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: seizure major surgical or invasive procedure: none history of present illness: mr. is a 52 year old gentleman with a pmh of dmii, cri, multiple neck abscesses, and traumatic brain injuries (sdh) of unknown etiology who presents after a seizure and fall from bed at his nursing home. . mr is a haitian earthquake survivor, who originally presented to his dentist in with a tooth abscess. he had the wound opened and required skin grafting for healing. he was found to have multiple abscesses in his neck. the abscesses were opened, and after the earthquake he was transferred to an airport that had been set-up as a health care facility. he developed a stage iv decubitus ulcer on her coccyx as well as around his penis from an indwelling catheter. he also was unable to swallow so a peg was placed. . he was transferred to , for better care since did not have adequate resources. he was stabilized and transferred to a nh in the area in . he was progressing and improving, however he had multiple falls that were not told to the family, and he developed a foot drop on friday. in the past few weeks he was more lethargic than usual. on he was observed having a tremor w/ teeth gringding, lasting several minutes. when ems arrived he was observed twisting on the right side. at osh he was loaded w/ dilantin, treated for hyperkalemia (5.9), and treated w/ unasyn with concern for aspiration pneumonia. when head ct and mri showed small sah (left parietal) and subdural hematoma (left frontal, parietal, bilat occipital) he was transferred to . past medical history: dm type 2 cri (w/ hx hyperkalemia) anemia s/p i and d of left neck abscess multiple uti's decubitus ulcer chronic brain injury of unknown nature g-tube placement (for malnutrition) social history: patient is a surviver of the haitian earthquake, who was transferred to for management of his multiple medical problems. was living in a nursing home in mass prior to admission. family history: htn, dmii physical exam: admission exam: vitals: t:97.9/97.7 bp:118/75 (108-124/58-86) p: 68 (68-76) r:16 o2:100% on ra general: alert,lying in bed in no acute distress, cacchectic heent: sclera anicteric neck: supple, jvp not elevated lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: normal rate and regular rhythm, normal s1 + s2, ii/vi sem murmur at the rusb, no rubs or gallops abdomen: soft, non-tender, peg tube in place with dressing c/d/i non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused, 2+ pulses in radials and dps bilaterally, no clubbing, cyanosis or edema skin: warm, dry neuro: moving all four extremities in bed, but unable to assess strength this am pertinent results: 10:26pm blood wbc-10.5 rbc-2.86* hgb-8.6* hct-25.9* mcv-91 mch-30.2 mchc-33.2 rdw-15.7* plt ct-330 10:26pm blood pt-12.8 ptt-26.5 inr(pt)-1.1 10:26pm blood plt ct-330 06:19am blood ret aut-0.7* 10:26pm blood glucose-88 urean-43* creat-2.0* na-147* k-4.3 cl-113* hco3-24 angap-14 09:00am blood glucose-124* urean-34* creat-1.8* na-142 k-4.8 cl-112* hco3-21* angap-14 10:26pm blood alt-47* ast-32 ld(ldh)-209 alkphos-292* totbili-0.3 05:55am blood alt-85* ast-59* alkphos-329* totbili-0.1 06:19am blood ck(cpk)-136 09:00am blood ck(cpk)-110 10:26pm blood ctropnt-0.19* 06:19am blood ck-mb-6 ctropnt-0.17* 09:00am blood ck-mb-4 ctropnt-0.15* 06:19am blood caltibc-203* ferritn-573* trf-156* 06:39am blood %hba1c-6.2* eag-131* 06:19am blood tsh-1.6 . c. diff toxin negative . imaging: non-contrast head ct, with multiplanar reformats. there is hyperdense thickening of the falx to the left of midline, compatible with a thin subdural hematoma, measuring no more than 3 mm. equivocal slightly larger idodense component is also noted, measuring up to 4 mm (2a:22). there is no further subdural collection identified. there is no subarachnoid, intraparenchymal or intraventricular blood identified. there is no parenchymal edema or mass effect. ventricles and sulci are prominent, compatible with atrophy, and there are periventricular white matter hypodensities, compatible with sequelae of chronic small vessel ischemic disease. the -white matter differentiation is otherwise preserved, without ct evidence of acute territorial infarction. the visualized bones are free of fracture. there is scattered opacification of the mastoid air cells, and mucosal thickening in the left ethmoids. remainder of the paranasal sinuses are clear. the extracranial soft tissues, including the globes and orbits, are unremarkable. impression: 1. thickening of the falx, compatible with a subdural hematoma. a thin hyperdense component measures no more than 3 mm, with a possible slightly larger isodense component also noted, as above. no further intracranial hemorrhage is identified. 2. global atrophy and sequelae of chronic small vessel ischemic disease are noted. comparison with prior imaging reportedly performed at an outside hospital would be helpful for evaluation of stability of these findings. eeg : impression: this in an abnormal continuous eeg due to the presence of frequent brief periods of rhythmic delta activity occurring maximally over the bifrontal regions seen more frequently during sleep. this pattern is most consistent with firda which is consistent with a mild to moderate diffuse encephalopathy or a deep midline structural defect. however, given the reduction in frequency and duration of these events after the administration of antiepileptic medication yesterday, these events could also represent atypical frontal lobe seizures. eeg : impression: this in an abnormal modified eeg telemetry due to the presence of frequent brief periods of rhythmic delta activity occuring maximally over the bifrontal regions. this pattern is most consistent with firda which is consistent with a mild to moderate diffuse encephalopathy or a deep midline structural defect. however, these may also represent atypical frontal lobe seizures. while a comparison with the previous tracing is limited given that the patient remains mostly awake, these periods of rhythmic delta activity appear to be less frequent than in the previous tracing. liver us : impression: no focal liver lesion or biliary dilatation seen. cholelithiasis with no sign of cholecystitis. scant trace of ascites. cxr : single portable upright view of the chest: the cardiomediastinal contour is normal. the heart is not enlarged. lung volumes are somewhat low, accentuating perihilar vascular crowding. left upper lobe consolidation is slightly more prominent. there is no pleural effusion. the bony thorax is unremarkable. impression: left upper lobe consolidation somewhat more prominent urine culture (final ): klebsiella pneumoniae. >100,000 organisms/ml.. proteus mirabilis. >100,000 organisms/ml.. sensitivities: mic expressed in mcg/ml _________________________________________________________ klebsiella pneumoniae | proteus mirabilis | | ampicillin------------ <=2 s ampicillin/sulbactam-- =>32 r <=2 s cefazolin------------- <=4 s 8 s cefepime-------------- <=1 s <=1 s ceftazidime----------- <=1 s <=1 s ceftriaxone----------- <=1 s <=1 s ciprofloxacin--------- =>4 r 1 s gentamicin------------ <=1 s <=1 s meropenem-------------<=0.25 s <=0.25 s nitrofurantoin-------- 64 i piperacillin/tazo----- 64 i <=4 s tobramycin------------ =>16 r <=1 s trimethoprim/sulfa---- 2 s <=1 s 05:55am blood alt-85* ast-59* alkphos-329* totbili-0.1 01:28pm cerebrospinal fluid (csf) wbc-0 rbc-0 polys-0 lymphs-87 monos-13 01:28pm cerebrospinal fluid (csf) totprot-29 glucose-69 all csf cultures were negative for growth and cytology did not reveal any malignant cells brief hospital course: 52 year old gentleman with a pmh of dmii, cri, multiple neck abscesses, and traumatic brain injuries (sdh) of unknown etiology who presents after a seizure and fall from bed at his nursing home. #neuro/mental status changes: pt was intially admitted to neurosurgery and it was felt that no surgical intervention was indicated. serial head cts showed stable sdhs. seizures were thought most likely related to multiple sdh/trauma. mri was obtained to evaluate vasculature for aneurysm given concern for sah on ct. prior images were uploaded for comparison. pt was initially started on phenytoin 100mg tid for seizure ppx and dose was later increased to 200mg po tid after eeg raised concern for frontal seizures. an mri was performed to further characterize ich and the previously seen subtle signal abnormality in the frontal cortical region on diffusion images was confirmed to be artifactual. pt was found to have a persistent encephalopathy and an lp was performed which was negative (cultures, smear & cytology). pt has had an early onset dementia of unclear etiology for the last year and mri showed global atrophy and ventricles enlarged out of proportion to global atrophy. pt was evaluated for possible nph, however a large volume tap was unsuccessful. in the setting of multiple sdhs, uti, seizures and renal insufficiency, neuro team recommended that a dementia work up should be postponed until medically stable and recovered from multiple sdhs. pt will require cognitive neurology outpatient evaluation at , number . . # acute change in mental status: pt was transfered to medicine around at which time he was not responding to commands. the patients dilantin was titrated down and he was given 1prbc for persistent anemia. hypernatremia (hypovolemic in nature) was corrected by increasing his free water boluses and ivf. pt was found to have a uti that was treated with ceftriaxone. encephalopathy improved after these interventions. given the persistent transaminitis on dilantin, pt was transitioned to keppra 500mg for seizure prophylaxis. pt was also started on seroquel qhs for intermittent agitation and by the time of discharge, he was responded to questions with one word answers, naming common objects and tolerating some oral diet. # chronic renal insufficiency: stable creatinine of 1.8-2.1 while an inpatient. urine lytes showed a fena of 3.9%, suspected to be from diabetic nephropathy, apparently diagnosed back in . # anemia: likely secondary to chronic renal insufficiency and acd. iron level was normal, ferritin was high, tibc was low. reticulocyte count was low. # dmii: newly diagnosed in according to his sister. hgb a1c was 6.2. pt was on lantus and sliding scale insulin at home. he had hypoglycemia while in house initially and as intake improved, his blood sugars became more stable. # sacral decubitus ulcer stage ii: this was noted on admission and wound care was consulted. pt was treated with barrier dressing, regular position changes and nutrition support with tfs. ulcer was healing well. # iatrogenic hypospadias: urology was consulted for urethral erosion chronic indwelling foley catheter, needed to heal sacral decub ulcers (stage iv). family members, were about the procedure and decision to follow-up in clinic to discuss the need for a suprapubic catheter (spc) was made. given improved mental status in and healing penile ulcer, a voiding trial was attempted which was successful. however, a condom catheter was applied for incontinence and risk of contaminating sacral decub. urology follow up was scheduled for ongoing management of this issue. # uti: urine cx grew klebsiella resistant to cipro/unasy and pansensitive proteus mirabilis. pt. was treated with ceftriaxone iv starting on and was written to complete a 10 day course given the indwelling cath/condom cath. # transaminitis. mild on arrival w/ elevated ap and nl bili. ruq us was negative, hepatitis serologies were negative, including hep bsab, for which he will require immunization. hep c was negative. hep a ab was positive. the lft abnormalities were thought possibly due to dilantin which was discontinued on . lfts should be followed up on . # hypothermia episode. pt. was triggered for an episode of hypothermia to f and infectious w/u revealed an aspiration pna. pt was empirically treated with ceftriaxone/flagy (started on ), ivf and warming blanket. hemodynamics normalized after 6 hrs of treatment and there were no further episodes of hypothermia. he was treated for presumed aspiration pna x 7 days (last day ) # loose stools. onset after tf restarted. c.diff negative x 2 as were common stool cultures, o/p. amylase/lipase were normal. atrributed due to osmotic load from tf, may need readjustment while at . medications on admission: omeprazole 20mg po daily colace 100mg via g-tube lantus 8 units sc daily novolin r insulin sliding scale heparin 5000 units sc tid remeron 15mg po qhs seroquel 75mg po qhs discharge medications: 1. lantus 8 units injected subcutaneously once a day in the morning 2. novolin r insulin please take according to your sliding scale 3. heparin (porcine) 5,000 unit/ml solution sig: one (1) 5000 units injection tid (3 times a day). 5000 units 4. mirtazapine 15 mg tablet sig: one (1) tablet po hs (at bedtime). 5. epoetin alfa 4,000 unit/ml solution sig: one (1) injection qmowefr (monday -wednesday-friday). 6. quetiapine 50 mg tablet sig: two (2) tablet po hs (at bedtime): give at 6pm daily please . 7. quetiapine 25 mg tablet sig: one (1) tablet po bid prn () as needed for agitation. 8. levetiracetam 500 mg tablet sig: 1.5 tablets po bid (2 times a day). 9. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day): day 1 = , total of 8 days, last day . 10. ceftriaxone 1 gram piggyback sig: one (1) gram intravenous once a day for 3 days: day 1 = duration 10 days last day . 11. outpatient lab work please perform cbc, chem 7 and lfts upon arrival. please recheck within one week prior to clinic appointments. 12. appointments please ensure patient follows up with appointments as listed above, changed from discharge summary time of writing. discharge disposition: extended care facility: senior healthcare of discharge diagnosis: primary: seizure intracranial bleed secondary: chronic renal insufficiency diabetes type 2 anemia pre-existing decubitus and urethral ulcer discharge condition: mental status: alert, oriented to hospital and city at best, other times only to name. able to perform dow backwards at best, at other time unable. names high frequency objects at best. follows 2 step commands at best. his mental status improves with family presence, requires a translator for appropriate communication. cns: eomi, perrl, face symmeetric, tongue midline, palate elevates symmetrically. motor: increased tone in ues, mild cogwheeling at b/l wrists and biceps, mild spasticity as well. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: mr. , it was a pleasure taking part in your care. you were admitted to because you had a seizure. we did a ct scan of your head which showed signs of a bleeding. it was not operable and remained stable throughout your hospital stay. . for seizures, you were evaluted by neurology and started on medications to suppress seizures. because of the dilantin use (antiseizure medicine) you developed abnormal liver enzymes. your seizure medicine was changed to keppra. we had wound care evaluate your ulcers and they recommended urology follow-up. . we made the following changes to your medications (please refer to your discharge medication list for details). you were discharged to a nursing home facility for further rehabilitation and because you required 24 hr care. followup instructions: please follow-up with your nursing home care doctors please set-up an appointment with a primary care physician when you leave your nursing home department: surgical specialties when: wednesday at 9:00 am with: urology unit building: sc clinical ctr campus: east best parking: garage department: cognitive neurology unit when: wednesday at 1 pm with: , md building: ks building (/ complex) campus: east best parking: main garage please ensure family member is present for appointment. please follow up with the liver clinic on with dr. at liver center, lmob , please call ( to confirm the appointment. please ensure family member is present for appointment. department: liver center when: tuesday at 1 pm with: , md building: lm bldg () campus: west best parking: garage procedure: spinal tap incision of lung enteral infusion of concentrated nutritional substances diagnoses: anemia of other chronic disease nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere urinary tract infection, site not specified friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site acute kidney failure, unspecified unspecified protein-calorie malnutrition other persistent mental disorders due to conditions classified elsewhere chronic kidney disease, stage iii (moderate) pneumonitis due to inhalation of food or vomitus pressure ulcer, lower back diarrhea metabolic encephalopathy urinary catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure hyperosmolality and/or hypernatremia accidental fall from bed subdural hemorrhage diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled proteus (mirabilis) (morganii) infection in conditions classified elsewhere and of unspecified site infection and inflammatory reaction due to indwelling urinary catheter localization-related (focal) (partial) epilepsy and epileptic syndromes with complex partial seizures, without mention of intractable epilepsy pressure ulcer, stage ii other urethritis nonspecific abnormal results of function study of liver other specified disorders of penis personal history of traumatic brain injury 

Answer: The patient is high likely exposed to