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 / fish / ativan attending: chief complaint: seizure major surgical or invasive procedure: intubated history of present illness: 43m with reported pmh of tbi s/p craniotomy/vp shunt, seizure disorder, polysubstance abuse and depression, who was transferred here after intubation for seizures at hospital. . history was as below from osh record: pt was found down/unresponsive in a motel, given narcan by ems and he became more responsive, was following some commands and was taken by ambulance to an osh. there, he had an ekg done, which showed afib with rvr with hr of 150. he was given iv diltiazem 25 mg with improvement in his hr. he was also given 5mg of iv haldol for agitation, and was then drowsy with mildly slurred speech. he was sent for a ct of head/neck, which was read as probable postop changes from his known tbi and r frontal craniotomy. after returning from the ct, he went to the bathroom, and was noted to have 1 gtc as he was returning from the bathroom. unclear duration of seizure. he was given 2mg of iv ativan. he then had another gtc when he was back on his stretcher, and was given 2 mg more of iv ativan, intubated for airway protection with etomidate/succ at 2315, and was noted to have pinpoint pupils (unclear if this was the initial exam also), and sent to . while at the osh, he was noted to have a tab of dilantin in his pocket. . of note, his tox screen were positive for opiates and alcohol, and lithium level was <0.2. he also had an elevated ast of 65, and an elevated cpk of 614, but were otherwise unremarkable. . in ed, initial vitals were: hr: 86, rr: 13, bp: 136/80, o2sat: 99, on vent, temp: 100.6 ??????f (38.1 ??????c). he was intubated and unsedated, and following most commands per neurology note. he was then put on propofol as he was trying to remove his ett, and became more sedated, not following commands. he had a phenytoin level drawn which was <0.6. he also had an elevated lipase of 61 and a lactate of 3.8. . prior to transfer to icu, patient noted to have temp of 103f, neurosurgery consulted at that time to access vp shunt given concern for intracranial/cns infection. bcx also sent. started on vancomycin and ceftriaxone. . on arrival to the icu, patient is unable to give further history or complete ros as he is intubated and sedated. past medical history: past medical history (per osh records): - depression - tbi s/p vp shunt - seizure disorder (no further info is available at this time) - etoh and substance abuse - djd - hepatitis c social history: positive for etoh, tobacco and illicits family history: unable to obtain physical exam: admission exam: . general: intubated and sedated heent: sclera anicteric, pinpoint pupils, unable to visualize oropharynx, ?dentures in place neck: jvp not elevated, no lad lungs: clear to auscultation anteriorly, no wheezes/rales/rhonchi cv: rrr, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, quiet bowel sounds, no rebound tenderness or guarding, no organomegaly gu: +foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema skin: left shoulder with erythematous abrasions, track mark along l forearm, scabs over left hip and left heel. shallow pink ulceration on medial aspect of right heel, clean base without drainage. . dishcarge exam: . aaox3. able to comprehend benefits of ongoing hospitalization, and risks of leaving the hospital against medical advice. pt currently appears non-toxic. linear thoughts, conversant. pertinent results: admission labs: . 12:45am blood wbc-6.3 rbc-3.79* hgb-11.9* hct-35.7* mcv-94 mch-31.5 mchc-33.4 rdw-14.0 plt ct-162 07:21am blood neuts-53.0 lymphs-36.9 monos-4.4 eos-5.2* baso-0.6 12:45am blood pt-11.5 ptt-30.3 inr(pt)-1.1 12:45am blood fibrino-222 07:21am blood glucose-73 urean-10 creat-0.9 na-143 k-4.1 cl-109* hco3-25 angap-13 07:21am blood alt-24 ast-56* ld(ldh)-247 ck(cpk)-822* alkphos-80 totbili-0.9 12:45am blood lipase-61* 07:21am blood albumin-3.4* calcium-8.3* phos-3.3 mg-1.9 . discharge labs: . micro: blood culture - pending blood culture - pending csf fluid - pending urine culture - no growth legionella antigen - no growth mrsa screen - negative sputum culture - pending . images: ct head from osh: cxr (per my read): small lung volumes, haziness throughout lung parenchyma concerning for pulmonary congestion. possible retrocardiac opacity as some of l hemidiaphragm is obscured. no other obvious consolidations. . cta head and neck w&w/oc & recon: no acute intracranial hemorrhage or mass effect. encephalomalacic changes in the right frontal and the right parietal lobe along with post-surgical changes with right-sided craniotomy and cranioplasty. ventricular catheter is seen through the left frontal approach, ending in the right caudate head. correlate clinically if this is desired position and with catheter function. patent major arteries as described above, without focal flow-limiting stenosis, occlusion, or aneurysm more than 3 mm within the resolution of ct angiogram. ct angiogram of the head is somewhat suboptimal due to delayed arterial phase imaging. paranasal sinus disease with mild mucosal thickening in the maxillary and the sphenoid and ethmoid air cells. degenerative changes in the cervical spine, inadequately characterized. 06:40am blood wbc-3.3* rbc-4.17* hgb-13.1* hct-39.3* mcv-94 mch-31.4 mchc-33.2 rdw-14.2 plt ct-137* 06:40am blood glucose-96 urean-7 creat-0.7 na-142 k-4.0 cl-109* hco3-25 angap-12 04:39am blood alt-27 ast-93* ld(ldh)-260* ck(cpk)-1049* alkphos-78 totbili-1.2 06:40am blood calcium-8.9 phos-3.8 mg-1.7 07:21am blood hbsag-negative hbsab-negative hav ab-negative 12:45am blood phenyto-<0.6* 12:45am blood asa-neg ethanol-34* acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 07:21am blood hcv ab-positive* 12:45am urine bnzodzp-neg barbitr-neg opiates-neg cocaine-neg amphetm-neg mthdone-neg 11:56 am sputum source: endotracheal. gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 4+ (>10 per 1000x field): gram positive cocci. in pairs and clusters. 2+ (1-5 per 1000x field): gram positive rod(s). 2+ (1-5 per 1000x field): gram negative rod(s). respiratory culture (preliminary): further incubation required to determine the presence or absence of commensal respiratory flora. staph aureus coag +. moderate growth. mrsa screen mrsa screen-final inpatient urine legionella urinary antigen -final inpatient urine urine culture-final inpatient csf;spinal fluid gram stain-final; fluid culture-final emergency blood culture blood culture, routine-pending inpatient blood culture blood culture, routine-pending inpatient brief hospital course: assessment and plan: 43m with reported pmh of tbi s/p craniotomy/vp shunt, seizure disorder, polysubstance abuse and depression, intubated for airway protection given 2 gtc at osh and found to have temp to 103 in ed. # ams/seizures: unclear history, patient found down in a motel room, appears that his mental status initially improved with narcan administration which points to medication effect. however, given the temp to 103 and 2 episodes of seizures at osh, concerning for cns infection initially. other etiologies for seizures could include substance abuse, etoh withdrawal, trauma, cns bleed or medication noncompliance. alcohol level of 49 here, less likely to have withdrawal seizures at this time, though concerning in the future. ct head/neck from osh did not show acute abnormalities or intracranial bleed, which was reassuring. unclear what medications he is on as an outpatient for his seizures. pt found with dilantin in his pocket, but his level is subtherapeutic. csf obtained and was without evidence of infection. vancomycin and ceftriaxone was received in the ed and was not continued. csf hsv pcr was also negative. he did require haldol and diazepam for intermittent agitation concerns; and we continued keppra dosing per neurology. # fevers: concerning for infection vs. cns fever given intracranial pathology vs. seizures vs. medication induced. infection most concerning given unclear immune status (hiv or ?ivdu). infection could be blood/endocarditis given concern for ivdu, aspiration pneumonia given alcohol use, or cns infection given hardware. csf with protein 43 and glucose of 73, not suggestive of bacterial meningitis but of high concern. cxr with ? aspiration pneumonia in a patient with unclear risk factors for mdr organism. sputum, blood and urine cultures were unrevealing. following clear csf, his antibiotics were discontinued. patient remained afebrile afterwards. # intubation for airway protection: patient intubated for airway protection/after being given 4 mg iv of ativan at osh. started on propofol for sedation given attempts to self-extubate in the ed. mental status appears close to baseline following extubation. # polysubstance abuse: patient with osh toxicology screen positive for oxycodone and alcohol. unable to give further history about substance abuse, however, etoh level found to be 34 in ed. this was initially concerning for alcohol withdrawal and he was dosed haldol and diazepam with good effect. social work was consulted for coping issues. # transaminitis: likely from alcohol use, no corroborating data at to see how significant his alcohol use and liver damage have been. per record, patient has history of hepatitis c, which was confirmed by serology here. # reported afib with rvr: patient with reported afib with rvr to 150-160s at osh, improved with diltiazem. on tele, pt appears sinus at this time. afib could have been triggered by infection, hypovolemia, or underlying heart disease. repeat ekg was stable. . the morning following transfer from the icu to the medical floor, pt chose to leave the hospital against medical advice. pt was evaluated for capacity, and was determined to have capacity to decide to leave the hospital against medical advice. pt set paperwork before physically leaving the hospital. neurology, neurosurgery, and social work notes were reviewed. per neurology consult recommendations, pt was provided a prescription for increased keppra dose to 1000 mg po bid, to minimize the risk of further seizures. medications on admission: medications (per osh records, uncomfirmed with patient): - lithium - keppra - fioricet - prozac - ? dilantin, pt had a pill in pt's pocket discharge medications: 1. levetiracetam 500 mg tablet sig: two (2) tablet po bid (2 times a day). disp:*120 tablet(s)* refills:*0* 2. lithium carbonate 300 mg capsule sig: one (1) capsule po twice a day. 3. prozac 20 mg capsule sig: one (1) capsule po once a day. discharge disposition: home discharge diagnosis: # seizure, convulsive # history of traumatic brain injury # drug use/dependence, alcohol discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were hospitalized at intubated for airway protection after a seizure. you were evaluated for infection. while it currently does not appear that you have an infection, lab results are not final yet. your hospitalization is not yet complete, and we have discussed our concerns about your decision to leave the hospital against medical advice. as we discussed, there are many possible complications from your decision, which may include more seizures, falls, injuries, including head injuries, and possible death. you were able to understand these risks as well as the possible benefits of remaining in the hospital, and you have decided to leave the hospital against medical advice. during this hospitalization, neurology has recommended increasing your keppra to 1000 mg po bid. we have provided a prescription for this increased dose. followup instructions: you have chosen to leave the hospital against medical advice. we strongly encourage you to follow up closely with your primary care physician, continue to address the issues of this hospitalization. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube diagnoses: unspecified viral hepatitis c without hepatic coma depressive disorder, not elsewhere classified acute respiratory failure other and unspecified alcohol dependence, unspecified opioid abuse, unspecified alcohol withdrawal other forms of epilepsy and recurrent seizures, without mention of intractable epilepsy 

Answer: The patient is high likely exposed to