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: history of present illness: this is a 66 year old long-standing type 1 diabetic who was admitted on , for intravenous antibiotics for his left heel ulcer. he was started on intravenous kefzol and was proceeding well until the following day when the neurology service got involved. in fact, he was noted to have fingerstick of 73 at around 3:30 p.m. he was given some juice with no change in fingerstick which remained 76 one half hour later. however, he was given further juice and one hour later around 4:30, his fingerstick remained at 109. during this time, the patient was noted to be incoherent and "not himself". the neurology service was called around 5:20 p.m. the patient was emergently seen for change in mental status. stat fingerstick done at around 5:45 p.m. showed a fingerstick of 127. his first neurological examination will be noted below. past medical history: 1. type 1 diabetes mellitus for forty-two years with retinopathy and neuropathy. 2. gastroparesis. 3. pacemaker. 4. left calcaneal osteoarthritis. 5. left chronic heel ulcer. 6. methicillin resistant staphylococcus aureus positive. 7. the patient carries a diagnosis of frontal dementia. social history: the patient previously lived with wife but now is in a nursing home. no tobacco or alcohol. he is a retired cpa. allergies: no known drug allergies. medications on transfer: 1. reglan 10 mg p.o. q.i.d. 2. flomax 0.4 mg q.d. 3. k-dur 20 meq b.i.d. 4. colace 100 mg p.o. b.i.d. 5. zinc 220 mg q.d. 6. kefzol one gram q8hours. 7. levaquin intravenous. 8. nph 10 units subcutaneous q.a.m. 9. nph 6 units subcutaneous q.h.s. 10. humalog 6 units subcutaneous q.a.m. physical examination: on transfer to the neurology service, temperature 96.1, blood pressure 120/62, pulse 78 and respiratory rate 20. the patient was in no acute distress but was aphasic. mucous membranes were moist. he had a regular rate and rhythm. lungs were clear to auscultation bilaterally. he had positive bowel sounds and he had 2+ pulses of the extremities. neurologic examination on transfer to the neurology service: mental status - the patient is frustrated speaking words, however, sometimes says complete sentences. he follows simple commands (close eyes, move your eyes). he can say today is tuesday but cannot say any other orientation parameters. naming is severely impaired, only would tell me "chair" from the naming cards. cannot repeat. simple sentences or words only. tends to look to the right. grasp was absent. cranial nerves - extraocular movements are intact. there were no saccades or nystagmus. the pupils are equal, round, and reactive to light and accommodation. there was normal facial sensation. face was symmetric. hearing was intact to finger rub. there was normal oropharyngeal movement. tongue was midline without fasciculation. sem and trap were within normal limits. motor - the patient had good tone in the upper extremities and slightly flaccid in the lower extremities and had profoundly atrophic right first fdi. examination was hampered by inability to follow commands, however, he had 5/5 strength in biceps and triceps bilaterally. of note, he could barely lift his leg on the right with better leg lifts on the left. there were boots bilaterally. sensory - there was a left hemisensory level to the t10 to pin prick. he notes pain in all the extremities. the patient had symmetric deep tendon reflexes in the upper extremities rated at 2+ and there was 1+ and symmetric deep tendon reflexes at the patella. achilles tendon reflexes were not tested because of boots. coordination and gait could not be further tested. an emergent ct with contrast was obtained that showed periventricular white matter changes. there were no acute infarcts visible. hospital course: the stroke service was emergently involved and the patient received 54.6 mg of tpa in a modified protocol. soon after receiving the tpa, the patient had very good recovery being able to speak in complete sentences with normal comprehension. this was noted in the unit, however, also in the unit, he had episodes of "unresponsiveness" but in general that lasted fifteen minutes or less but in general, his course improved and he was transferred to the floor the following day. the patient's course was unremarkable until the following morning and this is on thursday morning, , when he was noted to be less responsive by the nursing staff and he had periods of emesis while getting an electroencephalogram. the neurology team was called emergently upon the patient's return. at bedside, the patient was unresponsive and he was responsive only to deep sternal rub but he did wince to pain in all extremities. the patient was returned to the floor after he was deemed to be stable. he recovered quit well being able to converse with the staff and basically the right sided hemiplegia improved dramatically over the course of a couple days. also, while in the unit, he was started on dilantin for seizure prophylaxis and afterload his highest level was 33.6. when he came back to the floor, decision was made to hold the dilantin as there was no clear evidence that he was having any electrographic seizures. he was on 24 hour telemetry that failed to show any electrographic events. it only showed mild to moderate generalized slowing consistent with mild encephalopathy. on the floor, the patient has had several episodes where he becomes "unresponsive", does not communicate and then surprisingly comes back to baseline within minutes or within one hour or so. the patient was discussed on several instances at weekly conference with the staff attending and the team. at this point, we have several hypotheses of his waxing and course. the leading thought is that this is a manifestation of body dementia which he has several features of; namely, history of visual hallucinations and some parkinsonian features with noted rigidity at times on examination. we also investigated on whether he had another significant feature of body dementia, namely, rem c behavior disorder and wife apparently says that he does not have any gross limb movements while he is half asleep. however, this does not exclude the possibility of this patient having body dementia. the other obvious possibility remains an infectious/metabolic event, namely, yeast urinary infection. this possibility remains low on our list as the symptoms continued to wax and wane well after we had treated the yeast infection and the patient did not have any yeast in his urine. also in talking to his primary care physician, reported to us that the patient had had history of these "episodes" where he would become "catatonic" and suddenly wake up from his "slumber" as the primary care physician put it. the other major possibility in this patient is vertebral basilar system insufficiency. given his long-standing diabetes mellitus, the possibility exists that he has poor posterior circulation that would cause a deficit in blood flow in the reticular activating system, thereby causing decrease in mental status. in fact, at one of our conferences, it was noted that he may have some calcification of the basilar system. however, because he has a gastric pacemaker, we cannot perform a magnetic resonance scan on him. this remains a theoretical possibility. this would, however, not explain his focal neurological deficits; namely, the right sided hemiplegia. finally, the thought was also brought up that he may have a subclinical seizure disorder that would cause his focal neurological deficits and waxing and symptoms. however, on 24 hour telemetry, we could not find any evidence of electrographic seizures. however, the possibility of a seizure disorder being a clinical diagnosis cannot be excluded solely based on absence of electrographic events. for this reason, we have started the patient on 500 mg b.i.d. of keppra as a prophylactic measure. on the day of dictation, the patient has improved dramatically. he is back at his baseline, able to converse and has metric strength and is in no acute distress. he is following up with physical therapy and occupational therapy. we have had some issues with his blood sugar which we have appropriately treated with humalog and nph insulin with good results. today, his blood sugar has run anywhere between 150s to 200s. he will be therefore discharged back to his nursing home. medications on discharge: the patient is to continue all his outpatient medications with the addition of keppra 500 mg b.i.d. please also note, we are discharging the patient on coumadin 4 mg q.h.s. his inr today was 3.0 on course of 5 mg q.h.s. follow-up: 1. the patient apparently has neurologist back in . we would be happy to follow him in clinic if his primary care physician thinks that we could be of help. please call and arrange for a follow-up visit with dr. and dr. for next available follow-up. otherwise, the patient is to follow-up with his neurologist. 2. the patient is to follow-up with his primary care physician on the issues of anticoagulation and his diabetes mellitus. his inr should be kept between 2.0 and 3.0 condition on discharge: stable. , m.d. dictated by: medquist36 procedure: diagnostic ultrasound of heart other esophagoscopy enteral infusion of concentrated nutritional substances diagnoses: candidiasis of other urogenital sites other convulsions polyneuropathy in diabetes background diabetic retinopathy ulcer of heel and midfoot diabetes with neurological manifestations, type i [juvenile type], not stated as uncontrolled gastroparesis diabetes with ophthalmic manifestations, type i [juvenile type], not stated as uncontrolled diabetes with other specified manifestations, type i [juvenile type], not stated as uncontrolled 

Answer: The patient is high likely exposed to