory distress syndrome hyperglycemia tachycardia discharge condition: improved mentating appropriately ambulating independently discharge instructions: dear mr. , it was a pleasure taking care of you. you were admitted for pancreatitis due to heavy alcohol use and treated with iv fluids and pain medications. you also were treated for alcohol withdrawal, and no longer show any signs of withdrawal. you developed pneumonia associated with being on a ventilator and were treated with a course of antibiotics. you were found to have high blood sugars and started on insulin: please take 25 units of insulin glargine in the evening and use the insulin sliding scale as instructed. please follow up with your primary care doctor at the time and date listed below; you likely will not need to remain on insulin after your pancreatic function recovers. finally, your heart rate was found to be mildly elevated, possibly due to the stress of being in the hospital, with some contribution from fluid removal. your primary care doctor may need to address your elevated heart rate if it persists. followup instructions: friday, at 11:45am with dr. . name: , b location: medical group address: , , phone: fax: procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances enteral infusion of concentrated nutritional substances diagnoses: anemia, unspecified acute kidney failure, unspecified acute respiratory failure other specified cardiac dysrhythmias alkalosis methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site long-term (current) use of insulin diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled hyperosmolality and/or hypernatremia ventilator associated pneumonia acute pancreatitis other and unspecified alcohol dependence, continuous alcohol withdrawal other fluid overload 

Answer: The patient is high likely exposed to