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: history of present illness: on presentation, , the following history was obtained by the intensive care unit resident. patient is a 69-year-old female with a history of congestive heart failure, chronic obstructive pulmonary disease, status post recent admission to hospital for pneumonia complicated by chronic obstructive pulmonary disease exacerbation on a prednisone taper. she was discharged back to the nursing home four days prior to admission where she was recovering well until the night prior to admission. she was witnessed to have three generalized tonic-clonic seizures lasting approximately 20 minutes. ems was called and patient was intubated in the field for status. arrived at hospital with continued seizures, treated with ativan 4 mg, valium 5 mg and loaded with 5 phenytoin. head ct revealed diffuse white matter disease with evidence of edema, but no bleed. lumbar puncture was slightly bloody, although decreased white count from tubes one through four. she was transferred to for further management. she was given ceftriaxone 2 grams at hospital. patient had been treated for a urinary tract infection with bactrim and was noted to have a zoster rash on her back, which was noted at hospital. she was started on acyclovir at the time. according to the patient's family, she was more lethargic during the day, , although, the family was told that her vitals were okay. on arrival to , the patient was sedated and intubated. ct scan was reviewed with radiology and felt not to be consistent with subarachnoid hemorrhage. medical intensive care unit team was called and admitted the patient. she was not able to give any history of her own at that time. past medical history: 1. possible multifocal atrial tachycardia. 2. chronic obstructive pulmonary disease. 3. cardiomegaly. 4. congestive heart failure. 5. hypertension. 6. obesity. medications on admission: digoxin .25 mg po q.d., lasix 40 mg po q.d., potassium chloride 10 mg po q.d., diazepam 2 mg po t.i.d., azmacort 2 mg po q.i.d., famotidine 20 mg po q.h.s., multivitamin 1 tablet po q.d., vitamin c 500 mg po b.i.d., bactrim double strength b.i.d., theophylline 200 mg po b.i.d., fluticasone salmeterol 1 puff po b.i.d., acyclovir 800 mg po q.i.d., tylenol prn. allergies: patient has no known drug allergies. social history: she lives at a nursing home, former tobacco user with 60+ pack year history of smoking, quit six years prior to admission. patient was full code on admission. physical examination on admission: temperature was 97.3. heart rate 86-96. blood pressure 105-117/55-63, breathing at 12-13, 02 saturation 98%. arterial blood gas was 7.43, 44, 86 on simv with pressures 700 x 12, fio2 of .5, peep of 5, pressure support was 5. she has anicteric pupils, equal, round and reactive to light. no doll's eyes. oropharynx showed ett in place. she had a supple neck. lungs were clear to auscultation bilaterally. her heart was irregularly irregular with no murmurs, rubs or gallops. her abdomen is soft, nontender, nondistended, positive bowel sounds times four. she had 1+ edema. patient was sedated and unresponsive to voice, withdrawing toes, spontaneously opens eyes. laboratories from hospital: white blood cell count 15.3, hematocrit 56.2 with a differential of 90 neutrophils, 4 lymphocytes, 4 monocytes, platelets 136,000, inr 1.4, ptt is 25, sodium 140, potassium 4.5, chloride 99, bicarbonate 33, bun 44, creatinine 1.3, glucose 125, albumin 3.7, calcium 9, magnesium 2.1, tsh was 5.3, t4 7, t3 uptake 41, theophylline was 6.4, which is subtherapeutic. therapeutic range is . digoxin 1.4. ammonia was 36. alt 31, ast 25, alkaline phosphatase 112, t bilirubin .8, total protein 6.9. electrocardiogram shows sinus arrhythmia with st elevations in v1 and v2 and nonspecific st-t wave changes. cerebrospinal fluid tube one shows 2 white cells, 150 red cells, glucose of 75, protein 225. head ct demonstrated white matter disease, left cerebral edema with compression of the lateral ventricle, no gross shift, question of air bubbles. hospital course: hospital course can best be summarized day to day as her main problems were her neurologic problems and pulmonary problems and these were overlapping issues. the patient's work-up at included an mri of her head which showed diffuse cerebral edema. mra and mrv were normal and electroencephalogram showed frontal spike on the left with a diffusely slow background. treatment included reloading the patient with phenytoin steroids and acyclovir for presumed hsv encephalitis. follow-up mris did not demonstrate progression and in fact showed resolution of her cerebral edema. the culture results from hospital revealed hsv2 positive pcrs. it is felt to be positive for her aseptic meningitis or asymptomatic shedding from a sacral nerve root. the infectious disease service was not convinced that her clinical picture was consistent with hsv2, they felt it was more likely to be consistent with hhv6. the patient completed her acyclovir however, and this is not a further issue. the patient was noted to be more responsive and was finally extubated in the intensive care unit on . she was transferred to the medical service for further management. her neurologic exam at that time showed that her eyes were open at baseline. she was able to follow examiner with her eyes. her speech was slow, dysarthric with simple sentence production and soft voice. she was moving all four extremities, left greater than right, was capable of following one and two step commands with variable re-productability, cannot print by correct date or location but knew her name. cranial nerves respond to visual threat. full elevation and depression of eyes, right lateral gaze was intact, capable of moving eyes to the left, but incomplete motion. eyes were in mid position at baseline. facial sensation was difficult to assess, motion was noted to be decreased in her lower face on the right side. her hearing was grossly intact. palate was up bilaterally. head turning and shoulder shrug were difficult to assess. the patient had full tongue motion. her strength and normal bulk increased tone on right side, left side was stronger than right, but capable of moving all four extremities. patient was hyperreflexic in the right upper extremity, diffusely decreased lower extremity reflexes, toes are downgoing bilaterally. sensory examination showed that the patient was capable of localizing painful stimuli. she had no tremors. cerebellar signs were difficult to elicit. patient's course on the medical floor: on , the patient was noted to be more responsive. repeat mri showed some regression of the t2 hyperintensity white matter changes, especially in the centrum semiovale and a possible increase in cerebral blood flow. the patient continued to feel better. on , she was suctioned aggressively for several episodes of desaturation. on , the patient had no significant shortness of breath. a rash was noted for the first time. it is felt to be consistent with dilantin infatabs rash. the infatabs were changed back to the regular formulation and the rash slowly, but incompletely resolved. on , the patient was noted to have several desaturations which responded to aggressive suctioning. on , the patient was once again suctioned with improvement in her respiratory status. on , the patient was examined during morning pre rounds and found to have an arterial blood gas of ph 7.25, pco2 of 95, po2 of 56. she was intubated and taken back to the medical intensive care unit. the patient self extubated on and returned to the regular medical floor on . the patient was started on cpap while on the regular medical floor. she tolerated this treatment the first night. the patient on the morning of was noted to have decreased oxygen saturations. she was found to have an 02 saturation of 57%. an arterial blood gas was done at that time ph 7.38, po2 was 32, pco2 was 69. her bipap was adjusted and she was administered a nebulizer. follow-up arterial blood gas was ph 7.39, pco2 72, po was 79. patient was maintaining at her previous baseline. she was left in no apparent distress at that time on oxygen by shovel mask. the patient developed decreased oxygen saturations at 5:30 a.m. on . she was reintubated and taken back to the intensive care unit. after a long and protracted course in the intensive care unit, the decision was made by the patient's family to make the patient "do not resuscitate, do not intubate." she was extubated as she was tolerating spontaneous breathing trials. the patient's respiratory status did not improve. the decision was made to make her comfort measures only. the patient was called out to the regular medical floor on . on the morning of , she was found on pre rounds. her pupils were unreactive. she had no heart sounds, no breath sounds, no spontaneous movements, no response to pain, no radial or femoral pulses. the patient was pronounced dead on at 8 a.m. discharge condition: dead. discharge diagnoses: identical to her admission diagnoses with the addition of: 1. encephalitis. 2. cerebral edema. 3. seizure disorder. patient did not have any seizures during this hospitalization. dr., 12-761 dictated by: medquist36 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube insertion of endotracheal tube arterial catheterization diagnoses: acidosis urinary tract infection, site not specified congestive heart failure, unspecified obstructive chronic bronchitis with (acute) exacerbation other convulsions acute respiratory failure other alteration of consciousness unspecified infectious and parasitic diseases 

Answer: The patient is high likely exposed to