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: sudden onset severe headache major surgical or invasive procedure: : cerebral angiogram : placement of vp shunt history of present illness: 74f spanish speaking, with htn, experienced sudden onset severe ha on in r temporal region, but also with some neck discomfort. no trauma. pt apparently had not taken any bp meds that day. ems called and initial sbp 220-248. pt brought to where pt alert and neurologically intact by report. placed on nitroprusside and labetalol gtt. ct revealed sah in basal cisterns b/l. cta performed revealed no obvious aneurysm. past medical history: 1. dm 2. htn social history: resides at home with daughters, denies tobacco use family history: non-contribuitory physical exam: vs: afeb bp130/70 (on admission 220-248/90-119) hr60-80 rr20-22 general: wnwd heent: anicteric, mmm without lesions, op clear neck: supple, no carotid bruits cv: rrr s1s2 no m/r/g resp: ctab no r/w/r abd: +bs soft/nt/nd no hsm/masses ext: no c/c/e, distal pulses intact skin: no rashes, petechiae ms: a&o x 3, interactive, appropriate, following all commands cn: i ?????? not tested, ii,iii ?????? perrl (3-2mm ou), vff by threat; iii,iv,vi ?????? eomi, no ptosis, no nystagmus; v- sensation intact to lt; vii ?????? r facial weakness/asymmetry; viii ?????? hears finger rub b; ix,x ?????? palate elevates symmetrically; ?????? scm/trapezii b; xii ?????? tongue protrudes midline, no atrophy or fasciculations motor: nl bulk and tone, no tremor, rigidity or bradykinesia. no pronator drift. full power throughout ue and le. dtrs: (c56) br (c6) tri (c7) pa (l34) ac (s12) plantar l 2 2 1 1 1 mute r 2 2 1 1 1 mute sensory: w/d to pinch throughout. coord: finger tap rapid & symm, f??????n & fnf intact b. gait: deferred pertinent results: 06:38am blood wbc-15.9* rbc-3.22* hgb-9.8* hct-29.7* mcv-92 mch-30.3 mchc-32.8 rdw-13.4 plt ct-454* 02:47am blood neuts-69.3 lymphs-23.4 monos-6.4 eos-0.7 baso-0.2 06:38am blood glucose-171* urean-13 creat-0.6 na-133 k-3.5 cl-99 hco3-21* angap-17 06:38am blood calcium-8.5 phos-2.8 mg-2.1 03:14am urine color-yellow appear-clear sp -1.016 03:14am urine blood-tr nitrite-neg protein-30 glucose-neg ketone-neg bilirub-neg urobiln-neg ph-7.0 leuks-neg urine culture (final ): no growth. blood culture, routine (final ): no growth. gram stain (final ): 4+ (>10 per 1000x field): polymorphonuclear leukocytes. no microorganisms seen. fluid culture (preliminary): no growth. 12:55 pm blood culture source: venipuncture. blood culture, routine (pending): gram stain (final ): 1+ (<1 per 1000x field): polymorphonuclear leukocytes. no microorganisms seen. fluid culture (preliminary): no growth. cta head w&w/o c & recons 9:52 pm 1. 2-mm outpouching, from the posterolateral aspect of paraclinoid portion of the cavernous segment of the left internal carotid artery, seen on the thick section mip reformations can represent a tiny aneurysm. 2. focal prominence at the termination of the left supraclinoid internal carotid artery likely represents tortuosity, as this is not confirmed on multiple planes. 3. atherosclerotic disease involving the cavernous internal carotid arteries on both sides. 4. extensive subarachnoid hemorrhage with small amount of intraventricular component, as described above, without shift of the midline structures or intraparenchymal hemorrhage. ct head w/o contrast 3:21 am similar appearance of subarachnoid hemorrhage, now with a small amount of intraventricular blood in the occipital of the left lateral ventricle. ct head w/o contrast 9:56 am there is interval placement of the intraventricular drain, with tip in the region of the right foramen of . interval development of small amount of blood in the body of the right lateral ventricle without significant change in the extent of subarachnoid hemorrhage as well as small amount of blood in the left lateral ventricle. cta head w&w/o c & recons 2:16 pm 1. improvement in ventricular size following change in position of the ventricular drain. 2. subarachnoid hemorrhage. 3. no evidence of vasospasm or aneurysm identified on ct angiography. ct head w/o contrast 11:27 am 1. no significant change in the subarachnoid hemorrhage and dependent layering blood within the lateral ventricles. 2. slight increase in size of the ventricular system from . carot/cereb 10:53 am 1. severe vasospasm of the right a1 segment of the anterior cerebral artery. 2. moderate vasospasm of the left p1 segment of the posterior cerebral artery. 3. no aneurysms or arteriovenous malformations. 4. treatment of vasospasm with verapamil. ct head w/o contrast 12:00 pm 1. interval decrease in subarachnoid hemorrhage and hemorrhage within the basal cisterns. 2. no change in the ventricular system compared to . ct head w/o contrast 4:52 pm 1. unchanged appearance of subarachnoid hemorrhage in the sulci and basal cisterns since the prior study five hours ago. 2. unchanged ventricular system compared to the . brief hospital course: patient admitted to from osh for definitive treatment of a sah. on transfer her bp was quite elevated and initial management began in the ed with labetalol and nipride. she was admitted to the icu for close mental status monitoring and blood pressure management. she was also started on nimodipine. she was taken for angiogram on which was negative for aneurysm or vascular malformation. on , she also became more lethargic than her initial presentation. an evd was placed by dr. in the icu, and mental status significantly improved. on erythromycin was started for conjunctivitis. cta on revealed no evidence of vasospasm or aneurysm. the patient failed an evd clamping trial on . on the patient was found to be more lethargic and was febrile to 102.8, blood culture at this time was negative; repeat ct scan demonstrated slightly increased ventricular size. on the patient was started on a dilantin to keppra transition. csf analysis revealed 4+ pmns without microorganisms, culture revealed no growth. on the patient failed a second evd clamping trial, and again failed a third evd clamping trial on . on the patient again underwent angiogram which demonstrated severe vasospasm of the right aca, moderate vasospasm of the left pca, and no aneurysms or avms. verapamil was administered for treatment of the vasospasm. due to multiple failed evd clamping trials, the patient was taken to the or for vp shunt placement on . csf analysis from revealed 1+ pmns and was negative for microorganisms, culture at time of discharge is pending but has had no growth to date. the patient's foley catheter was reinserted on secondary to inability to void. the patient was evaluated by physical therapy and determined to be appropriate for rehabilitation. the patient was discharged to rehabilitation on in stable condition. medications on admission: synthroid 200mcg daily lipitor 80mg daily zetia 10mg daily labetolol 200mg daily citalopram 20mg daily meclizine 25mg daily enalapril 20mg daily tizanidine 2mg insulin lente 35-40units twice daily asa 81mg daily folic acid 800mg daily mvi daily discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 2. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for fever, pain. 3. nimodipine 30 mg capsule sig: two (2) capsule po q4h (every 4 hours): discontinue on (completion of 21 day course). 4. levothyroxine 100 mcg tablet sig: two (2) tablet po daily (daily). 5. labetalol 100 mg tablet sig: one (1) tablet po bid (2 times a day). 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 8. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 9. diphenhydramine hcl 12.5 mg/5 ml elixir sig: one (1) po q6h (every 6 hours) as needed. 10. butalbital-acetaminophen-caff 50-325-40 mg tablet sig: tablets po q6h (every 6 hours) as needed for headache. 11. oxycodone 5 mg tablet sig: one (1) tablet po q4-6h () as needed. 12. levetiracetam 500 mg tablet sig: two (2) tablet po bid (2 times a day). 13. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 14. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 15. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). 16. atorvastatin 80 mg tablet sig: one (1) tablet po hs (at bedtime). 17. hexavitamin tablet sig: one (1) cap po daily (daily). 18. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 19. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). discharge disposition: extended care facility: - discharge diagnosis: subarachnoid hemorrhage discharge condition: stable discharge instructions: general instructions ?????? have a friend/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, or excessive bending. ?????? you may wash your hair only after sutures and/or staples have been removed. ?????? you may shower before this time using a shower cap to cover your head. ?????? increase your intake of fluids and fiber, as narcotic pain medicine can cause constipation. we generally recommend taking an over the counter stool softener, such as docusate (colace) while taking narcotic pain medication. ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, and 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, or drainage. ?????? fever greater than or equal to 101?????? f. followup instructions: follow-up appointment instructions ??????please return to the office in 10 days for removal of your staples or sutures. ??????please call ( to schedule an appointment with dr. , to be seen in 4 weeks. ??????you will need a ct scan of the brain without contrast. procedure: arteriography of cerebral arteries arteriography of cerebral arteries injection or infusion of other therapeutic or prophylactic substance ventricular shunt to abdominal cavity and organs ventricular shunt to extracranial site nec diagnoses: unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled subarachnoid hemorrhage hypopotassemia retention of urine, unspecified unspecified transient cerebral ischemia communicating hydrocephalus acute conjunctivitis, unspecified 

Answer: The patient is high likely exposed to