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: status epilepticus major surgical or invasive procedure: ltm eeg monitoring vp shunt tap history of present illness: mr. is a 20 year old man with severe traumatic brain injury in , now admitted for status epilepticus. initial injury during roll-over mva in , ejected from car, sustaining subdural hematoma, skull fracture, sah, with midline shift requiring emergency hemicraniectomy for increased icps. given severity of injury, he was on prophylactic levetiracetam, although no record of clinical seizures and continuous eeg monitoring for total of 6 days showed no electrographic seizures, but occasional right hemisphere and left frontal spikes. discharged to rehab in . had right cranioplasty and vp shunt in . was being tapered off keppra because of sedation (to 250mg tid). mother reported that at rehab he followed some commands, answered yes/no questions, spoke few word phrases, and had been able to sit, lift head, and stand with assistance. on am, was found to be unresponsive with posturing; given ativan 4mg and taken to , where he continued to have recurrent generalized seizures despite ativan 10mg, dilantin 1g, keppra 2g. transferred to later on , where had continued right arm twitching, head deviation to right, eye twitching, which improved with propofol infusion and resolved with iv phenobarbital load. past medical history: right subdural hematoma multiple brain contusions tbi s/p vp shunt l1 burst fracture s/p peg, g-tube feeds only s/p trach, now decanulated social history: has been at in . family history: noncontributory physical exam: initial exam: gen: lying in bed, intubated/sedated cv: rrr, nl s1 and s2, no murmurs/gallops/rubs lung: clear to auscultation bilaterally abd: +bs soft, nontender ext: warm, well perfused, no edema skin: g-tube site okay, old trach scars mental status: intubated, sedated, does not open eyes, does not follow commands. cn: head appeared initially deviated toward right with facial twitching and eye twitching vertically. with increased propofol, only eye twitching, head midline. perrl 1.5mm not reactive. motor exam: initially with right hand twitching with stopped with increased propofol. has decerebrate extensor posturing and rigidity in upper and lower extremities. sensory: withdraws/postures lower extremities bilaterally to noxious stimuli. reflexes: brisk and symmetric at patella bilaterally. unable to elicit in ue due to tone/extensor posture. plantar response mute bilaterally. current exam: mental status: no spontaneous eye opening or eye opening to command. no eye movements to voice. does not follow commands. opens eyes partially to noxious stimuli. cn: pupils od , os , eomi to doll's, corneals and gag present. nearly continuous eyelid twitching. unable to see palate secondary to increased tone in jaw. motor: extensor posturing bilateral arms with contractures, increased extensor posturing to pain in ues, triple flexion in les to pain. reflexes absent in ues, 3+ at knees. triple flexion to plantar stimulation. pertinent results: initial labs: 10.4>11.8/34.2<346; 85 pmns, 6 bands, 5 lymphs na 140, k 4, cl 105, co2 24, bun 16, cr 0.4, gluc 128 alt 31, ast 19, ck 357 alk phos 144 t bili 0.8 alb 3.6 ca 8.6, phos 3.7, mg 1.6 pt 14.2, ptt 24.2, inr 1.2 phenytoin 10.6 reports: eeg (): eeg gives evidence for a severe diffuse encephalopathy with the presence of persistent epileptiform activity (pleds)over the left central-temporal region. eeg (): this is an abnormal video eeg due to the presence of left frontal delta slowing which represents focal cerebral pathology. it is also abnormal due to the appearance of very rare left frontal broad-based sharp waves which may represent epileptogenic cortex. there were two pushbutton activations, neither of which showed any clinical or electrical changes concerning for seizure. there were no electrographic seizures seen. imaging: le dopplers: extensive deep venous thrombosis of the left lower extremity extending from common femoral to popliteal veins. cta chest: acute segmental pulmonary emboli involving the right upper lobe anterior and apical segments and segmental and subsegmental emboli involving the posterior basal right lower lobe pulmonary arteries; bilateral lower lobe atelectasis with marked endobronchial secretions within the posterior basal segment of the left lower lobe, consistent with partial drowned lung. additional foci of patchy airspace consolidation in the remainder of the right lower lobe is suspicious for superimposed aspiration or infection brief hospital course: mr. is a 20 year old man with severe traumatic brain injury in , now admitted for status epilepticus. 1) status epilepticus/seizures: on am, was found to be unresponsive with posturing; given ativan 4mg and taken to , where he continued to have recurrent generalized seizures despite ativan 10mg, dilantin 1g, and keppra 2g. transferred to neuro icu later on , where he had continued right arm twitching, head deviation to right, eye twitching, which improved with propofol infusion and resolved with iv phenobarbital load. while in the neuro icu, he was initially monitored on ceeg, which showed left central-temporal pleds. he was maintained on dilantin, keppra and phenobarb. the doses of these medications were adjusted during hospital course. his continued unresponsive to commnads during hospitalization was thought to possibly be related to his , the plan is to slowly taper this, while continuing his current doses of keppra 1500 mg and dilantin 200 mg q8h. with regards to his dilantin dosing, we have had to go up on the standing dose as well as occasionally load him as his levels are frequently low and should be monitored to make sure they remain therapeutic. the keppra dose was recently increased to 1500 mg to prevent breakthrough seizures given the difficulty in maintaining a therapeutic dilantin level. his phenobarb dose is currently at 60 mg , with the plan to taper this to 45 mg next week and then to call dr. the following week regarding further medication adjustments. please contact dr. regarding any adjustments of seizure medications. 2) respiratory: initially intubated for airway protection in setting of status epilepticus. unable to be weaned off , tracheostomy was eventually performed and he is currently maintaining good o2 sats while on 40% trach mask. 3) id: he was initially spiking fevers, which was believed to be due to his autonomic dysregulation, but cultures were sent and he did have blood cultures (both centrally and peripherally) positive for coag negative staph. he was started on vancomycin for this and his central line was pulled as a possible source of infection. after fevers were controlled, a picc was placed for access. while in the icu, he also had a bal, which ended up growing pseudomonas and coag + staph. for the bacteremia, he was started on a 14 day course of vancomycin and for the pneumonia he was started on a 14 day course of ceftazadime. repeat blood cx have been negative and a repeat sputum cx only showed sparse growth of pseudomonas and coag + staph; this is likely colonization and as per id, there is no need to continue antibiotics longer for this as long as there is no further fevers or respiratory distress. to ensure the bactermia was not related to a csf infection given his vp shunt; neurosurgery was asked to tap the vp shunt; there was no evidence of infection in the csf. wound cultures were also performed of his areas of folliculitis on his torso to ensure that this was not a portal of entry of his bacteremia; there were no microorganisms seen on the wound cultures. will is currently afebrile. 4) heme: left lower extremity swelling was noted, so le dopplers were performed ands showed extensive deep venous thrombosis of the left lower extremity extending from common femoral to popliteal veins. a cta was subsequently performed and despite his ivc filter, there were acute segmental pulmonary emboli involving the right upper lobe anterior and apical segments and segmental and subsegmental emboli involving the posterior basal right lower lobe pulmonary arteries. for his dvt/pe, he was started on therapeutic lovenox. the decision was made to not start coumadin given its interaction with dilantin; he will thus need to remain on therapeutic lovenox for months for his dvt/pe. 5) tachycardia: he reportedly was tachycardic prior to admission and this was attirbuted to his autonomic instability from his injury. other contributing factors could be pain induced tachycardia and now, from his pe as well. his metoprolol was increased during hospitalization to 25 mg tid to help control his heart rate. he was continued on his home dose of clonidine. medications on admission: tylenol 650 mg gt q6h prn amantadine syrup 125 mg gt q24h baclofen 10 mg gt tid chlorhexidine oral rinse clonidine 0.1mg gt tid colace 100 mg gt senna 2 tabs gt dulcolax suppository prn fleets enema prn ferrous sulfate 300 mg gt qday neurontin 300 mg gt tid ibuprofen 800 mg gt q8h prn fever labetalol 800 mg gt keppra 250 mg gt metoprolol 50 mg gt q6h prn hr>110, sbp>160 oxycodone 10 mg gt q4h prn pain discharge medications: 1. phenobarbital 30 mg tablet sig: two (2) tablet po bid (2 times a day). 2. phenytoin 50 mg tablet, chewable sig: four (4) tablet, chewable po q8h (every 8 hours). 3. levetiracetam 500 mg tablet sig: three (3) tablet po bid (2 times a day). 4. enoxaparin 80 mg/0.8 ml syringe sig: one (1) subcutaneous q12h (every 12 hours). 5. baclofen 10 mg tablet sig: one (1) tablet po tid (3 times a day) as needed for spasticity. 6. clonidine 0.1 mg tablet sig: one (1) tablet po tid (3 times a day) as needed for htn. 7. mupirocin calcium 2 % cream sig: one (1) appl topical (2 times a day). 8. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day) as needed for tachycardia. 9. famotidine 20 mg tablet sig: one (1) tablet po once a day. 10. white petrolatum-mineral oil 56.8-42.5 % ointment sig: one (1) appl ophthalmic prn (as needed) as needed for dryness. 11. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 12. metoprolol tartrate 5 mg/5 ml solution sig: one (1) intravenous q4h prn as needed for tachycardia, hr > 110. 13. vancomycin 500 mg recon soln sig: one (1) recon soln intravenous q 8h (every 8 hours) as needed for gpc in blood for 2 doses. 14. ceftazidime 2 gram recon soln sig: one (1) recon soln injection q8h (every 8 hours) for 5 doses. 15. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h prn as needed for fever or pain. discharge disposition: extended care facility: hospital for continuing medical care - ( center) discharge diagnosis: status epilepticus dvt pe bacteremia pneumonia discharge condition: nonverbal and does not does not respond to commands currently bedbound discharge instructions: you were admitted to the hospital in status epilepticus. on am, you were found unresponsive with posturing; given ativan 4mg and taken to , where you continued to have recurrent generalized seizures despite ativan 10mg, dilantin 1g, and keppra 2g. you were then transferred to , where you had continued right arm twitching, head deviation to right, and eye twitching, which improved with propofol infusion and resolved with iv phenobarbital load. eeg the next morning showed epileptic activity but no electrographic seizures. on the last day of eeg monitoring, there was still diffuse slowing indicating an encephalopathy, but there were only very rare sharp waves in the left frontal region; this was an improvement from the initial eegs. despite the overall improved eeg, there was still diffuse encephalopathy with no significant improval in your level of arousal. it is believed that the could be contributing to your mental status; the dose was slowly titrated down. for seizure control, you are currently on keppra 1500 mg twice a day, dilantin 200 mg three times a day and 60 mg twice a day. the plan is to decrease the to 45 mg twice a day in one week and then the following week, to call dr. at ( regarding further instructions. for the status epilepticus, you were initially intubated. you then had another tracheostomy placed tp enable you to come off the ventilator. while in the hospital, you were spiking fevers and were found to have blood cultures positive for coag negative staph and a bronchoalveolar lavage was performed while you were intubated and it grew pseudomonas. for these infections, you were started on a 14 day course of vancomycin and ceftazadime respectively. your left leg was also noted to be swollen, so an ultrasound was performed on your legs. this showed that you had a dvt in your left leg; you were subsequently noted to have a pulmonary embolus, which is a clot in your lung that probably dislodged from the clot in your leg. for this, you were started on a blood thinning medication called lovenox, you will need to be on this for 3-6 months. followup instructions: please follow-up with dr. when able to visit her in outpatient clinic. while at rehab, please call her at ( regarding any questions with adjustment of seizure medications. procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more spinal tap incision of lung enteral infusion of concentrated nutritional substances temporary tracheostomy closed [endoscopic] biopsy of bronchus ventriculopuncture through previously implanted catheter central venous catheter placement with guidance diagnoses: acute respiratory failure pneumonitis due to inhalation of food or vomitus bacteremia grand mal status methicillin resistant staphylococcus aureus in conditions classified elsewhere and of unspecified site acute venous embolism and thrombosis of deep vessels of proximal lower extremity encephalopathy, unspecified other pulmonary embolism and infarction presence of cerebrospinal fluid drainage device other specified diseases of hair and hair follicles personal history of traumatic brain injury 

Answer: The patient is high likely exposed to