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: patient recorded as having no known allergies to drugs attending: chief complaint: lethargy/ chills/ disorientation major surgical or invasive procedure: r ij line placed in ed history of present illness: 73 year old, history of prednisone for chronic ra, hx of dvt now on filter, asthma, recently went onto trip to republic. he returned at yesterday and stopped over at . he remembered taking some hot dogs and spirit before he took flight to come back to . his return trip to , he was noted to have chills, increasing lethargy, disorientation and "asking strange question." he was subsequently brought by ems from airport. of note, his daughter also consumed hot dog but reportedly was still well. denies any recent sick contact or bug bites. past medical history: rheumatoid arthritis on prednisone chronically hx of dvt and s/ filter asthma ??cad s/p cholecystectomy s/p bilateral knee replacement social history: retired painter, lives alone and independent, denies tob and alcohol family history: history heart disease physical exam: on admission: bp 88/49 p 80s r 14 o2 90s on 2l gen: nad heent: perrl, sclrae aniceteric, op clear, dry mm neck: flat jvd, supple cv: rrr, no m/r/g chest: bibasilar crackles abd: s, nt/nd+bs, no hsm ext: wwp, no edema or rashes neuro: a+o x 3, motor and sensory grossly intact pertinent results: 12:20pm blood wbc-pnd rbc-pnd hgb-pnd hct-pnd mcv-pnd mch-pnd mchc-pnd plt ct-pnd 04:05am blood wbc-31.1* rbc-5.38 hgb-17.2 hct-48.2 mcv-90 mch-32.0 mchc-35.7* rdw-13.2 plt ct-275 12:20pm blood neuts-pnd lymphs-pnd monos-pnd eos-pnd baso-pnd 04:05am blood neuts-65 bands-19* lymphs-4* monos-4 eos-1 baso-0 atyps-3* metas-4* myelos-0 04:05am blood hypochr-normal anisocy-normal poiklo-normal macrocy-normal microcy-normal polychr-normal 12:20pm blood plt ct-pnd 04:05am blood plt smr-normal plt ct-275 04:05am blood pt-14.0* ptt-28.2 inr(pt)-1.3 08:25am blood glucose-129* na-142 k-2.8* cl-112* hco3-20* angap-13 04:05am blood glucose-115* urean-30* creat-1.9* na-140 k-5.4* cl-99 hco3-19* angap-27* 12:20pm blood alt-pnd ast-pnd ld(ldh)-pnd alkphos-pnd totbili-pnd 08:25am blood ld(ldh)-134 04:05am blood alt-46* ast-93* ck(cpk)-168 alkphos-59 amylase-53 totbili-1.7* 12:20pm blood lipase-pnd 04:05am blood ctropnt-0.01 04:05am blood ck-mb-1 08:25am blood calcium-7.4* phos-1.3* mg-1.0* 04:05am blood albumin-4.2 calcium-9.9 phos-1.1* mg-1.7 12:42pm blood lactate-2.8* 11:07am blood lactate-2.5* 09:59am blood lactate-2.3* k-3.0* 08:58am blood lactate-3.0* 07:25am blood lactate-3.33* 06:15am blood lactate-3.6* 04:32am blood lactate-5.1* 07:25am blood hgb-13.9* calchct-42 o2 sat-71 10:25am blood wbc-10.8 rbc-4.66 hgb-14.8 hct-43.7 mcv-94 mch-31.9 mchc-34.0 rdw-13.3 plt ct-206 10:25am blood plt ct-206 10:25am blood pt-13.2 ptt-32.9 inr(pt)-1.2 10:25am blood glucose-148* urean-18 creat-0.9 na-138 k-4.3 cl-103 hco3-29 angap-10 10:25am blood calcium-9.2 phos-1.7* mg-2.0 . cxr : prominence of the pulmonary vessels without frank pulmonary edema . blood cultures: no growth urine cultures: no growth 8:30 pm stool consistency: soft source: stool. **final report ** fecal culture (final ): no salmonella or shigella found. campylobacter culture (final ): no campylobacter found. ova + parasites (final ): no ova and parasites seen. . charcot- crystals present. . this test does not reliably detect cryptosporidium, cyclospora or microsporidium. while most cases of giardia are detected by routine o+p, the giardia antigen test may enhance detection when organisms are rare. fecal culture - r/o yersinia (final ): no yersinia found. fecal culture - r/o e.coli 0157:h7 (final ): no e.coli 0157:h7 found. 8:36 pm stool consistency: soft **final report ** ova + parasites (final ): no ova and parasites seen. . charcot- crystals present. . 3:19 pm stool consistency: soft **final report ** ova + parasites (final ): no ova and parasites seen. . ruq us: no evidence of biliary obstruction. ct chest: 1. lesion between left atrium and esophagus corresponds to a fluid density oval structure surrounded by fat. the latter likely reflects fat that has herniated into the posterior mediastinum through the esophageal hiatus. the etiology of the oval- shaped lesion is uncertain, but could represent an esophageal duplication cyst or other benign finding. a necrotic lymph node is less likely. by report, the patient underwent an outside ct years ago. direct comparison to the older study is recommended to document long-term stability and to exclude an acute process. 2. small bilateral pleural effusions, increased since study from . 3. focal area of cystic bronchiectasis in the lingula with a small fluid level, indicative of secretions. findings are likely sequela of prior pneumonia. 4. borderline enlarged precarinal mediastinal lymph node. . bone scan: no definite evidence of osteomyelitis or osseous metastases. brief hospital course: icu course: 73 year old, p/w acute history of chills/lethargy/disorientation, wbc of 30k, lactate 5, admit to for sepsis protocol (sepsis-hyperthermia + wbc 30; shock + lactate). #sepsis of unclear etiology. given the pt hisotry of chronic steroid use and his travel history, the initial differential diagnosis was wide. apart from the usual sources malaria, typhoid fever and traveler diarrhea were considered. the pt was started on levofloxacin and metronidazole in the ed. a cxr was unsuggestive for pneumonia, a ct w and w/o contrast of the abdomen and pelvis was negative. the wbc of initally 30k was trending down from with abx treatment. a urine culture did not reveal any infectious course. stool and blood cultures were pending. the pt was continued on a stress dose of steroids given is chronic steroid intake. to follow mental status closely .. #arf - creatinine was elevated (1.9) on admission. the cause was thought to be prerenal in context of a sepsis. the pt was treated with fluid boluses and urine output was monitored. the cr came down quickly and is now 0.9. because no previous data was available, it is difficult to estimate the pt's baseline. .. #gap metabolic acidosis and metabolic alkalosis was thought to be a combination of lactic acidosis, vomiting and contraction alkalosis. the pt was treated with aggressive ivf resucitation as by the must protocoll and electrolytes were repleted accordingly. his acid base disorder has resolved. .. #increased lft from first specimen, are thought to be due to hemolysis as all follow up lfts were normal and no other history or clinical symptoms consistent with a liver disease were given. .. #cv- an echo on admission showed a left atrium that is mildly dilated. the right atrium that is moderately dilated. overall left ventricular systolic function that is low normal (lvef 50-55%). the pt never presented shortness of breath, edema or any other signs of heart failure. an ekg did not show any ischemic changes. cardiac enzymes were negative x1. the rhythm-frequent pvc were thought to be in the setting of his sepsis. they resolved when the pt became afebrile. .. #fen-oral intake #ppx-hep sc #code-full code #communication -daughter course on the floor: mr. was transferred to the floor from the the day before discharge. while on the floor he was transitioned to po prednisone to complete a steroid taper, and his diet was advanced. he had a ruq ultrasound which showed no obstruction. he had a ct of the chest which showed a lesion between the l atrium and the espohagus which may be fat, but could be a cyst or other lesion. he had a ct 5 yrs ago in tn, and this study will need to be compared to that study. he also had a bone scane which showed no sign of osteomyelitis or osseous metastases. he was stable overnight, and discharged on with a cd/rom of his prior ct and possible further work up of the mass seen on ct. of note, his stool o&p were still pending on discharge, but came back negative. the source of his sepsis was never found. medications on admission: prednisone 5mg qd gold 3mg qd calcium carbonate 500mg qd colchicine 0.6mg qd hctz 25 qd asa 81mg qd b12 injections tylenol 650mg qd aleve fosamax discharge medications: 1. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 10 days. disp:*10 tablet(s)* refills:*0* 2. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 10 days. disp:*30 tablet(s)* refills:*0* 3. prednisone 5 mg tablet sig: five (5) tablet po once a day: please take 6 tablets for 2 days starting , then 4 tablets for 2 days, then 2 tablets for 2 days, then 1 tablet daily. disp:*60 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: primary: sepsis secondary: acute renal failure, asthma, dvt, rheumatoid arthritis discharge condition: patient is feeling well, afebrile, hemodynamically stable, eating, walking. discharge instructions: > 101, nausea & vomiting, dizziness, alteration in your mental status, confusion. followup instructions: please call your pcp to follow up on your return home. procedure: venous catheterization, not elsewhere classified infusion of vasopressor agent diagnoses: acidosis acute kidney failure, unspecified unspecified septicemia severe sepsis peripheral vascular disease, unspecified alkalosis septic shock postinflammatory pulmonary fibrosis rheumatoid arthritis personal history of venous thrombosis and embolism chronic obstructive asthma, unspecified nonspecific elevation of levels of transaminase or lactic acid dehydrogenase [ldh] swelling, mass, or lump in chest other premature beats nonspecific abnormal results of other specified function study 

Answer: The patient is high likely exposed to