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: no known allergies / adverse drug reactions attending: chief complaint: sore throat. major surgical or invasive procedure: 1. fiberoptic nasolaryngoscopy history of present illness: 49 year old male with a history of t2dm on insulin, af on warfarin s/p several failed cardioversions, who presented to earlier today with severe sore throat. symptoms started on where he awoke with a sore throat and blocked ears. he was able to eat dinner but this was painful and had chills and subjective fever on the evening of . on he awoke and was unable to speak, not because of a horse voice but felt it was muffled and was able to swallow although it was painful. he also noted generalised head pain and in particular anterior neck pain and some very mild sob which prompted presentation to the ed as he had previously been hospitalised for strep throat back in when this was complicated by fast af. he denied sick contacts. in the ed, he was found to be strep positive, and x-ray was concerning for epiglottitis. in the ed he received ceftriaxone 2gm and iv methylprednisolone 125mg iv. he was transferred to for further evaluation. . in the ed he was evaluated by ent who performed fiberoptic nasolaryngoscopy and found that the epiglottis was crisp without edema, erythema, or lesions with no supraglottic edema or masses, a widely patent airway and piriform sinuses were clear without pooling of secretions. they felt that there was no evidence of epiglottitis or supraglottic edema but advised admission for close airway monitoring and continued medical workup. he had a ct neck whcih showed no evidence for epiglottitis, or retropharyngeal abscess. on transfer vs were 97.4 90 116/56 97% ra. . in the icu, vita;s were t:99.5 bp:112/97 hr: rr:18 o2sat: 95% ra. he appeared well and was able to swallow secretions but this was painful and he was noted to spit these out into a container. he did feel that his sore throat had improved though and noted that teh congestion in his ears was clearing and had started to "". he had a midl cough but denied wheeze or hoarseness but he sometimes had excess of secretiosn such taht he was speaking through secretions at times and gave his voice a slight muffled quality. . on ros, he had a subjective fever on but none since and has a sore throat with odynophagia. cvs - no cp/sob/calf pain/palpitations (but does not know when he is in af) rs - mild cough, no wheeze, white sputum but not from lrt no sob gis - no n/v/diarrhea/constipation/ pain cns - stable numbness in left foot post mva and nil else hs - no nbleeding/bruising - no frequency, dysuria or hematuria . past medical history: osa on night cpap at home t2dm on insulin atrial fibrilation ? paroxysmal on warfarin with 3x failed cardioversions renal calculi asthma - seasonal hld mrsa previously ptsd mva with multiple trauma gout on allopurinol . sequelae from mva - fractured left clavicle, significant fractures left femur and multiple rib fractures vasectomy social history: medically retired former 911 dispatcher and worker at globe lives with wife and 2 children in house rarely drinks never smoked no illicits pets - 3 dogs all well no recent foreign travel family history: father - died t2dm, esrf requiring dialysis, mis mother - asthma, ca 3 brothers and 3 sisters - well physical exam: on admission: vitals: t:99.5 bp:112/97 hr: rr:18 o2sat: 95% ra gen: obese. well-appearing, well-nourished, some excess secretions but able to swallow. no stridor or stertor. heent: eomi, perrl 3+/3+, sclera anicteric, no epistaxis or rhinorrhea, mmm, op clear, enlarged 2+ mildly erythematous tonsils bilaterally with midline uvula and no pharygeal erythema neck: obese no jvd, carotid pulses brisk, no bruits, no cervical lymphadenopathy, no masses some anterior tenderness but no lad cvs: rrr, no m/g/r, normal s1 s2 but quiet hs given obesity, radial pulses +2 jvp not elevated rs: lungs ctab, no w/r/r gis: obese soft, nt, nd, +bs, no hsm, no masses ext: mild pitting edema 1+ to mid shin on l and ankle edema on r, no palpable cords calves snt cns: gcs 15/15 alert, oriented to person, place, and time. cn ii ?????? xii normal. moves all 4 extremities. strength 5/5 in upper and lower extremities. plantar reflex downgoing. skin: no jaundice, cyanosis, or gross dermatitis. no ecchymoses. . at discharge: gen: nad, handling own secretions heent: eomi, anicteric mmm, erythematous epiglottis, enlarged 2+ mildly erythematous tonsils bilaterally with midline uvula and no pharygeal erythema neck: mild cervial lad cv: rrr, no m/r/g resp: lungs ctab abd: soft nt nd ext: trace le edema, wwp, dp 2+ neuro: intact pertinent results: labs: 02:25pm blood wbc-13.3* rbc-5.08 hgb-14.7 hct-43.4 mcv-85 mch-28.9 mchc-33.8 rdw-14.0 plt ct-192 02:25pm blood neuts-89.6* lymphs-7.4* monos-2.0 eos-0.6 baso-0.4 08:50am blood wbc-13.9* rbc-5.00 hgb-14.6 hct-43.1 mcv-86 mch-29.3 mchc-33.9 rdw-13.7 plt ct-211 02:25pm blood pt-27.2* ptt-29.4 inr(pt)-2.6* 08:50am blood pt-28.8* ptt-30.9 inr(pt)-2.8* 08:50am blood glucose-251* urean-22* creat-0.9 na-137 k-4.3 cl-100 hco3-25 angap-16 08:50am blood alt-21 ast-13 alkphos-72 totbili-0.3 08:50am blood albumin-4.6 calcium-9.5 phos-3.3 mg-2.2 . imaging: ct neck with contrast: the epiglottis and aryepiglottic folds are normal. the piriform sinuses and hypopharynx are patent bilaterally. there is no evidence for retropharyngeal abscess, or fluid collection. there are bilateral prominent level 2 lymph nodes measuring 13 mm (2:55, 2:59) which may be reactive. the vessels of the neck appear normal. no masses are identified. sinuses and skull base appear normal. bone windows: there is irregular bony remodeling at the proximal left clavicle likely reflective of prior fracture. there is also irregular angulation in the distal margin of the left clavicle. there are old left anterior and posterior rib fractures. no suspicious sclerotic or lytic lesions are present, however. impression: 1. no evidence for epiglottitis, or retropharyngeal abscess. 2. prominent bilateral level 2 lymph nodes, which may be reactive. no masses identified. 3. irregularity to the left clavicle and left ribs likely reflective of old injury, correlate clinically. brief hospital course: 49 yearold male with history of t2dm, afib on warfarin, and osa who presents with sore throat and dyspnea, evidence of epiglottic swelling on plain films of the neck, and a positive rapid strep test without features of epiglottitis on fiberoptic nasolaryngoscopy or ct neck. there was no evidence of airway compromise. . # strep pharyngitis: imaging at osh was concerning for epiglottitis but there was no evidence of this on either ct neck or on fiberoptic nasolaryngoscopy by ent at . he was strep positive at osh and given solumedrol and ceftriaxone at the osh. there was no evidence of airway compromise and he was tolerating fluids on admission. she was continued on solumedrol and ceftriaxone iv on day 1 and 2 of his admission. he was given prescriptions for three days of prednisone 40mg daily and amoxicillin er for a seven day course to start on the day after discharge. ent followed daily and recommended follow up with dr. in weeks after discharge. . # atrial fibrillation: he was continued on metoprolol and diltiazem for rate control with good effect. chads2 = 2 on home dose warfarin for anticoagulation. he was therapeutic during his stay. he was advised that antibiotics may raise his inr and to have his inr checked on tuesday with results faxed to dr. . . # t2dm: recently has changed his diet to a diabetic diet and lost 20 pounds since . his home metformin and glyburide were held during admission, while he was continued on byetta and lantus daily. he was advised to hold his metformin until tuesday , which would be approximately 48 hours after his ct with contrast. his diabetic diet was praised with encouragement to continue. he was encouraged to add gentle exercise to his regimen. . inactive issues: # htn: continued metoprolol, diltiazem and . # ptsd: continued on venlafaxine, bupropion and sertraline. # gout: continued allopurinol. # osa: continued home cpap. # hld: continued rosuvastatin. . # code status: during this admission, the patient was confirmed full code. medications on admission: warfarin sun/tues 15mg mon/wed/fri/sat 10mg daily insulin glargine 72 units am metformin 1g exenatide 20mg s/c diltiazem hcl 240mg daily olmesartan 40mg daily glimepiride 4mg daily metoprolol tartrate 50mg allopurinol 300mg qd venlafaxine xr 150mg sertraline hcl 50mg po hs bupropion 300mg daily rosuvastatin 10mg daily percocet 1 tab qd celecoxib 200mg qd discharge medications: 1. amoxicillin 775 mg tab, multiphasic release 24 hr sig: one (1) tab, multiphasic release 24 hr po once a day for 7 days. disp:*7 tab, multiphasic release 24 hr(s)* refills:*0* 2. warfarin 5 mg tablet sig: three (3) tablet po once a day: sun/tues/thurs. 3. warfarin 5 mg tablet sig: two (2) tablet po once a day: mon/wed/fri/sat . 4. insulin glargine 100 unit/ml solution sig: seventy two (72) units subcutaneous once a day. 5. metformin 1,000 mg tablet sig: one (1) tablet po twice a day: restart on tuesday . 6. exenatide 10 mcg/0.04 ml pen injector sig: twenty (20) mcg subcutaneous (2 times a day). 7. diltiazem hcl 240 mg capsule, sustained release sig: one (1) capsule, sustained release po daily (daily). 8. olmesartan 20 mg tablet sig: two (2) tablet po daily (daily). 9. glimepiride 4 mg tablet sig: one (1) tablet po once a day. 10. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). 11. allopurinol 300 mg tablet sig: one (1) tablet po daily (daily). 12. venlafaxine 75 mg capsule, sust. release 24 hr sig: two (2) capsule, sust. release 24 hr po bid (2 times a day). 13. sertraline 50 mg tablet sig: one (1) tablet po hs (at bedtime). 14. bupropion hcl 150 mg tablet sustained release sig: two (2) tablet sustained release po once a day. 15. rosuvastatin 5 mg tablet sig: two (2) tablet po at bedtime. 16. percocet 5-325 mg tablet sig: one (1) tablet po once a day as needed for pain. 17. celecoxib 200 mg capsule sig: one (1) capsule po once a day. 18. prednisone 20 mg tablet sig: two (2) tablet po once a day for 3 days. disp:*6 tablet(s)* refills:*0* 19. outpatient lab work please have your inr checked on tuesday . please have the results faxed to dr. office at . discharge disposition: home discharge diagnosis: primary diagnosis: streptococcal pharyngitis secondary diagnosis: type 2 diabetes mellitus, atrial fibrillation discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. epiglottis is erythematous with minimal swelling of pharynx. discharge instructions: mr. , it was a pleasure taking care of you during your stay here at . you were treated for streptoccal pharyngitis, which is an infection of the throat. you were evaluated and seen by ent daily throughout your stay. you were initially treated with iv steroids and antibiotics, and then were subsequently transitioned to oral steroids and antibiotics. the following changes were made to your medication regimen: start amoxicillin x7 days: please complete the entire course start prednisone x3 days: no need for taper with short course hold metformin until tuesday please continue to check your blood sugars at home. please call your pcp if your blood sugar is greater than 400 for instructions. please have your inr checked on tuesday as antibiotics can elevate your inr. please have the results faxed to dr. office. please follow up with your pcp in one week. please call to make an appointment with dr. in two weeks. followup instructions: please make the following appointments: 1. please call to make an appointment with dr. in 1 week. 2. please call to make an appointment with dr. in clinic in weeks. md procedure: laryngoscopy and other tracheoscopy diagnoses: obstructive sleep apnea (adult)(pediatric) diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation long-term (current) use of anticoagulants obesity, unspecified streptococcal sore throat 

Answer: The patient is high likely exposed to