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: phenobarbital attending: chief complaint: 46-y.o. male presented s/p unwitnessed fall off bicycle with mental status changes of unclear aetiology. major surgical or invasive procedure: none history of present illness: mr. is a 44 year old man with a history of childhood encephalitis and associated seizures who had a helmeted bike accident on sunday morning (). his accident resulted in grade 1 ac-joint separation, diastasis of the left frontal zygomatic suture with tiny associated fracture, and loss of consciousness for an unknown period of time. he was in a bicycle road race riding approx 25 mph when he crashed his bike. he was not riding with anyone at the time; he had fallen behind a pack of cyclists and was trying to catch up. he had changed his tires prior to the race and had not broken them in. the last thing he remembers is going down a . he speculates that he might have seen something that caused him to slam on his brakes. his girlfriend reports that the damage to the bike only includes bent handlebars and a damaged left pedal with no serious damage to the wheels or frame. ems found him with decreased responsiveness and took him to shortly after the accident. upon arrival his pupils were equal and reactive. he was oriented to name and place but not date. he was not initially agitated, but became acutely agitated in the ct scanner, became physically aggressive, and was unable to be verbally or physicially restrained. ativan 2 mg iv was given without success. he was intubated and sedated with etomidate and succinylcholine to obtain ct scans and x-rays. he was transferred here on monday morning () for further evaluation for his "confusion and head injury." past medical history: - encephalitis (equine encephalitis per pt's girlfriend) at age 12. he had seizures of unknown type during the encephalitis. he was treated with phenobarbital which caused a paradoxical reaction of agitation and aggression. per girlfriend, he had residual seizures "off and on" for a little while after encephalitis. it is unknown the type of seizures or how long the residual seizures continued after the encephalitis. girlfriend reported that she did not notice any convulsions or staring spells in the 22 years that she has known him. he is not on any antiepileptic medications and is not being followed by a neurologist. - migraines associated with vision changes, nausea, vomiting, slurred speech, photophobia, phonophobia. last approx hours and occur 1-2 times a year. not followed by neurologist, not taking any prescription medications for migraines. social history: mr. works as a technical writer and is a triathlete. he lives with his girlfriend , whom he has known for 22 years. they have been together 1 year. he has been divorced twice, with two children (one from each marriage). he and had been together for 4-5 years prior to his two marriages. no etoh, smoking, illicit drug use. family history: father( sr, ) has had seizures all of his life. seizures are not well controlled on medications and he is considering surgery. no other known seizure history in the family. physical exam: t 98.3 (99.5 max) bp 103/51 hr 56 sleeping/81 awake rr 15 02sat 97% on ra general: sleeping in bed. neck brace removed. heent: small bruise noted over his left forehead. mental status: general: he was lethargic but arousable. he often fell back asleep during questioning. when he was awake, he was inattentive but easily redirected. he was oriented to his name and to place ("hospital"), but not to the date or specific hospital. he had some inappropriate giddiness and apathy to questioning. when he was awake he also had motor restlessness; he pulled off his ekg leads one by one and frequently moved his legs back and forth along the bed. language: he was able to follow basic commands. he answered questions appropriately, but slowly and with vague answers. no dysarthria or paraphasic errors. prososdy was normal. no left-right confusion. no evidence of apraxia or neglect. memory: he does not remember his bike fall. he was unable to report the bike route that he took the morning of his bike accident ("i was just riding out and about"). when he was asked when he last completed a triathalon, he replied "ages ago." cn: mild anisocoria (l pupil > r pupil), both reactive to light. no ptosis noted. no anhidrosis noted. eomi. no facial droop noted. some assymetry of the right mouth due to old childhood scar. palate elevated midline, tongue protruded midline. motor: no tremor, myoclonus, or other adventitious movements. normal bulk. normal tone. no pronator drift. strength was full throughout. no nuchal rigidity. sensation: light touch, temperature, proprioception, and vibration sense intact in all four limbs. coordination: no dysmetria or tremor on fnf. no dysdiadochokinesia. fine finger movements intact. dtrs: unable to elicit reflexes in the biceps and brachioradialis bilaterally, 1+ and symmetrical in the patella and ankle. left toes downgoing, right toes upgoing. abnormal lab values: ck 459 iu/l (troponin <0.01, ck-mb 5) phosphate 2.2 mg/dl hct: 37.5% pertinent results: 11:00am fibrinoge-211 11:00am pt-12.2 ptt-18.5* inr(pt)-1.0 11:00am plt count-198 11:00am wbc-13.3* rbc-4.70 hgb-14.9 hct-41.8 mcv-89 mch-31.6 mchc-35.5* rdw-13.8 11:00am asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 11:00am lipase-42 11:00am urea n-15 creat-1.1 11:09am glucose-144* lactate-2.3* na+-144 k+-4.3 cl--106 tco2-27 11:40am urine wbcclump-rare mucous-rare 11:40am urine granular-<1 hyaline-<1 11:40am urine rbc-0-2 wbc-0-2 bacteria-few yeast-none epi-0-2 trans epi-<1 11:40am urine blood-neg nitrite-neg protein-tr glucose-neg ketone-15 bilirubin-sm urobilngn-1 ph-6.5 leuk-neg 11:40am urine color-yellow appear-clear sp -1.024 11:40am urine bnzodzpn-neg barbitrt-neg opiates-neg cocaine-neg amphetmn-neg mthdone-neg brief hospital course: on , mr. became agitated at and was sedated and intubated for initial scans. ct head and c-spine showed no acute vascular event or fracture. urine tox screen was negative. he was transferred to and admitted to the ticu for further evaluation. he became agitated again upon treatment with fentanyl and was given haloperidol 5 mg x2. neurology was consulted because his mental status has not returned to baseline. mr. continued to be very agitated after extubation and required restraints and sedation. however, his mental status did improve. urine and blood toxicologies were negative. much of his history was gathered from his girlfriend. on neurological exam on , mr. was lethargic, inattentive, and disoriented to place and time. he answered questions appropriately but vaguely. he was unable to relate the history of his bicycle crash. cranial nerve exam was unremarkable except for some mild anisocoria without ptosis or anhidrosis. he had no nuchal rigidity. motor, sensory, and coordination exams were unremarkable. deep tendon reflexes were symmetrical throughout. right toes were upgoing; left toes downgoing. he was transferred to the floor. on , patient is substantially improved. he is able to recall the events leading to his fall. it seems highly likely this was not precipitated by a primary neurological event but we cannot say for sure. psychoactive medications were discontinued. he continues to be inattentive (difficulty with serial sevens). right toe remains upgoing. though his mental status was mostly but not completely restored to baseline, he was functioning well enough to be discharged and to follow up on an outpatient basis with neurology. medications on admission: none. discharge medications: 1. tylenol 325 mg tablet sig: two (2) tablet po every 4-6 hours as needed for pain. 2. outpatient physical therapy dx: fall w/ left shoulder ac separation 1-2x/week for strengthening/conditioning and rom discharge disposition: home discharge diagnosis: s/p fall concussion grade ii ac shoulder separation discharge condition: hemodynamically stable, tolerating a regular diet, pain adequately controlled. discharge instructions: you were brought to the hospital after an unwitnessed fall off your bicycle. you experienced changes in your mental status while in the hospital, and although you have improved markedly since you came, it is unclear what precipitated your fall. even though your head ct scan did not show any intracranial bleeding you may have experienced a mild head injury or a concussion. you may at times experience intermittent headaches, dizziness, irritability, increased fatigue. these symptoms should decrease over the next several weeks. if they do not improve you should follow up with dr. , behavioral neurology, at the number provided in your follow up instructions. it is important that you do not drive, operate large machinery, or make important decisions until you are re-evaluated by the neurologist. return to the emergency room if you develop any fevers, chills, worsening headaches, numbness/weakness in any of your extremeities, chest pain, shortness of breath, nausea, vomiting, diarrhea and/or any other symtpoms that are concerning to you. followup instructions: please call the department of radiology at ( to schedule an outpatient appointment for an mri of the head. please call the department of neurology for further work up of your seizures at to schedule a follow-up appointment with dr. after the mri. follow up with dr. , behavioral neurology if you or your family have ongoing concerns of symptoms associated with post concussive syndrome. please call for an appointment if one is needed. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours diagnoses: epilepsy, unspecified, without mention of intractable epilepsy closed fracture of malar and maxillary bones migraine, unspecified, without mention of intractable migraine without mention of status migrainosus closed fracture of other facial bones concussion with loss of consciousness of unspecified duration pedal cycle accident injuring pedal cyclist closed dislocation of acromioclavicular (joint) late effects of intracranial abscess or pyogenic infection 

Answer: The patient is high likely exposed to