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: history of present illness: the patient is a 34-year-old woman with a history of encephalitis at age 8, status post left hemisphere resective surgery at the age of 19 with residual right hemiparesis and language deficit with at the age of 8. she has been wheelchair bound since the resective surgery. she lives in a group home, and at baseline can communicate somewhat with gestures and limited language. she was admitted to hospital two times in for recurrent pneumonia, the first time requiring an the outside hospital her seizure frequency increased. her medications were adjusted at that time, and she became supratherapeutic on dilantin. her seizure medications were then held, and she subsequently presented to the on with very frequent partial seizures, witnessed to be up to five per hour. her seizures consisted of head and eye deviation to the right, eyelid blinking bilaterally, eye movement to the right, and left arm elevating tonically. these episodes lasted between 30 seconds and 60 seconds. also, at the time of her presentation to the , she was found to be tachypneic with decreased responsiveness. she was sent to the emergency department at that time. past medical history: 1. encephalitis at the age of 8; status post left hemisphere resective surgery at the age of 19 with residual right hemiparesis and language deficits, wheelchair bound since the time of the resective surgery. 2. seizure disorder since the encephalitis. 3. she is status post vagal nerve stimulator implantation in with fairly good response. 4. recurrent pneumonia including methicillin-resistant staphylococcus aureus pneumonia in the past. 5. multiple urinary tract infections. 6. adenoidectomy. medications on admission: allergies: an allergy to penicillin has been recorded, but her mother has stated that she thinks this is a mistake. family history: there is no history of seizures or febrile seizures in the family. there is no history of mental retardation or other developmental problems in the family. her father died of brain cancer. social history: she lives in a group home, which she moved to in . she graduated from high school before the resective surgery was done, and went to a special school after that. she has been wheelchair bound since the resective brain surgery. she enjoys watching television and doing crafts in her day program. she is able to move herself. at baseline, prior to admission, she was able to use utensils to feed herself. she required help to transfer to a toilet and was able to move herself slowly in her wheelchair. physical examination on presentation: physical examination on initial admission on revealed the patient's temperature was 99, blood pressure of 103/60, heart rate was in the 90s, respiratory rate was 24. the patient was initially unresponsiveness with labored breathing. heart was regular in rate and rhythm. lungs with diffuse upper airway noises. the abdomen was benign. extremities were without edema. on neurologic examination, the patient had intermittent right facial, eye, and mouth twitching but was still able to follow some commands on the left. pupils were 5 mm and reactive. extraocular movements were full. formal visual fields could not be tested, but the patient seemed to acknowledge all fields. there was a right facial droop. on motor examination, there was no spontaneous movement on the right. arm was held in flexed position with fingers flexed. the right lower extremity was externally rotated with flexion response to pain. the left upper extremity was without asterixis and had full strength. there was some difficulty maneuvering the left lower extremity, and strength was about 4+/5 throughout. reflexes could not be elicited. the left toes were downgoing. the right toes were upgoing. sensation was intact to light touch on the left. radiology/imaging: a chest x-ray on admission showed no infiltrate. pertinent laboratory data on presentation: dilantin level was 9. phenobarbital level was 25. white blood cell count was 4 (with 42% neutrophils), hematocrit was 33, platelets were 203. electrolytes, blood urea nitrogen, and creatinine were within normal limits. hospital course: after receiving 1 mg of ativan in the emergency department, her responsiveness and respiratory status improved. she was admitted to the neurology service and treated with ativan, topamax, dilantin, and phenobarbital for seizure control. on , she was transferred to the neurology intensive care unit for decreased responsiveness, fever, and increasing respiratory distress. on , she was intubated for airway protection. she continued to have frequent seizure activity intermittently with clinical episodes and by electroencephalogram. over the next several days her seizure frequency improved, and her respiratory status improved as well. a tracheostomy was placed on . the patient was found to have tracheomalacia, and a percutaneous endoscopic gastrostomy tube was placed on . her respiratory status continued to improve, and she was weaned off the ventilator. she did continue to have right eye blinking and facial twitching episodes intermittently which did not seem to have electroencephalogram correlation. she was transferred to the neurology floor out of the intensive care unit on . by that time, her seizures were well controlled with only the intermittent facial twitching and eye blinking, and she had completed a full antibiotic course for aspiration pneumonia. her respiratory status remained stable while on the floor. she did begin to complain of abdominal pain on the floor and also developed a low-grade temperature. she was found to have a urinary tract infection and started on antibiotics for this. a ct of the abdomen was done which found no evidence of abscess, a small hematoma around the site of the percutaneous endoscopic gastrostomy tube insertion, and significant constipation. the percutaneous endoscopic gastrostomy tube was checked by interventional radiology and found to be placed correctly and functioning correctly. she received laxatives, and her constipation resolved after an enema. she does continue to gesture and show some discomfort around the site of the percutaneous endoscopic gastrostomy tube; however, there remained no sign of infection or dysfunction of the percutaneous endoscopic gastrostomy tube, and a kub done on showed no obstruction or impaction. neurologically, she had remained stable with an unchanged right hemiparesis that is longstanding secondary to her left hemisphere resective surgery. her level of arousal and responsiveness has been normal over the last several days. she remained nonverbal, but followed commands, and gestures appropriately. the remainder of the hospital course by system: 1. neurology: as stated above, the patient was initially admitted and started on an increased dose of dilantin, continued on her phenobarbital, and started on topamax, as well as ativan for seizure control. she continued to have right facial and eye twitching intermittently throughout her entire hospital course. she had multiple electroencephalograms which showed widespread background slowing focally on the left but also on the right and with frequent sharp wave discharges in the left parasagittal region. there were occasional electrographic seizures seen by electroencephalogram, but the eye twitching and facial movements did not seem to have electroencephalogram correlation. she remained on phenobarbital, dilantin, and topamax throughout her hospital course; and the seizures were relatively well controlled on these medications. her goal levels for the phenobarbital was around 26 and for the dilantin around 18 with a free dilantin around 3. she was on olanzapine and zoloft on admission. these medications were discontinued as they were thought to be contributing to her decreased level of responsiveness. 2. pulmonary: the patient has a history of recurrent pneumonias, for which she was admitted to hospital in ; including methicillin-resistant staphylococcus aureus, which was found in her sputum. during this admission, she was treated for aspiration pneumonia and methicillin-resistant staphylococcus aureus. she is status post methicillin-resistant staphylococcus aureus which required intubation. she is status post tracheostomy on and has been doing well. she has been off the ventilator since , and respiratory status has been stable. she was seen by speech and swallow on for placement of a passy-muir valve to enable her to speak; however, she was unable to tolerate this secondary to coughing when the tracheostomy cuff was deflated and continued coughing with the passy-muir valve in place. she was found to have tracheomalacia, and therefore any placement of the passy muir valve must be done under bedside supervision. she should have the cuff deflated prior to passy-muir valve placement, and it should not be placed while she is asleep. she will follow up for management of the tracheostomy with dr. in four to six weeks. 3. infectious disease: the patient is status post an antibiotic course for pneumonia, as above. she is currently receiving ceftriaxone for treatment of morganella urinary tract infection that is resistant to levaquin. she will complete a 10-day course of the ceftriaxone. she has been afebrile for over 48 hours. 4. gastrointestinal: the patient is status post percutaneous endoscopic gastrostomy tube placement on . she has been tolerating tube feeds without complications. she does motion discomfort around the percutaneous endoscopic gastrostomy tube site. this was worked including an abdominal ct which showed a small hematoma around the site of the percutaneous endoscopic gastrostomy tube and constipation. the patient constipation was relieved after enema. she does still complain of some abdominal pain, but the percutaneous endoscopic gastrostomy tube is functioning well and has been checked by interventional radiology, and a gastrointestinal consultation was obtained who had no further recommendations at this time. medications on discharge: 1. topamax 125 mg per g-tube b.i.d. 2. phenobarbital 40 mg per g-tube at 8 a.m. and 60 mg per g-tube at 4 p.m. and 12 a.m. 3. ceftriaxone 1 g intravenously q.24h. (for a 7-day course; this was started on ). 4. dilantin 150 mg intravenously t.i.d. 5. colace 100 mg per g-tube t.i.d. 6. epogen 40,000 units subcutaneous every week. 7. miconazole powder p.r.n. 8. zinc sulfate 220 mg per g-tube q.d. 9. vitamin c 500 mg per g-tube b.i.d. 10. iron sulfate 325 mg per g-tube t.i.d. (in elixir form). 11. heparin 5000 units subcutaneous b.i.d. 12. dulcolax 10 mg p.o./p.r. p.r.n. 13. fleet enema p.r. p.r.n. 14. prevacid 30 mg per g-tube q.d. discharge diagnoses: 1. increased seizure frequency. 2. aspiration pneumonia. 3. status post tracheostomy. 4. status post percutaneous endoscopic gastrostomy tube. 5. old right hemiparesis secondary to left hemisphere resective surgery. 6. seizure disorder and mental retardation secondary to encephalitis. she will see drs. and in follow-up for management of her . , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube fiber-optic bronchoscopy enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy diagnoses: urinary tract infection, site not specified other convulsions pneumonitis due to inhalation of food or vomitus methicillin susceptible pneumonia due to staphylococcus aureus unspecified intellectual disabilities late effects of intracranial abscess or pyogenic infection 

Answer: The patient is high likely exposed to