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: acute pancreatitis major surgical or invasive procedure: intubation at an outside hospital ercp with sphincterotomy history of present illness: the patient is a 44 year-old female with a history of hypothyroidism, who presents with severe epigastric pain. the patient was in her usual state of good health until 3pm on the day of admission (), when she developed rapid-onset sweating and constant (non-fluctuating) epigastric pain that radiated to her back. coincident with the onset of pain, she reports new-onset nausea, with 1 episode of non-bloody vomiting. the patient reports a chronic alcohol intake of drinks per day. she denies previous episodes of abdominal pain, history of hyperlipidemia, history of discolored urine, recent flu-like illness, or abdominal trauma. due to the severity of the pain, the patient was immediately driven by her husband to . at (), the patient had hb 16, lipase >3000, k 2.8, undetectable etoh. ciwa score was less than 4. score was 0 on admission. she received iv fluids, folate, multivitamin injection, and thiamine. a ct of the abdomen/pelvis revealed a peri-pancreatic fluid collection, with fat stranding and a 4 cm calcified focus near the ampula of vater. mrcp was obtained, showing no ductal dilation and no gallstones. on , a cxr showed a lll opacity, and the patient was started on levo/ceftriaxone. the patient developed fever, change in mental status, hypoxia, and tachypnea leading to intubation, which was complicated by aspiration during the intubation procedure (abg post-intubation on 400/12/5 was 7.39/34/102). aspiration from og tube revealed coffee-ground emesis after intubation. she was transfered to on for further care and evaluation. ros: 1 month prior to presentation, patient reports diffuse rash on the torso (sparing arms/legs) composed of 1 mm red, intensely itchy papules. patient reports new bluriness of vision within the past 2 weeks, which is partially corrected by corrective lenses. review of systems was otherwise negative except as specified in the hpi (patient denies recent constipation, changes in hearing, tingling/ numbness/weakness, coughing of , hematuria, dysuria, in the stool, or easy bleeding). past medical history: hypothyroidism social history: patient lives at home with her husband and 4 children youngest is 13 y.o. (total 6 children). she works at a school and at a hardware store. she currently smokes 1 ppd for 30 years. etoh: long-standing use of beers/day. patient reports that she only drinks at night. cage . family history: mother: cva father: dm, htn, alcoholism (pt.'s father "died of alcoholism") patient's 2 brothers: alcoholism physical exam: vitals: t 100.7, bp 120/70, hr 80, rr 16, sat 93% (ra) general: patient is comfortable and conversational, nontoxic, in no apparent distress. mild confusion in fact finding/verbal response. skin: warm and well perfused. few small skin-colored 1mm papules on left side of abdomen. no petechiae/ecchymoses. no jaundice. heent: sclera anicteric. oral mucosa pink. dentition intact. trachea midline. neck supple. thyroid non-enlarged. pulmonary: breath sounds diminished bilaterally at bases, extending up 20-30 cm from base on left, and 10 cm from base on right. positive egophony noted bilaterally, with transition at the levels of diminished breath sounds (described above). slight dullness to percussion, with transition at same levels. no rales/wheezes/rhonchi. cardiac: regular rate and rhythm. no m/r/g. pmi was firmly tapping, quarter-sized, located btwn 4-5th intercostal space along midclavicular line. lymphatic: no cervical or supraclavicular lymphadenopathy. gi: +bowel sounds, abdomen soft. moderate distention. moderate tenderness to palpation in mid-epigastrum. no organomegaly. neuro: aaox3. peerla, eomi, tongue midline, face symmetric. moving 5/5x4. extremities: wwp. radial and dp pulses 2+ bilaterally. no edema. rom intact. pertinent results: admission labs: 12:09am wbc-11.5* rbc-3.59* hgb-12.5 hct-34.8* mcv-97 mch-34.8* mchc-36.0* rdw-12.6 plt ct-194 12:09am neuts-91.3* lymphs-6.6* monos-1.7* eos-0.3 baso-0.1 12:09am pt-14.9* ptt-31.5 inr(pt)-1.3* 12:09am glucose-114* urean-8 creat-0.5 na-137 k-3.8 cl-111* hco3-22 12:09am alt-11 ast-32 alkphos-50 amylase-429* totbili-0.6 12:09am lipase-411* 12:09am albumin-2.2* calcium-6.6* phos-1.5* mg-2.1 12:09am triglyc-118 01:29am type-art temp-37.8 rates-14/ tidal v-450 peep-5 fio2-60 po2-126* pco2-36 ph-7.38 caltco2-22 base xs--2 -assist/con intubat-intubated discharge labs: 08:05am wbc-9.1 rbc-3.76* hgb-12.4 hct-36.8 mcv-98 mch-32.9* mchc-33.7 rdw-13.2 plt ct-810* 08:05am glucose-106* urean-11 creat-0.6 na-141 k-5.1 cl-102 hco3-29 08:05am alt-44* ast-35 ld(ldh)-420* alkphos-65 amylase-106* totbili-0.4 08:05am lipase-146* studies: portable kub impression: 1. limited assessment of the lung bases, recommend correlation with dedicated chest radiographs performed same day from . 2. technically limited abdominal radiograph demonstrates prominent gaseous loops of bowel in mid-abdomen. if obstruction of concern, dedicated supine and erect radiographs with improved positioning can be obtained. cxr - impression: ap chest reviewed in the absence of prior chest radiographs: examination marked semi-upright has an appearance suggesting essentially supine positioning, and moderate right and moderate to large left pleural effusion, responsible for left lower lobe atelectasis. the heart size is normal and mediastinal veins are distended, reflecting supine positioning andvolume overload. et tube in standard placement, nasogastric tube tip in the region of the pylorus. cxr, pa & lat - findings: the patient has been extubated. the ngt has been removed. reduced effusions are seen bilaterally. comparing the frontal view, although residual effusions are present, left greater than right. some left basilar atelectasis is seen, but there is no patchy consolidation. pulmonary vascular markings, cardiac silhouette and mediastinal contours are normal. impression: improving but persistent effusions. ruq ultrasound - impression: 1. mildly distended gallbladder without evidence of gallstones. no definite son evidence of acute cholecystitis. 2. edematous heterogeneous pancreas. given the heterogeneous appearance, pancreatic necrosis should be considered and full evaluation with contrast enhanced ct is advised. 3. a focus of high attenuation seen on the outside hospital ct near the ampulla of vater is not imaged on the current ultrasound, likely related to differences in modality. brief hospital course: mrs. is a 44 year old female with hypothyroidism and frequent alcohol use who was transfered from an outside hospital with acute pancreatitis and respiratory failure. # acute pancreatitis: the patient's lipase and abominal pain initially improved, however, she continued to have mild epigastric abdominal pain and her lipase started to trend upward on hospital day 5. per the recommendation of the general surgery team that was following, gi was consulted for consideration of ercp vs. further imaging given that osh imaging showed necrosis in the pancreatic tail, a pseudocyst in the head of the pancreas (near the sma), and a non-obstructing stone in the ampulla of vater. the patient was taken for ercp, spincterotomy was performed, and several stones and biliary sludge were removed. the patient's abdominal pain improved and her lipase subsequently began to trend downward again. she is scheduled to have a cholecystectomy approximately two weeks after discharge and follow-up with gi for further pancreatic imaging as well. a ca -9 level was drawn while the patient was in house and will be followed-up when the patient returns for her pancrease-related follow-up appointments. # aspiration/hospital-acquired pneumonia: the patient vomited during intubation at the outside hospital. reviewing her osh images, it appears that she had a lll effusion, likely secondary to pancreatitis, prior to intubation, and then developed a right-sided consolidation post-intubation, likely from aspiration of vomitus. she was initially treated with vancomycin, zosyn, and levoquin. the latter was dropped on transfer to the medical floor, and the vancomycin was dropped when the patient's mrsa screen returned as negative. she was continued on zosyn until the day prior to discharge. the patient was successfully extubated on . # etoh abuse: the patient was extensively counselled by the medical team as well as social work regarding the contribution of alcohol consumption to pancreatitis and to help her strategize to identify ways to maintain sobriety on discharge. she was initially placed on a ciwa scale, but required minimal benzos initially. she was also given vitamin supplementation. medications on admission: medications on transfer: ctx 1gm daily mvi levothyroxine 50mcg daily ativan prn flagyl 500mg q8h prn protonix 40mg iv q12h propofol gtt saline 500cc/hr dilaudid prn medications at home: synthroid 50mcg daily discharge medications: 1. levothyroxine 50 mcg tablet sig: one (1) tablet po daily (daily). tablet(s) discharge disposition: home discharge diagnosis: primary diagnoses: acute pancreatitis pulmonary effusion aspiration pneumonia secondary diagnosis: hypothyroidism discharge condition: vital signs stable, afebrile, minimal abdominal pain. discharge instructions: you came to with severe upper abdominal pain, and breathing problems. tests and ct imaging showed that you had acute pancreatitis, causing pain in the abdomen. a pulmonary effusion (fluid in the lung) and aspiration pneumonia was the cause of your breathing difficulties. you have phelbitis in your right arm from the ivs. the swelling and pain should resolve with time. you can use warm compresses for comfort. to avoid future episodes of pancreatitis, it is important that you avoid drinking alcohol. there are many programs available, including aa. if you would like referrals for sobriety, please speak with your primary care physician. you will need to follow up with the general surgery service (dr. in 2 weeks as an outpatient for removal of the gallbladder, and with dr. from the gi service in 3 weeks for repeat imaging (a technique called mrcp), and evaluation of the pancreas. there are no changes to your home medications. call your physician or return to the hospital if you have new pain in the upper abdomen, or if you have nausea/vomiting, severe diarrhea, dizzyness, shortness of breath, heart palpitations, high fevers, or any other concerning symptoms. followup instructions: 1. surgical removal of gallbladder (cholecystectomy): . please call the general surgery department at ( to obtain specific details regarding time, place, and planning for the surgery, and to ask any further questions. 2. mrcp imaging of the pancreas: , 1pm, of the building on the of provider: mri phone: date/time: 1:15 3. gastroenterology: please call ( to schedule a follow-up appointment with dr. for a date on the same day (if possible) or soon after the mrcp imaging is performed. 4. call your pcp (, b ) to schedule a follow-up appointment (for general care coordination). procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours endoscopic removal of stone(s) from biliary tract endoscopic sphincterotomy and papillotomy alcohol detoxification diagnoses: anemia of other chronic disease hypocalcemia tobacco use disorder unspecified pleural effusion unspecified acquired hypothyroidism pneumonitis due to inhalation of food or vomitus diarrhea alcohol abuse, continuous acute pancreatitis cyst and pseudocyst of pancreas other abnormal glucose calculus of bile duct without mention of cholecystitis, without mention of obstruction hallucinations 

Answer: The patient is high likely exposed to