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: penicillins attending: chief complaint: respiratory distress, thrombocytopenia major surgical or invasive procedure: cvvh intubation central line placement history of present illness: 59 yom w/ h/o bipolar disorder, disease s/p radioactive ablation, htn, presents with fever and respiratory distress. he first developed fever to 105 6 days prior to admission, associated with generalized malaise, nausea, vomiting (bilious, no blood) and decreased po intake. he continued to have intermittent fevers despite round-the-clock tylenol (~ 6 tabs a day) and ibuprofen (3600 mg/day the first 3 days, followed by 2400 mg/day the next 3 days). he developed non-productive cough, diffuse myalgias, bilateral groin/lower back pain ~ 3 days prior to admission, at which time he began to note that his breathing "was heavier." on the day of admission, he became progressively more short of breath prompting presentation to the emergency room. . in ed t 101.4, hr 112, bp 150/60, resp 36, 100% nrb. cxr (poor film) without focal infiltrates or chf. he received ceftriaxone 1 g iv x 1, azithromycin 500 mg iv x 1, and vancomycin 1 g iv x 1 for presumed pneumonia. he had a bedside tte which showed ef 65%, no focal wall motion abnormalities or effusion. labs revealed that the patient was hyponatremic (na 126) and in acute renal failure (cr 3.5), with marked thrombocytopenia (plt 34). he was paced on bipap 10/10 100% at which time abg 7.36/37/409. patient is being admitted to the micu for further management. currently, the patient reports shortness of breath. he denies chest pain, nausea, vomiting, palpitations, lightheadedness, abdominal pain, recent sick contacts, or recent travel. he noted redness/tenderness of right index finger ~ 3 days ago, although he cannot remember an inciting trauma/insect bite. he reports that he had one episode of non-bloody diarrhea 2 days ago. this a.m. he had a small formed stool that had a small amount of blood coating it. past medical history: 1) disease s/p radioactive iodine therapy 2) temporal lobe epilepsy 3) s/p self orchiecomy in setting of psychotic break - hypotestosteronism 4) htn 5) bipolar disorder 6) sleep apnea on cpap 7) s/p tonsillectomy 8) diverticulosis social history: quit tobacco in (50 pk-yr history). retired, lives with wife. former etoh abuse, quit 3 yrs ago. no drug use. family history: brother died with aaa, father colon cancer. mother and pancreatitis. no family history of bleeding disorders. physical exam: t 101.4, hr 120, bp 110/60, resp 32, 100% bipap 10/10, fio2 0.5 gen: middle-aged male, moderate respiratory distress, tachypnic, diaphoretic. heent: perrl, eomi, anicteric, nl conjunctiva, omm dry, op clear, neck supple, no lad, no jvd, bipap mask in place cardiac: tachycardic, regular, no m/r/g appreciated pulm: cta bilaterally chest: bilateral gynecomasty abd: obese, hypoactive bs, moderately distended, soft, nt ext: no c/c/e, right index finger with distal erythema, tenderness, edema. warm, 1+ dp bilaterally neuro: cn ii-xii grossly intact and symmetric bilaterally. strength throughout. sensation intact to light touch proximally and distally in upper and lower extremities. skin: petechie over dorsal surface of feet bilaterally abd: hypoactive bs, moderately distended pertinent results: wbc 16.8 (pmn 68.3, bands 0, lymph 4.3, mono 26.9, eos 0.1, baso 0.3), hgb 15.3, hct 45.3, plt 34 (370 ) . pt 13.4, inr 1.2, ptt 26.3, fbg 592 . na 126, k 4.1, cl 89, hco3 22, bun 90, cr 3.5 ( 1.1 ) . alt 35, ast 58, alk phos 281, tbili 3.2, dbili 1.9, amyl 17, lip 24, ldh 790 . ck 97, tnt 0.68 . lactate 4 -> 2.9 . u/a: sm bili, tr prot, lg blood, rbc, wbc . cxr: poor quality. no definite evidence of pna or chf . ekg: st @ 119 bpm, ivcd, 2- depressions in i, avl v2-v6, elevation in v2. brief hospital course: 59 yom presents with sepsis/ards, arf and thrombocytopenia. the hospital course was significant for the following issues: p: 1) septic shock: potential infectious causes included pna (cough, although no clear infiltrate on sub-optimal cxr), uti (given positive u/a), cellulitis (right-index finger erythema) and assoaciated bacteremia. the patient was started on broad spectrum antibiotics and required pressor support for persistent hypotension. an a-line and central line were placed. blood and urine cultures were pending. the patient had elevated lfts as well. gi was consulted and thought this was consistent with shock liver. . 2) thrombocytopenia: potential causes included sepsis, dic (although fibrinogen not low and pt/ptt not significantly elevated), ttp-hus (fever, thrombocytopenia, arf; although no schistocytes on peripheral smear, no evidence of hemolysis), itp, med reacton (lamictal, high dose ibuprofen), malignancy, auto-immune process (anti-phospholipid ab syndrome). given absence of schistocytes (and lower suspicion for ttp), the patient was transfused 2 units of plt prior to placement of central line placement. . 3) respiratory distress: likely secondary to respiratory compensation in the setting of lactic acidosis (secondary to infection). no clear evidence of pna on cxr (although poor film), although this might have been viral/atypical pneumonia. the patient required intubation for worsening respiratory distress and became increasingly difficult to oxygenate. . 4) troponin elevation: most likely represents demand ischemia in the setting of sinus tachycardia/respiratory distress. cardiology consulted and did not recommend urgent intervention. cardiac enzymes were trended. . 5) acute renal failure: low fena suggesteds pre-renal etiology, likely in the setting of high-grade fevers and poor po intake. given thrombocytopenia, concern for ttp. the patient was aggressively fluid resuscitated. renal was consulted and a hemodialysis line was placed and the patient was started on cvvh. . 6) f/e/n: npo for now. the patient was started on tubefeeds after intubation. . 7) h/o seizures: the patient was continued on lamictal given concern for recurrence of seizures with abrupt withdrawal. 8) cardiac: on the evening of , the patient went into an unstable cardiac rhythm: vt--> vf arrest. a code blue was called and the patient was coded with cpr, defibrillation, epinephrine/atropine without success and the patient was declared dead at 2052 on . family were informed and declined an autopsy. medications on admission: 1) lisinopril 20 mg po daily - increased from 10 mg daily 2) lamictal 600 mg po daily 3) zoloft 200 mg po daily 4) testosterone discharge medications: none discharge disposition: expired discharge diagnosis: sepsis myocardial infarction renal failure respiratory failure shock liver discharge condition: deceased discharge instructions: none followup instructions: none procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified injection or infusion of thrombolytic agent venous catheterization for renal dialysis infusion of vasopressor agent diagnoses: acidosis pure hypercholesterolemia acute and subacute necrosis of liver acute kidney failure, unspecified unspecified septicemia severe sepsis paroxysmal ventricular tachycardia acute respiratory failure septic shock ventricular fibrillation epilepsy, unspecified, without mention of intractable epilepsy anticoagulants causing adverse effects in therapeutic use hemorrhage of gastrointestinal tract, unspecified 

Answer: The patient is high likely exposed to