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: history of present illness: baby boy #2 was born at 27 and 1/7 weeks gestation with a birth weight of 979 gm. this pregnancy was complicated by dichorionic-diamniotic spontaneous twin gestation. the mother was 27-year-old, g1 p0- 2 with the following prenatal labs. blood type ab+, antibody negative, rpr nonreactive, rubella-immune, hepatitis b surface antigen negative and gbs was unknown at the time of delivery. this pregnancy was complicated by premature preterm rupture of membranes on the day prior to delivery. mom did receive betamethasone x1 prior to delivery. mom had progressive labor and the infants were born by emergent c- section because of breech gestation during one of the twins. the apgar score of this twin, twin #2 or was 8 at one minute and 9 at five minutes of life. the patient's initial birth weight was 979 gm which was equal to the 25th- 50th percentile. the head circumference was equal to 26.5 cm which was equal to the 50th-75th percentile, and the birth length was 36 cm which equaled to the 50th percentile. this patient was intubated in the delivery room and was brought up to the nicu for further care. of note, this patient was discharged home at 41 and 4/7 weeks gestation. this was equal to day of life 99 on the day of discharge. physical exam at discharge: the weight at discharge was 3.75 kg which was equal to the 75th-90th percentile for post menstrual age. the discharge head circumference was 37 cm which was equal to greater than 90th percentile and the length was equal to 49.5 cm which was equal to the 50th-75th percentile for post menstrual age. generally: this patient is alert and well appearing during physical exam. the heent exam is significant for extraocular movements intact with a red reflex present bilaterally. the anterior fontanelle is open, soft and flat. the ears are normal set in rotation. the palate is intact and this patient has no significant dysmorphic features noted. neck was supple during the exam. the respiratory exam was consistent with clear breath sounds bilaterally with good aeration. the heart exam was normal s1, s2 with no murmur appreciated. the femoral pulses were equal bilaterally. the abdomen exam is consistent with a nondistended, nontender abdomen with no masses palpable. the patient does have a small, approximately 0.5 cm scar in the right upper quadrant of the abdomen which is the location of a chest tube placed for pneumothorax. this lesion is well healed. the gu exam is consistent with bilateral palpable testicles and bilateral hydroceles. this patient does have approximately 1.5 cm linear scars located at the proximal portion of the inguinal canals bilaterally. these scars are covered with steri-strips and appear pink and well perfused with no significant erythema or pus. the penis is circumcised. the hip exam reveals no clicks or clunks. the anus is patent. there is no sacral pits or tuft noted. the extremities are warm and well perfused and moving symmetrically. the neurologic exam demonstrates a normal tone and suck for post menstrual age and a normal morrow reflex. the infant does attempt to lift his head on ventral suspension. summary of hospital course by systems: respiratory: this patient was initially placed on high frequency ventilation until day of life 7. this patient did receive surfactant x2 for surfactant deficiency. this patient was transferred from high frequency to conventional ventilation on day of life 7 and remained on conventional ventilation until day of life 11. this patient was then weaned to cpap until day of life 54. this patient was then weaned to nasal cannula until day of life 69. the patient remained in room air from day of life 69 until day of life 99 at discharge. this patient also had a presumed pulmonary hemorrhage due to bloody secretions that were obtained from the endotracheal tube on day of life . the patient had no significant hemodynamic compromise from these secretions. this patient did have a right-sided pneumothorax that was noted in the 1st week of life and a chest tube was placed. this patient also had apnea of prematurity and was placed on caffeine. the patient's caffeine was discontinued on day of life 64 which was equal to 36 and 1/7 weeks post menstrual age. the patient had no significant apnea or bradycardia events for at least five days prior to discharge. cardiovascular: this patient did have a patent ductus arteriosus and was treated with indomethacin for 2 courses. echocardiograms were performed on and . the most recent echocardiogram on revealed no patent ductus arteriosus, a pfo and a left-sided peripheral pulmonic stenosis. the patient had normal structure and biventricular function at that time. fluids, electrolytes and nutrition: this patient was placed on total parenteral nutrition for the first 2 weeks of life. feedings were not started until day of life 13 because the patient was receiving indomethacin for the patent ductus arteriosus as previously mentioned. full feedings were achieved by day of life 19. the maximum kilocalories that this patient received was 30 calories per ounce with beneprotein. this patient will be discharged home on 20 calories per ounce enfamil ar or breast milk. gastroenterology: it was noted in the last month of this hospitalization that this patient had spitting and associated apneic events related to these spit-ups. due to these clinical findings a clinical diagnosis of reflux was made. the infant was clinically managed first with enfamil ar and the infant did show clinical improvement with the enfamil ar. two days prior to discharge this patient had blood-streaked spit-up x1. this event occurred after the patient breast fed. it is not clear if this patient had bloody spit-up related to problems with mom's breast milk or if the patient had true esophagitis. the nicu team started this patient on a 7-day course of ranitidine for possible esophagitis. the dosing of this is 10 mg b.i.d. for 7 days. it is recommended that this patient complete a 7-day course at this dose and then the pediatrician consider a maintenance dose of ranitidine for reflux. there have been no additional episodes of blood streaked emesis. this patient will be discharged home with enfamil ar with a few feedings with breast milk when available. we have noticed that breast milk helps regulate his stooling patterns which were infrequenct or hard in consistency when given an all formula diet. therefore, we recommend that the patient be discharged home with a combination of enfamil ar 20 k-calorie per ounce formula, as well as breast milk 2-3 bottles per day. gu: this patient did have bilateral hernias noted in the last 2-3 weeks prior to discharge. this patient had a bilateral hernia repair performed by dr. of on . this patient did have some apnea events after the anesthesia, but remained stable for approximately a week prior to discharge. the incision sites looked goog prior to discharge. of note, this patient does have bilateral hydroceles in addition to the bilateral hernias. a circumcision was performed after the surgery. infectious disease: this patient was initially treated with ampicillin and gentamicin for 14 days at birth. ampicillin and gentamicin were started due to concerns for sepsis related to mom's premature rupture of membranes and delivery. a lumbar puncture revealed increased white blood cell count and left shift and for a 14-day course. on day of life 48 which was equal to the patient had a cluster of apnea and bradycardia events. a blood culture was performed and group b streptococcus was obtained. the patient was initially started on vancomycin and gentamicin and when sensitivities returned the patient was transitioned to penicillin to treat the group b strep bacteremia. the patient completed a 14-day course of antibiotics for the group b strep bacteremia. a followup blood culture on , as well as lumbar puncture revealed no group b strep. breast milk was cultured as a possibility for the etiology of the group b strep and revealed mixed flora, but no significant group b strep. it was thought that this patient's group b strep bacteremia was due to a late onset sepsis. hematology: this patient did receive blood transfusions x2 in the first 2 weeks of life. one of the blood transfusions was received after the blood-tinged secretions from the endotracheal tube were found as previously mentioned. this patient received no ffp for coagulopathy. this patient had anemia of prematurity and was treated during the hospitalization with iron and vitamin e. the most recent hematocrit performed prior to discharge on was 30.4 with a reticulocyte count of 2.2%. this patient will be discharged home with supplemental iron sulfate of 2 mg of elemental sulfate per kg per day. endocrine: this patient had 2 abnormal newborn screens with low t4 levels. on tfts were checked and the patient had normal levels. of note, followup newborn screens were also normal. this likely represented transient hypothyroxinemia of prematurity. neurology: this patient had several head ultrasounds to screen bleeding related to prematurity. this patient had a normal head ultrasound performed on which was equal to day of life 1. a head ultrasound on revealed a right germinal matrix hemorrhage. a head ultrasound on revealed a right germinal matrix hemorrhage and slightly increased ventricular sizes. followup on revealed normal ventricular sizes and resolving right germinal matrix hemorrhage. the most recent head ultrasound was performed on and was normal with no evidence of periventricular leukomalacia or germinal matrix hemorrhages. this patient had a hearing screen that was performed prior to discharge and the patient passed. the patient also had ophthalmology screening for retinopathy of prematurity. this patient was followed several times during the hospitalization and the most recent exam was performed on . at this time the patient had a rop exam consistent with immature retina in zone 3 in the right eye and stage 1 zone 3 rop in th e left eye. it is recommended that this patient followup in 2 weeks with the ophthalmologist as an outpatient. psychosocial: the social worker was involved with this family. the social worker identified no significant psychosocial problems with this family. condition on discharge: stable. discharge disposition: home. name of primary care pediatrician: , md. the address is , , , . care/recommendations: feedings: enfamil ar 20 k-calories per ounce and breast milk 20 k- calories per ounce. it is recommended that this patient take at least 2-3 bottles a day of breast milk to prevent constipation that may be caused by enfamil ar. medications at discharge: 1. ferrous sulfate (concentration 25 mg/ml) 0.4 ml po daily (=2 mg of elemental iron/kg/day) 2. ranitidine 10 mg p.o. b.i.d. x5 days to complete a 7-day course at this dose. ranitidine: we recommended this patient complete a 7-day course of ranitidine at a dose of 10 mg p.o. b.i.d. which is equivalent to approximately 5 mg/kg/day to treat possible esophagitis. after this is completed, we recommend starting ranitidine at a dose for treatment of gastroesophageal reflux (recommended 2 mg/k/dose po q8 hours). car seat positioning screening was performed prior to discharge and this patient has passed. state newborn screening was performed during this hospitalization. this patient had initial abnormal newborn screens with low t4 levels on and . followup newborn screens performed on and were both normal. immunizations received during this hospitalization include hepatitis b vaccine on and pediarix, hib, pneumococcal 7-valent conjugate vaccine on . this patient also had synagis vaccine performed on . immunizations recommended: synagis rsv prophylaxis should be considered from - for infants who meet any of the following 4 criteria: 1. born less than or equal to 32 weeks. 2. born between 32-35 and 0/7 weeks with 2 of the following: daycare during rsv season, a smoker in the household, neuromuscular disease, airway abnormalities, or school age siblings. 3. chronic lung disease. 4. hemodynamically significant congenital heart disease. influenza immunization is recommended annually in the fall for all infants once they reach 6 months of age. before this age, and for the first 24 months of a child's life immunization against influenza is recommended for household contacts and out of home caregivers. this infant has not received the rotavirus vaccine. the american academy of pediatrics recommends initial vaccination of preterm infants at or following discharge from the hospital if they are clinically stable and at least 6 weeks, but fewer than 12 weeks of age. followup appointments scheduled/recommended: 1. followup appointment with primary care pediatrician on monday with dr. . 2. ophthalmology is recommended at 2 weeks after discharge to screen for retinopathy of prematurity. 3. one-month followup with dr. for postoperative evaluation of bilateral hernia repair. discharge diagnoses: 1. premature birth at 27 and 1/7 weeks gestation 2. dichorionic-diamniotic twin gestation 3. respiratory distress syndrome, resolved 4. pulmonary hemorrhage, resolved 5. right pneumothorax, resolved 6. chronic lung disease 7. apnea of prematurity, resolved 8. presumed sepsis, resolved 9. group b strep bacteremia, resolved 10. patent ductus arteriosus, status post indomethacin treatment, resolved 11. bilateral inguinal hernias status post repair 12. anemia of prematurity 13. retinopathy of prematurity 14. right germinal matrix hemorrhage, resolved 15. gastroesophageal reflux , procedure: insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more spinal tap incision of lung insertion of endotracheal tube enteral infusion of concentrated nutritional substances thoracentesis non-invasive mechanical ventilation injection or infusion of other therapeutic or prophylactic substance arterial catheterization other phototherapy prophylactic administration of vaccine against other diseases umbilical vein catheterization diagnoses: acidosis esophageal reflux need for prophylactic vaccination and inoculation against viral hepatitis twin birth, mate liveborn, born in hospital, delivered by cesarean section respiratory distress syndrome in newborn neonatal jaundice associated with preterm delivery 27-28 completed weeks of gestation primary apnea of newborn patent ductus arteriosus anemia of prematurity retrolental fibroplasia intraventricular hemorrhage, grade i septicemia [sepsis] of newborn ostium secundum type atrial septal defect other postprocedural status undescended testis malpresentation before labor affecting fetus or newborn interstitial emphysema and related conditions inguinal hernia, without mention of obstruction or gangrene, bilateral (not specified as recurrent) other preterm infants, 750-999 grams streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group b congenital hydrocele edema pulmonary hemorrhage congenital hypothyroidism 

Answer: The patient is high likely exposed to