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: doxycycline / ibuprofen attending: chief complaint: rash major surgical or invasive procedure: desensitization to penicillin () picc line placement/removal history of present illness: this is a 34 year old woman with recent diagnosis of syphilis who presents to the ed with a 1 day history of rash. she was diagnosed with syphilis on on routine blood work at /gyn dept by dr. : she had a positive rpr of 1:256 as well as negative hepb sag and ab, neg hiv, and neg hcv. she was put on doxycycline due to penicillin allergy of unclear etiology. she had taken almost 2 weeks of treatment, but developed a rash last night on her arms and torso (not palms/soles) which became worse and pruritic today after a walk outside. she came to the ed. . in the ed, she was noted to have a petechial rash believed to be secondary to drugs. she was given 50 mg benadryl. however, given her recent diagnosis of syphilis, id was consulted who recommended changing from doxycycline to penicillin. given her history of rash, she was admitted to the micu for penicillin desensitization. en route to the ed, she was noted to have systolic blood pressures in the 80's which resolved with administration of fluids, and she was given empiric levofloxacin after blood cultures were obtained. . ros: she reports a rash as per hpi which is pruritic. she has had a headache since 2 weeks ago, slightly before taking the doxycycline. it is bilateral, like a band around the head, , not associated with photophobia, neck stiffness, or vision changes. tylenol makes it better. she also complains of some "rib pain" in her abdomen from about the same time, which is but only lasts minutes. her doctors it to gastritis. all other ros negative. past medical history: childhood asthma social history: denies alcohol use, single with two children ages 14 and 18. used crack up until 4 months ago but denies since then and now lives at , a drug rehab center. last sexual activity 18 months ago. believes she contracted syphilis from a rape 10 years ago. family history: noncontributory physical exam: v: t97 p69 bp 99/62 r10 gen: no apparent distress heent: perrla, eomi, op clear neck: no lad resp: cta bilaterally no wheeze cv: rrr nl s1s2 no mgr abd: soft ntnd +bs no organomegaly ext: no edema skin: petechial light red nonblanching rash, not raised, over inner aspects of arms and both legs. scattered rash over stomach but not back. petechia separated by few centimeters each. pertinent results: 12:24pm blood wbc-5.9 rbc-4.09* hgb-12.7 hct-36.7 mcv-90 mch-31.0 mchc-34.5 rdw-13.5 plt ct-386 12:24pm blood glucose-91 urean-19 creat-0.8 na-140 k-4.2 cl-105 hco3-23 angap-16 05:40am blood calcium-9.2 phos-4.4 mg-2.1 brief hospital course: ms. new rash was deemed to be a drug rash secondary to her doxycycline use, so this was discontinued. since she failed , infectious disease consultation recommended that she be desensitized to penicillin for treatment of her late latent syphilis. she was admitted to the micu overnight for monitoring and tolerated the desensitization process uneventfully. she was then called out to the floor and continued on iv penicillin q4h to avoid re-sensitization. the plan was for her to complete a 14-day course of iv penicillin so that her total course of treatment would be 4 weeks (which would empirically treat for neurosyphilis). . for discharge, since she had no insurance, her only option for continuing outpatient iv antibiotics was to go to the hospital. she was adamant that she would not go there and was unwilling to even consider staying in-house for the duration of therapy. the drug rehab shelter where she had been staying, women's hope, is unable to take people with iv catheters and also does not have the capacity to administer medications. due to the patient's refusal of her only options for receiving iv penicillin, the infectious disease team recommended that she take a 3-week course of azithromycin. the id team and primary team both stressed to the patient that this is an *unproven* and very likely *inferior* treatment for her syphilis. furthermore, the risks of developing the neurologic, cardiac, and other severe manifestations of late syphilis were explained to the patent, and she demonstrated understanding of these risks. she will follow up with her pcp, . , who is aware of the above plan. she should have repeat rpr titers checked to evaluate efficacy of therapy. . if she were to need penicillin products again in the future, she would need to repeat the desensitization process. medications on admission: doxycycline tylenol prn headache discharge medications: 1. azithromycin 500 mg tablet sig: four (4) tablet po once a week for 2 doses: take first dose (4 tablets) on . take second dose (4 tablets) on . disp:*8 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary diagnosis: late latent syphilis, penicillin allergy (status-post desensitization) discharge condition: stable discharge instructions: you were admitted to the hospital for desensitization to penicillin, but you were not willing to go to the to complete your course of iv penicillin. we are sending you home with 2 doses of azithromycin with the understanding that this is *not* proven therapy. it is extremely important that you follow up with dr. and have your titers re-drawn. . please take all medications as prescribed. please attend all follow up appointments. . if you experience high fevers, shortness of breath, loss of consciousness, chest pain, or other concerning symptoms, then you need to seek medical attention. followup instructions: please see dr. at on thursday for followup. her office's phone number is . procedure: venous catheterization, not elsewhere classified immunization for allergy diagnoses: dermatitis due to drugs and medicines taken internally hypovolemia tetracycline group causing adverse effects in therapeutic use late syphilis, latent 

Answer: The patient is high likely exposed to