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: ibuprofen attending: chief complaint: respiratory distress major surgical or invasive procedure: none history of present illness: patient is a 84 year old male with daily etoh use, tobacco use, hypothyroidism, h/o throat cancer and dementia who presented to last saturday () after he was found to have a diffuse rash, fever to 102. per patient's son, on the day pta he started complaining of back pain which improved with 2 advil. the next day his daughter found him on the floor at his house with rash on his neck and back. of note, the patient's son reports that he has had progressive dysphagia, poor po intake and weight loss over the last year. . at he was also noted to have arf, transaminitis, uti. the patient's rash was noted to involve his entire body, sparing the mucous membranes. per report, it exfoliated without bullae. dermatology was involved, biopsy was done and showed leukocyto clastic vasculitis that was presumed to be advil. patient was initially treated for rmsf with ctx/levo/doxy but the this was d/c'd and he treated with a prednisone taper (po) and supportive care, almost like a burn victim. rash improved over the course. on tuesday the patient had afib with rvr, requiring a dilt drip and was transferred to the icu. reverted back to normal sinus rhythm. . the patient's renal failure was of unclear etiology, he initially presented with creatinine of 2.1 from a baseline of 1.6. creatinine peaked at 3.2 and 1.7 on transfer. the also had transaminitis on presentation that was approximately twice the upper limit of normal and trended down slowly. hepatitis c was negative. the patient was treated with levaquin for uti. he developed a leukocytosis during hospitalization than trended down with steroid taper. . despite improvement in rash, renal and liver function, on the patient's respiratory status started to worsen. he was hypoxic and put on a nrb, and abg showed 7.21/63/199, and he was put back on 2.5l nc and 02 sat remained stable. the pulm consult felt his acidosis was mixed and secondary to hypercapnia and acute on chronic renal failure and given his abg they intubated him. his post-intubated abg was worsened with ph at 7.16. he was also then noted to be hypotensive and started on dopamine. prior to leaving for the patient received 1 dose of zosyn and had head ct that was reportedly negative. . on arrival to the icu, the patient's sbp was 90-100 manual, his 02 sat was 95-100% on ac, 40%fio2. past medical history: throat ca s/p radiation in hypothyroidism tobacco etoh copd mild dementia social history: lives with son, retired , six children, smoker, etoh. family history: father with esophageal cancer, mother with . physical exam: vitals: bp 90/33 hr: 92 02sat: 95% on vent general: intubated, sedated. heent: eyes with crusting. lungs: bilateral rhonchi cardiac:rrr abdomen:soft, non-tender extr: some desquamation around fingertips, toes. new skin throughout, but without skin breakdown. bottom of feet dusky. feet cool bilaterally, otherwise warm throughout. bilateral 2+ pitting edema to ankles. neuro: sedated, responds to pain, perrl pertinent results: from osh: abc: 16.2 from 17.9 from sodium: 147 from 145 bun 65 from 54 creat: 1.7 from 1.4 from ast/alt on admission: 43/75 ck: 122 tsh: 9.97 bnp: 937 abg (post-intubation): 7.18/66/265/25 abg pre-intubation: 7.21/56/65/22 12:42am blood wbc-20.3* rbc-3.08* hgb-9.7* hct-31.4* mcv-102* mch-31.5 mchc-30.9* rdw-16.2* plt ct-188 03:55am blood wbc-7.9 rbc-2.80*# hgb-8.9* hct-26.2*# mcv-93 mch-31.6 mchc-33.8 rdw-17.6* plt ct-110* 12:42am blood neuts-93.9* bands-0 lymphs-4.1* monos-1.6* eos-0.1 baso-0.3 12:42am blood hypochr-normal anisocy-2+ poiklo-1+ macrocy-2+ microcy-normal polychr-normal ovalocy-1+ schisto-occasional tear dr1+ 12:42am blood pt-14.5* ptt-32.5 inr(pt)-1.3* 03:55am blood plt ct-110* 11:07am blood fibrino-526* 11:07am blood fdp-10-40* 01:20pm blood fibrino-505* 01:20pm blood fdp-0-10 12:42am blood glucose-94 urean-82* creat-1.9* na-150* k-4.7 cl-119* hco3-22 angap-14 05:24am blood glucose-107* urean-111* creat-3.0* na-150* k-4.4 cl-122* hco3-20* angap-12 09:25am blood glucose-124* urean-105* creat-2.8* na-150* k-3.9 cl-122* hco3-20* angap-12 03:13am blood glucose-119* urean-111* creat-3.4* na-133 k-3.9 cl-108 hco3-15* angap-14 03:55am blood glucose-102 urean-89* creat-1.7* na-145 k-3.6 cl-114* hco3-18* angap-17 12:42am blood alt-37 ast-14 ld(ldh)-206 ck(cpk)-78 alkphos-109 totbili-0.7 05:49am blood alt-28 ast-20 ld(ldh)-249 alkphos-118* totbili-0.5 04:01am blood alt-26 ast-26 ld(ldh)-239 alkphos-169* amylase-49 totbili-0.5 04:38am blood alt-31 ast-27 ld(ldh)-182 alkphos-243* totbili-0.8 12:42am blood ctropnt-0.02* probnp-* 09:25am blood ck-mb-7 ctropnt-0.03* 03:19pm blood ck-mb-8 ctropnt-0.04* 12:42am blood albumin-2.2* calcium-6.9* phos-5.7* mg-2.2 03:55am blood calcium-6.9* phos-4.8* mg-1.5* 11:07am blood caltibc-99* vitb12-474 folate-4.5 hapto-156 ferritn-866* trf-76* 01:20pm blood d-dimer-1601* 04:42am blood tsh-21* 05:49am blood cortsol-22.3* 06:47am blood cortsol-31.4* 07:37am blood cortsol-35.1* 10:58am blood -negative 10:58am blood anca-negative b 12:57am blood type- po2-76* pco2-58* ph-7.22* caltco2-25 base xs--4 04:54am blood type-art temp-36.1 rates-26/ tidal v-550 fio2-40 po2-101 pco2-35 ph-7.33* caltco2-19* base xs--6 -assist/con intubat-intubated 12:57am blood lactate-1.8 04:54am blood lactate-1.2 anaplasma phagocytophilum (human granulocytic ehrlichia ) igg/igm neg babesia antibodies, igg and igm neg herpes 6 dna pcr neg quantitative herpes simplex (hsv) 1, igg herpes simplex (hsv) 2, igg neg herpes simplex virus 1 and 2 antibody igm neg parvovirus b19 antibodies (igg & igm) neg spotted fever ab igg, igm neg varicella zoster antibody, igm neg cxr findings: indwelling devices are unchanged in position. heart remains enlarged. persistent consolidation in left perihilar and basilar region likely due to pneumonia based upon correlation with ct chest of . moderate to large bilateral layering effusions persist, as well as mild interstitial edema. right basilar opacity may reflect a combination of atelectasis and effusion, but an additional site of infection is possible. cxr findings: the tip of the endotracheal tube projects 4.5 cm above the carina. bilateral pleural effusions, left more than right, with moderate extent. retrocardiac atelectasis. normal size of the cardiac silhouette. minimal signs of overhydration. no pneumothorax. ct head findings: there is no evidence of acute hemorrhage or shift of normally midline structures. the ventricles and sulci are prominent consistent with age-related atrophy. there are extensive vascular calcifications of the bilateral vertebral arteries and cavernous portions of the internal carotid arteries. there is no acute major vascular territorial infarct. extensive streak artifact obscures the base of the skull. there is no evidence of acute fracture. ct chest extensive left lower lobe pneumonia with associated small parapneumonic effusion. multiple areas of ground-glass attenuation and minimal consolidation elsewhere in the lungs likely reflect early multifocal spread of pneumonia. brief hospital course: mr. was an 84 year old male who presented to the icu from with respiratory failure and a diffuse desquamating rash of unknown etiology, found to have gbs pneumonia, sepsis and multiorgan failure. on presentation he was septic and hypotensive, already intubated with end organ signs of renal failure, respiratory failure, shock, and metabolic acidosis. the patient was treated for gbs pneumonia with penicillin g and clindamycin. he was also treated with acyclovir for hsv infection. dermatology and infectious disease were consulted. his desquamating rash biopsy had shown leukoclastic vasculitis at the outside hospital; dermatologic pathology said the biopsy was consistent with a hypersensitivity reaction with a differential including drug-induced vs viral etiology. the rash may have been drug-induced, but there was also concern for toxic shock syndrome; the clindamycin should inhibit toxin production. over the two weeks of his icu stay, mr. developed worsening generalized edema and increased skin breakdown all over his body. much of his new skin breakdown was in dependent areas; he was unable to recover from the original insult, given his low albumin and clinical deterioration. he was tested empirically for the following antibodies, which all had negative results: anaplasma phagocytophilum (human granulocytic ehrlichia ) igg/igm; babesia antibodies, igg and igm; parvovirus b19 antibodies; varicella zoster antibody, igm; spotted fever. for the majority of his hospital stay, mr. was requiring two to three pressors to maintain adequate blood pressure. his mental status was altered even without sedation. he did have a head ct to rule out any acute intracranial process. he was able to interact with his family by tracking his eyes and nodding his head for a few brief hours the day before extubation. he also had significant metabolic acidosis in addition to renal failure on admission, which both were resolving slowly. he had some electrolyte imbalances initially, including hypernatremia up to 150, which resolved after the first week. he also had some transaminitis, which resolved. the patient was found initially to be in svt, though unclear whether in or , but had no further episodes in his last week of icu stay. mr. was anemic and require 3 units of packed rbc transfusion during his icu stay. he was guaiac positive but did not appear to lose a significant amount of blood through his stool. iron studies revealed anemia of chronic disease/inflammation. the patient also had renal failure, which may have contributed to his anemia. the patient had a very large, supportive family. the patient was extubated and taken off pressors on in the presence of many family members. passed within the hour. his family declined post-mortem autopsy. medications on admission: no home meds discharge medications: none discharge disposition: expired discharge diagnosis: sepsis discharge condition: expired discharge instructions: none. followup instructions: none. procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more enteral infusion of concentrated nutritional substances diagnoses: acidosis unspecified pleural effusion acute kidney failure, unspecified severe sepsis unspecified acquired hypothyroidism chronic airway obstruction, not elsewhere classified alcohol abuse, unspecified other persistent mental disorders due to conditions classified elsewhere acute respiratory failure other specified cardiac dysrhythmias septic shock dermatitis due to drugs and medicines taken internally hyperosmolality and/or hypernatremia streptococcal septicemia other psoriasis herpes simplex without mention of complication coma other drugs and medicinal substances causing adverse effects in therapeutic use personal history of malignant neoplasm of other and unspecified oral cavity and pharynx pneumonia due to streptococcus, group b 

Answer: The patient is high likely exposed to