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: no known allergies / adverse drug reactions attending: chief complaint: altered mental status major surgical or invasive procedure: intubation esophagogastroduodenoscopy history of present illness: 43yof with h/o etoh cirrhosis, cocaine abuse, and gastric bypass who presents with altered mental status. patient was unable to provide history. however per report, patient was notable altered by husband and was having darker stools for 2-3 days. denies fevers or chills. in the ed, initial vs were: 99.6 110 117/63 20 99%ra. on arrival patient was very combative haldol 5mg x 2. evaluation was significant for diffuse abdomen pain and melena on rectal exam. labs showed hct of 17.5. lfts were above base. plts were 183 (which is up from baseline) and inr was 1.7. lactate was 5.3 (previously normal). patient were started on protonix and octreotide. she was started on 1unit prbc. liver was consulted who planned for urgent egd while in icu. prior to transfer, patietn had ruq ultrasound that was not read. patient was then admitted to micu for further evaluation. . on arrival to the micu, patient was urgently intubated in preparation for egd. past medical history: -etoh abuse, denies hx of seizures, dt's -cocaine abuse -etoh hepatitis -depression with history of suicide attempts -sbo -pid -, s/p pelvic washout and drainage -recent syncopal episodes, w/u negative thus far, followed by neuro -s/p gastric bypass in -s/p open ccy -s/p laparotomy with loa for sbo -s/p left hip arthoplasty (as a child) social history: does not work due to "handicap," which patient reports is chronic left hip pain from her prior hip replacement. lives with her husband. denies tobacco use. has long history of etoh abuse. was sober for a few months, but started drinking again 2 weeks ago, up to 10 drinks daily (vodka). also endorses cocaine monthly, most recently 2 days ago. denies ivdu. family history: both parents with dm. father also with alzheimer's. denies any other fh. 2 brothers and 1 sister both healthy. no children. physical exam: admission exam general: intubated/sedated heent: sclera icteric, dry mm, perrl neck: supple, jvp not elevated, no lad cv: tachycardic. normal s1 + s2, no murmurs, rubs, gallops lungs: bibasilar crackles abdomen: soft, non-tender, obese, bowel sounds present, no organomegaly, no appreciable fluid wave gu: foley in place ext: warm, well perfused, 2+ pulses, no edema neuro: intubated/sedated, r gaze deviation, babinski positive on r foot discharge exam vitals: 98.7, 105-150/60-88, p105-113, rr20 100ra gen: nad, sitting up comfortably, endorses back pain heent: eomi, mmm neck: jvp not elevated, no lymphadenopathy cv: rrr, no m/r/g resp: cta b/l abd: soft, nt, nd, no organomegaly pertinent results: admission labs: 02:30pm pt-18.1* ptt-34.9 inr(pt)-1.7* 02:30pm plt count-183# 02:30pm neuts-82.2* lymphs-15.3* monos-2.1 eos-0.1 basos-0.3 02:30pm wbc-16.2*# rbc-1.79*# hgb-5.6*# hct-17.5*# mcv-98# mch-31.3 mchc-32.0 rdw-17.1* 02:30pm asa-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 02:30pm ammonia-129* 02:30pm albumin-2.5* 02:30pm alt(sgpt)-74* ast(sgot)-262* alk phos-147* tot bili-6.9* 02:30pm estgfr-using this 02:30pm glucose-99 urea n-13 creat-0.4 sodium-136 potassium-4.7 chloride-98 total co2-25 anion gap-18 03:09pm lactate-5.3* 03:18pm urine mucous-mod 03:18pm urine rbc-1 wbc-2 bacteria-few yeast-none epi-14 trans epi-1 03:18pm urine blood-tr nitrite-neg protein-tr glucose-neg ketone-10 bilirubin-mod urobilngn->12 ph-7.5 leuk-neg 03:18pm urine color-dkamb appear-hazy sp -1.016 03:18pm urine bnzodzpn-neg barbitrt-neg opiates-neg cocaine-pos amphetmn-neg mthdone-neg 03:18pm urine uhold-hold 03:18pm urine hours-random 11:28pm pt-17.8* ptt-40.8* inr(pt)-1.7* 11:28pm wbc-14.2* rbc-2.60*# hgb-7.8*# hct-23.7*# mcv-91# mch-29.9 mchc-32.7 rdw-18.1* 11:28pm calcium-6.9* phosphate-3.5 magnesium-1.1* 11:28pm glucose-123* urea n-12 creat-0.3* sodium-139 potassium-4.1 chloride-104 total co2-23 anion gap-16 imaging: egd : gastric remnant/pouch was 5 cm in length. large marginal ulcer ~ 1.3 cm with small blood clot and vissible vessel. no signs of active bleeding. the ulcer was injected at base in 4 quadrant with 1.5cc epinephrine 1:10.000, for a total of 6cc. 2 resolution hemoclips were deployed on the vissible vessel. mild erythema was noted in the gastric pouch gj anastomosis was identified along with blind jejunal limb and efferent jejunal limb. efferent jejunal limb was traversed till 25 cms were reached otherwise normal egd to second part of the duodenum ct head: conclusion: 1. no evidence of acute intracranial process. 2. ill-defined small low-attenuation foci, symmetrically located in the globi , be the result of a previous toxic or metabolic insult. cxr: impression: ng tube in mid esophagus. discharge labs 02:10pm blood wbc-10.4 rbc-3.12* hgb-9.6* hct-29.7* mcv-95 mch-30.9 mchc-32.5 rdw-17.6* plt ct-96* 06:00am blood wbc-4.0 rbc-2.63* hgb-8.2* hct-25.3* mcv-96 mch-31.3 mchc-32.5 rdw-16.8* plt ct-90* 02:10pm blood pt-19.4* ptt-34.4 inr(pt)-1.8* 06:00am blood pt-20.1* inr(pt)-1.9* 03:58am blood glucose-68* urean-7 creat-0.4 na-139 k-3.4 cl-109* hco3-24 angap-9 02:46am blood glucose-74 urean-5* creat-0.4 na-140 k-3.7 cl-110* hco3-20* angap-14 05:04am blood glucose-85 urean-3* creat-0.5 na-135 k-3.2* cl-104 hco3-22 angap-12 06:00am blood glucose-70 urean-2* creat-0.4 na-135 k-3.8 cl-107 hco3-24 angap-8 06:00am blood glucose-70 urean-2* creat-0.4 na-135 k-3.8 cl-107 hco3-24 angap-8 03:46am blood alt-64* ast-203* alkphos-133* totbili-6.8* 04:40am blood alt-50* ast-133* alkphos-146* totbili-6.6* 03:58am blood alt-34 ast-81* alkphos-110* totbili-6.6* 05:04am blood alt-27 ast-76* alkphos-102 totbili-6.4* 06:00am blood alt-22 ast-73* ld(ldh)-169 alkphos-90 totbili-5.7* 04:15pm blood calcium-8.5 phos-2.3* mg-1.6 02:10pm blood calcium-8.2* phos-3.2 mg-1.8 06:00am blood albumin-3.4* calcium-8.1* phos-1.6* mg-1.6 08:57am blood type- ph-7.41 04:27pm blood type-mix ph-7.40 brief hospital course: 43 yo female with active etoh abuse s/p gastric bypass, now admitted with altered mental status and active gi bleed with associated blood loss anemia. this required sedation and intubation with egd showing ulcer with visible vessel and clot treated with sclerotherapy and clips locally #gi bleed- from marginal ulcer at the location of her anastamosis. she had no varices on exam. she initially did not have any acute bleeding, however subsequently had a significant drop in her hematocrit which required transfusion and repeat egd which showed a bleeding ulcer which was treated with local epinephrine injections. her hematocrits were trended daily and she had no repeat exacerbations during her hospitalization. treated with antibiotics for 5 days post gi bleed. #anemia- following gi bleed, hct dropped. appeared to drop on the floor, but was as she was being rehydrated-> dilusional. she was not actively bleeding. d/c hct 25 but stable. #oliguria- patient had significant oliguria throughout her hospital stay. she was given fluid resuscitation with normal saline initially, and then transitioned to albumin treatment with minimal improvement in her urine output. throughout this time, she did not have an increase in her serum creatinine. when moved to the floor, she appeared dry and improved with fluid resuscitation. #transaminitis: likely related to etoh cirrhosis. patient has long history of etoh liver disease. #altered mental status ?????? patient was agitated on admission and required intubation/sedation for emergent procedure. while intubated she had a rightward gaze deviation. once she was successfully extubated, she no longer had any focal neurologic deficits, however she continued to be encephalopathic. she was treated with lactulose for hepatic encephalopathy with moderate improvement in her mental status. transitional issues #gi bleed: will need to follow up with gi for liver disease as well as to ensure not still bleeding and that hct stable. #alcohol abuse: patient with hx of alcohol abuse. she said she plans on stopping as an outpatient. she should receive counseling as an outpatient to help with this goal. medications on admission: none discharge medications: 1. folic acid 1 mg po daily 2. fluoxetine 20 mg po daily 3. furosemide 20 mg po daily 4. gabapentin 600 mg po qam 5. gabapentin 600 mg po hs 6. gabapentin 300 mg po noon 7. lactulose 30 ml po bid 8. pantoprazole 40 mg po q12h 9. solifenacin *nf* 5 mg oral daily 10. spironolactone 25 mg po bid 11. trazodone 50 mg po hs:prn insomnia 12. vitamin d 1000 unit po daily 13. ferrous sulfate 325 mg po tid 14. multivitamins 1 tab po daily 15. thiamine 100 mg po daily 16. lidocaine 5% patch 1 ptch td daily for back pain rx *lidoderm 5 % (700 mg/patch) please apply to back daily disp #*7 transdermal patch refills:*0 17. sucralfate 1 gm po qid rx *carafate 1 gram 1 tablet(s) by mouth four times a day disp #*120 tablet refills:*0 18. oxycodone (immediate release) 5 mg po q8h:prn pain please do not drive, operate heavy machinery, or drink alcohol while on this medication rx *oxecta 5 mg 1 tablet(s) by mouth every eight (8) hours disp #*10 tablet refills:*0 discharge disposition: home discharge diagnosis: primary diagnosis: altered mental status peptic ulcer with bleed thrombocytopenia secondary diagnosis: alcoholic hepatitis depression small bowel obstruction pelvic inflammatory disease with tubo-ovarian abscess status post gastric bypass () discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear ms. , it was a pleasure caring for you at the . you came for further evaluation of a gastrointestinal bleed. further evaluation showed that you had a bleeding ulcer that was stabilized. you are now being discharged home. it is important that you continue to take all your prescribed medications and follow up with your appointments listed below. the following changes have been made to your medications: we added oxycodone, to treat your pain. please do not drive, operate heavy machinery, or drink alcohol while on this medication. we added a lidocaine patch, which will also help to treat your pain we added sucralfate, which will help your ulcer followup instructions: department: liver center when: monday at 8:30 am with: , md building: lm campus: west best parking: garage department: bidhc when: wednesday at 3:30 pm with: np building: 545a centre st. (, ma) campus: off campus best parking: md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube endoscopic control of gastric or duodenal bleeding endoscopic control of gastric or duodenal bleeding diagnoses: acidosis thrombocytopenia, unspecified acute kidney failure with lesion of tubular necrosis alcoholic cirrhosis of liver iron deficiency anemia secondary to blood loss (chronic) depressive disorder, not elsewhere classified cocaine abuse, episodic hepatic encephalopathy other and unspecified alcohol dependence, continuous oliguria and anuria acute alcoholic hepatitis alcohol withdrawal bariatric surgery status chronic or unspecified gastrojejunal ulcer with hemorrhage, without mention of obstruction 

Answer: The patient is high likely exposed to