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: gentamicin / vancomycin attending: chief complaint: seizure versus syncope. major surgical or invasive procedure: brain cyst aspiration on and rickham reservoir placement. history of present illness: is a 65-year-old right-handed man with a history of anaplastic astrocytoma originally transferred to from on for possible seizure activity. per omed admit note, he was straining to have a bowel movement and then got up, felt dizzy, and lost consciousness. he then had deep breathing, drooling, and urinary incontinence. he was out for 10 minutes. head ct at showed a 3.7 cm x 3.8 cm lesion in the left frontotemporal lobe with adjacent edema and mass, with partial effacement of the left temporal lobe but no herniation or hemorrhage. he was then transferred here for further management. on admission, he noted a history of seizures that were manifested by speech arrest, once this past and once in . he is on keppra (recently decreased prior to admission), trileptal, and dexamethasone. his ros was also positive for constipation, a recent uti, s/p levofloxacin which finished on , word finding difficulties for 4 to 5 months, worsening vision, and left knee pain. he denied all other symptoms. past medical history: past medical history: -grade 3 astrocytoma: left temporal, diagnosed by biopsy in and s/p partial resection. s/p xrt and temodar x3. complicated by seizures -hypertension -hyperlipidemia -hypertrophic cardiomyopathy -bilateral knee surgeries now with arthritis -pulmonary embolus (ich with anti-coag) -h/o bradycardia past oncologicl history: grade iii anaplastic astrocytoma 1. partial resection on in 2. radiation + temodar in 3. pulmonary embolus 4. temodar monthly for 15 cycles ending in 5. intracerebral hemorrhage at 6. temodar restarted and completed 18 cycles social history: he is married less than 2 years ago though they have been together for many years. he is a retired physical education teacher who taught throughout . he spends most of the time in . he used to smoke cigars or 0-2 cigarettes daily and drink 1-2 drinks daily but stopped both in . he denies illicit drug use. family history: his mother had cad. his father had a question of lung cancer. his sister had copd (she was a smoker). physical exam: vital signs: temperature is 97.2 f, heart rate 60, blood pressure 155/77, respiratory rate 20, and oxygen saturation 99% in room air. general: he is alert, interactive pleasant male in no acute distress. he has word-finding difficulties throughout conversation. heent: he has dressing over left side of head c/d/i, pupils 2 mm and equal, sluggishly reactive, and eomi. neck: supple. lungs: bibasilar inspiratory crackles, no wheezes or rhonchi heart: regular rate and rhythm, no m/r/g abdomen: soft, nontender, nondistended, +bs extremities: no clubbing, cyanosis, or edema. skin: he has diffuse erythematous eruption over back, chest, legs neurological examination: he is awake, alert, and able to follow commands. there is no right/left confusion or finger agnosia. his calculation is intact. his language is non-fluent with frequent word-finding difficulty; his comprehension is good. he has difficulty with repetition. cranial nerve examination: his pupils are equal and reactive to light, 3 mm to 2 mm bilaterally. extraocular movements are full. visual fields are full to confrontation. funduscopic examination reveals sharp disks margins bilaterally. his face is symmetric. facial sensation is intact bilaterally. his hearing is intact bilaterally. his tongue is midline. palate goes up in the midline. sternocleidomastoids and upper trapezius are strong. motor examination: he does not have a drift. his muscle strengths are at all muscle groups. his muscle tone is normal. his reflexes are 2- at biceps, triceps, brachioradialis, and knees bilaterally. his ankle jerks are absent. his toes are down going. sensory examination is intact to touch and proprioception. coordination examination does not reveal dysmetria. his gait is steady. he does not have a romberg. pertinent results: admission labs: 137 102 18 ------------<89 3.9 29 1.0 estgfr: 75 / >75 (click for details) ca: 10.3 mg: 2.3 p: 2.6 alt: 18 ap: 78 tbili: 0.4 ast: 16 11.3 8.0>---<241 32.4 n:82.7 l:12.0 m:3.8 e:1.2 bas:0.4 comments: mcv: verified macrocy: 1+ pt: 12.0 ptt: 27.8 inr: 1.0 : slight increase in the size of the cystic region within the left temporal lobe with thickened enhancement along its posterior margin. this is only slightly apparent when compared to . however, compared to the prior from , the thickened enhancement is more pronounced. the nodule from the superior margin of the cyst appears to have less enhancement on today's examination. the degree of adjacent t2 signal abnormality is unchanged. the slightly thickened enhancement is concerning for tumor recurrence. left temporal cyst aspirate: negative for malignant cells. brief hospital course: a/p: this is a 65-year-old right-handed man with grade 3 astrocytoma who presents from osh with questionable syncope versus seizure, who developed with hypotension after antibiotics (vancomycin and gentamicin). (1) syncope: initial event that brought him in was thought to be vasovagal in nature due to valsalve in setting of hypertrophic cardiomyopathy. with treatment of his constipation and drainage of his tumor cyst, this did not recur. (2) hypotension: this was noted after a dose of gentamicin caused a rash. the medication was stopped and he was given bendryl and started on ranitidine. he was then given a dose of vancomycin. overnight his rash progressed from hives to diffuse erythema with pruritis and he became more hypotensive. he had an elevation in his creatinine and 5 point increase in his hematocrit without transfusion. he was given iv fluids and steroids for potential adrenal insufficiency and was sent to the icu for closer monitoring. he improved and was able to be placed on a steroid taper. elevated likely etiology is anaphylaxis versus anaphylactoid reaction (although hypotension less likely with anaphylactoid reactions). he is now presumed to have allergy to both gentamicin and vancomycin. (3) astrocytoma: from revealed increasing cystic mass. for this, he was taken to the or by neurosurgery on where he had a cyst aspiration which was negative for malignant cells. he had a rickham reservoir placed as well. he will follow-up with dr. as an outpatient for further evaluation and management. (4) seizure: his antiepileptic regimen was changed to keppra 1,000 mg 3 times daily (due to peak-dose drowsiness from 1,500 mg twice daily). his trileptal was changed to 150mg qam/qhs, with 300mg q noon. no seizure activity was noted on this admission. (5) obstructive sleep apnea: his history and body habitus are concerning for osa, which could exacerbate his seizure disorder. given that he was ordered for an ouptaient sleep study. (6) constipation: treated with an aggressive bowel regimen including enemas with good effect. (7) anemia: his hematocrit dropped today from 36 to 31; it was around 32 on admission. it was likely from hemodilution given ivf received in setting of anaphylaxis which subsequently remained stable. (8) urinary retention: on admission he was noted to have 400 cc pvr so foley catheter was placed with good effect. 2 days prior to discharge this was removed and he was able to urinate without difficulty. medications on admission: decadron 4 mg po bid colace sq heparin keppra 1000 mg po tid oxcarbazepine 150/300/150 oxycodone prn ranitidine 150 mg po bid senna simvastatin 40 mg po daily discharge medications: 1. diovan hct 160-25 mg tablet sig: one (1) tablet po once a day. 2. dexamethasone 4 mg tablet sig: one (1) tablet po bid (2 times a day) for 3 weeks: please take until you see your primary care doctor or your oncologist in 2 weeks to make a decision about decreasing the dose. disp:*42 tablet(s)* refills:*0* 3. levetiracetam 500 mg tablet sig: two (2) tablet po tid (3 times a day). disp:*540 tablet(s)* refills:*1* 4. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 5. oxcarbazepine 300 mg tablet sig: one (1) tablet po daily (daily): please take at noon. disp:*90 tablet(s)* refills:*1* 6. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 7. oxcarbazepine 150 mg tablet sig: one (1) tablet po twice a day: please take in the early morning and at night. disp:*180 tablet(s)* refills:*1* 8. docusate sodium 100 mg capsule sig: two (2) capsule po twice a day. disp:*120 capsule(s)* refills:*2* 9. senna 8.6 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* 10. lactulose 10 g packet sig: one (1) po twice a day as needed for constipation. disp:*30 * refills:*2* 11. milk of magnesia 7.75 % suspension sig: one (1) po twice a day as needed for constipation. disp:*60 doses* refills:*2* 12. dulcolax 5 mg tablet, delayed release (e.c.) sig: tablet, delayed release (e.c.)s po twice a day as needed for constipation. disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* discharge disposition: home with service facility: discharge diagnosis: primary diagnosis: seizure hypotension anaphylaxis rash astrocytoma . secondary diagnosis: hypertension hyperlipidemia discharge condition: stable. discharge instructions: please take all of your medications as prescribed. please keep all follow-up appointments. please do not take gentamicin or vancomycin in the future as these caused a rash and low blood pressure. please notify your primary care physician if you experience fevers, chills, worsening rash, dizziness, chest pain, shortness of breath, seizures or other concerning symptoms. followup instructions: please follow-up with your primary care doctor, dr. , in weeks. his phone number is . please have your sutures removed -24th in follow-up. please follow-up with dr. , md at 1:00pm. please call . procedure: intravascular imaging of intrathoracic vessels closed [percutaneous] [needle] biopsy of brain diagnoses: other primary cardiomyopathies other iatrogenic hypotension obstructive sleep apnea (adult)(pediatric) anemia, unspecified retention of urine, unspecified other constipation dermatitis due to drugs and medicines taken internally epilepsy, unspecified, without mention of intractable epilepsy personal history of venous thrombosis and embolism accidents occurring in residential institution other specified antibiotics causing adverse effects in therapeutic use malignant neoplasm of temporal lobe other anaphylactic reaction 

Answer: The patient is high likely exposed to