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: history of present illness: mr. is a 29 year old white male admitted on with increased abdominal pain and associated nausea and vomiting. the patient has a long history of alcohol abuse, pancreatitis, status post recent alcohol binge with 12 to 15 beers per day with occasional shots of alcohol. the patient's last drink was three days ago by report. the patient was transferred to the medical intensive care unit service from the floor with clinical and ct evidence of pancreatitis with no fluid collection. the patient was initially on nothing by mouth and given aggressive fluid resuscitation on the floor, but became hypoxic on and warranted medical intensive care unit evaluation. we were called to see the patient when he was hypoxic and tachycardiac and normotensive. the patient was started on ampicillin, gentamicin and flagyl in the emergency room. the patient has a history of adult respiratory distress syndrome in the setting of pancreatitis. at baseline, the patient is seen in pain clinic for chronic abdominal pain. he reports that he awoke on with abdominal pain that was different from his chronic pain. he came to the emergency room and reported episodes of nausea and vomiting. he denied melena, bright red blood per rectum or hematuria. the patient states he has had no hallucinations. he feels tremulous and is diaphoretic. he denies palpitations and has had no bowel movement since two days prior to admission. the patient denies orthopnea or paroxysmal nocturnal dyspnea. past medical history: 1. alcoholic pancreatitis with several admissions for the above; history of adult respiratory distress syndrome in the setting of pancreatitis, for which he was treated in the surgical intensive care unit approximately two years ago; at that time, the patient had a splenic hematoma and underwent a splenectomy with a distal pancreatectomy. 2. history of gastroesophageal reflux disease. 3. history of hypertension. 4. sleep apnea. 5. hypercholesterolemia. 6. chronic pain in left side of abdomen and left shoulder, seen in pain clinic, on oxycontin 30 mg twice a day. 7. alcohol withdrawal; long history of alcohol abuse and has been admitted to the hospital several times for delirium tremens; patient reports approximately two to three episodes of intubation in the intensive care unit in the setting of alcohol withdrawal. 8. right upper quadrant abscess, status post percutaneous catheter drainage in . 9. distal pancreatectomy and splenectomy, as above. medications on admission: oxycontin 30 mg p.o.b.i.d., albuterol meter dose inhaler p.r.n.; on transfer to medical intensive care unit, patient was on dilaudid 2 to 4 mg i.v.q.4-6h.p.r.n., nicotine patch, valium, thiamine 100 mg p.o.q.d., folate 1 mg p.o.q.d. and zantac. allergies: the patient has no known drug allergies. social history: the patient has been abusing alcohol since the age of 15 or 16. he has a history of detoxification times one which was unsuccessful. he denies intravenous drug use but does have a 17 pack year smoking history. he has no history of illicit drug use. he is unemployed and currently lives with his mother. family history: there is a history of alcoholism in the patient's father. physical examination: physical examination on admission to the intensive care unit revealed a temperature of 101.4, pulse 74 to 164, respiratory rate 20 to 28, blood pressure 108 to 132/70 to 100 and oxygen saturation 90% in room air. general: pleasant male with mild abdominal distress. head, eyes, ears, nose and throat: normocephalic, atraumatic, pinpoint pupils, anicteric sclerae, oropharynx clear, no jaundice. cardiovascular: tachycardiac, no murmur, rub or gallop. lungs: clear to auscultation bilaterally. abdomen: distended with epigastric to periumbilical pain, hepatomegaly with liver approximately 3 to 4 cm below costal margin. extremities: no cyanosis, clubbing or edema. skin: spider angiomata on anterior chest. neurologic examination: alert and oriented times three, not tremulous, 2+ reflexes throughout, motor in bilateral upper and lower extremities. laboratory data: at the time of transfer, white blood cell count was 18.1, hematocrit 47.3, platelet count 308,000, sodium 135, potassium 3.5, chloride 96, bicarbonate 16, bun 9, creatinine 0.5, glucose 100, amylase 405, lipase 1,685; white blood cell count later in the day had increased to 23 with 82% neutrophils, 3% bands, 12% lymphocytes and 3% monocytes. amylase was subsequently found to be 212 with a lipase of 522. electrocardiogram at the time of transfer: sinus rhythm at 159 with no ischemic changes; no change from , rate 142, qrs 471 at this time. radiologic data: right upper quadrant ultrasound: fatty infiltration of the liver. abdominal ct on : pancreatitis, no pseudocyst or fluid collection; status post partial pancreatectomy and splenectomy; fatty liver infiltration, inflammation of duodenum near the pancreatic head. chest x-ray: residual minor atelectasis, right lower lung zone greater than left lower lung zone. hospital course: the patient was subsequently transferred to the medical intensive care unit for further evaluation and treatment. at that time of transfer, he was on two liters of nasal cannula and was moderately agitated with abdominal pain. 1. pancreatitis: the patient was admitted to the medical intensive care unit with acute alcoholic pancreatitis. his amylase and lipase at the time of transfer were 212 and 522 respectively. his amylase went from 212 down to 26 on with lipase going from 1,620 at the time of admission to 522 at the time of transfer to the medical intensive care unit, 45 on to 28 on . the patient's alt remained in the 20 to 60 range with an ast in the same range. his alkaline phosphatase was 102 at the time of admission and 373 on . bilirubin was stable at 0.3 to 0.7. the patient was treated with aggressive fluid hydration in the setting of acute pancreatitis. he was given fluid boluses of 250 to 500 cc initially and was put on normal saline at 250 cc/hour for the first 12 to 24 hours. the patient ended up receiving a large normal saline load of approximately 16 liters during the hospitalization. the patient continued to have temperatures throughout the hospitalization, with a maximum temperature of 104.2 on several occasions. the patient is currently febrile to 102. we have done multiple blood, urine and sputum cultures and all cultures have remained negative. his sputum culture on grew two colonies of coagulase positive staphylococcus aureus, which was not aggressively treated. at this point, an infectious source of his fevers is thought to be unlikely as the patient has persistently had culture negative samples. the patient is thought to have elevated temperatures in the setting of severe acute pancreatitis and cytokine release. at the beginning of the hospitalization, the patient became progressively more hypotensive. he was on a propofol and ativan drip at this time. on , the patient was started on neo-synephrine as his blood pressure had dipped down in the high 70s to low 80s systolic and he was found to be unresponsive to fluid boluses. the patient was on 26.7 of neo-synephrine at this time. this was subsequently weaned off on and the patient did not require any further pressors throughout the hospitalization. the patient continued to be aggressively fluid resuscitated for the first seven to days of the hospitalization. he underwent a repeat abdominal ct on due to the fact that the patient had been hypotensive, had evidence of adult respiratory distress syndrome on chest x-ray and, by physical examination and ventilator numbers was not making any progress. furthermore, the patient continued to be febrile despite multiple negative cultures. a ct scan of the chest was done at the same time as a ct of the abdomen and the impression was: (1) extensive areas of patchy consolidation with confluence at bilateral bases which are worrisome for infection; (2) interval increase in the extent of fluid and peripancreatic stranding, now with loculation/pseudocyst formation and no evidence of pancreatitis necrosis. given the presence of a peripancreatic fluid collection, we had a ct guided fluid aspiration of this region. the fluid from this aspiration had negative polymorphonuclear neutrophils, negative gram stain and culture negative. on , the patient was empirically started on imipenem despite the absence of necrosis by subsequent ct scans. the patient was continued on imipenem for a total of seven days, however, he continued to spike fevers through this intervention and, given the negative cultures and negative evidence for futility of continuing this medication, it was discontinued on . throughout the course of the last week, the patient has slowly gotten better. his abdomen is slightly less distended with quiet, but positive, bowel sounds on the day of dictation, . he continues to be on nothing by mouth and has been fed via total parenteral nutrition since the day of transfer to the medical intensive care unit. furthermore, the gastroenterology and surgery services continue to follow the patient along with us and leave recommendations on a daily basis. 2. respiratory: the patient was admitted to the medical intensive care unit for closer monitoring. he required intubation on micu day number one in the setting of hypoxemia despite a 100% non-rebreather. the patient has had evidence of adult respiratory distress syndrome on chest x-ray, with bilateral opacification. furthermore, the patient has required fio2 of 1 at several points throughout the hospitalization to maintain oxygen saturation of approximately 90%. he has also required pronation on several occasions to facilitate oxygenation given his clinical picture and diagnosis of adult respiratory distress syndrome in the setting of pancreatitis. on , the patient underwent bronchoscopy in the setting of increased respiratory secretions. bronchoscopy showed purulent material in the bronchioles and had a gram stain with 3+ polymorphonuclear neutrophils and no organisms. the culture was negative. given the history of bilateral consolidation on the chest ct on , the patient was started on levaquin, which he remains on to this date, . we are continuing to attempt a decrease in ventilatory support. the patient was on pressure control ventilation throughout the majority of his hospitalization. the patient is currently on pressure control ventilation with a driving pressure of 20 and a peep of 12. tidal volumes are approximately 600 with fio2 0.5, respiratory rate 20 and i to e ratio of 1:1.5. the last gases on these settings have been 37/46/72. we will attempt to decrease the respiratory rate on pressure control ventilation and then ultimately try to change the pressure support ventilation to determine how the patient will do with less support. throughout the hospitalization, the patient's chest x-rays have gradually gotten better. his last chest x-ray on showed an improvement in the bilateral opacification. 3. sedation: the patient has been on ativan and morphine drips throughout the majority of this hospitalization. his ativan and morphine drips were at 25 and 80 per hour respectively. we have had addiction consults and pain management consults to aid in dealing with this difficult patient. currently, the patient's ativan and morphine are being decreased by 10% per day. he has been started on haldol 4 mg four times a day and is intended to get haldol 10 mg intravenously as needed for agitation as opposed to bolusing with ativan. the psychiatry consult has been helping us with weaning guidelines. given the patient's chronic pain history, and his baseline 30 mg twice a day of oxycontin as an outpatient, it will likely take several days to decrease his dose of these agents now that the patient is off cisatracurium which he had been on for approximately one and one-half weeks of the hospitalization. 4. nutrition: the patient has been receiving total parenteral nutrition throughout the entire hospitalization. this is dictated by the nutrition recommendations on a daily basis. 5. lines: the patient has a left internal jugular which is day number 12 on . he also has an arterial line which is day number 11 on . the arterial line will be discontinued today as we are planning to follow oxygen saturations as opposed to arterial blood gases. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances fiber-optic bronchoscopy fiber-optic bronchoscopy enteral infusion of concentrated nutritional substances temporary tracheostomy diagnoses: pneumonia, organism unspecified pure hypercholesterolemia unspecified essential hypertension hypotension, unspecified unspecified sleep apnea hyperosmolality and/or hypernatremia acute pancreatitis alcohol withdrawal 

Answer: The patient is high likely exposed to