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: past medical history: 1. hiv diagnosed in the year , followed by dr. . the most recent cd4 count was 287 and the viral load was 9,830, done on . 2. mononeuritis multiplex status post two sural-nerve biopsies. 3. sickle-cell trait. 4. hypertension. 5. bilateral cataracts in childhood requiring surgery. 6. g6pd trait positive. 7. status post liver biopsy for questionable hepatitis. 8. question of meningitis with chronic cns pleocytosis followed by the neurology. medications on admission: (on admission to the ) 1. prednisone 50 mg a day. 2. insulin drip. 3. ceftriaxone 1 gram iv q.12h. 4. heparin subcutaneously 5000 units b.i.d. family history: the patient denied any family history of diabetes mellitus. the patient reports that his mother has arthritis. social history: the patient is married and has two children. the patient works as a collections officer for the city of . he had contracted his hiv from his previous marriage. his previous wife had died of cervical cancer. the patient was originally from the republic. he is bilingual in english and spanish. his children are hiv negative. the only person who is aware of his hiv status is his current wire. the patient denied any tobacco use, alcohol, or drug use. physical examination: examination on admission to the hospital revealed the following: the patient was intubated and sedated. vital signs: temperature 102.8, blood pressure 136/73, pulse 119, respiratory rate 12, oxygen saturation 100%. the patient had post surgical pupils. heent: patient's pupils are post surgical with right-side esotropia. he was intubated and sedated. he had normal dentition, no thrush. neck: neck was supple. cardiovascular: examination revealed normal s1 and s2, sinus tachycardia and regular rate and rhythm with no murmurs and no friction rubs. respiratory: clear to auscultation bilaterally. abdomen: the abdomen is obese, protruding, which was soft, and did not appear to be tender. there was hypoactive bowel sounds ausculted. extremities: examination revealed normal extremities with no focal swelling. the distal pulses were all intact. the skin was dry and warm. neurological: examination revealed intubated and sedated patient, who responds to noxious stimuli. studies on admission revealed sodium of 165, potassium of 4.4, chloride 129, bicarbonate 28, bun 42, creatinine 1.7, sugar 140. serum calculated osmolality was 352. the patient's hematocrit was 38.9, white count was 8.6 and the platelet count was 107. the pt was 14.3, ptt 21.2. the albumin was 3.9, calcium 9.3, magnesium 2.4, phosphate 4.2, total bilirubin 0.5, ast of 79, alt 94. per report from the outside hospital, the patient has a normal ct of his head. hospital course: the patient was transferred from to the medical intensive care unit at . on admission he was hyponatremia and hyperosmolar. he was placed on insulin drip, given d5 and volume resuscitated with saline boluses. blood, urine, and spinal fluid cultures were also obtained for workup of his fever. the patient was empirically covered with acyclovir, 2 grams ceftriaxone q.12h., ampicillin, flagyl, and levofloxacin in the intensive care unit. chest x-ray done on admission revealed possible left lower lobe infiltrate in the retrocardiac window. the patient also received mri of his head with gadolinium for careful look at his pituitary for question of diabetes mellitus insipidus. no structural abnormalities were noted in this mri. with repletion involving resuscitation, the patient's sodium began to decrease. his mental status also improved upon weaning of his sedatives. he was extubated successfully on . at this time he remained febrile to a temperature of 101.4. on , the patient's sodium was corrected to a normal level of 142. he remained on an insulin drip at around 10 units an hour. he was converted to long-acting insulin with nph 60 units twice a day and transferred out to the floor. upon arrival to the floor, the patient, on examination, was found to have mild right lower quadrant tenderness on palpation. by , am labs had indicated that the hematocrit was dropping from a baseline of 39 on admission to the outside hospital to a hematocrit of 27 on . this was complicated by the fact that the patient is a jehovah witness. he was also noted to have guaiac-positive stool. given his history of bloody diarrhea, prior to his presentation to the , guaiac-positive stool and dropping hematocrit, a ct scan of his abdomen was done, which revealed severe cecal inflammation. the patient was made npo and placed on iv ampicillin, levofloxacin, and flagyl. he was getting ceftriaxone at this time at 2 grams every 12 hours for meningitic coverage. surgery service was consulted to follow the patient. the patient did very well clinically over the next few days. his diet was advanced as tolerated. on , he developed a low-grade temperature overnight at 100.8 to 100.9 without clear source. he was continued on ampicillin, levofloxacin, flagyl, and ceftriaxone at this time. right arm small pustule was noted at an old iv site. there was no pustule and no fluctuance and the lesion appeared superficial. the lesion proceeded to heal itself with no further complications. the patient's low-grade temperature, however, did not resolve. on , with worsening spiking, the ct of the abdomen was obtained. on this repeat ct scan, there was no change in the cecal thickening, which was observed. there was no evidence of intra-abdominal abscesses or perforations. incidentally noted on the ct scan was worsening of the patient's left lower lobe infiltrate as a questionable source of his fever. the vancomycin was added at this time. upon the start of vancomycin, the patient's fever spikes resolved to a mild low-grade temperature at 99.9 for two days. during this time, he still received regular blood/urine cultures with viral cultures including cmv antigenemia, which was sent. the patient was feeling very well clinically with no abdominal pain on examination. the patient had no cough, no crackles on lung examination, and the patient wanted to go home. between and 26th, the patient was noted to start to have tachycardia of unclear etiology. on , he started spiking temperature again overnight. he has finished his two-week course of meningitic doses of ceftriaxone at this time. decision was made to stop all previous antibiotics and change his antibiotic regimen to piperacillin/tazobactam for pseudomonal coverage. the patient was also noted to have worsening of his neuropathy symptoms. between and , the patient was on a rapid tapering of his prednisone dose. his prednisone was completely off by . on , the patient again had right lower quadrant tenderness on examination. repeat cat scan of his abdomen and chest was done on . there was still underfilling of his cecum, but the cecal inflammation was felt to be unchanged. there was interim evidence of improvement of the left lower lobe pneumonia. at that time it was felt that an infectious nidus may be his cecal inflammation and the department of gastroenterology was consulted to perform a colonoscopy. the patient received his colonoscopy on , which revealed a completely normal examination with a completely normal cecum. biopsies were taken for pathology, as well as culture. the patient's temperature meanwhile had been escalating and on , upon returning from his colonoscopy, his temperature was up to 105.8. he required cooling blankets, ice pats, as well as around-the-clock tylenol. on , the patient remained febrile at 104 to 105 degrees requiring cooling blankets. other than chills which he feels when his temperature is up to 104 to 105, the patient, otherwise, felt well. he had a good appetite. he had no headaches, no back pains, no nausea, vomiting, or shortness of breath. vital signs remained very stable, except for a tachycardia in the 110s to 130s with his temperature. his sugar remained well controlled and his multiple blood and urine cultures had been negative. at this point, it was felt that a bacterial cause for his persistent spike was unlikely. a cmv-pcr was sent. the hiv viral load and repeat cd4 count was also sent. all antibiotics were stopped on to observe the patient's fever curve off antibiotics in case this is a drug fever. summary of problems by system: 1. infectious: the patient has persistent fever of unclear origin. multiple scans of his chest and abdomen did not reveal any possible infectious source. at this time the differential diagnosis includes the following: viral syndrome, possible etiologies included cmv, ebv, or hiv itself. the patient may still have a resolving infectious diarrhea per the history he has given us. another possibility is drug fever and for this the antibiotics were all stopped. finally, this fever may be associated with vasculitis and connective tissue disease, which the patient has some evidence on his nerve biopsy, as well as his liver biopsy. this fever may have been masked by po prednisone, which he was taking. further investigations at this time include the following: awaiting viral cultures and hematology/oncology consultation, potential bone narrow biopsy for workup of fever of unknown origin. gallium scan is another possibility. 2. endocrinology: the patient has been receiving 60 of nph twice a day with good control of his blood sugar. 3. hiv: the patient is currently off all antiretroviral medicines. he is not to restart on any antiretroviral medicines until his current acute illness has resolved. 4. hematologic: the patient's hematocrit had been stable since . however, over to 30th, , it was noted that the patient has been decreasing his white blood cell count, as well as the percentage of his neutrophils. this has been followed daily and the hematology/oncology service has been consulted. 5. neurological: the patient has some peripheral neuropathy presumed to be mononeuritis multiplex. on sural-nerve biopsy there was a suggestion of hsv1 inclusion bodies in the nerve cells, as well as evidence of vasculitis, question of hiv vasculopathy. the neurology service is following the patient with agreement of tapering of his prednisone. the patient remains on 1200 mg neurontin three times a day to control his neuropathy. the patient also has a history of cns pleocytosis with elevated white counts and lymphocytic predominance in his lumbar punctures. differential diagnosis of this finding includes a slow hiv related meningitis, cns sarcoid, or carcinomatous meningitis. the department of neurology is following the patient and the patient will need to followup lumbar punctures in two to four weeks time after discharge with the clinic. 6. hypertension: the patient is on 100 mg of atenolol per day with good control of his blood pressure. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified diagnoses: pneumonia, organism unspecified unspecified essential hypertension hyposmolality and/or hyponatremia mononeuritis of unspecified site asymptomatic human immunodeficiency virus [hiv] infection status other specified viral meningitis sickle-cell trait diabetes with hyperosmolarity, type ii or unspecified type, not stated as uncontrolled 

Answer: The patient is high likely exposed to