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: patient recorded as having no known allergies to drugs attending: chief complaint: delirium major surgical or invasive procedure: none history of present illness: mr. is an 80 yo man with dm2, ckd (baseline most recently ~2.0), htn, bph, depression and a recent admission (discharged ) for volume overload who was found at home today by his son unresponsive. . ems could not measure his fsbs because it was critically high. in the ed, his initial vss were 101.6, 231/74, 74, 20, 97% on ra. initial finger stick was 667 here, serum blood sugarwas 636. pt received 4 x 10 units of insulin iv (not started on drip) and 4l ns. in addition, he received vancomycin, levofloxacin and metronidazole for his fever after cultures were drawn. . the pt was not able to give any additional history. . the pt's son, who spoke to the pt on the day prior to presentation, reported that he had no complaints one day pta. he did not c/o chest pain, shortness of breath, pain with urination, nausea, vomiitng, cough, sputum production or headache. the pt's son did report that the pt has been sloppy with his insulin compliance of late due to the recent loss of the pt's wife. past medical history: type ii dm ckd, baseline cr 1.6-2.0 htn bph depression social history: denies tobacco, alcohol, recreational drugs. family history: noncontributory physical exam: on admission: vitals: t: 101.6 bp: 191/70 p: 76 r: 27 sao2: 97% on 2lnc general: unable to rouse, appears agitated. does not respond to voice commands. heent: ncat, perrl but sluggish 4->3, no scleral icterus, mm dry, no lesions noted in op neck: supple, no significant jvd or carotid bruits appreciated pulmonary: lungs cta bilaterally, no wheezes, ronchi or rales cardiac: rr, nl s1 s2, ii/vi systolic murmur heard best at the rusb, no rubs or gallops appreciated abdomen: well-healed right lateral scar, soft, not apparently tender, nd, normoactive bowel sounds, no masses or organomegaly noted extremities: no edema, 2+ radial, trace dp pulses b/l lymphatics: no cervical, supraclavicular lymphadenopathy noted skin: no rashes or lesions noted. neurologic: difficult to rouse, not responsive to verbal commands. opens eyes spontaneously. perrl but sluggish 4->3. unable to assess cranial nerves secondary to non-cooperative pt. moves all extremities, reeflexes 2+ at brachioradialis, biceps, patella, diminished to absent at achilles bilaterally. no abnormal movements noted. upgoing toes bilaterally. pertinent results: 09:13pm glucose-100 urea n-37* creat-2.1* sodium-147* potassium-3.6 chloride-106 total co2-30 anion gap-15 06:33pm cerebrospinal fluid (csf) protein-57* glucose-197 06:33pm cerebrospinal fluid (csf) wbc-97 rbc-2* polys-93 lymphs-2 monos-5 06:33pm cerebrospinal fluid (csf) wbc-88 rbc-2* polys-96 lymphs-2 monos-2 05:05pm urine hours-random 05:05pm urine uhold-hold 04:33pm calcium-8.4 phosphate-1.5*# magnesium-2.3 01:12pm glucose-360* na+-139 k+-3.5 cl--98* tco2-33* 01:00pm urea n-41* creat-2.2* 07:00am asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 07:00am urine hours-random 07:00am urine gr hold-hold 07:00am wbc-7.7 rbc-4.89 hgb-12.9* hct-40.2 mcv-82 mch-26.4* mchc-32.2 rdw-14.8 07:00am neuts-78.9* lymphs-14.3* monos-4.5 eos-1.2 basos-1.1 07:00am pt-13.0 ptt-26.5 inr(pt)-1.1 07:00am plt count-461* 07:00am urine color-straw appear-clear sp -1.021 07:00am urine rbc-* wbc-0 bacteria-0 yeast-none epi-0 05:41am blood wbc-9.3 rbc-4.43* hgb-11.7* hct-34.4* mcv-78* mch-26.4* mchc-34.1 rdw-14.9 plt ct-346 05:44am blood wbc-10.9 rbc-4.31* hgb-11.3* hct-34.0* mcv-79* mch-26.2* mchc-33.3 rdw-15.0 plt ct-339 05:41am blood plt ct-346 05:44am blood plt ct-339 07:00am blood neuts-78.9* lymphs-14.3* monos-4.5 eos-1.2 baso-1.1 05:41am blood glucose-93 urean-22* creat-1.7* na-142 k-3.3 cl-101 hco3-35* angap-9 05:41am blood calcium-8.9 phos-2.8 mg-2.2 06:33pm cerebrospinal fluid (csf) wbc-97 rbc-2* polys-93 lymphs-2 monos-5 06:33pm cerebrospinal fluid (csf) wbc-88 rbc-2* polys-96 lymphs-2 monos-2 06:33pm cerebrospinal fluid (csf) totprot-57* glucose-197 06:30pm cerebrospinal fluid (csf) herpes simplex virus pcr-test name **final report ** gram stain (final ): no polymorphonuclear leukocytes seen. no microorganisms seen. fluid culture (final ): no growth. brief hospital course: #honk/dm2: no known precipitant, although according to pt's son, he likely has not been compliant with his insulin regimen lately. there were no obvious infectious etiologies in spite of his fever in the ed. his u/a was clean, his cxr and lung exam were essentially normal. he had not been c/o headache, and he had no wbc count. an lp done over 12hrs after abx started showed a white count of 98, mostly pmns, without any organism on gram stain or culture. there was no evidence of an acute coronary syndrome either by history or on ekg. the patient was aggressively volume repleted, treated with insulin drip protocol, and rapidly stabilized his blood sugars. once on the floor, the pt. tolerated full diabetic diet, fsg initially ranging from 196-238, but improving to 72-189 once his home regimen of insulin (25am/10pm) was restarted. plan on continuing home regimen with close outpatient f/u. . ## fever: white count not elevated, no infiltrate on cxr, u/a clean. as above, lp somewhat questionable considering earlier dose of abx. pt. was started on meningitis dosing of vancomycin, ceftriaxone and acyclovir for a 10 day course, which will be completed on . on the floor the pt. was afebrile, no leukocytosis, no growth on cultures, clean chest film and clean u/a. also, the pt. was without any symptoms. a picc line was placed for further abx therapy and good glycemic control was continued. consider dosing his vanc by level, giving 1g for trough less than 15. as before, course will be complete on . . ##delirium: likely related to hhns and perhaps fever. head ct within normal limits. no evidence of other ingestions on tox screens or history per son. once on the floor the patient was aaox1-2, and at baseline, according to discussion with son and pcp. improved versus admission. we continued to re-orient as needed, and assist with feedings/ambulation as needed. . ## htn: pt hypertensive to 220s/70s in the ed. did not received any antihypertensives. first, he was started with iv labetalol with goal sbp in the 160s and chased with po labetalol once ngt was in place. on the floor, as his renal function improved we restarted first his acei and then his . . ## ckd: cr 2.0 at last discharge, baseline per records from 1.6-2.0, raised to 2.4 on this admission but now back to 1.6. at discharge he appears hydrated on exam. his i/os were near-neutral without his home dos aging of diuretics. he may need to restart some dose of these diuretics in the near future. . ##chf: pt. with stable weight near 235lbs. plan to continue daily weights, and restart diuretics when needed for fluid retention. his home regimen was metolazone 5 mg qam, 30 minutes prior to furosemdie 80mg (daily). perhaps one could first restart his lasix and then add the metolazone if needed. . ## elevated troponin: likely secondary to ckd and arf. no ekg changes suggestive of ischemia. pt has no documented hx of cad, but given dm2, likely has underlying coronary disease. recheck ruled out mi. . ## depression: con't celexa, sw will see pt. soon. . ## fen/lytes: diabetic/heart healthy full diet. . ## prophylaxis: heparin sc 5000 tid, no indication for ppi . ## code status: full code, discussed with son, . ## contact: (son) home , cell , daughter-in-law . ## dispo: to sub-acute/rehab .. medications on admission: valsartan 80 mg daily aspirin 81 mg daily citalopram 20 mg daily metoprolol tartrate 50 mg twice daily furosemide 80 mg qam ergocalciferol (vitamin d2) 50,000 qweek insulin nph-regular (70-30) 25 units qam insulin nph-regular (70-30) 10 units q pm metolazone 5 mg qam, 30 minutes prior to furosemdie acetaminophen 500 mg q6hrs prn pain lisinopril 40 mg daily discharge medications: 1. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). 2. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 3. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed. 4. lisinopril 20 mg tablet sig: two (2) tablet po daily (daily). 5. valsartan 160 mg tablet sig: one (1) tablet po daily (daily). 6. heparin flush cvl (100 units/ml) 1 ml iv daily:prn 10ml ns followed by 1ml of 100 units/ml heparin (100 units heparin) each lumen qd and prn. inspect site every shift 7. ceftriaxone 2 gm iv q12h 8. ampicillin 2 gm iv q6h 9. acyclovir 1200 mg iv q12h 10. vancomycin 1000 mg iv q48h according to pharmacy calc of crcl of 18. 11. heparin flush cvl (100 units/ml) 1 ml iv daily:prn 10ml ns followed by 1ml of 100 units/ml heparin (100 units heparin) each lumen qd and prn. inspect site every shift 12. hydralazine 20 mg iv q6h:prn sbp > 160 13. sodium chloride 0.9% flush 10 ml iv daily:prn for pasv picc before and after each use inspect site daily 14. insulin nph 25units sq qam/ 10units sq qpm discharge disposition: extended care facility: hospital discharge diagnosis: primary: non-ketotic hyperglycemic hyperosmotic crisis hypertensive urgency delerium acute renal failure secondary: 1. type ii dm 2. cri, baseline cr 1.6-2.0 3. htn 4. bph 5. depression 6. chf discharge condition: good discharge instructions: please continue your antibiotics as instructed for the full 10 day course(done on ). continue to take your other medications as prescribed. if you experience any symptoms that worry you or your family please return to the hospital for further treatment. also, please weigh yourself daily to ensure your fluid status is not worsening followup instructions: please followup with your pcp 3 days of discharge also, you have the following appointment for the future: provider: , dpm phone: date/time: 3:40 procedure: venous catheterization, not elsewhere classified spinal tap incision of lung diagnoses: mitral valve disorders congestive heart failure, unspecified acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) chronic kidney disease, unspecified chronic systolic heart failure unspecified viral meningitis diabetes with hyperosmolarity, type ii or unspecified type, uncontrolled 

Answer: The patient is high likely exposed to