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: etoh withdrawal major surgical or invasive procedure: none history of present illness: this is a 44 year old male with a history of hypertension, chronic knee pain, and alcohol abuse with history of dts who was found down in the snow with hypothermia, now in alcohol withdrawal. per report, patient was found down outside by ems, initially temperature around 92.2, 94.5 oral on arrival to the ed. the patient does not recall being found or where he was at that time. he was found shivering with slurred speech and incontinent of urine. fs was 144. on arrival to the ed, he was following commands and speaking in full sententences. in the ed, he received a banana bag and 1 l ns. he was placed on a bearhugger and warmed up to t max of 99.4. once he awoke and was warmed, he was agitated, tachycardic, diaphoretic, & tremulous, c/w etoh withdrawal. he also expressed suicidal ideation; seen by psychiatry in ed who did not think he was an immediate danger to himself. on arrival to , belligerent, but after speaking with admitting resident, calmed down, apologized for his behavior and accepted plan for etoh detox. ros: the patient states he just feels like he was "run over by a truck." denies any fevers, chills, weight change, nausea, vomiting, abdominal pain, diarrhea, constipation. he reports occasional hematemesis, none recently, and occasional brbpr, none recently. never had any endoscopy. also complains of a headache now. denies cp, shortness of breath, orthopnea, pnd, lower extremity oedema, cough, urinary frequency, urgency, dysuria, lightheadedness, gait unsteadiness, focal weakness, vision changes, rash or skin changes. past medical history: hypertension chronic knee pain from mva in s/p multiple surgeries (? in ) hepatitis c from blood transfusion in the , never treated (couldn't stay sober long enough), history of biopsy many years ago alcohol abuse type 2 dm anxiety/depression s/p umbilical hernia repair social history: homeless for the last 4 months. was kicked out of shelter for 60 days approximately one week ago for beating up another resident. has been on the street since that time. smokes as much as possible. drinks at least 2 pints of schnapps and 1.5 gallons of vodka daily. has no family. adamantly denies any history of past or present ivdu. family history: breast cancer, hepatocellular cancer in his grandmother. physical exam: vitals: 97.4 143/80 88 18 98%ra pain: l chest/rib cage, r knee access: piv gen: desheveled, belching heent: anicteric, mmm cv: rrr, no m resp: ctab, no crackles or wheezing abd; soft, obese, +tenderness over r ribcage, otw nontender, +bs ext; no edema, no r knee swelling neuro: a&ox3, grossly nonfocal, mild tremors skin: no changes psych: more sedated today, but easily angry/agitated when awake gross dermatitis. no ecchymoses. pertinent results: wbc 5.5 hgb 15.8-->13.3-->12.1 mcv 88 lfts wnl chem panel unremarkable, k/phos/mag okay serum tox: etoh 277, +benzo . . imaging/results: cxr: and : no acute abnormality brief hospital course: 44year old male with longstanding etoh dependence c/b dts, tobacco abuse, narcotic abuse, hep c, depression/anxiety, chronic r knee pain, dm, homelessness brought to with environmental hypothermia when found down in ice on . was externally warmed up but then actively withdrawing, so t/f to micu. loaded with valium, given ivfs, bannana bag, stabilized overnight. then transfered to gen med for social work and placement. was continued on ciwa scale/valium through the night. was also started on seroquel 300mg qhs (on this as outpt). kicked out of several weeks ago for fighting, cannot return till , so now homeless. initially was agreeable for inpatient detox but on hd#2, refused detox. stated that his plan was to keep drinking and pass out every day and he does not care if he doesnt wake up. he denied active si or plan (passive). seen by psych who felt that he understood his risks and was capable of making his own decisions. signed out ama so that he can "go to liquor store and continue drinking". was not given any rx on discharge for valium/seroquel/cymbalta/klonopin per psych recs since his plan was to continue drinking and he openly admitted that he was abusing seroquel and cymbalta and he still has active scripts at his pharmacy in . attempts by psych at contacting his outpt psych were unsuccesful. of note, reported that he fell on l side so c/o a lot l chest/rib pain (cxr neg for fracture, no rib films done prior to him signing out ama) and chronic r knee pain. has h/o chronic narcotic abuse (percocet-30mg), here was getting oxycodone 15mg q4hrs prn. he states that he gets this off the street and through his md was not given for this. he was stated on clonidine here for htn but stated he would not take this on discharge (was previously on this and still has rx at pharmacy). refuse to comply with diabetic diet (and seroquel not helping). social work tried to talk with patient about finding a homeless shelter but pt did not want to wait for this. signed out ama on , got cab voucher so he can go to homeless shelter. . progress note . etoh withdrawal: +++longstanding etoh abuse, history of dts, not clear about seizures. also on chronic klonipine (benzo) contributing to withdrawal -cont valium per ciwa scale->decrease frequency as tolerated (also given that patient is on chronic klonipin). monitor for benzo intoxication -pt states very clearly that he intends to drink upon discharge (is variable about wanting detox) so will not given valium on discharge since high risk of abuse - cont mvi, folate, thiamine - psych and sw consult saw pt, he is not interested in inpatient detox, wants to sign out ama despite multiple discussions emphasizing risk (weather, continued drinking) . . pain: complaining of chronic r knee pain, also with some left sided rib pain, appears musculoskeletal, reproducible. cxr done in ed no obvious rib fracture and pt appears to be comfortable w/o any splinting and able to ambulate. chronic narcotic user. - valium as above, oxycodone 15mg ( from 20mg) q4 prn for pain (patient reports getting percocet-30 from pcp and off the street for 20years) and continue tylenol q6prn. no rx on discharge . . hepatitis c: reports infection during the from blood transfusion. denies any ivdu, no tatoos. has had biopsy in the past, no treatment. appears he has history of upper gi bleed but has never had endoscopy. lfts wnl, coags normal, albumin 4.1 all of which go against chronic hepatitis. . . anemia, acute drop: hct drop 42.9-->36.9 but has recieved ivfs and hct now stable and likely his baseline. no active bleeding noted but he is certainly high risk . . hypertension: supposed to be on nifedipine and clonidine at home, not sure if taking. also component of acute etoh withdrawal. -well controlled now with valium and clonidine 0.2mg . hold nifedipine. pt states he will not take this meds on discharge though he has clonidine that he uses for w/drawal symptoms. . . type 2 dm: on glipizide 10mg at home, has not been taking it. sugars now in 300s since he is taking good po. seroquel making dm worse. - resumed glipizide while here with ssi, refused to follow diabetic diet . . depression/anxiety: psych following, they do not feel he is actively suicidal despite his occ comments about wanting to lie in snow and die. they feel he has capacity to leave ama if he wants. -never recieved osh records from op psych re: prior hx and meds -for now, on seroquel 300mg qhs (pt admits that he abuses seroquel as outpt). holding cymbalta and klonipin (on valium as above) -spoke with psych resident, pt has refills on all his meds at pharmacy and given that he openly admits that he abuses all his meds, will no provide any additional rx on discharge . . tobacco abuse: nicotine patch 21mg/24hr while here . left ama . medications on admission: glucotrol 10 mg cymbalta 60 mg nifedipine cr 30 mg seroquel 300 mg hs clonidine 0.2 mg klonipin 2 mg tid percocet-30, 6 pills daily, prescribed, plus what patient buys illicitly discharge medications: 1. quetiapine 200 mg tablet sig: 1.5 tablets po qhs (once a day (at bedtime)). 2. clonidine 0.1 mg tablet sig: one (1) tablet po bid (2 times a day). 3. glipizide 10 mg tablet sig: one (1) tablet po bid (2 times a day). 4. multivitamin tablet sig: one (1) tablet po once a day. 5. thiamine hcl 100 mg tablet sig: one (1) tablet po once a day. 6. folic acid 1 mg tablet sig: one (1) tablet po once a day. discharge disposition: home discharge diagnosis: environmental hypothermia etoh dependence and withdrawal discharge condition: at risk for further etoh withdrawal and hypothermia discharge instructions: you were admitted to the intensive care unit after you were found down in the snow and hypothermic. while here, you developed alcohol withdrawal and were treated with valium. you were seen by psychiatry who said you were capable of making your own decisions since you understool all the risks associated with your behaviour. you decided to leave against medical advice despite being requested to stay for inpatient detox, especially since it is very cold outside and you are homeless now that you have been kicked out of until . you left despite this. you were not given any prescriptions as your pharmacy still has rx for you. followup instructions: please see you psychiatrist procedure: alcohol detoxification diagnoses: anemia, unspecified unspecified essential hypertension chronic hepatitis c without mention of hepatic coma diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled lack of housing other and unspecified alcohol dependence, continuous alcohol withdrawal hypothermia accident due to excessive cold due to weather conditions 

Answer: The patient is high likely exposed to