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, acute hepatitis. major surgical or invasive procedure: -intraamniotic digoxin injection () -dilation and evacuation of intrauterine pregnancy in pieces () history of present illness: patient is a 21 yo w g3p1, now 22w6d with pmh of etoh and vicodin abuse found at home in bathtub with altered mental status. she was brought to osh agitated and hypoxic, intubated and transferred for management of fulminant hepatic failure. initial labs include the following: ast 897, alt 1022, alk phos 119 t bili 5.5, alb 2.7, lipase 48, ammonia 157, hct 28.4, plt 304, inr 2.7, cr 1.4, tylenol<10, neg salicylate level, urine tox positive for opiates. ct head was without any abnormalities. past medical history: asthma g3p1 etoh abuse since age 15 social history: lives with her grandmother, smoker, heavy etoh abuse w/ daily bourbon. abuses vicodin which she buys on the street. has a 2.5 yo son who lives with father. history of prior si or hi. recent breakup with bf. family history: non-contributory. physical exam: vitals - t: 98.8 bp: 131/80 hr: 91 rr: 30 02 sat: 100% on 50% fio2 peep 5 general: sedated on vent, withdraws from painful stimuli heent: no icterus, scleral hemorhage on r, mmm, ett in place with dried blood on tube cardiac: tachycardic, regular, no mrg lung: ctab abdomen: gravid, soft, nt, bs+ ext: no edema, 2+ dp/pt pulses neuro: pupils equal and reactive to light, no clonus, knee reflexes hyperreflexic bilaterally. derm: no rashes pertinent results: labs at admission: 11:45pm blood wbc-5.9 rbc-2.93* hgb-8.9* hct-27.2* mcv-93 mch-30.3 mchc-32.6 rdw-17.9* plt ct-250 11:45pm blood neuts-67 bands-0 lymphs-21 monos-3 eos-5* baso-0 atyps-0 metas-3* myelos-1* 11:45pm blood pt-17.1* ptt-28.8 inr(pt)-1.5* 11:45pm blood glucose-115* urean-15 creat-0.5 na-146* k-3.9 cl-123* hco3-18* angap-9 11:45pm blood alt-439* ast-111* ld(ldh)-228 alkphos-69 totbili-4.3* 11:45pm blood albumin-2.4* calcium-7.1* phos-1.4* mg-1.5* 11:45pm blood hapto-28* 05:45am blood caltibc-247* ferritn-288* trf-190* 11:45pm blood triglyc-204* 05:06am blood triglyc-145 06:02am blood ammonia-59* 05:45am blood hbsag-negative hbsab-positive hbcab-negative hav ab-negative 11:58am blood smooth-negative 11:58am blood -negative 05:45am blood igg-736 05:45am blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 05:45am blood hcv ab-negative 08:35am blood herpes simplex virus 1 and 2 antibody igm-pnd labs at discharge: 07:22am blood wbc-11.3* rbc-2.40* hgb-7.7* hct-23.5* mcv-98 mch-32.0 mchc-32.8 rdw-17.2* plt ct-385 07:22am blood glucose-77 urean-5* creat-0.4 na-140 k-4.4 cl-107 hco3-27 angap-10 07:22am blood alt-73* ast-40 alkphos-72 totbili-1.7* 06:20am blood lipase-931* 05:45am blood calcium-7.9* phos-2.7 mg-1.6 iron-115 microbiological data: sputum culture () 9:59 pm sputum source: endotracheal. **final report ** gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 2+ (1-5 per 1000x field): gram positive cocci. in pairs and clusters. 2+ (1-5 per 1000x field): budding yeast. 1+ (<1 per 1000x field): gram positive rod(s). respiratory culture (final ): sparse growth commensal respiratory flora. staph aureus coag +. sparse growth. oxacillin resistant staphylococci must be reported as also resistant to other penicillins, cephalosporins, carbacephems, carbapenems, and beta-lactamase inhibitor combinations. rifampin should not be used alone for therapy. please contact the microbiology laboratory () immediately if sensitivity to clindamycin is required on this patient's isolate. staphylococcus species may develop resistance during prolonged therapy with quinolones. therefore, isolates that are initially susceptible may become resistant within three to four days after initiation of therapy. testing of repeat isolates may be warranted. sensitivities: mic expressed in mcg/ml _________________________________________________________ staph aureus coag + | erythromycin---------- =>8 r gentamicin------------ <=0.5 s levofloxacin---------- 0.25 s oxacillin------------- =>4 r rifampin-------------- <=0.5 s tetracycline---------- <=1 s trimethoprim/sulfa---- <=0.5 s vancomycin------------ <=1 s imaging studies: tte (): the left atrium is normal in size. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). transmitral and tissue doppler imaging suggests normal diastolic function, and a normal left ventricular filling pressure (pcwp<12mmhg). right ventricular chamber size and free wall motion are normal. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the estimated pulmonary artery systolic pressure is high normal. there is no pericardial effusion. impression: normal biventricular cavity sizes with preserved global and regional biventricular systolic function. abdominal ultrasound with doppler (): 1. normal grayscale appearance of the liver without biliary ductal dilatation. 2. normal doppler interrogation of liver. 3. small right pleural effusion and trace right perinephric fluid. eeg (): impression: abnormal portable eeg due to the slow background with bursts of additional generalized slowing. these findings indicate a widespread encephalopathy affecting both cortical and subcortical structures. medications, metabolic disturbances, and infection are among the most common causes. there were no areas of focal slowing, but encephalopathies may obscure focal findings. there were no epileptiform features. cxr (): portable ap chest radiograph was reviewed in comparison to prior study obtained the same day earlier at 05:09 a.m. the et tube tip is 4 cm above the carina. the ng tube tip is in the stomach. there is no change in the left retrocardiac consolidation with air bronchogram that might be consistent with infectious process. there is slight interval improvement of pulmonary edema which is currently mild to moderate. bilateral pleural effusions are present. brief hospital course: in summary a 21 year-old woman with past medical history of etoh and vicodin abuse, now presenting 22-weeks gravid with acute hepatitis, believed due to alcohol and acetaminophen toxicity. # liver failure, hepatitis. regarding her liver failure, her lfts peaked at 1022 (alt) and then trended down. t bili peaked around 5.5. hep serologies and autoimmune panel were negative. pt was seen by liver service who felt underlying etiology was secondary to chronic tylenol in setting of etoh abuse. she was treated with nac and started on lactulose. ruq u/s was negative for abnormalities. her inr though elevated at osh normalized at time fo discharge. hsv serology is the only test still pending. when she follows up in clinic on , liver enzymes should be rechecked to assess for resolution of hepatitis. # respiratory status, intubation, pneumonia. she was initially on propafol for sedation but this was discontinued due to elevated lipase. her lipase trended up for several days, peaking at 1046, then downtrending at time of discharge. she was extubated . a cxr was obtained that showed rll opacity and sputum cultures grew out mrsa. she was treated with a 7-day course of vancomycin and cefepime for healthcare-associated pneumonia. she denied respiratory complaints at time of discharge; she was afebrile with a white count of 11. # mental status, psychiatric status. after extubation, patient was noted to be sleepy though able to answer questions appropriately. the icu team started ciwa scale for concern of withdrawal as patient became agitated overnight with tachycardia. psychiatry evaluated pt and felt initially that intent of overdose was unclear, but recommend continued 1:1 sitter while mental status was being evaluated. she did report to psych resident that she took a lot of tylenol and vicodin. she had a recent arrest for illegally obtaining vicodin for which she has an upcoming court date. gradually her mental status cleared. psych re-evaluated her and felt that there was no need for 1:1 sitter. per their note, she continues to minimize her substance abuse, particularly around the need for ongoing treatment for substance abuse once she leaves the hospital. she was agreeable to getting into therapy. per their note, she did not appear to be at increased risk of harm to self or others and did not meet section 12 criteria for psych admission. arrangements have been made for patient to follow-up for therapy and substance abuse treatment in . # pregnancy, therapeutic abortion, birth control. patient underwent therapeutic abortion on (dilation and evacuation). this was preceded by intraamniotic injection of 1 mg digoxin on . obstetrics service has arranged for patient to have follow-up at for placement. of note, gc and ct swabs during this admission were negative. # pain control. after the tab, patient had significant pelvic cramping. this was treated initially with ketorolac and switched to ibuprofen at time of discharge. breakthrough pain was treated with oxycodone. patient in total received four doses of 5 mg oxycodone on and . # anemia. patient was noted to be anemic with hct ranging in mid to high 20s during this admission. iron studies were negative. mcv was 98. the anemia was felt to be secondary to marrow suppression from acute hepatitis and inflammation, in addition to blood loss from the therapeutic abortion (approximately 600 ccs). she should have a cbc rechecked during her follow-up appointment on , . # elevated lipase. as per above, this was felt secondary to propofol she received in the icu. the lipase was downtrending at discharge. it could be rechecked at follow-up. # smoking cigarettes. per her report, patient smokes 1 pk every 2-3 days. she did not smoke any cigarettes during this admission. she is requesting rx for nicotine patch, which has been provided at discharge. # social work. patient and family met with our social worker. sw note, she was amenable to outpatient counseling as well as outpatient addictions treatment. pt needs to call the following for intake appointment: for out patient counseling: tri town community action center: for structured out pt addictions program/intensive out pt: , : # fen: regular, replete electrolytes prn. # code: full. medications on admission: none. discharge medications: 1. ibuprofen 400 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for pain/cramping. disp:*30 tablet(s)* refills:*0* 2. multivitamin capsule sig: one (1) capsule po once a day. disp:*30 capsule(s)* refills:*2* 3. folic acid 1 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 4. thiamine hcl 100 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 5. nicotine 14 mg/24 hr patch 24 hr sig: one (1) transdermal once a day. disp:*30 qs* refills:*2* discharge disposition: home discharge diagnosis: primary diagnoses acute hepatitis intrauterine pregnancy at 23 weeks gestation discharge condition: vital signs stable. mental status: alert and oriented x3. ambulating without difficulty. discharge instructions: you were admitted to the hospital for evaluation of hepatitis and altered mental status. we believe that the hepatitis was due to tylenol (from taking too much vicodin) and alcohol. we have followed your liver enzymes during this admission and they are trending down towards normal. your hematocrit, or red blood cell count, has been low, which we suspect is due to the hepatitis and the blood loss from the abortion. it is important that you follow-up at community health center next week (an appointment has been scheduled) so that you can have the complete blood count and liver enzymes checked. additionally, you underwent therapeutic abortion during this admission. the obstetricians have scheduled a follow-up for you (provided below) at placement. followup instructions: -tri-town community action center / health center - appointment with dr. on , at 1:30pm. phone number is . -family planning clinic at phone: or date/time: at 2pm. -intake for outpatient addictions treatment program at center at in , ri. appointment is scheduled for tuesday at 10:00am, . procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours enteral infusion of concentrated nutritional substances dilation and curettage for termination of pregnancy intra-amniotic injection for abortion diagnoses: acute posthemorrhagic anemia acute and subacute necrosis of liver other, mixed, or unspecified drug abuse, unspecified depressive disorder, not elsewhere classified acute respiratory failure methicillin resistant staphylococcus aureus in conditions classified elsewhere and of unspecified site ventilator associated pneumonia poisoning by aromatic analgesics, not elsewhere classified alcohol abuse, continuous opioid abuse, unspecified acute pancreatitis accidental poisoning by aromatic analgesics, not elsewhere classified anemia of mother, antepartum condition or complication mental disorders of mother, antepartum condition or complication tobacco use disorder complicating pregnancy, childbirth, or the puerperium, antepartum condition or complication unspecified infection or infestation of mother, antepartum condition or complication liver and biliary tract disorders in pregnancy, antepartum condition or complication 

Answer: The patient is high likely exposed to