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: headache, increased confusion major surgical or invasive procedure: : right occipital craniotomy for abcess history of present illness: patient is a 19m who was seen in our ed on for worsening headaches and uri symptoms, at that time he had a negative head ct and fever work up and was discharged home. on the early morning of , his roommates found the patient in the bathroom with the water running confused, they called ems who brought him to . ct scan performed at arrival was revealing a large right parietal/occipital hyperlucency. past medical history: none social history: college student at berklee, no tobacco. resides with roommates family history: non-contributory physical exam: on admission: physical exam: t:100.4 bp: 130/88 hr:80 r: 18 o2sats: 100 gen: awake, restless, agitated, c/o headache heent: pupils: left 6mm, right 5mm brisk eoms: intact extrem: warm and well-perfused. neuro: mental status: awake, agitated, confused and restless orientation: oriented to self, home address in , student status at language: speech fluent with good comprehension . cranial nerves: i: not tested ii: pupils as above mm bilaterally. visual fields are full to confrontation. iii, iv, vi: extraocular movements intact bilaterally without nystagmus. v, vii: facial strength and sensation intact and symmetric. viii: hearing intact to voice. ix, x: palatal elevation symmetrical. : ua xii: tongue midline without fasciculations. motor: moving all four extremities spontaneously exam on discharge: alert and oriented x 3 ambulating independently in halls dense left sided field cut pertinent results: labs on admission: 05:40am blood wbc-15.2* rbc-4.64 hgb-13.8* hct-38.8* mcv-84 mch-29.6 mchc-35.5* rdw-13.6 plt ct-283 05:40am blood neuts-92.5* lymphs-4.6* monos-2.3 eos-0.1 baso-0.5 05:40am blood esr-10 05:40am blood glucose-182* urean-15 creat-0.9 na-138 k-3.7 cl-98 hco3-28 angap-16 05:40am blood alt-80* ast-41* alkphos-78 totbili-0.7 06:52pm blood ck(cpk)-234 06:52pm blood ck-mb-2 ctropnt-<0.01 05:40am blood calcium-9.4 phos-3.3 mg-1.8 05:40am blood crp-10.2* 05:40am blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg ---------------- imaging: --------------- head ct : impression: right parieto-occipital intraparenchymal bleed with surrounding edema and 1 cm of midline shift. questionable minimal subarachnoid bleed. differential diagnosis is broad and includes avm, underlying mass, venous thrombosis. correlation with mri/mra/mrv is recommended. ct torso : enlarged calcified and non-calcified mediastinal and hillar and axillary lymph nodes. ddx includes treated lymphoma, sarcoidosis, prior granulomatous dz. please clinically correlat. periportal edema and pericholecystic fluid. mra/v head : pfi: 1. about 2 cm measuring intensely enhancing mass in the posterior right occipital lobe with associated 3-cm hematoma anterior to the mass causing vasogenic edema and 6-mm shift of normally midline structures to the left. two additional enhancing, hemorrhagic lesions in the right frontal lobe. differential diagnosis is broad and includes metastatic disease from unknown primary, multifocal primary glial neoplasm, or hemorrhagic tumefactive demyelinating disease. infectious etiology is very unlikely. 2. no evidence of vascular abnormalities including no evidence of vascular malformation or intracranial venous thrombosis. ct head(post-op) : 1. expected post-surgical changes with small amount of blood products surrounding the surgical cavity, pneumocephalus in the surgical cavity and in the subdural space adjacent to the parieto-occipital craniotomy. 2. compared to the pre-surgical ct, unchanged vasogenic edema in the right parietal lobe. the midline shift to the left is decreased from pre-surgical 10 mm to post-surgical 5 mm. 3. no evidence of significant intracranial hemorrhage or infarction. brief hospital course: patient is a 19m who was origionally evaluated by our ed approximatley 6 weeks prior to uri and dental pain, returns on with increased confusion. he was taken to the er by his friends, when ct of the head was done, revealing a right occipital hyperlucency with significant mass effect and midline shift. he was therefore taken emergently for decompression. he tolerated the procedure well; the intraoperative pathology report was consistent with abscess. he spend the weekend in the icu, and he slowly had an improvement in his exam. once extubated, he was following commands and was non focal. his post op head cts demonstrated no acute hemorrhage. he was started on mannitol for vasogenic edema, which was taperd down over the weekend. on he was transferred out of the icu to the sdu. , he was seen and evaluated by pt and ot, and foley catheter was discontinued. on , picc line was placed in preparation for longer term iv antibiotics. intraop cultures returned anaerobic gnr#2/fusobacterium , the id team recommended 8 weeks of iv antibiotics and a picc line was placed. decadron was tapered down. dental x-rays showed no dental abcesses. on the patient was discharged home with services for iv home antibiotics. medications on admission: none; however recent empty rx bottle of azithromycin discharge medications: 1. levetiracetam 500 mg tablet sig: two (2) tablet po bid (2 times a day). disp:*120 tablet(s)* refills:*2* 2. acetaminophen 500 mg tablet sig: two (2) tablet po q6h (every 6 hours). 3. hydromorphone 2 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*50 tablet(s)* refills:*0* 4. methocarbamol 500 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*60 tablet(s)* refills:*0* 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 6. metronidazole in nacl (iso-os) 500 mg/100 ml piggyback sig: one (1) 500mg dose intravenous q8h (every 8 hours) for 8 weeks. disp:*qs 500mg dose* refills:*0* 7. ceftriaxone in dextrose,iso-os 2 gram/50 ml piggyback sig: one (1) 2gm dose intravenous q12h (every 12 hours) for 8 weeks. disp:*qs 2gm dose* refills:*0* 8. heparin, porcine (pf) 10 unit/ml syringe sig: one (1) ml intravenous prn (as needed) as needed for line flush: flush with 10ml normal saline followed by heparin as above daily and prn per lumen. disp:*qs ml(s)* refills:*0* 9. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. disp:*30 capsule, delayed release(e.c.)(s)* refills:*0* 10. outpatient lab work lfts, chem 7, cbc every week please fax results to ( 11. outpatient lab work every 2 weeks you will also need esr crp please fax to ( discharge disposition: home with service facility: home solutions discharge diagnosis: right occipital lobe abcess discharge condition: neurologically stable discharge instructions: general instructions wound care ?????? you or a family member should inspect your wound every day and report any of the following problems to your physician. ?????? keep your incision clean and dry. ?????? you may wash your hair with a mild shampoo 24 hours after your sutures are removed. ?????? do not apply any lotions, ointments or other products to your incision. ?????? do not drive until you are seen at the first follow up appointment. ?????? do not lift objects over 10 pounds until approved by your physician. diet usually no special diet is prescribed after a craniotomy. a normal well balanced diet is recommended for recovery, and you should resume any specially prescribed diet you were eating before your surgery. medications ?????? take all of your medications as ordered. you do not have to take pain medication unless it is needed. it is important that you are able to cough, breathe deeply, and is comfortable enough to walk. ?????? do not use alcohol while taking pain medication. ?????? medications that may be prescribed include: o narcotic pain medication such as dilaudid (hydromorphone). o an over the counter stool softener for constipation (colace or docusate). if you become constipated, try products such as dulcolax, milk of magnesia, first, and then magnesium citrate or fleets enema if needed). often times, pain medication and anesthesia can cause constipation. ?????? you have been prescribed keppra (levetiracetam), for antiseizure prevention, you will not require blood work monitoring. ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, and ibuprofen etc, as this can increase your chances of bleeding. activity the first few weeks after you are discharged you may feel tired or fatigued. this is normal. you should become a little stronger every day. activity is the most important measure you can take to prevent complications and to begin to feel like yourself again. in general: ?????? follow the activity instructions given to you by your doctor and therapist. ?????? increase your activity slowly; do not do too much because you are feeling good. ?????? you may resume sexual activity as your tolerance allows. ?????? if you feel light headed or fatigued after increasing activity, rest, decrease the amount of activity that you do, and begin building your tolerance to activity more slowly. ?????? do not drive until you speak with your physician. ?????? do not lift objects over 10 pounds until approved by your physician. ?????? avoid any activity that causes you to hold your breath and push, for example weight lifting, lifting or moving heavy objects, or straining at stool. ?????? do your breathing exercises every two hours. ?????? use your incentive spirometer 10 times every hour, that you are awake. when to call your surgeon: with any surgery there are risks of complications. although your surgery is over, there is the possibility of some of these complications developing. these complications include: infection, blood clots, or neurological changes. call your physician immediately if you experience: ?????? confusion, fainting, blacking out, extreme fatigue, memory loss, or difficulty speaking. ?????? double, or blurred vision. loss of vision, either partial or total. ?????? hallucinations ?????? numbness, tingling, or weakness in your extremities or face. ?????? stiff neck, and/or a fever of 101.5f or more. ?????? severe sensitivity to light. (photophobia) ?????? severe headache or change in headache. ?????? seizure ?????? problems controlling your bowels or bladder. ?????? productive cough with yellow or green sputum. ?????? swelling, redness, or tenderness in your calf or thigh. call 911 or go to the nearest emergency room if you experience: ?????? sudden difficulty in breathing. ?????? new onset of seizure or change in seizure, or seizure from which you wake up confused. ?????? a seizure that lasts more than 5 minutes. important instructions regarding emergencies and after-hour calls ?????? if you have what you feel is a true emergency at any time, please present immediately to your local emergency room, where a doctor there will evaluate you and contact us if needed. due to the complexity of neurosurgical procedures and treatment of neurosurgical problems, effective advice regarding emergency situations cannot be given over the telephone. ?????? should you have a situation which is not life-threatening, but you feel needs addressing before normal office hours or on the weekend, please present to the local emergency room, where the physician there will evaluate you and contact us if needed. followup instructions: follow-up appointment instructions ??????please return to the office in days (from your date of surgery) for removal of your sutures and a wound check.this appointment can be made with the nurse practitioner. please make this appointment by calling . if you live quite a distance from our office, please make arrangements for the same, with your pcp. ??????please call ( to schedule an appointment with dr. , to be seen in 4 weeks. ??????you will need a ct scan of the brain with & without contrast. infectious disease follow up: all laboratory results should be faxed to infectious disease r.ns. at ( all questions regarding outpatient antibiotics should be directed to the infectious disease r.ns. at ( - you need an mri with gadolinium in 8 weeks, this can be arranged thru our office, please call dr. office, refer to the number above. procedure: venous catheterization, not elsewhere classified other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain diagnostic ultrasound of heart diagnoses: intracerebral hemorrhage cerebral edema enlargement of lymph nodes intracranial abscess other specified bacterial infections in conditions classified elsewhere and of unspecified site, other anaerobes 

Answer: The patient is high likely exposed to