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: no known allergies / adverse drug reactions attending: chief complaint: status epilepticus major surgical or invasive procedure: intubated history of present illness: mr. is a 70 year-old man with pmh of afib (not on anticoagulation) s/p pacemaker, htn, copd, cad s/p cabg , dm2 and adrenal insufficiency (on chronic steroids), etoh w/d seizures who is transferred from an osh for status epilepticus. patient was admitted to the neurology service s/p five seizures last . he was intubated for airway protection/respiratory support initially in icu. seizures did not recur clinically or on eeg. etiology was thought to be secondary to etoh withdrawal. he was discharged with plan to take dilantin monotherapy for 4 weeks anthen discontinue it. (200mg at 8am/8pm and 150mg at 2pm). per wife, patient took dilantin for 4 weeks as instructed and tolerated it well. he discontinued it as planned. he was doing well until in he had a fall at home after "a few beers." he went to the hospital at that time, was told he was "fine" and sent home. since the fall, he had been bed ridden and unable to get up without maximal assistance secondary to pain in his right hip (which they later found out had multiple fractures). in , he was at home when he had an episode of flapping of the right arm, talking "mumbo jumbo, eyes open. this lasted 10-15 minutes. no associated tongue biting/incontinence. after the episode, he was unconscious and "slept for the next 6 days" in the hospital. per wife, his vitals were stable, etc. but he was asleep. he did have left upper/lower extremity paralysis per wife. this was found because when his left arm/leg were lifted up and released, they dropped, whereas on the right he was able to keep them up for a little bit. after mr. up gradually, his speech was slurred as well. these deficits gradually improved and he was back at baseline on discharge home after ~2 weeks in the hospital. during that admission, he was started on keppra 500mg . since that admission, he has been home but unable to walk around without assistance. thus, wife is sure he has not consumed etoh for 8 weeks as he is unable to stand up and get it himself and she has not given him any. today, he was "jittery" and restless all day. he ate dinner at 8pm. later, he was in bed. his sister in law asked him a question and he did not respond. when she went over to him, his head was turned to the left, his left eye was up and out, right eye looking straight ahead. he was unresponsive, said "i'm crazy," and then became unresponsive again. he had twitching of his abdomen, no tonic/clonic activity in upper or lower extremities. no tongue biting, no urinary incont. ems was called. he continued to be in this episode and was nonpresponsive to noxious stimuli. in the ed at osh, he "was observed to have shaking movements of his face, with disconjugate pupils and nystagmus." he was given 2 mg ativan, followed by bolus of 1000 mg keppra (takes keppra 500 mg as above). he was continuing to have "subtle seizure activity" despite these interventions, so he was intubated, started on propofol drip. notably, had leukocytosis with wbc 15 as well as chest x-ray consistent with pneumonia. he was started on ceftriaxone and azithromycin, and vancomycin given recent hospitalization. he was transferred to as it was not possible to place patient on eeg monitoring at osh. per wife, he did not have any fevers/chills, cough, diarrhea, dysuria prior to this episode. no recent falls, no etoh abuse. ros: unable to obtain as patient is sedated and intubated past medical history: - afib not on anticoagulation - s/p pacemaker - htn - copd - cad s/p cardiac bypass - dm2 - hx of gib - lbb - adrenal insuffiency social history: smoked 20 yrs 1ppd, quit 25 years ago, drinks 5-6 beers per day but not drinking recently. lives with wife, children. retired from being a truck driver family history: unknown physical exam: vitals: 35.6 80 110/78 16 100% (intubated) general: intubated, sedated heent: nc/at neck: supple, no carotid bruits appreciated. pulmonary: ctabl cardiac: rrr, no murmurs abdomen: soft, nontender, nondistended extremities: no edema, pulses palpated skin: no rashes or lesions noted. neurologic: -mental status: unresponsive to voice or sternal rub, did not follow commands,no eye opening. -cranial nerves: i: olfaction not tested. ii: perrl 2.5->1mm, briskly reactive. unable to visualize fundi. pt does not have corneal reflexes bilaterally iii, iv, vi: unable to test , pt unable to follow commands v: unable to test vii: no facial droop (although ett in place, therefore difficult to assess), facial musculature appears symmetric. viii: unable to test ix, x: unable to test : unable to test xii: unable to test -motor: normal bulk, tone throughout. no asterixis noted. does not withdraw to noxious stimuli in ue to nail bed pressure or abg needle. flexes/extends feet and toes to noxious stimuli, mild movement to noxious stimuli in les, but not brisk. -sensory: withdraws to noxious stim as above -dtrs: tri pat ach l 1 1 1 0 0 r 1 1 1 0 0 plantar response was up on the left, equivocal on the right. -coordination/gait: unable to test pertinent results: 06:05pm glucose-161* urea n-16 creat-0.8 sodium-144 potassium-3.3 chloride-112* total co2-22 anion gap-13 06:05pm calcium-8.8 phosphate-3.7 magnesium-1.8 06:05pm wbc-8.5 rbc-2.66* hgb-9.1* hct-28.8* mcv-108* mch-34.0* mchc-31.4 rdw-14.6 06:05pm plt count-196 05:58pm cerebrospinal fluid (csf) protein-43 glucose-112 05:58pm cerebrospinal fluid (csf) wbc-2 rbc-3* polys-16 bands-5 lymphs-49 monos-27 metas-3 03:47am type- po2-119* pco2-43 ph-7.33* total co2-24 base xs--3 comments-green top 03:47am lactate-1.0 03:30am glucose-194* urea n-20 creat-0.9 sodium-140 potassium-3.6 chloride-107 total co2-21* anion gap-16 03:30am estgfr-using this 03:30am alt(sgpt)-17 ast(sgot)-43* alk phos-86 tot bili-0.2 03:30am albumin-3.4* calcium-8.4 phosphate-4.1# magnesium-1.5* 03:30am asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 03:30am urine hours-random 03:30am urine bnzodzpn-neg barbitrt-neg opiates-neg cocaine-neg amphetmn-neg mthdone-neg 03:30am wbc-9.5# rbc-2.65* hgb-9.1* hct-28.5* mcv-107*# mch-34.3* mchc-31.9 rdw-14.4 03:30am neuts-77.2* lymphs-16.4* monos-5.6 eos-0.5 basos-0.2 03:30am plt count-200 03:30am pt-11.4 ptt-27.2 inr(pt)-1.1 03:30am urine color-straw appear-clear sp -1.005 03:30am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.5 leuk-tr 03:30am urine rbc-<1 wbc-5 bacteria-none yeast-none epi-0 03:20am po2-432* pco2-41 ph-7.32* total co2-22 base xs--4 brief hospital course: mr. is a 70 year-old man with pmh of afib (not on anticoagulation) s/p pacemaker, htn, copd, cad s/p cabg , dm2 and adrenal insufficiency (on chronic steroids), etoh w/d seizures in who is transferred from an osh for status epilepticus. neuro: the patient was monitored on continuous eeg while in the icu. he had contiuous pleds over the right frontotemporal area. this raised our concern for hsv encephalitis so he was started empirically on acyclovir and an lp was done. the lp showed only 2 wbcs and 3 rbcs, 5 bands, protein 43 and glucose 112. pcr is pending at this time but given benign csf the acyclovir was stopped after 1 day. the pleds may be arising from a recent infarct but given the fact that the patient had a pacer an mri could not be obtained. he was initially started on keppra and this was titrated up to 2000mg . once the patient was off of propofol he had two electrographic seizures so dilantin was added with a 1 gram load. overnight he became agitated and tore off his eeg leads. on the dilantin was discontinued due to a concern for poor bone healing (right acetabular fracture). he was started on trileptal 300 instead, but patient had another seizure on the floor so patient was loaded with fosphenytoin and dilantin was restarted and trileptal stopped. during the remainder of his stay, the patient was monitored clinically and on eeg. his eeg initially showed intermittent r-sided pleds. he was periodically agitated and belligerent, requring temporary restraints. because of this agitation, keppra was weaned to off and lacosamide was started and titrated up. his eeg improved and showed fewer and less severe discharges than before. on , the patient was insisting on signing out against medical advice. he got up from a chair without calling for assistance and was seen to fall down slowly in the hallway while leaning on a walker. this may have been a seizure, as the patient was sleepy afterwards. a head ct showed no acute injury, wrist and hip x-rays showed no fractures. he had a superficial abrasion on his r wrist. the patient recovered and was instructed to always call for assistance when getting out of bed or chair. per the patient's pcp, seizures have been thought to be related to etoh withdrawal which is why he was admitted on a low dose of keppra. it is unclear at this time what the etiology is of his seizure now. the most recent one by history sounds rather atypical but considering the eeg evidence it is likely that there is an underlying seizure disorder beyond etoh with drawal. the patient has a history of atrial fibrillation and was not anticoagulated. per the patient's pcp this is because of his etoh abuse and poor compliance. id: the patient was initially put on acyclovir as above but was stopped after a benign csf was obtained. the hsv pcr was negative, as was the csf culture. he also had a chest xray that was concerning for pneumonia so he was started on cefepime and vancomycin. this was stopped after 2 days because the patient's chest xray improved after diuresis and he had no further white count or fever. resp: patient was intubated for status. he was successfuly extubated on after getting extra lasix and diuresing the day prior. his respiratory status remained stable on room air for the remainder of his hospitalization. endo: patient has a history of adrenal insufficiency. he was continued on his home dose of fludrocortisone and hydrocortisone. his blood pressure and electrolytes were stable and he did not require stress dose steroids. medications on admission: the preadmission medication list is accurate and complete. 1. aspirin 81 mg po daily 2. fludrocortisone acetate 0.1 mg po daily 3. furosemide 40 mg po daily 4. humalog mix 75-25 *nf* (insulin lispro protam & lispro) 14/6 u subcutaneous 14units in the am, 6 units qhs 5. insulin sc sliding scale insulin sc sliding scale using reg insulin 6. hydrocortisone 15 mg po bid 15mg in am, 5mf in pm 7. levetiracetam 500 mg po bid 8. levothyroxine sodium 150 mcg po daily 9. lisinopril 10 mg po daily 10. oxycodone (immediate release) 10 mg po q6h:prn pain 11. paroxetine 40 mg po daily 12. potassium chloride 40 meq po bid duration: 24 hours 13. senna 1 tab po bid:prn constipation 14. atenolol 25 mg po daily 15. omeprazole 40 mg po daily 16. thiamine 100 mg po daily 17. folic acid 1 mg po daily discharge medications: 1. aspirin 81 mg po daily 2. atenolol 25 mg po daily 3. fludrocortisone acetate 0.1 mg po daily 4. folic acid 1 mg po daily 5. furosemide 40 mg po daily 6. hydrocortisone 15 mg po bid 15mg in am, 5mg in pm 7. levothyroxine sodium 150 mcg po daily 8. lisinopril 10 mg po daily 9. omeprazole 40 mg po daily 10. paroxetine 40 mg po daily 11. senna 1 tab po bid:prn constipation 12. phenytoin sodium extended 100 mg po tid seizures rx *phenytoin sodium extended 100 mg 1 capsule(s) by mouth three times a day disp #*90 capsule refills:*3 13. humalog mix 75-25 *nf* (insulin lispro protam & lispro) 14/6 u subcutaneous 14units in the am, 6 units qhs 14. oxycodone (immediate release) 10 mg po q6h:prn pain 15. thiamine 100 mg po daily 16. lacosamide 200 mg po bid discharge disposition: home with service facility: community nurse care discharge diagnosis: seizures discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. no focal neurologic weakness, has weakness from prior r hip surgery. discharge instructions: you were admitted for a seizure that would not stop. you were intubated and transfered to our hospital for continuous eeg monitoring. you have been started on antiepileptic medications to prevent future seizures. you had several seizures while in the hospital. your eeg showed abnormal brain activity indicating a high likelihood of further seizures. the cause of your seizures is possibly an underlying brain injury or abnormality. you were placed on phenytoin and levetiracetam for seizure control. your levetiracetam dose was raised to the maximum for better seizure control, but had to be lowered and then stopped because of worsening irritability. another seizure medicine, lacosamide, was added and the dose titrated up. you attempted to walk unassisted and had a fall, possibly due to a seizure. you did not have any serious injuries but you should always have assistance when you walk. followup instructions: please call to schedule a neurology follow-up appointment with dr. and dr. in 1 month. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours spinal tap incision of lung diagnoses: unspecified essential hypertension long-term (current) use of steroids diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled chronic airway obstruction, not elsewhere classified atrial fibrillation aortocoronary bypass status personal history of tobacco use other late effects of cerebrovascular disease grand mal status cardiac pacemaker in situ glucocorticoid deficiency accidents occurring in residential institution fall from other slipping, tripping, or stumbling physical restraints status 

Answer: The patient is high likely exposed to