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: no known allergies / adverse drug reactions attending: chief complaint: weakness major surgical or invasive procedure: tracheostomy picc line placement bronchoscopy history of present illness: patient is a 31 yo m with no significant pmhx who presented to osh with complaints of weakness developing acute respiratory failure found to have a saddle pe started on heparin gtt trasnferred to for further management. patient initially presented to osh ed with complaints of weakness, that started 5 days prior to presentation. he was initially seen in the ed, received 2l ns for hydration, and then discharged. he represented with porfound weakness, requiring his brother to help him to the . he had a headache and body aches. he also noted fevers, chills, and sweats, along with n/v. per osh h&p, the patient reported vomiting 10-15 times. the vomitus was non-bloody. he denied abdominal pain or diarrhea at the time of presentation. he denied recent travel or known sick contacts. his friend reports that he had bowel and bladder incontinence. he denied any sore throat. at the osh, the patient was initially able to provide history. upon presentation, his temperature was 99.3. he was thought to have pulmoanry edema for which he received lasix. because of his weakness and observation that he had a sensory level at t8, he was initially thought to have a transverse myelitis. however, mri of the head was negative; mri of the cervical and thoracic spine revealed no abnormalities. he underwent an lp at the osh; the lp showed wbc 550,00 with 15% polys, 19% lymphs, and 16% monos. the patient was noted to be serologically positive for lyme disease as well as ebv virus. lyme csf was negative. he was started on iv ceftriaxone for coverage of possible lyme meningitis. the patient also was given iv acyclovir prior to presentation to in case the patient's clinical picture represented ebv encephalitis. the patient was noted to have an acute hypoxic event on , during this osh hospitalization. cta at the osh showed saddle pe wtih probably lower lobe pulmoanry infarcts. leni at osh were negative fo dvt. the patient was intubated and started on heparin gtt. tte showed dilated hypokinetic rv with flattened septum and well preserved lv function. cardiac surgery evaluated the patient for thrombolectomy, who did not feel that thrombolectomy was acutely indicated. ct abdomen/pelvis at the osh showed normal kidney, ureters, and bladder as well as hepatomegaly and trace ascites. bone windows were negative. on arrival to the micu, the patient is intubated and sedation. review of systems: unable to obtain as patient is intubated and sedated. past medical history: none per osh records social history: unable to obtain as patient intuabted and sedated. . former marine. patient lives with his brother's family. he does not drink etoh. smoker 1 pack cigarettes every 2 days. family history: per osh recrods. father died of stroke at age 69. physical exam: admission exam vitals: 98.6, 177/117, 112, 24, 100% ra general: alert, oriented, no acute distress heent: sclera anicteric, mm dry, oropharynx clear, eomi, perrl cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: mild bibasilar crackles abdomen: soft, exquisitely ttp, + guarding, + rebound gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: cnii-xii intact, discharge exam general: awake and alert. heent: tracks to voice., answers to yes and no questions neck: trach in place with no external blood cv: rrr. no murmurs. lungs: coarse breath sounds anteriorly. no crackles or wheezes. abd: bs+. soft. nt/nd. ext: no clubbing, cyanosis, edema. neuro: hand grip equal, rue flexion. moving feet bilaterally more vigorously as compared with yesterday. 1+ patellar reflexes bilaterally. plantarflexion b/l. pertinent results: 01:45pm blood wbc-17.0* rbc-3.57* hgb-10.5* hct-33.4* mcv-94 mch-29.5 mchc-31.6 rdw-12.8 plt ct-364 03:44am blood wbc-11.5* rbc-3.80* hgb-11.5* hct-34.8* mcv-92 mch-30.3 mchc-33.1 rdw-12.9 plt ct-571* 04:38am blood wbc-11.7* rbc-3.42* hgb-10.4* hct-31.3* mcv-92 mch-30.4 mchc-33.2 rdw-15.1 plt ct-435 03:54am blood wbc-7.8# rbc-2.87* hgb-9.1* hct-24.7* mcv-86 mch-31.5 mchc-36.7* rdw-15.7* plt ct-511* 01:45pm blood pt-14.0* ptt-66.0* inr(pt)-1.3* 03:39am blood pt-13.1* ptt-27.3 inr(pt)-1.2* 05:31am blood pt-17.6* ptt-36.6* inr(pt)-1.7* 04:51am blood pt-19.2* ptt-39.0* inr(pt)-1.8* 03:54am blood pt-18.6* ptt-41.0* inr(pt)-1.8* 01:45pm blood glucose-110* urean-12 creat-0.6 na-142 k-4.2 cl-101 hco3-36* angap-9 04:24am blood glucose-186* urean-24* creat-0.6 na-145 k-4.7 cl-103 hco3-34* angap-13 03:53am blood glucose-126* urean-24* creat-0.6 na-139 k-4.4 cl-100 hco3-31 angap-12 03:03am blood glucose-86 urean-23* creat-0.6 na-139 k-4.6 cl-101 hco3-27 angap-16 04:20am blood glucose-124* urean-18 creat-0.5 na-134 k-4.3 cl-96 hco3-29 angap-13 03:54am blood glucose-87 urean-24* creat-0.4* na-139 k-4.4 cl-100 hco3-33* angap-10 01:45pm blood alt-61* ast-40 ld(ldh)-319* alkphos-152* totbili-0.3 02:58am blood alt-150* ast-39 ck(cpk)-43* alkphos-110 totbili-0.2 04:01am blood alt-93* ast-32 ld(ldh)-279* alkphos-92 totbili-0.5 04:20am blood alt-92* ast-28 03:54am blood alt-82* ast-41* ld(ldh)-175 alkphos-88 totbili-0.5 03:03am blood lipase-12 03:54am blood albumin-3.0* calcium-9.5 phos-4.5 mg-2.0 01:45pm blood vitb12-1446* 01:45pm blood tsh-1.5 04:15am blood hbsag-negative hbsab-positive hbcab-negative 07:50pm blood -negative 03:03am blood igg-1038 iga-173 igm-200 01:45pm blood pep-no specifi 04:15am blood hcv ab-negative 02:53am blood lyme by western blot-test name 02:53am blood mycoplasma pneumoniae antibody, igg-test 02:53am blood mycoplasma pneumoniae antibody igm-test 02:53am blood bartonella (rochalimea) henselae antibodies, igg and igm-test 02:53am blood arbovirus antibody igm and igg-test name mri head () abnormal, multifocal, t2-signal hyperintensity throughout the spinal cord, most severe in the cervical cord as above. similar abnormalities are present in the brain (that study is reported separately). this appearance is not specific though would favour viral infection, including that with west nile virus. other infectious entities may have a similar appearance, such as encephalomyelitis related to listeria, mycoplasma, or campylobacter, amongst others (given the element of rhomboencephalitis on the brain imaging). demyelinating processes such as ms, adem or neuromyelitis optica and other vatiants are also possibilities, as are other inflammatory disorders such as encephalitis. neoplastic or vasculitic etiologies are less likely given the appearance, short-interval change and extent of involvement. mri () in comparison to exam, diffuse bilateral t2/flair hyperintensities have significantly progressed. differential considerations remain infectious or non-infectious encephalitides, possibly a paraneoplastic process. demyelinating process such as adem is felt less likely given the lack of improvement despite reported treatment with steroids. neoplastic and vasculitic etiologies are unlikely given appearance and distribution. brief hospital course: patient is a 31 year old male with no significant pmhx who presented to osh with complaints of weakness developing acute respiratory failure found to have a saddle pe started on heparin gtt trasnferred to for further management with mri findings suggestive of adem treated with iv steroids/ivig, whose mental status and neurological function improved. # respiratory failure: multifactorial; etiologies include saddle pulmonary embolism with infarction in combination with profound weakness from adem. the patient was difficult to oxygenate at times initially. patient underwent trach and peg placement in light of prolonged intubation. improving currently, he is tolerating trach collar at times up to 30 minutes. speech and swallow are also working with him. be sure to look for signs of carbon dioxide retention if mental status worsens on psv as patient could tire out at times. he is usually arousable to voice, alert and can nod to yes/no questions, oriented x3. # adems: patient underwent head mri as well as full spine mri as part of work-up of his clinical picture, and neurology felt that the findings were consistent with adem. he was treated with 5 days of iv steroids and five more days of ivig. the patient's exam improved along with repeat mri imaging showed progression of the lesions, but this was in the context of improved exam clinically, and no further interventions were done. his diaphgram has improved function with today's nif of -43. he has slowly regaining strength in his extremities with 3/5 ue and le strength (r > l). please continue to ensure he has ongoing physical therapy. # pulmonary embolism: patient with saddle embolism at the osh. patient was hemodynamically stable upon arrival to with sbp 130-140s. patient was evaluated for thrombectomy at osh and it was felt that pulmonary embolectomy would be counter productive. patient was initially continued on heparin gtt, at one point being transitioned lovenox /coumadin which he currently is on with inr of 1.8 on , 1.8 , 1.7. coumadin was uptitrated to 12.5 mg from 10 mg daily on . if inr < 2.0 on , please consider increasing coumadin to 15 mg daily. continue lovenox bridge until therapeutic inr. # pericarditis: he was noted to have diffuse st elevations on . he had not chest pain. they resolved with ibuprofen 600 mg tid. # fevers of unknown etiology. resolved for past few days. work-up at the osh included: negative hiv; weakly positive lyme igm, negative lyme csf, negative monospot, negative babesia, negative anaplasma, positive ebv csf serology. id and neurology were consulted upon patient's arrival. repeat lumbar puncture was done; culture data returned showing no growth and serologies were negative. the patient was initially on broach spectrum antibiotics upon id recommendations, but with negative csf culture data, negative csf data antiobiotics were then peeled back. his fevers were attributed to adem and resolved week prior to discharge # elevated lfts: there was concern for viral hepatitis, though viral serologies at returned negative. ruq ultrasound did not show concerning findings. lfts were trended through the admission and remained stable. medications on admission: medications home: none . medications on transfer: --acyclovir 800mg once --ceftriaxone 2grams iv daily --famotidine 20mg --heparin gtt --ipratropium/albuterol 6-8 puffs qid --propofol 1000mg gtt --acetaminophen 650mmh q4hours prn pr --fentanyl 25mcg q1hours prn pain --zofram 4mg ib q6hours prn nausea discharge medications: 1. artificial tear ointment 1 appl both eyes prn dry eyes 2. chlorhexidine gluconate 0.12% oral rinse 15 ml oral use only if patient is on mechanical ventilation. 3. docusate sodium (liquid) 100 mg po bid hold for loose stools 4. enoxaparin sodium 100 mg sc q12h 5. erythromycin 0.5% ophth oint 0.5 in both eyes tid 6. pantoprazole 40 mg iv q24h 7. polyethylene glycol 17 g po daily:prn constipation 8. senna 1 tab po bid:prn constipation 9. warfarin 12.5 mg po daily16 discharge disposition: extended care facility: for the aged - macu discharge diagnosis: adem saddle pulmonary embolism discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: bedbound. discharge instructions: it was a pleasure to care for you at the hospital. . you were admitted for altered mental status and weakness. you were found to have a encephalitis and lung blood clot. you needed to be intubated during the admission and were cared for in the icu. you were treated for the encephalitis with ivig and are currently improving from a neurologic perspective. your respiratory status is also stable and slowly imroving. . your physcial therapy and rehab. will continue at a specialized facility. followup instructions: please follow up with your primary care physician after discharge procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more spinal tap incision of lung enteral infusion of concentrated nutritional substances other bronchoscopy percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy closed [endoscopic] biopsy of bronchus injection or infusion of immunoglobulin injection or infusion of oxazolidinone class of antibiotics central venous catheter placement with guidance diagnoses: acidosis anemia, unspecified tobacco use disorder pulmonary collapse other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure acute respiratory failure alkalosis encephalopathy, unspecified ventilator associated pneumonia accidents occurring in residential institution quadriplegia, unspecified unspecified infectious and parasitic diseases other tracheostomy complications nonspecific abnormal results of function study of liver surgical operation with formation of external stoma causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation infectious acute disseminated encephalomyelitis (adem) saddle embolus of pulmonary artery 

Answer: The patient is high likely exposed to