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: altered mental status, question fall major surgical or invasive procedure: endotracheal intubation history of present illness: hpi 47 y/o with a history of alcohol abuse presents to ed after found intoxicated. per ed notes the patient walking up to a gas station and called for help before throwing him self to the ground. there are scattered reports of complaints of back pain or a recent assualt. noted to smell of alcohol. he was able to ambulate and was a+ox3 prior to arrival at the hospital. bg in the field for 140. . upon arrival to the pt was 96.8, bp 113/78, hr 84, rr 14, 96% (on unclear level of oxygen. pt requested pain medication. he became increasingly somulent and desated to 86 % on nc. saturated improved to 97 % on non-rebreather but the pt became unresponsive to sternal rub. received narcan x 2 without improvement. serum etoh 184, tox positive for benzos. he was intubated for airway protection. et tube inserted orally after failed nasal intubation. during intubation pt sat up in bed requiring propofol gtt for sedation. received etomidate 20mg, succinylcholine 100mg, versed 6mg, fentanyl 100mg iv in ed. . upon arrival to floor pt intubated on sedated. unable to illicit further history. no contact person. . past medical history: pmh: alcohol abuse with previous withdraw (previous ed note from , no mention of seizures) social history: sh: homeless, history of alcohol abuse. last drink time unknown. family history: unknown physical exam: pe: t:96.4 bp:118/86 hr:93 rr:16 o2 100% on cmv 100%/500/14/5 gen: intubated and aggitated. trying to sit up and pull at tubes. purposeful movements, no epileptiform movements heent: resisting eye opening. et tube in place, ng in place neck: in hard collar cv: rrr. nl s1, s2. no murmurs, rubs or lungs: ctab, good bs bl, no w/r/c abd: soft, nt, nd. nl bs. no hsm. small bruising suggestive of recent sq heparin on abd. ext: wwp, no cce. 2+ dp pulses bl skin: no rashes/lesions, ecchymoses. neuro: intubated and aggitated. cn 2-12 grossly intact. will not cooperate for strength or sensation exam. moving all for ext. pertinent results: 01:55pm plt count-330# 01:55pm neuts-83.6* lymphs-12.8* monos-1.9* eos-1.5 basos-0.2 01:55pm wbc-7.6 rbc-4.44* hgb-14.5 hct-40.0 mcv-90 mch-32.6* mchc-36.3* rdw-13.4 01:55pm asa-neg ethanol-184* acetmnphn-neg bnzodzpn-pos barbitrt-neg tricyclic-neg 01:55pm ck-mb-2 ctropnt-<0.01 01:55pm lipase-56 01:55pm alt(sgpt)-23 ast(sgot)-48* ck(cpk)-110 alk phos-45 tot bili-0.7 01:55pm glucose-105 urea n-13 creat-0.8 sodium-140 potassium-4.9 chloride-105 total co2-25 anion gap-15 07:47pm pt-14.0* ptt-26.7 inr(pt)-1.2* . ct c-spine w/o contrast study date of 1:41 pm findings: there is no fracture or dislocation detected. the prevertebral soft tissues are normal. there is multilevel degenerative changes with no associated significant central canal stenosis or neural foraminal narrowing. the visualized outline of the thecal sac appears unremarkable. ct is not able to provide intrathecal detail comparable to mri. the patient is status post endotracheal tube and orogastric tube placement. the endotracheal tube balloon demonstrates overdistention. there is an external catheter that courses through to the left external jugular vein. . ct head w/o contrast study date of 1:41 pm non-contrast head ct: there is no hemorrhage, hydrocephalus, shift of normally midline structure, or evidence of major vascular territorial infarct. the -white matter differentiation is preserved. copious secretions are identified within the nasopharynx, which is likely related to ng tube/intubation. the visualized paranasal sinuses and mastoid air cells remain normally aerated. old right nasal bone fracture is identified. impression: no hemorrhage. impression: 1. no evidence of fracture or dislocation. 2. endotracheal tube in place with apparent overdistention of balloon. recommend slight deflation. 3. catheter visualized in the left external jugular vein. please correlate clinically. . ct pelvis w/contrast study date of 1:42 pm ct of the abdomen with intravenous contrast: the lung bases show mild dependent atelectasis. ng tube terminates in the stomach. the liver shows no focal lesion. the gallbladder is normal. the intra- and extra-hepatic bile ducts are not dilated. punctate focus of calcification in the body of the pancreas (2:27) may relate to parenchymal calcification, however, small stone is not excluded. there is no pancreatic ductal dilatation or peripancreatic stranding. the spleen and adrenal glands are normal. the kidneys enhance and excrete contrast symmetrically. a subcentimeter hypodensity in the lower pole of the left kidney is incompletely characterized. the intra- abdominal loops of large and small bowel maintain a normal caliber without evidence of obstruction. there is no free air or free fluid. small peripancreatic lymph nodes are present measuring up to 7 mm. aortic atherosclerotic calcification is moderate. the celiac trunk, sma, and are patent. a fat-containing umbilical hernia is present. ct of the pelvis with intravenous contrast: the rectum, sigmoid colon, prostate, and seminal vesicles are unremarkable. the bladder is collapsed and contains a foley catheter. there is no lymphadenopathy or free fluid. bone windows: no suspicious lytic or sclerotic lesion is identified. impression: 1. no evidence of anterior abdominal parenchymal organ injury. 2. punctate calcification in the mid body of the pancreas, which may represent a focal parenchymal calcification or small stone. there is no pancreatic ductal dilatation or peripancreatic inflammatory change. 3. mildly prominent peripancreatic lymph nodes, which is a nonspecific finding. . . mr cervical spine w/o contrast study date of 11:11 am findings: the study is compared with the unenhanced ct of the cervical spine . the sagittal stir sequence is essentially unremarkable, other than band-like hyperintensity in the c3 inferior endplate, which demonstrates corresponding t1-hypointensity, and sclerosis on the ct; this likely represents a combination of discogenic i and iii change. no other focal stir-signal abnormality is seen to suggest acute ligamentous or other soft tissue abnormality or spinal cord injury. the axial sequence is significantly degraded by motion artifact, limiting its interpretation, but there are multilevel degenerative changes, as follows: at c2-c3, a broad-based disc more than endplate osteophyte effaces the ventral csf, slightly indenting the ventral cord. there is more marked degeneration of the c3-c4 disc with broad-based herniation and endplate spondylotic ridge, significantly flattening the ventral cord. there is also at least moderately severe right neural foraminal narrowing, as on the ct. allowing for significant artifacts, the sagittal t2- weighted sequence demonstrates frank compression of the cord at this level, in part due to ligamentum flavum thickening, dorsally, with suggestion of central t2-hyperintensity (2:9), which may represent myelomalacia. there is no evidence of intramedullary hemorrhage on the gre sequence. the c4-c5 disc is better-maintained in height and signal intensity; however, broad-based endplate spondylotic ridge again effaces the ventral csf, flattening that aspect of the cord, and there is also bilateral neural foraminal narrowing at this level, as on the ct. at c5-c6 and c6-c7, disc-endplate osteophyte complex slightly effaces the ventral csf and flattens the cord, without intrinsic signal abnormality. the included upper cervical levels are grossly unremarkable, the craniocervical junction is within normal limits and the cervical spinal cord is otherwise normal in caliber and intrinsic signal intensity. the limited visualized posterior fossa structures are grossly unremarkable. impression: 1. no definite evidence of acute cervical spine or spinal cord injury. 2. multilevel degenerative disc, endplate and uncovertebral joint disease; this is most severe at the c3-c4 level where, in combination with ligamentum flavum thickening, there is frank cord compression. there is a suggestion of linear t2-hyperintensity in the central cord substance, which, given the lack of other evidence of acute injury, more likely represents chronic myelomalacia rather than edema. brief hospital course: mr is a 47 year old man with a history of alcohol abuse who presented with altered mental status and a question of trauma (fall versus assault) and was found to have a serum tox screen that was positive for alcohol and benzodiazepines. intubated for progressive somulence. . during this hospitalization the following issues were addressed: . # acute mental status change: on admission the pt was intubated for airway protection given his progressive somulence. the pt had a normal serum glucose and no fever or leukocytosis to to suggest infection. in the emergency room the pt had extensive imaging including a ct of the head, cervical spine and abdomen and pelvis to evaluate for traumatic injury. on physical exam the pt had no focal findings to suggest cva. on admission to the icu the pt remained apneic on arrival secondary to sedation. over the course of the first night of admission the pt became aggitated and in the morning the pt's sedation was weaned and the pt self-extubated. the pt was then noted to be alert and oriented to person, place and time and likely at baseline mental status. the pt's admission somnolence was likely due to alcohol and benzodiazepine intoxication. the pt did not have any additional episodes of somnolence or altered mental status during this admission. on discharge the pt's speech was clear, linear, regular rate, and he was alert and oriented times three. . # alcohol use: the pt reported a history of alcohol withdraw but denied a history of seizures with withdrawal. serum alcohol level on admission was 184 and the pt was treated with a bannana bag, thiamine, folate and a ciwa scale was initiated. on day two of hospitalization the pt was transferred to the medical floor and was notably agitated, anxious and tremulous. the pt received one dose of diazepam and over the course of the following 4 days the pt's ciwa score progressively declined. on discharge the pt's ciwa score had been in the 0-2 range for 72 hours and he had not received any diazepam since day 2 of admission. social work was asked to evaluate the pt and they recommended a dual diagnosis inpatient stay, but due to the pt's need for oxycodone the pt was unable to be placed in a dual diagnosis facility. the pt reported that he planned to look into outpatient alcohol cessation programs including one at . . # cervical spine tenderness: the pt complained of neck pain following his extubation on day 2 of admission, so has cervical collar remained in place. the spine service was asked to evaluate the pt for purposes of clearing his cervical spine and they recommended a cervical spine mri given point tenderness over the cervical spine. mri of the cervical spine showed no definite evidence of acute cervical spine or spinal cord injury and multilevel degenerative disc, endplate and uncovertebral joint disease that was most severe at the c3-c4, as well as evidence of chronic myelomalacia. the spine service recommended that the pt continue to wear the cervical spine/ j collar for the next few weeks and that he follow up with the spine service as an outpatient for potential operative or non-operative treatment. . # hepatitis c: during the pt's admission he was involved in an employee needle-stick injury. at the time of the injury the pt was somnolent and his hep c status was unknown. medications on admission: oxycodone nicotine patch senna gabapentin discharge medications: 1. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po bid (2 times a day) as needed for constipation. disp:*qs ml(s)* refills:*2* 2. gabapentin 300 mg capsule sig: one (1) capsule po tid (3 times a day). 3. nicotine 21 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily). 4. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*39 tablet(s)* refills:*2* 6. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. disp:*30 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: 1. alcohol intoxication, alcohol withdrawal 2. chronic degenerative cervical spine changes discharge condition: stable. able to breathe comfortably on room air, ambulate without assistance, attend to all adls. discharge instructions: you were admitted after an assault. initially you were extremely somnolent and unable to be aroused and you were intubated for airway protection. the following morning you removed the breathing tube. you most likely were somnolent due to intoxication from alcohol and oxycodone. you were treated during this admission for alcohol withdrawal and you did not show any signs of alcohol withdrawal after day 2 of admission. . during this admission you also reported some tenderness over the bones in your neck, so the spine service was asked to consult about your cervical spine. you had a cervical spine mri that showed chronic degenerative changes and now acute injury. the spine service recommended that you continue to wear your cervical spine collar until you see them in the office. . you have the below follow up appointments with your primary care providers and the orthopedic surgery spine physician. is very important that you attend your follow up appointments. . all of your home medications have been continued. please take your medications as directed. during this hospitalization you were also started on lactulose and senna for constipation and the vitamins folate and thiamine. . please call your primary care doctor or go to the nearest emergency room if you develop headaches, nausea, vomiting, weakness or numbness, are unable to tolerate food or liquids, fever > 100.4, chills, shortness of breath, chest pain, or any other concerning symptoms. . followup instructions: primary care follow up: you have primary care follow up scheduled with your normal pcp in . you also have the following appointment scheduled with another doctor in the medical group: dr. , monday, at 2:00pm. . orthopedic surgery follow up: dr. , at 9:30am. building, . procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube diagnoses: tobacco use disorder constipation, unspecified lumbago migraine, unspecified, without mention of intractable migraine without mention of status migrainosus lack of housing other alteration of consciousness sedative, hypnotic or anxiolytic abuse, unspecified alcohol withdrawal acute alcoholic intoxication in alcoholism, continuous cervicalgia apnea other myelopathy 

Answer: The patient is high likely exposed to