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 / erythromycin base / codeine / tape / sulfa (sulfonamides) / dipentum attending: chief complaint: found on floor by husband at home, unresponsive, breathing major surgical or invasive procedure: lumbar puncture history of present illness: 34 year old woman with dm1 on an insulin pump at baseline who was recently admitted here for foot cellulitis (mrsa with osteo, s/p partial amputation of the lt. foot) and again in the icu with dka who was found tuesday morning at approximately 10:30 pm, lying on the floor, moaning and combative, by her husband. she had last been seen by him at 7:30 pm. she had apparently fallen out of her wheelchair, and was on the kitchen floor, bleeding from a head lac. the dog food bowl was broken. he checked her blood glucose which was critically high. he disconnected her insulin pump. he contact ems. the first to arrive on the scene were the police, who felt that the pt. may have been seizing, but this subsided by the arrival of ems (seizure-like activity not described in the record). . she was initially transported to hospital, where her fsbg was found to be 910 - gap of 20, ph 7.26, serum acetone positive. she was given insulin 10 u x 1 and then 10 u per hour, then decreased to 5 u per hour when sugar was down to 400. she was febrile to 101.5 on admission there. blood cultures were drawn and iv ctx was administered. a head ct and c/s ct were both negative. she recieved a total of 5 litres of normal saline there. she was transferred to at the request of her family at 5:20 am wednesday, while still getting ns at 200/hr and insulin gtt still at 5 u per hour. . in the ed here, she was found to be minimally responsive to sternal rub, but she was breathing, had sbp of 154, hr 119, sat 96%. she was noted to be febrile to 104. blood cultures obtained and vanc and zosyn administered. her initial bg was 103 - her fluid was switched to d5 w at 150 per hour, in addition, she was given 2 more litres of ns, and her insulin gtt was turned off. past medical history: 1. type 1 diabetes mellitus- diagnosed at 9 months old. has neuropathy, nephropathy, and retinopathy. she is followed by dr. at the . on insulin pump. last a1c 7.4% on 2. peripheral diabetic neuropathy with left foot cellulitis, s/p recent hospitalization as above, resulting in partial amp lt. foot; readmitted in dka to icu (as outlined above). 3. autonomic dysfunction 4. hypercholesterolemia 5. iron deficiency anemia- pt was first diagnosed with iron deficiency anemia in and is followed for this by dr. in heme onc. it is felt to be due to her ulcerative collitis. pt receives parenteral iron as needed. reports a port-a-cath was placed 14 years ago for iv iron and she has had it since then. 6. pt reports that she was diagnosed with hypothyroidism at age 8. she was taken off all thyroid medications at age 29 and her tfts have been normal since that time. 7. ulcerative collitis- pt was diagnosed with ulcerative collitis in and underwent a pouch ileostomy in . social history: lives with husband in , ma. no tobacco, etoh, or illicits. works in marketing department at a nursing home; currently not working while she has foot infection but plans on returning. family history: numerous family members with type 2 dm physical exam: 76 kg 99.8 ax 115 157/60 sat 97 % on 2 l nc somnolent, responding to pain only warm/hot skin throughout mult visible small lacerations to head/face, non bleeding no visible eye deviation, pupils equal and minimally reactive (per mother her baseline is "sluggish" pupillary reaction) unable to visualize tongue, but no buccal lacs trachea midline tachy, reg, no mrg cta t/o, rt sided poc cath in place, no visible purulence or erythema abdomen soft, diminished bowel sounds, midline scar, seems to respond with facial grimmace to bilateral lower quadrant pressure foley in place draining clear, dilute-appearing urine no edema lt. foot dressed in dry guaze, tma with erythema, minimal purulence at incision site. nothing could be expressed from the wound. pertinent results: 06:20am blood wbc-11.8*# rbc-2.86* hgb-8.5* hct-notified c mcv-82 mch-29.7 mchc-36.1* rdw-14.7 plt ct-271 06:20am blood neuts-88.6* lymphs-7.0* monos-4.2 eos-0.1 baso-0.1 06:20am blood pt-12.5 ptt-38.9* inr(pt)-1.1 06:20am blood glucose-71 urean-32* creat-1.5* na-145 k-3.6 cl-112* hco3-22 angap-15 03:00am blood glucose-88 urean-10 creat-0.9 na-140 k-3.7 cl-109* hco3-26 angap-9 12:25pm blood alt-13 ast-18 alkphos-68 amylase-75 totbili-0.3 06:20am blood calcium-8.0* phos-1.4*# mg-2.2 03:00am blood calcium-8.0* phos-3.1 mg-1.9 12:25pm blood tsh-1.4 12:25pm blood free t4-1.0 12:09pm blood vanco-16.9* 12:25pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 06:54am blood po2-55* pco2-42 ph-7.34* caltco2-24 base xs--2 comment-green top 09:12pm blood lactate-1.6 . 06:20am urine color-yellow appear-clear sp -1.017 06:20am urine blood-lg nitrite-neg protein-500 glucose-1000 ketone-15 bilirub-neg urobiln-neg ph-5.0 leuks-neg 06:20am urine rbc-* wbc-0-2 bacteri-few yeast-none epi-0-2 06:20am urine castgr-* casthy-0-2 12:25pm urine bnzodzp-neg barbitr-neg opiates-neg amphetm-neg 06:20am urine ucg-negative . 02:20pm cerebrospinal fluid (csf) wbc-52 rbc-1120* polys-96 lymphs-2 monos-2 02:20pm cerebrospinal fluid (csf) wbc-52 rbc-2* polys-98 lymphs-0 monos-2 02:20pm cerebrospinal fluid (csf) totprot-46* glucose-67 02:20pm cerebrospinal fluid (csf) herpes simplex virus pcr-pnd . 6:20 am urine culture: no growth. . 2:20 pm csf;spinal fluid gram stain (final ): 2+ (1-5 per 1000x field): polymorphonuclear leukocytes. no microorganisms seen. fluid culture (final): no growth. viral culture: pending . blood culture: pending . stool viral culture: pending . left foot (3 views): there is no change in the appearance of the transmetatarsal amputation. the resection sites have well marginated bone without evidence of focal lysis to suggest osteomyelitis. there is no subcutaneous gas. bones remain diffusely demineralized secondary to disuse. surgical clips are again noted adjacent to the distal tibia posteriorly. as before, there are extensive calcifications. . cxr (single veiw): ap bedside chest: the heart is borderline enlarged. there is slight plethora. tip of right subclavian line is at junction of svc and right atrium. slight prominence of the lung markings in the lower lobe behind the heart is probably normal allowing for relatively elevated diaphragms and remainder lungs clear. no ptx or effusion on this semi-erect film. since exam , the slight congestion has developed (i doubt this reflects higher diaphragms). impression: pneumonia cannot be entirely excluded in the left lower lobe. probable congestion. . abdomen (single view): paucity of gas within the abdomen likely represents fluid filled loops of small bowel and is consistent with ileus. . cxr (portable): right jugular cv line is in region of cavoatrial junction. no pneumothorax. heart size is difficult to evaluate on this portable supine film. there could be slight cardiomegaly and some pulmonary engorgement consistent with chf, increased since the prior study of . mild atelectasis is present at the left base. no pneumothorax. . brief hospital course: # dka: the patient's anion gap closed rapidly on an insulin drip with iv d5w infusion during her stay in the micu. her mental status cleared. prior to transfer to the floor she was transitioned to her home insulin pump regimen. her blood glucose levels remained stable between 70-200. she was seen by consult regarding her insulin regimen. electrolytes were monitored daily and repleted as needed. she was discharged to home on insulin pump with follow-up with dr. . . # meningitis: the patient was sent to the micu. she was breathing spontaneously but only responsive to painful stimuli with fevers to 104f. on lp, the patient was discovered to have meningitis (csf with 60 wbc - 96% pmns, 2 rbc, protein 46, glucose 67; gram stain and bacterial culture negative, viral culture pending). id team was consulted and the patient was started on vancomycin, ceftriaxone, meropenem (for listeria coverage as she has a bactrim/pcn allergy), and acyclovir. over a period of two days, the patient's mental status cleared and her fever and photophobia resolved. although she continued to have a lingering headache, it responded well to pain medications. based on the lp results, her meningititis was believed to be likely early viral (enterovirus, hsv, other), and csf viral cultures as well as hsv pcr and west studies were sent and are pending. in addition, stool viral cultures were obtained and are pending. however, despite the low absolute wbc count, the neutrophilic predominance and slightly decreased glucose could indicate bacterial source. while the gram stain and culture were negative, she had been on vanco/levo/flagyl x 6 weeks at home and only finished this course 2 days pta. repeat lp was attempted but unsuccessful. acyclovir was discontinued after pcr was negative for hsv. meropenem and vancomycin were discontinued after the bacterial csf cultures were negative. however, she received ceftriaxone before the lp was done so she will be discharged on a 3 week course with vna service. she remained afebrile with stable hemodynamics until discharge. . # blurry vision: patient reports having significantly more blurry vision since pre-admission. she has a known right cataract and diabetic retinopathy. ophthalmology was consulted. patient will follow up with dr. at the center. she might need ultrasound of the right eye give her fall, and she will need laser treatment of her left eye for presence of small amounts of intraocular blood. . # partial left foot amputation: on admission, patient has pus draining from her partial amputatation. plastic surgery and were consulted and she was managed with dressing changes tid. her drainage stopped at time of discharge. she will f/u with plastic surgery as an outpatient. . # htn: while in the micu, the patient's antihypertensives were held. at transfer to the floor, her bp's were eleveated into the 170/110 range and she was restarted on metoprolol and lisinopril. . # low back pain: likely secondary to lp. she was given vicodin, which she takes at home as needed for pain, with good effect and morphine for breakthrough. she was discharged on her home dose of vicodin. . # chronic iron-deficiency anemia: her hct remained near baseline. she was guaiac negative. she receives parenteral iron as an outpatient and follows with dr. . the patient will require continued outpatient follow-up of her chronic anemia. . # fen: diet, monitored electrolytes daily and repleted as needed . # ppx: heparin sc tid . # code: full . # contact: ( (husband); proxy is mother: ( medications on admission: 1. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid 2. lisinopril 10 mg tablet sig: three (3) tablet po daily 5. ambien 5 mg tablet sig: one (1) tablet po at bedtime. 6. citalopram 20 mg tablet sig: one (1) tablet po daily 7. fludrocortisone 0.1 mg tablet sig: five (5) tablet po daily 8. venlafaxine 75 mg tablet sig: two (2) tablet po bid 9. aspirin 325 mg tablet sig: one (1) tablet po daily 10. atorvastatin 20 mg tablet sig: one (1) tablet po once a day. 11. lyrica 100 mg capsule sig: one (1) capsule po twice a day. 12. vicodin 5-500mg 1-2 tabs po bid prn pain 13. insulin pump - per regimen: this is actively being titrated by - most recently per record approx 1.3 to 1.5 u per hour, with boluses of 1 u per 10 grams of carbs at meals. discharge medications: 1. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 2. venlafaxine 75 mg capsule, sust. release 24hr sig: two (2) capsule, sust. release 24hr po daily (daily). 3. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 4. fludrocortisone 0.1 mg tablet sig: five (5) tablet po daily (daily). 5. lisinopril 10 mg tablet sig: three (3) tablet po daily (daily). 6. hydrocodone-acetaminophen 5-500 mg tablet sig: 1-2 tablets po every twelve (12) hours as needed for pain. 7. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 8. white petrolatum-mineral oil cream sig: one (1) appl topical daily (daily). 9. neomycin-bacitracin-polymyxin ointment sig: one (1) appl topical daily (daily). 10. aspirin 325 mg tablet sig: one (1) tablet po once a day. 11. lyrica 100 mg capsule sig: one (1) capsule po twice a day. 12. ambien 5 mg tablet sig: one (1) tablet po at bedtime. tablet(s) 13. insulin pump insulin pump, use clinic protocol 14. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 15. lisinopril 20 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 16. ceftriaxone-dextrose (iso-osm) 2 g/50 ml piggyback sig: two (2) grams intravenous q12h (every 12 hours): last doses on . disp:*10 grams* refills:*0* discharge disposition: home with service facility: discharge diagnosis: primary diagnosis: 1) diabetic ketoacidosis 2) aseptic meningitis . past medical history: 1. type 1 diabetes mellitus c/b neuropathy, nephropathy, and retinopathy 2. peripheral diabetic neuropathy with left foot osteomyelitis s/p partial amputation of left foot 3. autonomic dysfunction 4. hypercholesterolemia 5. iron deficiency anemia 6. hypothyroidism 7. ulcerative collitis s/p colectomy with pouch ileostomy. 8. cataracts discharge condition: hemodynamically stable, afebrile discharge instructions: please take all medications as advised. keep all appointments listed below. . a visiting nurse will give you antibiotics for the next two weeks. please complete the course of cetriaxone. . please follow up with dr. at the clinic about your vision changes. . continue to monitor your blood glucose levels as prescribed. call your doctor if you have any questions. . if you experience fever, chills, nausea, vomiting, abdominal pain, weakness, numbness, tingling, visual changes, stiff neck, or other concerning symptoms please call your doctor immediately or return to the emergency department for evaluation. followup instructions: you are scheduled for the following appointments. please contact the appropriate provider with any questions or if you need to reschedule. . pcp: . , . , friday at 1:30pm. please note that dr. has left . dr. will take over your care for dr. . please call at your earliest convenience so they can send you more information . . ophthalmology: dr. , (. (today) at 2pm. clinic, first floow. . endocrinology: dr. , (. at 1:30pm. at the clinic. . infectious disease: , md phone: date/time: 2:30 . plastic surgery: dr. , md. (. friday , at 1pm. md, procedure: spinal tap incision of lung diagnoses: nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere unspecified essential hypertension polyneuropathy in diabetes iron deficiency anemia, unspecified ulcerative colitis, unspecified diabetes with neurological manifestations, type i [juvenile type], uncontrolled diabetes with renal manifestations, type i [juvenile type], uncontrolled diabetes with ophthalmic manifestations, type i [juvenile type], uncontrolled diabetes with ketoacidosis, type i [juvenile type], uncontrolled background diabetic retinopathy other bone involvement in diseases classified elsewhere unspecified viral meningitis chronic osteomyelitis, ankle and foot diabetes with other specified manifestations, type i [juvenile type], uncontrolled peripheral autonomic neuropathy in disorders classified elsewhere 

Answer: The patient is high likely exposed to