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 / ceftazidime / carbamazepine / cephalosporins / cefepime attending: chief complaint: tracheostomy fell out major surgical or invasive procedure: trach replacement history of present illness: 43 yo f with encephalitis, epilepsy, right hemiparesis, global aphasia, tracheal stenosis, tracheobroncomalacia, chronic tracheostomy, and recent admission for pneumonia and uti, admitted to icu because trach fell out. . the patient discharged from yesterday, after a 16-day admission for uti and pneumonia. at her group home, her tracheostomy came out. she was found to be hypoxic and was to hospital, where her tracheostomy was replaced, but the balloon could not be inflated. she was transferred to for further management. . in the ed at , initial vital signs were t 96.8 hr 70 bp 112/68 rr 18 sat 100%. the emergency department physicians spoke with interventional pulmonology, who recommended admission to the micu, with a plan to take the patient to the or to replace the trach in the morning. vital signs on transfer hr 68 bp 95/60 rr 14 sat 100%/trach mask. . review of systems is unobtainable. past medical history: 1. encephalitis 2. epilepsy 3. partial left hemispherectomy at age 19 complicated by right hemiparesis and partial aphasia 4. mental retardation 5. left thoracolumbar scoliosis 6. vagal nerve stimulator implanted , needs battery change 7. h/o aspiration pneumonias, now on scopolamine patch 8. s/p peg placement using t tube 9. s/p tracheostomy 10. mrsa line infection in the past 11. hx multiple utis, urosepsis (enterococcus, vre, other) 12. difficult venous access requiring femoral sticks 13. constipation 14. mood disorder, on ssri; also zyprexa - dense global aphasia w/ right hemiparesis - right spastic hemiplegia - tracheal stenosis and tracheobroncomalacia (trach dependent) - recent h/o pseudomonas aspiration pna requiring hospitalization - major depression social history: no history of tobacco, alcohol, illicit drug use. lives in a group home. family history: no family history of seizures or . physical exam: on admission: vital signs: hr 54 bp 106/61 rr 13 sat 99% general: does not speak. heent: anicteric sclerae. eyelids twitching. moist mucous membranes. neck: trach in place with trach collar and trach mask. chest: exam limited by patient cooperation with deep breathing. normal respiratory effort. ctab. cv: rrr. normal s1, s2. no m/g/r. abdomen: +bs. soft. nt/nd extremitites: warm and well-perfused. radial and dp pulses 2+ bilaterally. neurologic: does not speak. eyelids closing rhythmically. perrl 7 mm -> 5 mm. moves all extremities. squeezes left hand. right upper extremity contracted. withdraws lower extremities to babinski test. plantar reflex mute bilaterally. . on discharge: vs: afebrile, hr57, bp90/55, rr 16, o2 sat 100% on trach mask (35%) general: nad, non-verbal at baseline heent: anicteric sclerae, eyelids twitching left > right, resists raising of eyelids. moist mucus membranes. neck: new portex trach in place with trach collar and mask cv: rrr, normal s1s/2, no murmurs/gallops/rubs pulm: ctab, no wheezing/rhonchi/rales abdomen: + bs, soft, non-tender, non-distended ext: warm, well perfused, no cyanosis/ecchymosis, trace-1+ bilateral lower extremity edema neurologic: does not speak, perrl. pertinent results: none new. . cxr : 1. interval improvement in pleural effusion and bibasilar opacities with residual interstitial edema. 2. tracheostomy tube is appropriately positioned. 3. vagal nerve stimulator overlies the left lower lung which limits evaluation. . 20 minute eeg: pending brief hospital course: 43 yo f with encephalitis, seizures, right hemiparesis, aphasia, tracheobronchomalacia, chronic trach, presents with trach that fell out and was replaced, with balloon unable to be inflated. . #tracheostomy with balloon not functioning: interventional pulmonary consulted in ed and replaced prvious trach with new portex 7mm (6cc air inflation). the patient was monitored in the icu without issues. her tube feeds and albuterol/ipratropium can be resumed on discharge. profound supraglottic edema, redundant tissue and subglottic stenosis/malacia were noted on bronchoscopy suggestive of gerd. ip recommended starting a ppi and gerd precautions (elevating head of bed, monitoring tube feeds etc). - start lansoprazole for gerd . # encephalitis/seizure disorder: the patient was continued on phenobarbital, keppra, zonisamide, dilantin. neurology evaluated the patient and felt there were no acute issues. initially, recommended eeg given relative hypotension and bradycardia. 20 minute eeg was performed, final read pending -- although neurology felt the patient's mental status is at baseline and did not need eeg monitoring. technically, ongoing seizure activity should cause tachycardia, not bradycardia. - follow-up final eeg read . #depression: continued on fluoxetine. . #hypothyroidism: the patient may actualy be sick euthyroid as patient's hypothyroidism diagnosis was made during acute illness. she was continued on home levothyroxine. . #access: 22-gauge piv on right shoulder; patient with very difficult access. . #communication: hcp is mother , cell phone: . . #code status: full code, confirmed with mother . ## transitional care: eeg final read pending. lasix held in-house for relative hypotension. lansoprazole started for gerd. medications on admission: 1. phenobarbital 30 mg tablet : two (2) tablet po bid (2 times a day). 2. phenobarbital 30 mg tablet : one (1) tablet po qhs (once a day (at bedtime)). 3. levetiracetam 100 mg/ml solution : fifteen (15) ml po bid (2 times a day). 4. levetiracetam 100 mg/ml solution : ten (10) ml po daily (daily). 5. zonisamide 100 mg capsule : four (4) capsule po daily (daily). 6. dilantin infatabs 50 mg tablet, chewable : 1.5 tablet, chewables po three times a day. 7. fluoxetine 20 mg/5 ml solution : five (5) ml po daily (daily). 8. olanzapine 5 mg tablet, rapid dissolve : one (1) tablet, rapid dissolve po hs (at bedtime). 9. montelukast 10 mg tablet : one (1) tablet po daily (daily). 10. levothyroxine 25 mcg tablet : one (1) tablet po daily (daily). 11. furosemide 40 mg tablet : one (1) tablet po daily (daily). 12. ipratropium bromide 0.02 % solution : one (1) neb inhalation q4h (every 4 hours). 13. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization : one (1) neb inhalation q4h (every 4 hours). 14. senna 8.6 mg tablet : one (1) tablet po daily (daily). 15. docusate sodium 50 mg/5 ml liquid : ten (10) ml po bid (2 times a day). 16. nystatin 100,000 unit/g powder : one (1) application topical three times a day. 17. camphor-menthol 0.5-0.5 % lotion : one (1) appl topical (2 times a day) as needed for dry skin. discharge medications: 1. phenobarbital 30 mg tablet : two (2) tablet po bid (2 times a day). 2. phenobarbital 30 mg tablet : one (1) tablet po qhs (once a day (at bedtime)). 3. levetiracetam 100 mg/ml solution : fifteen (15) ml po bid (2 times a day). 4. levetiracetam 100 mg/ml solution : ten (10) ml po daily (daily). 5. zonisamide 100 mg capsule : four (4) capsule po daily (daily). 6. dilantin infatabs 50 mg tablet, chewable : 1.5 tablet, chewables po three times a day. 7. fluoxetine 20 mg/5 ml solution : five (5) ml po daily (daily). 8. olanzapine 5 mg tablet, rapid dissolve : one (1) tablet, rapid dissolve po hs (at bedtime). 9. montelukast 10 mg tablet : one (1) tablet po daily (daily). 10. levothyroxine 25 mcg tablet : one (1) tablet po daily (daily). 11. ipratropium bromide 0.02 % solution : one (1) neb inhalation q4h (every 4 hours). 12. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization : one (1) neb inhalation q4h (every 4 hours). 13. senna 8.6 mg tablet : one (1) tablet po daily (daily). 14. docusate sodium 50 mg/5 ml liquid : ten (10) ml po bid (2 times a day). 15. miconazole powder 2% prn 16. camphor-menthol 0.5-0.5 % lotion : one (1) appl topical (2 times a day) as needed for dry skin. ** furosemide 40 mg tablet : one (1) tablet po daily (daily) held in-house for hypotension. discharge disposition: extended care discharge diagnosis: primary: tracheostomy malfunction secondary: * encephalitis * epilepsy * s/p peg placement using t tube * difficult venous access requiring femoral sticks * mood disorder, on ssri; also zyprexa * tracheal stenosis and tracheobroncomalacia (trach dependent) * recent h/o pseudomonas aspiration pna requiring hospitalization discharge condition: mental status: confused - always. level of consciousness: lethargic but arousable. activity status: bedbound. discharge instructions: -you were admitted after you were noted to be oxygenating poorly. your tracheostomy balloon was broken and non-functional. it was felt that your tracheostomy needed to be replaced. interventional pulmonary evaluated you and replaced your tracheostomy with a portex 7 (6cc of air). . -it is important that you continue to take your medications as directed. we made the following changes to your medications during this admission: --> start lansoprazole 30mg daily --> resume lasix 40mg daily depending on your blood pressures . -contact your doctor or come to the emergency room should your symptoms return. also seek medical attention if you develop any new fever, chills, trouble breathing, chest pain, nausea, vomiting or unusual stools. followup instructions: department: neurology when: monday at 11:30 am with: , rn building: sc clinical ctr campus: east best parking: garage . department: neurology when: monday at 10:00 am with: , md building: campus: east best parking: garage procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours fiber-optic bronchoscopy replacement of tracheostomy tube electroencephalogram diagnoses: other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure hypoxemia accidents occurring in residential institution aphasia unspecified intellectual disabilities localization-related (focal) (partial) epilepsy and epileptic syndromes with complex partial seizures, without mention of intractable epilepsy dependence on respirator, status mechanical complication of tracheostomy other causes of encephalitis and encephalomyelitis spastic hemiplegia and hemiparesis affecting dominant side 

Answer: The patient is high likely exposed to