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 / sulfonamides / tetracyclines attending: chief complaint: ams major surgical or invasive procedure: lumbar puncture performed on without complication. history of present illness: mr is a 46 yo man w/ hiv, hcv, polysubstance abuse found with changes in ms, with fecal incontinence/explosive diarrhea. all hpi at that time obtained from ems report, as patient intubated quickly after arrival for airway protection. per ems report, pt w/ bp 62/p, admitted to using iv heroin, initially reticent to come to ed for evaluation. after arrival in ed, agitated with increasing secretions and intubated for airway protection. now mr. is alert and orientated x 3, conversant. he cannot recall much of the circumstance surrounding last evening, reports developing moderate and then explosive diarrhea yesterday afternoon. again endorses using heroin yesterday. denies any other systemic symtems including fever, chills, sob, urinary changes. states he had a recent viral load and cd4 check though nothing is recorded in this system. past medical history: - hiv, last cd4 292, vl >100k in , oi: pcp, . followed br dr. . - hepatitis c. grade liver fibrosis. - alcohol abuse. h/o withdrawl seizures, shakes - etoh pancreatitis - hiv nephropathy - polysubstance abuse. - history of tylenol overdose. - peripheral neuropathy and neurogenic bladder. - cad s/p stent lcx - ugi bleed, no egd done social history: patient has a history of heavy alcohol and heroin abuse. denies drinking now, used heroin yesterday. is current smoker. lives independently in affiliation with an hiv case management group, on disability. formerly in methadone clinic, "walked off" shortly prior to admission. family history: n/c physical exam: exam on transfer to the medicine floor, . pe t 98.9 bp 111/67 hr 95 nsr r 14, 99% ra gen: pleasant, talkative, nad heent: mmm, perrla, eomi, sclerae anicter, conjuntiva normal apprearing. neck: without lad or noted jvd, r ij triple lumen in place lungs: diffuse coarse crackle b, no wheeze. coughing up grey sputum. cv: rrr s m/r/g, nl s1/s2 abd: s/nt/nd. + bs. liver edge 1 cm below costal margin. rlq scar from prior app'y noted. extrm: no edema, pulses 2+ ble. skin: no rashes, no erythema neuro: aox3, cn 2-12 intact, mae, neurologic function grossly intact, ms now appropriate pertinent results: 07:40pm urine bnzodzpn-neg barbitrt-neg opiates-neg cocaine-neg amphetmn-neg mthdone-pos 07:40pm urine color-amber appear-clear sp -1.019 07:40pm urine blood-tr nitrite-neg protein-30 glucose-neg ketone-tr bilirubin-sm urobilngn-1 ph-6.5 leuk-neg 07:40pm urine rbc-* wbc- bacteria-mod yeast-none epi- trans epi- 07:40pm urine granular-0-2 07:05pm alt(sgpt)-27 ast(sgot)-29 ck(cpk)-298* alk phos-130* amylase-71 tot bili-0.6 07:05pm ck-mb-7 ctropnt-0.06* 07:05pm calcium-9.3 phosphate-7.5*# magnesium-1.9 07:05pm asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-pos brief hospital course: patient was admitted intially to the micu and then transferred to the floor the next day. . 1. hypotension: though not thought to be sepsic shock, pt was pan-cultured and also checked for adrenal insufficiency by cosyntropin stim test (which was negative). ingestion of ativan, heroin, tca and extreme gi loss postulated to contribute to hypotension, which was responsive to fluids. lactate was wnl. r internal jugular triple lumen and foley were placed, and patient was intubated for airway protection. once transferred out of the micu, bps were appropriate. eventually pt was restarted on anti-hypertensives, and was discharged on lisinopril 20 mg daily. . 2. fevers: mr was afebrile on admission to the micu as well as on transfer to the medicine floor. he developed intermittent spiking fevers. cxr was initally read as unchanged from the prior studies, and all bcx and ucx demonstrated ng on day of discharge. lp was also negative for infectious process. fevers had resolved prior to discharge, and were attributed to questionable post-intubation pulmonary process. . 3. altered mental status: pt brought to emergency department with severely ams, presumed at that time to partially secondary to drug use and hypotension. mr. was promptly intubated and sent to micu for mangament of hypotension. after extubation, patient was a and o x 3 on transfer to the medicine floor. while on the floor, patient became quite confused and engaged in bizzare behaviors such as putting sputum on cereal thinking it was milk. he also was intermittently lethargic and very difficult to arouse. in the setting of intermittent fevers, an lp was performed which was negative. to r/o any ic pathology or mass, an mri of the head was obtained and also negative. eventually, in conjuction with attending and pt's case manager, team determined that ams was most likely secondary to in-house methadone dose, 120 mg daily. patient's methadone dose with reduced to 60 mg daily, with a dramatic improvement in patient's functional capacity and ms. methadone was titrated up to avoid withdrawal and preserve ms. was discharged on 100 mg methdone daily, and kept in house for several days longer than medically necessary until the next intake appointment at a methadone clinic could be arranged. he was scheduled to resume methadone dosing and counseling at bay cove on . . 4. acute renal failure: on admission to the micu, pt also had marked arf with cr to 7 from 1. he received aggressive hydration and creatinine fell to 4.3 after 24 hours. fena (calculated) = 1.3%, c/w renal etiology presumed to be atn hypovolemia. patient continued to receive agressive ivf and on discharge, creatinine was back at baseline level of 1.1. lisinopril reintiated as stated. . 5. diarrhea: stool was sent for cultures to r/o infectious etiolgy of diarrhea, especially in the setting of intermittent fevers. stool cultures for o & p, campylobacter, vibrio, yersinia, e. coli, cyclospora, cryptosporidium, giarida and c. difficle were all negative. diarrhea resolved spontaneously while in house. . 6. hiv: patient's hiv was under poor control and pt demonstrated questionable reliability in regards to medication compliance. for this reason, haart was held during this hospitalization. . 7. hep c stable during hospitalization. medications on admission: as stated by patient on transfer: 1. kaletra 2. truvada qam 3. klonopin 1 mg tid 4. lipitor 20 mg qday 5. asa 325 mg q day 6. atenolol 100 mg qday 7. lisinopril 5 mg qday 9. neurontin 1800 mg qday as taken from past records from , not included above: 1. indinavir sulfate 400 mg 2. tenofovir disoproxil fumarate 300 mg qd 3. ritonavir 100 mg 4. lamivudine 150 mg discharge medications: 1. amitriptyline 50 mg tablet sig: two (2) tablet po hs (at bedtime). 2. atorvastatin calcium 20 mg tablet sig: one (1) tablet po daily (daily). 3. atenolol 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. clonazepam 1 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 5. gabapentin 400 mg capsule sig: two (2) capsule po bid (2 times a day). 6. fentanyl 25 mcg/hr patch 72hr sig: one (1) patch 72hr transdermal q72h (every 72 hours). disp:*10 patch 72hr(s)* refills:*2* 7. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). disp:*20 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: primary diagnones: 1. hypotension 2. altered mental status 3. diarrhea 4. arf 5. fever . secondary diagnoses: 1. htn 2. hepatitis c 3. hiv 4. h/o substance abuse discharge condition: good, patient feeling well with clear mental status. discharge instructions: to patient: you have been accepted at the bay cove clinic for an appointment tomorrow, . you will need to follow up with them thereafter according to their explicit instructions. follow up with dr with the next two weeks. you should return to the clinic or to the emergency department with acute changes in your health, including fever (>101f), chills, shortness of breath, confusion, or excess sleepiness. followup instructions: with dr. in days (), as well as with at bay cove (). procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified spinal tap incision of lung insertion of endotracheal tube diagnoses: tobacco use disorder acute kidney failure with lesion of tubular necrosis unspecified viral hepatitis c without hepatic coma opioid type dependence, unspecified alcohol abuse, unspecified human immunodeficiency virus [hiv] disease other shock without mention of trauma diarrhea systemic inflammatory response syndrome due to noninfectious process without acute organ dysfunction person awaiting admission to adequate facility elsewhere other alteration of consciousness 

Answer: The patient is high likely exposed to