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: found down major surgical or invasive procedure: -placement of right sided ij cvl -arterial line placement -lumbar puncture history of present illness: this is a 27 y.o. male with a history of polysubstance abuse, depressive disorder nos, and gerd who presents after being found down at where he been admitted for detox. per notes, the patient endorsed an 8 mo history of abusing multiple types of opiates including oxycontin, methadone, and heroin. he had decided to quit and thus had managed to obtain methadone with the intent to wean himself gradually from that medication. unfortunately, on he accidentally overdosed on the methadone and was brought into hospital for treatment (it is unclear exactly what were the details of his overdose and how he was managed though it appears he was discharged from the emergency room). after discharge from the ed he self referred to for detox. he was admitted without incident and was alert, oriented, and appropriate. on the evening of he received his last dose of methadone at 8:00 pm. he also received his citalopram and omeprazole there by report and one dose of trazodone for sleep. the next morning he was found around 9:00 am to be unresponsive and tachypneic with pinpoint pupils. primary concern was for opioid overdose so the patient was given naloxone (total 0.8 mg) with no improvement in mental status by report but his miosis did resolve. he was then taken to the ed. initially he was hypertensive, tachycardic, tachypnic, febrile, and diaphoretic. though there was notable rigidity there was concern raised for serotonin syndrome given ssri and trazodone use. toxicologic screen was positive for methadone only and other labs were notable an elevated lactate and acute kidney injury. he was intubated and sedated with propofol and etomidate for for airway protection. subsequently became hypotensive. broad spectrum abx administered for suspected infectious etiology. he also received cyproheptidine to reverse possible serotonin syndrome and 6.8 l of fluid after an elevated cpk suggested rhabdomyolysis. lp was also performed to evaluate for meningitis. past medical history: 1) gerd 2) depressive disorder nos 3) polysubstance abuse 4) hx of suicide attempt at age 15 social history: notable for 2-3 years of abuse of opioids and cocaine. per the patient's reports at he does not feel cocaine is a problem though he was concerned about his opioid abuse. unclear smoking history and alcohol abuse history. he lives with his girlfriend in an apartment with their daughter. is unemployed. one other son who lives with his mother. family history: unknown physical exam: vitals: 98.7 117/81 71 18 100%ra pain: denies access: piv gen: nad, sleepy this am heent: mmm cv: rrr, no m resp: ctab, no crackles or wheezing abd; soft, nontender, +bs ext; no edema neuro: new baseline skin: mulitple tattoos psych: easily agitated. pertinent results: na 137, k 5.7, cl 108, hco3 20, bun 32, cr 2.5, glu 124 ck: mb: 117 mbi: 0.5 trop-t: 0.82 ca: 6.5 mg: 2.2 p: 2.5 . wbc 17.8, hgb 12.2, mcv 89, hct 35.9, plt 227 ---n:78.7 l:14.5 m:6.2 e:0.4 bas:0.1 . pt: 17.6 ptt: 30.0 inr: 1.6 . abg 7.33/40/59/22 alt: 3558, ast 4323, ap: 102, ldh 5900, tbili: 0.5 : 461 lip: 31 . discharge time: wbc 12.8->10 (downtrending) hgb 11.2 (stable ) bun 24/1.6 (plateaued since ) mag 1.7 inr 1.4 ast 47, alt 160 (overall improved from ast/alt 6000s/4000s) ck -->400s tsh 2.1 serum tox neg, hep a/b/c neg blood cx all ntd c-diff neg . . . csf: 1 wbc, 1 rbc (68% lymphs, 32% monos) protein 26, gluc 90 . ua: cloudy, trace le, lg blood, (-) nitrite, 100 prot, (-) gluc, (-)ketone, rbc, wbc, moderate bacteria, granular casts . other studies: ct head w/o contrast: impression: bilateral hypodense appearance of the globus pallidus, nonspecific, but may be related to patient's history of drug overdose. an mri is recommended for further evaluation. partial opacification of the bilateral ethmoid and right maxillary sinus. . cxr: impression: patchy airspace opacities within the bilateral hilar and left basilar regions. given the patient's history of intoxication, these findings are suspicious for aspiration. however, given the perihilar opacities, central pulmonary vascular congestion cannot be excluded. ct head : impression: 1. interval increase in the prominence of hypodensity in the bilateral globus pallidus. 2. stable partial opacification of the bilateral ethmoid sinuses. mri/mra head : impression: 1. extensive areas of restricted diffusion involving the white matter, corpus callosum, both globus pallidus and right hippocampus indicative of acute infarct/ischemia likely due to global hypoxia. 2. no evidence of midline shift or herniation. mra of the head: the head mra demonstrates normal flow signal within the arteries of anterior and posterior circulation. eeg: impression: this is an abnormal portable eeg due to the slow background, suggestive of an widespread encephalopathy. the marked rhythmicity of the background activity suggests a predominant involvement of the deep brain structures. there were no epileptiform features seen and no lateralized findings, although the slow background could obscure additional focal slowing. . . cxr: nothing acute brief hospital course: 27 year old male with a history of polysubstance abuse, depression with sis, admitted after found down (obtuneded), with anoxic brain injury (per mri/eeg). hospital course complicated by rhabdo, arf, aspiration pna->respiratory failure/intubation. medical issues stable, slow recovery from anoxic brain injury, going to rehab for pt/ot/speech therapy. 1)anoxic brain injury/found down: the ultimate etiology of the patient's initial obtundation remains unclear. conflicting stories from the various interested parties (girlfriend, family, etc...) and conflicting reports about the patient's substance use prior to arrival at . per notes patient received methadone at 8:00 pm and next seen 9:00 am next morning at which time he was unresponsive and hypoxic. possible overdose vs seizure vs serotonin syndrome. of course, given history of opioid abuse there is concern the patient may have overdosed. his drug screen was only positive for methadone. of note, his mental status did not resolve after receiving naloxone, but it is possible that at that point anoxic brain injury was primary mechanism of obtundation. other possible primary insults would include seizure (though not supported by eeg) or serotonin syndrome due to trazodone in addition to his ssri. at presentation to the hospital as the patient was noted to have clonus, hypertension, and fever there was increased concern for serotonin syndrome so toxicology was consulted and on their recommendation the patient received a course of cyproheptidine (antidote to serotonin syndrome) with no clear improvement. in the ed tox screen was negative except for methadone and ct revealed only bilateral hypodensity in the globus pallidus. the patient did spike a fever so also had an lp, which showed no pleiocytosis or findings concerning for meningitis. osmolality was also checked and the patient had no osmolal gap suggesting there had been no ingestion of non-ethanol alcohols. over the following days the patient's other pathologies (respiratory distress/pna, hypotension, arf etc...) continued to resolve but he continued to have altered ms and not localize to noxious stimuli or follow commands. repeat ct showed persistent hypodensity of the globus pallidus bilaterally. neurology consult was called and thought this was most consistent with anoxic brain injury but recommended mri/mra and eeg. mri/mra showed findings consistent with anoxic brain injury and eeg revealed extensive areas of restricted diffusion involving the white matter, corpus callosum, both globus pallidus and right hippocampus indicative of acute infarct/ischemia likely due to global hypoxia. eeg showed findings consistent with global encephalopathy without lateralizing or epileptiform activity. the patient's family was informed of these findings and a likely unfavorable prognosis. nevertheless, after extubation the patient did begin to answer simple questions appropriately and speak to his family though he did continue to not be aware of his name or situation intermittently and reported he was unable to move his extremities, but intermittently had reflexive movements. upon transfer to the medical floor, his mental status continued to improve very slowly. he was able to speak coherently, raise his limbs against gravity, take pos w/o aspiration. he was evaluated by pt/ot and speech therapy who recommended rehabilitation for further regaining of mobility/speech therapy. his current ms waxes/wanes. he can be uncooperative when awake trying to climb out of bed. at other times, he is calm. also on klonipin for tremors per neuro which has sedating effect, thus dose decreased 1mg -->0.5mg tid. . other issues during hospitalization were: hypoxemic respiratory failure, extubated , aspiration pna/pneumonitis. sputum cx with op flora supported aspiration dx. initially broad abx (vancomycin, pipercillin/tazobactam, and levofloxacin)---> unasyn until (7days). currenlty doing well on ra. . rhabdomyolisis with arf/atn, transamintitis. cks up to 25k, creat peak 4.8, initially anuric, s/p 7l fluids with improvement. now creat plateued 24/1.6 (x5days) by time of discharge, likely his new baseline. lfts and cks also much improved, should have complete metabolic panel checked every few days for next couple weeks. needs f/u pcp . . fever of unknown origin: the patient was persistently febrile throughout first part of his hospital stay. blood cultures persistently negative and no other localizing signs except possible aspiration pneumonia (thought unlikely as respiratory status was improving). had some diarrhea (on lactulose), c-diff neg x2. he eventually defervesced without any intervention and has been afebrile for several days . rashes: the patient had areas of erythema on his medial knees at presentation with some vesicles. these were cultured for herpes and were negative. thought most likely due to pressure injury when found down. a wound care consult was called for concern for skin breakdown, and he was placed on a first step mattress. . tremors and diaphoresis: he was noted to be tremulous and diaphoretic during his stay. he had a normal tsh, and a resolving fever and wbc count. he was placed on klonopin for tremors. this dose was reduced to 0.5mg tid on day of discharge given increased somnolence with 1mg dose. . depression and polysubstance abuse. he was followed by psychiatry and social work during his stay. he did not express suicidal ideations during his stay. he was briefly on a one-to-one sitter. his celexa was not resumed on discharge, and he will require psychiatric follow up as an outpatient. medications on admission: -omeprazole 20 mg po daily -citalopram 40 mg po daily discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection injection tid (3 times a day). 2. labetalol 200 mg tablet sig: three (3) tablet po tid (3 times a day). 3. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 4. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed. 5. miconazole nitrate 2 % powder sig: one (1) appl topical tid (3 times a day) as needed. 6. clonazepam 1 mg tablet sig: one (1) tablet po tid (3 times a day). 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). discharge disposition: extended care facility: r at radius discharge diagnosis: 1. anoxic brain injury 2. transaminitis 3. acute renal failure 4. rhabdomyolysis 5. depression 6. polysubstance abuse 7. tremors discharge condition: stable discharge instructions: you were admitted to the hospital and found to have anoxic brain injury. if you develop increased pain, fevers, chills, tremors, confusion, or weakness, you should call your primary care doctor or go to the emergency room. followup instructions: please follow up with your psychiatrist and a primary care doctor. to make an appointment with a primary care doctor in , you can call . 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 arterial catheterization diagnoses: esophageal reflux acute kidney failure with lesion of tubular necrosis depressive disorder, not elsewhere classified opioid type dependence, continuous acute respiratory failure pneumonitis due to inhalation of food or vomitus anoxic brain damage other encephalopathy hyperosmolality and/or hypernatremia rhabdomyolysis shock, unspecified 

Answer: The patient is high likely exposed to