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: tylenol ingestion major surgical or invasive procedure: intubation history of present illness: of note, patient not willing to discuss much at the time of initial examination. most of the history was obtained from review of minimal available records. the patient is a 19 y/o m with unknown pmhx who was transferred to from an osh for management of acetaminophen overdose. per the patient, he took approximately 100 extra strength tylenols 3 days ago. per report, the patient was ultimately brought to the ed by his mother because of several days of vomiting. pertinent osh labs included apap 73 ug/ml, salicylic acid <4 mg/dl, ast/alt = 661/824, tbili 7.4, inr 2.0. utox was positive for acetaminophen and thc. wbc remarkable for 21.1. he was given loading dose of iv nac and transferred to ed. per report, the patient also reported that he had taken several other medications but would not give further details other than a list of home medications (see below). in the ed at , serum tox and urine tox were negative. acetaminophen level was 39. he was seen by toxicology in the ed, who recommended continuing the nac treatment and obtaining a lithium level. hepatology also saw the patient in the ed and final recommendations were pending at the time of transfer. when asked about his actions, the patient stated that he was trying to end his life. psychiatry attempted to speak with the patient, but he refused, citing his scientology beliefs. prior to transfer from the ed, the patient's vs were: 100.0 91 143/57 18 100%ra. . on arrival to the floor, the patient's vs were t: 99.4 bp: 147/63 p: 89 r: 19 o2: 96% on ra. he complained of some abdominal pain. he also complained of numbness/weakness in his legs and his left arm. he also complained of feeling swollen. he was not cooperative with any further questioning. . after initial evaluation on arrival to the micu, the patient began to refuse care. he would not let nursing place additional iv's and refused lab draws. he stated that he wanted to be left to die. his case was discuss with psychiatry and with the ethics service ( ) and the hospital legal service. it was determined that the patient did not have the capacity to make these decisions. the decision was made to sedate and intube the patient to allow for further management of his serious medical condition. past medical history: ? asthma ? psychiatric condition social history: lives with parents. denies alcohol, tobacco and ivdu. family history: mother has known hypertension physical exam: physical exam upon admission: vitals: t: 99.4 bp: 147/63 p: 89 r: 19 o2: 96% on ra general: alert, non-cooperative, oriented x 1. heent: nc/at. pupils dilated but equal and reactive. eomi. neck: supple lungs: cta anteriorly; no wheezes, rhonchi, or rales noted. cv: rrr, no r/g, 2/6 systolic murmur loudest at the lusb abdomen: soft, non-distended, reports right-sided abdominal pain with palpation, no rebound or guarding noted gu: foley in place ext: warm, well perfused, 2+ pulses neuro: perrl, eomi, face symmetric, exhibits weakness on eyelid closure and reports generalized decreased sensation in the face bilaterally, reports weakness and numbness in the lue, reports weakness in the bilateral le's and numbness in the distal le's (from the knees distally) . physical exam upon : vs: 100 162/80 range (144-180/74-90) 78 18 95% ra general: nad. oriented x3. clothes are sweaty on exam. heent: ncat. sclera anicteric. perrl, eomi. neck: left central removed, site is clean,dry, intact non-tender. cardiac: rr, normal s1, s2. no m/r/g. no s3 or s4. lungs: ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. extremities: warm. no c/c/e. no femoral bruits. 2+ pulses le/ue b/l skin: no stasis dermatitis, ulcers, scars, or xanthomas. neuro: cn intact, no focal deficits. pertinent results: labs upon admission: . 03:20pm blood wbc-17.0* rbc-4.83 hgb-15.7 hct-44.9 mcv-93 mch-32.5* mchc-35.0 rdw-12.9 plt ct-304 03:20pm blood neuts-92.0* lymphs-6.0* monos-1.5* eos-0.2 baso-0.2 03:20pm blood pt-25.7* ptt-33.9 inr(pt)-2.5* 10:46pm blood pt-41.0* ptt-40.3* inr(pt)-4.3* 11:05am blood fibrino-291 03:20pm blood glucose-95 urean-17 creat-1.0 na-139 k-3.9 cl-106 hco3-21* angap-16 03:20pm blood alt-1891* ast-1664* ck(cpk)-223 alkphos-95 totbili-5.5* dirbili-1.9* indbili-3.6 10:46pm blood alt-7533* ast-7567* ld(ldh)-5805* alkphos-84 totbili-3.6* 12:34pm blood alt-* ast-7838* alkphos-125 totbili-3.9* 03:20pm blood albumin-4.2 calcium-8.8 phos-2.9 mg-2.1 03:20pm blood ammonia-17 05:47am blood hbsag-negative hbsab-positive hbcab-negative hav ab-positive 03:20pm blood lithium-<0.2 03:20pm blood asa-neg ethanol-neg acetmnp-39* bnzodzp-neg barbitr-neg tricycl-neg 04:18am blood acetmnp-13 12:34pm blood acetmnp-7* 07:08pm blood acetmnp-neg 04:57pm blood type- po2-117* pco2-31* ph-7.45 caltco2-22 base xs-0 comment-green top 11:54pm blood type-art temp-36.6 rates-14/ tidal v-500 peep-5 fio2-40 po2-192* pco2-39 ph-7.36 caltco2-23 base xs--2 -assist/con intubat-intubated 06:27am blood lactate-0.8 11:44pm blood o2 sat-84 11:54pm blood freeca-1.07* . labs upon : . 06:30am blood wbc-9.9 rbc-3.41* hgb-10.9* hct-30.5* mcv-90 mch-32.1* mchc-35.8* rdw-13.7 plt ct-695* 03:54am blood neuts-64.1 lymphs-23.7 monos-8.1 eos-3.4 baso-0.7 07:30am blood pt-16.3* ptt-30.4 inr(pt)-1.4* 06:30am blood glucose-83 urean-25* creat-1.9* na-137 k-4.7 cl-100 hco3-23 angap-19 06:30am blood alt-128* ast-53* ck(cpk)-109 alkphos-77 totbili-1.7* 06:30am blood ck-mb-4 ctropnt-0.04* 06:30am blood calcium-9.3 phos-5.6* mg-2.0 06:30am blood cortsol-12.9 07:33am blood vanco-11.4 06:11am blood lactate-0.6 : wbc: 8.6 hgb:11.7 hct 33.8 plt 582 : cr: 1.2 na: 139 k 3.8 cl 104 hco3 24 : ast 64 alt 36 alk po4 79 tbili 1.3 . echocardiogram : the left atrium is mildly dilated. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). tissue doppler imaging suggests a normal left ventricular filling pressure (pcwp<12mmhg). right ventricular chamber size and free wall motion 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. the mitral valve leaflets are mildly thickened. there is no pericardial effusion. . cxr: (most recent to ): in comparison with the study of , the monitoring and support devices are unchanged. the lungs are essentially clear without vascular congestion or pleural effusion. . ct head: : there is no evidence of hemorrhage, edema, mass or midline shift or infarction. sulci are normal in caliber and configuration. slight asymmetry of ventricles, unchanged from prior exam, possibly positional in nature. basilar cisterns are patent. no fracture is identified. . lue us: : thrombosis of left basilic vein. no deep venous thrombosis in left upper extremity. . renal artery ultrasound with doppler: : 1. no son findings to suggest renal artery stenosis. 2. diffusely increased cortical echogenicity noted bilaterally. these findings are suggestive of possible diffuse parenchymal process. 3. trace amount of free fluid adjacent to the left kidney. 4. mild circumferential wall thickening of the bladder, of uncertain etiology. . ekg : sinus rhythm. low inferolateral lead t wave amplitude. st-t wave configuration also suggests early repolarization pattern. findings are non-specific. brief hospital course: is a 19 year old man admitted after presenting to and outside hospital with nausea and vomitting after reported ingestion of 100 extra strength tylenol. he was initially refusing medical care and causing self-harm and was intubated after consultation with ethics. . the patient's acute hepatitis was secondary to apap ingestion. he was intubated for protection as was refusing medical care on admission, as well as riping out iv lines. he was treated with nac until tylenol level was undetedtable. hepatology consulted and followed closely. transplant surgery evaluated and deemed him not a transplant candidate given underlying psychiatric conditions and suicide attempt. patient monitored with labs and transaminiases peaked in 10,000's. they trended down as did inr and tbili. a ct scan of his head showed no evidence of cerebral edema. . the patient suffered hypoxic respiratory failure several hours after attempted extubation upon completion of nac. he developed hypoxia and frothy pink secretions consistent with flash pulmonary edema. he was reintubated and diuresed as below. he grew out mssa from sputum and was treated with 8 days of cefepime and 2 weeks of vancomycin (last dose ) for a ventilator acquired pneumonia. note he was initially treated with nafcillin but developed acute renal failure secondary to acute interstitial nephritis. after diuresis he was extuabted without difficulty. . his acute renal failure was thought to be secondary to apap toxicity and possibly acute interstitial nephritis secondary to nafcillin use. renal was consulted and recommended a lasix drip. he diuresed well and the lasix drip was stopped. he has since maintained good urine output and his creatinine has remained stable at 1.9 for several days approaching . . the patient was hypertensive on the medical floor with systolic blood pressures ranging from 140-180. considering his age, positive family history and recent history of flash pulmonary edema, an initial work up for secondary causes of hypertension was begun. renal artery ultrasound with doppler showed no evidence of renal artery stenosis, but did show diffuse parenchymal disease consistent with his apap toxicity and is likely the cause of what may be transient hypertension. morning fasting cortisol was within normal limits. should his hypertension persist despite normalization of his creatinine and kidney function, we recommend further outpatient work up for secondary causes of hypertension including primary hyperaldosteroism and pheochromocytoma. he was started on amlodipine 5mg daily on . . the patient complained of chest pressure the morning of . ecg was checked and had non-specific t wave changes in the lateral leads along with early repolarization, consistent with prior ecgs. one set of cardiac enzymes revealed normal ck and ckmb. his chest pressure resolved without intervention and there was no suspicion for acute coronary syndrome. . the patient developed low grade fevers while on the medical floor. an extensive workup was completed which included negative blood cultures, negative culture from the tip of his removed central venous line, negative urine and sputum cultures and recently clear chest x-ray. his fevers may be due to a resolving subcaspsular kidney hematoma noticed on ct abdomen or due to resolving acute liver or kidney injury. upon to psychiatry, we have very little suspicion of underlying infection and consider him medically stable for transfer. . the patient attempted suicide with tylenol overdose. he recently broke with pregnant girlfriend, which was thought to be an inciting event. per his family, he has had prior history of psychiatric problems. psych was consulted and felt he has major depressive disorder with possible psychotic features. he will be to inpatient psychiatry for full evaluation and management. . it is recommended the patient establish regular care with a new primary care physician upon who can monitor his liver and renal function as well as his hypertension and newly started amlodipine. . he should have his cbc, lfts and chem 10 checked weekly while in the psychiatry unit. . the patient was full code for this admission. medications on admission: unknown; however, pt reportedly did bring with him a list of medications, including the following: bactrim seroquel clarithromycin ranitidine "amox" oxycodone lithium prilosec cephalexin asa proair the patient also presented a bag of medications, including bottles of seroquel, oxycodone/apap, lithium, clarithromycin, bactrim, amoxicillin, cefalexin, tylenol, ibuprofen, ranitidine, omeprazole, as well as a proair inhaler. medications: 1. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 2. multivitamin tablet sig: one (1) tablet po daily (daily). 3. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 4. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. 6. olanzapine 5 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po daily (daily). 7. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 8. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: puff inhalation every four (4) hours as needed for shortness of breath or wheezing. disposition: extended care facility: - diagnosis: primary diagnoses: suicide attempt acetaminophen overdose acute liver failure acute renal failure ventilator acquired pneumonia secondary diagnoses: major depressive disorder with possible psychotic features hypertension condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. instructions: you were admitted for tylenol overdose. you developed acute liver failure, acute renal failure, and pneumonia and were intubated in the intensive care unit. your acute liver failure improved over the course of treatment and your renal function stabilized. your pneumonia was successfully treated with antibiotics. while on the medical floor, your blood pressure was elevated and a new medication was started to lower it. your medical issues are stable and you are now ready for full psychiatric evaluation and care. . please take the medications: -start amlodipine 5mg by mouth daily for high blood pressure. -start senna 8.6 mg twice daily as needed for constipation. -start multivitamin 1 tab daily -start folic acid 1 mg daily -start thiamine 100mg daily -start docusate sodium 100 mg twice daily as needed for constipation -start olanzapine 5 mg daily -start albuterol inhaler 1-2 puffs every 4 hours as needed for shortness of breath or wheezing. . please establish care with a primary care doctor upon your from the psychiatric unit in order to monitor your liver function and renal function. additionally, your blood pressure should be monitored and if it returns to normal, your new medication (amlodipine) may be able to be stopped. . it was a pleasure taking care of you. followup instructions: we recommend the patient establish care with a primary care doctor from the psychiatric unit. he was found to be hypertensive on the medical floor and will need further work up as an outpatient for secondary causes of hypertension if his blood pressure does not normalize. his new primary care doctor can adjust his amlodipine as necessary. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube insertion of endotracheal tube arterial catheterization arterial catheterization alcohol detoxification diagnoses: acidosis abnormal coagulation profile acute and subacute necrosis of liver acute kidney failure, unspecified suicide and self-inflicted poisoning by tranquilizers and other psychotropic agents acute respiratory failure methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site personal history of noncompliance with medical treatment, presenting hazards to health surgical or other procedure not carried out because of patient's decision encephalopathy, unspecified ventilator associated pneumonia poisoning by aromatic analgesics, not elsewhere classified suicide and self-inflicted poisoning by analgesics, antipyretics, and antirheumatics alcohol abuse, continuous leukocytosis, unspecified home accidents poisoning by psychodysleptics (hallucinogens) alcohol withdrawal acute edema of lung, unspecified major depressive affective disorder, single episode, severe, specified as with psychotic behavior other unspecified secondary hypertension hypothermia not associated with low environmental temperature acute venous embolism and thrombosis of superficial veins of upper extremity 

Answer: The patient is high likely exposed to