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: lisinopril / ampicillin attending: chief complaint: throat/mouth swelling major surgical or invasive procedure: direct laryngoscopy history of present illness: 51 yom h/o dm, htn and hld presenting with increased throat swelling, difficulty swallowing and voice change. patient had tooth ache starting approximately 1 week ago. on saturday he noted some submandibular swelling starting on saturday. he went to the dentist office yesterday and was prescribed amoxicillin. he began to have chills last night and this morning noted increased swelling with difficulty swallowing. he also noted a change in his voice. he has had no difficulty breathing. he denies any fevers. no n/v/d. . ed noted: ludwig's angina. ed course: initial vitals: 98.2 89 123/72 18 97% ra. exam was notable for woody submental fullness that is tender to palpation, bilateral jugular chain lad, tooth #31 appearing decayed and it is loose. surrounding gingiva is mildly tender to palpation. labs noted to be cr 2.3 after 1 l ivf came down to 1.9. recieved unasyn 3g /clindamycin 600mgiv. ent c/s: valecula, base of tongue and cords okay. omfs cs: got then panorex film, but still needs ct after ivf hydration, no or tonight, admit to micu will follow. afebrile 85 117/71 18 94% ra. 2x piv. past medical history: dm2, diet controlled hypertension hyperlipidemia social history: he is from the united states. he is currently employed by the state - atheletic super at . he did smoke - 37 year ppd. he drink alcohol moderatly. no ivdu. family history: noncontributory physical exam: at admission: vitals: t: 98 bp:130/77 p:79 r: 18 o2: 93% ra general: in mild distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, lad, submandibular swollen, tjm tenderness. lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi 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 gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: at admission: 05:10pm blood wbc-11.7*# rbc-4.58* hgb-14.0 hct-39.7* mcv-87 mch-30.6 mchc-35.3* rdw-13.1 plt ct-262 05:10pm blood neuts-77.5* lymphs-14.3* monos-5.4 eos-2.5 baso-0.3 06:26am blood pt-12.1 ptt-22.2 inr(pt)-1.0 05:10pm blood glucose-225* urean-21* creat-2.3*# na-141 k-3.8 cl-102 hco3-22 angap-21* 05:20pm blood lactate-1.2 12:20am urine color-straw appear-clear sp -1.007 12:20am urine rbc-<1 wbc-5 bacteri-none yeast-none epi-0 blood culture blood culture, routine-pending inpatient blood culture blood culture, routine-pending inpatient mrsa screen mrsa screen-pending inpatient urine urine culture-pending inpatient blood culture blood culture, routine-pending emergency blood culture blood culture, routine-pending emergency : ct neck w/contrast (eg:parotids) impression: 1. no abscess or fluid collection in the floor of mouth, or elsewhere. 2. asymmetry of the parapharyngeal fat and adjacent palatine tonsil may represent early phlegmon; this finding should be correlated with direct visualization. the study and the report were reviewed by the staff radiologist. : cxr findings: the lung volumes are low. borderline size of the cardiac silhouette. tortuosity of the thoracic aorta. no pleural effusions, no pneumonia. no lung nodules or masses. brief hospital course: 51 y/o man with a pmh significant for dm (diet controlled), hld and htn who presented to the ed on with throat swelling and dysphagia. . # ludwig's angina: classic findings: he noted a tooth ache about 1 week prior to admission that was accompanied by submandibular swelling. for this he took 1600mg ibuprofen tid without relief. he went to the dentist on and was prescribed amoxacillin. the following day he noted dysphagia, drooling, voice changes and chills and presented to the ed for further evaluation. . in the ed vs were stable (t 98.2 hr 89 bp 123/72 rr 18 o2 sat 97% ra). ent noted a widely patent airway and omfs was consulted and panorex was obtained. omfs felt there was bilateral jugular chain lad and tooth #31 was noted to be decaying with local gingival erythema and swelling. he received iv unasyn/clinda and was admitted to the micu for ludwig's angina. ct neck was obtained in the micu that showed - no abscess or fluid collection in the floor of mouth, or elsewhere. asymmetry of the parapharyngeal fat and adjacent palatine tonsil may represent early phlegmon; this finding should be correlated with direct visualization. he was monitored overnight in the micu and called out to the floor on hospital day 2. . during his fisrt night on the floor, the micu resident was paged because of tongue swelling. he did not have stridor. there was a question of whether he had angioedema from the unasyn. he was given iv dex 10mg (q8h), benadryl 50 iv x1, famotidine 20 iv x1 was given. he denied lip swelling, pruritis or rash. in the morning, ent evaluated his airway by laryngoscopy and felt that the edema had worsened and was not characteristic of angioedema as there was increased elevation of the floor of his mouth. his antibiotics were changed to clinda iv and levofloxacin. the oral surgeons were contact and extraction of the infected tooth was recommended. . he was transferred to the icu for closer monitoring of his airway. on arrival he is breathing comofrtably without stridor. he notes imporvement in the swelling that he attributes either to steroids or the change in antibiotics. he is able to swallow secretions without difficulty. he has only one allergy to lisinopril and that was an episode of pancreatitis several years ago. he again denies any sense of ithcy throat, lip swelling or bronchospasm. . his icu course was remarkable for dramatic improvement after the steroids in terms of the face swelling. also, patient noted great improvement upon massaging of submandibular area and resulting expression of green-colored, purulant material drained from gum area adjacent to dental caries (spontaneous decompression of absesss). id saw him and advised a final regimen of clindamycin po w/o steroids and no further levofloxacin. . # arf: pt has been taking 1600mg ibuprofen three times day for 4 days. decreased po intake. this improved with ivf. . # dm2, diet controlled: diabetic diet. blood sugars were elevated steroids. . # hypertension: continued norvasc/diovan . # hyperlipidemia: continued simvastatin # communication: patient # code: full (discussed with patient) transitions of care: his cxr from was concerning for left apical opacity which deserves interval attention and followup with primary care physician as an outpatient as well as a ppd for tuberculosis screening. finally he was told to refrain from nsaid use, and to see the oral surgeons for tooth extraction as well as to f/u with he pcp : following her blood glucose which was elevated steroids. medications on admission: home meds: diovan 160 mg tab oral 1 tablet(s) once daily amlodipine 10 mg tab oral 1 tablet(s) once daily simvastatin 20 mg tab oral 1 tablet(s) once daily . allergies: lisinopril discharge medications: 1. valsartan 160 mg tablet sig: one (1) tablet po daily (daily). 2. simvastatin 20 mg tablet sig: one (1) tablet po once a day. 3. amlodipine 10 mg tablet sig: one (1) tablet po once a day. 4. chlorhexidine gluconate 0.12 % mouthwash sig: one (1) ml mucous membrane (2 times a day). disp:*60 ml(s)* refills:*0* 5. clindamycin hcl 300 mg capsule sig: one (1) capsule po every eight (8) hours for 14 days. disp:*42 capsule(s)* refills:*0* discharge disposition: home discharge diagnosis: submandibular space infection/cellulitis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to with throat swelling. you were evaluated by the ear, nose and throat as well as oral maxofacial surgery services. there was a concern for neck space infection related to an infected tooth. you were started on antibiotics and steroids. your condition improved. your kidney function was found to be low on admission, which was likely due to taking a lot of ibuprofen in the setting of not drinking enough fluids. please stop taking ibuprofen until you are seen by your primary care physician (pcp). your blood sugars were also elevated during this hospitalization likely because you were on steroids but you should also check with your pcp about this. please consider at this time that you may have an allergy to penicillin and to consider getting testing for this as an outpatient. finally, a chest x-ray done here at showed an area of possible scarring in the left upper lobe which is of uncertain significance. please ask your pcp to consider another chest x-ray as well as test a ppd for potential latent tuberculosis. please continue your home medications with the following changes: 1. start taking clindamycin - an antibiotic please stop: -nonsteroidal anti-inflammatory medications (ie. ibuprofen) until you see your primary care doctor followup instructions: please schedule an appointment with oral surgery at as soon as possible to have the tooth extraction. if you cannot keep the appointment then he will be seen on 23rd of at 2pm. contact please call with any questions for appointment sceduling. md procedure: laryngoscopy and other tracheoscopy diagnoses: unspecified essential hypertension adrenal cortical steroids causing adverse effects in therapeutic use diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified other and unspecified hyperlipidemia hypoxemia hematuria, unspecified pulmonary eosinophilia dental caries, unspecified antirheumatics [antiphlogistics] causing adverse effects in therapeutic use cellulitis and abscess of oral soft tissues 

Answer: The patient is high likely exposed to