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: patient recorded as having no known allergies to drugs attending: chief complaint: confusion major surgical or invasive procedure: fluro-guided lumbar puncture left scl central line picc line intubation history of present illness: this is a 50 y/o male with pmh significant for cp w/spastic quadraparesis, congenital hydrocephalus s/p vp shunt placement at birth, who was in his usual state of health until am, when he hit his head on a wheelchair lift. per patient, he was returning from an outpatient mri appointment for evaluation of a possible aneurysm, when getting out of the , hit the top of his head. he felt relatively well until last night when his ha became unbearable and had an episode of n/v. he felt chills at the time but does not recall having a fever. he did not feel confused and called the ambulance on his own. in the ed, neurosurg evaluated him w/ ct and mr of head and did not feel that his shunt was problem at this time. they will flush the stent during this admission. mri showed enlarging basilar and l vertebral artery aneurysm. he had hyponatremia to 125 and received almost 3l ns. on review of systems, he has fever, nausea/vomiting in the ed, photophobia, recent uri w/o sputum production and h/o utis. he denies urinary symptoms, abdominal pain, constipation, diarrhea, weakness or neck stiffness. past medical history: 1. cerebral palsy (since birth) 2. congenital hydrocehpalus s/p vp shunt from birth - dr. is his long ime neurosurgeron () 3. cervical spinal stenosis s/p c3-4 decompression & fusion; c5-6 laminectomy 4. s/p left nephrectomy 5. h/o childhood meningitis . social history: social hx: lives alone with daily assistance. denies any tobacco, etoh, or illicit drug use. many brothers and sisters . family history: family hx: mother with h/o cva, father with h/o cad, brother with h/o cad physical exam: on admision general: upset, cursing male w/ arms folded on chest sitting in bed; in nad heent: perrl, eomi, no scleral icterus, mmm, oropharynx clear neck: supple, trachea midline, no lad; neck w/ full rom chest: faint bibasilar rales, no wheezes or rhonchi cv: rrr, no m/r/g abd: soft, + bs, round, distended. no tenderness to deep palpation or rebound. no guarding. no hepatosplenomegaly ext: no pitting edema, 2+ dp pulses - erythematous legs that blanch; negative brudzinski neuro: alert & oriented x3; cn ii-xii individually tested and grossly intact. motor and strength exam limited by pt's quadraparesis skin: warm, dry, small 1cm open lesion at sacrum; no exudate or swelling .. on transfer to icu vitals: t:95 p:88 vented ac 600x18 peep 5 100% fio2 bp: 165/130 sao2: 100% general: not responsive to sternal rub. heent: nc/at, pupils initially during code were 5mm and not responsive. on exam in teh , they are now 2 mm and not responsive. no scleral icterus noted, mmm, no lesions noted in op neck; increased tone as is the rest of his exam pulmonary: lungs cta bilaterally cardiac: rrr, nl. s1s2, no m/r/g noted abdomen: soft, nt/nd, normoactive bowel sounds, no masses or organomegaly noted. extremities: no c/c/e bilaterally, 2+ radial, dp and pt pulses b/l. neurologic: gcs score of 5. abnormal flexion. pupils fixed. corneal reflex absent. does not blink to treat. no dolls eye reflex. no gag. increased tone throughout. breathing over the vent. pertinent results: admission 08:35pm urine color-yellow appear-clear sp -1.015 08:35pm urine blood-sm nitrite-neg protein-neg glucose-tr ketone-15 bilirubin-neg urobilngn-neg ph-7.0 leuk-neg 08:35pm urine rbc-3* wbc-5 bacteria-many yeast-none epi-<1 08:35pm urine amorph-occ 04:00pm glucose-90 urea n-11 creat-0.6 sodium-125* potassium-3.8 chloride-90* total co2-22 anion gap-17 04:00pm calcium-8.3* phosphate-2.1* magnesium-1.7 04:00pm wbc-7.8 rbc-4.10* hgb-12.5* hct-34.0* mcv-83 mch-30.6 mchc-36.8* rdw-14.0 04:00pm plt count-303 03:37pm urine hours-random creat-88 sodium-135 03:37pm urine color-yellow appear-clear sp -1.030 03:37pm urine blood-mod nitrite-neg protein-tr glucose-tr ketone-15 bilirubin-neg urobilngn-neg ph-7.0 leuk-sm 05:50am glucose-123* urea n-11 creat-0.6 sodium-125* potassium-4.3 chloride-92* total co2-25 anion gap-12 05:50am wbc-7.3 rbc-4.42* hgb-12.9* hct-36.1* mcv-82 mch-29.2 mchc-35.7* rdw-13.2 05:50am plt count-322 05:50am pt-12.9 ptt-23.4 inr(pt)-1.1 . csf- analysis wbc rbc polys lymphs monos eos macroph 02:03pm 81 10* 34 24 38 1 3 tube 4 02:03pm 121 231* 31 30 32 7 1 clear and trace xanthochromic chemistry chemistry totprot glucose 02:03pm 146* 37 1; tube 2 2:03 pm csf;spinal fluid tube 3. gram stain (final ): no polymorphonuclear leukocytes seen. no microorganisms seen. fluid culture (final ): no growth. fungal culture (preliminary): no fungus isolated. acid fast culture (preliminary): the sensitivity of an afb smear on csf is very low.. if present, afb may take 3-8 weeks to grow.. viral culture (preliminary): no virus isolated so far. imaging mr angiography of the circle of demonstrates fusiform aneurysms of the basilar artery and left vertebral artery. the basilar artery aneurysm has enlarged in recent years and there may be thrombus within it. . ct head there is a right ventriculostomy catheter with its tip in the midline at the third ventricle. the ventricles are unchanged in size and configuration. there is a large fusiform basilar artery aneurysm which measures 14 mm. there is no evidence of intracranial hemorrhage. the -white matter differentiation is relatively preserved. there is a small lacune in the left lentiform nucleus. smaller areas of hypodensity are also identified within the subcortical white matter in the left frontal and right parietal lesions and may also represent chronic microvascular ischemic changes. . on icu transfer findings: the study is significantly degraded by motion artifact. given this limitation, there has been interval development of subarachnoid hemorrhage around the mid brain cisternal spaces, as well as the superior vermian cistern. the previously seen fusiform basilar artery aneurysm is not well identified on today's study secondary to motion. the tip of the right ventriculostomy catheter is in stable position in the midline at the level of the third ventricle. there is no hydrocephalus, or shift of normal midline structures. previously seen areas of low attenuation in the left frontal and right parietal lobes are unchanged. findings were discussed with dr. on , with urgent neurosurgical consultation advised and secured. impression: interval development of subarachnoid hemorrhage surrounding the midbrain. while this distribution of hemorrhage can be non-aneurysmal in origin, clearly the fusiform basilar artery aneurysm needs to be considered as a possible source of hemorrhage, as well. brief hospital course: pt had multiple attempts to obtain csf - procedure team, resident, neuro resident made attempts. called neurosurg to assess whether we could tap his shunt. no sample obtained; pt's clinical status appeared to deteriorate, and he was started on empiric treatment w/ ceftriaxone, vancomycin and ampicillin. ct of head also completed to assess stability of his aneurysm given his complaint of acute ha - no changes from earlier in the day. afebrile, vitals stable. pt had fluro-guided lp w/o complications yesterday w/ pain service. csf obtained which did not show obvious infection and trace xanthrochromia. elevated temp to 100.8; did not send blood and urine cx, cxr. otherwise, pt denied any discomfort. continued to have ha last night which improved w/ dilaudid 1mg x1. also, his sodium worse today - 118 from 122 despite fluid restriction. pt asymptomatic. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ________________________________________________________________ icu course: pt had respiratory arrest at 1pm on . pt was intubated. initial exam showed fixed 6mm pupils. emergent ct scan of head showed "subarachnoid hemorrhage surrounding the mid brain with foci of hemorrhage extending into the third ventricle as well as possibly into the trigone of the left lateral ventricle", likely from known vertebral/basilar annurysum. pt was transferred to the icu from rediology. there was a concern for mennigitis on admission but csf negative. has completed 10d empiric course of ampicillin and ceftriaxone. antibiotics were stopped upon icu tranfer. neurosurgery was consulted who felt no surgical intervention was possible to change outcomes. neurology was also consulted. they recommended iv mannitol, and bp control so labetolol drip was started with goal sbp 120-140. he was also loaded with 1g iv pheytoin and then started on 100mg tid. mannitol was given to keep serum osm above 300. overnight,around 2am , neurological status began to improve with return of pupil and corneal relfex. also now withdraws from painful stimuli. neurology has arrange for transfer to neurosurgery. medications on admission: 1. lisinopril 2.5 mg qd 2. zanaflex 2 mg qhs 3. baclofen 10 mg tid discharge medications: 1. lansoprazole 30 mg susp,delayed release for recon sig: thirty (30) mg po daily (daily). mg 2. artificial tear ointment 0.1-0.1 % ointment sig: one (1) appl ophthalmic prn (as needed). 3. labetalol 5 mg/ml solution sig: 0.5-2 mg/min intravenous titrate to (titrate to desired clinical effect (please specify)): sbp120-140. mg/min 4. phenytoin sodium 50 mg/ml solution sig: one hundred (100) mg intravenous q8h (every 8 hours). discharge disposition: extended care discharge diagnosis: primary: subarachnoid hemorrhage . secondary: 1. cerebral palsy (since birth) 2. congenital hydrocehpalus s/p vp shunt from birth 3. cervical spinal stenosis s/p c3-4 decompression & fusion; c5-6 laminectomy 4. s/p left nephrectomy 5. h/o childhood meningitis discharge condition: critical discharge instructions: per neurosurgical team followup instructions: per neurosurgical team md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified spinal tap incision of lung insertion of endotracheal tube diagnoses: subarachnoid hemorrhage pressure ulcer, heel other disorders of neurohypophysis presence of cerebrospinal fluid drainage device meningitis, unspecified hereditary spastic paraplegia 

Answer: The patient is high likely exposed to