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: morphine attending: chief complaint: altered mental status major surgical or invasive procedure: central venous catheter placement, intubation, picc line, lumbar puncture history of present illness: 54 yo f with h/o htn, hyperlipidemia transferred to after osh head ct was concerning for acute infarct. she reports she has been feeling unwell over the past week with headache, nausea/vomiting, myalgias and arthralgias. she also endorses fevers/chills over this time period. she reports she was seen by her pcp and was diagnosed with the "flu" and was treated with amoxicillin. she and family report that over the past week she has also experienced 2 episodes of slumping to the ground without clear loc. she has been confused following these episodes per both patient and family. at her family's urging, she presented to for further evaluation. there, she underwent head ct which demonstrated a right temporal lobe lesion concerning for acute infarct. thus, she was transferred to for further evaluation and management. . in the ed, initial vitals were t: 102.2 bp: 117/72 hr: 113 rr: 16 o2 sat: 94% ra. on exam she was noted to have a "petechial rash" per verbal s/o (not on our exam) and developed vesicular lesions on her palms while in the ed. ua was negative for infection and cxr from osh was reviewed by ed and radiology and reportedly negative for infiltrate/acute cardiopulmonary process. ct head from osh was reviwed with radiology and neurology and there was concern for infarct, abscess or mass. neurology was consulted and recommended mr for further evaluation, lp, and coverage with ctx/vanco/acyclovir. they additionally recommended eeg to r/o seizure activity given these "drop" episodes followed by increased confusion. mri/mra was performed which demonstrated marked temporal lobe edema. because of the edema, lp was deferred and she received empiric rx with 2g iv ceftriaxone, 1g iv vancomycin, and 800mg iv acyclovir. she received 4.5 l ivfs. . ros: as above. denies photophobia, further denies cp/sob. no abdominal pain, no diarrhea, no blood in stool. no dysuria/hematuria. past medical history: htn hyperlipidemia (familial) s/p hysterectomy s/p tonsillectomy social history: lives with husband at home. retired high school teacher. taught business and accounting and retired 2 years ago. denies tobacco and alcohol use. family history: hypercholesterolemia (paternal grandparents, daughter) physical exam: vs: t- 98.6, bp - 159/51, hr - 101, rr - 19, o2 - 100% 2 l nc gen: confused, lethargic heent: at, nc, perrla, eomi, no conjuctival injection, anicteric, op clear, mmm, neck supple, no lad, no carotid bruits cv: rrr, nl s1, s2, no m/r/g pulm: ctab, no w/r/r with good air movement throughout abd: soft, nt, nd, + bs, no hsm ext: warm, dry, +2 distal pulses bl, no femoral bruits neuro: cn ii-xii grossly intact, 4/5 strength in ues. pt. unable to cooperate with strength testing in les. brisk reflexes in biceps, brachioradialis and patella. downgoing toes bilaterally. no sensory deficits to light touch appreciated. skin: discrete vesicles on hands and eczematous skin on soles, otherwise no lesions pertinent results: mra brain w/o contrast: (1) extensive flair signal abnormality and mild enhancement predominantly involving the medial temporal lobe in addition to right insula and a small focus of the right frontal lobe. given clinical history findings are more likely due to herpes encephalitis. however, followup imaging after resolution of clinical symptoms is recommended to exclude the possibility of infiltrative glioma. (2)multiple foci of hyperintense flair signal abnormality of white matter of both cerebral hemispheres, with morphology and distribution more characteristic of demyelinating disease, but given history of hyperlipidemia and hypertension, could reflect chronic small vessel infarction. . time-of-flight mr angiography of the head including circle of : the anterior and posterior circulations including circle of are patent without evidence of aneurysm, stenosis, occlusion, dissection or vascular malformation. . ct head w/o contrast: (1) extent of cortical and white matter abnormality consistent with presumed herpes encephalitis is not significantly changed in extent. however, evidence of increased cerebral edema is noted by increased sulcal effacement of the right parietal and right temporal lobes. (2) comparison difficult given difference in modality. however, mild increase in effacement of the right perimesencephalic cistern is concerning for developing transtentorial/uncal herniation. . eeg: abnormal portable eeg due to the abnormal background consisting of disorganized, low voltage fast activity. this likely reflects medication effects from recent benzodiazepine or barbiturate administration. there were no areas of prominent focal slowing. there were no epileptiform features and no electrographic seizure activity was noted. . ct head w/o contrast: no interval change . cxr portable: (1) malpositioned right subclavian picc line with tip in the right atrium that needs to be retracted by at least 7-8 cm. (2) the patient is status post extubation. . ct head w/o contrast: (1) no acute intracranial hemorrhage. (2) no change in the large hypodense area, noted involving the right temporal, right inferior frontal, basal ganglia and thalamus, with mild mass effect on the right lateral ventricle better evaluated on prior mr study. . mri head w/ and w/o contrast: overall there has been no significant change in the mass effect as well as the t2 signal abnormalities involving the right temporal lobe, right inferior frontal lobe and superior frontal lobe laterally as well as subtle abnormality in the left subinsular region. on the current examination, there appears to be slightly more distinct enhancement visualized in the right medial temporal lobe. however, it is unclear whether this is due to differences in technique as only axial t1 images could be compared and the sagittal post-gadolinium images on the current study are limited by motion. further followup recommended. . eeg: brief hospital course: 54 y.o. female with recent history of "drop attacks" presenting with fever, altered mental status and temporal lobe edema on head mri, treated for viral (likely hsv) encephalitis . # viral (likely hsv) encephalitis: initial head imaging revealed right temporal lobe edema and given prodromal viral syndrome concern was for hsv meningoencephalitis. she was covered empirically with ceftriaxone/vancomycin/acyclovir. she was loaded with phenytoin and placed on maintenance dose. given edema and mass effect on initial imaging, lp was deferred in this setting. upon arrival to the icu, mental status continued to decline and she was intubated for airway protection. eeg was performed on arrival to the icu which revealed low voltage fast activity which likely reflects medication effects from recent benzodiazepine or propofol. there was otherwise no clear epileptiform activity. neurosurgery was consulted and recommended mannitol which she was continued on; since having been titrated down. serial head cts have been stable. id was also consulted and recommended continuation of acyclovir; ceftriaxone and vancomycin were discontinued. she was extubated successfully on . the patient was given acyclovir on the floor. . # altered mental status: most likely in the setting of hsv meningoencephalitis. eeg without clear epileptiform activity however has been loaded with and remains on standing dilantin given high risk of seizures. the patient resolved her altered mental status after dilantin and acyclovir use. . # rash: unclear etiology as it is not petechial in nature which might be seen in a bacterial meningitis. rash is mostly isolated to the palms of hands and is somewhat vesicular in nature. viral dfa and cultures were sent and are pending. . # htn: briefly hypotensive following intubation and transiently on neosynephrine. neo was then restarted with goals to maintain maps >60 for cerebral perfusion. she has since been weaned off neo successfully. antihypertensive medications have been held in this setting. . medications on admission: amoxacillin 500mg po tid promethazine 25mg prn atenolol 50mg po daily lipitor 40mg daily zetia discharge medications: 1. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). 2. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 3. acyclovir sodium 500 mg recon soln sig: 1.6 recon solns intravenous q8h (every 8 hours) for 34 doses. disp:*68 recon soln(s)* refills:*0* 4. heparin flush 10 unit/ml kit sig: two (2) 2ml intravenous every eight (8) hours: flush each port of picc line per protocol after each use. disp:*qs * refills:*2* 5. outpatient lab work please have phenytoin level drawn first thing in the morning prior to usual dose on monday and have this result faxed to dr. at 6. dilantin kapseal 100 mg capsule sig: three (3) capsule po at bedtime. disp:*90 capsule(s)* refills:*2* discharge disposition: home with service facility: , discharge diagnosis: primary 1. viral encephalitis (likely secondary to hsv) secondary 1. hypercholesterolemia 2. hypertension discharge condition: hemodynamicaly stable, ambulatory patient to work with physical therapy as an outpatient. discharge instructions: you were admitted to an outside hospital for fevers, myalgias, and two fainting episodes and transferred to for concern of a ct scan. imaging and laboratory studies here indicated that you suffered a viral encephalitis, most likely due to hsv. you were admitted to the micu and had a breath tube placed to protect your airway. your primary care team worked with teams of neurologists and infectious disease experts to best direct your care. you were treated for your infection, in addition to being given medicines to prevent seizures and to lower the pressure in your head. your medication regimen has changed from when you came into the hospital. please review you medicines carefully and take as directed - this is very important. we also recommend that you continue to have physical therapy as an outpatient. please seek immediate medical attention for the following: fevers, headache, vision changes, extreme tiredness, fainting spells, or for any other concerns. followup instructions: 1.) id - id mentioned that they would set up an and time. call ( 2.) neuro - follow up scheduled for wednesday, at 5pm on the of the building in dr. and dr. clinic. 3.) primary care physician with dr. scheduled for monday, at 10:30 am. location of is now at 500 in , exit 44 from 495. please have dilantin level drawn before or at that before taking morning dilantin dose (if drawing level at , bring prescription sheet). 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 enteral infusion of concentrated nutritional substances diagnoses: pure hypercholesterolemia mitral valve disorders unspecified essential hypertension acute respiratory failure cerebral edema herpetic meningoencephalitis 

Answer: The patient is high likely exposed to