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: bactrim / sulfa (sulfonamide antibiotics) / clindamycin / prochlorperazine / penicillins / quinolones attending: chief complaint: wrist and ankle pain major surgical or invasive procedure: i&d of left wrist abscess on in the operating room history of present illness: mr. is a 45 y/o m with hiv, hcv and prior cellulitis episodes presents with 4 days of fevers, night sweats shaking chills and left wrist and ankle pain. he reportedly gives himself im injetions of norflex in his thighs daily and has had thigh cellulitis in the past requiring drainage in the or in the past and a left thigh cellulitis in for which he was sent home with a picc line for iv vancomycin. he denies iv drug use recently (last in ) and his picc line was pulled in 8/. he has had some recent nasal congestion and has been on azithromycin but denies sore throat, cough, sob, dysuria, frequency, cp, palpitations. given his joint pain and fevers he presented to his pcp who sent him to the ed. vs on arrival to ed: t 100 hr 108 bp 124/74 r 18 o2 sats 99% on ra. pt was given vanc 1gram iv x 1 and oxycodone. cxr, wrist and ankle films were unremarkable. on arrival to the floor patient reports improvement in the pain in his ankle but worsening redness, warmth, swelling and pain in his wrist over the course of the day. he was taking extra oxycodone and oxycontin over the past 4 days for the pain with little relief. he has been taking all of his medications. he denies sick contacts. to 2 weeks ago, but denies any other travel. he denies trauma to the joints, iv drug use. past medical history: hcv-plans to start theapry in near future per patient dm -on lantus and aspart sliding scale hiv per pt last cd4 in 500s (per patient), vl undectable chronic sinusitis s/p surgery migraines thigh cellulitis social history: smokes 1 ppd, no etoh, remote history of iv drug use (had a 2 day relapse in ), but denies any drugs currently, unemployed, used to work in catering management. lives with roommates. family history: any medical problems in his family. physical exam: ros: denies weight loss, fatigue, visual changes, lightheadedness, worsening of his ha, diarrhea, constipations, bledding, bruising, hematuria, orthopnea, pnd, le edema, skin rash vitals:t 101.3 bp 158/86 hr 105 r 20 o2 sata 93 % on ra general: flushed but otherwise comfortable appearing middle aged male heent:op clear, mmm, sclera anicteric, scattered excoriations on face ln: no cervical or axillary lad cv: tachycardic, rr, nl s1s2, i could not appreciate m/g/r pulm: lung cta b/l back: no spinal, paraspinal or cva tenderness abd: obese, soft, nt/nd, i could not appreciate hepatospelnomegaly ext: left hand and wrist are edematous and erythamtous and warm, erythema extend halfway up forearm and the dorsum of the hand. most of the erythema is located over the left wrist. the area was outlined patient has severe pain in wrist on active and passive motion. right wrist is unremarkable. left foot is erythematous. he has full rom of the ankle and is able to bear weight. the erythmatous area was outlined. no le edema. skin: no petechiae, splinter hemmhorhages, osler nodes or lesions neuro: aaox3 pertinent results: cxr: the lungs are clear without consolidation or edema. the mediastinum is unremarkable. the previously noted right upper extremity picc line has been removed in the interval. the cardiac silhouette is within normal limits for size. no effusion or pneumothorax is noted. the osseous structures are unremarkable. impression: no acute pulmonary process. left wrist x-ray: 1. no visible acute fracture. 2. some displacement of the pronator quadratus fat pad volar to the radius is seen. if there is high degree of clinical suspicion for fracture, further assessment with mri is suggested. left ankle x-ray: impression: no evidence of traumatic injury or significant underlying degenerative joint disease. essentially normal exam. please note this is the third in a series of normal ankle x-rays dating back to . ecg: sinus rhythm, rate 97, normal pr, no st-t wave changes. 04:34am blood wbc-6.3 rbc-4.53* hgb-12.7* hct-37.9* mcv-84 mch-28.1 mchc-33.5 rdw-14.3 plt ct-321 01:00pm blood wbc-6.3 rbc-3.97* hgb-11.3* hct-33.7* mcv-85 mch-28.6 mchc-33.7 rdw-15.2 plt ct-233 06:25am blood neuts-60.7 lymphs-26.2 monos-7.0 eos-5.1* baso-0.9 06:25am blood pt-13.4 ptt-30.9 inr(pt)-1.1 06:00pm blood esr-31* 04:34am blood glucose-86 urean-17 creat-0.9 na-138 k-4.4 cl-102 hco3-25 angap-15 01:00pm blood glucose-148* urean-9 creat-0.8 na-135 k-4.0 cl-100 hco3-26 angap-13 04:34am blood alt-49* ast-27 ld(ldh)-179 alkphos-106 totbili-0.2 06:25am blood alt-237* ast-211* alkphos-122 totbili-0.4 04:34am blood calcium-8.9 phos-4.6* mg-2.3 06:35am blood vanco-16.3 blood cultures x 2 on and no growth. final. 1:28 pm swab left wrist. gram stain (final ): no polymorphonuclear leukocytes seen. no microorganisms seen. wound culture (final ): no growth. anaerobic culture (final ): no growth. acid fast smear (final ): no acid fast bacilli seen on direct smear. acid fast culture (preliminary): a swab is not the optimal specimen for recovery of mycobacteria or filamentous fungi. a negative result should be interpreted with caution. whenever possible tissue biopsy or aspirated fluid should be submitted. no mycobacteria isolated. fungal culture (preliminary): no fungus isolated. a swab is not the optimal specimen for recovery of mycobacteria or filamentous fungi. a negative result should be interpreted with caution. whenever possible tissue biopsy or aspirated fluid should be submitted. potassium hydroxide preparation (final ): test cancelled by laboratory. patient credited. inappropriate specimen collection (swab) for fungal smear (koh). 11:40 am swab left wrist dorsal tissue. gram stain (final ): no polymorphonuclear leukocytes seen. no microorganisms seen. wound culture (final ): no growth. anaerobic culture (final ): no growth. potassium hydroxide preparation (final ): test cancelled by laboratory. patient credited. inappropriate specimen collection (swab) for fungal smear (koh). fungal culture (preliminary): no fungus isolated. acid fast culture (preliminary): a swab is not the optimal specimen for recovery of mycobacteria or filamentous fungi. a negative result should be interpreted with caution. whenever possible tissue biopsy or aspirated fluid should be submitted. no mycobacteria isolated. acid fast smear (final ): no acid fast bacilli seen on direct smear. 6:00 pm immunology **final report ** hiv-1 viral load/ultrasensitive (final ): hiv-1 rna is not detected. performed using the cobas ampliprep / cobas taqman hiv-1 test. detection range: 48 - 10,000,000 copies/ml. this test is approved for monitoring hiv-1 viral load in known hiv-positive patients. it is not approved for diagnosis of acute hiv infection. in symptomatic acute hiv infection (acute retroviral syndrome), the viral load is usually very high (>>1000 copies/ml). if acute hiv infection is clinically suspected and there is a detectable but low viral load, please contact the laboratory for interpretation. it is recommended that any new positive hiv-1 viral load result, in the absence of positive serology, be confirmed by submitting a new sample for hiv-1 pcr, in addition to serological testing. 9:46 am urine site: clean catch source: cvs. **final report ** chlamydia trachomatis, nucleic acid probe, with amplification (final ): negative for chlamydia trachomatis by pcr. neisseria gonorrhoeae (gc), nucleic acid probe, with amplification (final ): negative for neisseria gonorrhoeae by pcr. 6:00 pm immunology **final report ** hcv viral load (final ): 56,800 iu/ml. performed using the cobas ampliprep / cobas taqman hcv test. linear range of quantification: 43 iu/ml - 69 million iu/ml. limit of detection: 18 iu/ml. left wrist pathology 1. soft tissue, left wrist volar ulna, biopsy (a): a soft tissue, most likely synovium, with acute and chronic inflammation, reactive change and focal necrosis. see note. b. fibrinopurulent exudate. 2. soft tissue, left wrist dorsal, biopsy (b): synovium with focal fibrosis, otherwise unremarkable. note: gms, gram and stains performed on block a are negative for fungal and bacterial organisms. h&e slides reviewed with dr. . . brief hospital course: wrist and dorsal foot tenosynovitis: culture negative, biopsy of l hand synovium was largely unrevealing. the patient's urine gc was negative. he was treated empirically with vancomycin initially and symptoms did not completely improve, given gc was still a possibility he was sent to the icu for ceftriaxone desensitization and treated with an empiric 2 week course of vanc/ceftriaxone. discharged on with 8 remaining days. afebrile for > 2 days prior to discharge. he was set up with pcp/id follow up and will follow up with rheumatology in case his symptoms do not improve. diabetes: home medications continued anxiety: continued effexor and clonazepam htn, benign: continued verapamil medications on admission: venlafaxine xr 150 mg po daily oxycodone sr (oxycontin) 40 mg po q12h oxycodone (immediate release) 5 mg po/ng q4h:prn pain pseudoephedrine 30 mg po q6h:prn sinus congestion omeprazole 40 mg po daily lantus 30 units qhs and novolog ss albuterol inhaler 2 puff ih q4h:prn sob cyclobenzaprine 10 mg po/ng hs gabapentin 600 mg po/ng q8h norflex *nf* (orphenadrine citrate) 30 mg/ml injection q6h migraine zolpidem tartrate 10 mg po hs:prn insomnia atorvastatin 40 mg po/ng daily verapamil sr 240 mg po q24h clonazepam 2 mg po/ng valacyclovir 1 gram po qdaily darunavir 800 mg po daily ritonavir 100 mg po daily emtricitabine-tenofovir (truvada) 1 tab po daily benadryl 25-50 mg prn sleep asa 81 mg po daily trazadone 100mg po hs prn sleep allergies: bactrim/sulfa-rash, pcn-rash, clindmycin -anaphylaxis, compazine-seizure, quinolones-rash discharge medications: 1. outpatient lab work cbc with differential, chem 7 (na, k, cl, hco3, bun, cr, glucose), lfts (ast, alt, alk phos, total bilirubin). to be drawn . results to be faxed to dr. (fax# ) (phone# ) 2. vancomycin 500 mg recon soln sig: 1250 (1250) mg intravenous q 8h (every 8 hours) for 12 days. disp:*36 doses* refills:*0* 3. ceftriaxone in dextrose,iso-os 2 gram/50 ml piggyback sig: two (2) grams intravenous q24h (every 24 hours) for 12 days. disp:*12 doses* refills:*0* 4. venlafaxine 75 mg capsule, sust. release 24 hr sig: two (2) capsule, sust. release 24 hr po daily (daily). 5. oxycodone 40 mg tablet sustained release 12 hr sig: one (1) tablet sustained release 12 hr po q12h (every 12 hours). 6. oxycodone 10 mg tablet sig: one (1) tablet po every 4-6 hours as needed for pain. disp:*40 tablet(s)* refills:*0* 7. pseudoephedrine hcl 30 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for sinus congestion. 8. omeprazole 20 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po daily (daily). 9. insulin glargine 100 unit/ml solution sig: thirty (30) units subcutaneous at bedtime. 10. novolog 100 unit/ml solution sig: as directed units subcutaneous qac and qhs: per sliding scale. 11. cyclobenzaprine 10 mg tablet sig: one (1) tablet po hs (at bedtime). 12. gabapentin 300 mg capsule sig: two (2) capsule po q8h (every 8 hours). 13. norflex 30 mg/ml solution sig: one (1) injection injection four times a day as needed for migraine. 14. zolpidem 5 mg tablet sig: two (2) tablet po hs (at bedtime) as needed for insomnia. 15. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 16. verapamil 120 mg tablet sustained release sig: two (2) tablet sustained release po q24h (every 24 hours). 17. valacyclovir 500 mg tablet sig: two (2) tablet po qdaily (). 18. darunavir 400 mg tablet sig: two (2) tablet po daily (daily). 19. ritonavir 100 mg capsule sig: one (1) capsule po daily (daily). 20. emtricitabine-tenofovir 200-300 mg tablet sig: one (1) tablet po daily (daily). 21. benadryl 25 mg capsule sig: capsules po at bedtime as needed for insomnia. 22. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 23. trazodone 100 mg tablet sig: one (1) tablet po at bedtime as needed for insomnia. 24. clonazepam 1 mg tablet sig: two (2) tablet po bid (2 times a day). 25. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) puff inhalation q4h (every 4 hours) as needed for sob. 26. epipen 0.3 mg/0.3 ml pen injector sig: one (1) pen intramuscular once as needed as needed for allergic reaction characterized by feeling like you are going to faint or throat closing / trouble breathing for 1 doses. disp:*1 epi pen* refills:*1* discharge disposition: home with service facility: home therapies discharge diagnosis: left wrist cellulitis with multiple abscesses left ankle cellulitis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted for infection involving your left wrist and left ankle. there were pockets of infection around your left wrist which were incised and drained by orthopedics on . you were treated with intravenous vancomycin and ceftriaxone. medication changes: start taking vancomycin and ceftriaxone (iv antibiotics) oxycodone dose has been increased temporarily to 10mg every 4 hours as needed for pain followup instructions: name: , r. location: associates of health address: , 2nd fl, , phone: appointment: friday 2:30pm department: rheumatology when: tuesday at 9:30 am with: , md building: lm bldg () campus: west best parking: garage procedure: venous catheterization, not elsewhere classified arthrocentesis immunization for allergy other local excision or destruction of lesion of joint, wrist synovectomy, wrist biopsy of joint structure, wrist diagnoses: tobacco use disorder unspecified essential hypertension chronic hepatitis c without mention of hepatic coma diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled need for desensitization to allergens cellulitis and abscess of leg, except foot cellulitis and abscess of upper arm and forearm migraine, unspecified, without mention of intractable migraine without mention of status migrainosus asymptomatic human immunodeficiency virus [hiv] infection status cellulitis and abscess of hand, except fingers and thumb pyogenic arthritis, forearm other tenosynovitis of hand and wrist tenosynovitis of foot and ankle 

Answer: The patient is high likely exposed to