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 / bactrim attending: chief complaint: l hand pain major surgical or invasive procedure: rij central line placement history of present illness: 49 y/o m with h/o crystal-proven polyarticular gout, previously on allopurinol 300mg po qd but non-compliant, hiv low cd4 128, aids, hcv, recent gib from esophageal varices, current ivda who presents with left wrist pain and left 2nd mcp & pip pain/swelling, subjective fevers, chills, sweats x several days. . patient had dinner with 'lots of shrimp', woke next morning with acute onset of left wrist/hand pain swelling. he has noted that for the past 5 days he had increasing pain in his left wrist and hand. in past, patient would take indocin for gout flares but cannot now b/c of variceal bleed. he was on allopurinol 300 qd but for past few months stopped all his meds and was using iv drugs (most recent injection 1 week pta). he restarted his allopurinol 3 days prior to admission in the setting of the acute attack. notably, per patient wrist started getting better day prior to admission spontaneously. recent admission for melena, variceal bleed. in setting of the wrist/hand pain, patient felt feverish, also was worried that he was gi bleeding and presented to the ed. past medical history: 1. hiv/aids. (dx . cd4 120 . not on haart since summer secondary to relapse into drug use. not taking prophylactic meds. h/o thrush and zoster, never had pcp, h/o positive toxo igg in , hx of positive cmv igg in , hx of negative rpr in . per id recs on , he should be started on dapsone 100 mg daily for pcp and azithromycin 1200 mg qweek for .) 2. h/o osteomylitis 10 yrs ago (from ivda) in left foot, left knee, left mtp joints 3. gout (dx age 18; hx of tophi removal; on allopurinol in the past. was seen in clinic .) 4. hepatitis c. (dx ; genotype 4a. no hx of jaundice, ascites, or encephalopathy; pt has esophageal varices s/p multiple bandings - most recent novemeber ) 5. substance abuse -- heroin iv almost daily, occasional methadone (has been in methadone programs in his past (last summer ); has also tried inpatient detox programs without success 6. chronic knee pain from degenerative joint disease 7. recent cellulitis - on keflex x 1 week for skin infection secondary to injection of leg veins and skin popping social history: smokes 2 ppd x 20 yrs. no current etoh use (last use 15 yrs ago). polysubtance abuse - daily heroin, occasional methadone, cocaine, and benzos. contracted hiv and hep c from ivda. lives alone. unemployed. family history: non-contributory. physical exam: vs: 98 91/47 67 18 95%ra gen: fatigued appearing medium frame male, disheveled heent: ncat, anicteric, dry mm, op clear without lesions neck: supple, no jvp elevation cv: pmi nondisplaced, rr, nl s1, ?fixed split s2, no mrg lungs: i:e = 1:2, good air movement, late inspiratory wheeze, fine crackles at bases b/l abd: protruberant, bulging flank, soft, distended, nontender, splenomegaly back: no spinal or cva tenderness ext: warm, no edema, +clubbing, cap refill<2sec; left hand with erythema along radial surface of wrist and 1st mtp, pip, tender to deep palp, rom full at wrist, decreased at 1st digit pip, minimal warmth neuro: cn grossly intact, mae, a&o x 3, no asterixis pertinent results: portable ap and lateral views of the left wrist (): bony mineralization appears normal. there is narrowing and articular surface irregularity of the radiocarpal joint. periarticular erosions are present at the metacarpophalangeal joints. correlation with the right hand radiographs reveals periarticular erosions at metacarpophalangeal joints as well. cystic changes are noted in the left capitate, as well as in the right carpal bones. there is no fracture or malalignment. . 02:54pm wbc-7.3# rbc-4.75 hgb-12.7* hct-37.2* mcv-78* mch-26.8* mchc-34.2 rdw-18.1* 02:54pm neuts-78.1* lymphs-15.8* monos-5.1 eos-0.7 basos-0.3 brief hospital course: 1. left hand pain: patient was evaluated by rheumatology and orthopaedics, who both felt the joint unlikely to be septic. arthrocentesis was attempted, but was unsuccessful. given pt's h/o of crystal-proven gout, the etiology was felt to most likely be gout. pt's clinical history and exam supported this diagnosis. he was started on a 3 day course of colchicine, and a short prednisone taper. pt subsequently noted symptomatic improvement in his left hand pain. there was also objective improvement in erythema and edema by clinical exam. . 2. hypotension: pt was noted to have sbp in 80s while in the ed. he was mentating without difficulty and responded to fluid resuscitation. the decision was made to admit pt to micu for monitoring. in the micu, he remained asymptomatic and sbps were at pt's baseline of 90-100s without intervention. serum lactate was normal and blood cultures remained no growth at the time of discharge. 3. ivdu - patient has a known h/o heroin abuse. he was seen by , and given a low-dose of methadone while hospitalized. he was also counseled regarding placement for detox. . 4. hiv/aids - pt is not on haart. he was continued on dapsone and azithromycin prophylaxis. . 5. gib - pt has known varices, s/p banding. he was given ppi for gi prophylaxis. medications on admission: endorses intermittent adherence, was not taking meds as directed since last d/c given inability to obtain them; notes he took a few over the past 2 days, cannot name them discharge disposition: home discharge diagnosis: gout discharge condition: stable discharge instructions: please return to the ed if you have fevers, worsening pain, redness, or swelling in your hand. call if you have any other questions or concerns. followup instructions: here are your appointments: , m.d. phone: date/time: 10:30 gi west,room one gi rooms date/time: 8:30 , md phone: date/time: 8:30 procedure: venous catheterization, not elsewhere classified diagnoses: chronic hepatitis c without mention of hepatic coma iron deficiency anemia secondary to blood loss (chronic) gout, unspecified human immunodeficiency virus [hiv] disease dehydration opioid abuse, unspecified osteoarthrosis, localized, not specified whether primary or secondary, lower leg 

Answer: The patient is high likely exposed to