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 major surgical or invasive procedure: s/p lumbar puncture history of present illness: this is a 51yo f w/ pmh of afib on coumadin, htn, p/w 24 hours acute onset r hand and ankle pain and ha (pounding/generalized), + subjective fever/chills. + photophobia. also endorses a cough yesterday that made her vomit and frequent loose stools over the past few days. no current n/sob/cp or cough. + continued pain in r thumb. + exposure to sick children at daycare. her husband has also had a cold. no exposures to tuberculosis. . in the ed: vitals 103.3 ->105, 98, 149/59, 20, 96% on ra. found to have nuccal rigidity. petechiae on feet. lp w/ no glucose and high protein concerning for bacterial meningitis. dph notified. given vanc 1 g, ceftriaxone 2 g, ampicillin 2 g, decadron 10 mg iv x 1, morphine 4 mg iv x 1 and fentanyl 50 mcg iv x2. ams (a/o but drifts off, sometimes inappropriate, but is arousable). . course- on broad spectrum abx. , lab called with gram stain actually 4+ gram negative dipplococci, likely meningococcus. . ros: (+) as per hpi, + runny nose. (-) denies recent weight loss or gain. denied constipation or abdominal pain. past medical history: 1. atrial fibrillation on warfarin s/p dccv x 2 2. hypertension since - on enalapril and sotalol 3. hyperlipidemia since - on lipitor 4. pulmonary calcified granuloma - pulmonologist: dr. 5. borderline/mild pulmonary hypertension 6. gastroesophageal reflux disease social history: single lives with a significant other she has three children 27, 14, 11. she owns a daycare which she runs in her own home. she doesn??????t smoke of drink. she travels to 1x per year but no tuberculosis exposures that she is aware of. last travel was at the end of the summer when she went to . family history: there is no family history of premature coronary artery disease or sudden death. there is a history of htn in her mother, an uncle with mi, and aunt with dm. physical exam: vitals: t: 99 p: 80 bp: 111/66 r: 23 sao2: 93% on 2l general: awake, sleepy but oriented x 3. occasionally gets confused when answering questions. heent: nc/at, perrl, eomi without nystagmus, no scleral icterus noted, dry mm, w/ crusting around her mouth neck: +nucal rigidity, no adenopathy noted pulmonary: + crackles at l base otherwise ctab cardiac: rrr, nl. s1s2, no m/r/g noted abdomen: obese, soft, nt/nd, normoactive bowel sounds, no masses or organomegaly noted. extremities: no c/c/e bilaterally, 2+ radial, dp and pt pulses b/l. + petechiate (? palp) on dorsum of bilateral feet neurologic: -mental status: alert, oriented x 3. able to relate history w/ some extraneous details. -cranial nerves: ii-xii intact -motor: normal bulk, strength and tone throughout. no abnormal movements noted. ? some arm rigidity (r>l) -plantar response was flexor bilaterally. pertinent results: wbc-14.5*# rbc-5.03 hgb-14.2 hct-40.8 mcv-81* mch-28.2 mchc-34.7 rdw-14.3 plt ct-154 neuts-79* bands-8* lymphs-6* monos-4 eos-0 baso-0 atyps-3* metas-0 myelos-0 wbc-15.7* rbc-4.33 hgb-12.6 hct-37.5 mcv-87 mch-29.2 mchc-33.7 rdw-14.6 plt ct-122* neuts-89* bands-1 lymphs-5* monos-5 eos-0 baso-0 atyps-0 metas-0 myelos-0 wbc-11.4* rbc-3.95* hgb-11.5* hct-33.5* mcv-85 mch-29.2 mchc-34.5 rdw-14.6 plt ct-159 07:50pm blood pt-19.3* ptt-25.7 inr(pt)-1.8* 06:00am blood pt-18.6* ptt-22.2 inr(pt)-1.8* glucose-122* urean-12 creat-0.9 na-136 k-3.2* cl-98 hco3-23 calcium-10.4* phos-1.9* mg-1.6 glucose-120* urean-16 creat-0.6 na-145 k-3.2* cl-109* hco3-26 calcium-8.9 phos-3.0 mg-2.1 07:50pm blood alt-32 ast-27 alkphos-63 amylase-37 lipase-27 blood type-art po2-78* pco2-32* ph-7.47* caltco2-24 base xs-0 09:02am blood glucose-203* lactate-2.4* na-141 k-3.6 cl-108 09:02am blood freeca-1.32 09:15am blood ch 50-pnd head ct noncontrast: there is no evidence of acute intracranial hemorrhage, shift of normally midline structures, or hydrocephalus. -white matter differentiation appears grossly preserved. visualized paranasal sinuses appear normally aerated. impression: no evidence of acute intracranial hemorrhage or shift of normally midline structures. cxr: the lungs are well expanded and clear. the mediastinum is unremarkable. mild tortuosity of the thoracic aorta is again noted. the cardiac silhouette is borderline enlarged but stable. no effusion or pneumothorax is evident. the visualized osseous structures are unremarkable. impression: no acute pulmonary process. cxr picc placement: lung volumes are moderate. there is no acute cardiopulmonary process. the lungs are clear and pleural surfaces are smooth with no effusion or pneumothorax. the heart is stable in size with mild enlargement and mild unfolding of the aorta is noted. right picc has been placed with tip in the right atrium. impression: right picc terminates in the right atrium. findings were discussed with from the venous access team at the time of the exam. 09:20pm cerebrospinal fluid (csf) wbc-312 rbc-91* polys-81 lymphs-10 monos-4 eos-5 cerebrospinal fluid (csf) totprot-570* glucose-0 7:50 pm blood culture left ac venipuncture. aerobic bottle (final ): neisseria meningitidis. beta-lactamase negative: presumptively sensitive to penicillin. anaerobic bottle (pending): 8:00 pm blood culture venipuncture. aerobic bottle (final ): neisseria meningitidis. beta-lactamase negative: presumptively sensitive to penicillin. anaerobic bottle (pending): 9:20 pm csf;spinal fluid #3. gram stain (final ): this is a corrected report . reported by phone to dr () at 2:40pm. 3+ (5-10 per 1000x field): polymorphonuclear leukocytes. 4+ (>10 per 1000x field): gram negative diplococci. previously reported as. no polymorphonuclear leukocytes seen. no microorganisms seen (). fluid culture (preliminary): neisseria meningitidis. moderate growth. beta lactamase negative. beta-lactamase negative: presumptively sensitive to penicillin. 2:37 pm stool consistency: loose source: stool. clostridium difficile toxin assay (final ): feces negative for c. difficile toxin by eia. (reference range-negative). viral culture (pending): brief hospital course: 51 f w/ pmh of afib, htn, osa on cpap, p/w neisseria menigitis and bacteremia . 1) meningicoccal meningitis: lp in the er with glucose of zero and high total protein consistent with bacterial meningitis. ultimately returned neisseria meningicoccus. patient initially received vanc, ceftriaxone 2g iv q12 and ampicillin 2 g iv q 4hrs + dexamethasone. tailored to ceftriaxone 2g iv q12. blood cultures also positive on . patient will need 14 days of ceftriaxone starting , first set of negative blood cultures. id involved throughout, has follow up with dr. . will need safety labs, cbc, chem-10, lft's week of on the ceftriaxone. clinically patient very well, did have persistent headache through but no apparent ch50 within normal limits, no evidence of terminal complement deficiency. infectious disease contact department of public health given multiple exposures as patient has her own daycare. . 2) afib: h/o difficult-to control rate s/p multiple cardioversions. anticoagulated on coumadin (subtherapeutic). coumadin initially held given critical illness. resumed by . inr goal 2-2.5. held givne inr 2.7. re started will need inr check on maintained on quinidine throughout. heart rate generally high 50's to low 60's. . 3) htn: bp well controlled, largely off agents. had been on low dose metoprolol which was largely held throughout. . 4) osa: on cpap 11 at home. patient non compliant at home,secondary to headached. attempted in house but patient refused with headache. . 5)c. diff colitis: patient with diarrhea beginning before admission. empiric flagyl started, c.diff returned positive. will need flagyl course for at least 10 days after the cessation of ceftriaxone. diarrhea improving by , no loose stools by . . . ) communication: (partner) ; . medications on admission: quinidine 324 mg po q8 hrs diltiazem cd 300 mg 1 tab daily ranitidine 150 mg 1 tab coumadin 2.5 mg 2 tabs on mon and fri and 1 tab remaining days zocor 40 mg 1 tab daily enalapril 5 mg 1 tab daily metoprolol 150 mg daily discharge medications: 1. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). 2. simvastatin 40 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 3. quinidine gluconate 324 mg tablet sustained release sig: one (1) tablet sustained release po q8h (every 8 hours). 4. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 17 days. disp:*51 tablet(s)* refills:*0* 5. warfarin 2.5 mg tablet sig: one (1) tablet po days (,tu,we,th,sa). 6. warfarin 5 mg tablet sig: one (1) tablet po days (mo,fr). 7. enalapril maleate 5 mg tablet sig: one (1) tablet po once a day. 8. toprol xl 25 mg tablet sustained release 24 hr sig: three (3) tablet sustained release 24 hr po once a day. 9. ceftriaxone sig: 2 grams iv q 12 hour until dispense: quantity sufficient 10. line care please provice picc line care per critical care system protocol. discharge disposition: home with service facility: homecare discharge diagnosis: 1. meningicoccal meningitis 2. c. difficile colitis secondary: 1. atrial fibrillation 2. hypertension 3. obstructive sleep apnea discharge condition: stable, afebrile, ambulating, good po intake. discharge instructions: follow up as below. if you have worsening headache, nausea, vomiting, fevers, chills, diarrhea, abdominal pain or any other new concering symptoms, contact your doctor or go to the emergency room immediately. all medications as prescribed. you will need to be on the ceftriaxone through . continue flagyl (aka metronidazole) the antibiotic pill for diarrhea until . have your coumadin level (inr) checked at the building as you usually do. please have this checked within the next week and contact your nurse at who usually follows this for you. you must have labs checked as directed below. we have given you a prescription for this. followup instructions: follow up with your primary care doctor this week. call to make an appointment for this week. you must have cbc, chem-10, lft's checked the week of . dr. will follow these labs up. you had the previosly scheduled appointment: provider: phone: date/time: 1:45 follow up with the infectious disease doctor, dr. as scheduled: provider: ,md mph: date/time: 11:00 md procedure: venous catheterization, not elsewhere classified spinal tap incision of lung diagnoses: obstructive sleep apnea (adult)(pediatric) esophageal reflux unspecified essential hypertension atrial fibrillation other and unspecified hyperlipidemia intestinal infection due to clostridium difficile postinflammatory pulmonary fibrosis long-term (current) use of anticoagulants meningococcal meningitis 

Answer: The patient is high likely exposed to