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: phenytoin attending: chief complaint: headache and collapse major surgical or invasive procedure: craniectomy for subdural evacuation bolt placement by dr cerebral angiogram w/onyx embolization by dr wills ogelsby gastric tube 12 french by in interventional radiology. history of present illness: this is a 65 year old female with a known avm that was diagnosed in . she developed a sudden onset headache around 11:30 pm the day of admission while walking down stairs. she also had left sided weakness and she slowly lowered herself down. she vomited a few times at home and ems was called by her husband. she was taken to an outside facility where she was intubated and transferred to for further care after a head ct that was obtained revealed a large right temporal parietal hemorrhage with midline shift. past medical history: right temp/parietal avm social history: she is married family history: nc physical exam: on admission: gen: wd/wn, comfortable, nad. heent: ncnt neck: supple. lungs: cta bilaterally. cardiac: rrr. s1/s2. abd: soft, nt, bs+ extrem: warm and well-perfused. neuro: mental status: intubated, obtunded, non responsive to verbal and painful stimuli. cranial nerves: i: not tested ii: pupils right 4mm irregular, non reactive, left 2mm non reactive positive corneals positive cough positive gag motor: no withdrawl or flexion with painful stimuli on discharge : the patient is restless in bed, and favors the left side. she is intermittently verbal but not oriented. she moves the right side (arm and leg)and left leg spontaneously/purposfully. the patient moves the left arm is contracted with minimal movement seen by husband at times. the pupils are 3mm with brisj reaction. the right craniectomy incision is clean dry and intact with disolvable sutures in place. the gtube insicion is intact with suture in place pertinent results: head cta : 1. large 4.1 x. 5.2 x 3.0 cm acute right temporoparietal intraparenchymal hemorrhage - likely due to an avm - causing mass effect with sulcal effacement and midline shift to the left by about 1.3 cm, effacement of the right lateral ventricle, early entrapment of the left atrium, effacement of the ambient and basilar cisterns concerning for early transtentorial herniation. 2. 12 mm acute subdural hematoma along the right cerebral hemisphere. no subarachnoid or intraventricular hemorrhage. 3. no large acute territorial infarct. head ct : impression: expected appearance status post hemicraniectomy with 9 mm of leftward shift decreased from 13 mm preoperatively. head ct : 1. stable right frontal/parietal hematoma. 2. s/p endovascular embolization of the right sided avm, with a new evolving infarct in the entire right posterior cerebral artery territory. 3. decreased leftward shift of midline structures. decreased mass effect on right midbrain. 4. increased extraaxial blood along the right hemicraniectomy site. cxr as compared to the previous radiograph, there is increased size of the cardiac silhouette. extensive bilateral diffuse focal parenchymal opacities, left more than right, with a predominantly interstitial pattern. in addition, at the left lung base, subtle kerley b lines are visible. the findings would be suggestive with early interstitial edema or atypical pneumonia. no pleural effusions. no pneumothorax. no other abnormalities. ct head 1. slight interval change in appearance of right frontal/parietal hematoma likely reflects redistribution rather than recurrent hemorrhage. overall volume of hematoma appears stable. 2. radiodense embolic material status post embolization of right avm. unchanged. 3. progressive cytotoxic edema in the entire right posterior cerebral artery distribution, compatible with evolving infarct. 4. mass effect upon the right cerebral hemisphere with diffuse sulcal effacement, and slightly increased leftward midline shift, now measuring 7-8 mm, previously 5 mm. cxr 4/12/11impression: 1. no acute cardiopulmonary process. no pneumonia. 2. resolution of prior vascular congestion. 3. standard positions of the right picc and dobbhoff feeding tube. ct head w/o contrast study date of 9:28 am findings: comparison to the prior study is slightly limited by differences in the position of the patient's head. the previously noted right frontal/parietal parenchymal hematoma appears grossly stable, with stable surrounding edema. radiopaque embolization material is again noted in the region of the known underlying arteriovenous malformation. the extent of brain herniation through the right hemicraniectomy defect appears minimally decreased or stable. small amount of extra-axial hyperdense blood along the hemicraniectomy defect is stable. there is a stable fluid collection in the hemicraniectomy defect, superficial to the blood, with decreased air content compared to the prior exam. an evolving recent infarction in the right posterior cerebral artery territory is again noted. leftward shift of midline structures appears slightly decreased since the prior study, now measuring 7 mm at the level of the septum pellucidum, compared to 9 mm previously; however, the comparison is limited by differences in patient positioning. small amount of subdural blood remains present along the left tentorium. no new intracranial abnormalities are visualized. impression: 1. stable right frontal/parietal hematoma with surrounding edema. 2. evolving recent infarction in the right posterior cerebral artery territory. 3. while comparison to the study is limited by differences in patient positioning, there may be a slight improvement in leftward shift of midline structures and in mild herniation of brain tissue through the right hemicraniectomy defect. chest (portable ap) study date of 4:49 pm dobbhoff is looped in the esophagus and needs to be repositioned. findings were discussed with dr. at 5:20 p.m. on by dr. . cardiac size is top normal. there is mild vascular congestion. there is no pneumothorax or pleural effusion. abdomen (supine only) port study date of 9:31 pm impression: dobbhoff tube terminates in the stomach. eeg study date of findings: abnormality #1: bursts of bifrontal, hz delta frequency slowing were seen, particularly in wakefulness. abnormality #2: an attenuated background was seen involving the right hemisphere, particularly in the posterior quadrant. background: in the most awake-appearing portions of the tracing, particularly on the left side, a moderately well-organized 7.5-8.5 hz background was seen. hyperventilation: could not be performed as the patient was unable to cooperate. intermittent photic stimulation: could not be performed as the test was requested as a portable study. sleep: no normal sleep or wake transitions were seen. ardiac monitor: revealed a generally regular rhythm with average rate of 72 bpm. impression: this is an abnormal recording due to the presence of bursts of bifrontal slowing, and an attenuated background on the right. the first abnormality is indicative of deep midline dysfunction or may be seen in hydrocephalus; the second abnormality can be seen with the presence of a fluid collection between the cortex and electrodes. no evidence of ongoing seizures was seen at the time of this recording. chest (portable ap) study date of 8:41 am impression: 1. repositioning of dobbhoff feeding tube, now coiled within the stomach. 2. no acute cardiopulmonary process. perc g/g-j tube plmt study date of 4:12 pm no report available 05:44am blood wbc-10.4 rbc-3.35* hgb-10.2* hct-30.0* mcv-90 mch-30.5 mchc-34.0 rdw-13.6 plt ct-512* 05:44am blood plt ct-512* 05:44am blood glucose-97 urean-19 creat-0.3* na-145 k-3.9 cl-112* hco3-25 angap-12 05:44am blood calcium-8.8 phos-3.3 mg-2.1 01:55am blood wbc-9.3 rbc-3.94* hgb-12.5 hct-33.9* mcv-86 mch-31.7 mchc-36.8* rdw-13.3 plt ct-297 01:55am blood pt-12.2 ptt-23.4 inr(pt)-1.0 04:38am blood pt-12.4 ptt-24.4 inr(pt)-1.0 01:55am blood glucose-129* urean-12 creat-0.6 na-140 k-3.4 cl-104 hco3-26 angap-13 01:55am blood calcium-8.5 phos-2.7 mg-1.9 08:03am blood osmolal-313* 05:28am blood type-art po2-201* pco2-39 ph-7.38 caltco2-24 base xs--1 intubat-intubated brief hospital course: this is a 65 year old woman who collapsed and was brought to the er. she ahd a ct head which showed a large rigth intraparenchymal hemorrhage. a cta was obtained which showed a r avm and a r sdh with midline shift. she was taken to the or immediately for a r hemicraniectomy and subdural evacuation. an icp bolt was placed at that time. she was then brought to the icu for monitoring. a post-op head ct showed decreased midline shift. later on she went to angio for embolization of the avm. she remained stable in the icu and was extubated on after removal of her icp bolt. a helmet was ordered and arrived on . ms. was transferred to the step down unit on where she remained stable. speech and swallow evaluation on showed that the patient could not have po intake but could reassess with pureeds when more awake. in the morning of the patient was found to not be following commands, her right pupil was 3mm and non reactive. a stat head ct showed increased edema. she she was transferred to the icu for close observation. she remained in the icu through . in the step down unit, she was following commands, moving her right upper and lower extremities spontaneously. it was noted that her left upper extremity was becoming contracted and afo splint was ordered. speech and swallow had been following the patient closely given her overall lethargy and absent swallow initiation they felt she should remain npo and receive a peg. on , the patient pulled out her dop hoff feeding tube and this was replaced. on , an eeg was ordered because there was a question of a possible seizure. the patient exhibited a blank stare for 45 seconds without blink to threat. an eeg was performed that was consistent with bifrontal slowing without evidence of ongoing seizures was seen at the time of the recording. the patient was fluid volume depleated and given a fluid bolus and initiation of ivf. given the possible seizure the decision was made to keep the patient on keppra 1000mg as an ongoing long term medication. on she underwent placement of a wills ogelsby gastric tube in interventional radiology. she also had bilateral lower extremity ultrasound due to right leg pain which was not performed due to the patients legs beeing in constant motion. on , tube feedings were initiated and the goal was to have the tube feedings and intravenous fluids to equal 85cc/hr. on , the patient spoke a few sentences to her husband. she was moving about in the bed and attempting to sit up. opening her eyes to stimulus. the patient's abdomen is soft and non tender. the patients legs were non tender on palpation there was no edema or erythema. the decision was made to cancel the lower extremity ultrasound as the patient was no longer symptomatic. the patent will follow up with dr for a post-operative visit in 4 weeks and for a cerebral angiogram with a non contrast head ct prior. the patient will follow up with interventional radiology for her gastric tube evaluation and possible replacement in 3 months.the patient was discharged to center today. medications on admission: none discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 2. propranolol 10 mg tablet sig: one (1) tablet po tid (3 times a day). 3. miconazole nitrate 2 % powder sig: one (1) appl topical qid (4 times a day) as needed for rash. 4. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 5. senna 8.6 mg capsule sig: one (1) tablet po bid (2 times a day). 6. potassium & sodium phosphates 280-160-250 mg powder in packet sig: one (1) powder in packet po tid (3 times a day): please reevaluate need. moniotr serum potassium and serum phos levels three times a week. 7. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain: do not exceed 4 grams in 24 hours. 8. heparin, porcine (pf) 10 unit/ml syringe sig: one (1) ml intravenous prn (as needed) as needed for line flush. 9. metoclopramide 5 mg/ml solution sig: two (2) injection q6h (every 6 hours). 10. levetiracetam 500 mg/5 ml solution sig: two (2) intravenous (2 times a day): for seizure prophylaxis. 11. famotidine(pf) in (iso-os) 20 mg/50 ml piggyback sig: one (1) intravenous q12h (every 12 hours). 12. hydralazine 20 mg/ml solution sig: 0.5 injection q6h (every 6 hours) as needed for sys > 160: 10 mg iv q 6 hours prn for sbp > 160. discharge disposition: extended care facility: - discharge diagnosis: right subdural hematoma right iph right avm dysphagia discharge condition: mental status: confused - always. level of consciousness: lethargic but arousable, verbal intermittently , moves about in bed, favors her left side. activity status: bedbound/ may get out of bed to the chair with max assist discharge instructions: cerebral angiogram with embolization medications: ?????? continue all other medications you were taking before surgery, unless otherwise directed ?????? you make take tylenol or prescribed pain medications for any post procedure pain or discomfort. you have been prescribed keppra for to prevent seizures. you will not need any levels drawn with this medication. what activities you can and cannot do: ?????? when you go home, you may walk and go up and down stairs. ?????? you may shower (let the soapy water run over groin incision, rinse and pat dry) ?????? your incision may be left uncovered, unless you have small amounts of drainage from the wound, then place a dry dressing or band aid over the area that is draining, as needed ?????? no heavy lifting, pushing or pulling (greater than 5 lbs) for 1 week (to allow groin puncture to heal). ?????? after 1 week, you may resume sexual activity. ?????? after 1 week, gradually increase your activities and distance walked as you can tolerate. ?????? no driving until you are no longer taking pain medications what to report to office: ?????? changes in vision (loss of vision, blurring, double vision, half vision) ?????? slurring of speech or difficulty finding correct words to use ?????? severe headache or worsening headache not controlled by pain medication ?????? a sudden change in the ability to move or use your arm or leg or the ability to feel your arm or leg ?????? trouble swallowing, breathing, or talking ?????? numbness, coldness or pain in lower extremities ?????? temperature greater than 101.5f for 24 hours ?????? new or increased drainage from incision or white, yellow or green drainage from incisions ?????? bleeding from groin puncture site *sudden, severe bleeding or swelling (groin puncture site) lie down, keep leg straight and have someone apply firm pressure to area for 10 minutes. if bleeding stops, call our office. if bleeding does not stop, call 911 for transfer to closest emergency room! please follow up with interventional radiology k physicians assisstant for evaluation and possible change of wills ogelsby 12 french gastric tube in three months. there are three round white plastic discs that will fall off on their own. the suture at the gastric tube site will stay in place until follow up. this patient had a right craniectomy- there is no bone covering the skull on the right side. the patient should not lie on the right side and should always be position on her back or to the left while in bed. when the patient's head of the bed is at 90 degrees or if the patient is very active while in bed or if the patient is out of bed- please have the helmut on at all times. 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, or drainage. ?????? fever greater than or equal to 101?????? f. followup instructions: please follow-up with dr. for a diagnostic angiogram in 4 weeks. you will need pre-operative arrangements prior to your diagnostic cerebral angiogram, these instructions will be given to you at the time you make your appointment.you will also need a follow up head ct without contrast as you will be following up with dr at that time for your right craniectomy. call to make arrangements for this to make this appointment. please follow up with interventional radiology k physicians assisstant for evaluation and possible change of gastric tube. the suture will stay in place until follow up. please call the radiology daycare unit and make an appointment with the physican assistant in 3 months. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified incision of cerebral meninges enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] arteriography of cerebral arteries arterial catheterization other surgical occlusion of vessels, intracranial vessels intracranial pressure monitoring magnetic removal of embedded foreign body from cornea diagnoses: other convulsions subarachnoid hemorrhage compression of brain cerebral edema altered mental status subdural hemorrhage aphasia iatrogenic cerebrovascular infarction or hemorrhage acute edema of lung, unspecified dysphagia, oropharyngeal phase other musculoskeletal symptoms referable to limbs 

Answer: The patient is high likely exposed to