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: penicillins attending: chief complaint: pcp: . chief complaint: visual changes reason for micu admission: pcn desensitization. major surgical or invasive procedure: pcn desensitization history of present illness: pt is a 42 y.o male with h.o hiv (last cd4 479, vl 13,700), not on haart who was started on doxycycline (pcn allergy) 5 days ago for secondary syphilis (titer 1:64). he reported to his pcp that he had been having visual problems for the past month. he was sent urgently to ophthal where b/l anterior uveitis and b/l disc edema was seen. he was sent to the ed for imaging, lp with thoughts of pcn desensitization. pt was referred for infectious w/u. . pt states that since , he developed chills, skin rash (purple/pink spots on torso/arms/face/neck/penis, joint pains, swollen cervical lymph nodes, abdominal bloating (constipation), as well as visual changes (white lights in periphery, white circles and lines). pt denies fever, eye pain, photophobia, neck stiffness, cp/sob/palp, abd pain/n/v/d/c/melena/brbpr/dysuria/hematuria/parestheisas or weight loss. +uri symptoms since the weekend. magnesium for constipation. he then was using a friend's bactrim, which he reports some improvement in symptoms. he decided to return to his doctor down . there, hiv labs as well as rpr were drawn and pt was started on doxycycline for secondary sphyllis. pt returned yesterday and reported the eye symptoms(which he did not before) and was sent for urgent optho eval, then eval. . in the ed, vital signs were initially: 21:07 4 97.2 92 125/83 16 98 68, 127/93, rr 16, sat 99% on ra. no ekg. pt denies fever or headache, reports fatigue. head ct performed, plaque found on arm (pt states there for 2 months) past medical history: hiv-last cd4 479, vl 13,700 dx 10yrs ago, on haart for 1 yr in beginning. recent dx of sphyllis- titer 1:64, started on doxycycline x5 days. admission for seizures -started on dilantin, no longer taking tobacco and amphetamine abuse asthma anxiety and depression . social history: pt lives on , formerly had long term partner. unemployed. smokes 1/2-1ppd. h.o crystal meth use, last use 3 months ago. denies ivda. denies etoh. family history: unknown, pt reports he was adopted physical exam: physical examination: vs:t. 98.5, bp 141/92, hr 76, rr 19, sat 96% on ra gen:the patient is in no distress and appears comfortable skin:+fading maculopapular rash on torso/arms, ankles. heent:perrla, eomi, anicteric, mmm, no op lesions. neck: no discrete lymphadenopathy. chest:lungs are clear without wheeze, rales, or rhonchi. cardiac: regular rhythm; no murmurs, rubs, or gallops. abdomen: no apparent scars. non-distended, and soft without tenderness, +bs extremities:no peripheral edema, warm without cyanosis neurologic: alert and appropriate. cn ii-xii grossly intact. bue , and ble both proximally and distally. sensation intact to lt. pertinent results: 03:19pm cerebrospinal fluid (csf) protein-104* glucose-50 03:19pm cerebrospinal fluid (csf) wbc-112 rbc-64* polys-1 lymphs-93 monos-0 macrophag-6 03:19pm cerebrospinal fluid (csf) wbc-154 rbc-159* polys-1 lymphs-95 monos-0 macrophag-4 05:38am glucose-101* urea n-11 creat-0.8 sodium-136 potassium-3.7 chloride-102 total co2-27 anion gap-11 05:38am alt(sgpt)-25 ast(sgot)-27 ld(ldh)-231 alk phos-81 tot bili-0.3 05:38am albumin-3.5 calcium-8.8 phosphate-3.5 magnesium-1.9 05:38am tsh-1.1 05:38am wbc-6.3 rbc-4.27* hgb-12.4* hct-35.1* mcv-82 mch-29.0 mchc-35.3* rdw-14.5 05:38am neuts-44* bands-2 lymphs-44* monos-5 eos-3 basos-1 atyps-0 metas-1* myelos-0 05:38am hypochrom-normal anisocyt-normal poikilocy-normal macrocyt-normal microcyt-normal polychrom-occasional 05:38am plt smr-normal plt count-153 05:38am pt-13.7* ptt-30.5 inr(pt)-1.2* 05:38am pt-13.7* ptt-30.5 inr(pt)-1.2* 12:51am pt-12.4 ptt-30.2 inr(pt)-1.0 11:55pm glucose-124* urea n-13 creat-0.9 sodium-138 potassium-4.0 chloride-100 total co2-28 anion gap-14 11:55pm estgfr-using this 11:55pm estgfr-using this 11:55pm calcium-9.1 phosphate-2.8 magnesium-1.9 11:55pm urine hours-random 11:55pm urine gr hold-hold 11:55pm wbc-7.9 rbc-4.53* hgb-13.0* hct-37.5* mcv-83 mch-28.6 mchc-34.5 rdw-14.5 11:55pm neuts-31.2* lymphs-59.9* monos-6.5 eos-1.7 basos-0.7 11:55pm plt count-169 11:55pm urine color-straw appear-clear sp -1.013 11:55pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg . head ct- impression: no acute intracranial hemorrhage or mass effect. the study and the report were reviewed by the staff radiologist. . cxr-, j m 42 pa and lateral view, chest: the lungs are clear and the cardiomediastinal and hilar contours and pleural surfaces are normal. impression: no acute cardiopulmonary process. the study and the report were reviewed by the staff radiologist. 05:38am blood tsh-1.1 05:38am blood fluorescent treponemal antibody (fta-abs)-pnd brief hospital course: assessment & plan: pt is a 42 y.o male with hiv, not on haart, who presents with positive rpr and visual disturbances. . #rash/visual disturbances/joint pain-pt with hiv,not on haart (last cd4 479). pt reporting visual disturbances for some time now. pt with recent rpr 1:64. reportedly optho visit demonstrating anterior uveitis and b/l disc edema. differential is broad, but most likely is related to neurosphyllis. -lp to eval for opening pressure, cell count/diff, glucose/protein, and csf for spirochetes was all done an normal. he had an opening pressure of 18. 6cc of clear fluid sent for evaluation wbc 112, lymphs 93, prot 104, gluc 50. -pcn desensitization was done an pcn started for 2 week course. -head ct normal -csf vdrl and treponemal testing all pending at discharge. -optho was called and recommended therapy for anterior uveitis. they did not evaluate the patient, stating this needed to be done as an outpatient. close f/u was arranged. . #hiv-pt not on haart . #abdominal bloating-no pain on exam. will add on lfts. will consider abdominal imaging if persistant. . #htn-will continue home dose atenolol for now . #joint pains-no erythema, swelling, to suggest septic joint. likely related to above process. -tx for sphyllis as above medications on admission: atenolol 25 mg tab oral daily doxycycline 100 mg tab oral discharge medications: 1. penicillin g potassium 20,000,000 unit recon soln sig: four (4) million units q4h injection q4h (every 4 hours) for 2 weeks. disp:*336 million units q4h* refills:*0* 2. epipen 0.3 mg/0.3 ml pen injector sig: two (2) pens intramuscular once as needed for allergic reaction. disp:*2 pens* refills:*2* 3. outpatient lab work cbc, bun/cr, and lft's on . fax to , md at clinic, . 4. prednisolone acetate 1 % drops, suspension sig: one (1) drop ophthalmic q4h (every 4 hours). disp:*1 month supply* refills:*0* 5. tobramycin-dexamethasone 0.3-0.1 % ointment sig: one (1) appl ophthalmic qhs (once a day (at bedtime)). disp:*1 months supply* refills:*2* 6. cyclopentolate 1 % drops sig: one (1) drop ophthalmic q 8h (every 8 hours). disp:*1 months supply* refills:*2* 7. atenolol 25 mg tablet sig: one (1) tablet po daily (daily). discharge disposition: home with service facility: vna discharge diagnosis: primary diagnosis: 094.9 neurosyphilis nos secondary diagnosis: 401.1 hypertension, benign secondary diagnosis: v08 hiv, asymptomatic secondary diagnosis: 360.12 uveitis discharge condition: mental status:clear and coherent level of consciousness:alert and interactive activity status:ambulatory - independent discharge instructions: as we discussed, you were admitted for an infection of your central nervous system. you will need 2 weeks of iv antibiotics for this. we have arranged f/u for you in both opthomology and infectious disease clinic. please keep these follow up appointments and make sure you take the eye drops as directed. followup instructions: appointment #1 md: dr. specialty: opthalmology date/ time: 3:15pm location: , ma phone number: special instructions for patient: appointment #2 md: pa specialty: infectious disease date/ time: location: 49 way, ma phone number: special instructions for patient: the office will call with an appointment. if you do not here from them in 2 business days please call and book an appointment. procedure: venous catheterization, not elsewhere classified spinal tap incision of lung diagnoses: tobacco use disorder asthma, unspecified type, unspecified nausea alone asymptomatic human immunodeficiency virus [hiv] infection status benign essential hypertension amphetamine or related acting sympathomimetic abuse, continuous syphilis, unspecified syphilitic iridocyclitis (secondary) 

Answer: The patient is high likely exposed to