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: pt. presented on this admition with increased lethargy, a ct scan revealed increase in the size of the ventricles and developing hydrocephalus. major surgical or invasive procedure: right cranioplasty with bone flap replacement external ventricular drain placement ventricular-peritoneal shunt placement history of present illness: 62 yo m with hx traumatic ich s/p r craniectomy and r-temporal lobectomy () admitted on for fever and ms change. patient was admitted from after falling off ladder. he was found to have ich and emergent r craniectomy and evacuation of hematoma was performed on . course was complicated by increasing midline shift necessitating widening of r temporal lobectomy on . pt also had peg-tube and ivc filter placed. he was discharged to rehab on . according to wife, pt had been doing well until day of admission on when he was noted to be less responsive with temp of 100.6. on day prior to admission he had been more interactive and was able to participate with physical therapy. past medical history: -intracranial hemorrhage s/p r sided craniectomy and evacuation of hematoma. s/p right sided temporal lobectomy () -hypercholesterolemia -htn -s/p peg -s/p ivc filter (placed because of prolonged immobilization in setting of recent bleed.) social history: married, admitted from rehab facility family history: n/c physical exam: on admission: t:97.6 bp:160/88 hr:57 rr:18 o2sats 100% gen: intubated and sedated heent:lg l occipital scalp lap pupils:l 3mm-2mm, r 2mm-1mm eoms can't be tested neck: c-collar in place extrem: warm and well-perfused with lateral lac on l scapula. neuro: mental status: sedated orientation: sedated recall: sedated language: intubated naming intact. intubated cranial nerves: i: not tested ii: pupils reactive to light, l 3mm to 2mm, r 2mm-1mm. visual fields not tested iii, iv, vi: extraocular movements not tested v, vii:unable to test viii: unable to test ix, x: unable to test : unable to test xii: unable to test motor: normal bulk and tone bilaterally. no abnormal movements, tremors. moving upper ext. spont. unable to test pronator drift sensation: sedated toes downgoing bilaterally coordination: not tested exam on discharge: minimal verbalization, +eye opening to loud voice. baseline right ptosis and right facial droop. spontaneous and purposeful movements of the upper extremities r>l. wiggles toes on right foot to command. left foot is flacid. pertinent results: labs on admission: 12:00pm blood wbc-9.6 rbc-3.82*# hgb-11.9*# hct-33.0*# mcv-86 mch-31.2 mchc-36.2* rdw-13.5 plt ct-417 12:00pm blood neuts-81.4* lymphs-10.1* monos-4.6 eos-3.5 baso-0.3 12:00pm blood pt-13.1 ptt-27.7 inr(pt)-1.1 12:00pm blood glucose-114* urean-24* creat-0.7 na-136 k-4.5 cl-98 hco3-32 angap-11 12:00pm blood alt-104* ast-42* ck(cpk)-28* totbili-0.3 12:00pm blood lipase-46 12:00pm blood ctropnt-<0.01 04:00pm blood calcium-11.9* phos-3.9 mg-1.9 03:00am blood pth-61 labs on discharge: 05:53am blood wbc-6.3 rbc-2.64* hgb-7.8* hct-22.5* mcv-85 mch-29.7 mchc-34.8 rdw-14.2 plt ct-223 03:52am blood neuts-79.8* lymphs-11.1* monos-3.5 eos-5.5* baso-0.1 05:28am blood pt-14.1* ptt-53.9* inr(pt)-1.2* 05:53am blood glucose-123* urean-24* creat-0.7 na-137 k-3.7 cl-106 hco3-25 angap-10 imaging: : impression: low lung volumes with bibasilar atelectasis. no pneumonia. : ekg sinus rhythm. no previous tracing available for comparison. hct: impression: 1. no new acute intracranial hemorrhage. slightly improved leftward shift of midline structures. 2. new hydrocephalus, especially of the left lateral ventricle and third ventricle. no definitive obstructing mass seen. hct: impression: 1. status post right frontal cranioplasty with unchanged pneumocephalus and post-surgical changes in the right middle cranial fossa. 2. interval increase in right subdural fluid collection measuring 14 mm. unchanged leftward shift of normally midline structures, approximately 7 mm. 3. persistent dilatation of the left lateral ventricle. interval placement of a left ventriculostomy catheter. mri head: impression: 1. no large areas of acute infarction or new hemorrhage. evaluation for subtle foci of restricted diffusion is somewhat limited due to the presence of blood products in the parenchyma as well as in the occipital horns. 2. subdural fluid collection in the right frontoparietal and surgical resection cavity filled with fluid in the right middle cranial fossa, with edema of the cerebral parenchyma and mass effect on the right lateral ventricle and 8 mm shift of the midline structures to the left, not significantly changed compared to the prior study of , allowing for the technical differences. 3. enhancement around the periphery of the subdural fluid collection in the surgical resection cavity may relate to post-surgical changes or other causes of inflammation/infection if there is clinical concern for infection. hct : impression: 1. unchanged right subdural hematoma with mass effect causing 5 mm leftward subfalcine herniation. 2. there is focus of high attenuation in the lower pons, which could reflect artifact at the skull base. however, pontine hemorrhage cannot be excluded and mri to rule out hemorrhage is recommended. mri head: no evidence for acute hemorrhage in the pons as questioned on the recent ct. slight increase in size of the subgaleal collection on the right compared to previous examination from , but no significant change compared to yesterday's ct. stable right subdural collection with stable enhancement along its medial margin. hct :impression: 1. interval removal of a drain from the right subdural collection, which is not significantly changed in size. 2. persistent hydrocephalus and stable leftward shift of the midline. mri head : no evidence of hemorrhage or infarction. no change in subgaleal and subdural fluid collections with mass effect. brief hospital course: on pt. was admitted for w/u of his fevers and hydrocephalus, he went to the or on for cranioplasty(replacement of bone flap), he was extubated in the or and transferred to the floor. on , he developed respiratory distress and fevers and was transferred to the icu, a fever w/u revealed a uti with coag negative staph in the urine. , it was noted on physical exam that pt. had significant nuchal rigidity, an lp was performed and later and id was consulted. an external ventricular drain was placed for surveillance of the csf and in the interim until a permanent shunt could be placed. cultures from csf have to date, not grown any organism, and wbc thought to be pilocytic in nature. on , swabs from the bone flap grew the organism p. acne, and appropriate antibiotics were started(cefepime for two weeks and vancomycin 4wks). on , routine lenis were performed and massive bilateral dvt's were identified. he was started on heparin infusion until inr could be therapeutic. upper extremity ultrasound performed to identify superficial thrombosis in r basilic/cephalic veins. warfarin therapy was deferred until in the setting of pending systemic cultures to determine if in fact bone flap was infected, and may necessitate removal. his nuchal rigidity continued to improve, and vps was cleared for placement by infectious disease on . procedure was uneventful. on , his lfts were noted to have mild elevation and cefepime was discontinued. he was to continue on vancomycin until . he continued to have temperatures to 101.9. in the setting of subsequent negative cultures, the fevers were thought to related to antibiotics, and they were discontinued on . the p. acne that was isolated from the bone flap was determined to be pathogenic. on he was again febrile to 101.4, however in the setting of recently discontinued vancomycin(thought to be causative of ongoing fever), and relatively long half life, he was not cultured. his wbc was 6.3 on , and thereby not suggestive of ongoing infectious process. he was seen and evaluate by physical and occupational therapy and determined to be appropriate for rehab disposition. he was discharged to an appropriate facility on where his warfarin transition is to continue(goal inr 2.5-3) medications on admission: 1) appl ophthalmic prn (as needed). 2. clonidine 0.3 mg tablet : one (1) tablet po tid (3 times a day). 3. lisinopril 40 mg tablet : tablet po daily (daily). hydralizine 50mg q6 hydroclorothiazide 25mg 4. simvastatin 20 mg tablet : two (2) tablet po daily (daily). 5. heparin (porcine) 5,000 unit/ml solution : one (1) ml injection tid (3 times a day). 6. magnesium hydroxide 400 mg/5 ml suspension : thirty (30) ml po q6h (every 6 hours) as needed for constipation. 7. famotidine 20 mg tablet : one (1) tablet po bid (2 times a day). 8. docusate sodium 50 mg/5 ml liquid : ten (10) ml's po bid (2 times a day). amlodipine 10mg daily dilantin 600mg qhs 10. acetaminophen 160 mg/5 ml solution : po q4h (every 4 hours) as needed for fever or pain. 11. oxycodone 5 mg tablet : 1-2 tablets po every 4-6 hours as needed for pain. 12. dulcolax 10 mg suppository : one (1) rectal at bedtime as needed for constipation discharge medications: 1. amlodipine 5 mg tablet : two (2) tablet po daily (daily). 2. simvastatin 10 mg tablet : one (1) tablet po daily (daily). 3. white petrolatum-mineral oil 42.5-56.8 % ointment : one (1) appl ophthalmic prn (as needed). 4. bisacodyl 5 mg tablet, delayed release (e.c.) : two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 5. docusate sodium 100 mg capsule : one (1) capsule po bid (2 times a day). 6. senna 8.6 mg tablet : 1-2 tablets po bid (2 times a day) as needed. 7. nystatin 100,000 unit/ml suspension : five (5) ml po qid (4 times a day) as needed for fungal infection. 8. levetiracetam 100 mg/ml solution : one (1) po bid (2 times a day). 9. thiamine hcl 100 mg tablet : one (1) tablet po daily (daily). 10. folic acid 1 mg tablet : one (1) tablet po daily (daily). 11. modafinil 100 mg tablet : two (2) tablet po qd (). 12. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 13. ferrous sulfate 300 mg (60 mg iron)/5 ml liquid : five (5) ml po daily (daily). 14. metoprolol tartrate 50 mg tablet : three (3) tablet po tid (3 times a day). 15. hydralazine 50 mg tablet : one (1) tablet po q6h (every 6 hours). 16. erythromycin 5 mg/g ointment : apply ophthalmic qid (4 times a day): apply to both eyes. 17. spironolactone 100 mg tablet : one (1) tablet po daily (daily). 18. lisinopril 20 mg tablet : four (4) tablet po daily (daily). 19. aspirin 81 mg tablet, delayed release (e.c.) : one (1) tablet, delayed release (e.c.) po daily (daily). 20. heparin (porcine) in d5w 25,000 unit/250 ml parenteral solution : 1200 (1200) units/hr intravenous asdir (as directed): please titrate to goal ptt 50-70 until inr is therapeutic. 21. hydralazine 20 mg/ml solution : 0.5 ml injection q4h (every 4 hours) as needed for sbp>160. 22. warfarin 5 mg tablet : two (2) tablet po once (once) for 1 doses: loading dose to be given at 1600 on . please check inr in am. . 23. iss refer to nursing insulin sliding scale discharge disposition: extended care facility: - discharge diagnosis: aseptic meningitis hemiparesis hydrocehpalus fevers, etiology: drug protien/calorie deficiency discharge condition: neurologically stable discharge instructions: ?????? have a friend/family member check your incision daily for signs of infection. ?????? take your pain medicine as prescribed. ?????? exercise should be limited to walking; no lifting, straining, or excessive bending. ?????? increase your intake of fluids and fiber, as narcotic pain medicine can cause constipation. we generally recommend taking an over the counter stool softener, such as docusate (colace) while taking narcotic pain medication. ?????? you have been discharged on keppra (levetiracetam), you will not require blood work monitoring. ?????? clearance to drive and return to work will be addressed at your post-operative office visit. ?????? make sure to continue to use your incentive spirometer while at home, unless you have been instructed not to. call your surgeon immediately if you experience any of the following ?????? new onset of tremors or seizures. ?????? any confusion or change in mental status. ?????? any numbness, tingling, weakness in your extremities. ?????? pain or headache that is continually increasing, or not relieved by pain medication. ?????? any signs of infection at the wound site: redness, swelling, tenderness, or drainage. ?????? fever greater than or equal to 101?????? f. followup instructions: follow-up appointment instructions ??????your sutures have been removed, and thereby an office appointment for this purpose is not indicated ??????please call ( to schedule an appointment with dr., to be seen in 4 weeks. ??????you will need a ct scan of the brain without contrast. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified spinal tap incision of lung insertion of endotracheal tube enteral infusion of concentrated nutritional substances ventricular shunt to abdominal cavity and organs arterial catheterization other intubation of respiratory tract bone graft to skull other craniotomy ventricular shunt to extracranial site nec diagnoses: acidosis obstructive hydrocephalus pure hypercholesterolemia urinary tract infection, site not specified other nervous system complications peripheral vascular complications, not elsewhere classified other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation altered mental status staphylococcus infection in conditions classified elsewhere and of unspecified site, other staphylococcus urinary complications, not elsewhere classified hemiplegia, unspecified, affecting unspecified side gastrostomy status unspecified viral meningitis benign essential hypertension fever presenting with conditions classified elsewhere ptosis of eyelid, unspecified late effects of accidental fall other specified acquired deformity of head personal history of other injury meningismus 

Answer: The patient is high likely exposed to