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 major surgical or invasive procedure: intubation and mechanical ventilation endoscopy (egd) history of present illness: the patient is a 58-year-old man with a history of heavy etoh use who presented to the ed with altered mental status. the patient had been drinking 18-20 beers nightly for approximately 30 years, then quit "cold " on . he reportedly never suffered from any withdrawals. he was prescribed wellbutrin and ambien to help with cravings, but discontinued these medications as they caused confusion and gait disturbance. this week he has been vacationing on with his significant other when he experienced worsening altered mental status and was take to an osh ed for evaluation. there he was evaluated for a stroke with a head ct that was negative, and he was transferred here for further evaluation. past medical history: - heavy etoh use - pud, hitory of bleeding ulcer - lower extremity swelling social history: the patient is from , tn. he was vacationing on with his significant other, who is from . the patient drank 18-20 beers/night for the last 30years, but stopped . he does not smoke and has no other history of drug use. he does use vitamins and other dietary / herbal supplements daily, including milk thistle and phosphatidylcholine. pt. works as a stump grinder. he was also a professional hockey player. family history: non-contributory physical exam: physical examination: vs - temp 99.6f, bp 130/80, hr 96, r 18, o2-sat 99% ra mental status - alert and oriented x 2.5. was not aware what hospital he was in, thought he was still in . general - comfortable, in no acute distress heent - nc/at, pupils equal and round, sclera mildly icteric neck - supple, no lad or jvd lungs - cta bilat, no r/r/w heart - rrr, nl s1-s2 abdomen - +bs, soft/nt/nd, no masses or hsm, no rebound/guarding extremities - pink, warm skin - no jaundice or stigmata of chronic liver disease pertinent results: cxr - the endotracheal tube has its tip approximately 56 mm from the carina. the tip of the ng tube is projected over the gastric antrum. there has been a prior cholecystectomy. the cardiomediastinal silhouette is unremarkable. the lungs are clear. . ct head - no acute intracranial process. . abd u/s - coarsened hepatic echotexture consistent with cirrhosis. no focal liver lesions id'd on this limited exam. patent hepatic vasculature. prior cholecystectomy. splenomegaly consistent with portal htn, but no definite intra-abdominal ascites. . egd: erythema in the gastroesophageal junction compatible with esophagitis, grade 1 varices at the lower third of the esophagus, portal hypertensive gastropathy, erosive gastritis . cbc: 03:45pm blood wbc-7.1 rbc-4.32* hgb-13.3* hct-37.5* mcv-87 mch-30.9 mchc-35.6* rdw-15.8* plt ct-71* 09:15pm blood wbc-5.6 rbc-3.84* hgb-11.8* hct-33.1* mcv-86 mch-30.7 mchc-35.7* rdw-15.7* plt ct-57* 04:15am blood wbc-5.9 rbc-3.64* hgb-11.4* hct-31.7* mcv-87 mch-31.4 mchc-36.1* rdw-16.0* plt ct-53* 04:50pm blood wbc-7.8 rbc-3.91* hgb-12.1* hct-33.7* mcv-86 mch-30.9 mchc-35.9* rdw-16.0* plt ct-51* 03:38am blood wbc-7.1 rbc-3.63* hgb-11.4* hct-32.0* mcv-88 mch-31.5 mchc-35.7* rdw-16.0* plt ct-54* 03:18am blood wbc-6.2 rbc-3.45* hgb-11.3* hct-30.4* mcv-88 mch-32.7* mchc-37.1* rdw-16.1* plt ct-60* 06:00am blood wbc-4.9 rbc-3.27* hgb-10.5* hct-28.3* mcv-87 mch-32.1* mchc-37.0* rdw-15.8* plt ct-63* 06:00am blood wbc-3.6* rbc-3.26* hgb-10.2* hct-28.7* mcv-88 mch-31.3 mchc-35.5* rdw-15.9* plt ct-75* . chemistry: 03:45pm blood glucose-146* urean-15 creat-1.2 na-139 k-6.1* cl-109* hco3-21* angap-15 09:15pm blood glucose-154* urean-14 creat-1.0 na-141 k-3.6 cl-111* hco3-24 angap-10 04:15am blood glucose-131* urean-14 creat-1.0 na-142 k-3.3 cl-113* hco3-25 angap-7* 04:50pm blood glucose-136* urean-14 creat-1.1 na-141 k-3.6 cl-110* hco3-23 angap-12 03:38am blood glucose-128* urean-14 creat-1.1 na-140 k-3.3 cl-109* hco3-25 angap-9 03:18am blood glucose-135* urean-12 creat-0.9 na-138 k-3.6 cl-108 hco3-26 angap-8 06:00am blood glucose-144* urean-11 creat-0.9 na-139 k-3.6 cl-107 hco3-27 angap-9 06:00am blood glucose-155* urean-10 creat-0.9 na-139 k-3.3 cl-106 hco3-26 angap-10 . cardiac enzymes: 03:45pm blood ck-mb-6 03:45pm blood ctropnt-<0.01 09:15pm blood ck-mb-7 ctropnt-0.02* . calcium/mag/phos/albumin: 03:45pm blood calcium-9.6 phos-3.4 mg-1.8 09:15pm blood albumin-2.9* calcium-9.4 phos-3.7 mg-1.7 04:15am blood albumin-2.7* calcium-9.4 phos-3.6 mg-1.7 04:50pm blood calcium-9.1 phos-2.9 mg-2.0 03:38am blood albumin-2.7* calcium-8.9 phos-3.3 mg-1.9 09:07am blood iron-150 06:00am blood calcium-8.9 phos-3.3 mg-1.6 06:00am blood calcium-8.5 phos-3.1 mg-1.7 . iron studies: 04:15am blood vitb12-1623* 09:07am blood caltibc-225* ferritn-200 trf-173* . ammonia: 04:00pm blood ammonia-141* 09:15pm blood ammonia-82* . hepatitis b and c: 04:15am blood hbsag-negative hbsab-negative hbcab-negative 04:15am blood hcv ab-negative . autoimmune hepatitis studies: 09:07am blood smooth-positive 09:07am blood -negative 09:07am blood igg-1741* . afp: 09:07am blood afp-4.7 . brief hospital course: 58m with pmh of heavy etoh use who presented with two weeks of progressive confusion. labs were consistent with chronic liver disease (low albumin, elevated inr, low platelets). elevated lfts and 2:1 ast/alt ratio revealed alcoholic hepatitis. patient does not have many physical exam findings consistent with stigmata of chronic liver disease. ammonia on arrival was 141, suggestive of possible hepatic encephalopathy. the patient was transferred to the medical icu for airway protection in the setting of altered mental status. while in the medical icu, the patient was intubated. abdominal doppler ultrasound performed in the micu was consistent with cirrhosis and splenomegaly. patient was initiated on lactulose for hepatic encephalopathy, and the dose was titrate for 3 bowel movements/day. multivitamin, thiamine, folate repletion was also initiated given history of alcohol abuse. when his mental status improved, the patient was successfully extubated and breathed comfortably. he was transferred to the medical floor for further care. at the medical floor, further lab results suggest that hepatitis b and c, autoimmune hepatitis, and hemochromatosis were unlikely. egd was performed and results were consistent with grade 1 esophageal varrices, mild gastritis, mild esophagitis, and portal hypertension related gastropathy. patient states that he had 3 bowel movements on the day of discharge, his mental status was significantly improved. pt. will follow up with his pcp and acquire gastroenterologist near his home. he will need to have his h.pylori checked. additionally he knows that he will need his afp monitored and a liver us every 6 months. he will need an egd in 18 months. regarding his gastritis, we have started him on protonix. he was also started on nadolol 20mg qdaily for his grade 1 varices. medications on admission: - lansoprazole - hctz - wellbutrin - ambien discharge medications: 1. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 2. multivitamin,tx-minerals tablet sig: one (1) tablet po daily (daily). 3. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 4. lactulose 10 gram/15 ml syrup sig: sixty (60) ml po qid (4 times a day): please adjust the dose to achieve 3 bowel movements a day. disp:*1200 grams* refills:*3* 5. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*3* 6. nadolol 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: hepatic encephalopathy alcoholic cirrhosis grade 1 esophageal varices mild esophagitis mild gastritis portal hypertension gastropathy discharge condition: stable with resolving altered mental status discharge instructions: you were admitted for altered mental status. you were found to have hepatic encephalopathy. you were admitted to the medical icu and intubated to protect your airway from secretions. you received a doppler ultrasound that showed you to have liver appearance consistent with cirrhosis, splenomegaly, and no portal hypertension. you were given lactulose to help with your hepatic encephalopathy and altered mental status. based on your lab results, you were found unlikely to have hemochromatosis, hepatitis b or c, autoimmune hepatitis or hepatocellular carcinoma. you received an egd and were found to have esophageal varices, mild esophagitis, mild gastritis, and portal hypertension gastropathy. . please take all of the listed medications. you were started on lactulose; please make sure you take enough lactulose to have three bowel movements per day. please avoid all nsaids and -2 inhibitors like aspirin, ibuprofen, celecoxib. if you experience pain, pleae take tylenol at a maximum dose of 2 grams per day. please take protonix 40 mg and nadolol 20 mg by mouth daily. . please follow up with your pcp and check .pylori serology and treat if positive. please also follow up with your pcp regarding an outpatient abdominal ultrasound, afp levels, and getting vaccinated for hepatitis b and please have your hepatitis a titer checked (blood test). you should have an afp blood test and ultrasound every six months and another endoscopy (egd) in 18 months from now. . please go to an emergency room if you throw up blood or experience rectal bleeding, altered mental status, nausea, vomiting, fever, chills, worsening abdominal pain. followup instructions: please follow up with your pcp and check .pylori serology and treat if positive. please also follow up with your pcp regarding an outpatient abdominal ultrasound, afp levels, and getting vaccinated for hepatitis b. md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours other endoscopy of small intestine insertion of endotracheal tube diagnoses: thrombocytopenia, unspecified alcoholic cirrhosis of liver portal hypertension acute respiratory failure hepatic encephalopathy esophagitis, unspecified esophageal varices in diseases classified elsewhere, without mention of bleeding unspecified gastritis and gastroduodenitis, without mention of hemorrhage other and unspecified alcohol dependence, continuous 

Answer: The patient is high likely exposed to