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: codeine / codeine anhydrous / ambien attending: chief complaint: code stroke/altered mental status major surgical or invasive procedure: mri eeg history of present illness: the pt is a 67 year-old gentleman who presented with alteration in mental status. the pt was unable to offer a history at the time of my encounter. therefore, the following history is per the primary team, ems and the medical record. per ems, the pt was last seen well by his wife at 1am before going to bed last night (i.e. 8 hours prior to presentation). this morning at approximately 8am, his wife found him in bed not responding to her and "thrashing around." she called ems. on their arrival, they found the pt to be unresponsive with eyes deviated to the right and "pinpoint". given history of diabetes mellitus, fingersticks were performed and were 84 and 106. he was given 2mg of iv ativan without effect. he was subsequently brought to the ed for further evaluation. at the time of my initial encounter, the pt was in the midst of intubation. therefore, a detailed nihss could not be performed (see brief examination below). he was subsequently sedated and paralyzed, unfortunately further obscuring the examination. the pt was unable to offer a review of systems. past medical history: - hypertension - diabetes mellitus, on insulin (insulin regimen nph 40 q am + ss) with hga1c 5. - chronic renal failure (baseline creatinine 1.7 - 3.1) - peripheral neuropathy - glaucoma - hepatitis b: sag neg, sab+, cab+ - hepatitis c: hcv vl 86k , genotype ib - anemia - baseline hct 26-32 - h/o chest pain, no cad on angiography - substance abuse (none since ') - h/o osteomyelitis - h/o back pain - legally blind - h/o ppd conversion - erectile dysfunction - h/o mva with extensive injuries requiring skin graft social history: social history is significant for the absence of current tobacco use (quit in , 2 packs/week for ~50 yrs). there is no h/o of alcohol abuse. no ivdu, although crack abuse till 's. patient is married with 3 children, lives with wife. retired . family history: no cad in family; h/o cancer physical exam: vitals: t: 98.5f p: 80 r: 16 bp: 253/140 sao2: 98% general: lying in bed with eyes closed, intubated. heent: nc/at, mmm neck: no carotid bruits appreciated. no nuchal rigidity pulmonary: lungs with transmitted sounds bilaterally cardiac: rrr, nl. s1s2, no m/r/g noted abdomen: soft, nt/nd, normoactive bowel sounds extremities: no c/c/e bilaterally, 2+ radial, dp pulses bilaterally. skin: no rashes noted, multiple healed scars over abdomen and legs. neurologic (initial examination just prior to intubation and sedation): -mental status: does not open eyes to verbal or noxious stimuli. no verbal output. does not follow commands. -cranial nerves: perrl 1.5 to 1mm and briskly reactive. eyes were initially deviated to the right, on reexamination approximately 10 minutes later, eomi to oculocephalic maneuver. corneal reflex and nasal tickle present bilaterally. no overt facial asymmetry. gag reflex intact. -motor: normal bulk throughout. could not assess tone. was seen to move all extremities antigravity in a semi-purposeful manner during line placement before he was chemically paralyzed. no overt adventitious movements were noted. -sensory: could not assess prior to intubation, sedation and administration of paralytics. -dtrs: could not assess prior to intubation, sedation and administration of paralytics. plantar response was mute bilaterally. pertinent results: 09:50am wbc-7.4 rbc-3.29* hgb-10.3* hct-32.9* mcv-100* mch-31.3 mchc-31.3 rdw-14.8 09:50am urine bnzodzpn-neg barbitrt-neg opiates-neg cocaine-neg amphetmn-neg mthdone-neg 09:50am ctropnt-<0.01 09:50am ck-mb-6 09:50am alt(sgpt)-44* ast(sgot)-76* ck(cpk)-134 alk phos-77 amylase-156* tot bili-0.3 11:57am phenytoin-15.6 brief hospital course: neurologic: patient was initially admitted to the neuro-intensive care unit for close observation. considerations for patient's etiology of mental status change were multiple and included seizure, hypertensive encephalopathy, metabolic, infectious, toxic, medication/substance withdrawl, stroke. a head ct scan did not demonstrate evidence of bleed or evolving infarct. mri was negative for infarct but showed extensive small vessel disease presumably from poorly controlled hypertension. as seizure was high on the differential patient had bedside eeg monitoring which showed moderate enceohpalopathy on and . on a 15 second seizure was witnessed and captured with eeg showing no epileptiform acitivity and relatively normal background. in the emergency room he received 1.5 grams of iv phenytoin (in addition to total of 4mg iv lorazepam) in ed, and was continued on dilantin 100/100/130, then increased to 100/100/230. lfts were slightly elevated on , but normal on and again very mildly elevated . ammonia level was withing normal limits and then repeated for continued encephalopathy but continued to be normal . tsh was normal. csf studies were sent to r/o cns infection and patient had normal results with no growth and negative hsv pcr. a second set of mri/cts was obtained to make sure that patient had not developed any interval neurological process that could be affecting his mental status, and these studies were normal. the pateint's delerium began to clear some after he was placed in a windowside bed and forced into a more regular day/night sleep schedule with daytime stimulation. cardiac wise he was followed on telemetry. no arythmia noted. hypertension was previously poorly controlled at home on lisinopril, catapress, amlodipine and hydralazine. lisinopril was increased from 20 to 40, amlodipine continued at 10 daily, hydralazine continued at 75 q6hrs, catapress increased from 1 to 3. lopressor was started and eventually titrated up to 150mg tid. cardiac enzymes were negative at admission. pulmonary: patient self-extubated and tolerated well. endocrine: patient's home doses of nph insulin initially held as he was intubated and not receiving nutrition. was maintained on a regular insulin sliding scale. when tube feeds started, he had home dose of nph (24 qam, 20 qpm) restarted. nph titrated up as patient's blood sugars continued to be elevated. consult called and patient was started on lantus 15 with humalogue sliding scale. renal: has history of chronic renal insufficiency. creatinine was 2.3 on admission and corrected to baseline level of 1.8 within 24 hours. the patient was found to be retaining urine during the admission. he was catheterized. at discharge, he was being treated for a uti and foley was discharged. he will need a post-void residual checked after transfer to assure that he is not retaining urine. should he become aggitated or in pain, urinary retention needs to be ruled out. inectious disease: cxr was negative for pneumonia. ua was negative but urine cultures grew beta strep. was started on bactrim initially and then changed to clindamycin based on sensitivities. stool studies showed no cdiff. csf studies also sent and negative cultures and hsv pcr. he had one uti treated with ciprofolxacin and then a second uti developed before discharge. he was started on cipro and vanc to which the organisms were sensitive. gi: lfts slightly elevated , then normal . again mildly elevated with ast less elevated than prior but lipase again similarly elevated with no clear reason. patient's abnominal exam at this time normal with no tenderness and normal bowel sounds. patient had normal bowel movements and no diarrhea or tube feeding residuals, then passed swallow eval and started diabetic diet. fen: was hypernatremic so replenishing free water deficit of 3.4 l (plus insensible losses) with 100cc/hr of d51/2ns for total of 4 l prophyllactically received sc heparin, pneumoboots, ppi. medications on admission: (per recent discharge summary): 1. clonidine 0.2 mg/24 hr weekly 2. aspirin 81 mg po daily 3. omeprazole 20 mg po once a day. 4. lisinopril 20 mg po daily 5. amlodipine 10 mg po daily 6. insulin: nph insulin 24 units in the morning, 20 units qhs 7. atorvastatin 10 mg po daily 8. oxycodone-acetaminophen 5-325 mg po q6h as needed. 9. pilocarpine hcl 4% drops one drop ophthalmic q8h 10. dorzolamide-timolol 2-0.5 % one drop ophthalmic daily 11. latanoprost 0.005 % drops one drop ophthalmic hs 12. hydralazine 75 mg po q6h 13. isosorbide dinitrate 20 mg po tid discharge disposition: extended care facility: - discharge diagnosis: hypertensive encephalopathy. discharge condition: good. patient becoming more oriented daily. discharge instructions: follow up as below. do not drink or use drugs. take medications as directed. rehab: please note that the patient has history of urinary retention. please check a post-void residual tonight to assure that the patient is not retaining. if in the future, there is aggitation or pain, please consider that he may be retaining urine. please also place the patient in a window-adjacent bed. his delerium seems to improve significantly if he is forced into a regular wake/sleep schedule by daytime stimulation. followup instructions: after discharge from rehabiliation, please call your : : , m. to arrange neurologist: provider: , md phone: date/time: 11:30. , of building. provider: , m.d. phone: date/time: 2:30 procedure: venous catheterization, not elsewhere classified spinal tap incision of lung diagnoses: acidosis urinary tract infection, site not specified chronic hepatitis c without mention of hepatic coma diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified other convulsions chronic kidney disease, unspecified hypertensive encephalopathy chronic viral hepatitis b without mention of hepatic coma without mention of hepatitis delta legal blindness, as defined in u.s.a. 

Answer: The patient is high likely exposed to