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: fluconazole / dilantin / penicillins / ertapenem attending: chief complaint: worsening nausea/vomiting/headache major surgical or invasive procedure: removal of vps placement of external ventricular drain removal of external ventricular drain history of present illness: hpi: pt was recently discharged from hospital after vp shunt insertion for obstructive hydrocephalus. two days after d/c she developed nausea and vomiting which has been increasing in frequency over the last 5-7 days, occurring 5-6 times yesterday and 3-4 times today. she also has had worsening of her baseline intermittent headaches over the last 2-3 days. she has been complaining of pain. no fever, no diarrhea. presented to where she had a repeat nchct that showed new blood in ventricular system as well as intraparenchymal blood along shunt tract. she was given 50 mg iv hydrocortisone due to vomiting, as well as zofran, and she was transferred to . past medical history: pituitary adenoma s/p resection with right craniotomy pe s/p ivc filter, on lovenox impaired vision: r eye blindness, blurry l eye hypertension siadh due to adenoma hyponatremia chronic back and hip pain nephrolithiasis impaired mental status at baseline s/p tah for fibroids social history: married with 3 children. family history: +htn in mother physical exam: physical exam t 97.7 hr 80 bp 165/91 rr 18 o2 sat 98%ra heent: mmm, shunt palpable, no tenderness or erythema around reservoir or around track, staples in place neck: supple cardiac: rrr, n s1 & s2, no murmur chest: ctab : bowel sounds present, non-distended, mild tenderness to palpation in extremities: no edema neuro: mse: awake, alert, and fully oriented. speech fluent, comprehension intact through translation via her daughter who was accompanying her today. cn: r pupil 7 mm and unreactive but preexisting deficit and mild r ptosis, l pupil 4 to 2, eomi without nystagmus, complete loss in the right eye without light detection, only left nasal field vision in the l eye, facies symmetric, facial sensation is intact to light touch bilaterally, hearing is intact to finger rub bilaterally, tongue protrudes midline, palate elevates midline, sternocleidomastoids and trapezii are strong. motor: nml bulk and tone, no drift, no adventitious movements, muscle strength 5/5 throughout reflexes: dtrs in 2+ and symmetric bilaterally, ues 3+ and symmetric, plantars downgoing bilat sensory: intact to light touch, no extinction to dss coordination: no dysmetria on finger-nose-finger gait: deferred but walking independently and no ataxia according to daughter on discharge: neuro/ms: spanish speaking, with translation pt a/a/ox3, pupils left /brisk right 6nr at baseline with complete loss, eomi face symmetric, tongue midline, mae with generalized weakness, no pronator drift. pertinent results: nchct comparison: . findings: there is a right frontal ventriculoperitoneal shunt coursing through the right frontal lobe with tip terminating in the region of the foramen of . the overall course of this shunt is unchanged from . however, there is interval development of hemorrhage along the course of this shunt with associated vasogenic edema. additionally, there is new intraventricular hemorrhage with blood layering posteriorly within the lateral ventricles. again seen is a small amount of intraparenchymal hemorrhage within the inferior bifrontal lobes, left greater than right, similar in appearance to prior study. the ventricular system is more prominent, suggesting an element of hydrocephalus. otherwise, again seen is a suprasellar mass, with extension to the level of the clivus, floor of the third ventricle, and sphenoid and ethmoidal sinuses. this mass is overall unchanged. there is no shift of normally midline structures. no acute major vascular territorial infarction is identified. ct head w/o contrast 6:00 am ct head w/o contrast reason: ? vent size, please do if possible at 5 am on thank medical condition: 50 year old woman with reason for this examination: ? vent size, please do if possible at 5 am on thank you contraindications for iv contrast: none. indication: please reassess size of ventricles. comparison: ct study from . technique: non-contrast head ct. findings: again seen is evidence of prior frontotemporal craniotomy on the right with a right frontal burr hole. minimal amount of hyperdensity along the previous ventricular catheter tract in the right frontal region remains, although pneumocephalus has resolved. the ventricular size is unchanged compared to previous study. configuration of the large suprasellar mass is unchanged. extent of the heterogeneous inferior left frontal lesion with surrounding edema is also stable. a small amount of blood in the occipital of the right lateral ventricle may be slightly decreased compared to the previous study. no new areas of hemorrhage are identified. total opacification of the left sphenoid air cell, near total opacification of the right sphenoid air cell, and opacification of the posterior left ethmoid air cells are also stable findings. soft tissues demonstrate removal of the skin staples and resolution of the subcutaneous emphysema. impression: 1. no new hemorrhage. stable ventricular size. 2. suprasellar and left frontal lesions, unchanged. small amount of blood layering in the occipital of the right lateral ventricle, and a small amount of blood along the prior right frontal ventricular catheter, stable. mr head w & w/o contrast 8:21 pm mr head w & w/o contrast reason: assess for brain abscess medical condition: 50 year old woman with pmh obstructive hydrocephalus, recent removal of vp shunt, now with meningitis reason for this examination: assess for brain abscess contraindications for iv contrast: none. mr head history: a 50-year-old female with sellar tumor status post partial resection with subsequent hemorrhage recently with hemorrhage around new ventricular shunt now with meningitis, assess for brain abscess. technique: multiplanar multisequence mr images of the head were obtained before and after the administration of iv gadolinium. findings: comparison is made to most recent head ct from as well as a prior head mr from . again seen is blood within the former right frontal ventricular shunt tract. there is minimal enhancement along the shunt tract, but no discrete fluid collections concerning for abscesses are identified. surrounding t2 hyperintensity around the shunt tract is seen consistent with edema. there is minimal pachymeningeal enhancement underlying the right frontal craniotomy site as before which likely represents postop change. tiny amount of pneumocephalus is seen. intraventricular blood is again seen in the occipital horns. the ventricles are dilated, as before. again seen is a large homogenously enhancing mass involving the sella, clivus, sphenoid sinus, extending into the adjacent basal cisterns as before. the tumor is encasing the right internal carotid artery and the mca artery as before. old hematoma in the left inferior frontal lobe is again seen, as well as surrounding t2 hyperintensity, which likely represent gliosis. impression: 1. blood and minimal enhancement along the right frontal shunt tract with large area of surrounding vasogenic edema. 2. no peripherally enhancing fluid collections concerning for abscesses. 3. enlargement of the ventricles with intraventricular blood and pneumocephalus as seen on the most recent ct scan. 4. no significant change in the large enhancing sellar mass with invasion of the adjacent structures as described above. no significant change in an old hematoma and surrounding gliosis of the left inferior frontal lobe. chest (portable ap) reason: r/o pneumonia medical condition: 50 year old woman with h/o ivh, s/p evd removal, fever 101.5 reason for this examination: r/o pneumonia ap chest, 10:46 a.m., history: drain removal. fever. rule out pneumonia. impression: ap chest compared to : heart size top normal. lungs clear. no pleural abnormality. mild elevation of the left hemidiaphragm longstanding. no pneumothorax. labs: wbc 5, hgb 12, hct 33.1, plts 392 inr 1.1, ptt 37.4 gluc 115, bun 13, creat 0.8, na 135, k 4.7, cl 98, hco3 28 11:14am blood wbc-4.8 rbc-3.52* hgb-11.4* hct-31.1* mcv-88 mch-32.5* mchc-36.7* rdw-13.4 plt ct-336 04:28pm blood esr-40* 04:13am blood glucose-77 urean-7 creat-0.6 na-142 k-3.5 cl-112* hco3-23 angap-11 04:13am blood calcium-8.4 phos-2.8 mg-1.7 02:48pm blood osmolal-271* 04:28pm blood crp-8.3* 05:16am blood vanco-20.3* brief hospital course: this 50yo female spanish speaking only patient admitted for shunt removal. pt was previously admitted in mid and underwent laparoscopically assisted right sided vp shunt placement for hydrocephalus. two days later, she was seen at with nausea vomitting and headache and found to have a bleed along the course of the vp shunt. she transferred to and urgently underwent shunt removal with placement of evd drain on . due to postoperative fevers and hyponatremia, infectious disease and endocrinology were consulted. perioperatively, she was covered with prophylactic cefazolin from ; that was continued while she had her drain in place. she had her drain removed on uneventfully, tip not sent for culture. she was noted to have a leak from the burr hole generated in the course of placing her evd and had stitches placed on overnight. she developed fevers and then developed neck stiffness on and underwent lp at 12:30 am. she was given vancomycin, ceftriaxone and acyclovir at 2 am. her coverage was changed to ceftazidime, vancomycin on at 6 pm. pt's abx coverage further changed to vanco and ertapenem, which will end on . additionally, since patient's first surgery for pituitary mass patient developed panhypopit after surgery and has been on hydrocortisone and lt4 replacement since admission, pt has been on stress dose of hydrocortisone 50mg iv q8 hours. levothyroxine was continued at home dose(100mcg qday). she was found to have hyponatremia since : 130 and trended down to 126 despite being on ivf: ns 80cc/hr since admission. patient placed on sodium tablets tid with fluid restriction to 500cc/day. pt now eating and drinking regularly on fluid restriction, and has balanced input and output. pt is feeling well. her headache has resolved. she denies nausea or vomiting. pt restarted lovenox id following patient for esr/crp trend. neurologically pt improving with improved sodium levels, afebrile and repeat ct showing stable ventricle size, no hydrocephalous. pt consulted by physical therapy and cleared for d/c home without pt services required. pt discharged home on iv abx for 6 remaining days, drug levels to be tested and patient instructed with spanish interpreter to follow up with dr. on with ct. medications on admission: meds: lasix 40 qday keppra 1000 kcl 20 meq er qday ca 500 tid enalapril 5 levothyroxine 100 mcg qday lovenox 0.7 cc (70 mg) sq hydrocortisone 20/12.5 mg omeprazole 20 qday percocet 5-325 1-2 tabs q4hprn allergies: fluconazole (rash), dilantin (rash), and penicillins (rash). discharge medications: 1. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day). 2. sodium chloride 1 gram tablet sig: two (2) tablet po tid (3 times a day). disp:*180 tablet(s)* refills:*2* 3. enalapril maleate 5 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 4. hydrocortisone 20 mg tablet sig: one (1) tablet po qam (once a day (in the morning)). disp:*30 tablet(s)* refills:*2* 5. hydrocortisone 20 mg tablet sig: 0.5 tablet po qpm (once a day (in the evening)). disp:*30 tablet(s)* refills:*2* 6. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. levetiracetam 500 mg tablet sig: two (2) tablet po bid (2 times a day). disp:*120 tablet(s)* refills:*2* 8. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 9. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 10. enoxaparin 80 mg/0.8 ml syringe sig: one (1) subcutaneous q12h (every 12 hours). disp:*60 * refills:*2* 11. vancomycin in dextrose 1 gram/200 ml piggyback sig: one (1) intravenous q 12h (every 12 hours) for 6 days. disp:*24 * refills:*0* 12. saline flush 5-10cc flush 5-10cc sash and prn 13. outpatient lab work vanco trough q week and serum sodium q weekly 14. heparin flush 100units/ml please flush 100units/ml 3-5ml sash and prn 15. outpatient lab work crp/esr weekly please fax to clinic 16. ertapenem 1 gram recon soln sig: one (1) intravenous once a day for 6 days. disp:*6 * refills:*0* discharge disposition: home with service facility: critical care systems discharge diagnosis: intraventricular hemorrhage shunt failure hyponatremia hydrocephalus siadh pituitary mass discharge condition: neurologically stable discharge instructions: discharge instructions for craniotomy/head injury ?????? have a family member check your incision daily for signs of infection ?????? take your pain medicine as prescribed ?????? exercise should be limited to walking; no lifting, straining, excessive bending ?????? you may wash your hair only after sutures and/or staples have been removed ?????? you may shower before this time with assistance and use of a shower cap ?????? increase your intake of fluids and fiber as pain medicine (narcotics) can cause constipation ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, ibuprofen etc. ?????? if you have been prescribed an anti-seizure medicine, take it as prescribed and follow up with laboratory blood drawing as ordered call your surgeon immediately if you experience any of the following: ?????? new onset of tremors or seizures ?????? any confusion or change in mental status ?????? any numbness, tingling, weakness in your extremities ?????? pain or headache that is continually increasing or not relieved by pain medication ?????? any signs of infection at the wound site: redness, swelling, tenderness, drainage ?????? fever greater than or equal to 101?????? f followup instructions: please call if you need to cancel your scheduled appointment with dr. on . please arrive in the morning for a 10:30am cat scan without contrast, then follow with an 11am appointment with dr.. follow up with infectious disease doctors 2 weeks with esr and crp blood work. call for an appointment. follow up with endocrinology dr. in 2 weeks. call for an appointment. ( provider: , m.d. phone: date/time: 2:30 procedure: venous catheterization, not elsewhere classified spinal tap incision of lung intravascular imaging of intrathoracic vessels removal of ventricular shunt closed biopsy of skin and subcutaneous tissue diagnoses: other chronic pain anemia, unspecified obstructive hydrocephalus unspecified essential hypertension unspecified acquired hypothyroidism intracerebral hemorrhage other nervous system complications pain in joint, pelvic region and thigh epilepsy, unspecified, without mention of intractable epilepsy personal history of venous thrombosis and embolism other disorders of neurohypophysis backache, unspecified other specified antibiotics causing adverse effects in therapeutic use mechanical complication of nervous system device, implant, and graft personal history of tuberculosis meningitis, unspecified panhypopituitarism panhypopituitarism 

Answer: The patient is high likely exposed to