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: fentanyl / compazine / dilaudid attending: chief complaint: altered mental status major surgical or invasive procedure: intubation history of present illness: history of present illness (adapted from med consult note by dr. and neurology note by dr. ): 64 f with hcv, initially admitted to with mental status changes and fever. per her husband, she was found speaking "gibberish" and groaning, not following commands. on the way to the hospital, they had stopped at a railroad crossing, at which time she tried to exit the vehicle, and needed to be restrained. . of note, she had presented to her pcp, . , at mass on with a herpetic-rash on the right side of her face and back. these were cultured and grew mssa, and treated with bactroban and keflex. . her review of systoms is otherwise negative. specifically, she has had no recent travel history, any hiking or any recent sick contacts or unusual exposures. according to the husband, the patient was fine about 1 week ago. . at , a head ct showed bilateral subarachnoid hemorrhages. in addition, her laboratory values were significant for a plt 62, hct 28, cr 1.6, and tbili 2.2. of note, in , her plt was 231 and hct 33. her creat in was 0.7. . of note, her labs also included a tox screen that was positive for benzos, amphetamines, and opiates. . she was transferred to the neurosurgery service here at the . here, she was loaded with dilantin, a r radial a-line placed, and ct imaging performed of her head and neck. this showed subarachnoid hemorrhages in her right frontal, left frontal, and left parietooccipital lobes. in addition, a 2-mm aneurysm from the supraclinoid internal carotid artery was visualized, as well as a subcentimeter lesion along the left parietotemporal lobe likely representing a meningioma. an lp was also performed, which showed 450 rbcs, 110 wbcs, with 81% polys and 14% bands. she was given vanco, ceftriaxone, ampicillin, and acyclovir. . her course here is also significant for finding of a cool, cyanotic right hand after placement of the right radial a-line. past medical history: hepatitis c, according to husband pt has been treated with an incomplete course of interferon in the past at unsuccessfully; he denies any h/o cirrhosis but he is a poor historian anemia (unclear baseline or etiology) fibromyalgia depression s/p tubal ligation s/p d&c s/p tonsillectomy social history: married, lives with husband; former er nurse, abruptly ended job, but never gave an explanation to husband or family; no etoh; h/o ivdu family history: noncontributory physical exam: on admission: vitals - tm 102.1, tc 98.1, bp 116/68, hr 113, rr 32, o2 sat 100%, wt 54.2 kg ac 450x20/0.4/5.0 general - intubated and sedated heent - sclera anicteric, perrl, c-collar in place cv - tachy, but regular; syst mur best heard at apex chest - course ventilated breath sounds, but grossly ctab abd - no stigmata of chronic liver diseasea; nabs, soft, nt/nd, no g/r; no hepatosplenomegaly; r femoral a-line c/d/i ext - no edema; r hand, and bilat l>r feet cool and cyanotic appearing skin - no patechia; ? & oslers lesions on l hand pertinent results: ap chest () - the tip of an endotracheal tube projects approximately 2.9 cm above the carina. the proximal sideport of a nasogastric tube is below the diaphragm though the tip courses below the confines of the radiograph. the cardiomediastinal silhouette is unremarkable, and the lungs are grossly clear without evidence of overt edema. there is no evidence of pleural effusion or pneumothorax. . cta head/neck (): several foci of subarachnoid hemorrhage in the right frontal, left frontal, left parietooccipital lobes are noted. there is minimal associated edema without evidence of mass effect or infarction. a 5-mm extra-axial lesion (2, 18) along the left parietotemporal lobe may represent a meningioma. the carotid and vertebral arteries and their major branches are patent with no evidence of stenosis. there is a 2-mm aneurysm in the posterior margin of the supraclinoid internal carotid artery. . ct head (): new 4 mm hemorrhage within the left posterior thalamic region. in conjunction with evidence of one and possibly two infarcts within the left parietal lobe region, as well as the rather posteriorly situated area of subarachnoid blood, it seems unlikely that the left supraclinoid internal carotid artery aneurysm is cause for any of the hemorrhagic or ischemic lesions seen. trauma could certainly account for the subarachnoid hemorrhage but would seem less likely as a cause of the thalamic hemorrhage. brief hospital course: 64 f with staph aureus bacteremia including endocarditis, pneumonia, and meningitis. . bacteremia/septic shock - gpc cultures growing from blood, urine, and sputum, with wbc in csf and vegetations on mitral valve. possibly stemming from recent mssa skin lesion. pt started on gentamycin, vancomycin and acyclovir, but was switched to nafcillin as cultures showed mssa. c/s id for appropriate antibiotic use. gave fluid bolluses to maintained bp, but eventulally ussed pressors to continue to support bp . respiratory failure - intubated in ed for airway protection respiratory alkalosis. morphine for comfort while intubated . endocarditis: pt with heart murmer and evidence for mitral regurg and vegitations seen on tte. clinical signs of septic emboli throught body. tee was performed to better define extent of disease, and cardiology and ct surtery were consulted. pt's family decided to not consider surgery in acute period, so daily ekg's were performed to monitor cardiac progress . ams: pt presented with ams and evidence of sah on ct scan. given endocarditis, septic emboli are likely cause, but many other possible causes. given elevated wbc on lp, could be encephalitis, and viral cultures are pending. thrombocytopenia not severe enough to cause hemorage. there was concern for domestic abuse, but pattern of injury does not suggest trauma, and other more likely causes. repeat head ct from shows no new hemorrhage. pt showed signs of flaicd paraysis. given ich nsgy and neuro recommended to trasnfuse platelets to goal of 70 and continue dilantin for seizure prophylaxis. we did not administer anticoagulants based on the concern for new or reoccurance of intracranial hemorrhage. . thrombocytopenia: given overal septic picture, likely from dic. baseline labs from with plt in 230s. schistocytes on smear reviewed overnight and an elevated ldh, along with mental status changes, fever, and renal failure raises concern for ttp; however, hct stable and normal haptoglobin. time course too rapid for hit. recent abx use for treatment of mssa skin lesion may be precipitant for itp. cool extremities also raises consideration of arterial thrombi. abdominal us showed no splenic enlargement, so sequestration is less likely. heme was consulted to hep determine origin and possible treatments. . acute renal failure: creat elevated from 0.7 last year; fena last night consistent with prerenal physiology. ttp also in the differential, as are arterial or septic thromboemboli. pt was hydrated based on cvp, but eventually pt becam anuric. . pt had thrombosis of r radial artery, and went to the or with vascular surgery for venous graft. post op the venous graft clotted as well due to the lack of anticoagulation due to ich. simutaneously extensive clot burden was extending in the legs and throughout the right arm. the option of amputation was discussed with the family, but was decided against given the poor prognosis. . hepatitis c: per husband, no known h/o cirrhosis. although she presented with elevated pt & ptt, only ptt is mildly elevated now. low albumin, elevated inr are suggestive of decreased functional capacity of the liver. this would also go along with a thrombocytopenia if there is splenomegaly from portal hypertension, and mental status changes. . dnr/dni; as pt's status worsened shown by renal failure, increasing respiratory failure, requirement of pressors, and significant clot burdern, the pt's husband decided the patient would have wanted to be dnr. this decision was discussed again with step son, mother, and additional family members. interventions such as pressors and intubation were continued, but no additional treatments such as amputation were given. pt eventually went in to sudden cardiac arrest, and acls was withheld in concordance with the patients dnr status. medications on admission: clonazepam 0.5 cymbalta 30 qd oxycodone 40 tid valium 5 prn tinazidine 4 qd discharge medications: none discharge disposition: expired discharge diagnosis: deceased discharge condition: deceased discharge instructions: deceased followup instructions: deceased md, procedure: 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 incision of vessel, upper limb vessels repair of blood vessel with tissue patch graft transfusion of platelets diagnoses: mitral valve disorders cirrhosis of liver without mention of alcohol chronic hepatitis c without mention of hepatic coma acute kidney failure, unspecified severe sepsis subarachnoid hemorrhage methicillin susceptible staphylococcus aureus septicemia septic shock methicillin susceptible pneumonia due to staphylococcus aureus acute and subacute bacterial endocarditis meningitis, unspecified arterial embolism and thrombosis of upper extremity 

Answer: The patient is high likely exposed to