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: keflex attending: chief complaint: mental status change major surgical or invasive procedure: central line placement history of present illness: 71 year-old man with baseline dementia presented on at 9:20pm with fever to 103.9, lethargy, and mental status changes per nh staff. of note, the patient was recently treated for a pna with z-pack x4 days at his nursing home. in the ed, cxr showed ?rll infiltrate and he received levo/flagyl/vanco. he subsequently became hypotensive (80's/40's), lactate 2.9. multiple urgent sepsis treatment (must) protocol was initiated, and he received 4 u ffp (inr 3.5), central line placement, and 3l ns before transfer to micu for further mgmt. lp was attempted x 3 without success. while in the micu, he was covered empirically with bactrim for presumed meningitis, vanco/levo for possible pneumonia. sbp stabilized at 110-120 following hydration. he was subsequently transferred to the general medical floor for further management. at time of transfer to the general medical floor, he was intermittently answering simple questions and denied shortness of breath, chest pain, abdominal pain, nausea, vomiting, or headache. past medical history: - dementia with delusions - oa - pvd - r hip avascular necrosis - seizure disorder - h/o dvt - ?bone cancer: diagnosis is unclear social history: lives in . is dependent with feeding and all adls and is bedbound. family history: noncontributory physical exam: vitals: tc 100.4, tm 100.6, pc 77, pr 73-82, bpc 124/58, bpr 90s-120s 30s-50s, resp 30, resp 20-40, o2 sat 97% 3l nc i/o 10 hrs: 1340/550 general: elderly, chronically-ill appearing male, alert, oriented to person and "hospital," tachypnic heent: perrl, anicteric, dry mucus membranes. stiff neck, although unclear how much of this is volitional/contractures. no lad, no jvd. pulm: scaterred wheezes l>r, occasional ronchi, decreased ls at bases bilaterally cardiac: rrr, soft s1/s2, no m/r/g appreciated abdomen: moderately distended, soft, nt, no masses, nabs extremities: le edema, l (2+) >r (1+) to mid calf, warm with palpable dp pulses bilaterally. upper extremities contracted bilaterally. neuro: able to squeeze hands and wiggle toes bilaterally. 1+ dtr upper extremities and lower extremities bilaterally. pertinent results: labs on admission: urine blood-lg nitrite-neg protein-30 glucose-neg ketone-150 bilirubin-neg urobilngn-neg ph-6.5 leuk-tr urine rbc->50 wbc-0-2 bacteria-many yeast-none epi-0-2 abg po2-86 pco2-39 ph-7.40 total co2-25 base xs-0 glucose-97 urea n-17 creat-0.5 sodium-141 potassium-3.1* chloride-108 total co2-26 phenobarb-17.1 phenytoin-12.2 wbc-11.3* rbc-3.40* hgb-10.5* hct-30.8* mcv-90 mch-31.0 mchc-34.3 rdw-12.8 neuts-84.6* lymphs-10.4* monos-4.3 eos-0.5 basos-0.2 plt count-334 radiology: cxr: low lung volumes, no congestive heart failure, no new infiltrates head ct: no ich; previous seen abnormality represented artifact kub: no free air, stool/gas in rectum. chronic deformities of the right hip joint and left acetabulum. osteopenia. cxr: low lung volumes, multiple healing left rib fractures . ekg: nsr @ 88, nl axis, twi in iii, no st changes. brief hospital course: assessment and plan: 71 year-old man with baseline dementia, seizure disorder, presents from nursing home with fever to 103.9, lethargy, and change in mental status. 1) hypoxia: the etiology of the patient's hypoxia is unclea,r as there is no clear evidence of pneumonia/chf on cxr, although he is a clear aspiration risk. abg 7.46/33/65 on 4l nc, consistent with a respiratory alkalosis (possibly central) and non-ag metabolic acidosis (in the setting of recent ns volume resuscitation). the patient was continued on albuterol/atrovent nebs and flovent. he will be treated with a 14 day course of levofloxacin/metronidazole for presumed aspiration pneumonia. 2) leukocytosis/fever: on admission, the patient had a fever and leukocytosis. the source of infection was unclear, given no clear infiltrate on cxr (although certainly an aspiration risk), negative influenza dfa, negative urine cultures, and blood cultures with ngtd. given fever, mental status change, there was concern for meningitis. given that an lp could not be obtained in the emergency department on admission, he was treated with an empiric 7 day course of bactrim/vancomycin for possible meningitis (to cover typical organisms and listeria). the patient developed an erythematous rash over his upper extremities and neck on , which was believed to possibly be secondary to bactrim. however, given his allergy to cephalosporins and limited meningitis treatment options, he was treated with h2 blockers and topical steroids, and was able to complete the bactrim course without further complications. as mentioned above, he will complete a 14 day course of metronidazole/levofloxacin for presumed aspiration pneumonia. 4) change in mental status: initial change in ms likely in the setting of infection (see above). there was no evidence of seizure activity, and he was continued on his home dose of dilantin/phenytoin. tsh and vitamin b12 levels were normal. at time of discharge, the patient was at his baseline mental status. 5) nutrition/goals of care: mr. failed multiple speech and swallow evaluations during the course of his hospital stay. initially, a nasogastric tube was placed for tube feeding. following discussion with the patient's guardian , it was decided that the patient would not have a peg tube placed, given his poor long-term prognosis, poor baseline functional status, and desire to keep him as comfortable as possible. he will be given assistance with eating what he wants, and his guardian accepts the risk of aspiration/clinical deterioration. he will complete his 14 day course of antibiotics, but the remainder of his meds will be limited to those needed for his comfort. he is being discharged to his nursing home with plan to transition to hospice care. medications on admission: coumadin 3.5 mg po qod furosemide 40 mg po daily dilantin 200 mg po daily phenobarbitol 90 mg po daily actinel 35 mg po qweek seroquel 12.5 mg po bid, 25 mg po qhs colace/dulcolax/enemas prn azithromycin (started ) tylenol 500 mg po bid vitamin c 500 mg po bid oscal 500 + d tid vicodin prn discharge medications: 1. albuterol sulfate 0.083 % solution sig: one (1) neb inhalation q6h (every 6 hours). 2. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours). 3. albuterol sulfate 0.083 % solution sig: one (1) neb inhalation q4h (every 4 hours) as needed. 4. phenytoin 50 mg tablet, chewable sig: four (4) tablet, chewable po daily (daily). 5. phenobarbital 30 mg tablet sig: three (3) tablet po qam (once a day (in the morning)). 6. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 7. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 7 days. 8. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 7 days. discharge disposition: extended care facility: roscommon discharge diagnosis: primary: systemic inflammatory response syndrome secondary: aspiration pneumonia, seizure disorder, dementia, peripheral vascular disease, history of deep vein thrombosis, osteopenia discharge condition: patient is currently stable. discharge instructions: comfort-oriented care followup instructions: please follow-up with dr. () as needed. procedure: venous catheterization, not elsewhere classified spinal tap incision of lung transfusion of other serum diagnoses: unspecified septicemia other convulsions peripheral vascular disease, unspecified sepsis other persistent mental disorders due to conditions classified elsewhere pneumonitis due to inhalation of food or vomitus alkalosis dermatitis due to drugs and medicines taken internally disorder of bone and cartilage, unspecified pressure ulcer, ankle sulfonamides causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to