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 / ceclor / cefoxitin / tetracycline / codeine / demerol / clindamycin / moxifloxacin attending: chief complaint: meningitis major surgical or invasive procedure: none history of present illness: history of present illness: this is a 60 year old female with a history of auto immune mediated myelitis initiated on ivig on . she presented to with 2 day history of headache initially responsive to advil. yesterday she awoke with severe headache and chills, with the development of nausea and emesis. she also had blurry vision. due to the severity of her symptoms she called her neurologist who recommended ed evaluation. at an lp was performed which showed 60 red cells and 600wbcs in tube 4, glucose 62 and protein 114 with negative gram stain. fluid was clear and colorless. a head ct was negative and a cxr showed a rll infiltrate. she was given a dose of vancomycin and anzithromycin and sent to for further management given history of multiple antibiotic allergies. in the ed initial vs were t 97.7 hr 80 bp 97/57 02 98% ra rr 20. blood cultures were sent. she was noted to have nuchal rigidity and she was given acyclovir and tylenol. id was consulted with recommendation for iv bactrim and iv meropenem in icu setting. typically flares once a year with autoimmune myeltis, with 2 flares this year. over last month symptoms have worsened with joint pain and neuropathy, weakness, constipation, poor apetite. got ivig x 1 on with plan for 4 additional treatments weekly with decadron, zofran given. muscle weakness improved but 2 days later pt had worsened headache with photophobia, with nausea and non bloody emesis. had neck stiffness yesterday. no recent travel. past medical history: autoimmune mediated myelitis diagnosed in 94 partial complex seizure disorder last a couple of weeks ago severe glaucoma cervical spondylitis depression asthma social history: lives with her daughter and husband. does not drink etoh. quit smoking years ago. denies illicits. retired nurse. family history: no history of seizure daughter: dm mother: dm, stroke age 47 multiple family members with cad brother with cerebral palsy, 2nd brother with palsy sister with rheumatoid arthritis, sister with asthma physical exam: physical exam on admission: general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: cnii-xii intact, 5/5 strength upper/lower extremities, grossly normal sensation, 2+ reflexes bilaterally, gait deferred, finger-to-nose intact physical exam on discharge: vs - 98.1, 98.7, 95-122/42-80 (currently 99/65), 67, 18, 96% general - well-appearing female in nad, comfortable, appropriate heent - nc/at, perrl, eomi, glasses in place, sclerae anicteric, mmm, op clear neck - supple, no thyromegaly, no jvd, no nuchal rigidity lungs - cta bilat, no r/rh/wh, good air movement, resp unlabored, no accessory muscle use heart - rrr, no mrg, nl s1-s2 abdomen - nabs, soft/nt/nd, no masses or hsm, no rebound/guarding extremities - wwp, no c/c/e, 2+ peripheral pulses (radials, dps) skin - no rashes or lesions neuro - awake, a&ox3, cns ii-xii grossly intact, muscle strength throughout, sensation grossly intact throughout, cerebellar exam intact (however patient with some difficulty on finger to nose, able to do dysdiokenesia) pertinent results: 01:02am plt count-179 01:02am neuts-64.6 lymphs-25.2 monos-9.3 eos-0.5 basos-0.4 01:02am wbc-5.7 rbc-3.52*# hgb-11.1*# hct-32.2*# mcv-92 mch-31.5 mchc-34.4 rdw-12.5 01:02am glucose-98 urea n-10 creat-0.7 sodium-138 potassium-3.6 chloride-106 total co2-26 anion gap-10 01:15am lactate-0.9 02:15am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.5 leuk-neg - blood cultures pending x 2 - ngtd - urine culture no growth final csf: gram stain negative, 60rbcs, 600wbcs, gram stain negative, hsv pcr-negative, culture with no growth final - csf: gram stain (final ): no polymorphonuclear leukocytes seen. no microorganisms seen. no growth - prelim, final pending 01:47pm cerebrospinal fluid (csf) wbc-7 rbc-23* polys-1 lymphs-49 monos-8 atyps-42 01:47pm cerebrospinal fluid (csf) wbc-9 rbc-17* polys-1 lymphs-71 monos-0 atyps-28 01:47pm cerebrospinal fluid (csf) totprot-26 glucose-51 labs on discharge 05:32am blood wbc-6.2 rbc-3.87* hgb-12.2 hct-34.9* mcv-90 mch-31.6 mchc-35.0 rdw-12.7 plt ct-181 10:59am blood glucose-102* urean-10 creat-1.0 na-131* k-4.3 cl-98 hco3-27 angap-10 10:59am blood calcium-8.8 phos-3.2 mg-2.0 brief hospital course: 60 year old woman with history of auto immune mediated myeltiis presenting with headache now with lp suggestive of early bacterial meningitis vs aseptic meningitis admitted to for antibiotic desensitization. acute issues: # meningitis: on admission she had nuchal rigidity and headache with symptoms evolving following exposure to ivig, with suspected adverse reaction to ivig. additionally, aseptic meningitis following ivig infusion has been reported. her initial lp could also reflect an early bacterial meningitis vs viral meningitis. although the gram stain was negative, antibiotic initiation was recommended by the infectious disease team, as some organisms such as neisseria can be slow to culture. she received iv acyclovir, vancomycin, bactrim and underwent desensitization to ceftriaxone. hsv pcr was requested from osh lp. she did develop throat swelling at higher dose of ceftriaxone and required iv solumedrol, benadryl and famotidine. the patient subsequently tolerated ceftriaxone. she was transferred to the floor on hod 2. hsv pcr was negative at osh and thus acyclovir was discontinued. the id team recommended a repeat lp and this was done. it showed no signs of infectious etiology with only 7 wbcs, no organisms or polys, and negative gram stain. antibiotics were discontinued at this time. the patient was observed for 12 hours after and was without symptoms or fever. she was discharged home with the thought that the meningitis was aseptic and secondary to adverse reaction to ivig. # autoimmune mediated myelitis: pt had acute flare of her myeltis with ivig given. she had improvement of myelitis symptoms with ivig but development of nausea and headache subsequently as well as aseptic meningitis picture, most likely an adverse reaction to ivig. this was discussed by her neurologist given that she is planned for weekly ivig. the patient was scheduled to follow up with her outpatient neurologist dr. for further treatment. chronic issues: # asthma: home advair was continued. # glaucoma: continued eye drops # h/o seziures: home clonazepam 1.5mg with additional 1 mg dose at 2 pm was continued. transitional issues: - patient will follow up with outpatient neurologist regarding futher care of autoimmune myelitis. - csf culture pending. - blood cultures pending. medications on admission: klonopin 1.5 am, 1mg at 2pm then 1.5mg qpm xalitan 1 drop each eye bedtime azopt l eye 1drop three times a day advair 250/110 1 puff allergies: ceclor-anaphylaxis cefoxitin- anaphylaxis clindamycin- rash codeine-rash demerol-hypoytension moxifloxacin -(wheeze, hypotension) tetracycline-rash scopolamine-wheeze discharge medications: 1. azopt *nf* (brinzolamide) 1 % ou tid 2. clonazepam 1.5 mg po bid 3. clonazepam 1 mg po daily at 2 pm 4. fluticasone-salmeterol diskus (250/50) 1 inh ih 5. xalatan *nf* (latanoprost) 0.005 % ou hs discharge disposition: home discharge diagnosis: aseptic meningitis secondary to adverse reaction to ivig discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: mrs. , you were admitted to hospital because you were having head aches and neck stiffiness and thought to have meningitis. you were transferred here because of your history with allergies to antibiotics. we initially treated you with antibiotics. however, we now think that your symptoms are not caused by an infectious meningitis but most likely secondary to an adverse reaction to your recent ivig treatment. a repeat lp at showed no signs of infection. it was a pleasure caring for you, your doctors followup instructions: name: , location: department: neurology address: , phone: appointment: tuesday 4:00pm name: pa address: , , phone: appointment: thursday 10:45am *this is a follow up appointment for your hospitalization. you will be reconnected with your primary care provider after this visit. procedure: central venous catheter placement with guidance diagnoses: asthma, unspecified type, unspecified personal history of tobacco use unspecified glaucoma depressive disorder, not elsewhere classified constipation, unspecified localization-related (focal) (partial) epilepsy and epileptic syndromes with simple partial seizures, without mention of intractable epilepsy unspecified viral meningitis gamma globulin causing adverse effects in therapeutic use other causes of myelitis 

Answer: The patient is high likely exposed to