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: acetaminophen attending: chief complaint: transfer to micu from osh s/p intubation and status epilepticus major surgical or invasive procedure: none history of present illness: this is a 52 year old man with past medical history significant for hepatitis c cirrhosis, etoh abuse and psoriasis who presented to osh in status epilepticus and then transferred to for further care. apparently, patient was found unresponsive and so ems was called. he was found to be in status epilepticus (several witnessed seizures, +tongue biting) but due to the cluttered nature of his house, it took a long time to get out. he was taken to hospital. he was given ativan and his seizures stopped. he also received ceftriaxone. for unclear reasons that were not documented (possibly airway protection), patient was induced with propofol and intubated after attempting to obtain a head ct. . of note, patient had been recently discharged from on for a question of seizure and transient neurologic symptoms. he had been admitted to the neurology service for long term monitoring and the eeg showed no epileptic seizures. per family report, the patient was having seizures at home ( times in the past occasionally requiring hospitalizations). patient was transported to for further care and management. in the ed, patient was febrile to 101.6 with normal cxr and wbc. neurology was consulted and felt seizure could be secondary to either etoh withdrawal vs seizure disorder from non-med complaince vs infectious. patient's dilantin level was noted to be low and so he was given a loading dose. patient was seizure free while in the ed. past medical history: 1. hepatitis c cirrhosis w/esophageal varices (followed by heptatologist at ) 2. etoh abuse 3. psoriasis 4. hypothyroidism 5. seizure disorder, generalized tonic/clonic and complex partial in setting etoh withdrawal (followed by neurologist at ) 6. hydrocephalus, unclear etiology 7. ? chf social history: note: social history and family history obtained post-extubation patient report having difficulty with binge drinking etoh. last binge occurred last weekend . denies tobacco or drug use. he is unemployed and had been an engineer. his brother and father live nearby. family history: mother died of mi at age 68. brother has dm. physical exam: pe: t: 101.6 hr 76 bp 127/59 rr 19 o2sat 97% cmv 600x15 peep 5 fio2 50% gen: pt intubated and sedated heent: perrl, eomi, op clear, no obvious tongue laceration neck: no lad lungs: cta b/l ant and laterally, ventilator sounds cardiac: rrr s1/s2 no murmurs abdomen: obese, soft, decreased bs ext: multiple patches of psarosis on forehead, arms/elbows, lle and right knee foot. neuro: sedated, reponsive to stimuli, moves ue/le pertinent results: labs on admission: wbc-8.6 rbc-4.09* hgb-13.2* hct-36.2* mcv-89 mch-32.3* mchc-36.5* rdw-13.0 plt ct-96* neuts-84.5* lymphs-9.4* monos-5.8 eos-0.1 baso-0.2 pt-14.3* ptt-32.3 inr(pt)-1.3* glucose-147* urean-16 creat-1.2 na-135 k-3.7 cl-98 hco3-26 angap-15 alt-48* ast-103* ld(ldh)-246 ck(cpk)-256* alkphos-108 amylase-28 totbili-1.7* lipase-27 01:50am blood ck-mb-4 ctropnt-<0.01 04:48am blood ck-mb-2 ctropnt-<0.01 . albumin-3.9 calcium-8.7 phos-2.7 mg-1.5* tsh-4.2 . 11:10am blood phenyto-16.2 01:50am blood phenyto-5.8* . cerebrospinal fluid (csf) wbc-1 rbc-1* polys-10 lymphs-36 monos-54 totprot-39 glucose-85 . urine color-yellow appear-clear sp -1.004 blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-5.0 leuks-neg . csf fluid cx - no growth blood cx - no growth urine cx - no growth . . imaging: : ir guided lp - successful fluoro guided lumbar puncture. samples were sent for routine laboratory analysis as requested by the referring physician . chest (portable ap): an endotracheal tube terminates 5 cm above the carina. the nasogastric tube tip is not visualized but is below the diaphragm. the patient is supine, rotated, with low lung volumes. therefore, the cardiac and mediastinal contours are difficult to assess. the lungs are grossly clear. no clear pleural effusions or pneumothoraces are identified. appropriately placed endotracheal tube. . ct head w/o contrast - no intracranial hemorrhage or mass effect. involutional change of the brain, which is prominent for a person of this age. . : abdomen u.s.(portable) - four quadrants were evaluated for presence of ascites, which was not identified. therefore, no suitable spot was marked for paracentesis. . ekg: nsr @ 79, nl axis, no st changes brief hospital course: micu course: patient was transferred to while intubated and sedated. he was found to be febrile in the ed to 101.6, afebrile on admission to micu. he did not have a leukocytosis. his phenytoin level was 5.8 (low). he was continued on dilantin, his dose was increased per neurology, and started on keppra. paitent's seizure was felt to be either due to infection, being subtherapeutic on aeds, or etoh withdrawal. he was changed from ac to psv, had failed lp attempts x 3, and was continued on vancomycin, ampicillin, and ceftriaxone. he remained afebrile and was been successfully extubated. he had some residual ms changes / post-ictal confusion. patient also was thrombocytopenic and anemic which was thought to be due to alcoholism. he had a mild transaminitis, c/w alcoholism and chronic hep c. . on review of systems post extubation, patient felt confused with "lack of memory." he denied pain, stiff neck, difficulty breathing, cough, dysuria. briefly, 52 year old man with past medical history significant for hepatitis c cirrhosis, etoh abuse, psoriasis who presents from osh intubated and s/p status epilepticus. . ## seizures - differential diagnosis for seizures included infectious etiology such as meningitis, non-complaince with medication as dilantin level low, or possible etoh withdrawal. unclear what resulted from the recent neurologic/seizure work-up that was performed at . regardless, patient's outpatient neurologist was contact and agreed that patient should be on both dilantin and keppra for prevention of seizure and that etoh withdrawal was also a possibility. . due to subtherapeutic levels, patient got dilantin 500mg in ed and his dilantin dose was titrated up to achieve a goal level between 15 to 20. keppra was also continued. head ct was negative for intracranial hemorrhage or mass. several attempts were made at a lumbar puncture on initial admission to the micu but were unsuccessful. patient subsequently underwent fluoro-guided lumbar puncture post-extubation, a few days after he was started on empiric antibiotics. patient was initally treated with ceftriaxone, vancomycin and ampicillin which were discontinued once the gram stain of the csf was negative and since patient's mental status had improved dramatically. it was agreed by neurology given the absence of white blood cells and micro-organisms in the csf and how well the patient looked that bacterial meningitis was very unlikely. patient was also kept on a ciwa scale with prn valium (watching to avoid hepatotoxicity). at time of discharge, patient was not requiring coverage with ciwa scale and patient's dilantin level was 16.2. patient was seizure free throughout the hospital course. . ## fever - most likely secondary to seizures. cxr negative and pt without elevated wbc. urinanalysis and urine culture were negative. lumbar puncture was performed as above. abdominal us was negative for ascites. . ## hepatitis c cirrhosis - slight transaminitis and elevated bilirubin which remained stable throughout hospital course. patient had a benign abdominal exam. continued aldactone and nadolol and lactulose. . ## hypothyroidism - tsh was wnl and continued levoxyl at home dose. . ## anemia and thrombocytopenia - most likely secondary to hepatitis c cirrhosis. although haptoglobin was low, pt/ptt were not incredibly elevated. patient's platelet count stabilized and was at admission level 80-90k by time of discharge. he will need to follow-up with his pcp regarding further if needed. . ## ppi: ppi, heparin sc, lactulose . ## fen: adv to regular diet as tolerated. patient was tolerating a regular diet at time of discharge. . ## code: full confirmed with patient . ## dispo: held family mtg @11am to discuss dispo, family not wanting pt to come home b/c he would be living with father sleeping on the couch. family currently attempting with help of lawyer to get appartment for patient. case management has screened patient for ns/ without any bed offers. still waiting to hear back from house. otherwise, shelter would be the only option if family unwilling to take pt back. patient may qualify for some nursing care for few weeks but it would only be temporary . ## communication: father is hcp (; brother ( medications on admission: nadolol 40mg aldactone 25mg folate 1mg daily levoxyl 50mcg daily thiamine 100mg daily ferrous sulfate 325mg daily lactulose 15cc nexium 40mg daily keppra 1500 dilantin discharge medications: 1. nadolol 20 mg tablet sig: two (2) tablet po bid (2 times a day). 2. spironolactone 25 mg tablet sig: one (1) tablet po bid (2 times a day). 3. lactulose 10 g/15 ml syrup sig: fifteen (15) ml po bid (2 times a day). 4. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*1 months* refills:*2* 5. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). disp:*1 month* refills:*2* 6. nystatin-triamcinolone 100,000-0.1 unit/g-% cream sig: one (1) appl topical (2 times a day) as needed. 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 8. multivitamin capsule sig: one (1) cap po daily (daily). disp:*1 month* refills:*2* 9. levetiracetam 500 mg tablet sig: three (3) tablet po bid (2 times a day). disp:*1 month* refills:*0* 10. calcipotriene 0.005 % ointment sig: one (1) appl topical (2 times a day): apply to psoriatic areas. disp:*1 month* refills:*2* 11. betamethasone dipropionate 0.05 % cream sig: one (1) appl topical (2 times a day): apply to psoriatic areas. not for skin folds. disp:*1 month* refills:*2* 12. hydrocortisone 1 % cream sig: one (1) appl topical (2 times a day): apply to psoriatic areas. apply to skin folds only. disp:*1 month* refills:*2* 13. levothyroxine 50 mcg tablet sig: one (1) tablet po daily (daily). 14. phenytoin sodium extended 100 mg capsule sig: two (2) capsule po tid (3 times a day). disp:*1 month* refills:*0* 15. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po once a day. discharge disposition: home discharge diagnosis: primary diagnosis: seizure disorder . secondary diagnosis: hepatitis c cirrhosis w/ esophageal varices etoh abuse psoriasis discharge condition: good discharge instructions: please take medications as prescribed. please keep follow-up appointments. if you have any more seizures, fevers/chills or any other followup instructions: please follow-up with your primary care physician. : . date/time: 2:00pm location: 605 phone (. please have your pcp refer you to a psychiatrist at for evaluation of pt's depression. please follow-up with your neurologist at within 1 week of discharge. have dr. consider evaluation by neuro-behaviorial specialists for further workup. please follow-up with your hepatologist in months. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours spinal tap incision of lung insertion of endotracheal tube diagnoses: thrombocytopenia, unspecified anemia of other chronic disease congestive heart failure, unspecified cirrhosis of liver without mention of alcohol chronic hepatitis c without mention of hepatic coma unspecified acquired hypothyroidism alcohol abuse, unspecified grand mal status other psoriasis 

Answer: The patient is high likely exposed to