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: valproic acid attending: chief complaint: pain and swelling major surgical or invasive procedure: intubation and extubation arterial line placement and removal history of present illness: pt is 42 yo m with h/o anoxic brain injury in , who p/w l ear pain/swelling. mother reports that pt has had breathing problems the past 3 weeks, and has had l ear pain/swelling for months. he has been treated with several course of prednisone, per mother. pt's mother, pt has had fevers and cold sweats "off and on" for months. she says she is currently "being investigated" because hospitals are "making her look like the bad one." she insists that her son "is sick and has an infection" and was not treated appropriately at recently. . in the , pt was found to be tachypnic and had labored breathing. because of wheezing on exam, he was given alb/atrovent nebs and solumedrol 40mg iv. he was tried on bipap, however his abg was 7.23/81/162, and he was becoming more somnolent. he was then given propofol and intubated for hypercarbic resp failure. he was given clinda iv and levoflox iv because of small dental abscesses seen on neck ct. past medical history: - anoxic brain injury: complicated by cortical vision loss, seizures, cognitive dysfunction, myoclonus (prolonged admission in after presumed drug overdose per reports), followed by behavioral neurology - type 2 diabetes: previously followed by (last visit note dated ) with dr. . had been on insulin, now only on oral . - ? osa (hx of nocturnal hypoxia during prior admissions) - hypercholesterolemia - bipolar disorder - h/o "asthma" per mother, also h/o asbestos exposure per mother - h/o substance abuse- thought to be the cause of anoxic brain injury - chronic low back pain - obesity social history: was living at home with mother, who also has guardianship. was previously doing well in rehab but with decreased functional capacity at home, thought to benefit from additional rehab/pt. no etoh, no tobacco. previous drug use may have contributed to anoxic brain injury per reports although documentation of this not obtained this admission. family history: non-contributory physical exam: vitals: t 97.2 bp 87/45 hr 80 rr 16 o2 sat 91% on ac/600/16/100% gen: obese, intubated, sedated heent: thick neck (unclear if edema or obesity). r ear clear, l ear with ? impacted cerumen (per ed). mild l sided facial erythema. cardio: rrr, nl s1s2, no m/r/g resp: r sided rhonchi anteriorly abd: soft, nt, obese, +bs ext: no c/c/e neuro: sedated pertinent results: 05:13pm type-art po2-78* pco2-47* ph-7.39 total co2-30 base xs-2 03:03pm type-art po2-84* pco2-43 ph-7.43 total co2-29 base xs-3 03:03pm glucose-229* lactate-1.1 k+-3.4* 03:03pm freeca-1.14 10:19am glucose-260* urea n-10 creat-0.8 sodium-138 potassium-4.0 chloride-103 total co2-30 anion gap-9 10:19am alt(sgpt)-21 ast(sgot)-19 ld(ldh)-233 alk phos-80 amylase-24 tot bili-0.3 10:19am lipase-17 10:19am albumin-3.5 calcium-8.6 phosphate-1.4*# magnesium-2.0 10:19am wbc-6.7 rbc-4.63 hgb-13.1* hct-39.8* mcv-86 mch-28.3 mchc-32.9 rdw-14.2 10:19am plt count-246 10:19am pt-12.9 ptt-26.9 inr(pt)-1.1 08:27am urine color-straw appear-clear sp -1.014 08:27am urine blood-neg nitrite-neg protein-neg glucose-1000 ketone-tr bilirubin-neg urobilngn-neg ph-8.0 leuk-neg 04:42am type-art po2-162* pco2-81* ph-7.23* total co2-36* base xs-3 intubated-not intuba 04:05am type-art po2-107* pco2-87* ph-7.23* total co2-38* base xs-5 12:12am comments-green top 12:12am lactate-0.7 12:05am glucose-191* urea n-9 creat-0.8 sodium-140 potassium-3.8 chloride-101 total co2-33* anion gap-10 12:05am estgfr-using this 12:05am ast(sgot)-22 ld(ldh)-301* alk phos-86 amylase-29 tot bili-0.2 12:05am lipase-31 12:05am calcium-8.9 phosphate-3.9 magnesium-2.1 12:05am calcium-8.9 phosphate-3.9 magnesium-2.1 12:05am wbc-9.0 rbc-4.85 hgb-13.9* hct-41.9 mcv-86 mch-28.6 mchc-33.1 rdw-14.2 12:05am neuts-51.0 lymphs-32.3 monos-4.8 eos-11.6* basos-0.3 12:05am plt count-250 12:05am plt count-250 12:05am sed rate-4 . neck ct w/contrast impression: 1. periapical lucency involving the right maxillary second molar ( tooth #2), with thickening of the suprajacent buccal soft tissues. findings may represent a periapical abscess with gingivitis and soft tissue extension. 2. no associated fluid collection to suggest soft tissue abscess. 3. mucosal thickening within the right frontal and maxillary sinuses, likely chronic inflammatory in etiology. . admission cxr: patchy retrocardiac airspace opacity concerning for evolving pneumonia or aspiration. . single ap supine chest radiograph: exam is limited by respiratory motion. a left retrocardiac opacity persists and may represent pneumonia or atelectasis. no chf or pleural effusions. et tube is in unchanged position. ng tube descends below the diaphragm, however the tip is not seen due to motion artifact over the abdomen. old left rib fracture is noted. impression: no evidence of chf. equivocal left lower lobe pneumonia. exam is limited by respiratory motion. . panorex impression: suboptimal evaluation due to technique precludes evaluation of the mandibular or maxillary alveolus. recommend dedicated dental radiographs if there is a particular area of concern. brief hospital course: this is a 42 yo m with h/o anoxic brain injury, p/w hypercarbic resp failure and possible small dental abscesses. the patient was admitted to the icu and the following issues were addressed: . 1. hypercarbic resp failure: likely initial insult of decreased resp drive due to narcotics/benzos. initially placed on vanco/levo/clinda in emergency department for concern for sepsis (re: pna) in setting of hypercarbia and hypotension. chest xray without signs of pneumonia. hypotension resolved quickly. likely has component of chronic co2 retention as well. was extubated the day after admission and initially very agitated thought to be secondary to benzo withdrawl vs. baseline poor mental status. psychiatry was consulted for assistance with patient's extensive medication list. he was initially placed on iv valium and haldol instead of his home regimen of klonopin and seroquel as patient was combative and refusing to take po medications. patient became calm and cooperative with the medication regimen and was switched back to all home meds with the exception of decreased narcotics (placed on low dose fentanyl patch) and klonopin dose. both adjustments were made re: concerns of respiratory depression on presentation. patient was at baseline mental status per his sister at the time of transfer to the floor. his home medications were continued home medications although with decreased klonopin dose from 1 tid to 0.5 tid and changed paxil to lexapro (home meds: seroquel, baclofen, klonopin, paxil). he was started on a low dose fentanyl patch which was titrated upwards as needed for pain control. . 2. l ear/facial pain: likely secondary to right sided dental abscesses seen on neck ct. possibly due to poor oral hygeine in setting of diabetes. has been chronic infection per pt's mother. initially on vanc/levo/clinda in ed, changed to augmentin and completed an 8 day course. dental was consulted after panorex was obtained, and they suggested omfs consultation for extractions. omfs consulted and determined that patient should have teeth extracted eventually, but there was no emergent need for extraction while in house. he should have a full dental consultation as an outpatient. . 3. hypotension: pt with sbp 80's-90's on admission. afebrile. likely secondary to propofol for sedation after intubation given pt had normal bp throughout ed course. stable after extubation. . 4. eosinophilia: resolved. likely to steroids as resolved after steroids discontinued. (steroids given in ed for concern of copd exacerbation). esr 4. . 5. dm 2: on metformin at home, held oral intitially as patient was not taking po's. home metformin dose restarted as patient calm, cooperative, and taking adequate po. his blood sugars were well controlled throughout his hospital course and was maintained on a sliding scale insulin. . 6. h/o anoxic brain injury c/b seizures: no reported seizures in ed. continued home seizure meds. no seizures while in house. his lamictal and gabapentin were continued. pscychiatry continued to follow patient while in house and recommended switching his paxil 40 qd to lexapro 10mg daily. they also recommended haldol prn to control agitation but he was not requiring these on a daily dose as his agitation was well controlled without medications. . 7. chronic back pain: pt on high dose narcotics at baseline, which may have contributed to hypercarbic resp failure. this was decreased and patient is currently on fentanyl patch with morphine prn, which has controlled his pain well. high doses of narcotics should be avoided given his respiratory failure. . 8. fen: diabetic, lyte repletion . 9. ppx: hep sc, ppi, bowel regimen . 10. access: 2 piv's . 11. code: full code . 12. comm: his hcp is (an attorney), who has been appointed to be his temporary guardian. can be reached at: (. his social situation is complicated as his mother, , often misrepresents herself as the guardian and will give consent for procedures and present old document of guardianship in order to do so. she can be reached at: (mother) (h), (c), but again, the legal guardian is , and not the mother. . #) dispo: to rehab. social work, cm, and mental health cm all involved in patient's situation. medications on admission: albuterol 90 mcg 1-2 puffs inh q6h prn fluticasone 110 mcg 2 puffs inh amoxicillin (started ) metformin 500 mg qd paroxetine hcl 40mg qd baclofen 20 mg tid gabapentin 600 mg tid lamotrigine 25 mg docusate sodium 100 mg atorvastatin 20 mg qd quetiapine 300 mg pantoprazole 40 mg qd clonazepam 1 mg tid bisacodyl 10 mg qd prn senna 8.6 mg hydromorphone 2-8 mg 5 times daily prn discharge disposition: extended care facility: - discharge diagnosis: primary diagnosis: hypercarbic respiratory distress altered mentas status diabetes mellitus hypertension discharge condition: stable. mental status at baseline. calm and cooperative. discharge instructions: you were admitted to for respiratory distress which may have been caused by overmedication with narcotics and benzodiazepines. you should avoid taking high doses of these sedating medications in the future. you were put on a ventilator for a short period of time but were stable once off the breathing machine. . your paxil has been changed to lexapro, a similar medication which is for depression. we have discontinued hydromorphone and changed your pain medicine to morphine. we have also decreased the amount of klonopin you are getting to the dose. . please call your doctor if you develop fevers, chills, chest pain, shortness of breath, abdominal pain, nausea, vomiting, or any other concerning symptoms. followup instructions: please make an appointment to follow up with your primary care doctor, , within the next two weeks. . please make an appointment to see the maxillofacial surgeon as an outpatient to arrange teeth extraction as recommended during this admission. call to schedule that appointment. . provider: , md phone: date/time: 2:00 provider: , md phone: date/time: 1:30 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube arterial catheterization diagnoses: obstructive sleep apnea (adult)(pediatric) pure hypercholesterolemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled poisoning by benzodiazepine-based tranquilizers accidental poisoning by benzodiazepine-based tranquilizers acute respiratory failure anoxic brain damage epilepsy, unspecified, without mention of intractable epilepsy chronic obstructive asthma, unspecified bipolar i disorder, most recent episode (or current) unspecified periapical abscess without sinus 

Answer: The patient is high likely exposed to