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: clindamycin attending: chief complaint: fall, nausea and vomiting secondary to alcohol use. major surgical or invasive procedure: flexible bronchosopy (). history of present illness: 34 y/o gentleman with known alcohol abuse was found down in his bathroom with vomit and blood around him. his landlord called police after a water leak from his apartment. patient was transfered to and was found to have two seizure episodes en route. patient received ivf greater than 1 l ns (unclear amount), thiamine 100 mg and 1 mg folate. patient also received 10 meq kcl, 40 mg iv pantoprazole and zosyn 3.375 gm iv once. cxr there showed pneumomediastimum without pneumothorax and he was transfered to ed. . in ed his vitals were t 98.2 hr 92 bp 124/50 rr 16 o2 sat 98%. patient was alert and oriented times three but was a poor historian. his family saw him and thought that he was at baseline. he has had trouble giving history and recalling events at baseline per family. patient was given metronidazole 500 mg iv, fluconazole 200 mg iv and vancomycin 1 gram iv. he also received 1 unit of prbc. his urine output was greater than 700 ml in ed over approx 4 hours. thoracics was consulted who recommended a barium swallow study. preliminary read was some distal filling defect without any extravasation. recommended gi consult. . on arrival to the micu his vitals were t 95.9 hr 89 bp 156/53 rr 15 100% 4lnc. patient denies any acute distress. he states that he was aware of ems coming into his house. he states that he might have had a seizure this morning. he also had a seizure one week ago. he has had episodes of binge drinking. his last drink was three days ago per patient. he drank greater than 1 bottle of vodka that night but unable to quantify. he denies any fever, chills, chest pain, shortness of breath, nausea, abdoinal pain, dysuria, diarrhea, constipation, focal numbness or weakness. he has noticed dark urine and dark colored stool in the last two days. he has depressed mood per family history after losing his job recently. patient denies any suicidal ideation. past medical history: alcohol abuse sdh in secondary to fall known alcohol withdrawl seizures otherwise denies any medical problems social history: works in construction. 20 pack/year tobacco. drinks etoh in binges. family history: noncontributory. physical exam: vitals: t 95.9 hr 89 bp 156/53 rr 15 100% 4lnc gen: alert and oriented x 3 (not date but month/year). poor historian. nad heent: peerl, eom-i, mucous membranes are dry, bruise in lower lip, jvp not elevated lungs: clear to auscultate bilaterally heart: tender to palpate in left chest wall, s1s2 rrr, no mrg abdomen: bs present, soft ntnd ext: wwp, dp 2+ neuro: cn ii-xii grossly intact, strength 5/5, sensation is intact, normal muscle tone. pertinent results: complete blood count 10:01pm blood wbc-10.0 rbc-2.96*# hgb-10.2*# hct-26.0*# mcv-88 mch-34.4* mchc-39.1* rdw-13.0 plt ct-145* 03:07am blood wbc-9.5 rbc-3.02* hgb-10.2* hct-26.1* mcv-87 mch-33.7* mchc-38.9* rdw-13.8 plt ct-155 05:15am blood wbc-9.2 rbc-3.05* hgb-10.1* hct-28.0* mcv-92 mch-33.1* mchc-36.0* rdw-13.4 plt ct-200 06:05am blood wbc-6.9 rbc-2.98* hgb-10.0* hct-27.3* mcv-92 mch-33.5* mchc-36.5* rdw-13.9 plt ct-199 05:10am blood wbc-7.2 rbc-2.99* hgb-10.3* hct-28.1* mcv-94 mch-34.6* mchc-36.8* rdw-14.0 plt ct-267 . liver function and coags 04:25pm blood alt-52* ast-131* ck(cpk)-8404* alkphos-41 totbili-1.6* 12:44pm blood alt-54* ast-115* alkphos-33* totbili-1.0 05:15am blood alt-56* ast-130* ld(ldh)-372* ck(cpk)-2634* alkphos-36* totbili-1.0 05:10am blood alt-49* ast-66* ck(cpk)-615* alkphos-33* totbili-0.3 04:25pm blood pt-13.5* ptt-22.2 inr(pt)-1.2* 03:07am blood pt-12.6 ptt-20.7* inr(pt)-1.1 05:15am blood pt-12.1 ptt-22.1 inr(pt)-1.0 . renal function and electrolytes 04:25pm blood glucose-102 urean-149* creat-3.1*# na-126* k-2.6* cl-72* hco3-41* angap-16 10:01pm blood glucose-93 urean-110* creat-2.3* na-135 k-2.8* cl-89* hco3-36* angap-13 03:07am blood glucose-93 urean-86* creat-2.0* na-140 k-3.0* cl-95* hco3-37* angap-11 12:44pm blood glucose-82 urean-59* creat-1.6* na-143 k-3.0* cl-99 hco3-35* angap-12 11:50pm blood glucose-80 urean-36* creat-1.2 na-139 k-2.7* cl-97 hco3-33* angap-12 05:15am blood glucose-75 urean-27* creat-1.2 na-138 k-2.9* cl-98 hco3-32 angap-11 12:48pm blood glucose-87 urean-19 creat-1.0 na-134 k-3.4 cl-98 hco3-29 angap-10 06:05am blood glucose-92 urean-10 creat-1.1 na-137 k-3.0* cl-101 hco3-30 angap-9 05:10am blood glucose-134* urean-6 creat-1.0 na-137 k-3.9 cl-107 hco3-25 angap-9 10:01pm blood albumin-2.8* calcium-6.6* phos-2.5*# mg-3.1* 03:07am blood albumin-3.0* calcium-7.2* phos-1.8* mg-3.3* 05:10am blood calcium-7.9* phos-1.6* mg-1.8 . cardiac enzymes 04:25pm blood ck-mb-19* mb indx-0.2 04:25pm blood ctropnt-0.05* 10:01pm blood ck-mb-14* mb indx-0.2 ctropnt-0.04* . anemia studies 03:07am blood caltibc-291 vitb12-878 folate-12.0 ferritn-377 trf-224 iron-42* . serum toxicology 04:25pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg . electrocardiogram () sinus rhythm. non-specific st-t wave changes. compared to the previous tracing st-t wave changes are new. . imaging barium swallow () impression: 1. no extraluminal contrast appreciated. no evidence for esophageal perforation. 2. filling defect in the distal esophagus persistent on all images and associated with a delay in clearance of the esophagus. this is concerning for food/other impacted material, and endoscopic evaluation is recommended. . abdominal ultrasound () impression: no evidence of fluid or hemorrhage. . cxr pa and lateral () impression: slight improvement in pneumomediastinum. left lower lobe opacification remains the same and is most likely atelectasis versus aspiration. . ct chest with po contrast () impression: 1. findings do not suggest active esophageal perforation or mediastinal infection: interval decrease in pneumomediastinum, no extravasation of oral contrast or dominant periesophageal gas collection, no mediastinal fluid collection. the presence of a small esophageal tear is better evaluated endoscopically. 2. normal esophagus. small hiatal hernia. 3. new bibasilar peribronchial infiltrates may represent aspiration versus atelectasis. minimal right pleural effusion. brief hospital course: a 34 year-old gentleman with alcohol abuse presents with seizure, pneumomediastinum, acute renal failure and rhabdomyolysis. . 1. pneumomediastium / ?esophageal tear / ?mediastinitis possibly secondary to alcohol withdrawal seizure versus esophageal tear during emesis. distal barium filling defect on barium swallow raised concern of distal esophageal origin. . on admission to the icu, the patient was afebrile and hemodynamically stable. thoracic surgery was consulted in the ed and felt surgery was not indicated. vancomycin, zosyn and fluconazole were initiated. interventional pulmonary performed a bronchoscopy showing normal anatomy and no evidence of tear or rupture. gi was also consulted and recommended npo and intravenous ppi. endoscopy was deferred in order to avoid risk of any further damage to the esophagus. a repeat cxr showed a stable pneumomediastinum. fluconazole was discontinued after discussion with id. . patient spent one night in the icu after which he underwent ct chest with po contrast showing no esophageal leak and resolving pneumomediastinum. he was then transferred to the medical floors with stable vitals. per gi recommendations, his diet was progressed slowly to cold clears, then full clears, then solids. his antibiotics were switched to augmentin and flagyl for presumptive treatment of mediastinitis eventhough there was no radiographic evidence to suggest inflammation to the mediastinum. he will complete a ten day course of antibiotics. . gi has recommended that patient undergo upper endoscopy as outpatient, once stabilized, for close evaluation for esophageal tear. . 2. rhabdomyolysis. this was felt to be secondary to his fall and seizures. he was treated with iv fluids and his ck normalized. . 3. acute renal failure. this was felt to be secondary to dehydration and rhabdomyolysis; his admission fena was c/w prerenal azotemia. his creatinine normalized with iv hydration. he maintained a good urine output. . 4. alcohol dependence and withdrawal. per osh report, he had seizures en route to the ed from his apartment, most likely due to alcohol withdrawl. on admission to this hospital ciwa protocol was instituted and he was monitored on telemetry. his serum toxicology was negative on admission. . upon transfer to the floors, his ciwa scores were consistently less than 10. however, he was intermittently tachycardic and as he was 48-72 hours after his last drink, with a history of dts and withdrawal seizures, he was started on standing valium with a slow taper. he was monitored on telemetry and there was no seizure activity. there were no hallucinations. . he was treated with iv hydration, multivitamin, thiamine, and folate from time of admission. social work was consulted and provided information regarding detox programs. . 5. anemia. his hematocrit was stable in the high 20s during this admission. he was guiaic positive stool in ed and noted to have tarry stools by gi service. an abdominal ultrasound was negative for intra-abdominal bleed. his iron was 42 with a tibc of 291 and ferritin of 277, suggestive of mild iron deficiency. b12 an folate were normal. he will need to have endoscopy and colonoscopy as outpatient to work-up gi bleed. . 6. depression. patient may benefit from psychiatric consult as outpatient. . 7. dizziness. he developed dizziness after transfer to the floors from the intensive care unit. his description was consistent with bppv, brought on with rapid head movements, position changes in bed, or shifts from supine to standing. -hallpike maneuver demonstrated lateral nystagmus and reproducibility of dizziness. epley meneuver was moderatly thereapeutic, although this did not entirely cure his symptoms. we believe he may have bppv secondary to head trauma prior to admission. as there were no other neuorologic symptoms and ct at osh was negative, we did not feel follow-up imaging was warranted. his dizziness quickly resolves after head movement ceases, he is able to ambulate, and overall his symptoms have been improving gradually since onset about five days prior to discharge. he has been cleared by physical therapy. . he was npo initially and his diet progressed slowly as tolerated. electrolytes were repleted as needed. subcutaneous heparin was used for venous thrombosis prophylaxis. his code status is full code. medications on admission: none denies any otc/herbal 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:*2* 3. multivitamin tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 5. amoxicillin-pot clavulanate 875-125 mg tablet sig: one (1) tablet po bid (2 times a day) for 10 days: last day . disp:*20 tablet(s)* refills:*0* 6. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 10 days: last day . disp:*30 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary diagnoses alcohol withdrawal pneumomediastinum likely secondary to small esophageal tear rhabdomyolysis acute renal failure . secondary diagnoses alcohol dependence discharge condition: vital signs stable. afebrile. discharge instructions: you were hospitalized for treatment of nausea and vomiting. there was air in the space surrounding the heart, which may be due to leak from the esophagus while you were vomiting. recent imaging shows that the air has almost entirely gone away. furthermore, there is no leak in the esophagus seen on recent imaging. it is possible that this leak has healed. bronchoscopy was performed while you were in the intensive care unit to look at the airways. there were no abnormalities detected. . we have started you on antibiotics to treat infection from the esophageal leak. in order to complete a ten-day course, please take clindamycin and augmentin for 10 more days. we have also given you prescriptions for vitamins and a medicine called pantoprazole to help decrease acid secretion in the stomach. . you met with our social worker while you were in the hospital and she helped you arrange for a place to stay. you planned to go to place of promise on the day after leaving the hospital. . please follow-up with your primary care provider. should have an upper endoscopy performed as an outpatient to look at the esophagus, stomach, and first part of the small intestine. . please call your doctor or return to the emergency room if you have any bleeding, belly pain, or any other symptoms that are concerning to you. followup instructions: please follow-up with dr. in the next two weeks . you need to have upper endoscopy performed as outpatient. md procedure: fiber-optic bronchoscopy diagnoses: anemia, unspecified acute kidney failure, unspecified hyposmolality and/or hyponatremia other convulsions depressive disorder, not elsewhere classified hypopotassemia gastroesophageal laceration-hemorrhage syndrome rhabdomyolysis lack of housing electrolyte and fluid disorders not elsewhere classified benign paroxysmal positional vertigo alcohol withdrawal interstitial emphysema other and unspecified alcohol dependence, episodic 

Answer: The patient is high likely exposed to