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 attending: chief complaint: altered mental status and fever major surgical or invasive procedure: lumbar puncture history of present illness: pt. was in usoh until 6.30pm on the night prior to admission, when he felt generally fatigeud and ill. he noted to have had a low grade fever and took a nap. at 8.30, his wife heard grunting noises from bedroom, as she arrived, she noted that he could not get oob despite attempts. he was able to answer some of her questions, but was "confused" some of his words were part of normal volcabulary, but did not make sense situationally. after ~ 20 mins, he was eventually able to get oob and walk to kitchen. he was able to drink a glass of water, however wife noted that he continued to not be himself (he did not know how to check his bg which he does regularly). she then noted again that he appeared weak (stumbling in the room, from side to side). she helped him to a chair, where he was unable to support himself and slumped down. he was able to respond to her, however, again was felt to be confused. there was no aphasia, he did not have anomia, his words were no "gibberish" but simply did not make sense in the context. he did not have any premontory sx, no auras, no shaking, no incontinence, no tongue biting. no prior episodes like this before. no ha, no neck stiffness, phono/photophobia. no recent travel, no exposures. . in the ed, initial vs were: 100.2 90 137/65 15 98% 4l nc. patient was noted to have a wbc given 16k, inr 2.3, cr 1.8 and troponin of 0.02. he underwent cxr and ct head that were negative for infection and ich respectively. he was found to have an oral temp of 103.9f and noted to have sbps drop to high 80s. he received 4l ns, 1g of tylenol, vancomycin 1g, ceftriaxone 1g, aspirin 325mg, and neutra-phos powder packet 1. . on the floor, vs were 97.7f 89/56 84 96% 3lnc. pt. was alert and oriented x3, however w/ mild recall deficit. past medical history: - afib - hl - dm - ckd, stage unknown. social history: lives in w/ wife. in computer training, website design and sales. - tobacco: pipe, quit 25yrs ago. - alcohol: 2d/wk - illicits: denies. family history: no cad,mi. gfa/gmo - cva breast cancer/brca mutation in multiple female family members. physical exam: vs: 97.7f 89/56 84 96% 3lnc general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, + jvd. lungs: crackles at bases. cv: /, normal s1 + s2, no murmurs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, trace edema b/l to 1/2 up shins, 2+ pulses, no clubbing, cyanosis or edema neuro: ms: alert, oriented x 3. attn: dowb in 7 seconds. naming intact to low and high frequency objects, repetition intact, and writing intact. no evidence of apraxia or neglect. registration intact, recall at 5 mins . cns: vff to confront, eomi, perrl, face symmetric, intact to lt, tongue and palate midline/symmetric, shoulder shrug intact. motor: normal tone, nl. bulk. ues in umn distribution and at ip/h/ta in /l. no pronator drift. dtrs 1+ at /tri, 1+ at patella b/l. toe down on r, equivocal on l. fnf and hks intact. gait deferred. pertinent results: admission labs 10:20pm blood pt-24.6* ptt-28.9 inr(pt)-2.3* 10:20pm blood wbc-16.4* rbc-4.48* hgb-13.8* hct-39.9* mcv-89 mch-30.9 mchc-34.6 rdw-13.8 plt ct-190 10:20pm blood glucose-160* urean-28* creat-1.8* na-134 k-5.0 cl-99 hco3-27 angap-13 10:20pm blood calcium-10.0 phos-0.7* mg-1.8 10:20pm blood alt-20 ast-27 alkphos-58 totbili-1.1 05:03am blood ck(cpk)-196 03:55pm blood ld(ldh)-259* 10:20pm blood ctropnt-0.02* 05:03am blood ck-mb-3 ctropnt-<0.01 05:03am blood calcium-8.4 phos-2.0* mg-1.5* 10:33pm blood lactate-1.9 10:16am blood lactate-2.3* blood cx () pending ucx pending csf gram stain - no pmns or organisms seen csf cell count: 10:48am cerebrospinal fluid (csf) wbc-2 rbc-3* polys-0 lymphs-67 monos-30 macroph-3 10:48am cerebrospinal fluid (csf) totprot-39 glucose-91 brief hospital course: # metabolic encephalopathy: etiology unclear. initial concern was for embolic event vs. seizure activity vs menengitis. he had a lp on that was clear fluid and cell count/prelim gram stain which was negative for menengitis. he also underwent an eeg on and results are pending as of . embolic event secondary to a. fib was less likely given therapeutic inr (2.3). throughout the day on pt's mental status improved and he was lucid, a/o x3 and interactive by time of transfer to the floor. . # sepsis syndrome. source of leukocytosis and fever unclear. with septic physiology in the ed, but responded to ivf. he did not require pressors. ua neg, cxr w/o focal infiltrate, and lp did not show menengitis. he was initially started on emperic treatment for menengitis (ctx 1g and vanc) and azithro for possible cap on . after lp came back negative, ctx was changed to 1g daily for pna coverage, azithro was continued, and vanc was d/c'd on . lfts were unremarkable, and bcx is pending from . wbc trended down throughout stay as did his fevers. # hypotension. likely due to septic physiology. received 4 l of ivf in the ed and pressures were stable throughout course. ekg w/o ischemic signs/changes, and troponin trended down from 0.02 to 0.01. also had elevated lactate of 1.9 on which actually increased to 2.3 on but clinically remained stable and no clinical concern for hypoperfusion. . # volume overload by cxr and lung exam on , likely to ivf. (+6l over last 24 hr in ). we diuresed him to a goal of -1-2l on . resp status remained stable on nc. . # hypoxemic resp. distress. likely due to volume overload as above and possible pna (treated for cap, given clinical criteria w/o cxr changes). continued cap tx (ctx and azithro) and diuresis with a goal of negative 1-2 l/day with good response. he did have some desats into the low 90s on 5l nc on the morning of , but by transfer to floor, satting mid 90s on 4-5l nc. . # renal failure. cr elevated at 1.9 but was stable and this is his baseline per pcp. held lisinopril. . # atrial flutter/fibrillation. rate controlled. we restared his digoxin on and continued his coumadin after his lp, which was increased to his home dose of 6mg daily on after inr became subtherpeutic. remained in af. . # dm. fs stable throughout admission on lantus 14u am and hiss which pt. self regulates with carb counting medications on admission: digoxin 0.25mg daily apidra insulin ss glyburide 5mg daily lantus 14-16u in am lisinopril 5mg daily simvastatin 20mg daily vit d 1000u daily coumadin 5mg daily. discharge medications: 1. ceftriaxone in dextrose,iso-os 1 gram/50 ml piggyback sig: one (1) gm intravenous q24h (every 24 hours) for 4 doses. disp:*4 gm* refills:*0* 2. heparin, porcine (pf) 10 unit/ml syringe sig: two (2) ml intravenous daily and prn as needed for line flush. disp:*10 ml(s)* refills:*0* 3. insulin glargine 100 unit/ml solution sig: sixteen (16) units subcutaneous once a day. disp:*480 units* refills:*2* 4. furosemide 20 mg tablet sig: three (3) tablet po once a day for 14 days. disp:*42 tablet(s)* refills:*0* 5. warfarin 7.5 mg tablet sig: one (1) tablet po once daily at 4 pm. disp:*20 tablet(s)* refills:*0* 6. insulin lispro 100 unit/ml solution sig: 10-20 units subcutaneous four times a day as needed for hyperglycemia: using the sliding scale and carb counting you have used previously at home. disp:*500 ml* refills:*0* 7. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 8. digoxin 250 mcg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. azithromycin 250 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 4 days. disp:*4 tablet(s)* refills:*0* discharge disposition: home with service facility: homecare discharge diagnosis: sepsis - resolved community-acquired pneumonia type ii diabetes mellitus with complications, controlled chronic kidney disease stage ii atrial fibrillation discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were diagnosed with sepsis from community-acquired pneumonia. the infection is improved but you should finish the full 10 day course of iv antibiotics. your diabetes is now well controlled on your home insulin regimen. you received a great deal of iv fluids as part of the treatment for sepsis and you still have a great deal of fluid swelling in your body for which you were started on a diuretic. you will probably only need to take the diuretic until the swelling resolves, after which you can stop it. the diuretic (furosemide) can cause your blood potassium level to drop ( dangerous condition), so you need to have your blood levels checked periodically and followe by your primary care doctor. followup instructions: name: , v. address: , e23-281, , phone: appt: at 11:30am procedure: spinal tap incision of lung diagnoses: pneumonia, organism unspecified acute kidney failure, unspecified unspecified septicemia severe sepsis hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation atrial flutter long-term (current) use of anticoagulants delirium due to conditions classified elsewhere chronic kidney disease, stage ii (mild) diabetes with renal manifestations, type ii or unspecified type, uncontrolled 

Answer: The patient is high likely exposed to