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: unresponsiveness major surgical or invasive procedure: intubation prior to arrival eeg to evaluate for /epileptiform activity --> negative history of present illness: mr. is an 86 year old man with a history of htn, afib presents from osh after an episode of unresponsiveness followed by combative behavior requiring intubation for airway protection. per report he was at home watching the game with his wife. was in his usual state of good health watching the game on television with his wife. his wife left the room for a few minutes and when she returned the patient was slumped over, staring and was unresponsive. when she was unable to arouse him she called ems who brought him to . when ems arrived he was found to have urinary incontinence, blood in his mouth, and diaphoresis. glucose and vitals were wnl. he became combative and was ultimately intubated for airway protection. he had no reported focal deficits on exam. he had a cxr concerning for possible pneumonia and was treated with flagyl 500 mg iv, levofloxacin 750 mg iv, and 1 l ns iv. a ct head showed no evidence of mass lesion, mass effect or intracranial bleeding. he was transferred to for further neurologic evaluation. . in the ed vs were t 98.8 rectal hr 56 bp 107/61 rr 20 spo2 100%. he was able to move all four extremities. repeat cxr showed ett 4 cm above the and rll opacity consistent with aspiration pneumonia. repeat ct head showed extensive bilateral periventricular white matter changes but no acute process. he was treated empirically for meningitis with vancomycin 1 g iv, ceftriaxone 2 g iv, ampicillin 4 g iv, acyclovir 900 mg iv, 1 l ns iv and underwent lp. lp showed slightly elevated csf protein of 54, glucose 69 (serum 139), 2 wbc (84 l 16 m), 1 rbc. urinalysis was negative for infection. lab work was notable for lactate 2.5, negative cardiac enzymes, chem 7 within normal limits, toxicology screen positive only for benzos after receiving ativan 2 mg iv and versed 2 mg iv x 2 at the osh prior to intubation. . past medical history: 1. total knee replacement 2. hypertension 3. bph 4. restless leg syndrome social history: patient lives with his wife. is independent of all adls. he uses a cane for ambulation. family history: no family history of seizures. physical exam: vs: 97.3, 136/93, 70, 20@97%(ra) ga: nad, comfortable appearing heent: perrla, symmetric, mmm. no lad. neck supple. op clear. cards: rrr, s1/s2 heard, no murmurs/gallops/rubs. pulm: ctab with questionable decreased breath sounds/inspiratory crackles at the bases abd: soft, nt, +bs extremities: no edema. dps, pts 2+. skin: scattered ecchymoses and skin tears on bilateral forearms. mottling on rle. neuro/psych: perrl, responds to verbal stimuli, maintains eye contact, does not consistently follow directions, moves all four extremities. aox3 this am. pertinent results: admission labs: . 04:48pm type- po2-159* pco2-42 ph-7.41 total co2-28 base xs-2 comments-green-top 04:48pm lactate-1.6 04:29pm glucose-94 urea n-14 creat-0.8 sodium-139 potassium-4.8 chloride-107 total co2-24 anion gap-13 04:29pm calcium-8.1* phosphate-3.1 magnesium-2.2 04:29pm vit b12-360 07:09am type-art po2-128* pco2-40 ph-7.48* total co2-31* base xs-6 intubated-intubated 07:09am lactate-1.3 06:46am glucose-97 urea n-16 creat-0.9 sodium-135 potassium-3.0* chloride-98 total co2-30 anion gap-10 06:46am alt(sgpt)-15 ast(sgot)-25 alk phos-44 tot bili-1.1 06:46am calcium-8.3* phosphate-2.5* magnesium-1.8 06:46am wbc-8.3 rbc-4.02* hgb-13.2* hct-36.2* mcv-90 mch-32.8* mchc-36.3* rdw-13.6 06:46am plt count-132* 06:46am pt-13.1 inr(pt)-1.1 01:30am cerebrospinal fluid (csf) protein-53* glucose-69 01:30am cerebrospinal fluid (csf) wbc-2 rbc-1* polys-0 lymphs-84 monos-16 11:38pm urine bnzodzpn-pos barbitrt-neg opiates-neg cocaine-neg amphetmn-neg mthdone-neg 11:38pm urine color-yellow appear-clear sp -1.012 11:38pm urine blood-sm nitrite-neg protein-neg glucose-neg ketone-15 bilirubin-neg urobilngn-neg ph-8.0 leuk-neg 11:38pm urine rbc-* wbc-0-2 bacteria-none yeast-none epi-0 11:30pm glucose-135* urea n-19 creat-1.0 sodium-142 potassium-3.4 chloride-102 total co2-28 anion gap-15 11:30pm ctropnt-0.01 11:30pm calcium-8.7 phosphate-2.0* magnesium-1.9 11:30pm tsh-2.2 11:30pm asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 11:30pm wbc-8.1 rbc-4.10* hgb-13.0* hct-37.6* mcv-92 mch-31.8 mchc-34.7 rdw-13.4 11:30pm neuts-81.1* lymphs-12.0* monos-5.3 eos-1.0 basos-0.5 11:30pm plt count-174 11:30pm pt-11.6 ptt-20.7* inr(pt)-1.0 11:27pm glucose-128* lactate-2.5* k+-3.2* . micro: . sputum cx: sparse commensal flora, yeast . blood cx: pending . csf: gram stain (final ): 1+ (<1 per 1000x field): polymorphonuclear leukocytes. no microorganisms seen. this is a concentrated smear made by cytospin method, please refer to hematology for a quantitative white blood cell count.. fluid culture (preliminary): results pending. . imaging: . ekg: sinus bradycardia, rate 53, 1st degree av block, lad, rbbb, several pvcs cxr: 1. et tube 3.8 cm from the carina, its tip is difficult to evaluate. 2. right hemidiaphragm elevation. concern for left lower lobe pneumonia. . ct head: 1. no acute intracranial findings. 2. extensive periventricular white matter hypodensities, sequela of microvascular infarcts, limits sensitivity for acute vascular territorial ischemia, for which mri would be more sensitive. 3. atrophy. 4. sinus opacification. . mri brain: 1. no evidence of acute infarction. 2. findings suggestive of amyloid angiopathy. 3. moderate small vessel ischemic disease. age-related involution. 4. right parasagittal calvarial enhancing lesion is nonspecific in appearance, which could represent benign or malignant entities. differential diagnosis includes hemangioma and/or metastasis. attention on followup is suggested. 5. subcentimeter left frontal hemangioma. a second punctate faintly enhancing focus in the left parietal lobe is likely artifactual (15:15). attention on followup is suggested. 6. paranasal sinus disease. . cxr: the endotracheal tube and nasogastric tubes have been removed. there are continued extremely low lung volumes with elevation of the right hemidiaphragm. bibasilar atelectatic changes are again seen, though in the appropriate clinical setting, the possibility of pneumonia would have to be considered. . , eeg: eeg showed slow alpha rhythm with mild diffuse slowing, but no epileptiform activity. final report still pending at discharge. brief hospital course: 86 year old man presented after an episode of unresponsiveness followed by combative behavior requiring intubation for airway protection at osh and transfer to for further neurologic evaluation given concern for possible . . 1. unresponsive episode/ams: staring spell associated with unresponsiveness, questionable loss of bladder control, and blood in the oral cavity were concerning for activity. lack of focal deficits on exam made embolic cva a less likely source for his unresponsiveness. patient's negative ct head and lack of recent trauma or anticoagulation are reassuring that there was no intracranial bleed. patient's lp was without evidence of meningitis or bleed. infectious work up is significant only for possible aspiration pneumonia. per report this pneumonia was likely secondary to altered mental status rather than the etiology for lowered threshold. hsv pcr from csf was negative. his toxicology screens were only positive for benzos after administration of ativan 2 mg iv prior to intubation. chem 7, lfts, tsh were within normal limits. initial eeg was performed while on propofol and was nonspecific. neurology was consulted and did not recommend initiating treatment with antiepilectics. a repeat eeg failed to identify any epileptiform activity by preliminary read. remained the most likely etiology despite negative evaluation. given concern for an unprovoked , the patient was instructed not to drive for six months after discharge. ** the official eeg report was not available at the time of discharge, but was reviewed by the neurology consultants prior to discharge and felt to be benign.** . 2. aspiration pneumonia: per history patient was without any evidence of respiratory distress, hypoxemia, or hypercapnea on presentation to the osh. his intubation was primarily for airway protection given his altered mental status. he was subsequently diagnosed with an aspiration pneumonia, which was not a significant barrier to extubation. he was extubated one day prior to transfer to the floor. on transfer he was on day 2 of a 10-day course of unasyn for treatment of aspiration pneumonia due to evidence of bibasilar infiltrate on cxr. unasyn was replaced with levofloxacin and metronidazole upon transfer to the floor, to be continued through . patient was never hypoxic on the floor. ** patient was discharged with four remaining days of levofloxacin and metronidazole. ** . 3. htn: normotensive throughout admission. home valsartan-hctz was separated into individual components as combination pill was non-formulary. patient was also hypokalemic on presentation so hctz and lasix were held. patient was changed from atenolol to metoprolol on admission given history of atrial fibrillation. hctz was restarted after resolution of hypokalemia but lasix continued to be held throughout admission. . 4. history of atrial fibrillation: normal rate throughout admission. patient was changed from atenolol to metoprolol and was discharged home on metoprolol. ** patient may be restarted on atenolol as an outpatient pending further evaluation and clarification of history of atrial fibrillation. ** . 5. bph: stable. patient continued on tramulosin. . 6. restless leg syndrome: no complaints during admission. quinine was held as an inpatient given history of atrial fibrillation, as quinine in combination with atrial fibrillation can be dangerous. medications on admission: diovan/ hctz 160/25mg tamsulosin hcl 0.4 mmg klor-con qualaquin 324mg atenolol 100mg lasix 20mg asa 325mg aleve 220mg discharge medications: 1. levofloxacin 500 mg tablet sig: 1.5 tablets po daily (daily) for 4 doses: continue taking this medication as prescribed until . do not skip any doses. disp:*4 tablet(s)* refills:*0* 2. metronidazole 500 mg tablet sig: one (1) tablet po every eight (8) hours for 4 days: take one dose the evening of . continue to take the medication as prescribed until all pills are gone. . disp:*13 tablet(s)* refills:*0* 3. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 4. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po hs (at bedtime). 5. valsartan-hydrochlorothiazide 160-25 mg tablet sig: one (1) tablet po once a day. 6. lasix 20 mg tablet sig: one (1) tablet po once a day. 7. k-chlor sig: one (1) once a day: patient on this medication per history for hypokalemia associated with lasix and hctz. exact dosage unknown. 8. metoprolol succinate 50 mg tablet sustained release 24 hr sig: 1.5 tablet sustained release 24 hrs po once a day. disp:*45 tablet sustained release 24 hr(s)* refills:*0* discharge disposition: extended care facility: of discharge diagnosis: primary diagnosis: altered mental status unresponsive episode concerning for secondary diagnoses: hypertension restless leg syndrome bph atrial fibrillation (undocumented, not on coumadin) discharge condition: mental status: confused - sometimes. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: mr. : you were admitted to after an episode of unresponsiveness that was concerning for a . tests were performed to evaluate for a . these tests were negative but can sometimes miss even when one has occurred. you should not drive for the next six months as there is a chance that another could occur during that time period. you will not be sent home on any medications to prevent seizures. some changes have been made to your medications as per below. you will need to take two antibiotics for the next four days. 1. metronidazole 500 mg by mouth every eight hours: you should take one dose the evening after being discharged. you will need to continue this medication until . do not skip a dose. 2. levofloxacin 750 mg by once a day. take your first dose of this medication on . do not skip a dose. 3. you were started toprol xl 75mg daily -- stop your atenolol -- stop taking quinine 324 mg by mouth three times a day until you are evaluated by your cardiologist as this medication can affect your heart rhythm your cardiologist can decided whether or not to continue the medication changes above. followup instructions: please have your primary physician refer you to a neurologist in your area. ** be sure to keep all outpatient appointments as described below. if you cannot attend an appointment, please call to reschedule.** name: , , np (cardiology) address: 237a , , phone: appointment: wednesday, :15am * is the np on dr. team* procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours spinal tap incision of lung diagnoses: thrombocytopenia, unspecified unspecified essential hypertension atrial fibrillation other convulsions hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) acute respiratory failure pneumonitis due to inhalation of food or vomitus encephalopathy, unspecified knee joint replacement restless legs syndrome (rls) 

Answer: The patient is high likely exposed to