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: penicillins attending: chief complaint: change in mental status, memory impairment, confusion major surgical or invasive procedure: biopsy of right parietal lobe lesion biopsy of right iliac lymph node bronchoscopy/bal history of present illness: 59 m with hx of cad s/p cabg, dmii (hba1c 5.1), >50% bil carotid stenosis, ventral hernia repair , who presents with 2-3 weeks of mental status changes, including impaired memory/confusion, and one week of ha. two weeks pta, pt's friend/boss noticed his demeanor was slightly different and that he was losing his train of thought while speaking, and was "just not acting himself". five days pta pt returned to his grocery store job (he was on medical leave s/p surgery) and was noted to have difficulty performing tasks that previously were second nature. he could not remember how to operate the register or lottery machine, and had coordination problems when trying to wrap a . during this time he developed a waxing and frontal headache, "" pain at times. over the next two days, these symptoms persisted and were very noticeable to the other employees. he consistently would forget what he was doing and at one point started speaking french for ten minutes to his english-speaking boss. pt also reports that over this two week time period he has felt unstable on his feet, although this has been occurring to some extent since abd surgery. boss sent him to pcp on wed ; pcp noted pt was having difficulty with tandem gait and remembering what he had had for breakfast; neuro exam was otherwise unremarkable. pcp sent him for contrast mri, which revealed 15-20 ring-enhancing lesions in cerebrum, cerebellum, brainstem. he was sent directly from mri to for further work-up, but on arrival could not remember why he was there. he left the ed, walked back to mri facility; they subsequently sent him back to the ed by ambulance. patient denies vision changes (including blurring and scotoma), lightheadedness, tinnitus, hearing changes, numbness or tingling, or changes in strength. his boss/friend reports no slurring of speech, but does report pt giggles quite often. per pt and friend, there are lucid periods, when he behaves normally with intact memory. the pt denies having a hx of serious infections or stds. he never uses protection during intercourse, and only had two different female partners in his life. he denies ever having hematuria. he has never been tested for hiv. denies fevers, chills, cough, n/v/d. notably, his bp have been well controlled for several years at 130s/70s and his last few hba1cs have been in the 5s. he has had a 10 lb weight loss since surgery in . patient does not travel outside of . denies sick contacts. in the ed, his vitals were t99.5 hr76 rr16 sao2 100% ra. pt unable to state time, gave "" as year initially, but then noted to be aox3 forty minutes later. rest of exam unremarkable. piv 20 in r arm. cbc, chem-7 unrevealing. urine and serum tox screen negative. urine sent. blood culturesx2 drawn. vitals prior to transfer 97.7 72 152/81 16 99%ra past medical history: diabetes mellitus type ii (hba1c 5.1 , 5.6 , 5.4 ) cad s/p cabg old anterior mi (ef 35-40% in ). carotid stenosis (>50% bil) social history: as per hpi. additionally, haitian, came her 17 years ago, has never been back. has no connections with family in , does not want like to talk about it. lives alone in . works at grocery store. strong support from boss. smoked ppd, quit in . minimal alcohol, no drugs. family history: unknown physical exam: exam on admission vs: tc 99 bp 199/84 hr 75 rr 22 99% ra general: well-appearing, thin haitian man in nad, comfortable & pleasant. heent: nc/at, sclerae anicteric, no conjunctival injection, mmm, op clear. adentulous. neck: supple, no thyromegaly, no jvd, carotid bruits bil. no cervical lad. heart: rrr, no mrg, nl s1-s2, 1-2/6 systolic ejection murmur. lungs: cta bilat, no r/rh/wh, good air movement, resp unlabored. abdomen: soft/nt/nd, no masses or hsm, no rebound/guarding. extremities: wwp, no c/c/e, 2+ peripheral pulses. skin: no rashes or lesions. mental status: gen: alert, interactive, expanded affect. difficult to follow train of thought, +flight of ideas and at times nonsensical speech and circumstantiality. orientation:to person, place, and time. attention: has difficulty naming days of the week forwards and backwards. speech/: fluent w/o paraphasic errors; follows simple and complex commands without l/r confusion. repetition, naming intact. memory: at registration, 0/3 at 5 minutes. normal fund of knowledge. calculations:intact (9 quarters = $2.25). cn: i: not tested. ii: vffc. right pupil oval, 5 mm to 3 mm. left pupil round 4mm to 2 mm. no rapd. iii,iv,vi eomi w/o nystagmus (or diplopia). mild ptosis. v: sensation intact to lt. vii: face symmetric without weakness. viii: hears finger rub equally and bilaterally. ix,x: voice normal. palate elevates symmetrically. : scm and trapezii full. xii: equivocal tongue protrusion motor: normal bulk and tone; no tremor, rigidity, or bradykinesia. no pronator drift. 5/5 strength upper and lower extremities. coordination: dysmetria with finger-to-nose-finger movements. no truncal ataxia. reflex: 1+ bicep, brachial, patellar, and ankle jerk sensory: lt intact. joint position intact. no evidence of extinction. gait: posture, stance, stride, and arm-swing normal. mild imbalance with tandem gait. able to walk on heels and toes. romberg negative. ------------------- exam on discharge: avss. comfortable, nad neuro: memory: objects at registration, two hours later. able to name months forwards and backwards. cn ii-xii intact, except for: 1) impaired l-sided palate raise, 2) anisocoria: r pupil > l pupil, both responsive. 5/5 strength in ue and le. minimal dysmetria with finger-nose-finger. heel to shin intact. lt intact in ue and le. gait stable. pertinent results: : wbc 8.7, hct 27.7, mcv 96, plt 329 : na 137, k 4.5, cl 103, co2 28, bun 30, cr 1.2, glu 217 : alt 26, ast 33, alkphos 122, tbili 0.6 : pt 14.5, ptt 26.9, inr 1.3 : tibc 208, ferritin 255, transferrin 160 : tsh 1.1 afp 2.01 urine and serum tox negative : lymph node bx, flow cytometry negative microbiology 1. multiple bacterial blood cultures done , , , , , , : no growth 2. rapid plasma reagin test (final ): nonreactive. 3. csf cryptococcal antigen: negative 4. csf culture gram stain (final ): no polymorphonuclear leukocytes seen. no microorganisms seen. fluid culture (final ): no growth. fungal culture (preliminary): no fungus isolated. acid fast culture (preliminary): the sensitivity of an afb smear on csf is very low.. if present, afb may take 3-8 weeks to grow.. no mycobacteria isolated. 5. , , induced sputum concentrate smear for afb: negative; afb cultures pending 6. hiv antibody negative 7. hiv-1 viral load/ultrasensitive (final ): negative 8. toxoplasma igg antibody (final ): positive for toxoplasma igg antibody by eia. 236 iu/ml. 9. bal acid fast smear (final ): no acid fast bacilli seen on concentrated smear. acid fast culture (preliminary): no mycobacteria isolated. gen-probe amplified m. tuberculosis direct test (mtd) (preliminary): sent to state lab for further identification . test requested by dr.,gowri @ 10. 9:00 am tissue right iliac node. gram stain (final ): no polymorphonuclear leukocytes seen. no microorganisms seen. tissue (final ): no growth. anaerobic culture (final ): no growth. acid fast culture (preliminary): no mycobacteria isolated. acid fast smear (final ): no acid fast bacilli seen on direct smear. fungal culture (preliminary): no fungus isolated. potassium hydroxide preparation (final ): no fungal elements seen. 11. hbv viral load (final ): 1,560 iu/ml 12. 12:30 pm swab site: brain right brain mass. gram stain (final ): no polymorphonuclear leukocytes seen. no microorganisms seen. wound culture (final ): no growth. anaerobic culture (final ): no growth. acid fast smear (final ): no acid fast bacilli seen on direct smear. acid fast culture (preliminary): no mycobacteria isolated. fungal culture (preliminary): no fungus isolated. 13. hcv antibody : negative 14. htlv i and ii western blot : negative 15. quantiferon gold : positive 16. strongyloides antibody : negative 17. brucella antibody : negative 18. histoplasma antibody : negative 19. histoplama urine antigen : negative 20. csf wbc rbc polys lymphs monos 5 1 0 80 20 totprot glucose 80 38 cmv pcr negative ebv pcr negative toxoplasma pcr negative cysticercus antibodies, igg csf: negative csf gram stain (final ): no polymorphonuclear leukocytes seen. no microorganisms seen. fluid culture (final ): no growth. fungal culture (preliminary): no fungus isolated. acid fast culture (preliminary): the sensitivity of an afb smear on csf is very low.. if present, afb may take 3-8 weeks to grow.. no mycobacteria isolated. tissue culture data: no positive culture data. 1. universal pcr for tuberculosis pending on paraffin embedded brain tissue. 2. brain tissue pathology showed granuloma with focal areas of necrosis. special stains for afb were negative. unfortunately, brain tissue was not sent to microbiology. 3. external iliac node sent to microbiology and pathology: no growth of afb at current time in this tissue; pathology showed lymphoid tissue with necrotizing granulomas. csf cytology : negative for malignant cells other studies ct torso : solitary right apical lung lesion, soft tissue in attenuation, with a few foci of peripheral calcification and spiculated margins. no associated hilar, mediastinal, or supraclavicular adenopathy is identified. extensive retroperitoneal and pelvic adenopathy, with multiple nodes demonstrating central hypoattenuation suggesting necrosis, and extensive adjacent inflammatory change and edema throughout the retroperitoneum. in the setting of peripherally enhancing brain lesions seen on outside hospital mri, both neoplastic and infectious etiologies for these findings must be considered. the right apical lung lesion could represent a primary lung neoplasm, less likely metastasis, though infectious etiologies including tuberculosis could cause a similar appearance. the retroperitoneal lymphadenopathy would be unusual secondary to a primary lung neoplasm, and the extent of inflammatory change would be atypical of lymphoma. infectious or inflammatory processes, including possible abdominal tuberculosis or aids-related opportunistic infections such as , are thus alternate considerations. tissue sampling is recommended, and a right external iliac node measuring up to 3.3 cm would represent a reasonable site for initial biopsy. --- tte : regional lv systolic dysfunction c/w cad/prior mi. no valve vegetations seen. torn/calcified mitral chordae seen. --- bil leni : impression: no evidence of deep vein thrombosis in either leg. --- mri : impression: multiple infra- and supratentorial ring-enhancing lesions, relatively unchanged since the most recent examination dated . differential diagnosis is broad and includes but is not limited to metastatic disease and infectious processes. there is no evidence of new lesions in this short interval, fiducial markers are in place. --- and : biopsy of superficial nodes --- : brain biopsy --- ct head non con ndication: multiple brain lesions, now presenting for post-operative follow-up. findings: the patient is status post right parietal craniotomy. a small amount of gas is seen overlying and subjacent to the craniotomy site. a tiny hyperdense focus in the parietal lobe on the right (2:21) is consistent with a small amount of blood in the surgical bed. otherwise, there is no intracranial hemorrhage, vascular territorial infarction. numerous ring-enhancing lesions are better assessed on the concurrent mri. however, note is made of areas of parenchymal hypodensity such as in the thalamus on the left and in the left cerebellar peduncle, which correspond to lesions seen on mri. ventricles are normal in size and in configuration. there is expected effacement of the sulci of the parietal lobe on the right and elsewhere sulcation appears normal. extracranial soft tissue structures are normal. impression: expected post-surgical changes, immediately following a right parietal craniotomy. --- ct head non con indication: hypertension and altered mental status in a patient recently status post brain biopsy. findings: as before, the patient is status post right parietal craniotomy and the small amount of adjacent subcutaneous gas and pneumocephalus is unchanged. there has been no interval intracranial hemorrhage. there is no vascular territorial infarction. the extent of ring-enhancing intracranial lesions was characterized to better effect on an mr from , though areas of parenchymal hypodensity are noted in the left cerebellar peduncle, and the thalamus on the left. aside from mild expected effacement of the sulci over the right parietal lobe, ventricles and sulci are normal in size and in configuration. there is interval increase in subcutaneous soft tissue swelling subjacent to the craniotomy site, with a new 4 x 1 cm pocket of fluid (2:8), likely a developing postoperative seroma. impression: 1. interval increase in subcutaneous soft tissue swelling and development of a 4 x 1 cm pocket of fluid subjacent to the right craniotomy site, likely a developing seroma. 2. no interval intracranial hemorrhage or change. --- cxr ap findings: there is a status post sternotomy and aortocoronary bypass surgery. borderline size of the cardiac silhouette. no evidence of pulmonary edema. no pneumonia. no pleural effusions. on the chest radiograph, no miliary pattern or opacities are seen. --- cxr pa/lat impression: no acute cardiopulmonary abnormality. --- eeg impression: this is an abnormal routine eeg in the awake and drowsy states, due to the presence of a disorganized hz theta rhythm background, and frequent bursts of generalized and bifrontal (synchronous and independent) delta frequency slowing, seen during the most awake portions of the recording. this pattern is consistent with a mild diffuse encephalopathy. there were no focal abnormalities or epileptiform features noted. of note, the presence of lead artifact over the p4-o2 electrodes throughout the tracing may obscure any underlying abnormalities. --- mri spine: a. degenerative changes of the spine with no evidence of spinal or vertebral tuberculous involvement. b. numerous findings are only partially visualized including the known intracranial lesions, right apical pulmonary lesion, ascites, mesenteric and paraaortic lymphadenopathy, and left vocal cord paralysis. ---- brief hospital course: 59 haitian male presents with 2-3 weeks of mental status changes found to have 15-20 ring-enchancing cns lesions by outside mri. he is found to additionally have rul nodule, pelvic lad, with ln and brain biopsy suggestive of disseminated tuberculosis. he was started on anti-tuberculosis therapy with steroids on . his delirium/encephalopathy markedly improved since starting anti-tuberculosis therapy. hospital course: : neuro deficits seen: anisocoria (r pupil>l pupil, both responsive), gait instability, memory impairment, expanded affect, and confusion. : torso ct revealed a 1.5x1.5x3cm^3 mass in rul (no mediastinal or hilar lad) and retroperitoneal lad. hiv ab negative. lumbar puncture: unremarkable in terms of rbcs, wbcs, glucose; mild protein elevation. csf ncc ab, cmv pcr, ebv pcr, toxoplasma pcr sent and found negative. : echo performed: regional lv systolic dysfunction c/w cad/prior mi. no valve vegetations seen. torn/calcified mitral chordae seen. -: ruled out for pulmonary tuberculosis by is afb negativex3, patient taken out of isolation. : bal performed; washings negative for malignant cells and otherwise unremarkable. , : rt iliac ln biopsy performed, pathology positive for necrotizing granuloma, consistent with tuberculosis. no malignant cells. stains negative for organisms; afb, fungal, bacterial cultures pending. immunophenotyping negative for lymphoma. : pt with calf pain; bilateral leni performed and negative for dvt. : pre-op imaging followed by brain biopsy of right parietal lesion performed. post-op imaging showed expected post-operative changes. pathology notable for granulomas composed of immune cells and focal areas of necrosis. no eosinophils. gram, afb, and gms stains negative for organisms. afb, fungal, and bacterial gram stains from tissue swabs and paraffin-embedded tissue negative; cultures pending. universal pcr for afb pending. : after brain biopsy, pt developed hypertensive emergency, fevers to 105.5 with rigors, acute change in mental status and with incomprehensible speech, and was uncommunicative and transferred to icu icu course 59 year old male with history of type 2 diabetes, hypertension, hepatitis b and recent ventral hernia repair who was admitted for altered mental status, felt possibly due to miliary tuberculosis with cns involvement who is transferred to the icu for acute worsening of mental status, hypertensive emergency vs. urgency and fevers 104 with rigors. patient's episode resolved with initiation of vanc/cefepime/flagyl and with time. it is possible he had a seizure. eeg was discussed but not initiated because techs not available overnight but symptoms had resolved by am. his bp was elevated to 160s and in setting of recent brain biopsy was goal<140. his lisinopril was increased to 40mg daily and he was given iv and po hydral. the morning after admission the patient was aaox3 and appropriate and back to baseline per primary team. : pt started on four drug anti-tuberculosis regimen with steroids: ethambutol 1000mg po qd, pyrazinamide 1000 mg po qd, rifampin 600mg po qd, inh 300 mg po qd, 60mg prednisone qd. additionally, because of chronic hbc infection (see below), entecavir 0.5 mg po qd was also started to prevent viral replication in the setting of steroid treatment. pt tolerating treatment. lfts since starting treatment have been wnl. : pt underwent spinal mri to rule out tuberculoma involvement of spine, which was negative. problem list: # presumed disseminated tuberculosis with granulomas in the brain, necrotizing granulomas on right iliac lymph node biopsy, positive quantiferon gold. extensive workup also pursued for fungal, parasites, and malignancy. pulmonary tuberculosis ruled out with sputum afb smears negative x3. four drug tuberculosis regimen started on # encephalopathy relating to brain lesions: pt initially noted to have anisocoria (r pupil>l pupil, both responsive), gait instability, memory impairment, expanded affect, and confusion. this began to all improve once tuberculosis treatment initiated. # htn: pts bps were reasonably well-controlled on his home regimen until brain biopsy. after procedure, patient required uptitrations of his blood pressure medications, including the addition of a clonidine patch on . his blood pressure was still high on discharge, but clonidine patch typically takes 2-3 days for efficacy. he is discharged on the following regimen: lisinopril 40 mg po/ng daily amlodipine 10 mg po/ng daily hydralazine 50 mg po/ng q8h clonidine patch 0.1mg qwed # hepatitis b/ elevated lfts: patient was found to have mildly elevated lfts on admission and chronic hepatitis b by blood tests (as above). hepatology was consulted; they recommended entecavir 0.5 mg po qd when starting steroid treatment (as part of anti-tuberculosis regimen), to prevent reactivation. entecavir was subsequently started with anti-tuberculosis treatment. lfts have been within normal limits on subsequent testing. # diabetes mellitus, type ii- did not require insulin until after starting steroid treatment on . subsquently put on lantus 8u qam on and continues to be on sliding scale. - continue sliding scale, but will likely need adjustment of lantus. goal fasting blood glucose is 120. # cad - stable. patient was off aspirin in setting of procedures. this was restarted on . # right upper lung lesion seen on ct torso: recommend follow-up ct to assess for interval change in size. transitional issues pending studies: - tissue cultures for afb/ fungus/ bacteria - brain tissue universal pcr other issues: - weekly cbc, chem10, and lfts in setting starting anti-tuberculosis treatment with steroids - transportation to and from appointments (detailed in other sections) - prednisone taper starting (as detailed in opat note) - blood pressures running high; recently started clonidine patch, will need follow-up - will need f/u of diabetes and fixed insulin dosing - repeat ct chest to assess rul lesion for interval change medications on admission: metolazone 5 mg po qam ibuprofen 600 mg po prn pain oxycodone 5 mg po prn pain (not taking) carvedilol 12.5mg po bid furosemide 40mg po qod simvastatin 40mg daily lisinopril 10mg daily glyburide 2.5mg po bid asa 81mg po daily omeprazole 20 mg po before first meal of day discharge medications: 1. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 2. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 3. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 4. carvedilol 12.5 mg tablet sig: two (2) tablet po tid (3 times a day). 5. lisinopril 20 mg tablet sig: two (2) tablet po daily (daily). 6. entecavir 0.5 mg tablet sig: one (1) tablet po daily (daily). 7. rifampin 300 mg capsule sig: two (2) capsule po q24h (every 24 hours). 8. pyrazinamide 500 mg tablet sig: two (2) tablet po daily (daily). 9. ethambutol 400 mg tablet sig: 2.5 tablets po daily (daily). 10. prednisone 20 mg tablet sig: three (3) tablet po daily (daily). 11. pyridoxine 50 mg tablet sig: two (2) tablet po daily (daily). 12. isoniazid 300 mg tablet sig: one (1) tablet po daily (daily). 13. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 14. polyethylene glycol 3350 17 gram/dose powder sig: one (1) po bid (2 times a day) as needed for constipation. 15. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for fevers, pain. 16. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 17. sulfamethoxazole-trimethoprim 800-160 mg tablet sig: one (1) tablet po daily (daily). 18. clonidine 0.1 mg/24 hr patch weekly sig: one (1) patch weekly transdermal qwed (every wednesday). 19. hydralazine 50 mg tablet sig: one (1) tablet po q8h (every 8 hours). 20. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day): hold for diarrhea. 21. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day): hold for diarrhea. 22. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime): 1 drop to each eye. 23. insulin glargine 100 unit/ml solution sig: eight (8) units subcutaneous once a day. 24. insulin lispro 100 unit/ml solution sig: one (1) sliding scale subcutaneous four times a day: please see attached sliding scale. discharge disposition: extended care facility: - discharge diagnosis: primary diagnosis: disseminated miliary tuberculosis secondary diagnoses: hepatitis b coronary artery disease diabetes mellitus type ii carotid stenosis hypertension discharge condition: mental status: confused - sometimes. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to the hospital with confusion, memory impairment, and instability with walking. an mri image of your head taken before you were admitted showed multiple masses scattered through your brain. while you were in the hospital you were extensively worked up for your symptoms and findings. while you were in the hospital, many blood and urine tests were sent. a procedure called a lumbar puncture was performed to examine fluid in your spinal cord. a different procedure called a bronchoscopy was performed to examine your lungs. tissue from your brain and a pelvic lymph node was obtained and examined (in a procedure called a "biopsy"). you underwent multiple radiographic imaging tests including cat scans and mri. based on our findings, we think you have tuberculosis in your brain and other parts of your body. we did not find anything to suggest cancer. additionally, we found that at some point you were infected with hepatitis b. you were subsequently started on a multi-drug regimen to treat tuberculosis and hepatitis b. you have been tolerating this treatment in the hospital. this treatment is very detailed and will require frequent blood tests to make sure your body continues to tolerate the medicine. additionally, it will make your blood sugars more difficult to control. to help with all of this we have placed you in a tuberculosis treatment center at the hospital in . the director of this infectious disease. while we are quite confident that tuberculosis is the cause of your illness, we cannot be 100% sure. if after a period of time you are not improving or getting worse, additional tests will be required to determine the best treatment. we have made many appointments for you with several different doctors (detailed below). it is extremely important that you make all these appointments; the hospital will help you make these appointments and find transportation for you. we have made many changes to your medications; these are detailed in the attached documentation. followup instructions: we have scheduled the following appointments for you: ----------- transportation to and from these appointments must be provided by rehabilitation center ----------- 03:10p , md division of infectious disease medical office building , phone: fax: ----------- 1:10pm provider: function lab phone: date/time: 1:10pm 1:30pm provider: . /dr. phone: date/time: 1:30pm division of pulmonology, critical care, and sleep medicine department of medicine , ------------ 02:15p provider: , . md department of neurosurgery medical office building, ------------ 11:00a provider: , department of ophthalmology sc clinical ctr, hmfp- eye , ma ( ------------ procedure: spinal tap incision of lung other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain closed [endoscopic] biopsy of bronchus biopsy of lymphatic structure biopsy of lymphatic structure diagnoses: other primary cardiomyopathies anemia, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status pulmonary collapse other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation cerebral edema old myocardial infarction infection and inflammatory reaction due to other vascular device, implant, and graft seroma complicating a procedure encephalopathy, unspecified phlebitis and thrombophlebitis of superficial veins of upper extremities viral hepatitis b without mention of hepatic coma, acute or unspecified, without mention of hepatitis delta postprocedural fever tuberculoma of brain, tubercle bacilli not found by bacteriological examination, but tuberculosis confirmed histologically other tuberculosis of intestines, peritoneum, and mesenteric glands, tubercle bacilli not found by bacteriological examination, but tuberculosis confirmed histologically 

Answer: The patient is high likely exposed to