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: rocephin / ativan attending: chief complaint: status epilepticus major surgical or invasive procedure: intubation/extubation head ct history of present illness: the pt is a 53 year-old right-handed man with fragile x and seizures, learning disability, recurrent aspiration pneumonia, ocd, htn, gerd and recent colonoscopy and polypectomy presents after having 2 prolonged seizures as transfer from ed. patient had a recent colonoscopy on at which point had a polypectomy. after this had been feeling generally unwell. no nausea, vomiting or abdominal pain but non-specific. per report, staff had no concerns prior to presentation and patient had been eating well and taking his medications with no fevers etc. nursing staff from facility present in the ed had not seen him recently and family noted he had said he felt unwell but nil else. he had been with his sister on and had to go back to his group home given general malaise. at his group home he was noted to have a generalised tonic clonic seizure with bilteral limbs legs > arms shaking with no tongue biting or incontinence per report and ems were called. unfortunately when i called his group home, no-one who had seen this was available. seizure terminated after 15mins following im diazepam. in the ambulance, patient had another seizure and was still seizing when brought into ed at 14:52. there he was noted to have red, mottled skin all over his body, and patient was unresponsive with evidence of generalised tonic-clonic seizure for >30 minutes total duration. in addition, he was afebrile and had no signs of meningism and abdomen was soft and non-tender he received iv midazolam which decreased seizure activity and skin appearance started to normalise and he was given rocuronium 75mg and etomidate 20mg, intubated for airway protection and started on a fentanyl and midazolam infusions and seizure activity ceased. cxr there revealed bilateral atelectasis and ct-head was negative. ua was also negative and no source of infection was found. wcc 12.9 and lactate 2.0 with tni negative and ca 8.4. he was empirically started on iv pip/tazo 3.375g and vancomycin 1g. of particular note, phenytoin level was subtherapeutic at 6.1, carbamazepine was normal at 8.3. per staff, he had am aed doses. he did not have an lp at osh. he was then transferred to for eeg monitoring. on assessment here, patient was intubated and sedated currrently on fentanyl 50 and midazolam 4 and was agitated moving all four limbs arms less than legs and had bilateral arm restraints. he did not have any clinnically obviosu seizure activity adn did not appear in pain adn did ot grimace on palpating his abdomen. he has been afebrile throughout his hospital stay both here and at . . . per family, his normal seizures are gtc seizures and has not had one for 2-3 years. has never required icu admission for seizures (although has for aspiration pneumonia). per staff, he last had staring spells ? absence 2-3 years ago and none since. . . on neuro/general ros - patient sedated and intubated. per family member - had been feeling generally unwell with no weakness or other new neurological symptoms. he had no apparent abdominal pain, nausea, vomiting, fevers, chills, sob, cough or wheeze on current assessment. family did mention that he had been constipated. . . . . ********** physical exam: vitals: t: 98.8 p: 84 r: 12 bp: 111/64 sao2: 100% on 50% o2 general: intubated and sedated. moving all 4 limbs. not verbalising. heent: nc/at, no scleral icterus noted, mmm, no lesions noted in oropharynx neck: supple, no carotid bruits appreciated. no nuchal rigidity pulmonary: lungs cta bilaterally without r/r/w cardiac: rrr, nl. s1s2, no m/r/g noted abdomen: soft, nt/nd, normoactive bowel sounds, no masses or organomegaly noted. pr examination no tenderness and normal rectal tone, no obvious erythema around anus and no clear abscesses. soft brown stool on gloved finger. gu: gross orchidomegaly in keeping with fragile x - no erythema. extremities: no c/c/e bilaterally, 2+ radial, dp pulses bilaterally. spine: pronounced sacral dinple. skin: no rashes or lesions noted save slight rash on left neck. . . neurologic: . -mental status: sedated. moving all 4 limbs not opening eyes. gcs e1 vt m4-5. . -cranial nerves: i: olfaction not tested. ii: perrl 3 to 2mm and sluggish. vff unable to be assessed. funduscopic exam revealed no papilledema, exudates, or hemorrhages ? cataracts. iii, iv, vi: normal doll's eye. v: unable to be assessed. did not perform corneal reflex. vii: no facial droop, facial musculature symmetric unable to assess power. viii: hearing not assessed. not following commands. ix, x: intaxct gag. : unable to assess. xii: intubated. unable to assess. . . limb exam: -motor: normal bulk, tone throughout. seems full power in limbs (moving all 4 luimbs) but not obeying commands. moving arms less than legs. no adventitious movements, such as tremor, noted. no asterixis noted. -sensory: withdraws to painful stimulus bilaterally in le and ue. -dtrs: tri pat ach l 2+ 2+ 2+ 2+ 3 r 2+ 2+ 2+ 2+ 3 brisk reflexes throughout with 5 beats of clonus on left and 9 beats on right. plantar response was extensor bilaterally. -coordination: unable to assess. -gait: unable to assess. ********** laboratory data: 05:45pm blood wbc-14.7* rbc-3.87* hgb-13.3* hct-38.4* mcv-99* mch-34.5* mchc-34.7 rdw-12.4 plt ct-279 05:45pm blood pt-13.9* ptt-17.1* inr(pt)-1.2* 05:45pm blood urean-14 creat-0.7 05:45pm blood lipase-30 05:45pm blood albumin-4.0 05:45pm blood phenyto-29.0* 05:45pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 06:09pm blood type-art tidal v-500 peep-5 fio2-100 po2-370* pco2-62* ph-7.24* caltco2-28 base xs--2 aado2-281 req o2-53 -assist/con intubat-intubated 06:09pm blood glucose-133* lactate-1.2 na-139 k-4.1 cl-105 05:57pm blood lactate-1.5 06:09pm blood hgb-13.9* calchct-42 . urine: 05:45pm urine color-yellow appear-clear sp -1.013 05:45pm urine blood-sm nitrite-neg protein-tr glucose-neg ketone-neg bilirub-neg urobiln-neg ph-6.0 leuks-neg 05:45pm urine rbc-4* wbc-1 bacteri-none yeast-none epi-0 05:45pm urine casthy-3* 05:45pm urine mucous-rare 05:45pm urine bnzodzp-pos barbitr-neg opiates-neg cocaine-neg amphetm-neg mthdone-neg . ekg: sr 1st deg hb pr 202 lad and partial rbbb with rsr' in v1-2 radiologic data: non-contrast ct of head: awaited. has been requested. apparently normal at . . . radiology: cxr - clear chest and et tube in place . ct-head - given to radiology and shoudl be uploaded onto the system. per read at negative. nil on my read and also on review by radiology. *************** assessment: 53m with fragile x and seizures, learning disability, recurrent aspiration pneumonia requiring icu admission, ocd, htn, gerd and recent colonoscopy and polypectomy presents after feeling unwell for 3 days with 2 prolonged seizures and intubated for airway protection. on neurological examination, patient is moving all 4 limbs and nil localisable on exam with brisk reflexes throughout and bilateral extensor plantars and nil on fundoscopy and no signs of meningism and afebrile. elevated wcc 14.7 ? seizures but also given recent colonoscopy ? inflammation/infection. infection screen negative. continuing iv pip/tazo and vanc given unclear picture. low phenytoin 6.1 despite seemingly taking all his aeds and loaded at osh with iv phenytoin with repeat level here 29. admitting to neuro icu with a plan for hopefully quick weaning of sedation and extubation with eeg in am. . . plan: . # neuro: - admit to neuro-icu under attending dr - q2 vitals and neurochecks - routine eeg in am - phenytoin level added on post phenytoin load - 29 - aed levels in am - change to iv keppra and phenytoin - serum adn urrine tox negative save benzodiazepines - continnue aeds as follows: keppra iv 1500mg phenytoin iv 100/200mg topiramate 100mg carbamazepine 600mg - ngt for admin of po meds - seizure and fall precautions - aim to wean sedation (was on midaz 4 and fentanyl) and extubate when possible - given no meningism on exam and no hx of fevers no current need for lp - holding home risperidone - no mri needed at present - ct-head should be uploaded onto the system - iv diazepam 5-10mg prn seizures . # cardiology: - telemetry in icu - ecg in am. . # respiratory: - continue ventilationa dn wean as above as soon as possible - repeat cxr in am . # gi: recent colonoscopy and polypectomy. - change po ranitidine to iv famotidine - watch gi status . # id: ua was negative - continue pip-tazo and vanc for now - follow wcc and fever curve - f/u blood cultures and uc added on . . # fen: npo but meds via ngt. when able for soft diet and honey liquids ppx - dvt - heaprin s/c - gi - famotodine - laxatives prn . . # code: presumed full . dispo: neuro icu dr , md, mrcp neurology resident this case was discussed with dr , neurology chief resident. dr , accepting icu attending was informed. addendum by , md on at 9:31 am: 9am. neurology attending. i have reviewed the history fro a caregiver who works with at his home, reviewed the medical record, and examined him.dr has accurately recorded th information and the plan of care with which i fully agree he has had known seizures and maintained on 4 anticonvulsants as well as risperidol and prozac. had not been feeling well after colonoscopy but apparently took meds as before. had two grand mal seizures one at the home one at . he is still intubated and had been given versed. he is easily alerted and has not focal visual, motor, reflex, or sensory signs. will remove the intubation, hydrate and ambulate. will contact dr his usual physician and neurologist. md past medical history: pmh: fragile x seizures - last 2-3 years ago gtc seizures learning diability recurrent aspiration pneumonia previosu requiring icu stay ocd htn gerd social history: social hx: lives in a group home mobilises independently eats soft diet and honey consistency liquids ? alcohol/smoking history pertinent results: 06:09pm type-art tidal vol-500 peep-5 o2-100 po2-370* pco2-62* ph-7.24* total co2-28 base xs--2 aado2-281 req o2-53 -assist/con intubated-intubated 06:09pm glucose-133* lactate-1.2 na+-139 k+-4.1 cl--105 06:09pm hgb-13.9* calchct-42 05:57pm comments-green top 05:57pm lactate-1.5 05:45pm urea n-14 creat-0.7 05:45pm estgfr-using this 05:45pm lipase-30 05:45pm albumin-4.0 05:45pm phenytoin-29.0* 05:45pm asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 05:45pm urine hours-random 05:45pm urine bnzodzpn-pos barbitrt-neg opiates-neg cocaine-neg amphetmn-neg mthdone-neg 05:45pm wbc-14.7* rbc-3.87* hgb-13.3* hct-38.4* mcv-99* mch-34.5* mchc-34.7 rdw-12.4 05:45pm pt-13.9* ptt-17.1* inr(pt)-1.2* 05:45pm plt count-279 05:45pm fibrinoge-252 05:45pm urine color-yellow appear-clear sp -1.013 05:45pm urine blood-sm nitrite-neg protein-tr glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.0 leuk-neg 05:45pm urine rbc-4* wbc-1 bacteria-none yeast-none epi-0 05:45pm urine hyaline-3* 05:45pm urine mucous-rare brief hospital course: icu course: mr. had no acute events overnight in the icu. he was initially intubated and sedated on fentanyl/versed. he was placed on a spontaneous breathing trial which he passed and was subsequently extubated. he was following commands and moving all extremities well even prior to his extubation. following extubation, i had a chance to examine him. he refuses to speak with me, although he does follow most of my commands. he prefers to lie on his left side. because of his white count, he had been started on antibiotics at the outside hospital. chest xray showed no infiltrate, so we discontinued his iv antibiotics. we continued aspiration precautions given his history of recurrent aspiration pneumonia. floor course: neuro: mr. was drowsy upon transfer to floor, but continued to improve. it is most likely secondary to the sedation from intubation. he returned to his baseline and had no further seizures. heme: inr was elevated to 1.4 following seizure. we rechecked the next day and it was 1.1. fen/gi: phosphorus level was low at 1.3, was repleated with neutraphos. prior to discharge, level was 3. the only med change was increasing his dilantin dosage to 125mg in am and 250mg in pm dispo: mr. will return to his group home, and will follow up with dr. on at 9:30am. medications on admission: medications: aeds: keppra 1500mg phenytoin 100/200mg topiramate 100mg carbamazepine 600mg other medications: vitamin d 1000 units qd chlorhexadine 12% oral rinse 15ml spit and swallow ranitidine 150mg fluoxetine 40mg qd risperidone 0.25mg qd oxybutynin 10mg qd doxazosin 2mg qd desmopressin 0.4mg qd eucerin lotion 1 small app folic acid 0.4mg qd diazepam as needed for dental procedures, no seizure prns albuterol 1-2 puffs prn sob immodium 2mg prn loose bowel motions ibuprofen 600mg prn q6h muscle pain or headache thick it for thickening liquids to honey consistency . allergies: lorazepam ceftriaxone discharge medications: 1. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 2. carbamazepine 200 mg tablet sig: three (3) tablet po bid (2 times a day). 3. fluoxetine 20 mg capsule sig: two (2) capsule po daily (daily). 4. levetiracetam 500 mg tablet sig: three (3) tablet po bid (2 times a day). 5. phenytoin 125 mg/5 ml suspension sig: two y five (225) mg po qpm (once a day (in the evening)). disp:*30 days* refills:*2* 6. phenytoin 125 mg/5 ml suspension sig: one y five (125) mg po qam (once a day (in the morning)). disp:*30 days* refills:*2* 7. doxazosin 1 mg tablet sig: two (2) tablet po hs (at bedtime). 8. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 9. topiramate 100 mg tablet sig: one (1) tablet po bid (2 times a day). 10. oxybutynin chloride 5 mg tablet sig: one (1) tablet po bid (2 times a day). 11. white petrolatum-mineral oil cream sig: one (1) appl topical (2 times a day). 12. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 13. risperidone 0.5 mg tablet sig: 0.25 mg po daily (daily). discharge disposition: extended care discharge diagnosis: status epilepticus discharge condition: condition: good mental status: alert. back to baseline ambulation: independent discharge instructions: dear mr. , it has been a pleasure taking care of you. you were admitted to our hospital because you had a long seizure. you required a lot of medications to stop the seizures, and these medications can make patients very sleepy, and you therefore needed some help breathing. a tube was placed to help you breath, and it was removed the next day. you did not have any further seizures during your hospital change. we are making one medication change: you will be now discharged on dilantin 125mg in the morning and 225mg in the evening. followup instructions: follow up with dr., on at 9:30 am. will need dilantin level checked then. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube diagnoses: esophageal reflux unspecified essential hypertension grand mal status fragile x syndrome 

Answer: The patient is high likely exposed to