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: right frontal bleed major surgical or invasive procedure: : right-sided frontotemporal craniotomy for frontal lobectomy, evacuation of hematoma, microscopic dissection and duraplasty. : now left sided high frontal evd placement. : 1. tracheostomy. 2. percutaneous endoscopic gastrostomy (peg). history of present illness: 68yo right-handed woman with pmh significant for hypertension, stroke in , vascular dementia, and recent shingles, presents as a transfer from an outside hospital for headache. she reports that she was in her usoh until the morning of presentation, when she awoke with headache at 4:41am. the headache was frontal and sharp. she was found to have a right frontal bleed approximately 3cmx3cm. pt was admitted to the neurology service and followed by serial exams she was acting impulsive but awake, alert and orientated x3, inattentive with some left hand coordination problems. she underwent an mri but was inconclusive due to patient movement. at approximately 0430 this am the rn caring for the patient noticed a spike in bp to 190s followed by decrease mental status, left hemiparesis and left sided neglect. a repeat ct showed enlargement of the right frontal bleed. was on aspirin until two days ago past medical history: stroke, details unknown - approx presumed vascular dementia hypertension shingles 2 weeks prior with lesions on her abdomen and buttocks, now healed social history: denies tobacco and drug use, drinks glasses of wine 3-4x/week family history: father with disease and a series of strokes, daughter with lupus physical exam: vitals: bp 159/99 hr 71 r 17 97% ra heent: ncat, mmm, op clear neck: no bruits cv: rrr, nl s1, s2, no m/r/g chest: cta bilaterally abd: soft, ntnd, bs+, erythematous marks on abd presumably healed vesicles ext: warm and dry awakes to name, hospital, but falls back to sleep easily pupils equal bilaterally gaze is deviated to the right and cannot be overcome. right facial droop face is symmetric. she holds her right arm anti-gravity but the left falls to the bed, flaccid; the left arm has some withdrawal to pain. withdraws bilateral lower extremities right>left ct: right frontal intraparenchymal hemorrhage has markedly increased in size measuring 6.1 x 5.5 cm and extending superiorly towards the vertex. there is surrounding vasogenic edema and increased leftward subfalcine herniation, now measuring 13 mm compared to 8 mm previously. labs: pt: 11.5 ptt: 26.5 inr: 1.0 wbc 10.2 plt 239 crit 40.7 pertinent results: 08:59pm glucose-126* urea n-16 creat-0.7 sodium-137 potassium-3.7 chloride-103 total co2-23 anion gap-15 08:59pm alt(sgpt)-14 ast(sgot)-21 alk phos-45 amylase-28 tot bili-0.6 08:59pm calcium-9.0 phosphate-4.3 magnesium-2.1 08:59pm asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 08:59pm urine bnzodzpn-neg barbitrt-neg opiates-neg cocaine-neg amphetmn-neg mthdone-neg 08:59pm wbc-9.4 rbc-4.03* hgb-13.1 hct-37.3 mcv-93 mch-32.4* mchc-35.0 rdw-14.9 08:59pm neuts-80.5* lymphs-13.3* monos-4.2 eos-1.9 basos-0.2 08:59pm plt count-244 08:59pm pt-12.2 ptt-30.3 inr(pt)-1.0 08:59pm urine blood-sm nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 08:59pm urine rbc-0-2 wbc-<1 bacteria-few yeast-none epi-<1 ct : 1. a large right frontal area of intraparenchymal hemorrhage with surrounding edema and associated minimal mass effect. no other foci of acute hemorrhage identified. differential diagnosis includes hemorrhagic transformation of underlying brain mass or metastasis. other less likely etiologies would include amyloid angiopathy and hemorrhagic conversion of a previous area of infarction. vascular anomalies such as arteriovenous malformations could also be considered. an mri/mra is recommended for further characterization. 2. high-density material located within the sphenoid sinus. differential includes inspissated secretions versus hemorrhage versus fungal infection. clinical correlation is recommended. mr : incomplete study with motion, limited flair images. complete study could not be acquired as patient was unable to continue. right frontal hematoma with surrounding edema is again seen. a repeat study can be obtained with sedation. ct : after the right frontal craniotomy and partial evacuation of the right intraparenchymal hematoma, there has been moderate improvement in the mass effect, with an improvement in the shift of normally midline structures. there are post-surgical changes with an air-fluid level located anterior to the right frontal lobe and a small extraaxial fluid collection seen overlying the right cerebral convexity. mr/mra : 1. compared to the prior study, there has been a slight increase in the size of the right frontal intraparenchymal hemorrhage, with associated subfalcine herniation. 2. there has been interval development of marked intraventricular extension of hemorrhage and associated hydrocephalus. 3. there is no definite evidence of aneurysm or av malformation. there is no definite evidence of underlying tumor, there is prominent enhancment along the margins of the hematoma which may be related to the acute hematoma, less likely this could be neoplastic leptomeningeal enhancement. 4. medial to the area of the right superior frontal intraparenchymal hemorrhage, there is an area of increased diffusion-weighted image signal in the parasagittal white matter. however, adc maps are not available to confirm whether this may represent an acute infarct. ct : 1. marked increased in size of right frontal intraparenchymal hemorrhage with 13 mm leftward subfalcine herniation and mass effect on the lateral ventricles and suprasellar cistern. pathology : acute-subacute hematoma and secondary ischemic necrosis of nearby neurons.arteriolosclerosis, indicative of hypertensive cerebrovascular angiopathy.rigid, eosinophilic superficial cortical and leptomeningeal small arteries and arterioles, consistent with congophilic amyloid angiopathy.scattered neocortical amyloid plaques and neurofibrillary tangles, commensurate with alzheimer's disease. ct : 1. since prior study, there has been an interval decrease in the degree of mass effect with mild decrease in the blood and pneumocephalus seen within the operative bed. 2. mild decrease in the amount of intraventricular blood. 3. the right intraparenchymal hematoma and the small amount of subarachnoid hemorrhage are stable compared to prior examinatio n. ct : 1. mild interval increase in size of right extra-axial low attenuation fluid collection. 2. no change in right intraparenchymal hematoma and small amount of subarachnoid hemorrhage. 3. stable hydrocephalus and layering blood within the posterior horns of the lateral ventricles ct : 1. compared to prior study, there has been interval placement of a ventriculostomy catheter with tip within the left frontal . 2. there has been no significant interval change in the size of the intraparenchymal, subarachnoid, and intraventricular hemorrhages. 3. there is minimal increase in the size of the lateral ventricles compared to prior examination. map/dvt (): no evidence for dvt with the right or left lower extremity ct : 1. no significant change in the size of the intraparenchymal and subarachnoid hemorrhage. minimal decrease in the size of the intraventricular hemorrhage. 2. no new areas of hemorrhage. 3. unchanged appearance of the ventricular catheter and the size of the ventricles. 4. increased opacification of the sphenoid sinus, especially on the right side. ct : 1. no significant change in the size of the intraparenchymal and subarachnoid hemorrhage. minimal decrease in the size of the intraventricular hemorrhage. 2. no new areas of hemorrhage. 3. unchanged appearance of the ventricular catheter and the size of the ventricles. 4. increased opacification of the sphenoid sinus, especially on the right side. ct : 1. compared to the prior study from , the ventricular system appears stable. 2. there is a stable appearance of the right frontal intraparenchymal hemorrhage as well as the subarachnoid hemorrhage. 3. there is a slight decrease in the hemorrhage layering within the lateral ventricles bilaterally. 4. there are no new foci of hemorrhage. ct : 1. the position of the ventriculostomy catheter is stable. the ventricular system also appears stable. 2. there is stable appearance of the right frontal intraparenchymal hemorrhage, the subarachnoid hemorrhage, and the intraventricular hemorrhage. there are no new foci of hemorrhage. there is a small focus of pneumocephalus in the right frontal region. ct : 1. there has been interval removal of the left ventricular drain. there is no air in bilateral lateral ventricles. otherwise, the sizes of the ventricles are unchanged from the prior study. 2. there is stable appearance of the right frontal lobe intraparenchymal hemorrhage, subarachnoid hemorrhage, and intraventricular hemorrhage. there is no evidence of new hemorrhage or mass effect. ct : 1. there has been interval development of new hemorrhage in the precentral gyrus along the motor cortex. there is no change in the slight leftward shift of normally midline structures. 2. patient is status post removal of the left ventricular drain. there continues to be air in the lateral ventricles but less than the prior study. the size of the ventricles is unchanged compared with the prior study. 3. the appearance of the prior right frontal lobe intraparenchymal hemorrhage, subarachnoid hemorrhage, and intraventricular hemorrhage are unchanged from the prior exam. ct : overall there has been no significant interval change. no new hemorrhage is identified. there is stable appearance of the right frontal lobe hemorrhage as well as of the hemorrhage along the _____ cortex on the right side. no change in the slight leftward shift of the normally midline structures. decreased amount of air within the lateral ventricles. stable appearance of the intraventricular hemorrhage. ct : final report pending, ct stable brief hospital course: the patient was transferred from an osh after presenting with a headache, and was found to have a right frontal hemorrhage on a ct. she was sent to the er for further evaluation and care. the patient was evaluated by neurology as well as neurosurgery; she was admitted to neurology for further investigation, and the differential includedamyloid, sinus venous thrombosis, hypertensive hemorrhagiv stroke, metastatic lesion, and vascular anomaly. further imaging was suggested, including ct, mr/mra, as well as keppra for seizure prophylaxis, mannitol and nicardipine for blood pressure control < 160. the patient was intubated to protect her airway, sent to the neuro icu, and kept npo for possible resection. on , the patient was taken tot he operating room for a right craniectomy for a right-sided frontotemporal craniotomy, for frontal lobectomy, evacuation of hematoma, microscopic dissection and duraplasty. on , her decadron dosage was decreased to 4 mg , and a ct of the head was stable. also, the mri/mra was negative for aneurysm, avm, or masses. on the first of , the decadron wean was continued, and serial cts were followed; her ventricles were increased in size on the first. pathological results returned as amyloid angiopathy. on the second day of , a left sided high frontal evd was placed intraoperatively, with a stable post-operative ct. a sputum culture revealed gram positive cocci in pairs, chains, and clusters (subsequently noted to be haemophilus ingluenzae, beta lactamase negative), and vancomycin as well as ampicillin were started for tracheobronchitis; the patient was pan-cultured as she was febrile overnight. her csf had 40 wbcs, rbcs, however the final culture had no growth. the infectious disease team was involved for management of antibiotics, and infectious evaluation. serial blood cultures were obtained, as well as serial csf cultures. on , the csf smear was negative, with 100wbc:3675rbc 16 polys, 60mp's. persistent fevers were questionable attributed blood in the csf/ventricles rantehr than infectious. on , the patient had negative lenis for dvt , as part of the evaluation for continued fevers, and was restarted on cefazolin, and ampicillin was stopped for h. influenzae coverage as well as for evd coverage. she was also sent to the operating room for a tracheostomy and peg tube placement. mannitol was weaned, and decadron was finally weaned to a stop. though the patient remained febrile at times, her neurologic exam and reactions improved, and the patient appeared brighter. serial blood cultures as well as sputum cultures were routinely followed; c.diff was also sent, which eventually returned as negative. on , a ct showed less ventricular hemorrhage, but still enlarged in size; the patient failed a clamp trial of her evd. on , her drain was clamped. on the tenth of , her antibiotic regimen was changed as per the infectious disease recommendations; ampicillin was stopped, and levofloxacin was started. the ct remained stable, and the patient was prepared for transfer to the stepdown unit from the icu. on , the evd was removed; a subsequent ct revealed slightly larger temporal horns, but the patient's neurological examination remained stable. on , however, the patient was slightly less responsive, and a ct showed continued high right frontal intraparenchymal hemorrahge on and 16. the neurology stroke team made blood pressure recommendations of less than 140 mm hg systolic, and less than 130 mm hg map, and continued keppra for seizure prophylaxis. the bleed was stabilized with no worsening of the patient's condition. during her stay, physical therapy was consulted to evaluate and care for the patient. the patient was discharged to a rehabilitation facility in stable condition, afebrile, having finished a course of multiple antibiotics. medications on admission: senna, colace, lisinopril, donepril, keppra, heparin and escitropram discharge medications: 1. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 3. donepezil 5 mg tablet sig: two (2) tablet po hs (at bedtime). 4. escitalopram 10 mg tablet sig: one (1) tablet po daily (daily). 5. albuterol 90 mcg/actuation aerosol sig: six (6) puff inhalation q6h (every 6 hours) as needed for wheezing. 6. ipratropium bromide 17 mcg/actuation aerosol sig: six (6) puff inhalation qid (4 times a day) as needed for wheezing. 7. oxycodone-acetaminophen 5-325 mg/5 ml solution sig: 5-10 mls po q4h (every 4 hours) as needed. 8. famotidine 20 mg tablet sig: one (1) tablet po q12h (every 12 hours). 9. potassium & sodium phosphates mg packet sig: two (2) packet po daily (daily). 10. acetaminophen 160 mg/5 ml solution sig: po q4h (every 4 hours) as needed for fever. 11. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day) as needed. 12. miconazole nitrate 2 % powder sig: one (1) appl topical qid (4 times a day) as needed. 13. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). 14. metoprolol tartrate 50 mg tablet sig: two (2) tablet po tid (3 times a day). 15. insulin regular human 100 unit/ml solution sig: sliding scale sliding scale injection asdir (as directed). 16. levetiracetam 500 mg tablet sig: three (3) tablet po bid (2 times a day). 17. sodium chloride 0.9% flush 3 ml iv daily:prn peripheral iv - inspect site every shift 18. potassium chloride 20 meq/50 ml piggyback sig: sliding scale intravenous prn (as needed). 19. magnesium sulfate 4 % solution sig: sliding scale injection prn (as needed). 20. fentanyl citrate 50-100 mcg iv q2h:prn 21. calcium gluconate 100 mg/ml (10%) solution sig: sliding scale intravenous asdir (as directed). 22. hydralazine 20 mg iv q6h hold if sbp <120 23. sodium chloride 0.9% flush 3 ml iv daily:prn peripheral iv - inspect site every shift discharge disposition: extended care facility: - discharge diagnosis: amyloid angiopathy discharge condition: stable discharge instructions: ?????? have a family member check your incision daily for signs of infection ?????? take your pain medicine as prescribed ?????? exercise should be limited to walking; no lifting, straining, excessive bending ?????? you may wash your hair only after sutures and/or staples have been removed ?????? you may shower before this time with assistance and use of a shower cap ?????? increase your intake of fluids and fiber as pain medicine (narcotics) can cause constipation ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, ibuprofen etc. ?????? if you have been prescribed an anti-seizure medicine, take it as prescribed and follow up with laboratory blood drawing as ordered ?????? clearance to drive and return to work will be addressed at your post-operative office visit call your surgeon immediately if you experience any of the following: ?????? new onset of tremors or seizures ?????? any confusion or change in mental status ?????? any numbness, tingling, weakness in your extremities ?????? pain or headache that is continually increasing or not relieved by pain medication ?????? any signs of infection at the wound site: redness, swelling, tenderness, drainage ?????? fever greater than or equal to 101?????? f followup instructions: you will need a repeat cerebral angiogram in 6 weeks (around ). please call to arrange this. you will need a non contrast cat scan of the head in 2 weeks. please call to arrange this you have a suture in your head from the ventricular drain site - this needs to be removed on procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain insertion of endotracheal tube enteral infusion of concentrated nutritional substances temporary tracheostomy ventricular shunt to extracranial site nec transfusion of platelets diagnoses: obstructive hydrocephalus unspecified essential hypertension intracerebral hemorrhage compression of brain acute and chronic respiratory failure acute bronchitis alzheimer's disease vascular dementia, uncomplicated cerebral atherosclerosis amyloidosis, unspecified hemophilus influenzae [h. influenzae] infection in conditions classified elsewhere and of unspecified site 

Answer: The patient is high likely exposed to