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: ich major surgical or invasive procedure: lp ventricular drain placement intubation cvl placement arterial line placement history of present illness: this is a 62 year old man with a history of hypertension and smoking who presented to an outside hospital this morning complaining of severe headache and left sided weakness. he is currently intubated and sedated and the notes from the oh er are scant. i spoke with the staff at his homeless shelter () who say that he was well until this morning around 6am, when he was suddenly unable to move his left arm. they immediately called ems. he was brought to the oh ed: vitals were hr 68 bp230/119 rr 18 o2sat 100%. initial nihss=8 (left limb weakness, ataxia, dysarthria). head ct at 6:15am revealed a 2.2x2.1 cm hyperdensity within the right basal ganglia. per the ed notes, he was complaining of headache at 7:50am and given 2mg of dilaudid for pain. shortly thereafter, he became obtunded and was intubated for "neurologic deterioration". during intubation, he received fentanyl, versed and succ. over his course, he received an additional 10mg iv labetalol for elevated blood pressure. he was also given ativan 2mg x 7 (14mg total), versed 2mg x1 and dilantin 1g iv x1. prior to transfer, he was given a dose of vecuronium (about 40minutes ago) and versed. in our ed, he received another 4mg of versed (trying to pull out ett with right hand). past medical history: htn hepatitis c, untreated etoh abuse h/o cocaine use social history: living in a homeless shelter since . he has some family in the area and a girlfriend who is very close to him. etoh use. h/o cocaine, unsure if he has been using lately. family history: unknown physical exam: bp-138/83 hr-60 rr-16 o2sat-98 gen: lying in bed, intubated, sedated heent: nc/at, ett and ogt in place neck: no tenderness to palpation, normal rom, supple, no carotid or vertebral bruit cv: rrr, distant s1 and s2, no murmurs/gallops/rubs lung: clear to auscultation bilaterally abd: +bs soft, nontender ext: no edema neurologic examination: mental status: intubated and sedated, eyes closed. unresponsive to verbal or tactile stimulation. +grimace with vigorous sternal rub (no eye opening). cranial nerves: pupils pinpoint bilaterally. no blink to threat. absent vor. absent corneals, no response to nasal tickle. +gag motor: normal bulk bilaterally. increased in the left leg. withdraws right arm and leg to noxious stim. triple flexion of left leg and internal rotation of left arm to noxious stimulation. sensation: withdrawal as above reflexes: more brisk on left, +2 on right toes upgoing bilaterally coordination/gait: unable to assess pertinent results: 11:08am blood wbc-5.4 rbc-4.58* hgb-14.4 hct-41.8 mcv-91 mch-31.4 mchc-34.3 rdw-14.3 plt ct-184 11:42am blood pt-12.9 inr(pt)-1.1 11:08am blood glucose-140* urean-13 creat-0.9 na-141 k-4.3 cl-105 hco3-25 angap-15 11:08am blood alt-28 ast-37 ck(cpk)-295* alkphos-72 amylase-37 totbili-0.3 02:22pm blood ck(cpk)-256* 10:13am blood ck(cpk)-158 11:08am blood ck-mb-5 ctropnt-<0.01 02:22pm blood ctropnt-<0.01 10:13am blood ck-mb-2 ctropnt-<0.01 11:08am blood albumin-3.8 calcium-8.3* phos-2.6* mg-1.8 11:08am blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 05:25pm urine color-yellow appear-clear sp -1.025 05:25pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-1 ph-5.0 leuks-neg 03:51pm urine rbc-0-2 wbc-0-2 bacteri-none yeast-none epi-<1 11:08am urine bnzodzp-pos barbitr-neg opiates-pos cocaine-neg amphetm-neg mthdone-neg 11:38pm cerebrospinal fluid (csf) wbc-311 rbc-* polys-88 lymphs-8 monos-4 11:38pm cerebrospinal fluid (csf) totprot-79* glucose-57 ---- sputum cx : haemophilus influenzae, beta-lactamase negative. moderate growth. beta-lactamse negative: presumptively sensitive to ampicillin. confirmation should be requested in cases of treatment failure in life-threatening infections.. streptococcus pneumoniae. rare growth. presumptive resistance not confirmed by mic. refer to mic results. sensitivities: mic expressed in mcg/ml _________________________________________________________ streptococcus pneumoniae | ceftriaxone-----------<=0.06 s erythromycin----------<=0.06 s levofloxacin---------- 1 s penicillin------------<=0.06 s tetracycline---------- <=1 s trimethoprim/sulfa---- <=0.5 s vancomycin------------ <=1 s brief hospital course: 62 year old with hx of htn and smoking who presented to osh with left sided weakness and headache, found to have a large, right-sided ich centered in the thalamus. his exam was limited by sedation for much of his early stay, but he consistently had little to no movement on his left side, but would follow commands on the right. the etiology of the bleed, given the location, is likely to be poorly controlled hypertension. 1.neuro: the pt was admitted to the icu and kept on close neurochecks given the spread of his hemorrhage into all ventricles and the concern that he may develop hydrocephalus. a ct scan here showed progression from the outside scan, and despite normal coags, he was given factor 7 as it was not known whether his bleeding continued. his bp was controlled aggressively to keep his sbp<150. he had serial ct scans which showed stability. out of concern that he may develop hydrocephalus given clotted blood in the 4th ventricle, an evd was placed and tpa was introduced into the ventricles. this resulted in clearance of blood from the 3rd and 4th ventricles. his icp remained in the 7-10 range with the drain and when clamped, it stabilized out at ~14. the drain was removed. the patient was kept sedated as he became very agitated when off sedation and his bp would rise above goal ranges. when weaned, he consistently followed commands on the right side but not the left. his pupils were pinpoint and difficult to assess throughout. on transfer to the floor, the patient's alertness improved, as did his attention to the left side of space and awareness of his weakness. the patient requires further titration of his captopril up - current dose is 37.5mg tid, for goal sbp<140. 2.id: the patient was spiking fevers since admission and this seemed to worsen over time, with spikes to the 103 range at times. his wbc ct went to 14, but then resolved over several days on antibiotics. multiple sets of blood cultures were negative. multiple uas and urine cultures were also negative. he had a sputum sent which grew haemophilus and strep pneumoniae. he also had a cxr which showed lll hazy opacity. he was put on vancomycin, levofloxacin, and flagyl. this was narrowed to levofloxacin when the sensitivities returned. he continued to be intermittently febrile. csf was sent from his ventricular drain which had a negative gs and 300 wbcs(but with 200k rbcs, so the ratio is appropriate for normal blood). however, as the fevers continued, he was expanded back to vancomycin and ceftazidime. he has evidence of sinus disease on multiple cts. ent looked at the scan and did not feel that this could account for his fevers. id was consulted and suggested repeating the csf analysis. this was done and showed meningitis; fevers resolved on antibiotics and the external ventricular drain was removed. he requires further antibiotic treatment until . 3.cv: as above, he had significant hypertension with agitation. he was started on metoprolol and lisinopril, with prn hydralazine being used. hydralazine will be titrated down, since lisinopril was switched to captopril. when sufficient bp control is achieved, hydralazine should be d/c'd, with further increase in captopril if necessary. 4.pulm: he was stable from a respiratory standpoint throughout. on , an incidental r pulmonary nodule was found. on , however, chest ct showed no r nodule, but did show severe emphysema, chronic lll inflammatory changes and a lll nodule. these lung changes were clinically silent and repeat ct was recommended in 3mo's for follow up. 5.he was put on tube feeds and tolerated these well throughout. on transfer from the icu, he tolerated ground food well. medications on admission: cardizem(not taking) discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection (2 times a day). 2. acetaminophen 325 mg tablet sig: two (2) tablet po q4-6h (every 4 to 6 hours) as needed. 3. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 4. therapeutic multivitamin liquid sig: one (1) cap po daily (daily). 5. metoprolol tartrate 25 mg tablet sig: three (3) tablet po tid (3 times a day). 6. sodium chloride 1 g tablet sig: one (1) tablet po bid (2 times a day) as needed for hyponatremia. 7. nicotine 14 mg/24 hr patch 24hr sig: one (1) patch 24hr transdermal daily (daily). 8. lansoprazole 30 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 9. docusate sodium 150 mg/15 ml liquid sig: one (1) po bid (2 times a day). 10. captopril 12.5 mg tablet sig: three (3) tablet po tid (3 times a day). 11. ceftazidime-dextrose (iso-osm) 2 g/50 ml piggyback sig: one (1) intravenous q8h (every 8 hours). 12. thiamine hcl 100 mg/ml solution sig: one (1) injection daily (daily). 13. hydralazine 20 mg/ml solution sig: one (1) 5mg injection q8h (every 8 hours). 14. vancomycin 500 mg recon soln sig: recon solns intravenous q 12h (every 12 hours): 750mg iv q12. end after . discharge disposition: extended care facility: rehab discharge diagnosis: htn etoh hcv smoking cocaine use intracerebral hemorrhage in right basal ganglia/caudate bacterial meningitis discharge condition: improved discharge instructions: please continue to take all meds. followup instructions: - repeat chest ct with iv contrast in 3mo to follow lll pulmonary noduleprovider: provider: . / phone: date/time: 4:30 md, procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more spinal tap incision of lung enteral infusion of concentrated nutritional substances injection or infusion of thrombolytic agent arterial catheterization ventricular shunt to extracranial site nec diagnoses: tobacco use disorder unspecified essential hypertension chronic hepatitis c without mention of hepatic coma intracerebral hemorrhage other emphysema meningitis due to unspecified bacterium 

Answer: The patient is high likely exposed to