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: latex / fentanyl / risperidone attending: chief complaint: nausea, vomiting, headache major surgical or invasive procedure: none history of present illness: is a 23 year-old ftm transgender patient with hiv (: vl 931, cd4 318; started truvada/atazanavir/ritonavir on , discontinued, restarted two weeks ago), chronic untreated hepatitis c, and recent zoster who presents with two days of acute on chronic headache, fevers, nausea, vomiting, and diarrhea. he describes feeling well until , when he was hospitalized with epigastric/luq abdominal pain of unclear etiology and herpes zoster. he began and was admitted for headache, fever to 103, nausea, vomiting and ?zoster recurrence after not completing the course of acyclovir from the prior admission. he had a negative lp and largely unremarkable evaluation at that time. . he reports persistent malaise since , never returning to baseline after the two admissions, and experiencing persistent headache (distinguished from usual migraines by location and absence of aura and photophobia), nausea, 2-3 episodes nbnb emesis per week, intermittent fevers. over the last few days, he developed worsening of these symptoms (severe nausea, episodes vomiting, diarrhea x4, fever to 100.5, frontal headache behind eyes, with new myalgias and arthralgias x1day) for which he presented to the ed. . in the ed, initial vs were: 97.6 83 134/86 18 100. he was given acylovir 600 mg iv, morphine 4 mg iv x 2, zofran 4mg iv x 1, and 2l ns. an lp was negative and she was treated empirically with zosyn and acylovir. ct head and abdominal ultrasound were also negative. . on the floor on the morning after admission, he is lying in bed, mildly anxious, complaining of nausea, headache, and "general malaise." . ros as per hpi. in addition, he reports 13 lb weight loss over 2-3 months. he also notes rash and tingling/pain of left arm in same distribution of previously treated shingles. denies rhinorrhea, congestion, sore throat. denies cough, shortness of breath, chest pain or tightness, palpitations, abdominal pain, dysuria, recent change in bowel or bladder habits. denies si. past medical history: past medical history: - hiv ( started : truvada, atazanavir, ritonavir; diagnosed approx , took pmtct 1 yr ago; : vl 931, cd4 318; no history oi) - hepatitis c diagnosed in , no ifn therapy, last hep c vl 558,000 - cerebral palsy, s/p multiple surgeries, persistent leg spasticity requiring use of wheelchair for long distances, mild urinary retention at times. - asthma, mild intermittent - prior thrush due to advair for asthma - h/o multiple utis secondary to neurogenic bladder psh: - s/p appendectomy - c-section past psychiatric history: - depression: sees dr. at health center, taking cymbalta. - history of suicide attempts: last sa was in , requiring icu admission at hospital. pt overdosed on his medications at that point (prozac, trileptal, seroquel). reports hx of 2 sa by od, and 2 sa by cutting. first sa at age 13-14. - history of self cutting, last circa , self reports near fatal cut. - history of anorexia/bulimia, currently with active behaviors including restricting and purging. - ptsd - rape survivor - adhd - on concerta - ocd - trauma/abuse social history: female-to-male gender, has all female organs, does not take hormones. currently lives in with 1 yo son and is in a relationship with female partner. hx of crystal meth, heroin, cocaine use. occasional etoh, +tobacco, reports cutting down to 5 cig/day. reports close relationship with his mother's adoptive family (his grandparents). family history: mother: cancer, ? cervical, ovarian, endometrial (died ) physical exam: physical examination (on floor morning of ): vitals: t: 98.2 bp: 108/68 p: 81 r: 16 o2: 99% ra general: alert, oriented, mild distress heent: +sclera icteric, mmm neck: supple, no meningismus, no cervical or supraclavicular lad lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema skin: nonerythematous, papular lesions on left forearm and arm, no vesicles. exam at discharge (): vitals: t: 98.0 bp: 99/62 p: 64 r: 16 o2: 97% ra general: alert, oriented, no distress heent: extraocular movements intact, conjunctivae noninjected, sclera anicteric, moist mucous membranes neck: supple, no meningismus, no cervical or supraclavicular lad lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema skin: no erythema, icterus, or exanthem pertinent results: : wbc-6.9# rbc-4.81 hgb-12.3 hct-37.8 mcv-78* rdw-14.0 plt ct-339 neuts-66.9 lymphs-26.4 monos-5.3 eos-0.8 baso-0.6 caltibc-355 ferritn-50 trf-273 : wbc-7.9 lymph-7* abs -553 cd3%-80 abs cd3-441* cd4%-36 abs cd4-200* cd8%-40 abs cd8-220 cd4/cd8-0.9 esr-30* crp-32.9* : glucose-98 urean-7 creat-0.7 na-135 k-4.0 cl-98 hco3-27 angap-14 alt-49* ast-43* ld(ldh)-151 alkphos-89 totbili-6.9* dirbili-0.2 indbili-6.7 lipase-27 : alt-33 ast-30 alkphos-67 totbili-0.4 dirbili-0.1 indbili-0.3 : ttg-iga-1 urine rbc-0-2 wbc-* bacteri-few yeast-none epi-3-5 blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-7.0 leuks-tr . cerebrospinal fluid (csf): wbc-3 rbc-0 polys-0 lymphs-93 monos-7 totprot-29 glucose-60 herpes simplex virus pcr-negative cryptococcal antigen negative . : blood culture negative x2 , : blood culture positive x3 for group b strep : urine culture positive for group b strep . hcv viral load (final ): 2,720,000 iu/ml. cmv pcr negative . head ct (): negative for mass or bleed cxr (): negative ruq ultrasound (): no abnormalities noted kub (): no abnormalities noted . tte (): no evidence of endocarditis tee (): no evidence of endocarditis . ct abd/pelvis (): 1. new left hydronephrosis and hydroureter. while no obstructing stone or mass is seen, stones in patients who are on indivir are not radioopaque on ct and this cannot be excluded. 2. mild periportal edema and probable mild gallbladder wall edema represent nonspecific findings. no biliary ductal dilatation. 3. splenomegaly, similar to before. 4. borderline retroperitoneal and pelvic lymph node enlargement redemonstrated. 5. dependent atelectatic changes in both lung bases. . abdominal ultrasound (): no hydronephrosis; small amount of fluid at superior pole of right kidney; gallbladder with large amount of sludge, not overly dilated, apparent gallbladder wall thickening and edema is seen, but the patient was not in pain and there was no son sign. . labs on discharge (): 07:12am blood wbc-6.7 rbc-4.27 hgb-10.9* hct-34.4* mcv-81* mch-25.4* mchc-31.6 rdw-14.8 plt ct-457* 07:12am blood neuts-65.4 lymphs-27.2 monos-6.5 eos-0.2 baso-0.8 07:12am blood glucose-76 urean-12 creat-0.5 na-137 k-4.5 cl-101 hco3-28 angap-13 brief hospital course: reviewed by problem: . 1. group b strep (gbs) bacteremia. on the day of admission (), developed fever to 100.5. the next day, he was hypotensive to sbp of 70 (responsive to ivf) and his temperature spiked to 104. blood and urine cultures drawn were positive for gram positive cocci, and he was started on vancomycin; once the results showed group b streptococcus, he was changed to ceftriaxone. blood and urine cultures cleared by , and he remained afebrile throughout the hospitalization. afb/fungal blood cultures were negative. no source for the bacteremia was identified on ct abd/pelvis or abdominal us and the patient refused a pelvic exam. tte was negative for endocarditis. tee performed was also negative for endocarditis, but was complicated by respiratory distress (stridor, but no airway obstruction or inflammation on laryngo-bronchoscopy) leading to intubation. was extubated the next day without incident. a midline was placed and the patient was discharged with vna and infusion services to complete a 3 week course of iv antibiotics. . 2. respiratory distress (). per the report of the pacu staff, the patient recovered from the tee sedation (primarily propofol) well, and the patient reports being awake and feeling fine. then around 5:15pm, he developed tachypnea and chest discomfort, "as if someone was sitting on my chest", that was unlike any of his previous asthma exacerbations. he began making stridorous upper airway sounds and using accessory muscles to breath, though he remained normotensive and was satting in the mid to upper 90s. epinephrine had no effect and no airway edema was visualized on laryngoscopy, but given the persistent distress, the team decided to electively intubate, and the patient was transferred to the micu. after intubation, the respiratory team in the pacu performed bronchoscopy, which failed to reveal any evidence of airway inflammation or obstruction. the patient was extubated the following morning without incident. the etiology of the distress seems most likely to be psychiatric in etiology. . 3. headache. the patient reported a different quality to this headache than is usual for his migraines, but neurological exam was nonfocal and csf was negative for infection. he was treated symptomatically with acetaminophen, ketorolac, fioricet, and at times po narcotics. it improved during the hospitalization and the patient denied headache on the day of discharge. . 4. nausea and emesis. the etiology is unclear from prior studies and abdominal exam was benign throughout the hospitalization. his symptoms seemed to be exacerbated by the antiretrovirals, especially ritonavir. he was treated symptomatically with ondansetron and metoclopramide. compazine was tried, but made the patient sedated; he also reported a dystonic type reaction. . 5. hiv. truvada, atazanavir, and ritonavir were continued during the hospitalization. his unconjugated hyperbilirubinemia was attributed to atazanavir and was probably exacerbated by decreased urine output secondary to neurogenic bladder. . 6. neurogenic bladder. a foley was placed during the admission after hydronephrosis was seen on ct abd/pelvis; the hydronephrosis resolved after placement. he was discharged with a foley in place (to be changed by vna) and to follow up with urology. . 7. left arm pain/tingling. initially was thought to be possible zoster recurrence, but absence of rash/progression was more consistent with post-herpetic neuralgia. was initially treated with gabapentin (which was discontinued due to sedation and possible gi side effects) and lidocaine patch (which was continued throughout hospitalization). . 8. gallbladder wall thickening/edema. unclear significance, with no clinical correlation, most likely related to aggressive iv fluid hydration for hypotension. --would recommend following up with ruq us in months. medications on admission: 1. oxcarbazepine 300 2. acetaminophen 325 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for fever, pain. 3. morphine 15 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for headache. 4. duloxetine 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 5. concerta 18 daily 6. truvada, reyataz, norvir discharge medications: 1. oxcarbazepine 150 mg tablet sig: two (2) tablet po bid (2 times a day). 2. duloxetine 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 3. ritonavir 100 mg capsule sig: one (1) capsule po daily (daily). 4. atazanavir 150 mg capsule sig: two (2) capsule po daily (daily). 5. emtricitabine-tenofovir 200-300 mg tablet sig: one (1) tablet po daily (daily). 6. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. 7. concerta 18 mg tablet extended rel 24 hr sig: one (1) tablet extended rel 24 hr po once a day. 8. outpatient lab work weekly (on , ): cbc, chem7, alt, ast, alk phos, bilirubin (total and direct), crp, esr, tox screen please fax results to , attn: . 9. ceftriaxone in dextrose,iso-os 2 gram/50 ml piggyback sig: one (1) intravenous q24h (every 24 hours) for 12 days: starting last dose . disp:*12 bags* refills:*0* 10. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily). disp:*14 adhesive patch, medicated(s)* refills:*0* 11. metoclopramide 10 mg tablet sig: one (1) tablet po every six (6) hours as needed for nausea. disp:*40 tablet(s)* refills:*0* 12. clotrimazole 1 % cream sig: one (1) appl topical (2 times a day). disp:*1 tube* refills:*0* 13. ondansetron 4 mg tablet, rapid dissolve sig: tablet, rapid dissolves po every 4-6 hours as needed for nausea. disp:*40 tablet, rapid dissolve(s)* refills:*0* 14. foley please change foley on . 15. foley catheter 14 fr misc sig: one (1) miscellaneous once a month. disp:*2 * refills:*0* 16. leg bag for foley dispense 20 17. heparin flush 10 unit/ml kit sig: one (1) intravenous once a day for 12 days. disp:*12 * refills:*0* 18. saline flush 0.9 % syringe sig: two (2) injection once a day as needed for before and after antibiotic for 12 days. disp:*36 * refills:*0* discharge disposition: home with service facility: all care vna of greater discharge diagnosis: primary: group b strep bacteremia secondary: hiv chronic hepatitis c discharge condition: hemodynamically stable, ambulating without assistance, tolerating oral diet and medications. mental status: clear and coherent. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified spinal tap incision of lung diagnostic ultrasound of heart insertion of endotracheal tube fiber-optic bronchoscopy diagnoses: tobacco use disorder cirrhosis of liver without mention of alcohol chronic hepatitis c without mention of hepatic coma other pulmonary insufficiency, not elsewhere classified depressive disorder, not elsewhere classified bacteremia headache dehydration hydronephrosis migraine, unspecified, without mention of intractable migraine without mention of status migrainosus asymptomatic human immunodeficiency virus [hiv] infection status herpes zoster with other nervous system complications infantile cerebral palsy, unspecified obsessive-compulsive disorders streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group b posttraumatic stress disorder personal history, urinary (tract) infection neurogenic bladder nos panic disorder without agoraphobia cocaine abuse, in remission opioid abuse, in remission history of physical abuse trans-sexualism with unspecified sexual history amphetamine or related acting sympathomimetic abuse, in remission 

Answer: The patient is high likely exposed to