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: right sided weakness and headache major surgical or invasive procedure: peg tube placement endotracheal intubation history of present illness: the pt is a 56 year-old right-handed male with a past medical history of stroke 9 years prior with transient left sided symptoms, htn (and has not been taking medication for months now) who presents after vomiting and right sided weakness, and found at osh to have a left pontine bleed and transferred to . (history obtained from notes/patient's wife) the patient was a passenger in his car and was doing errands with his wife. at one point she turned to him and thought he looked grey. he complained of severe nausea and she pulled over to the side of the road. she then noted a right facial droop and he appeared to be having trouble with his right arm, possibly his right leg. as his wife is rn she thought he may be having a stroke and called ems who picked him up and transported him to . at aj he was noted to be significantly hypertensive, with multiple bps at 260/120s. he had a head ct and was noted to have a left sided pontine hemorrhage. at the time according to notes he was awake and could respond to commands, was not using his right arm and right leg, and had a right facial droop. he could respond to commands with his left side. he was given labetalol for his bp and then transferred to for further eval. here he was initially seen by the ed and neurosurgery team. on initial exam they neurosurgeons felt he was able to say his name, had slurred speech, a right facial droop, they only elicited upgaze. he was able to follow commands with his left arm/leg, and had no movement at the right. he apparently was becoming more sleepy as the interview progressed and he was sent to the ct scanner. the ct demonstrated a stable bleed, with slightly more edema than on the prior scan. on return from the scanner the patient was even more somnolent and he was intubated and sedated out of concern for protecting his airway. neurosurgery at this point recommended no surgical intervention and neurology was called to evaluate the patient. of note per his wife the patient has long standing hypertension however as he has been unemployed for some time and does not have health insurance. he has not taken any of his antihypertensive medications for many months now. on neuro ros and gros largely unavailable, prior to presentation the patient had nausea, clear dysarthria and weakness as described above. per wife no recent fevers, no recent weight loss or gain. no cough, shortness of breath. no recent change in bowel or bladder habits. past medical history: - htn - history of old stroke with ? left sided symptoms (?numbness) 9 years prior - pseudogout social history: lives with wife and has adult children. currently unemployed, has been out of work for some time, currently without insurance and as a result has not been taking his medication. occ etoh, no tob, no drugs wife hcp: mother: family history: mother with stroke, multiple family members with cad and htn physical exam: admission vitals: t: 98.2 p:70 r: 16 bp: 173/123 -> 128/92 sao2: 100 general: intubated, sedated, heent: nc/at, no scleral icterus noted, mmm, no lesions noted in oropharynx, intubated neck: supple, no carotid bruits appreciated. no nuchal rigidity pulmonary: mechanical breath sounds b/l cardiac: rrr, nl. s1s2, no m/r/g abdomen: soft, nt/nd, normoactive bowel sounds extremities: no c/c/e bilaterally, 2+ radial, dp pulses bilaterally. skin: no rashes or lesions noted. neurologic: -mental status: asleep and sedated, grimaces to pain but will not open eyes, does not follow commands, allowed ~30 minutes off sedation and began to buck and fight vent so patient was re sedated -cranial nerves: i: olfaction not tested. ii: perrl right 3.5->2 , left 3mm->2mm, does not blink to threat. iii, iv, vi: can get vertical dolls, can't get horizontal in either direction v, vii: corneal's intact bilaterally ix, x: gags and coughs -motor: right upper ext: no withdrawal to nox stim r leg: triple flexes lue: occ spontaneous movements but does not withdraw to stim lle: makes purposeful movements with leg -sensory: withdraws to nox at le b/l, not reliably in either arm -dtrs: tri pat ach l 2 2 2 2 1 r 2 2 2 2 1 plantar response was mute bilaterally clonus 5-7 beats in right leg, none in left discharge gen: nad, lying comfortably in bed heent: atraumatic, bearded cv: rrr, no murmurs pulm: ctabl abd: peg in place c/d/i ext: no edema neuro: ms: alert, oriented to , , language dysarthric but fluent, no paraphasia cn: l eye fixed in midposition, r eye can abduct but not adduct motor: r arm was anti-gravity; l arm had d b t fe r leg anti-gravity; l leg ip q h ta sensory: no gross deficits coordination: unable to test due to weakness reflexes: more brisk on right side gait: unable to assess pertinent results: ct (head) 1) acute hemorrhage within the pons, extending into the left middle cerebellar peduncle with possible slight interval increase in the posterior component within the pons as compared with exam performed 2 1/2 hours prior. remainder of the exam is stable. 2) diffuse bilateral periventricular white matter hypodensity is notable in a patient of this age. findings are non-specific, and while could relate tovchronic small vessel disease, although other etiologies such as demylenating/inflammatory processes are not excluded. findings could be further evaluated on mri, if no clinical contraindication. video swallow: penetration with thickened honey consistencies. silent aspiration due to oral residue. brief hospital course: hospital course: neurologic: he was first seen by the neurosurgery service who noted that he was able to say his name and follow simple commands with the left hand and leg. no movement at the right arm/leg. per their exam he had upgaze, but difficulty with lateral eye movements. he apparently was getting more somnolent and was sent to the scanner, which showed the pontine bleed with some slightly worse edema. on return from the scanner he continued to be somnolent and was intubated by the ed team out of concern for airway protection. when taken off sedation he will grimace to noxious stimulation but will not open his eyes. he has intact corneals, gag present, reactive pupils, has vertical vor, but cannot get horizontal. no movement at the right arm, triple flexes right leg, spontaneous movements of left leg, and purposeful withdrawal. occasional spontaneous movements of left arm, but no withdrawal to stimulation. given his recent non-compliance with his anti-htn medications, and elevated pressures, this is likely a hypertensive bleed. patient was admitted to the icu for further management. follow up head ct on - stable left pontine hemorrhage extending into the left middle cerebellar peduncle, with stable mild surrounding edema and mild effacement of the fourth ventricle. unchanged extensive supratentorial white matter hypoattenuation, notable for the patient's age, which could indicate advanced chronic small vessel disease. patient was extubated on and has been doing well since that time. he was transferred to the floor. he was unable to pass his speech and swallow exam and received a peg tube by surgery on . the tube feeds were started without complication. cardiovascular: patient was initially started on labetalol gtt for a goal sbp 140-160 using an aline. after extubation he was switched off the gtt and started on amlodipine with prn hydralazine as needed for control of his bp. he was restarted on a home regimen of antihypertensives with good blood pressure control. 1. hydrochlorothiazide 25 mg gt daily 2. lisinopril 20 mg gt daily 3. atenolol 50 mg gt daily 4. amlodipine 10 mg gt daily gastrointestinal / abdomen: - was initially npo while intubated. after extubation the patient was evaluated by speech and swallow and required a peg tube. endocrine: - riss to keep blood sugars low fluids: ns @ 100 ml/hr prophylaxis: dvt: boots /stress ulcer: famotidine medications on admission: - not currently taking any of his prescribed medications discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for fever. 2. docusate sodium 50 mg/5 ml liquid sig: ten (10) ml po bid (2 times a day). 3. heparin (porcine) 5,000 unit/ml solution sig: one (1) ml injection tid (3 times a day). 4. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 5. multivitamin tablet sig: one (1) tablet po daily (daily). 6. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 7. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 8. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 9. atenolol 50 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 10. lisinopril 20 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 11. hydrochlorothiazide 12.5 mg capsule sig: two (2) capsule po qhs (once a day (at bedtime)). 12. verapamil 80 mg tablet sig: one (1) tablet po q8h (every 8 hours). 13. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed for constipation. 14. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. discharge disposition: extended care facility: hospital for continuing medical care - ( center) discharge diagnosis: pontine hemorrhage discharge condition: mental status: confused - sometimes. very dysrathric, but fluent. level of consciousness: lethargic but arousable. activity status: bedbound. discharge instructions: you were admitted to the neurology service after you became weak on the right side of your body and had a headache. you were found on ct to have a pontine hemorrhage. on examination you were inititally minimally arousable and you were intubated for airway protection and cared for in the neuro-icu. you were extubated and transferred to the neuro stepdown unit once your blood pressure was adequately controlled. you did not pass speech and swallow and required a peg tube for enteral nutrition. physical therapy saw you and felt that you would benefit from an acute rehab. you will need to have an mri prior to your follow-up with dr. . one has been scheduled for you on . you will follow-up with dr. in neurology clinic on you were started on several medications to adequately control your blood pressure. they are listed below. 1. hydrochlorothiazide 25 mg gt daily 2. lisinopril 20 mg gt daily 3. atenolol 50 mg gt daily 4. amlodipine 10 mg gt daily followup instructions: provider: , .d. phone: date/time: 2:30 md, procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] diagnoses: thrombocytopenia, unspecified unspecified essential hypertension acute kidney failure, unspecified intracerebral hemorrhage personal history of noncompliance with medical treatment, presenting hazards to health dysarthria hemiplegia, unspecified, affecting unspecified side facial weakness dysphagia, unspecified 

Answer: The patient is high likely exposed to