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: alcohol intoxication, altered mental status major surgical or invasive procedure: intubation and then extubation for respiratory compromise and airway protection during episode of acute severe alcohol intoxication history of present illness: mr. is a 58-year-old male with past medical history significant for etoh abuse and anemia who presented with unresponsiveness and found to be significantly intoxicated with etoh level of 516 on admission in the emergency room. he was intubated in the er for airway protection. patient had limited recollection of events leading up to his emergency room course. . in the emergency department initial vital signs were t: 97.1 bp: 130/70 hr: 84 rr:20. he received 2l ns ivfs and he was placed on fentanyl and midazolam drips. initial review of systems was unable to be obtained. he was intubated for airway protection and admitted to the medical icu for airway management and monitoring for alcohol withdrawal. labs were also notable for hypernatremia with na of 150. . he was given free water boluses to help resolve hypernatremia while in icu and he was successfully extubated and placed on a ciwa scale with valium on prior to transfer from micu to general medical floor. . vital signs per medicine resident note upon arrival to medical floor on were t 100.1, hr 95, bp 152/95 and rr 20 with o2 saturation 97% on room air. . past medical history: -alcohol abuse -right bimalleolar ankle fracture s/p orif -longstanding anemia social history: patient was homeless at time of admission and states he moves from shelter to shelter in the colder weather. consumes about to pint vodka per day, sometimes "other" alcohol. denies having seizures in the past. smokes 1 ppd. denies other illicit drug use / ivdu. family history: not able to convey, not cooperative with questioning. physical exam: admission exam: vitals: t 95.2f, bp 116/82, hr 78, intubated with rr 18 gen: intubated and sedated, not responding to commands heent: nc/at, pupils pinpoint bilaterally, op clear, ett in place neck: supple, no lad pulm: ctab, no wheezes or crackles appreciated card: bradycardic, no murmurs appreciated abd: +bs, soft, non-tender, non-distended ext: no le edema skin: intact, no lesions appreciated neuro: sedated, pupils constricted and minimally responsive, not withdrawing to painful stimuli, babinski equivocal bilaterally . discharge exam: vitals: t 99.6f, bp 107/67, hr 102, rr 20 and o2 sat 100% ra. general: well appearing male, walking with cane in hallway, nad heent: nc/at, perrla and eomi. poor dentition but op clear of any erythema, exudates. nares clear. neck: no jvd, no lad, supple pulm: poor aeration at bases with decreased lung sounds, otherwise clear to auscultation card: rrr, no murmurs/rubs/gallops abd: nt/nd, normoactive bowel sounds in all quadrants, non-distended, no cva tenderness and no suprapubic area tenderness neuro: cns grossly in tact, no resting tremor noted, slow speech at times but appropriate, sensation to light touch in tact, gait slow with cane and shuffles at times ext: 2+ pedal pulses, no edema skin: no rashes . pertinent results: admission labs: 07:20pm asa-neg ethanol-516* acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 07:20pm wbc-6.6 rbc-4.12* hgb-13.2* hct-41.0 mcv-100* mch-32.1* mchc-32.3 rdw-17.6* 07:20pm pt-13.3 ptt-20.9* inr(pt)-1.1 07:20pm fibrinoge-348 07:24pm glucose-102 lactate-5.3* na+-150* k+-3.2* cl--102 tco2-26 08:30pm urine bnzodzpn-neg barbitrt-neg opiates-neg cocaine-neg amphetmn-neg mthdone-neg 08:44pm type-art po2-517* pco2-40 ph-7.34* total co2-23 base xs--3 imaging studies: . cxr: in comparison with the study of , there are continued atelectatic changes at the left base. no evidence of acute focal pneumonia or vascular congestion. . cxr: the patient is rotated to the right. there has been interval removal of the endotracheal tube. the lungs are well expanded and clear without focal consolidation, pleural effusion or pneumothorax. the stomach is distended. the cardiac and mediastinal silhouettes and hilar contours are stable allowing for rotation. impression: no acute cardiopulmonary process. no evidence of pneumonia. . abd ultrasound: echogenic liver consistent with fatty infiltration. other forms of liver disease and more advanced liver disease including significant hepatic fibrosis/cirrhosis cannot be excluded on this study. . ct head : global atrophy, slightly advanced for stated age of 58 years. otherwise, no acute intracranial process identified. the patient is intubated with pooling of secretions in the oropharynx. . cxr : presumed left lower lobe atelectasis. there is prominence and poor definition in the right hilar region. it is difficult to exclude underlying mass lesion with potential downstream atelectasis. consider ct scan if indicated once clinically feasible. endotracheal tube in satisfactory position. . cardiac /ekgs: ekg - rate mid 50s, sinus bradycardia. baseline artifact. non-specific intraventricular conduction delay. possible left ventricular hypertrophy. non-specific st-t wave changes could be due to left ventricular hypertrophy, although cannot exclude ischemia or a metabolic/drug effect. poor r wave progression in leads v1-v3 could be due to left ventricular hypertrophy or lead placement. no previous tracing available for comparison. . . microbiology data: urine culture -8:30 pm urine source: cvs. **final report ** urine culture (final ): beta streptococcus group b. >100,000 organisms/ml.. blood culture pending x2 blood cultures pending x2 blood cultures pending x2 . discharge labs: 05:05am blood wbc-7.3 rbc-3.81* hgb-12.3* hct-37.2* mcv-98 mch-32.2* mchc-32.9 rdw-17.3* plt ct-395 05:05am blood plt ct-395 05:05am blood 05:05am blood glucose-119* urean-10 creat-0.9 na-135 k-3.2* cl-98 hco3-28 angap-12 05:05am blood calcium-8.7 phos-4.1 mg-1.3* brief hospital course: in summary, mr. is a 58 year old male with longstanding history of alcohol abuse who was brought to emergency room after being found unresponsive in the setting of etoh intoxication and required urgent intubation for airway protection and close monitoring. patient was successfully extubated ~36 hours after presentation and followed closely with as-needed dosing of valium for etoh withdrawal. initial hypernatremia, hypothermia and lactic acidosis all resolved slowly but he continues to have intermittent hypokalemia, low magnesium and lasting mild anemia. patient had notable hospital course for fevers and thorough workup with multiple labs, microbiology studies and chest/abdominal imaging in search of fever source. ultimately, patient grew out over 100k colonies of group b streptococcus bacteria from urine culture which was felt to be the most likely cause for his recent fevers and he was discharged on antibiotics as outlined below. please see below for detailed problem list based summary of hospitalization. . #. etoh intoxication/intubation for airway protection: patient significantly intoxicated on admission. extubated after <36 hours. he scored on ciwa for hypertension and tachycardia, requiring 3 doses of valium on and two doses on with scattered doses over the following few days. by patient was stable enough so that he had not scored any ciwa scale points for over 24 hours and his ciwa monitoring and valium both discontinued. telemetry discontinued . social work and nursing addictions were consulted and followed patient closely during his admission. patient was given gentle ivfs initially and slowly transitioned to a regular diet which he tolerated well. given anemia and longstanding etoh use he was also started on daily 100mg thiamine, 1mg folate supplement and a daily multivitamin. also counseled on etoh avoidance at time of discharge. fortunately, two follow-up cxrs on and showed no evidence of any infiltrates associated with recent intoxication and intubation/extubation. . #. lactic acidosis: likely secondary too dehydration in setting of etoh intoxication. no high fevers or signs of infection initially when he had elevateed lactate level, trended down to normal after generous iv fluid resuscitation in the icu setting. . #fevers: spiked to 102f range on and again overnight on after over 24hrs no fevers. cxr from was negative for any infiltrates and he denied any cough or shortness of breath. recent ruq us negative for any biliary process and he denied any nausea, vomiting or diarrhea symptoms. urine and blood cultures re-sent again overnight but early morning urine culture data returned positive for >100k group b strep growth which suggested uti as most probable source. recent foley placed and male so will plan to treat x 7 days for complicated course. will plan to follow-up final blood cultures pending at time of discharge as well as the urine culture sensitivity data. he was discharged with plan for amoxicillin 500mg tid coverage x 7 days for uti given very limited side effect profile and excellent gbs . this information conveyed to the pine stree inn nurse at time of discharge to shelter. . #gait imbalance: noted mild gait imbalance soon after arrival to medical floor but after several days his reassessed gait improved, especially with use of cane. seen and evaluated by physical therapy who felt patient was safe for discharge to shelter setting. he may have been more challenged when patient was post-intoxication stage and on ciwa actively. walks with cane at baseline. be from long term etoh use as well. . #hypernatremia: noted at time of admission with sodium high of 150 which slowly resolved after several free water boluses in the micu. this was attributed to severe dehydration in setting of intoxication and etoh. at time of discharge na was in normal range at 135. . #hypothermia: noted at time of initial admission on after patient found outside with altered mental status. felt to be from environmental exposure and his body temperature regulated within less than 24 hours of admission with gentle warming with blankets. . #fluids, electrolytes and nutrition: given alcoholism he was continued on supplements with thiamine, folate and daily multivitamins. followed his mg and potassium closely given tendency for hypomagnesemia and hypokalemia. regular diet, gentle ivfs given prn but very good po intake at time of discharge. . #prevention: heparin sc for dvt prevention . #code status: discussed twice with patient by medical housestaff and patient desired to be full code status. . medications on admission: none discharge medications: 1. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*1* 3. multivitamin tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. amoxicillin 250 mg capsule sig: two (2) capsule po q8h (every 8 hours) as needed for uti for 7 days. disp:*42 capsule(s)* refills:*0* discharge disposition: home discharge diagnosis: primary diagnoses: . 1. alcohol withdrawal 2. respiratory distress 3. fevers 4. urinary tract infection discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: dear mr. , . you were admitted to the hospital with alcohol intoxication and put on a breathing machine because you were not awake enough. you were taken off the breathing machine and given valium to prevent alcohol withdrawal symptoms such as anxiety and rapid heart rates or palpitations. after several days this valium medication was tapered and stopped. by the time of discharge now you demonstrated no active signs that were felt to be concerning for acute alcohol withdrawal. . you also had an evaluation of your fevers with a chest x-ray and you did not have any evidence of pneumonia. you had additional abdominal imaging studies which showed no evidence of any gall bladder infections. blood and urine samples/labs were collected to continue to search for a source of your fevers and a urine culture was ultimately positive for group b streprococcus bacteria so you were started on a 7 day course of antibiotics to treat this infection. the medical team will continue to monitor your pending blood cultures after your discharge to ensure you do not have to be treated for any other infections. . during your hospital stay you had some low potassium levels and low magnesium levels which were repleted. it is very important that you have these labs followed on an outpatient basis. . as discussed, please follow up with your new primary provider at the health clinic. appointment details are listed below. you need to have your electrolytes (potassium, magnesium) evaluated and you need to be seen to monitor for improvement in your urinary tract infection symptoms. . . medication instructions / new medications: -please continue taking a daily thiamine supplement (100mg daily) -please continue taking a daily folic acid supplement (1 mg daily) -please continue taking a daily multivitamin -please continue taking amoxicillin 500mg tablets every 8 hours (or three times daily) over the next 7 days to effectively treat your urinary tract infection . as explained, if you have any recurrent fevers, confusion or feel ill please return to the hospital emergency room or contact your new primary care provider listed below. . the social work team here has counseled you on the harms of ongoing alcohol use, please continue your efforts to abstain from alcohol use as an outpatient. you were set up for discharge to inn in and given a cab voucher for transportation there at time of discharge. the nurse at the shelter was also notified of your arrival. followup instructions: please see your new primary care provider for appointment which has been set up for you for monday at 1:30pm with n.p. (works with dr. . office location is , ma. office is on . phone #. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube diagnoses: acidosis anemia, unspecified tobacco use disorder urinary tract infection, site not specified abnormality of gait hypopotassemia hyperosmolality and/or hypernatremia disorders of magnesium metabolism abdominal pain, generalized lack of housing alcohol withdrawal hypothermia streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group b acute alcoholic intoxication in alcoholism, continuous accident due to excessive cold due to weather conditions 

Answer: The patient is high likely exposed to