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: seizures major surgical or invasive procedure: none history of present illness: mr. is a 39-year-old right-handed man with a history of epilepsy which began at the age of /2. he has been followed by dr. from hospital since . he recently moved back to for family reasons and was sent here by dr. . he had a generalized convulsion at the time, without any associated fever or illness. the eeg then apparently showed an abnormality in the left temporal region. he was treated briefly with phenobarbital. he remained seizure-free until he was 23 years old, when he had his second generalized seizure while he was driving on i-95. this was in . he recalls that he suddenly felt like he could control or focus his eyes, and the eyes were rolling back uncontrollably, with the arms becoming rigid within a second. he then lost consciousness. his father was in the car at the time and noted that he had a 15-minute episode of generalized limb shaking. luckily, this did not result in a car accident and the car eventually coasted to a stop. he was taken to a local hospital and dilantin 300 mg a day was started. about 3 years later in , he had another generalized seizure, again while he was driving. he was taking dilantin at the time. he woke up in the car confused, and the police told him that he had witnessed seizure activity. his dilantin was increased to 400 mg at that time. he was well until when he had an episode of status epilepticus, in the setting of stress and sleep deprivation. within 1 hour, he had 2 episodes of 20-minute generalized seizure and another 10-minute episode. he was taken to . after that, he noted significant cognitive problems with very poor memory and visuospatial skills. after this episode, he was tried on valproate, which did not work. lamictal was then added to the regimen, and ativan was also given for about 6 months. during this time, he continued to have occasional seizures, during which he would spontaneously lose his train of thought very briefly for a few seconds. he may also lose track of time for up to 5-10 minutes at a time. if he forgot to take his medications, he noted an intense nervous or flighty sensation, which would build for several hours. he denies any olfactory, gustatory, or auditory hallucinations. he denies any epigastric sensations or out of body experiences. in , he moved to for his phd. he was under the care of at hospital. he was admitted to the inpatient epilepsy monitoring unit for about a week. the eeg showed left-sided slowing with epileptiform discharges. he eventually was weaned off the dilantin as he had been on it for quite a long time, and it was not quite effective for him. keppra was added in . he states that his last seizure was about 3 years ago, both in terms of the generalized seizures, as well as the occasional interruptions in his train of thought. he is currently doing well without any clear side effects. he continues to have memory difficulties, which he believes is a residual of the episode of status epilepticus in . he also has some difficulty with visual spatial abilities, and he may forget how to get into or out of a building. he states that he had formal cognitive testing with a neuropsychologist at hospital. he takes his medications three times daily and prefers tid to dosing. this way, if he misses a dose, it is not a large amount. he is typically delayed with his medications and misses a dose once a week at most. aside from the medications above, he has not tried any other anticonvulsant. typical triggers for his seizures include stress and medication non-compliance. in terms of his epilepsy risk factors, his paternal aunt has generalized seizures, but he does not know the details. his had a non-febrile seizure at age 4 years old. he denies any history of cns infections, febrile seizures, or significant head injuries. developmental and birth history: as far as he knows, he was born full term via vaginal delivery, without complications. he met all of his developmental milestones and did well in school. past medical history: 1. hypercholesterolemia. 2. myopia. 3. malaria in when he was travelling to . 4. kidney infection in . social history: he currently lives with his sister. is single and has no children. he just completed his phd in anthropology at . he is unemployed and in the process of looking for a job. he does not smoke, drink alcohol, or use drugs. family history: his mother has multiple sclerosis and mitral valve prolapse. his father has rapid heartbeat and stroke. his sister has no neurological problems. his had a non-febrile seizure at age 4 years old. his paternal aunt has epilepsy as described above. alzheimer disease also seems to run in multiple paternal relatives. physical exam: on examination, his blood pressure is 138/90, heart rate 88 and regular, and his respirations are 12. general exam: he appears well, in no apparent distress. eyes: disc margins sharp bilaterally, no scleral icterus. respiratory: clear to auscultation bilaterally. cvs: normal s1, s2. no murmurs. abdomen: no positive bowel sounds. no tenderness. extremities: no peripheral edema. skin: no obvious hyper or hypopigmented lesions. neurologic exam: mental status: the patient is fully awake, alert, and oriented. he gives a full history without difficulty. his language is intact. his calculation and attention are also intact. he is able to register and recalls after 5 minutes and with hints. cranial nerves: perrla, extraocular movements full without nystagmus, visual fields full, face and sensation intact, face symmetric, tongue midline, and no dysarthria. motor exam: normal bulk and tone throughout. there is a mild postural tremor in both hands, no asterixis. slightly decreased finger taps in the left hand. otherwise, full strength throughout. sensory: intact to all modalities throughout. coordination: finger- nose-finger and rapid alternating movements intact. reflexes: 2+ throughout and downgoing toes. gait: narrow-based gait, able to tandem, toe and heel walk without difficulty. no romberg sign. pertinent results: 11:44pm type-art peep-5 po2-211* pco2-39 ph-7.45 total co2-28 base xs-3 intubated-intubated 11:44pm lactate-1.6 11:44pm freeca-1.07* 06:51pm glucose-104* urea n-9 creat-1.0 sodium-141 potassium-3.8 chloride-105 total co2-25 anion gap-15 06:51pm calcium-8.2* phosphate-2.4* magnesium-2.1 06:51pm phenytoin-14.5 valproate-<3 06:51pm hct-41.3 03:47pm type-art peep-5 o2-50 po2-83* pco2-38 ph-7.27* total co2-18* base xs--8 intubated-intubated 02:55pm cerebrospinal fluid (csf) protein-27 glucose-94 02:55pm cerebrospinal fluid (csf) wbc-1 rbc-1* polys-0 lymphs-84 monos-16 01:30pm urea n-13 creat-1.2 01:30pm estgfr-using this 01:30pm lipase-30 01:30pm calcium-8.5 phosphate-2.6* magnesium-2.5 01:30pm phenytoin-17.1 01:30pm asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 01:30pm urine hours-random 01:30pm urine hours-random 01:30pm urine gr hold-hold 01:30pm urine bnzodzpn-neg barbitrt-neg opiates-neg cocaine-neg amphetmn-neg mthdone-neg 01:30pm wbc-12.1* rbc-5.64 hgb-16.2 hct-47.1 mcv-84 mch-28.6 mchc-34.3 rdw-13.4 01:30pm pt-12.9 ptt-20.9* inr(pt)-1.1 01:30pm plt count-153 01:30pm fibrinoge-295 01:30pm urine color-straw appear-clear sp -1.014 01:30pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-tr bilirubin-neg urobilngn-neg ph-5.0 leuk-neg mri impression: 1. two small areas of acute infarct right cerebellum. 2. findings indicative of left mesial temporal sclerosis. 3. no enhancing brain lesions. brief hospital course: seizures: patient was transferred from after a status epilepticus. at that time he were intubated for airway protection and admitted into our neurology icu. patient's episode of convulsive status epilepticus at least for 45 minutes by report. there was no clear trigger to this in that he was compliant with his medications and he was not ill at that time. a spinal tap was unremarkable and did not show any evidence of cns infection. there was no systemic infection as well after a thorough workup. his eeg telemetry showed left greater than right temporal lobe discharges interictally but no electrographic seizures. as patient was also having mood disturbance and that keppra can sometimes cause mood lability and psychiatric side effects, this was weaned off and replaced with trileptal. he did do well with the trileptal transition. for the episodes noted of status, he was loaded with dilantin and maintained on stable maintenance dose of 100 mg t.i.d. the lamictal remained the same. he remained stable for discharge on trileptal 600 mg t.i.d., lamictal 150 mg t.i.d., dilantin 100 mg. the dilantin can be tapered off per dr. as an outpatient, and you should follow up with her. patient was also given the instructions that he cannot drive by state law. psych: he was subsequently noted to have significant mood swings, suicidal and homicidal deation. he was extremely angry with his previous ph.d. professor who he believes has been dishonest and who has hindered his academic advancement. we had psychiatry evaluate him during the hospital stay. at that time, he was no longer suicidal. he was instructed to follow up with his primary care doctor about to an outpatient psychiatrist. stroke: for further investigation, a brain mri was done with and without contrast to evaluate for any new lesions or structural changes that may have precipitated this episode of status. it is quite unusual given that he had been seizure-free for almost six years prior to this. the brain mri showed changes in the temporal region consistent with left mesial temporal sclerosis. in addition, there were two small areas of acute stroke found in the cerebellum that was incidental. he was not symptomatic at that time. given the embolic appearance, he had a stroke workup including telemetry, cardiac echo, which demonstrated a pfo. his lipid profile indicated a slightly elevated cholesterol and ldl levels. he was started on aspirin for stroke prophylaxis and zetia for cholesterol control. he was subsequently discharged on . patient's (ldl) was found to be elevated, and since he had an adverse reaction to statins in the past, he was started on zetia. has been scheduled follow up with dr. a stroke neurologist for further work up and management. medications on admission: 1. keppra 500 mg 3 times daily (since ). 2. lamictal 150 mg 3 times daily. 3. ativan 0.5 mg p.r.n. 4. multivitamins. 5. calcium. 6. aspirin 81 mg daily. 7. omega-3, 3000 mg a day. 8. coenzyme q10, 15 mg 3 times a week. 9. inderal 40 mg p.r.n. for tremors. discharge medications: 1. lamotrigine 150 mg tablet sig: one (1) tablet po tid (3 times a day). 2. phenytoin sodium extended 100 mg capsule sig: one (1) capsule po three times a day. disp:*90 capsule(s)* refills:*2* 3. oxcarbazepine 600 mg tablet sig: one (1) tablet po tid (3 times a day): brand name only. disp:*90 tablet(s)* refills:*2* 4. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. lorazepam 0.5 mg tablet sig: one (1) tablet po tid prn as needed for for seizure clustering. 6. aspirin, buffered 325 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 7. propranolol 60 mg tablet sig: one (1) tablet po twice a day as needed for tremors. 8. outpatient lab work in 2 weeks, have lab work drawn for na (sodium), trileptal level, lamictal , and dilantin level. please fax these results to dr. office. discharge disposition: home discharge diagnosis: status epilepticus right cerebellar stroke patent foramen ovale hyperlipidemia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were transferred from after a status epilepticus (continuous seizure). at that time you were intubated for airway protection and admitted into our neurology icu. you were monitored on eeg, which showed left more than right temporal slowing and occasional left temporal discharges. your lamictal level was slightly low, and you had taken an antibiotic a few weeks prior to admission which may have lowered your seizure threshold. mri head showed left mesial temporal sclerosis. you were tapered off keppra, and started on dilantin and trileptal. the dilantin can be tapered off per dr. as an outpatient, and you should follow up with her. mri head showed two small areas of infarct in your right cerebellum. an echocardiogram of your heart was done, which showed a patent foramen ovale, which means that there is a small hole between the two of your heart, which may have allowed a small clot to pass up into your brain. an ultrasound was done of your legs, which showed no signs of clots there. since there were no clots found on ultrasound you were started on a full dose aspirin 325 mg daily. your cholesterol (ldl) was found to be elevated, and since you have had an adverse reaction to statins in the past, you were started on zetia. you have been scheduled to follow up with dr. a stroke neurologist for further work up and management. you will need to have an insurance and call the number below to register. you had some suicidal ideation after your seizure, and should follow up with your primary care doctor to an outpatient psychiatrist. ***by massachusett's law you are unable to drive within 6 months of having a seizure. you should also avoid activities where having a seizure would place you at significant risk such as bathing or swimming alone.*** followup instructions: for your seizures: , d. office phone: ( thursday, at 10am post hospitalization follow up and cholesterol: primary care physician at 2:30 pm name: ,surendra address: , , phone: fax: for your stroke: dr. 2:30pm please a)get an insurance from your pcp b)call to register provider: , md phone: date/time: 2:30 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours spinal tap incision of lung diagnoses: depressive disorder, not elsewhere classified other and unspecified hyperlipidemia ostium secundum type atrial septal defect grand mal status cerebral artery occlusion, unspecified with cerebral infarction personal history of malaria suicidal ideation 

Answer: The patient is high likely exposed to