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, acute renal failure acute respiratory distress syndrome major surgical or invasive procedure: percutaneous gastrostomy percutaneous tracheostomy history of present illness: this is a 50 yo male hx of etoh abuse. he presented to an osh with abdominal pain and found to be extremely hypertensive 218/134, elevated lipase and amylase. pt was placed on the floor. wbc at this point was pan cultures were sent negative to the date. he was placed on a ciwa scale, and after receiving ativan the pt became tachypneic, needing intubation. after this, pt started deteriorating progressively. he became hypoxic in spite mechanical ventilation, developed renal failure now with a creatinine of 3.8 from 1.0 baseline. we received this patient in the icu on an ativan drip of 75 mg/hour. past medical history: htn splenectomy (~30 years ago) social history: etoh abuse. drinks heavily daily smokes tobacco family history: n/c physical exam: vs: 100.5, 105 st, 92/45 sao2 91% on 100% fio2 chest: lungs coarse heart: st abd: firm, decreased bs, no obvious masses ext: clammy pertinent results: ct abdomen w/o contrast 9:22 pm impression: 1. findings consistent with severe pancreatitis. diffuse peripancreatic stranding and multiple enlarged mesenteric lymph nodes. pancreatic necrosis cannot be adequately evaluated without iv contrast. evaluation of the surrounding vasculature is also limited without iv contrast. 2. no evidence of intraperitoneal free air. 3. moderate sized bilateral pleural effusions with associated atelectasis. 4. small foci of subcutaneous emphysema anterior to the anterior abdominal wall. . ct head w/o contrast 9:21 pm impression: 1. ovoid hypodensity in the left caudate head, likely due to a subacute lacunar infarction. 2. moderate paranasal sinus and mastoid air cell mucosal thickening. equivocal sphenoid sinus air-fluid levels. . liver or gallbladder us (single organ) port 8:27 am impression: 1. no definite intra or extrahepatic biliary ductal dilatation. no gallstones seen. 2. gallbladder wall edema likely related to the patient's pancreatitis. . mr head w/o contrast 10:10 am impression: 1. small early-subacute infarction in the subcortical white matter of the posterior right frontal lobe, most likely embolic. 2. chronic lacunar infarctions in the periventricular white matter, in the head of the left caudate nucleus, in the left pons, and in the left middle cerebellar peduncle. 3. fluid in the sphenoid and bilateral maxillary air cells, which may indicate acute sinusitis. opacification of the ethmoid and mastoid air cells may be related to intubation, but an infectious process cannot be excluded. 4. normal mra of the circle of . . cardiology report echo study date of conclusions: the left atrium is elongated. no thrombus/mass is seen in the body of the left atrium. the right atrium is moderately dilated. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses and cavity size are normal. regional left ventricular wall motion is normal. no masses or thrombi are seen in the left ventricle. left ventricular systolic function is hyperdynamic (ef>75%). right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. no masses or vegetations are seen on the aortic valve. the mitral valve appears structurally normal with trivial mitral regurgitation. no mass or vegetation is seen on the mitral valve. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. . ct chest w/contrast 4:00 pm impression: 1. no significant interval change in extent of peripancreatic fat stranding involving the body and tail of the pancreas consistent with pancreatitis. no evidence of pseudocyst, or areas of pancreatic necrosis. associated peripancreatic lymphadenopathy is unchanged. 2. normal spleen not identified in the left upper quadrant. multiple soft tissue density implants seen within the left upper quadrant and left anterior abdomen are suggestive of splenosis. 4. moderate sized bilateral pleural effusions with bibasilar atelectasis, unchanged. diffuse ground glass opacities in both lungs suggestive of mild pulmonary edema. . ct head w/o contrast 10:37 pm impression: 1. technically limited study secondary to contrast extravasation. 2. no evidence of acute intracranial hemorrhage. 3. worsening sinus disease, with air-fluid levels suggesting acute sinusitis. . mr head w/o contrast 8:32 am impression: 1. new early-to-subacute infarction involving the left precentral sulcus/gyrus and subcortical white matter. normal progression of previously identified right posterior frontal infarct. 2. stable appearance to chronic small vessel ischemia changes within the periventricular white matter, left pons, left middle cerebellar peduncle. 3. increased opacification of paranasal sinuses. . cta neck w&w/oc & recons 8:16 am impression: 1) minimal atherosclerotic calcification involving the carotid bulbs and ica origins bilaterally without evidence of significant stenosis. otherwise unremarkable ct angiogram of the neck. 2) bilateral pleural effusions with evidence of volume overload/chf. 3) pansinus disease as above. . complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 03:00am 10.8 2.66* 9.1* 27.2* 102* 34.2* 33.5 15.7* 483* renal & glucose glucose urean creat na k cl hco3 angap 03:00am 105 14 0.9 138 4.6 102 26 15 enzymes & bilirubin alt ast ck(cpk) alkphos totbili dirbili 10:00am 80* 89* 31* 143* 0.4 brief hospital course: this was a 50-year-old man who had entered the hospital on with acute pancreatitis and most recently an acute cerebrovascular accident affecting the caudate lobe. neuro: patient initially on ativan gtt. his neurologic exam on admission was very limited given his sedation, he is not moving any extremity or responding to pain. of note he does not have any extraocular movements with dolls, which, given his history, is concerning for wernicke's encephalopathy. he has a small, ovoid, l caudate hypodensity on ct, read by radiology as subacute. it is hard to tell by history how acute this is. it is possible that it is a small vessel lacunar infarct, which would most likely be due to small vessel atherosclerotic disease. he was found to have l frontal cva, r subcortical cva (both subacute). altered mental status for 2 weeks, and was very difficult to wake. his mental status remained depressed. on , versed were weaned. he recovered on and was opening his eyes on command, much awake and afebrile. on , he was stable neurologically. he now inconsistently follows commands and was still requires ativan for agitation and soft wrist restraints. . resp: he was started on levaquin and flagyl for an aspiration pna at the osh. he was intubated (reportedly for tachypnea, although they were also increasing ativan at this point so this is unclear). had a generalized seizure during his hospital course and was given dilantin iv for treatment of this, along with the ativan. abd ct was repeated and showed evidence of pneumoperitoneum, so he was transferred to for further management. he had a prolonged course on the ventilator. he had proven difficult to wean from the ventilator. after consultation with his family, it was elected to proceed with placement of a tracheostomy and gastric feeding tube. he finally received a trach on . after tach placement, he was weaned from the trach vent and tried on the trach mask. he was requiring respiratory care for rhonchi and needing frequent suction. he gets easily agitated and drops with o2 sats. . cv: he was tachycardic on admission. he was resuscitated with several fluid boluses and ordered for iv lopressor. he was tachycardic at times, up to 130-150's, mostly when agitated. . renal: he developed renal failure. his creatinine was 3.8 from 1.0 baseline. this slowly improved with continued fluid resuscitation. his renal status was wnl and he was auto diuresing well. . gi/abd: his abdomen was firm and distended on admission. his pancreatitis resolved during this hospitalization. his amylase was 117 at admission and lipase was 74. these both resolved while he was npo and getting ivf. he was having significant diarrhea. c.diff were all negative, and tubefeedings were temporarily held while the diarrhea resolved. he continued with the lansoprazole and imodium. he was also receiving pancrease. . fen: he was npo, ivf, tpn. he had a peg tube placed at the bedside on . he was off tpn and tolerating tube feedings. . left ue infiltrate: on , approximately 90cc of optiray iv contrast was accidentally infiltrated into the patient's left arm. due to the patient's baseline underlying edema, the injury was not immediately noticed; however, within 30 minutes infiltration was confirmed via contrast enhancement of the patient's left upper extremity on scout films. his iv was immediately removed and a warm compress was placed. this improved with conservative management. . -----imaging: ct neck: b/l no significant stenosis. mri: new cva in l frontal lobe, acute>subacute, precentral area extending to subcortical white matter; lenis: neg -tee-pfo, lvh mild outflow tract obstruction; kub: few dilated loops of bowel, no free air, air fluid levels. cta c/a/p: no change. no areas of necrosis or pseudocyst. echo: ef> 75%, nrm valves; eeg -> very slow waves mri/a: new post r frontal subcortical infarct, old lacunars ruq us: gb wall edema; ct: severe pancreatitis, b/l eff. . -----micro: cath-ng. stool-neg, bcx - msse (); 3/6,7 cdiff - neg; vre+; cvl/bcx/ucx - p, scx - mrsa; . -----abx: linezolid , flagyl , (po vanco )(/fluc ) . activity: he was being to the chair and sitting-up for several hours during the day. medications on admission: none discharge medications: 1. heparin (porcine) 5,000 unit/ml solution : one (1) injection tid (3 times a day). 2. miconazole nitrate 2 % powder : one (1) appl topical (2 times a day) as needed for apply to groin & l foot erythema. 3. albuterol 90 mcg/actuation aerosol : six (6) puff inhalation q4-6h (every 4 to 6 hours) as needed. 4. hydralazine 25 mg tablet : one (1) tablet po q6h (every 6 hours) as needed for sbp >140. 5. acetaminophen 325 mg tablet : 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 6. aspirin 325 mg tablet : one (1) tablet po daily (daily). 7. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 8. clonidine 0.1 mg/24 hr patch weekly : one (1) patch weekly transdermal qfri (every friday). 9. amylase-lipase-protease 20,000-4,500- 25,000 unit capsule, delayed release(e.c.) : two (2) cap po tid w/meals (3 times a day with meals). 10. metoprolol tartrate 50 mg tablet : one (1) tablet po bid (2 times a day). 11. levothyroxine 100 mcg tablet : one (1) tablet po daily (daily). 12. linezolid 600 mg tablet : one (1) tablet po q12h (every 12 hours) for 2 days. 13. insulin regular human 100 unit/ml solution : regular sliding scale injection asdir (as directed): see sliding scale. 14. albuterol 90 mcg/actuation aerosol : six (6) puff inhalation q4-6h (every 4 to 6 hours) as needed. 15. lorazepam 1 mg tablet : two (2) tablet po qid (4 times a day). discharge disposition: extended care facility: medical center - discharge diagnosis: pancreatitis alcohol withdrawl acute renal failure acute respiratory distress syndrome cva deconditioning mental status change discharge condition: fair discharge instructions: * increasing pain * fever (>101.5 f) * persistent vomiting * inability to pass gas or stool * increasing shortness of breath * chest pain . please resume all of your regular medications and take any new meds as ordered. . followup instructions: please follow-up with dr. as needed. call ( with questions or concerns. please follow-up with neurology in weeks. call ( to schedule an appointment. md, procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances diagnostic ultrasound of heart enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] arterial catheterization temporary tracheostomy pulmonary artery wedge monitoring extraction of other tooth diagnoses: acidosis tobacco use disorder unspecified essential hypertension acute kidney failure, unspecified other convulsions other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure acute respiratory failure bacteremia diarrhea metabolic encephalopathy other and unspecified complications of medical care, not elsewhere classified cerebral artery occlusion, unspecified with cerebral infarction other and unspecified alcohol dependence, unspecified acute pancreatitis alcohol withdrawal other specified disorders of the teeth and supporting structures 

Answer: The patient is high likely exposed to