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: neck pain and quadriparesis major surgical or invasive procedure: : c3-c6 laminectomies for c2-c7 epidural abscess. : percutaneous tracheostomy at bedside in sicu. : c2-t1 posterior instrumented spine fusion with icbg. history of present illness: neurology consult note: cc: fever, neck pain, resp distress, weakness hpi: 47 m w/ hx ivda, hep c, alcoholism, copd, presented to hosp with fever, cough, and neck pain. symptoms began on sat 2 days prior when he developed neck stiffness. nonetheless, he traveled with his wife to to gamble. on sun he felt worse, but was mostly fatigued and slept in the car ride back to ma as his wife drove. morning, he began c/o b/l hand tingling and electric shock pains going down his body. he developed a fever, and began vomiting and shaking. he thought that he was withdrawing from etoh. his last drink had been sat. his wife notes that he became diffusely weak and was unable to walk straight when he tried to walk. his wife brought him in a wheelchair to hosp, where his temp was noted to be 103 f. cxr was purportedly suggestive of a mild lll pna. nchct at midnight was normal. at 2:15 am, er reports that he was c/o b/l ue weakness and ongoing neck stiffness and intact ms. at 2:45, neck pain is reported as . he had apparently been dropping his sat and was placed on a nrb. at 2:50 am, o2 sat noted to be 88% on nrb and though still awake, he was becoming lethargic. he was felt to require intubation, and was intubated at 3 am. post intubation, though pt appeared to be able to answer yes/ no and move eyes, he had no withdrawal to noxious stim in any ext. he was transferred to and obtained an emergent mri pan-spine showing significant epidural fluid collection, likely blood, possibly infected. there were also bone marrow changes of unclear etiology, but possibly c/w malignancy. prior to mri, pt received ceftriaxone, levaquin, and decadron. notably, pt comes with ct head and ct-spine reports from with an indication for "l arm numbness." of note, his wife reports an unintentional weight loss of 100 lbs over about 3 years. she also notes that he had an hiv test 1 month ago that was negative. pmh: copd hep c 2 brain aneurysms, 2 mm in the r cavernous carotid artery and 4 mm at the origin of the l ophthalmic artery ivda both heroin and cocaine, last use 6 months ongoing alcoholism l temp lobe arachnoid cyst meds: suboxone 8mg/2mg, 1 tab all: nkda fh: sister and grandparents with alcoholism. also generically cad and cancer sh: (+) tobacco, 1 ppd x 30 years, 6 beers per day, prior iv heroin and cocaine use, last 6 months ago. formerly worked as a furniture mover exam: t- 104.4 (tm = f) bp- 115/68 hr- 104 rr- 14 o2sat 100%intubated gen: lying in bed, nad heent: nc/at, moist oral mucosa neck: in c-collar, but appears supple and he spont moves it side to side. cv: rrr, nl s1 and s2, no murmurs/gallops/rubs lung: clear to auscultation bilaterally abd: +bs soft, nontender ext: no c/c/e; equal radial and pedal pulses b/l. apparent track marks r antecubital fossa neurologic examination: mental status: off propofol for 10 min, opens/closes eyes to command and inconsistently follows command to look left/right. cranial nerves: pupils pinpoint and min reactive to light bilaterally. appeared to have btt b/l. extraocular movements intact bilaterally, no nystagmus. of note, there did appear to be some disconjugate mvmts and initially felt r eye did not elevate as well as the l, later they seemed equally full. acknowledges sensation to lt in v1-v3. facial movement symmetric on grimace. (+) corneals. motor: normal bulk bilaterally. flaccid tone throughout. there is no spont mvmt and no mvmt to noxious stim thoughout. later he appears very agitated, grimacing hard and coughing hard, yet still no mvmt of any limb sensation: no withdrawl of any limb to noxious; also no apparent grimacing to noxious. reflexes: 0 and symmetric throughout. toes downgoing on l, mute on r labs: ph 7.25 pco2 63 po2 284 hco3 29 basexs 0 comments: ph: verified ph: provider notified lab policy type:art; intubated; fio2%:100; aado2:383; req:66; rate:14/; tv:500; mode:assist/control urine opiates pos urine benzos, barbs, cocaine, amphet, mthdne negative lactate:1.3 129 97 13 136 agap=12 3.2 23 0.6 estgfr: >75 (click for details) alt: 56 ap: 73 tbili: 2.4 alb: ast: 96 ldh: 289 dbili: tprot: : lip: 22 serum acetmnphn 11.7 serum asa, etoh, , , tricyc negative comments: positive tricyclic results represent potentially toxic levels;therapeutic tricyclic levels will typically have negative 101 4.6 12.1 34 36.5 n:92.2 l:3.5 m:3.6 e:0.5 bas:0.2 comments: plt-ct: verified by smear plt-ct: notified -ed 5:20 a.m. sed-rate: 34 plt-est: very low pt: 15.3 ptt: 37.4 inr: 1.3 ua: large blood, 30 prot, 12 urobilinogen, mod bili, tr ketones, rbc, 0-2 wbc, few bact imaging: cxr (my read): r lung base cut off, but otherwise no clear i/e. mri pan-spine: predominantly posterior epidural collection from craniocervical junction through t2, with some signal features that suggest the presence of blood, i.e. this could be an infected epidural hematoma rather than just an epidural phlegmon. extensive edema/enhancement in the interspinous ligaments from c1-2 through c4-5, and in the posterior paravertebral soft tissues of the cervical spine, which could indicate traumatic injury or spread of infection. not clear if the epidural collection extends into the skull base - suggest head mri. cervical spine ct would also be useful to assess for posterior element fractures. cervical spondylosis, worst at c5-6 and c6-7, with spinal cord deformity and abnormal cord signal, could be edema or myelomalacia. diffusely abnormal bone marrow signal, could be due to anemia, chronic systemic illness, or infiltrative disorder including infiltrative malignancy. no focal thoracic spine abnormalities below t2. chronic mild l1 compression deformity. mild lumbar spondylosis. mild epidural edema/enhancement surrounding a disc bulge at l1-2, likely reactive inflammation as there is no evidence of diskitis/osteomyelitis at this level. a/p: 47 m w/ hx ivda, hep c, alcoholism, copd, with significant throbmocytopenia, presented from hosp with 3 days neck pain and 1 day of fever to tmax 105 f, vomiting, malaise, b/l hand parasthesiae and shooting electric pains down his body, found with significant epidural fluid collection from craniocervical junction to t2, thought to be blood, possibly infected (which seems likely given raging fever). exam now seems c/w quadraplegia, and the acuity of his change can certainly be seen with epidural abscess. ms at least minimally intact and cn's appear intact, though he had some dyscongugate eye movements. he is being taken emergently to the or for emergent eploration and evacuation. recs: agree with emergent surgical evacuation f/u cultures (including bcx at ) and broad coverage abx brain mri w/ and w/o gad 100 lb weight loss and abnormal bone marrow signal probably warrant cancer screen will follow on consult service note: contact = wife at case discussed with , md, neurology attendning , md/phd, pgy-3 resident in neurology past medical history: see above social history: see above family history: see above physical exam: see above for exam on admission. now with approx 4/5 strength in ble. regaining strength in bue. c-collar. trach with pmv. pertinent results: 05:15pm type-art po2-101 pco2-38 ph-7.37 total co2-23 base xs--2 04:44am lactate-1.3 brief hospital course: micro: : bcx: mrsa : or (c-spine) cx: mrsa : mrsa screen: negative : bcx: mrsa : bal: yeast : bal: yeast : bcx ng : bcx ng : tissuecx ng : urinecx ng : mrsa neg . imaging: : skull films (screen for mri): negative : mri spine: epidural abscess (? infected hematoma) from craniocervical junction to t2 : echo: normal left ventricular global and regional systolic function. lvef > 55%. right ventricular dilation, sign, and evidence of right ventricular pressure/volume overload raises the concern for significant pulmonary emboli. no vegetations identified : cta chest: no pulmonary embolism, aortic dissection or aneurysm. severe interlobar and left lower lobe segmental and subsegmental bronchial mucoid impaction with left lower lobe atelectasis. small multifocal peri-bronchovascular ground-glass opacities are most likely infectious or inflammatory in origin : dvt ultrasound neg : cxr cont opacification at l base, most likely related to atelectasis and possible effusion. : nl tte : ct new cervical and upper thoracic spinal fusion hardware, unremarkable. partially visualized left lung nodule, likely a partially visualized focus of ground-glass opacity similar on ct . : cxr minimal blunting of l costophrenic sinus could suggest small pleural effusion, unchanged retrocardiac atelectasis, ngt unremarkable : cxr hazy opacification at l base w obscured hemi-diaphgragm consistent with small pleural effusion and atelectasis : cxr 5pm stable appearance to small left pleural effusion and atlectesis at l base. : cxr small amount of left lower lobe volume loss . events: : or: cervical laminectomy, drainage epidural abscess : perc trach at bedside. neuro exam c/w quad. bronch w/extensive secretions b/l : moving all extremities. bue : vanc level 15.1. no preop dht. weaned to tc. methadone 20 . tfs back to goal. npo for 2pm or time. wife to visit and reconsent. : or for orif/fusion c2-t2 iliac bone graft : ct : repeat ct w/ nl hardware. still lg amounts secretions. alert/moving all extremities. dobhoff placed, tf re-started. right picc line placed. retaining co2, methadone held and placed on a rate to blow off co2. : bronchoscopy. : atelectasis on cxr in am, incr to ps/cpap . evening cxr unchanged, ++increased secretions. afeb. kept settings same on. ?bronch in am if continued secretion difficulties. : started on soft solid diet after bedside swallow. : awaiting rehab. copious secretions. : speech/swallow->pmv, nectar thick puree diet. ok to d/c staples per orthospine. awaiting placement w/masshealth insurance. outline of hospital stay as above. briefly, was intubated at osh and transferred to for emergent evaluation and treatment of paralysis requiring intubation prior to transfer. taken to or for decompression emergently. remained in icu being treated for epidural abscess, respiratory failure and pna. had trach placed on . had posterior spine fusion on . weaned from vent to pmv and mobilized with pt/ot. has started regaining strength in bue/ble. id continued to follow for abx regimen. speech and swallow has consulted for diet. is ready for transfer to rehab. medications on admission: see above discharge disposition: extended care facility: discharge diagnosis: cervical spine epidural abscess with spinal cord injury. discharge condition: stable discharge instructions: you have undergone the following operation: posterior cervical decompression and fusion c2-t1 for epidural abscess. immediately after the operation: - activity: you should not lift anything greater than 10 lbs for 2 weeks. you will be more comfortable if you do not sit in a car or chair for more than ~45 minutes without getting up and walking around. - rehabilitation/ physical therapy: o 2-3 times a day you should go for a walk for 15-30 minutes as part of your recovery. you can walk as much as you can tolerate. o isometric extension exercise in the collar: 2x/day x 10 times perform extension exercises as instructed. - cervical collar / neck brace: you need to wear the brace at all times until your follow-up appointment. you may remove the collar to take a shower. limit your motion of your neck while the collar is off. place the collar back on your neck immediately after the shower. - wound care: remove the dressing in 2 days. if the incision is draining cover it with a new sterile dressing. if it is dry then you can leave the incision open to the air. once the incision is completely dry (usually 2-3 days after the operation) you may take a shower. do not soak the incision in a bath or pool. if the incision starts draining at anytime after surgery, do not get the incision wet. call the office at that time. if you have an incision on your hip please follow the same instructions in terms of wound care. - you should resume taking your normal home medications. - you have also been given additional medications to control your pain. . please allow 72 hours for refill of narcotic prescriptions, so please plan ahead. you can either have them mailed to your home or pick them up at the clinic located on 2. we are not allowed to call in narcotic prescriptions (oxycontin, oxycodone, percocet) to the pharmacy. in addition, we are only allowed to write for pain medications for 90 days from the date of surgery. - follow up: o please call the office and make an appointment for 2 weeks after discharge. please call the office if you have a fever>101.5 degrees fahrenheit, drainage from your wound, or have any questions. physical therapy: oob as tolerated with pt. wbat ble. no heavy lifting. treatments frequency: daily dsd until fully healed. followup instructions: call to schedule follow-up appointment with dr. in about 2 weeks. procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more imageless computer assisted surgery excision or destruction of lesion of spinal cord or spinal meninges enteral infusion of concentrated nutritional substances arterial catheterization other exploration and decompression of spinal canal other exploration and decompression of spinal canal other exploration and decompression of spinal canal other exploration and decompression of spinal canal other exploration and decompression of spinal canal temporary tracheostomy closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus local excision of lesion or tissue of bone, other bones excision of bone for graft, other bones other cervical fusion of the posterior column, posterior technique insertion of (naso-)intestinal tube insertion or replacement of skull tongs or halo traction device plastic operation on pharynx insertion or replacement of skull tongs or halo traction device plastic operation on pharynx fusion or refusion of 9 or more vertebrae combined alcohol and drug detoxification insertion of recombinant bone morphogenetic protein diagnoses: pneumonia, organism unspecified thrombocytopenia, unspecified tobacco use disorder unspecified pleural effusion severe sepsis chronic airway obstruction, not elsewhere classified unspecified viral hepatitis c without hepatic coma acute respiratory failure loss of weight altered mental status intraspinal abscess acute osteomyelitis, other specified sites other and unspecified alcohol dependence, continuous combinations of opioid type drug with any other drug dependence, continuous methicillin resistant staphylococcus aureus septicemia mixed acid-base balance disorder cervical spondylosis with myelopathy other ill-defined cerebrovascular disease 

Answer: The patient is high likely exposed to