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: no known allergies / adverse drug reactions attending: chief complaint: ventriculitis major surgical or invasive procedure: lumbar puncture x 2 intubation with central line in icu history of present illness: mr is a 65 year-old with pmh of a psoriasis who presented with encephalopathy and possible left occipital mass from and osh. mr symptoms initially started on with mild headache and fevers. per his wife he was not experiencing any changes in vision, nausea, vomiting, changes in his bowels or urine. he was walking and talking appropriately. he did not take any medications for these symptoms however, continued to have fevers up to 101.4. on when the symptoms persisted, they decided to go to the emergency room at an osh for further evaluation. with his symptoms of headache and persistent fevers, he was empirically started on antibiotics and a lumbar puncture was done done in the ed. this wbc 3930 (64% pmn) and was initially started on acyclovir, vancomycin, ceftriaxone, and ampicillin. he continued to have headache at the osh. on at 4 pm, he became very encephalopathic (reportedly confused, combative, disoriented). temp at that time was 39.1. wife stated this confusion came on quickly over the course of a few hours. the following morning a decision was made to transfer to for further management. initial ct showed hypodensity in the left periventricular occipital area consistent with edema and follow up head ct with contrast showed area of enhancement surrounded by edema. no shifting of midline structures or hemorrhage. past medical history: -insomnia -rotator cuff injury -knee surgery -psoriasis social history: 2 glasses of wine per night. no illicit drugs. no smoking. works as school teacher. currently teaching and . lives with wife. have multiple animals: (dog, cat, 2 alpacas, and chickens). family history: significant for dementia and lung cancer in father. physical exam: vitals: t:99.7 p:94 r: 22 bp:145/82 sao2:94% general: awake, noncooperative, agitated. . heent: nc/at, no scleral icterus noted, mmm, no lesions noted in oropharynx (or tooth abscess) neck: supple, has nuchal rigidity pulmonary: lungs cta bilaterally without r/r/w cardiac: rrr, nl. s1s2, no m/r/g noted abdomen: soft, nt/nd, no masses or organomegaly noted. extremities: warm and well perfused skin:blanching rash on left torso, umbilicus, and bilateral chins neurologic: -mental status: drowsy requiring recurrent stimulation, not oriented to oriented person, place or date. follows simple commands. no appendicular commands. inattentive. language is fluent. speech mildly dysarthric. -cranial nerves: i: olfaction not tested. ii: perrl 3 to 2mm and brisk. appears to blink to threat bl but is inconsistent. unable to visualize secondary posterior eye with fundoscopic exam secondary to movement and agitation iii, iv, vi: eomi without nystagmus. normal saccades. v: facial sensation intact to light touch. vii: no facial droop, facial musculature symmetric. viii: hearing intact to voice. ix, x: palate elevates symmetrically : 5/5 strength in trapezii and scm bilaterally. xii: tongue protrudes in midline. -motor: normal bulk, tone throughout. no adventitious movements, such as tremor, noted. no asterixis noted. moving all extremities against gravity and with resistance in upper and lower extremities bilaterally. unable to test individual muscle groups secondary to patient noncooperation. -sensory: withdraws to noxious in all 4 extremities. -dtrs: tri pat ach l 2 2 2 2 2 r 2 2 2 2 2 plantar response was extensor bilaterally. -coordination: no intention tremor or abnormal movements. -gait: unable to assess. pertinent results: 09:20pm glucose-161* urea n-20 creat-1.0 sodium-139 potassium-3.0* chloride-104 total co2-24 anion gap-14 09:20pm estgfr-using this 09:20pm alt(sgpt)-25 ast(sgot)-32 ld(ldh)-242 ck(cpk)-242 alk phos-35* tot bili-0.5 09:20pm ck-mb-2 09:20pm albumin-3.2* calcium-7.4* phosphate-4.3 magnesium-2.3 09:20pm wbc-8.7 rbc-3.49* hgb-10.8* hct-30.3* mcv-87 mch-31.0 mchc-35.7* rdw-12.9 09:20pm plt count-241 09:20pm pt-14.3* ptt-22.6 inr(pt)-1.2* 09:20pm urine color-straw appear-clear sp -1.007 09:20pm urine blood-mod nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.0 leuk-neg 09:20pm urine rbc-* wbc-0-2 bacteria-occ yeast-none epi-0-2 08:01pm type-art po2-274* pco2-37 ph-7.46* total co2-27 base xs-3 brief hospital course: mr is a 65 year-old with pmh of a psoriasis who initially presented with encephalopathy and possible left occipital mass from and osh. mr symptoms initially started on with mild headache and fevers. per his wife he was not experiencing any changes in vision, nausea, vomiting, changes in his bowels or urine. he was walking and talking appropriately. he did not take any medications for these symptoms however, continued to have fevers up to 101.4. on when the symptoms persisted, they decided to go to the emergency room at an osh for further evaluation. with his symptoms of headache and persistent fevers, he was empirically started on antibiotics and a lumbar puncture was done done in the ed. we believe that the abx were started before the lp by records. this wbc 3930 (64% pmn) and was initially started on acyclovir, vancomycin, ceftriaxone, and ampicillin. he continued to have headache at the osh. on at 4 pm, he became very encephalopathic (reportedly confused, combative, disoriented). temp at that time was 39.1. wife stated this confusion came on quickly over the course of a few hours. the following morning a decision was made to transfer to for further management. initial ct showed hypodensity in the left periventricular occipital area consistent with edema and follow up head ct with contrast showed area of enhancement surrounded by edema. no shifting of midline structures or hemorrhage. . he was admitted to the neuro - icu and had a neuro exam significant for neck stiffness, disorientation, and inattentiveness. on an mr likely pyogenic ventriculitis, centered in occipital of l lat ventricle. id was consulted and patient was started on flagyl for additional anaerobe coverage for possible abscess. thought being this was likely a bacterial brain abscess that broke into ventricle causing ventriculitis, which has not grown organisms due to antibiotics before lp (osh csf cultures final and negative) or due to bacteria not easily seen on gram stain/cx like listeria. most csf viral pcrs negative. pt with continued fevers on day 6 of abx raises question of other process. areas of concern are gallbladder (ct torso showed gallbladder inflammation and alt), pancreas (some pancreatic inflammation on ct torso but lipase normal), drug fever (normal differential; rash present since admission here), and c diff (pt with diarrhea with 2 toxins negative). on a tee was done which did not show evidence of endocarditis. ef >55%, trivial mr/tr. unfortunately no bubble study was done to look for asd and a tte was reordered with bubble. he was extubated on and has had continued improvement in his orientation and mental status. low grade fevers continued. . the patient was transferred to the floor on . . neuro: the patient remained neurologically stable throughout course on the floor. no focal changes were noted. patient was monitored for signs of hydrocephalus which did not develop. . repeat mri on "mild interval improvement of flair signal changes in the left peritrigonal white matter and residual enhancement in the posterior of left lateral ventricle and medullary cisterns. no new abnormality." head ct showed "1. no evidence of acute intracranial hemorrhage. 2. in comparison to , exam, the ventricles appear increased in size, which may be reflective of communicating hydrocephalus. 3. confluent hypodensity surrounding the occipital of the left lateral ventricle, at the site of ventriculitis. . id: patient maintained on iv ceftriaxone, metronidazole, vancomycin and ampicillin upon transfer to the floor. blood cultures all negative for growth. wbc count was not elevated. hiv ab returned negative. b glucan, aspergillus, csf studies for vzv, cmv, hsv, hhv-6, and ebv all returned negative. . tagged wbc scan was performed on , demonstrating: no occult infectious source found. . at time of discharge, he was on iv ceftriaxone and metronidazole with picc placement. . renal: patient was noted to be hypokalemic during micu course and again on the floor with lowest value of 2.7 on . hypokalemia most likely due to gittelmans vs bartter syndrome in context of no diarrhea, no fevers, lack of diuretic use. blood pressures in the 120s-150s/70s-90s. he was put on a sliding scale for repletion in the micu which was stopped upon transfer to the floor. when hypokalemia occured again, he was repleted with 40meq k+ tid as needed. amiloride was initiated and potassium levels were followed in both serum and urine levels were checked. renin and aldosterone levels were ordered, pending reults at time of discharge. the renal team was consulted and will follow up with the patient in clinic on . . gi: patient was monitored for c diff colitis with all stool tests returning negative. he had one guaiac positive stool on . in context of normal hematocrit and platelets levels, no acute process was suspected. patient advised to follow-up as outpatient for further work-up. medications on admission: -trazadone discharge medications: 1. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 2. amiloride 5 mg tablet sig: one (1) tablet po daily (daily). 3. ceftriaxone in dextrose,iso-os 2 gram/50 ml piggyback sig: one (1) intravenous q12h (every 12 hours). 4. metronidazole in nacl (iso-os) 500 mg/100 ml piggyback sig: one (1) intravenous q8h (every 8 hours). discharge disposition: extended care facility: st. hospital rehabilitation unit discharge diagnosis: ventriculitis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). neuro exam: at baseline (known left esotropia) discharge instructions: you were admitted for decreased responsiveness in the setting of what was found to be a ventriculitis. this means there was inflammatory material in one of the fluid-filled spaces within your brain. from mri it appeared there may have been an abscess that ruptured into ventricle. all of our cultures, both from your csf and blood remained negative. you improved significantly over the course of your hospitilization on multiple antibiotics. it was also noted that you had low levels of potassium in your blood and it was felt this was likely due to losses of potassium from your kidneys (bartter's or gitelman's syndromes). to help maintain your potassium levels you were started on a medication called amiloride. you will need a prolonged course of iv antibiotics to treat your ventriculitis and will be on ceftriaxone and flagyl until . followup instructions: call dr. office at for neurology follow-up. infectious disease: provider: , md phone: date/time: 9:50 infectious disease: provider: , md phone: date/time: 11:00 nephrology: provider: , md phone: date/time: 3:30 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more spinal tap incision of lung diagnostic ultrasound of heart insertion of endotracheal tube enteral infusion of concentrated nutritional substances arterial catheterization closed [endoscopic] biopsy of bronchus central venous catheter placement with guidance diagnoses: cerebral edema other encephalopathy other psoriasis intracranial abscess meningitis due to unspecified bacterium 

Answer: The patient is high likely exposed to