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: is the 3.010 kg product of a 38 week gestation pregnancy, born to a 35- year-old g4, p1, now 2 woman. prenatal screens: type a positive, antibody negative, rubella immune, rpr nonreactive, hepatitis b surface antigen negative, group beta strep status negative. the pregnancy was notable for fetal diagnosis at 33 weeks gestation of agenesis of the corpus callosum, bilateral hydronephrosis, and enlarged cardiac silhouette. labor was induced and led to a spontaneous vaginal delivery under epidural anesthesia. there was no intrapartum fever or other clinical evidence of chorioamnionitis. rupture of membranes occurred one and one-half hours prior to delivery and yielded clear amniotic fluid. the infant was initially hypotonic at delivery and was apneic and bradycardic. he was orally/nasally suctioned, received positive pressure ventilation for 90 seconds with good response. apgars were 5 at one minute and 9 at five minutes. there were prominent oral secretions, grunting respirations and intercostal retractions. primary survey revealed several dysmorphic features. prenatally, the family was followed at the advanced care center at . physical examination upon admission to the neonatal intensive care unit was weight of 3.010 kg, 50th percentile, length 48 cm, 50th percentile, head circumference 31.5 cm, 10th percentile. physical examination: on discharge: weight 2.810 kg. general: pink, well perfused infant with nasal airway in place. skin: warm and dry. color pink. heent: nasal airway in place in left nostril. low set ears. palate intact. hypertelorism. redundancy of the nuchal skin. positive red reflex bilaterally. chest: mild intercostal retractions, breath sounds equal, transmitted upper airway sounds. cardiovascular: regular rate and rhythm. pulses normal. well perfused. normal s1. abdomen: soft, nontender, nondistended, no splenomegaly, liver 1 cm below the right costal margin, no masses, active bowel sounds. anus patent. three vessel cord. gu: hypospadias. testes descended bilaterally. musculoskeletal: both hands with clinodactyly and fourth and fifth digit syndactyly, left palmar crease, right post axial polydactyly. hips and spine normal. clavicles intact. neurologic: active, responsive to stimuli, normal tone, symmetrical movements. suck, root and gag reflexes intact. hospital course by systems: 1. respiratory: this infant was treated with continuous positive airway pressure for respiratory distress on admission to the neonatal intensive care unit. he was able to wean to room air by day of life #1. on day of day of life #4 he began to have increased work of breathing with considerable upper airway congestion resulting in obstruction. a 2.5 ett was placed nasopharyngeally to help maintain a patent airway. on early in the morning, the tube was removed because of secretions and due to multiple desaturations, another tube was placed 3.0 size. he was evaluated by the oto-rhino-laryngology service from . a flexible endoscope exam was performed at the bedside and showed a narrow nasal passage on the right and very red inflamed vocal cords. as there had been no lower airway instrumentation this vocal cord inflammation was felt to be related to possible reflux. the consultation service is requesting a computed tomography scan of the sinues with 0.5 mm cuts to determine whether this is bony or soft tissue obstruction. pyriform aperture stenosis or lacrimal duct cyst are in the differential diagnosis. as noted above, the baby requires a nasal airway for ease of breathing. he is also being treated with neo-synephrine and steroid drops to his nasal passages (the regimen is neosynephrine 0.125% 1-2 drops each nares q 3-8 hours x 48 hours followed by 0.1% dexamethasone ophthalmic solution 2 gtts each nare x 48 hours and prednisolone 0.120% 2 drops each nare qid x 3 days). he has completed the neosynerphine medication and will be finished with the dexamethasone dosing tomorrow am when the prednisolone should be started. prilosec was also started to treat reflux. a chest x-ray obtained upon admission to the neonatal intensive care unit was within normal limits. the infant has also had some periods of apnea in clusters. at times these are associated with obstruction but most are thought to be central. since these spells have not been extremely severe and there is a concern for possible reflux, caffeine has not yet been started but may need to be considered if the severity of the spells worsen. 2. cardiovascular: due to the history of the enlarged heart on prenatal ultrasound a cardiology consultation and echocardiogram were obtained on the day of birth. the echocardiogram showed pulmonary artery hypertension, a dilated hypertrophied right ventricle, moderate to large patent ductus arteriosus with bidirectional flow and a small patent foramen ovale. this baby has maintained normal heart rates and pressures. no murmurs have been noted. baseline heart rate is 80-120 beats per minute with a recent pressure of 69/47 mmhg, mean arterial pressure of 55 mmhg. 3. fluids, electrolytes and nutrition: this infant was initially npo and maintained on intravenous fluids. enteral feeds were started on day of life #2 and gradually advanced to full volume. at the time of discharge he is taking 120 ml per kg per day of enfamil 20 or breast milk, all by gavage feeding. he has tried occasionally to breast feed or oral nipple feed without success. serum electrolytes were checked most recently on , with a sodium of 146, potassium of 4.6, chloride 110, co2 24, bun 4, creatinine 0.4. weight on the day of discharge is 2.745 kg. 4. infectious disease: a screening complete count was obtained upon admission to the neonatal intensive care unit. the white count was 8,700 with a differential of 30% polymorphonuclear cells, 0% bands. a culture was obtained and was no growth at 72 hours. rule out sepsis with antibiotics was not required due to infant's stability and negative tests. per urology request he is being prophylaxed for urinary tract infection. he was initially treated with ampicillin and that was changed to amoxicillin, (20 mg/kg/d) given once daily. 5. hematological: hematocrit at birth was 54.4%. platelets are 195,000. this infant has not received any transfusions of products. 6. renal: the infant's bun and creatinine were normal with the most recent bun of 4 and creatinine of 0.4 on . a renal ultrasound was performed on , and showed severe hydronephrosis with a thickened bladder. with these findings the baby was sent for a voiding cystourethrogram at . this showed no reflux. there was still concern due to the severe hydronephrosis and renal function and a mag 3 nuclear medicine study is planned for the week of . as previously mentioned, the baby is on amoxicillin urinary tract infection prophylaxis at the request of the urology team. 7. genetics: the genetics consultative team from has been involved with this baby. a sample for chromosomes was sent on and the karyotype remains pending at the time of discharge. the genetics consult team has requested a skull x-ray to rule out wormian bones in assessing the diagnosis of schinzel-giedion syndrome. further lab studies recommended are a chromosomal micro array and a arx test which is a dna test looking for a gene that is associated with brain anomalies. the skull films and the microarray and arx test have not been done yet. 8. gastrointestinal: a serum bilirubin was obtained on day of life #4 with a result of total bilirubin of 9 mg/dl. as previously mentioned, the baby is being treated for presumed reflux with omeprazole. 9. neurological: the infant had a head ultrasound performed on , which confirmed the diagnosis of agenesis at the corpus callosum and a magnetic resonance imaging study on , that showed bilateral frontal gyral simplification with punctate lesions in the white matter consistent with white matter injury. the baby is being followed by the neurology service from . 10.sensory: audiology hearing screening has not yet been performed. 11.psychosocial: the medical center social worker has been involved with this family. the contact social worker is and she can be reached at . the family has been in communication with all of the consultation services from . the family is from and have been staying in hotels locally since the mother's discharge from the postpartum unit. discharge disposition: transfer to for continuing diagnostic care. the medical record number is . condition on discharge: fair. the primary pediatrician has not yet been identified. care and recommendations on discharge: 1. feeding: enfamil 20 or expressed breast milk at 120 ml/kg per day by gavage. 2. medications: amoxicillin 60 mg p.o., once daily (20 mg/kg/d), omeprazole 3 mg p.o. once daily (1mg/kg), s/p phenylephrine drops 0.125% two drops every four hours for 48 hours ending on , dexamethasone ophthalmic solution 0.1% two drops to each eye every six hours times 48 hours to end on in am, prednisolone 0.125% drops two drops every six hours times 72 hours to begin on in the morning. 3. iron and vitamin d supplementation: iron supplementation is recommended for preterm and low birth weight infants until 12 months corrected age. all infants that predominantly breast feed should receive vitamin d supplementation at 200 international units (may be provided as a multivitamin preparation) daily until twelve months corrected age. 1. car seat position screening has not been performed. 2. state newborn screen was sent on , with no notification of results to date. 3. immunizations: no immunizations have been administered. 4. immunizations recommended: synagis rsv prophylaxis should be considered from through for infants who meet of the following four criteria: 1. born at less than 32 weeks; 2. born between 32 and 35 weeks with two of the following: day care during rsv season, a smoker in the household, neuromuscular disease, airway abnormalities or school age siblings; 3. chronic lung disease; 4. hemodynamically significant congenital heart disease. influenza immunization is recommended in the fall for all infants once they reach six months of age. before this age and for the first 24 months of the child's life, immunization against influenza is recommended for household contacts and out of home caregivers. this infant has not received rotavirus vaccine. the american academy of pediatrics recommends initial vaccination of preterm infants at or following discharge from the hospital if they are clinically stable and at least six weeks but fewer than twelve weeks of age. discharge diagnoses: 1. agenesis of the corpus callosum. 2. hydronephrosis. 3. hypospadias. 4. syndactyly and polydactyly. 5. dysmorphic facial features. 6. suspicion for congenital chromosomal defect. 7. respiratory distress secondary to nasal obstruction. 8. presumed gastroesophageal reflux. 50.580 dictated by: medquist36 d: 00:47:57 t: 02:58:03 job#: procedure: non-invasive mechanical ventilation diagnoses: esophageal reflux single liveborn, born in hospital, delivered without mention of cesarean section other specified conditions originating in the perinatal period hypospadias other obstructive defects of renal pelvis and ureter congenital reduction deformities of brain other disease of nasal cavity and sinuses conditions due to anomaly of unspecified chromosome hypochondriasis syndactyly of multiple and unspecified sites 

Answer: The patient is high likely exposed to