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: penicillins / sulfa (sulfonamide antibiotics) / mercaptopurine analogues (thiopurines) attending: chief complaint: baclofen overdose. major surgical or invasive procedure: 1. nasogastric tube 2. picc line history of present illness: this is a 52 year-old female who is a pathologist at with a history of worsening ms who presents to the ed with baclofen overdose. the history was obtained from the patient's husband. the patient has relapsing progressive multiple sclerosis that has been worsening over the last two years and has been wheelchair bound. the husband states that she has had for years, but seemed more depressed over the last week. he could not identify a particular trigger, but thought that the holidays had made things worse. the patient was at home alone when the husband got a call from his wife who was tearful and said she had taken "20 tabs" of baclofen, but the husband thought she had taken more. per ed they had estimated ~80-170 pills equaling 3400mg) he called ems and on arrival they cound her "sleepy" and tachycardic to the 120-140's. . in the ed she was 97.6 98 158/78 14 100% ra. she became more somnolent then unresponsive and was intubated for airway protection. she was started on a propofol gtt in the ed. initial vent settings were tv: 500, peep: 5, rr: 12 and fio2: 50%. cxr showed right main-stem intubation and tube was withdrawn 3 cm. her abg was 7.32/45/132/24. she was given 25g of charcoal. her labs were significant for a tox screen positive for opiates and amphetamines. she had a mildly positve ua and was give cipro. she was seen by tox in the ed who recommended supportive care, tachyarrhythmias per acls and bradydysrhythmias with atropine. . on arrive to the icu the patient was intubated and sedated. . ros: unable to obtain past medical history: relapsing progressive multiple sclerosis sleep apnea - mixed picture: cpap dependent sarcoidosis (in lung, diagnosed when moved to us for residency) social history: she was practicing at as a liver pathologist until 5 months ago. husband is a pulmonologist. she was born in , brought up in . family history: her brother has ms, but currently less severe. physical exam: on admission: gen: intubated and sedated heent: pupils reactive to light, sclera anicteric, no epistaxis or rhinorrhea, mmm, og in place neck: no jvd, carotid pulses brisk, no bruits, no cervical lymphadenopathy, trachea midline cor: rrr, no m/g/r, normal s1 s2, radial pulses +2 pulm: lungs ctab anteriorly, no w/r/r abd: soft, nt, nd, +bs, no hsm, no masses/ supra-pubic catheter ext: no c/c/e, no palpable cords neuro: cn ii ?????? xii grossly intact. grimace to pain. patellar dtr +1. plantar reflex downgoing. skin: no jaundice, cyanosis, or gross dermatitis. no ecchymoses. . at discharge: general: awake, alert, and oriented neuro exam: she has normal pupillary reactions and eoms. no dysarthria. strength in ues reveals right>left and distal>proximal weakness mostly in an umn pattern although right biceps also are quite weak. fes are particularly weak at 2-3/5, and ffs slightly weak (5-/5). elsewhere mostly . tone relatively normal in ues but prominent spasticity bilaterally in les with only trace ip movement, quads, 2-3/5 foot dfs. toes easily upgoing. pertinent results: labs on admission: 05:08pm wbc-9.8# rbc-4.77 hgb-13.5 hct-41.1 mcv-86 mch-28.4 mchc-32.9 rdw-13.9 05:08pm plt count-394 05:08pm neuts-84.4* lymphs-8.9* monos-4.1 eos-0.9 basos-1.8 01:37pm glucose-140* urea n-12 creat-0.4 sodium-135 potassium-3.6 chloride-100 total co2-24 anion gap-15 01:37pm pt-11.9 ptt-23.0 inr(pt)-1.0 01:37pm asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 01:43pm urine bnzodzpn-neg barbitrt-neg opiates-pos cocaine-neg amphetmn-pos mthdone-neg 01:43pm urine color-yellow appear-clear sp -1.024 01:43pm urine blood-mod nitrite-pos protein-75 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-mod 01:43pm urine rbc-* wbc-* bacteria-few yeast-none epi-0-2 01:43pm urine ca oxal-rare 09:36pm type-art rates-14/ tidal vol-500 o2-50 po2-31* pco2-42 ph-7.39 total co2-26 base xs--1 intubated-intubated vent-controlled 03:35pm type-art po2-132* pco2-45 ph-7.32* total co2-24 base xs--3 . micro: stool clostridium difficile toxin a & b: negative sputum gram stain-final; respiratory culture: no growth urine legionella urinary antigen: negative blood culture blood culture: pending mrsa screen mrsa screen-negative blood culture blood culture: pending urine culture: pansensitive escherichia coli . imaging: cxr: ogt in stomach. rue picc stable. lungs remain clear without effusion or pneumothorax. eeg: impression: this tracing gives evidence for a severe diffuse encephalopathy with periods of runs of what looks like relatively sustained epileptiform activity over both central regions and also occasional multifocal independent interictal epileptiform spike wave discharges seen on the spike detection algorithm only. it is also noted that the frequency of the sustained epileptiform activity seemed to decrease during the course of the study. cxr: the et tube tip continues to be relatively low, 2 cm above the carina. there is progression of the left lower lobe opacities, still most likely represent atelectasis, but should be further followed to exclude the possibility of developing infection. otherwise, no significant change has been demonstrated. cxr: the patient is intubated with the tip of the et tube in the proximal aspect of the right main stem bronchus. if the tube is withdrawn approximately 3 cm, it would be appropriately positioned. there is left retrocardiac atelectasis. no pneumothorax or pleural effusion is present. there is an og tube within the stomach. cardiomediastinal silhouette and hilar contours are normal. impression: right mainstem bronchial intubation. mild retrocardiac atelectasis. brief hospital course: 52 year-old female pathologist with history of worsening ms admitted with baclofen overdose. hospital course complicated by seizures and delirium. . #baclofen overdose: husband reports that she took 70 baclofen pills. tox screen was negative for coexisting substances. she was intubated for airway protection given sedation in the ed. she was seen by toxicology in the ed who recommended supportive care. on the first hospital day, she had brady and tachyarrhythmias. in addition, she had two seizures that day- the first of which was self limited and the second which did not respond to iv ativan. she was started on a midazolam drip for seizure prevention. she was subsequently loaded with dilantin and then midazolam was weaned once dilantin was therapeutic. she was also hooked up to ceeg. the seizures were beleived to be due to baclofen withdrawal. her baclofen was restarted at half dose 36 hours after intoxication taking the half life of baclofen into consideration. it was subsequently increased to home dose. her eeg improved after she was restarted on her home dose of baclofen. her dilantin was then stopped as she does not have an underlying seizure disorder but rather had seizures as she was withdrawing from thr baclofen. . #respiratory distress: she was intubated for airway protection in the setting of sedating overdose with baclofen. initial cxr showed right main stem intubation with subsequent lll atelectasis. the ett was pulled back and confirmed with cxr. on the third day of hospitalization (), she had a new leukocytosis, a fever to 100.7, and thick secretions with some concern for a rll infiltrate. vancomycin and cefepime were started for hcap treatment for a planned 8 day course. a picc line was placed for these antibiotics. she was extubated without issue after 5 days of invasive ventilation. after transfer to the neurology service from the icu, she had no evidence of any infection and her cxr was clear, so it was decided that her antibiotics would be stopped (on ). during her stay on the floor, she has had no respiratory issues. . #psych: given her impulsive suicide attempt, she was followed by the psych department while she was an inpatient. they determined that discharge to reheab, where she would be followed by the psych department there, would be a safe discharge for her. her effexor er was initially held, but was subsequently restaretd at a dose of 37.5 mg as per psych. can consider adding adderall when at rehab as per psych. . #uti: she had a mildly positive urinalysis and a urine culture revealing pansensitive e.coli. she was initially treated with ciprofloxacin on . however, this was discontinued once vancomycin/cefepime was started on . . #ms: she has secondary progressive ms. her outpatient psychiatrist and neurologist, venlafaxine and mycophenalate were held during her acute illness. mycophenalate was restarted on . venlafaxine was also subsequently restarted at a dose of 37.5 mg daily as per psych. . #fen: she was fed with tpn during her intubation. she failed speech and swallow on the day of extubation. a nasogastric tube was placed for both tube feeds and medication administration. a repeat speech and swallow evaluation showed that she had no difficulty with swallowing and she was started on a regular diet. medications on admission: tylenol #3 2 tabs :prn adderall 10mg baclofen 20mg qid cellcept 1000mg pramipexole 0.125mg 1-2 tabs prn vesicare 10mg daily:prn venlafaxine 150mg sr daily bisacodyl 10mg recally twice a week vitamin d3 1000u daily cyanocobalamin 1000mcg sl daily discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 3. pramipexole 0.125 mg tablet sig: 1-2 tablets po daily prn. 4. polyethylene glycol 3350 17 gram/dose powder sig: one (1) po daily (daily) as needed for constipation. 5. baclofen 10 mg tablet sig: two (2) tablet po qid (4 times a day). 6. mycophenolate mofetil 500 mg tablet sig: two (2) tablet po bid (2 times a day). 7. trazodone 50 mg tablet sig: 0.5 tablet po hs (at bedtime) as needed for insomnia. 8. venlafaxine 37.5 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po daily (daily). 9. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for hold for loose stool. 10. acetaminophen-codeine 300-30 mg tablet sig: 1-2 tablets po q6h prn as needed for pain. discharge disposition: extended care facility: - discharge diagnosis: baclofen overdose secondary progressive ms discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: you were admitted to the hospital with a baclofen overdose, which you say was an impulsive and not a planned act. upon arrival to the ed, you were intubated for airway protection. you were seen by toxicology, who reccommended supportive care. during your first day in the hospital, you had 2 seizures for which you were started on dilantin and placed on ceeg. the seizures and the subsequent delusions you experienced were likely due to withdrawal from baclofen. you have since been restarted on your home dose baclofen. the dilantin has also been stopped as you do not have an underlying seizure disorder. after you were extubated, you were transferred to the neurology service. while on the neurology service, you passed a speech and swallow eval and was started on a regular diet. you were also seen by pt, who reccomended that you would benefit from rehab given that you were bedbound for 1 week. you were seen by psychiatry, who restarted you on your home effexor and also helped formualte the plan for a safe discharge to , where you will be followed by the psychiatry service there. with regards to your ms, you were continued on your home dose of cellcept. followup instructions: provider: , phone: date/time: 1:00 provider: , m.d. phone: date/time: 2:00 provider: , md phone: date/time: 1:30 md, procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances insertion of endotracheal tube central venous catheter placement with guidance diagnoses: pneumonia, organism unspecified obstructive sleep apnea (adult)(pediatric) urinary tract infection, site not specified other convulsions sarcoidosis pulmonary collapse other specified cardiac dysrhythmias encephalopathy, unspecified multiple sclerosis drug-induced delirium suicide and self-inflicted poisoning by other specified drugs and medicinal substances lung involvement in other diseases classified elsewhere poisoning by skeletal muscle relaxants 

Answer: The patient is high likely exposed to