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: altered mental status major surgical or invasive procedure: lumbar puncture endotracheal intubation history of present illness: nf admit. briefly, this is a 39 yo m w/ hiv (cd4 199, vl 624k) no h/o haart, no oi, who was admitted w/ acute onset of ms change, f to 104, confusion and agitaion. pt describes no prodromal symptoms prior to this episode. states he was sleeping all afternoon but awoke and was "behaving bizarrely". pt's partner noticed the strange behavior and took the patient to the er. the patient has no memory of this so it remains unclear what the nature of this behavior was. although the patient's vitals signs were stable in the in the ed, it was felt that his altered ms protection. had lp questionable for bacterial meningitis. pt covered for meningitis and pna (b/l infiltrates) w/vanco, ceftriaxone, acyclovir (for viral meningitis). extubated and transferred to the floor. social history: lives w/ male partner. denies smoking, ivdu. occ etoh use. physical exam: t97.6, bp 108/60, 70, 20 100% ra perrla. oropharynx clear no cervical sm/sc la. l sc line. regular s1,s1. no m/r/g lca b/l +bs. soft. nt. nd no le edema. pertinent results: 02:10am pt-14.8* ptt-31.7 inr(pt)-1.4 02:10am plt count-149* 02:10am macrocyt-1+ 02:10am neuts-68.5 lymphs-26.3 monos-4.7 eos-0.1 basos-0.4 02:10am wbc-5.5 rbc-3.67* hgb-11.7* hct-34.8* mcv-95 mch-32.0 mchc-33.7 rdw-15.0 02:10am asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 02:10am tsh-0.37 02:10am osmolal-298 02:10am albumin-3.6 calcium-8.4 phosphate-1.9* magnesium-1.4* 02:10am lipase-33 02:10am alt(sgpt)-126* ast(sgot)-61* ld(ldh)-243 alk phos-83 amylase-66 tot bili-0.4 02:10am glucose-139* urea n-50* creat-2.8*# sodium-135 potassium-4.4 chloride-102 total co2-19* anion gap-18 05:30am urine eos-negative 05:30am urine rbc-* wbc-0-2 bacteria-few yeast-none epi-0-2 05:30am urine blood-mod nitrite-neg protein-neg glucose-tr ketone-neg bilirubin-neg urobilngn-neg ph-6.5 leuk-neg 05:30am urine color-straw appear-clear sp -1.012 05:44am cerebrospinal fluid (csf) wbc-55 rbc-25* polys-18 lymphs-65 monos-17 05:44am cerebrospinal fluid (csf) wbc-35 rbc-5* polys-70 lymphs-30 monos-0 05:44am cerebrospinal fluid (csf) protein-36 glucose-90 05:52am freeca-0.97* 05:52am type-art po2-262* pco2-50* ph-7.21* total co2-21 base xs--8 09:40am hcv ab-negative 09:40am hbsag-negative hbc ab-positive hav ab-negative 09:40am cortisol-10.3 ct head: impression: no mass effect or hemorrhage. cxr impression: subtle patchy opacities likely represent pcp pneumonia in this hiv+ patient. other causes of pneumonia cannot be excluded. prominence of the hila likely represents pulmonary vascular congestion or lymphadenopathy ct chest/abdomen/pelvis-impression: patchy opacities, basiliar consolidation and apical bullae. these findings likely represent pcp . other causes of infectious pneumonia cannot be excluded. brain mri impression: diffuse dural and tentorial enhancement without associated leptomeningeal enhancement. underlying meningitis cannot be excluded and follow-up is suggested. cerebral atrophy compatible with patient's known hiv status. cxr pa/lat: impression: near-complete resolution of bilateral infiltrates. tiny pleural effusion. micro: csf;spinal fluid gram stain-final; fluid culture-final; cryptococcal antigen-final; fungal culture-final; acid fast culture-final; viral culture-preliminary csf;spinal fluid vdrl (csf)-final bronchoalveolar lavage gram stain-final; respiratory culture-final; immunofluorescent test for pneumocystis carinii-final; fungal culture-final; acid fast smear-final; acid fast culture-final sputum gram stain-final; respiratory culture-final {gram negative rod(s)}; legionella culture-final; immunofluorescent test for pneumocystis carinii-final; fungal culture-final; acid fast smear-final; acid fast culture- note: preliminary {afb grown in culture; additional information to follow} urine/serology legionella urinary antigen -final serology/blood cryptococcal antigen-final brief hospital course: a/p 39 yo m w/ hiv/aids, admitted w/ change in ms, f, currently being treated for s pneumo meningitis/pna. 1)pna/meningitis- id consulted on the case and felt that he should be treated for both pneumonia and meningitis. blood, csf, and urine cultures remained negative (including for legionella for virus). gram stain of sputum was positive for gpc in pairs, and it was felt that patient likley had s.pneumo (although cultures were negative). mri was c/w meningitis, but it could not be discerned whether this was viral or bacterial. repeat lp before pt transferred to floor showed few white cells and monocyte predominant. it was unclear how to interpret this result so it was felt that the patient should complete a course of ceftriaxone at the meningeal dose. -picc placed for completion of 14d course of ceftriaxone 2g iv qd -pleural effusions should be followed radiographically. 2)hiv-pt was w/o evidence of opportunistic infection while on floor. he had apparently been speaking with his pmd regarding starting haart therapy. his low cd4 count neccesitated that we begin pcp . -bactrim 1 ds -haart as outpt. 3)hilar lad- finding on chest ct. should be followed as outpt in weeks pending radiographic resolution of pna -f/u as outpt w/repeat ct.(however note below) ***post hospital course c/b discovery of afb positive sputum culture, as per attg note pmd contact who was to contact pt. sent to state for identification and sensititivities. 4)low plts- 104 on admission, then dropped slightly but improved over the course of admission. possibly initially low secondary to sepsis/sirs vs hit ab. on d/c plt 133. -further w/u as outpt. discharge medications: 1. ceftriaxone sodium 2 g recon soln sig: one (1) intravenous once a day for 8 days. disp:*16 grams* refills:*0* 2. trimethoprim-sulfamethoxazole 160-800 mg tablet sig: one (1) tablet po qd (once a day). disp:*30 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: presumed strep pneumo pneumonia presumed strep pneumo meningitis thrombocytopenia - hit ab positive hiv discharge condition: good discharge instructions: 1. take all your prescribed medications 2. follow-up with your physician next week 3. keep yourself well-hydrated 4. call your physician or return to the ed for any fevers, chills, nausea, vomiting, headache, diarrhea, or anything else that concerns you followup instructions: see dr. at community health center next week call for an appointment. follow-up in infectious disease clinic within 1-2 weeks please call for an appointment. 1) consider repeat cxr to follow-up your pleural effusions 2) need to address initiating haart (anti-retroviral) therapy 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 closed [endoscopic] biopsy of bronchus diagnoses: unspecified pleural effusion acute kidney failure, unspecified unspecified septicemia severe sepsis human immunodeficiency virus [hiv] disease septic shock pneumococcal pneumonia [streptococcus pneumoniae pneumonia] pneumococcal meningitis 

Answer: The patient is high likely exposed to