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: betadine viscous gauze / iodine containing agents classifier / naprosyn / clindamycin / lactose attending: chief complaint: "i was at and then came here because i was told i may have had seizure." major surgical or invasive procedure: none history of present illness: 63yo married white woman with reported h/o multiple personality disorder, depression, ptsd, and recently documented h/o bipolar disorder, also with a medical h/o sleep apnea, ehlers-danlos, and previous seizure due to intracranial hematoma, who was transferred form hospital at husband of patient's request for psychiatric evaluation and possible psych admission. per notes (sent on transfer), the patient was recently admitted to on for question of seizure. labs, mri/mra, head ct were all negative. eeg was negative for seizure activity, but showed some generalized slowing. patient was also seen by psychiatry while there for expansive affect and pressured speech. diagnosed with bipolar disorder with hypomanic episode, likely secondary to taking antidepressants wrong (taking more wellbutrin than she was supposed to). also had a subtherapeutic vpa level. psych planned to taper antidepressants, and dose of wellbutrin to 150 daily and celexa 20 daily. patient was discharged home with plan to follow-up with outpt neuro and psych (though doesn't have any outpt psych treaters in place). per the husband, the patient continued to have pressured speech, sleep, only 10minutes at a time for a total of 30 minutes. was restless in bed. he became concerned about her and felt he was unable to contain her and called 911. she was taken back to . repeat labs and head imaging was negative. recommended inpt psych admit, but the husband wanted transfer to which the hope that the patient could be admitted if needed psychiatrically at and set up with outpt behavioral health treaters at . per the patient, she reports feeling "hyper" meaning that she has more energy than usual, has a hard time sleeping, and feels she talks faster than usual. she reports having similar "hyper" episodes throughout her life. unable to give an accurate history about the frequency, length or when the last episode was. denies increased spending, promiscuity or goal directed behaviors during these episodes. however her husband endorses that she will have "manic" episodes over a year, then not have any for a few years since he has known her for 38 years. he endorses that at her worst, she does have disorganized thoughts, rapid speech, increased goal directed behavior (such as scrubbing floor in middle of night) and decreased need for sleep (though would sleep some each night). he noticed that this "manic" episode started about the same time as the potential seizure like activity on . patient is unable to give a accurate account of her meds, but she is the one who self administers them. she endorses that she often changes her meds on her own and endorses needing help with accurately taking her meds. psych ros: patient denies any current depressed mood or neurovegetative symptoms. denies any suicidality. denies any current or past psychotic symptoms. denies any dissociate episodes. denies any active sx of ptsd except an occasional trauma related nightmare. past medical history: psych hx: (per patient, verified with husband) dx: multiple personality disorder since teens diagnosed by counselor at , due to trauma history. reports this has not been active for many years. reports h/o depressive episodes that required hospitalization. history of ptsd, not currently active. denies bipolar disorder, however recent psych eval at reports diagnosis of bipolar disorder (hypomanic episodes) hosp: multiple (up to 10) at . 1st at age 15. most recent was . mostly for depressive episodes. med trials: unknown (reports seroquel once, but caused significanat inc appetite). sa/sib: twice: first age 15 (asa overdose 85 tablets). admitted to hospital. second (unknown age, but not recent) was by psych med ingestion. treaters: previously was seen at by dr. (psychopharm) and dr. (therapist) for many years until (at which time they suggested patient get treaters at southbay mhc, closer to her home, bc the patient had a bad mva due to her driving and didn't want to put the patient further at risk by making her drive to from ). currently, the patient is in the intake process at southbay, but does not have an actual therapist or psychiatrist. past med hx: ehlers danlos syndrome, htn, angina, sleep apnea (refuses cpap), ? h/p tias, cataracts, h/o seizure to intracrania hematoma, s/p l5-s1 fusion and laminectomy social history: substance abuse hx: etoh: h/o etoh abuse drinking 1 bottle wine daily up until 6 months ago, at which time she self tapered with help of her outpt psychiatrist. has not used since. no h/o blackouts or inpt detoxes. tob: smoked 2ppd for 40 yrs, quit in drug: none for >20 yrs. experimented with mj and "other" drugs when she was young. denies any h/o ivda. coffee: drinks four 32oz glasses of coffee daily. does not want to cut down. social hx: raised in and . sexually abused by father from age . went to court for which her father was sent to for substance abuse treatment. then lived with her mother, who she reports made her drop out of school in 9th grade to support the family. she worked in telescope factory. has 2 sisters and 1 brother, only stays in contact with one sister in ma. 1st marriage with 2 children (son and daughter) who now live in and hullbrook ma. divorced and remarried 38 yrs ago to current husband. children with current husband. now on ssdi for many years due to psych illness. husband works. legal issues in past. reports dv by husband in past, hit patient once in 's and pushed patient once. she does not feel unsafe. he currently calls her names at times, but she reports they are in couples counseling for this and working through their issues. reports she has one friend (with mild mental retardation) who she is close to and sees almost every day. family history: family psych hx: sister with ; son with depression and sa when he was 9 years old. denies any other known psychiatric family history. physical exam: physical exam: vs: bp: 180/66 hr: 56 temp: 98.6 resp: o2 sat: 98% height: 5'3" weight: 203.8 lbs gen: obese caucasian female, alert and interactive, looking stated age, dressed in hospital , grooming fair heent: normocephalic, oropharnyx clear. perrl, eomi. cv: rrr, no m/r/g pulm: ctab abd: +bs, ndnt, soft ext: mild 1+ pitting edema of right foot skin: extensive erythematous scarring of shins bilaterally "pt attributes to her ehlers-danlos syndrome) neurological: cn: ii: perrla iii, iv, vi: eom intact v: facial sensation intact bilat vii: facial mvts symmetric bilat viii: finger rub audible bilat ix, x: palate raise symmetric bilat : scm and trapezii bilat xii: tongue midline motor: normal bulk and tone, strength 4/5 in r leg (longstanding), in left leg and right arm; also appears full strength in left arm but cannot fully test due to pain in left shoulder sensory: grossly intact to light touch bilaterally reflexes: 1+ biceps, triceps, brachioradialis and patellar reflexes. hyporeflexic cerebellar: intact finger to nose. gait: intact abnormal movements: none noted. mental status: appearance: obese caucasian female, alert and interactive, looking stated age, dressed in hospital , grooming fair, good eye contact behavior: cooperative with interview, friendly, pleasant, frequently laughing and joking mood: "great" affect: hyperthymic, pleasant, energetic thought process: tangential, rambling, but logical and redirectable thought content: regarding her medical issues (shoulder, rash on buttocks); no delusions or bizarre content judgment: fair insight: fair si/hi: denies si/hi perception: no avh, delusions, or paranoia cognitive exam: attention: able to recite dowb orientation: oriented to person, place, and date memory: registration and recall fund of knowledge: knows president calculations: quarters in $2.25 = 9 abstraction: "don't throw stones if you live in a glass house" = 'how dare you shit on someone else when you're shitting on yourself' speech: pressured rate, high volume, normal prosody language: used appropriately pertinent results: lab data: from osh () dated : cbc wnl; bmp wnl except glu 112; lfts wnl; tsh/t4 wnl; b12 wnl serum tox negative vpa 22.0 u/a: tr bld utox: negative head ct: no intracranial abnl mri brain/neck & mra with gad on : small vessel disease and mld atrophy. ekg : sinus brady at 58, qt/qtc 464/456 lab data: from 08:10pm glucose-93 urea n-22* creat-0.9 sodium-140 potassium-3.9 chloride-101 total co2-28 anion gap-15 08:10pm alt(sgpt)-20 ast(sgot)-22 alk phos-99 tot bili-0.3 08:10pm calcium-9.3 phosphate-3.0 magnesium-2.2 08:10pm vit b12-928* 08:10pm tsh-0.86 08:10pm valproate-18* 08:10pm asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 08:10pm wbc-7.3 rbc-4.12* hgb-13.3 hct-38.3 mcv-93 mch-32.2* mchc-34.6 rdw-13.5 08:10pm neuts-59.2 lymphs-27.8 monos-7.9 eos-3.8 basos-1.3 08:10pm plt count-257 brief hospital course: admitted to 4 for further work-up and management of ?bipolar illness. on day 1 of hospitalization, pt was continued on her medication regimen as described in discharge records from hospital. she was interactive in the milieu and was able to participate in conversation with her treatment team. she was ambulatory, ate meals, showered, engaged in conversations, had a visit from her husband. she did endorse pain from a recent car accident and received prn doses of percocet q8h prn. her citalopram and bupropion were discontinued on day 1 of hospital stay due to concern for pt having bipolar illness and antidepressants worsening risk for mania. her gabapentin was decreased from 600mg to 300mg . during the night after, pt reported rolling out of bed and hitting her head. she was evaluated right away by the intern on-call (see her note in omr) and did not have any exam findings or mental status changes after this fall. then around 8am on day 2 of hospitalization she was found in bed to be hypersomnolent with slowed respirations (/min). her o2sats were stable around 95%. her hr was in the 40s, bp elevated at 190s/160s (some concern as to whether or not this was an accurate based on machine used and cuff size used). medicine was called urgently to see the patient and evaluate. she received iv access urgently. she then responded to a very brisk sternal rub and became more aroused. moved all 4 extremities spontaneously in thrashing/writing movements that were non-rhythmic, non-stereotyped movements. her level of arousal continued to improve such that after several minutes she could respond to orientation questions, knew she was at in , knew month/date/year. stat head ct ordered to to concern for intracranial event s/p fall with altered mental status. meds given for hypertension. over the course of the next half hour or so, pt remained agitated, thrashing all limbs, writhing in bed, intermittently more responsive to persons at bedside. she was unable to participate in a neuro exam due to not being cooperative. medicine consult resident was in to see pt and agreed with stat head ct and bp management. pt had head ct done and during that again became unarousable with slowed respirations. decision was made due to limited medical support on psych unit that pt would be transferred to medicine for ongoing care. through notes from hospital, she was admitted there prior to transfer to 4 with what sounds like nearly identical symptoms to what we're seeing here this morning (altered mental status, abnormal body movements). she is listed in their discharge diagnosis as having seizures as primary diagnosis. she received a work-up there including head ct, brain mri/mra and routine eeg which did not demonstrate acute intracranial abnormality nor active seizure activity on eeg. she was transferred to 4 for further psych management, and now seems to have recurrent symptoms similar to what she presented with there.] medications on admission: 1. wellbutrin sr 150mg daily ( from 150mg on ) 2. celexa 20mg daily ( from 30mg daily on ) 3. depakote 500mg (has not been taking accuratly, vpa 22.0 on ) 4. baclofen 20 tid 5. asa 81 daily 6. gabapentin 600 7. metoprolol tartrate 25mg qhs 8. singulair 10mg qhs 9. omeprazole 20mg qhs 10. oxybutynin 1mg daily 11. kcl 20mg 12. simvastatin 40mg daily 13. amlodipine 10mg daily 14. lisinopril 5mg daily discharge medications: 1. ondansetron 4 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po q8h (every 8 hours) as needed for nausea. 2. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for pain. 3. gabapentin 300 mg capsule sig: one (1) capsule po bid (2 times a day). 4. montelukast 10 mg tablet sig: one (1) tablet po hs (at bedtime). 5. miconazole nitrate 2 % powder sig: one (1) appl topical (2 times a day) as needed for candidal rash. 6. potassium chloride 10 meq tablet extended release sig: two (2) tablet extended release po bid (2 times a day). 7. divalproex 500 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po bid (2 times a day). 8. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 9. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 10. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 11. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 12. metoprolol tartrate 25 mg tablet sig: one (1) tablet po hs (at bedtime). 13. baclofen 10 mg tablet sig: two (2) tablet po tid (3 times a day). 14. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 15. alum-mag hydroxide-simeth 200-200-20 mg/5 ml suspension sig: thirty (30) ml po q4h (every 4 hours) as needed for stomach upset. 16. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q8h (every 8 hours) as needed for stomach upset, constipation. 17. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain,fever. discharge disposition: extended care discharge diagnosis: bipolar disorder type ii with current hypomanic episode; reported ptsd, not active; reported multiple personality disorder, not active. discharge condition: level of consciousness: lethargic and not arousable. mental status: confused - sometimes. activity status: ambulatory - independent. mse: general: somnolent, unarousable except to sternal rub; previously pleasant, talkative speech: none, snoring; previously rambling, easily redirectable mood/affect: unable to assess; previously hypomanic t. form: unable to assess. previously no loa/tt/tuberculosis. severe foi t. content: unable to assess; previously no hallucinations/delusions/paranoid ideation. no grandiosity cognition : somnolent, previously oriented j/i: fair discharge instructions: you were admitted because you were experiencing symptoms of hypomania, including decreased sleep, pressured speech, and expansive affect. there was also a concern for seizures and you had a workup at hospital that was negative. while on the inpatient psychiatric unit at , you had another episode of altered mental status, moving your limbs and were sleepy afterwards. due to concern for another seizure or other medical cause for this episode, you were transferred to medicine for a further workup. -please continue all medications as directed. -please avoid abusing alcohol and any drugs--whether prescription drugs or illegal drugs--as this can further worsen your medical and psychiatric illnesses. *it was a pleasure to have worked with you, and we wish you the best of health.* followup instructions: provider: , md phone: date/time: 10:30 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours spinal tap incision of lung other endoscopy of small intestine other endoscopy of small intestine insertion of endotracheal tube hemodialysis venous catheterization for renal dialysis endoscopic control of gastric or duodenal bleeding suture of duodenal ulcer site central venous catheter placement with guidance diagnoses: end stage renal disease obstructive sleep apnea (adult)(pediatric) acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified acute posthemorrhagic anemia iron deficiency anemia secondary to blood loss (chronic) hyposmolality and/or hyponatremia atrial fibrillation hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other and unspecified hyperlipidemia other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure acute respiratory failure bacteremia methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site intestinal infection due to clostridium difficile methicillin susceptible pneumonia due to staphylococcus aureus personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits methicillin resistant staphylococcus aureus in conditions classified elsewhere and of unspecified site chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction encephalopathy, unspecified other and unspecified infection due to central venous catheter bipolar disorder, unspecified precipitous drop in hematocrit vascular disorders of kidney hemoperitoneum (nontraumatic) other disorders of muscle, ligament, and fascia restless legs syndrome (rls) streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group b posttraumatic stress disorder abnormal involuntary movements eosinophilia dissociative identity disorder ehlers-danlos syndrome narcolepsy, without cataplexy 

Answer: The patient is high likely exposed to