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: phenytoin / antihistamines / cipro attending: chief complaint: respiratory failure major surgical or invasive procedure: intubation history of present illness: mr is a 46 yo man c hx of alcohol dependence, depression , adhd.multiple suicide attempts including phenobarb overdose. pt recently transferred from hosp .has been there since for detox from alcohol. pt had been c/o being unable to sleep over the last 72 hours.pt was given trazodone and seroquel after which he was found on the floor at the lobby of the institution, obtunded. in ed: pinpoint pupils, responding only to pain. bp 130/70 hr 70.spo2 99% rr 10. given 2 mg iv narcan with no response. pt was intubated for airway protection. started on propofol drip. urine was (+) for benzos. ct of head with craniotomy on the left, no acute bleeding. ct c-spine negative for fracture, kept in c-collar until able to clinically clear. charcoal through ng tube was started. past medical history: delirium tremens bipolar disorder suicide attempts traumatic brain injury s/p assault secondary seizure disorder (d/2 trauma?) cerebellar ataxia (seizure meds?) hep b 's esophagus hx delirium tremens social history: lives in a shelter in unemployed no source of income alcohol use since age 22 drinks 1 and gallons of vodka every day hx of many detoxes (one note reported >100) denies use of any other illicit drugs/street pills/ivda family history: non-contributory. physical exam: vs bp 116/82 hr 78 t 98.8 -gen: caucasian man, intubated , sedated, no response to pain -heent: pinpoint pupils -neck: no jvp -chest: cta bl -cv: rrr no m/g/r -abd: nt, nd -ext: no edema pertinent results: 03:57pm type-art o2-20 po2-138* pco2-40 ph-7.39 total co2-25 base xs-0 09:16am type-art po2-64* pco2-48* ph-7.36 total co2-28 base xs-0 05:40am type-art temp-37.0 rates- tidal vol-600 peep-5 o2-100 po2-347* pco2-53* ph-7.36 total co2-31* base xs-3 aado2-312 req o2-58 -assist/con intubated-intubated 05:24am glucose-131* urea n-6 creat-0.6 sodium-142 potassium-3.8 chloride-107 total co2-27 anion gap-12 05:24am alt(sgpt)-30 ast(sgot)-18 ld(ldh)-145 ck(cpk)-68 alk phos-58 tot bili-0.3 05:24am ck-mb-3 ctropnt-<0.01 05:24am albumin-3.8 calcium-8.8 phosphate-4.2 magnesium-1.6 05:24am valproate-65 05:24am wbc-6.3 rbc-4.02* hgb-12.5* hct-35.9* mcv-89 mch-31.0 mchc-34.8 rdw-13.8 05:24am neuts-51.7 lymphs-40.7 monos-4.4 eos-2.2 basos-1.0 05:24am plt count-401 05:24am pt-12.3 ptt-24.2 inr(pt)-1.1 02:50am urine hours-random 02:50am urine bnzodzpn-pos barbitrt-neg opiates-neg cocaine-neg amphetmn-neg mthdone-neg 02:50am urine color-yellow appear-clear sp -1.013 02:50am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-tr bilirubin-neg urobilngn-neg ph-6.5 leuk-neg 02:28am comments-green top 02:28am glucose-158* lactate-1.6 na+-143 k+-3.4* cl--101 tco2-29 02:23am urea n-8 creat-0.7 02:23am ck(cpk)-68 amylase-32 02:23am ck-mb-notdone ctropnt-<0.01 02:23am phenytoin-<0.6* 02:23am asa-neg ethanol-neg acetmnphn-neg bnzodzpn-pos barbitrt-neg tricyclic-neg 02:23am wbc-5.2 rbc-4.38* hgb-13.7* hct-38.9* mcv-89 mch-31.4 mchc-35.3* rdw-13.9 02:23am pt-12.4 ptt-24.9 inr(pt)-1.1 02:23am plt count-425 02:23am fibrinoge-266 . ct c-spine: there is anterior cervical spine fusion seen at c4-c5. degenerative changes are seen at this level and at c3-4 and c4-5, as well as moderate to severe spinal stenosis. no fractures are identified. there is mild kyphosis at c3-4 probably related to degenerative changes and fusion. the patient is intubated and has a nasogastric tube; prevertebral soft tissue swelling cannot be assessed. there appears to be some posterior pleural thickening at the right pulmonary apex. impression: degenerative changes of the spine, spinal stenosis, with cervical spine fusion at c4-5; no acute fracture is identified. . ct head: no acute intracranial hemorrhage. previous left craniotomy and encephalomalacia of left frontal lobe. . cxr: 1. successful intubation. successful placement of nasogastric tube. 2. retrocardiac opacity with air bronchograms suggesting consolidation. . ekg: sinus rhythm inferior/lateral st-t changes since previous tracing, no significant change . brief hospital course: the patient was admitted to the medical icu, intubated and sedated. he was extubated on hospital day #1 without complication, and quickly weaned to room air by hd . he remained somewhat sleepy but arousable to voice. a psychiatry consult was obtained and the patient was deemed not suicidal and the exact etiology of his obtundation/respiratory depression remained unclear. . unresponsive episode: the pt was found down after being given seroquel at an outside detoxification facility. the pt was noted to be unresponsive and was intubated for respiratory depression. the pt also underwent a ct head which ruled out a mass effect or bleed. the pt also underwent an mri neck which showed the pt to be status post fusion at c4-5. there was no evidence of a fracture involving the posterior aspects of the vertebral bodies or acute encroachment on the spinal canal. there was hyperintensity in the cervical spinal cord at c4-5 which likely represents malacia from prior compression. there was some evidence of a narrowing of the spinal canal at the c4-5 and levels but the spinal cord was also noted to be atrophic through these levels and did not appear compressed. there was no evidence of ligamentous injury posteriorly (of note, the hardware prevented evaluation of the possibility of anterior longitudinal ligament disruption). to date, the etiology of the pt's unresponsive episode was unclear but it was thought to be most likely toxic/ metabolic. the pt was evaluated by psychiatry and they recommended a toxic-metabolic workup. on the first day on the , the pt requested to leave against medical advise. the pt was evaluated urgently by the psychiatry service and was deemed to be capable of making a decision. pt was deemed safe for discharge, and appeared to have good understanding the of medical concerns and risks of premature discharge. the psychiatry service felt that the pt was not suicidal, psychotic or confused. their primary concern was that pt will resume alcohol abuse on discharge. he was also subsequently evaluated by the medicine attending, dr. and was deemed medically stable for discharge home. the following studies: tsh, rpr and b12 were pending at the time of discharge and will need to be followed up as an outpatient by the patient's primary care provider. . etoh abuse the pt was noted to be slightly tremulous on admission to the . it is likely that he is out of the window period for alcohol withdrawal. the pt was continued on thiamine, folate and multivitamins. the pt was encouraged to participate in a more intensive addictions treatment, including inpatient rehabilitation. the pt reported that he is on a "waiting list" at hosp and does not want us to pursue this further. . seizure disorder the pt was continued on anti-epileptics and there was evidence of active seizure activity.the pt was offered complete workup of possible underlying seizures, including an eeg, but he refused. the pt was made aware of the possibility of recurrent seizures with the possibility of harm to himself or someone else. the pt acknowledged and accepted these risks. he was instructed to not drive until he was cleared to do so by a neurologist. the pt may benefit from an eeg as an outpatient in the event of recurrent seizures. . neck pain the pt was noted to complain of neck pain. there was no evidence of fracture or misalignment on ct. the pt also underwent an mri that showed no evidence of a cord compression or a ligamentous injury. he was given a soft collar by the orthopedics service which he agreed to wear until there was improvement of neck pain. . ?ascites the pt was noted to have a mild shifting dullness on clinical exam. however, there is no current evidence of synthetic dysfunction. the pt would benefit from an out-patient evaluation of underlying ascites and possible cirrhosis with an abdominal ultrasound. . prophylaxis: the pt was maintained on pantoprazole and was encouraged to ambulate. . code: full code medications on admission: depakote 500mg tid neurontin 600mg tid ritalin 54mg qam campral 666mg tid thiamine 100mg daily seroquel 100mg qhs effexor 225mg qd . all: dilantin, tegretol, antihistamines, cipro discharge medications: 1. venlafaxine 75 mg tablet sig: two (2) tablet po daily (daily) for 7 days. disp:*14 tablet(s)* refills:*0* 2. divalproex 500 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po tid (3 times a day) for 7 days. disp:*21 tablet, delayed release (e.c.)(s)* refills:*0* 3. gabapentin 300 mg capsule sig: two (2) capsule po q8h (every 8 hours) for 7 days. disp:*14 capsule(s)* refills:*0* 4. 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* 5. concerta 54 mg tab, sust release osmotic push sig: one (1) tab, sust release osmotic push po once a day for 7 days. disp:*7 tab, sust release osmotic push(s)* refills:*0* 6. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: -unresponsive episode: likely adverse effect of medication -substance abuse with h/o dts -bipolar disorder -multiple suicide attempts -s/p subdural hematoma in ' following trauma w/ evacuation and cranitomy -secondary seizure disorder -cerbellar ataxia -hbv -'s esophagus -?c-spine surgery several years ago -s/p appy discharge condition: stable, in no respiratory distress and has no confusion. discharge instructions: please report to the nearest emergency room if you have lighheadedness, loss of consciousness, worsening neck pain, nausea, vomiting, confusion, weakness or loss of sensation. . there has been a change in your medications. please take all medications as directed. please ask your primary care provider for refills of your home medications. . please call your pcp and schedule an appointment to see her within the next week. you will need to ask your pcp to on the final results of your mri head and neck. . please continue to attend your aaa meetings and see your psychiatrist within one week of discharge. followup instructions: please call your pcp after discharge and schedule an appointment to see her within the next week. md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube diagnoses: cirrhosis of liver without mention of alcohol other convulsions depressive disorder, not elsewhere classified acute respiratory failure poisoning by other antipsychotics, neuroleptics, and major tranquilizers attention deficit disorder with hyperactivity bipolar i disorder, most recent episode (or current) unspecified lack of housing viral hepatitis b without mention of hepatic coma, acute or unspecified, without mention of hepatitis delta other and unspecified alcohol dependence, continuous accidental poisoning by other specified tranquilizers accidental poisoning by antidepressants 

Answer: The patient is high likely exposed to