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: azithromycin / augmentin / klonopin / aspirin / atorvastatin / escitalopram / amlodipine attending: chief complaint: decreased ms major surgical or invasive procedure: intubation and mechanical ventilation history of present illness: 43 year-old male with pmh of cad, transferred from the micu. originally, presented with after a week of flu like illness with altered mental status and thought to have seroquel od (prior od on ccb/bb). intubated at for airway protection. of note, u tox, s tox are negative. (though were + for tca at osh). however, it was determined that no meds were missing when partner counted them. therefore, episode of altered mental status is not completely understood. while in the micu, patient's sedation was lightened and he self extubated. an lp was performed for has and showed xanthochromia in all 4 tubes. to exclude possibility of a traumatic tap, lp was repeated and showed 3550 rbcs in tube 4 without any microorganisms. this was concerning for sah vs herpes vs mycotic aneurysm. pcr for hsv is currently pending. cta was performed on day of transfer and read pending at time of this note. mri spine was ordered to rule out aneurysm/avm but patient could not tolerate the procedure secondary to nausea. he now feels back to normal in terms of his thinking and fairly decent in terms of his mood. however, he continues to experience vertigo and nausea especially when he lays flat. patient now without headaches. past medical history: past medical history: 1. cad- s/p multiple stents with stent to lad, prca, rca, d1, mid lcx at various times within the past 8 months. cath showed no flow limiting disease with ef=50%. 6 caths since . his outpatient cardiologist notes that he has a severe coronary vasculopathy (based on his having quickly developed seperate coronary occlusions in rapid succession; this is why the stents were each inserted on seperate occassions; this is also in the context of presently having clear coronaries) 2. hypertension 3. hyperlipidemia 4. tremor--essential 5. s/p hernia repair pcp is . . cardiologist is at . past psychiatric history: has had inpatient admissions x 2 on d4 this summer. both of these were serious suicide attempts by od, prompting icu admissions. had stay at for etoh in past. followed outpatient by dr. in (. 4 prior suicide attempts: deliberately crashing car @ 18yo wnen intoxicated (reported on this interview), od ~10 years ago (noted to sw), od about 2 months ago leading to micu admit and od on benadryl also leading to brief micu admit. has had ect since , which has been helpful. was receiving maintenance therapy once per week until late , then increased to 3x/week secondary to continued symptoms of depression. last ect tx was at least 1 week ago (delayed secondary to medical issues). social history: born in , 2nd of 6 children (5 sisters). moved around as a child secondary to father's position in navy, ultimately settling on cape for high school. had 1 and half years at community college. took care of mother before she died from cancer, took care of prior parner before he died from cancer. lives with partner (), partner's sister and mother. 3 year old yorkshire terrier, . enjoys playing with dog, tending to garden, unable to do much of either secondary to illness. works in kitchen at -. currently applying for disability. substance abuse history: smokes one pack tobacco a day. h/o etoh dependence with section 35 to ~15 years ago, in aa, sober since with just one day of drinking in the spring. distant h/o experimentation with mj as teenager. family history: father with etoh dependence. great aunt with ?depression, completed suicide. physical exam: vitals: t:97.2 p:75 r:12 bp:117/79 sao2:100% on ac 650/125 x 12 100% 7.24/42/335 general: intubated and sedated heent: nc/at, perrla, but sluggish, eomi without nystagmus, no scleral icterus noted, et at 21cm neck: supple, no jvd or carotid bruits appreciated pulmonary: lungs cta bilaterally without r/r/w cardiac: rr, nl. s1s2, no m/r/g noted abdomen: obese, soft, nt/nd, hypoactive bowel sounds, no masses or organomegaly noted. extremities: no c/c/e bilaterally, 2+ radial, dp and pt pulses b/l. skin: no rashes or lesions noted. neuro: sedated. no hypertonia pertinent results: 09:00pm glucose-298* urea n-33* creat-2.5*# sodium-142 potassium-4.1 chloride-112* total co2-17* anion gap-17 09:00pm alt(sgpt)-17 ast(sgot)-18 ck(cpk)-95 alk phos-79 amylase-51 tot bili-0.2 09:00pm lipase-60 09:00pm ctropnt-<0.01 09:00pm ck-mb-notdone 09:00pm asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 09:00pm urine hours-random 09:00pm urine hours-random 09:00pm urine gr hold-hold 09:00pm urine bnzodzpn-neg barbitrt-neg opiates-neg cocaine-neg amphetmn-neg mthdone-neg 09:00pm wbc-18.9*# rbc-3.77* hgb-12.4* hct-34.7* mcv-92 mch-32.9* mchc-35.8* rdw-12.9 09:00pm neuts-88.1* bands-0 lymphs-8.1* monos-0.7* eos-2.4 basos-0.7 09:00pm hypochrom-normal anisocyt-normal poikilocy-normal macrocyt-normal microcyt-normal polychrom-normal 09:00pm plt smr-normal plt count-401# 09:00pm urine color-straw appear-clear sp -1.011 09:00pm urine blood-lg nitrite-neg protein-tr glucose-250 ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 09:00pm urine rbc->50 wbc-21-50* bacteria-few yeast-none epi-0 08:28pm type-art po2-335* pco2-42 ph-7.24* total co2-19* base xs--8 intubated-intubated 08:28pm type-art po2-335* pco2-42 ph-7.24* total co2-19* base xs--8 intubated-intubated 08:28pm type-art po2-335* pco2-42 ph-7.24* total co2-19* base xs--8 intubated-intubated 08:28pm type-art po2-335* pco2-42 ph-7.24* total co2-19* base xs--8 intubated-intubated cxr: 1.9 impression: appropriate placement of endotracheal tube and nasogastric tube. prominence of the pulmonary vasculature likely relates to patient position. cxr: findings: the patient has been extubated. there is a left-sided subclavian central venous catheter with the tip in the upper to mid svc. cardiac and mediastinal silhouettes appear within normal limits. no focal pulmonary opacities, pleural effusions, or evidence of pneumothorax. osseous structures appear unremarkable. ct head: findings: there is no sign for the presence of an intracranial hemorrhage, mass effect, or shift of normally midline structures. there is no evidence for minor or major vascular territory infarction. the density values of the brain parenchyma are normal. there is no overt extracranial pathology seen other than mild bilateral ethmoid sinus mucosal thickening. mr head findings: the right vertebral artery distal to the origin of the right posterior inferior cerebellar artery is extremely hypoplastic. additionally, there are bilateral fetal-type posterior cerebral arteries, the latter finding presumably correlating with the rather diminutive basilar artery. within the limitations of mr angiography, there is no definite sign for the presence of an aneurysm, although conventional angiography remains the standard study necessary to more unequivocal exclusion of this pathological process. there are no areas of hemodynamically significant stenosis identified. within the limitations of coverage of this study, there is no overt sign for the presence of a vascular malformation. cta head: impression: no evidence of aneurysm. a preliminary report of no subarachnoid hemorrhages seen, no aneurysm detected on axial images was provided by dr. and confirmed by dr. . echo: conclusions: the left atrium is normal in size. left ventricular wall thickness, cavity size, and systolic function are normal (lvef>55%). regional left ventricular wall motion is normal. tissue velocity imaging demonstrates an e/e' <8 suggesting a normal left ventricular filling pressure. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the pulmonary artery systolic pressure could not be quantified. there is no pericardial effusion. compared with the report of the prior study (tape unavailable for review) of , the findings are similar. based on aha endocarditis prophylaxis recommendations, the echo findings indicate a low risk (prophylaxis not recommended). clinical decisions regarding the need for prophylaxis should be based on clinical and echocardiographic data. mrcspine conclusion: no radiological explanation for the clinical and laboratory abnormalities noted in your history. addendum: there is a mild chiari i malformation of the cerebellar tonsils, with the tonsillar tips approximately 5 mm below the plane of the foramen magnum. additionally, there are type 2 degenerative endplate changes involving the c5-6 and c6-7 interspaces. finally, there is a mild degree of congenital narrowing of the ap diameter of the cervical spinal canal from the c3 through c6-7 levels. mr conclusion: no radiological explanation for the clinical and laboratory abnormalities noted in your history. addendum: there is a mild chiari i malformation of the cerebellar tonsils, with the tonsillar tips approximately 5 mm below the plane of the foramen magnum. additionally, there are type 2 degenerative endplate changes involving the c5-6 and c6-7 interspaces. finally, there is a mild degree of congenital narrowing of the ap diameter of the cervical spinal canal from the c3 through c6-7 levels. mr 1//18 findings: there is mild facet joint degenerative change bilaterally at the l5-s1 interspace, with a 2 mm subchondral cyst involving the left s1 superior articular facet. there is no other overt lumbar spinal pathology seen. the rootlets of the cauda equina do appear apposed at the l4-5 interspace level. most probably, this finding relates to the relatively diminished size of the thecal sac secondary to the presence of abundant epidural fat at this locale. conclusion:no definite signs for the presence of spinal pathology accounting for the clinical and laboratory findings noted in your history. however, meningitis can be easily overlooked by even contrast enhanced mri. brief hospital course: 43 yo male with multiple h/o of si, cad s/p pci, p/w apnea/bradycardia/hypotension in setting of od. per hcp, only seroquel was unaccounted for at home (2300mg...is usually on 150gm/day). further inquiry revealed a ha preceding the pt's unresponsiveness. the patient's running problems were ms changes, infection, hypotension, acidosis, respiratory failure, cad, arf, nausea and vertigo. . ms changes: initially thought to be due to seroquel od, but history did not ultimately support this initial diagnosis. ddx includes cns infection (likely viral given non-toxic appearance and prodrome 1 week prior), sah (supported by xanthochromia on lp x 2), trauma (no outward evidence of this), hiv sequela. intubated airway protection and self extubated. ms cleared. however, story remains unclear. psych consultant believed that he was not actively si and felt that suicide attempt with od was unlikely the cause of episode. u tox, s tox were negative. (though were + for tca at osh). pt was stabalized in the icu and eventually transferred on hd 3 to the floor. his ms y improved in this process without a clear diagnosis. pt had fever on and so was covered with levo/flagyl and was cultured. culture data as follows: : bcx with mssa (1/4 bottles), gnr (1/4 bottles) : sputum with staph aureus pending : sputum with staph aureus : sputum with staph aureus treated with clinda rather than levo/flagyl since (emperic to cover poss comm acquired mrsa). cxr does not indicate a pna from aspiration (though there did seem to be an aspiration while pt was intubated). it was later decided that levo/vanc was a preferable treatment while pt was in house. suspician for a true infection was low per clinical picture, and it was rather suspected that the growth may have been an unusual contaminant, however, antiobiotics were administered in case culture was true. pt was discharged to finish 14 day course of levo. . the csf revealed persistant blood and xanthocromia and high protein on two occasions. pt was covered with empiric acyclovir until csf pcr demonstrated no hsv. on workup, pt had mri suggesting chiari malformation hypoplastic r vert, small posterior art, no aneurysm seen, no acute stroke. cta was also negative for aneurism or bleed. defect of the spinal cord such as avm or aneurism was suspected due to hyperasthesia in chest but mr showed no abnormality. the last possibility that had to be ruled out was a sentinal bleed from a small cranial aneurism that was being missed by mr/cta, so a angiogram was performed which did not demonstrate any major abnormalities on discussion with the radiologist, however a formal read is pending as of discharge date. . hypotension: pt presented with hypotension, considered a seroquel vs neurovasc event. resolved on . pt by enzymes. . acidosis: pt was in primary metabolic on arrival. which resolved after stabilization and intubation. . resp failure: pt presented with respiratory failure and was intubated on . self extubated and doing well. . cad: asa, plavix (allergies noted; only makes him bleed), held bb/ccb due to low blood pressure. . arf: cr 2.2 on presentation: (baseline 0.7): kept map >65mm. fena was elevated. atn is likely given hypotension and high fena. slowly resolved over course of stay to a cr=1.3. ua appears infected, but ucx showed no growth. pt was stabalized, feeling well in good mood with no headache, pain, vertigo, nausea, or any other major complaints and discharged on medications on admission: atorvastatin calcium 40 mg tablet po qd amlodipine besylate 5 mg po qam clopidogrel bisulfate 75 mg qam metoprolol tartrate 75 mg po bid aspirin 325 mg qd quetiapine fumarate 25mg qam, 50mg noon, 75mg qhs gemfibrizole 600mg po bid topomax 75mg po qd neurontin 800mg po qhs cymbalta 60mg po qd discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 3. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h (every 6 hours) as needed. 4. acetaminophen 325 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. 5. quetiapine 25 mg tablet sig: five (5) tablet po hs (at bedtime). 6. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 5 days. disp:*4 tablet(s)* refills:*0* 7. duloxetine 30 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po bid (2 times a day): speak with your doctor about returning to your normal dose. 8. quetiapine 25 mg tablet sig: one (1) tablet po q24h (every 24 hours). 9. quetiapine 25 mg tablet sig: two (2) tablet po bid (2 times a day) as needed. 10. gabapentin 400 mg capsule sig: two (2) capsule po daily (daily). 11. gemfibrozil 600 mg tablet sig: one (1) tablet po bid (2 times a day). 12. meclizine 12.5 mg tablet sig: two (2) tablet po tid (3 times a day) for 7 days. disp:*42 tablet(s)* refills:*0* 13. toprol xl 25 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po once a day. disp:*30 tablet sustained release 24hr(s)* refills:*2* 14. lisinopril 5 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 15. atorvastatin 40 mg tablet sig: one (1) tablet po once a day. 16. outpatient lab work please ask your doctor's office to check your chem 7 and draw a blood culture in 1 week. the results must be called to dr. office. discharge disposition: home discharge diagnosis: altered mental status depression bacteremia h.flu pneumonia hematochezia cad sp stents discharge condition: good discharge instructions: please continue your home medications, as administered by your partner. were found to have blood in your stool, so you need to have this followed up. please ask your doctor you for a colonoscopy. please call your doctor if you have further confusion, fevers, headaches, or notice blood in your stool. please discuss further adjustment of your psych medications with your outpatient psychiatrist. we've stopped your amlodipine. instead you will be on toprol and lisinopril. please have your doctor's office check your blood pressure and your lab work. please finish a course of levaquin. followup instructions: please an appointment to see your pcp: , in the next 2 weeks. please request a repeat guiac as you were positive during your stay and may require a screening colonoscopy. you should also see your psychiatrist in the next 2 weeks. please an appointment to see dr. in neurology phone: in the next weeks. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours spinal tap incision of lung insertion of endotracheal tube arteriography of cerebral arteries arterial catheterization diagnoses: acidosis coronary atherosclerosis of native coronary artery acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified unspecified essential hypertension subarachnoid hemorrhage percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia acute respiratory failure bacteremia pneumonia due to hemophilus influenzae [h. influenzae] 

Answer: The patient is high likely exposed to