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: sulfa (sulfonamides) / ativan / ceftriaxone attending: chief complaint: difficulty breathing, stridor major surgical or invasive procedure: tracheostomy lumbar puncture history of present illness: this is a 64 year old man with complicated neurological and medical history below, who is followed by . and as an outpatient, who presents with several days of worsening inspiratory and expiratory stridor, and shortness of breath. according to the patient and his wife, he has felt slightly short of breath since he left the hospital this past summer. he has also had a hoarse, "raspy" voice. his wife thinks his breathing and voice have been worse over the past few months. several days ago, the breathing was worse than ever, and he had to take many breaths in the middle of sentences; the stridor is loud and comes/goes during the day. he snores loudly at night. in the early hours of the morning, he felt like he couldn't breathe if he turned to one side while lying down; his chest felt tight; his wife called ems and he was brought to hospital, where a ct showed a 1.3 cm extrathoracic mass occluding 50% of the airway. he was transferred to for further w/u, and went to the or for rigid bronchoscopy and tracheoscopy which was apparently negative. prior to the procedure, he had been ordered for decadron, heliox, and racemic epi. following the procedure, as no mass was seen, meds were stopped. ent has been consulted as well. the patient says he has had shortness of breath for months, which he feels is worse with conversation and actually improves when he is exercising and not trying to talk. however, he notices no change from beginning to building up exercise. past medical history: - htn - hypercholesterolemia - cad s/p mi s/p angioplasty, had stents - kidney stones removed social history: lives with wife, retired corrections officer; tob ppd x 25yrs, no etoh, no drugs. has seen chiropractor for back, neck in past, though no hx injuries to either. family history: niece died of lupus, uncle had cancer (unknown type, elderly), father d. brain hemorrhage (elderly). no other strokes, sz, neuro d/o incl ms, mg, no blood/clotting d/o, and no other autoimmune d/o. physical exam: examination: t 97.6 hr 77 bp 143/72 rr 11-24 (currently slightly tachypneic), 100%ra general appearance: tachypneic, loud stidor, has to catch breath frequently when talking heent: moist mucus membranes, clear oropharynx neck: supple, no bruits, though there is both inspiratory and expiratory stridor, heard on ausculation of trachea bilaterally and transmitted to lower lung fields bilaterally. no palpable masses. heart: regular rate and rhythm, no murmurs lungs: transmitted upper airway sounds abdomen: soft, nontender +bs extremities: warm, well-perfused skull & spine: neck movements are full and not painful to palpation in the paraspinal soft tissues mental status: the patient is alert and attentive, +dow backwards, normal registration/recall. good knowledge for current events. language is intact with no errors. there is no apraxia or agnosia. cranial nerves: the visual fields are full. the optic discs are difficult to visualize - cataracts bilat. eye movements are significant for inability to completely bury sclera on r eye lat gaze, but o/w normal and no diplopia; no nystagmus. pupils react equally to light, both directly and consensually. sensation on the face is intact to light touch, pin prick. facial movements are normal and symmetrical. hearing is intact to finger rub. the palate is weaker on the right than the left, and the tongue may also be slightly weak when pushing against the right cheek, though it protrudes midline - no fasciculations. voice is hoarse, more so than when i saw him in . he can count from 100 to 89 before taking another breath. motor system: elevated tone in the legs bilaterally, normal in the arms. with the exception of weakness of r edb, the power is normal in all 4 limbs, including shoulder abductors, and extensors and flexors of the arms, wrists, fingers, hips, knees, feet and toes. there is no tremor, drift, or abnormal movements. reflexes: the tendon reflexes are present, symmetric in upper ext, brisk at knees with 2 beats clonus at each ankle; both toes are upgoing. sensory: sensation is intact to pin prick, light touch, vibration sense, and position sense in all extremities and trunk. coordination: there is no ataxia. slow foot tapping compared to finger tapping bilat; nl f->n gait: could not be assessed - for ent eval shortly pertinent results: 06:25am blood wbc-4.4 rbc-3.79* hgb-11.7* hct-33.7* mcv-89 mch-31.0 mchc-34.8 rdw-13.0 plt ct-202 10:50am blood neuts-85.1* lymphs-12.1* monos-2.5 eos-0.2 baso-0.2 06:25am blood plt ct-202 03:02am blood esr-14 06:25am blood glucose-100 urean-5* creat-0.7 na-139 k-3.8 cl-103 hco3-29 angap-11 06:25am blood calcium-9.1 phos-3.2 mg-2.0 07:20am blood anca-negative 07:20am blood -negative dsdna-negative 03:02am blood crp-2.4 07:52pm blood crp-1.6 06:10am blood iga-175 07:20am blood gq1b igg antibodies-pnd 07:20am blood sm/rnp antibodies (without )-test 07:20am blood ro & - 07:20am blood angiotensin 1 - converting -test 08:26am blood angiotensin 1 - converting -test brief hospital course: neurology: patient admitted to sicu and later transferred to neurology service for presentation of concern of has new r palate weakness and possibly some r tongue weakness, urinary hesitancy, and fixed stridor. these finding were in addition to more chronic findings of inability to fully abduct right eye, spastic lower extremities. the etiology of mr. findings were investigated. it was thought that his presentation of symptoms were localized to the brain stem and perhaps a combination of pseudobulbar signs and lower motor neuron signs. he underwent work up including mri of the head (normal) and c spine (cervical spondolysis. serum labs for antigq1b ab pending, smab/ smirnp ab neg, ssa ab pos, ssb ab neg, ace level wnl. lumbar puncture showed 26 wbc (5% polys 80%lymphs),109 rbc, protein 35, glucose 80. csf studies showed no oligoclonal bands, anti- ab and whipple's pcr, ebv pcr all neg. tuberculosis csf pcr is pending. full paraneoplastic antibody panel will have to be sent as outpatient because of insurance issues. cytology also sent on csf and no malignant cells seen. patient received imipenem, vancomycin and acyclovir until csf cx and hsv pcy were negative. patient was treated with 5 day course of ivig without significant improvement in symptoms from presentation. he had a repeat indirect laryngoscopy by ent which showed no significant change in vocal cord movement. this study will have to be as outpatient in the near future per ent recs. his lower leg spasticity improved with home dose of baclofen and valium. he worked with pt and was able to ambulate with walker. he was recommended to be discharged to inpatient rehabilitation facility for further care by pt. respiratory: ent was consulted to evaluate stridor. on fiberoptic laryngoscopy neither vocalcord opens completely, implying bilateral weakness. rigid broncoscopy by ir was nml with no signs of tracheal lesions/masses. he passed a swallow study with preserved gag and cough. based on the concern of stridor, the patient was initially kept in icu and received tracheostomy on without complications. he was again evaluated post-op by speech and swallow service who reaffirmed his ability to swallow and provided passey-muir valve so patient could have a trach plug when not eating/talking. urology: patient evalauted by urology for concern of weeks of urinary retention. he demonstrated with two unsuccessful voiding trials significant obstruction vs detrusor dysfunction. the differential includes bph or other neurogenic causes (medication, infection, anesthesia, anatomic unlikely). urodynamic studies were recommended but not performed on this hospitilization and patient will need to follow up with urology as outpatient. he had a foley placed and told to continue avodart. fen/gi: patient tolerated po diet and cleared to eat po diet by speech and swallow service. id: patient is mrsa cx positive and was on mrsa precautions during his stay in the hospital. medications on admission: meds: 1. ecasa 2. lopressor 3. klonopin 4. baclofen 15/15/15/20 5. valium 2.5 mg po bid 6. avodart 7. vitamin e discharge medications: 1. albuterol sulfate 0.083 % solution sig: one (1) inhalation q6h (every 6 hours) as needed. 2. baclofen 10 mg tablet sig: 1.5 tablets po tid (3 times a day). 3. baclofen 10 mg tablet sig: two (2) tablet po daily (daily). 4. vitamin e 100 unit capsule sig: two (2) capsule po daily (daily). 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 6. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 7. diazepam 5 mg tablet sig: 0.5 tablet po bid (2 times a day). 8. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). 9. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed. 10. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day) as needed. discharge disposition: extended care facility: cape and rehab discharge diagnosis: presumed paraneoplastic brainstem disease discharge condition: stable-unable to completly bury right on abduction, right palate does not raise symmetrically with left, slow tongue movements, stridor, raspy voice, spastic lower extremities with clonus and bialt upgoing toes. discharge instructions: take medications as instructed. please call dr. if any new symptoms arise. followup instructions: provider: . /reubens phone: date/time: 4:30 provider: , .d. phone: date/time: 9:45 md procedure: spinal tap incision of lung enteral infusion of concentrated nutritional substances other bronchoscopy laryngoscopy and other tracheoscopy temporary tracheostomy injection or infusion of immunoglobulin diagnoses: pure hypercholesterolemia unspecified essential hypertension percutaneous transluminal coronary angioplasty status retention of urine, unspecified personal history of urinary calculi stridor unspecified infectious and parasitic diseases cervical spondylosis without myelopathy paralysis of vocal cords or larynx, unspecified abnormal involuntary movements neoplasm of uncertain behavior of brain and spinal cord other encephalitis and encephalomyelitis due to other infections classified elsewhere 

Answer: The patient is high likely exposed to