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: cellulitis, found down major surgical or invasive procedure: s/p intubation and extubation s/p central line placement s/p picc line history of present illness: mr. is a 22 yo m with morbid obesity with hx of recent rle cellulitis. he was being treated for his cellulitis at hospital when he was found down in his urine and stool, and had a temp of 106. per osh's report he was "non-verbal" and had a witnessed aspiration event. his father recalled that a few days prior to this incident, had mentioned not feeling well and complaining of a ha. after being found down, he was intubated for airway protection and prevention of further aspiration. an lp showed 300 rbc, no wbc. he was started on ceftriaxone, ampicillin, vanc, and acyclovir, and given 8l of ns and dexamethasone empirically. his sbps persisted in the 90's and his hr remained in the 130's, thus he was transferred to and admitted to the micu on . once in the micu, his pet scan showed rul infiltrate, splenomegaly and mesenteric retroperitoneal lad. an eeg was performed (read still pending). blood cultures at osh grew + gpc (staph epidermidis), and he was therefore switched to vanco/zosyn on . osh cultures were negative for csf growth from lp, hsv pcr was negative. hiv viral load was negative, ebv/cmv igg +, igm -. dfa flu was neg. he had several episodes of hyperglycemia requiring large doses of insulin. he also had elevated cr and arf, which improved with ivf. his fevers and leukocytosis resolved on antibiotics. he self extubated on and was weaned off 02. he had poor memory of preceding events, but was a&ox3 post-extubation. he also had diarrhea, and stool studies were sent. so far they have been negative, including for c. diff, and pt reports that his diarrhea has improved. at this time, he denies cp, ha, fevers, chills, sob, n/v, or abdominal pain. past medical history: morbid obesity hx of cellulitis in , requiring hospitalization social history: from , works at job corp as electrician, drinks alcohol socially, denies tobacco and drugs. is currently attending school at ft. in . family history: strong family hx of dm (paternal grandmother, father), mother has alcoholism. physical exam: tc: 97.1, tm: 98.7, bp: 120/80 (120-126/70-80), p: 68 (68-74), rr: 18, o2 sats: 98% ra, fs 111-132 gen: morbidly obese, alert, talkative, nad heent: perrl, eomi, mmm, anicteric sclera neck: thick, difficult anatomy, rij intact cv: rrr, nl s1 s1 no m/g/r resp: ctab abd: + bs, obese, soft, nt ext: rle with diffuse erythema, swelling, mild skin breakdown, however looks improved from original line drawing of borders on skin. 2+ pitting edema at ankles b/l. neuro: awake, alert, oriented, appropriate responses to questions. pertinent results: imaging ct chest/abd/pelvis : the consolidation noted in the posterior segment of the right upper lobe does not have the typical appearance of atelectasis and might represent superimposed aspiration/pneumonia. fatty liver and splenomegaly with the spleen measuring 15.9 cm. multiple nonspecific enlarged nodes are noted within the mesentery within the retroperitoneum and along the both external iliac arteries/pelvic walls. lenis : neg for dvt eeg : markedly abnormal portable eeg due to the marked suppression of the background with bursts of generalized slowing and prominent beta activity. these findings indicate a widespread encephalopathy. the propofol noted on the requisition is the most likely explanation, and the widespread beta rhythm suggests medication effect. there were no areas of persistent focal slowing, but encephalopathies may obscure focal findings. there were no epileptiform features. cxr : has been placement of a right ij central venous catheter with its lead tip in the mid to distal svc. no pneumothoraces are seen. lungs are clear. cardiac silhouette is within normal limits. cxr : the right internal jugular line was removed. the right picc line tip terminates at the junction of the right brachiocephalic vein and svc. the cardiomediastinal silhouette is stable and the lungs are clear. there is no pleural effusion or pneumothorax. echo : the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size and global systolic function (lvef>55%). due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. impression: suboptimal image quality. no valvular pathology or pathologic flow identified. mild symmetric left ventricular hypertrophy with preserved global biventricular systolic function. cxr portable ap : the right picc line tip is at the junction of the right brachiocephalic vein and svc. the cardiomediastinal silhouette is unremarkable. there is a faint opacity in the right lower lung which appears new compared to the prior study and may represent developing pneumonia, although note is made that the technique of the exam is suboptimal, thus reevaluation with pa and lateral radiograph is recommended for precise evaluation of this area. no appreciable pleural effusion is demonstrated. cxr ap and lateral : in comparison with the study of , there is no change. no evidence of acute cardiopulmonary disease. central catheter again extends to the upper portion of the svc. brief hospital course: a/p: 22 obese m found down in setting of rle cellulitis, found down with loss of urinary/bowel continence, fever of 106, and gpc bacteremia. # altered mental status: likely toxic-metabolic in setting of coag neg staph bacteremia/sepsis from rle cellulitis. initially he received antibiotics for suspected meningitis (ceftriaxone, vanc, ampicillin, acyclovir), however the csf from the osh showed wbc=0, cultures negative including negative hsv pcr of the csf. his antibiotics were then changed to vancomycin & zosyn on , with resolution of his leukocytosis and clinical improvement - his mental status quickly returned to baseline and his fever resolved after the abx were started. blood cultures at osh grew + gpc (staph epidermidis). his hypotension resolved with ivf administration. his eeg showed no signs of epileptic activity. he was given a full 14 day course of vancomycin, and a 7 day course of zosyn (both were started on ). there was no further growth from blood cultures. an ir guided picc line was placed for long-term abx given until , when the picc was removed. a tte echo was done and no valvular vegetations suggestive of endocarditis were seen (results above). # fever: the patient was febrile on admission but improved following treatment with antibiotics. unfortunately, on he again begame spiking fevers (day of vancomycin). he continued to spike fevers over the next few days. no localizing symptoms. lfts were recheked on and were normal, aside from an elevated alt of 48. a cxr (pa & lat) showed no evidence of pna. his blood cx remained ngtd, and were sampled from both his picc and his peripheral iv. a ua on showed moderate blood, 38 rbcs, trace protein, and no evidence of infection (no elevated wbc, no bacteria/yeast). this will need to be followed by his pcp in . his ucx was negative. a rectal exam was done to r/o prostatitis, and his prostate was not tender on exam. his previous tte on had showed no valvular pathology, mild symmetric lvh. he was febrile for 24 hours prior to discharge. # aspiration pna: patient reportedly had a witnessed aspiration even during initial incident, and completed 7 days of zosyn and vancomycin as above. he was breathing comfortably on room air after extubation. follow-up cxrs showed no signs of pneumonia. # rle cellulitis/bacteremia: blood cultures from grew staph epidermidis; its most likely source was his rle cellulitis. his cellulitis continued to improve and he completed a 14 day course of vancomycin in the hospital, as insurance would not cover outpatient iv antibiotics. # hyperglycemia: during the patient's stay in the icu, his blood glucose was very difficult to control, likely due to the steroids he initially received, his bacteremia, and underlying insulin resistance. initially he required up to 18 units/hour on an insulin drip to maintain his blood sugars. once his infection improved, he remained off insulin with well-controlled blood sugars < 150. nutrition and social work were consulted to discuss eating habits in the setting of morbid obesity. outpatient f/u was arranged with his pcp in . # guaiac positive stools: he had a low hemotocrit on admission but this remained stable. he was started on ppi for 30 days, as it was felt that he likely had stress gastritis in the setting of sepsis. # arf: pt had an elevated cr on admission, likely secondary to sepsis/pre-renal etiology. this normalized with resolution of infection. # hypertension: after his initial hypotension, he became hypertensive with sbps in the 150's-160's. pt refused starting hctz 25 mg qd, and will instead have his bps followed by his pcp in . # access: picc line was placed for 14 day course of iv antibiotics. # lymphadenopathy/splenomegaly: splenomegaly & mesenteric/retroperitoneal lymphadenopathy were noted on pt's initial ct scan. a peripheral blood smear reviewed by hematopathology showed mature pmns and normal lymphocytes, with no immature forms. this finding was not felt to be consistent with a viral infection. his ebv & cmv serologies were c/w a prior infection, however his igm was negative for both & his cmv vl was negative. both his hiv antibody/viral load were negative. follow-up was arranged for pt to see his pcp and consider repeat ct in weeks as an outpatient. # transaminitis: ct scan showed fatty liver. viral hepatitis serologies were negative. pt had outpatient f/u arranged for evaluation of ?nash with his pcp in . # dispo: patient completed a 14 day course of iv antibiotics for coag neg staph bacteremia in the hospital as he did not have insurance that covered outpatient iv antibiotics. he was discharged to home in with outpatient pcp . medications on admission: none discharge medications: 1. protonix 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po bid (twice a day) for 30 days. disp:*60 tablet, delayed release (e.c.)(s)* refills:*0* discharge disposition: home discharge diagnosis: cellulitis coag neg staph bacteremia and sepsis secondary hyperglycemia morbid obesity discharge condition: stable, ambulating, eating po discharge instructions: you were admitted with cellulitis of your leg which caused a bacterial bloodstream infection with a bacteria called staph. you were admitted to the intensive care unit on a ventilator. you completed a course of antibiotics. please call your primary care physician or seek immediate medical attention if you notice any of the following: loss of consciousness, loss of bladder/bowel control, dizziness, fever, nausea, vomiting, chills, chest pain/pressure, palpitations, confusion, abdominal pain, weakness, or any other concerning symptoms. medication changes: you completed a 14 day course of vancomycin and a 7 day course of zosyn antibiotics for the infection. you were started on a new medication called protonix to help decrease the inflammation/irritation in your stomach - please take this twice a day as instructed. followup instructions: please be sure to follow-up with your primary care doctor, dr. , on friday, , at 2:45 pm (office number ). you will need to follow-up the following problems with her: ------ 1. impaired glucose tolerance 2. elevated liver function tests and fatty liver seen on ct scan 3. follow-up outpatient ct scan of abdomen to re-evaluate lymphadenopathy in weeks 4. follow-up on your blood pressure, which was elevated during your hospitalization (consider starting a medication for this) 5. guaiac positive stools 6. hematuria (microscopic amounts of blood in your urine) procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified diagnoses: acidosis toxic encephalopathy diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified severe sepsis methicillin susceptible staphylococcus aureus septicemia acute respiratory failure pneumonitis due to inhalation of food or vomitus cellulitis and abscess of leg, except foot morbid obesity unspecified gastritis and gastroduodenitis, with hemorrhage other chronic nonalcoholic liver disease 

Answer: The patient is high likely exposed to