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 withdrawal major surgical or invasive procedure: none history of present illness: 45f hx of etoh abuse presenting with etoh withdrawl. patient has been on a 1 week etoh binge, drinking of vodka daily. last drink was on friday. for last 2 days has been feeling shaky. developed nausea and vomiting of nonbloody/nonbilious vomit. has been drinking grape koolaid and has dark purplish vomit as a result. mild epigastric abdominal and ruq pain that started after vomiting. no cp/sob. no dark or tarry stools or diarrhea. in the ed, initial vs were: 98.0 148 147/97 18 99% ra. very tachy and tremulous. wbc elevated to 15.6 and hct at 49.1. cr elevated at 1.7 and hco3 down at 13. cxr clear. given 2l ns and 2mg iv ativan x 4. tremulousness improved but still very tachy. lipase normal. other lfts normal. lactate 1.6. serum tox screen neg. admitted to icu for frequent ciwas. of note, history of admission to in early with essentially the same presentation. alcohol withdrawal, tachy, elevated wbc/hct hemoconcentrated to 45. at that time, wbc came down to 8.8 and hct came down to 31.7 with iv fluids. diff was also left-shifted on presentation at that time and hco3 at 8. on arrival to the micu, patient very sedated. minimally responsive and unable to answer any question. able to arouse to state of mumbling and following very simple commands, but quickly drifts off. . review of systems: unable to obtain past medical history: - alcohol abuse, most recent detox was in the . she becomes tremulous when withdrawing (usually within 1 day) but has never had hallucinations or had seizures - cholecysectomy in social history: lives alone in . works as an analyst at an it company. she smokes a half a pack of cigarettes daily. she drinks of a fifth of vodka daily x 2 years. she denies other drug use family history: mom: mi at 58, aunt: mi, father with alcoholism physical exam: exam upon admission: general: somulent, minimally responsive to voice, laying still with eyes close, no tremors, appears comfortable heent: sclera anicteric, very dry mm, lips cacked with dark purple (reported to be grape juice by pt in ed), oropharynx clear, peerla neck: supple, jvp not elevated, no lad cv: tachy, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally anteriorly abdomen: soft, nt/nd, bowel sounds present, no organomegaly gu: foley in place ext: cool, 2+ pulses, no clubbing, cyanosis or edema neuro: lying still with eyes closed, minimally responsive, some garbled words, following few simple commands (opens mouth, sticks out tongue), small movements of hands and feet bilaterally, normal tone, pupils normal sized and equal/reactive bilaterally . discharge exam vs - temp 99 f, bp 127/87-143/102, hr 81-90, r 18, o2-sat 100% ra general - comfortable in nad heent - nc/at, sclerae anicteric, mmm, op clear neck - supple, no cervical lymphadenopathy lungs - cta bilat, no r/rh/wh, good air movement, resp unlabored, no accessory muscle use heart - pmi non-displaced, rrr, no mrg, nl s1-s2 abdomen - nabs, minimally tender to palpation in epigastric/ruq region. no masses or hsm, no rebound/guarding extremities - wwp, no c/c/e, 2+ peripheral pulses (radials, dps) skin - no rashes or lesions neuro - awake, a&ox3, cns ii-xii grossly intact, muscle strength throughout, sensation grossly intact throughout pertinent results: labs upon admission: serum: 06:45pm blood wbc-15.6*# rbc-4.50# hgb-15.1# hct-49.1*# mcv-109* mch-33.6* mchc-30.8* rdw-12.9 plt ct-116* 06:45pm blood neuts-89.2* lymphs-6.7* monos-3.4 eos-0.4 baso-0.4 06:45pm blood plt ct-116* 06:45pm blood glucose-148* urean-39* creat-1.7*# na-137 k-4.6 cl-90* hco3-13* angap-39* 06:45pm blood alt-55* ast-58* alkphos-80 totbili-1.2 06:45pm blood albumin-5.7* calcium-9.1 phos-1.6*# mg-1.9 06:45pm blood lipase-31 06:45pm blood osmolal-316* 06:45pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 06:46pm blood lactate-1.6 urine: 09:32pm urine color-yellow appear-hazy sp -1.019 09:32pm urine blood-mod nitrite-neg protein->600 glucose-neg ketone-150 bilirub-mod urobiln-4* ph-6.5 leuks-neg 09:32pm urine rbc-1 wbc-3 bacteri-few yeast-none epi-4 09:32pm urine castgr-1* casthy-62* labs upon discharge: 05:45am blood wbc-4.4 rbc-3.03* hgb-10.5* hct-32.7* mcv-108* mch-34.6* mchc-32.1 rdw-12.6 plt ct-54* 05:45am blood glucose-83 urean-7 creat-0.6 na-138 k-3.2* cl-103 hco3-26 angap-12 05:45am blood calcium-8.6 phos-2.7 mg-1.7 reports: admission ecg: sinus tachycardia with baseline artifact. borderline left axis deviation. possible left anterior fascicular block. compared to the previous tracing of heart rate is increased. cxr: semi-upright ap view of the chest: the cardiac, mediastinal and hilar contours are normal. lungs are clear and the pulmonary vascularity is normal. no pleural effusion or pneumothorax is present. there are no acute osseous abnormalities. impression: no acute cardiopulmonary abnormality. brief hospital course: 45 yo f with hx of etoh abuse who presents with tachycardia, tremulousness, n/v and inability to tolerate po related to etoh withdrawal. . # etoh withdrawal - patient with history of alcohol abuse (drinking of vodka daily) presented with alcohol withdrawal. she has no known hx of seizures or dts, and last drink on friday (2 days prior to admission). patient initially with n/v, epigastric pain, tremulousness, tachycardia consistent with etoh withdrawal. she was given ativan 2 mg iv x 4 in the ed which caused significant sedation. she was then admitted to the micu for frequent ciwa monitoring, but did not require any benzodiazepines overnight. she was given several liters of ivf for mild tachycardia and dehydration which improved by morning. she also received thiamine, folate, multivitamin (iv followed by po). her mental status improved by the morning after admission. her diet was advanced and she was called out to the medical floor with q4 prn ciwa. patient had minimal benzo requirements while on the floor. her electrolytes were monitored closely and repleted appropriately. she was seen by social work who provided her with resources needed for detoxification programs. the patient was discharged home with plans to contact and follow up with her primary care doctor. . # anion gap acidosis: initial gap was 34 with lactate 1.6. likely due to alcoholic ketoacidosis. acidosis resolved with fluid resuscitation. . # : cr elevated on admission likely due to pre-renal state in setting of significant dehydration. elevated hct/wbc and elevated albumin also supported significant hemoconcentration from alcohol use and dehydration. resolved with ivf. . # hypertension - continued home lisinopril . # transaminitis: on admission, mild alt/ast elevation with both in 50s with normal tbili. likely due to alcohol use. of note, she has had elevations during prior admissions as well and had negative hepatitis serologies in last 8 months. lfts normalized during admission, and no further workup performed during admission. . # anemia - patient found to have hct drop from 49-29 during admission likely due to dilutional effect from all ivf received (drop in all cell counts). she had no evidence of active bleed and remained hemodynamically stable. hct returned to baseline ~30. anemia and thrombocytopenia likely related to marrow suppression from etoh use rather than liver dysfunction as inr and albumin wnl. . transitional issues: - patient provided with resources for program - electrolytes and cbc should be rechecked at follow up - full code during admission, contact medications on admission: - lisinopril - 5 mg tablet - 1 tablet(s) by mouth once a day - zolpidem - 5mg table qhs for insomnia, mr x 1 - valacyclovir - 1,000 mg tablet - 2 tablet(s) by mouth twice a day as needed for prn for one day for outbreak - protonix discharge medications: 1. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 2. valacyclovir 500 mg tablet sig: two (2) tablet po twice a day as needed for outbreak. 3. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 4. ambien 5 mg tablet sig: one (1) tablet po at bedtime as needed for insomnia. 5. multivitamin tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: primary diagnosis: alcohol withdrawal, acute kidney injury secondary diagnosis: hypertension discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear ms. , it was a pleasure caring for you while you were admitted to . you were admitted for alcohol withdrawal, nausea, and vomiting. you were treated with valium for your withdrawal symptoms and hydrated with intravenous fluids. you were seen by social work who provided you with resources to help you stop drinking. . please start taking multivitamin, thiamine, folate daily. . please take your medications as prescribed and follow up with your primary care doctor . you should have your blood counts and electrolytes checked at your follow up appointment. . followup instructions: department: when: thursday at 2:45 pm with: , md building: (, ma) campus: off campus best parking: none procedure: alcohol detoxification diagnoses: acidosis tobacco use disorder unspecified essential hypertension acute kidney failure, unspecified other specified cardiac dysrhythmias dehydration other and unspecified alcohol dependence, continuous alcohol withdrawal nonspecific elevation of levels of transaminase or lactic acid dehydrogenase [ldh] essential and other specified forms of tremor other secondary thrombocytopenia 

Answer: The patient is high likely exposed to