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: penicillins / clindamycin / dilaudid attending: chief complaint: headache major surgical or invasive procedure: cerebral angiogram history of present illness: reason for consult: called by emergency department to evaluate ich pt. name is . hpi: the pt is a 66 year-old rhm w/ hl/dm and ? htn who developed sudden onset r sided retroorbital ha, nausea, took tylenol without relief. within minutes developed l sided weakness and l facial droop, but apparently was responding appropriately and following commands, albeit slowly. his wife noted his speech was like speaking w/ a mouth full of marbles. he seemed unsettled, moving things around on the kithchen counter w/o purpose. ems was called. he was able to walk to the ambulance, but needed support and direction. at hospital gcs was 15, bp was 139/63 but ranged between 139 - 167 systolic. pt. developed worsening nausea, emesis and pounding ha around 21.30, bp at that time was noted as 204/95. ct head revealed a large r frontal iph w/ sah. he was tx w/ fosphenytoin 1g, intubaed (etomidate, succinyl choline, versed) and started on ativan gtt. transferred to . vs here on propofol were 118/51 83 on cmv/ac. exam was notable for gcs of 5, unresponsive to verbal, grins to noxious, eyes midline brisk, no deviation, present corneal and gag w/o vor, w/o localization to noxious, brisk flexor on r to noxious away from stimulus and r flex on nox to lue. rle w/ brisk withdrawal, while, lle w/ grin and rle flx. l toe is up and tone lle >> rle. per discussion w/ wife, there were no prodromal symtptoms or signs. he was in usoh, watching a bruins game. no new medications, no hx of drug use. he was not straining at the time, no hx of recent trauma. . past medical history: htn hl dm afib prior cva/tia/ich social history: lives in ma w/ wife. is a retired electrical company manager, now volunteers at the police office family history: bio father unknown. mother's side: htn hl dm cva/tia cad/pvd cancer intracerebral anneurysms/avm connective tissue disorders ( dahnlos, marfans, pkd) physical exam: vitals: t: 97.1 p:83 r: 16 bp: 118/51 sao2: 100% on cmv assist general: obtunded. heent: nc/at, no scleral icterus noted neck: supple. pulmonary: cta bilaterally, laterally cardiac: rr, nl. s1s2, no m/r/g abdomen: soft, nt/nd, no masses or organomegaly noted. extremities: warm, dry, no edema; clubbing present pulses: 2+ radial, dp bilaterally. neurologic: gcs of 5 (eye opening 1, motor 3, verbal 1) off propofol x 10 minutes. ms: unresponsive to verbal, grins to noxious. eyes midline briskly reactive 4->2, no deviation. present are corneal and gag, there is no vor. -motor/sensory: normal bulk. no posturing. increased tone in lle > lue. lue not antigravity, extends to noxious and causes rue to flex w/o localization. rue withdraws briskly to noxious, flexor. lle, trace triple flexion to noxious sluggishly, rle flexes briskly to nox applied at lle. rle to nox brisk withdrawal away from stiumuls. -dtrs: diffusely brisk in b/l ues symmetrically as of right now, lle 3+, rle 2+. plantar response: right - flexor left - extensor pertinent results: 141 104 21 164 agap=13 ------------ 04:30am blood wbc-12.1* rbc-3.69* hgb-10.8* hct-32.0* mcv-87 mch-29.3 mchc-33.9 rdw-13.0 plt ct-413 05:20am blood wbc-15.6* rbc-3.95* hgb-11.7* hct-34.3* mcv-87 mch-29.6 mchc-34.1 rdw-13.0 plt ct-370 06:20am blood wbc-11.1* rbc-3.85* hgb-11.1* hct-33.2* mcv-86 mch-28.7 mchc-33.3 rdw-12.8 plt ct-302 06:00am blood wbc-10.9 rbc-3.43* hgb-10.1* hct-29.8* mcv-87 mch-29.4 mchc-33.8 rdw-12.8 plt ct-291 04:30am blood wbc-10.8 rbc-3.39* hgb-10.0* hct-29.4* mcv-87 mch-29.6 mchc-34.1 rdw-12.8 plt ct-252 02:07am blood wbc-14.2* rbc-3.57* hgb-10.3* hct-30.1* mcv-84 mch-28.7 mchc-34.1 rdw-12.7 plt ct-243 02:27am blood wbc-13.1* rbc-3.70* hgb-10.3* hct-31.0* mcv-84 mch-27.9 mchc-33.2 rdw-12.7 plt ct-223 02:10am blood wbc-15.7* rbc-3.44* hgb-9.5* hct-29.2* mcv-85 mch-27.7 mchc-32.5 rdw-12.9 plt ct-185 01:25am blood wbc-16.7* rbc-3.53* hgb-10.2* hct-30.3* mcv-86 mch-28.9 mchc-33.6 rdw-13.0 plt ct-183 02:08pm blood wbc-12.0* rbc-3.72* hgb-11.1* hct-32.5* mcv-87 mch-29.8 mchc-34.2 rdw-12.9 plt ct-212 01:42am blood wbc-15.6* rbc-3.84* hgb-11.5* hct-33.6* mcv-87 mch-29.9 mchc-34.1 rdw-13.0 plt ct-265 06:03am blood wbc-14.9* rbc-4.12* hgb-12.4* hct-36.0* mcv-88 mch-30.1 mchc-34.4 rdw-12.9 plt ct-267 11:30pm blood wbc-15.5* rbc-4.50* hgb-12.9* hct-38.8* mcv-86 mch-28.7 mchc-33.2 rdw-12.8 plt ct-210 coags 04:30am blood plt smr-normal plt ct-413 05:20am blood plt smr-normal plt ct-370 06:20am blood plt smr-normal plt ct-302 01:42am blood plt ct-265 chem 7 04:30am blood glucose-138* urean-25* creat-0.8 na-131* k-4.3 cl-97 hco3-26 angap-12 05:20am blood glucose-54* urean-24* creat-0.7 na-136 k-4.2 cl-99 hco3-25 angap-16 06:20am blood glucose-161* urean-21* creat-0.8 na-136 k-4.2 cl-99 hco3-26 angap-15 06:00am blood glucose-260* urean-22* creat-0.7 na-132* k-4.3 cl-97 hco3-27 angap-12 04:30am blood glucose-176* urean-20 creat-0.8 na-135 k-4.2 cl-100 hco3-29 angap-10 02:07am blood glucose-116* urean-20 creat-0.7 na-137 k-4.0 cl-103 hco3-26 angap-12 02:10am blood glucose-163* urean-21* creat-0.9 na-139 k-3.9 cl-105 hco3-26 angap-12 02:20am blood glucose-195* urean-20 creat-0.8 na-139 k-3.8 cl-105 hco3-24 angap-14 06:03am blood glucose-186* urean-19 creat-1.0 na-137 k-4.5 cl-103 hco3-26 angap-13 02:18pm blood ck(cpk)-102 02:18pm blood ck-mb-2 ctropnt-<0.01 06:03am blood ck-mb-2 ctropnt-<0.01 11:30pm blood ctropnt-<0.01 04:30am blood calcium-8.2* phos-4.0 mg-2.2 05:20am blood calcium-8.0* phos-4.5 mg-2.3 06:20am blood calcium-8.1* phos-3.7 mg-2.1 06:00am blood calcium-7.8* phos-2.7 mg-2.0 cholest-114 04:30am blood calcium-7.7* phos-3.8 mg-2.1 02:07am blood calcium-7.9* phos-3.9 mg-2.0 02:27am blood calcium-7.9* phos-3.5 mg-2.0 02:10am blood calcium-7.9* phos-2.9 mg-1.8 01:25am blood calcium-7.5* phos-2.0* mg-2.1 02:20am blood calcium-8.1* phos-1.5* mg-1.6 01:42am blood calcium-8.0* phos-2.1* mg-2.2 06:03am blood calcium-8.3* phos-3.0 mg-1.8 06:00am blood %hba1c-7.4* eag-166* 01:59pm urine blood-neg nitrite-neg protein-25 glucose-neg ketone-tr bilirub-neg urobiln-4* ph-7.0 leuks-neg 02:08pm urine blood-sm nitrite-neg protein-100 glucose-1000 ketone-15 bilirub-neg urobiln-1 ph-5.5 leuks-neg 01:39am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-6.5 leuks-neg 01:59pm urine rbc-0-2 wbc-0-2 bacteri-few yeast-none epi-0-2 02:08pm urine rbc-* wbc-* bacteri-few yeast-none epi-0-2 01:39am urine bnzodzp-pos barbitr-neg opiates-neg cocaine-neg amphetm-neg mthdone-neg radiologic data: ct from osh 2130 reveals a 4.5 x 3.9 x 5.0 cm r frontal hemorrhage in mca/aca territory, w/ sah in frontal lobes w/ mild masse effect on r frontal w/o ivh. ct head and cta c- head: large right frontal parenchymal hemorrhage w/ subarachnoid blood similar to prior study. new/increased left hemispheric sah (2:22, 2:18). mass effect on right lateral ventricle. 2mm leftward shift of midline structures. new intraventricular hemorrhage right > left lateral ventricles. cta: patent carotid, vertebral arteries, patent circle of . no aneurysm identified mri +/- ; impression: redemonstration of a large right frontal intraparenchymatous hematoma as described in detail above, causing effacement of the sulci, and mild midline shifting towards the left, approximately 2.9 mm of shifting is demonstrated in the transverse projection. after the administration of gadolinium contrast, there is evidence of prominent arterial and venous vessels surrounding the inferior aspect of the hemorrhage with a prominent single vessel coursing along the lateral aspect of the hematoma and slightly increased flow voids in this area, the possibility of an underlying vascular malformation cannot be completely excluded, other entities occult by the hematoma are also considerations, followup is recommended. no significant areas with magnetic susceptibility are identified to suggest amyloid angiopathy, however, this entity cannot be completely ruled out. cerebral angiogram findings: left common carotid arteriogram showed normal carotid bifurcation. normal filling of the internal carotid along the cervical, petrous, cavernous and supraclinoid portions. both anterior and middle cerebral arteries were seen and appeared normal. there was no aneurysm or arteriovenous malformation seen. there was normal venous phase of the study. the external carotid artery with its branches were normal with no dural avf. right common carotid arteriogram showed some atherosclerotic changes in the common carotid and proximal internal carotid with no significant stenosis. there was normal filling of the internal carotid along the cervical, petrous, cavernous and supraclinoid portions. there was some displacement of intracranial vessels due to mass effect from the right frontal bleed with area of reduced vascularity representing the area of intracerebral hemorrhage. there was early bifurcation of the right middle cerebral artery. the anterior cerebral artery was seen and appeared normal. there was no aneurysm or arteriovenous malformation. the venous phase of the study was normal with prominent superficial cortical veins. right external carotid artery showed normal filling of the vessel and its branches with no evidence of dural av fistula. left vertebral arteriogram showed normal filling of the dominant distal vertebral artery. basilar appears normal in course and caliber. the left pica, both aicas, scas and pcas were seen and appeared normal. the right pca appears smaller than the left pca. there was no aneurysm or arteriovenous malformation. impression: diagnostic cerebral angiogram was done, which did not show any aneurysm, arteriovenous malformation, or dural av fistula to account for the patient's intracerebral hemorrhage. cxr findings: as compared to the previous examination, there is no relevant change. the dobbhoff tube is in unchanged position, with the tip projecting over the distal part of the stomach. the course and position of the left-sided central venous access line is also unchanged. unchanged size of the cardiac silhouette with mild retrocardiac atelectasis. no newly appeared focal parenchymal opacities cxr impression: improving left lower lobe pneumonia. ct head impression: 1. no significant change in the previously noted right frontal hematoma with surrounding edema and mass effect on the right lateral ventricle with 3.4 mm leftward shift of the midline structures. no new acute intracranial hemorrhage. no acute fracture. 2. small amount of fluid/mucosal thickening in the left side of the sphenoid sinus. ct torso (prelim) chest: small left effusion w/ relaxation atelectasis. right base atelectasis. no pulm nodule or mass. no consolidation. small scattered nodes but no mediastinal or hilar adenopathy by size criteria. dobhoff reaches stomach. airways widely patent. abd/pelv: no evidence of malignancy. liver, spleen, kidneys, adrenals and pancreas appear normal. min biliary studge. msall and large bowel normal in caliber and appearance. air in bladder, correlate with catheterization. atherosclerosis without aneurysm eeg pending brief hospital course: hospital course by problem; . neurology; the patient was admitted to the neurology icu for q1h neurochecks. his sbp was maintained 100-160 mmhg and hob greater than 30 degrees. he was started on keppra 500 mg for seizure prophylaxis. serial ct head imaging remained stable. an mri brain was concerning for possible avm, but subsequent conventional angiogram did not show any evidence of vascular malformation. the most likely cause of bleed is either hypertension or amyloid angiopathy. he was noted to be drowsy with fluctuating lvel of consciousness while in the hospital. he underwent mri for evaluation followed by ct torso to rule out underlying mass , both of which did not show any evidence of underlying mass/ malignancy. he had unwitnessed fall on in the afternoon, after which he had ct scan which did not show evidence of change in size of bleed or new bleed. he was initially started on keppra which was later stopped as he developed rash. he underwent eeg which was normal . resp; the patient required intubation for airway protection but was extubated without difficulty. he was noted to have left lower zone infiltrate on chest xary and was started on broad spectrum antibiotics (cipro and vanco). after transfer to floor, he was noted to have rising wbc on and , however he did not have fever. the trend was closely monitered and it showed downward trend on . . id; the patient spiked fevers to 103 on and had leukocytosis. blood and urine cultures have been negative to date. one sputum sample grew gram positive rods. cxr showed a possible lll infiltrate. he was started on vancomycin and ciprofloxacin for presumed ventilator-associated pneumonia and antibiotics were stopped after a course of 11 days as he showed clinical and lab signs of resolution and developed skin rash. . cv; the patient required phenylephrine to maintain map > 70 early in the hospital course but has been normotensive since extubation. his home ace-inhibitor has been resumed. . endo; the patient was maintained on a regular insulin sliding scale and nph. his home glyburide has been resumed. derm- he developed rash over left arm followed by anterior abdominal wall and also on legs. the most likely cause is thought to be medication induced, either due to vancomycin, ciprofloxacin or keppra. this should be watched closely in next few days. ot/pt/rehab; he was evaluated by rehab team. he was unable to pass speech and swallow test and was on tube feeds till . it was discussed with family and it was decided to proceed with peg tube for feeding issues. he underwent peg tube on . as his mental status improves, his ability to take pos should be reassessed. ot/pt recommended for extended care facility for further care. medications on admission: - glyburide 5mg - quinipril 5mg daily - metformin 500mg - simvastatin 40mg daily - asa 81 daily discharge medications: 1. white petrolatum-mineral oil 42.5-56.8 % ointment sig: one (1) appl ophthalmic prn (as needed) as needed for eye care. 2. polyvinyl alcohol 1.4 % drops sig: 1-2 drops ophthalmic prn (as needed) as needed for eye care. 3. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 4. glyburide 5 mg tablet sig: one (1) tablet po bid (2 times a day). 5. quinapril 5 mg tablet sig: one (1) tablet po daily (daily). 6. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day) as needed for constipation. 7. acetaminophen 325 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for temp > 101, pain. 8. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for c. 9. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) units injection tid (3 times a day). 10. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day) as needed for thrush. 11. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical qid (4 times a day) as needed for itching. 12. diphenhydramine hcl 25 mg capsule sig: one (1) capsule po q6h (every 6 hours) as needed for itching. 13. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 14. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: inhalation q6h (every 6 hours) as needed for wheezing. 15. insulin lispro subcutaneous discharge disposition: extended care facility: - discharge diagnosis: right frontal bleed, ? hypertensive in origin discharge condition: mental status: confused - sometimes level of consciousness: lethargic but arousable activity status: out of bed with assistance to chair or wheelchair discharge instructions: you were admitted for evaluation of stroke. you had ct scan of brain as well as mri which showed bleed in right frontal lobe of brain. you were evaluated by neurosurgery and underwent angiogram which did not show evidence of avm or aneurysm. the most likely cause of bleed is thought to be related to hypertension. you were dound to have pneumonia for which you were treated with antibiotics. you were started on medication called keppra for prevention of seizures which was later stopped while in the hospital as you developed rash , most likley to either antibiotics or keppra. you underwent peg tube placement for feeding. you underwent ct scan of torso which did not show evidence of mass. you underwent eeg which showed ... please take your medications as prescribed. please call 911/ your doctor if questions. please follow up with the appointments as scheduled. followup instructions: provider: , md phone: date/time: 2:30 please call , m. pcp's office after discharge for follow up. md procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] arteriography of cerebral arteries diagnoses: unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hyposmolality and/or hyponatremia intracerebral hemorrhage other and unspecified hyperlipidemia dermatitis due to drugs and medicines taken internally ventilator associated pneumonia other and unspecified anticonvulsants causing adverse effects in therapeutic use family history of other cardiovascular diseases other and unspecified anti-infectives causing adverse effects in therapeutic use hemiplegia, unspecified, affecting nondominant side 

Answer: The patient is high likely exposed to