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: dilantin attending: chief complaint: htn after neurosurgical procedure, agitation major surgical or invasive procedure: none history of present illness: of note, mr. is alert and oriented times person only and thus is a poor historian. history obtained from records. mr. is a 63-year-old gentleman recently admitted from to to the neurosurgical service due to rupture of an anterior communicating artery aneurysm requiring coiling, complicated by hydrocephalus, seizures, and aspiration pna, now with trach collar and peg. on , he had been transferred to and presented to from there overnight due to headache, agitation, and hypertension. . patient was discharged from neurosurgical service on to an extended care facility. according to notes from facility, patient was progressively htn with bps in the 170s/100s and complained of persistent headache. he was given dilaudid for headache and hydralazine for htn. transfer to apparently for concern for acute pathology in context of recent neurosurgical intervention. . upon arrival to ed, initial vitals were: 97.8 64 150/92 22 100% 15l trach mask. patient was found to be agitated, a&o x1. he was given zyprexa 2.5mg and hyralazine 10mg iv x1 for an elevated blood pressure. per report, ct head was unchanged from post-vp shunt images. neurosurgery was consulted, who felt that patient's issues did not necessitate neurosurgical intervention. thus, patient was was admitted to medicine for delirium/agitation work-up. upon transfer, vitals were: 159/84, 65, 18, 96% on ra. past medical history: : sah from acomm rupture complicated by hydrocephalus, seizure ivc filter for lower extremity dvt ventriculo peritoneal shunt palcement trach/peg aspiration pna treated with vanc/zosyn htn hypercholesterol foot surgery acute on chronic sdh evacuation in social history: etoh per day, no tobacco, unemployed family history: no h/o aneurysm physical exam: o: t: 97.5, bp: 185/108 hr:88 rr 22 o2sats 94% ra general: deconditioned, comfortable, nad. heent: vp shunt site c/d/i. mm are dry. pupils: perrla eoms full neck: supple, no meningismus, trach collar is c/d/i with minimal secretions cardiovascular: rrr, soft midsystolic murmur at the rusb, non-radiating. abd: nondistended, soft, nttp, normoactive bowel sounds, subumbilical shunt c/d/i, no erythema or masses. neuro: mental status: alert and oriented times one, to person only. his speech is altered due to his trach collar, which does not have passe muir valve. cn: eomi, perrl, facial sensation is in tact, motor: decreased bulk bilaterally. no abnormal movements, tremors. no pronator drift. grips are full strength. lower extremities are antigravity and symmetric. cooperative, follows commands. hand grip is bilaterally. he is able to lift both feet of the bed bilaterally when flexing at the hip. he is moving all of his extremities. he was sleeping, but awakened easily when i called his name. unable to assess coordination, gait because he was uncooperative. babinski is negative bilaterally. pertinent results: admission: 12:10am glucose-86 urea n-25* creat-0.8 sodium-141 potassium-3.9 chloride-107 total co2-31 anion gap-7* 12:10am alt(sgpt)-45* ast(sgot)-30 alk phos-285* tot bili-0.4 12:10am lipase-88* 12:10am vit b12-1423* folate-16.0 12:10am tsh-5.4* 12:10am wbc-7.2 rbc-2.72* hgb-8.8* hct-25.6* mcv-94 mch-32.2* mchc-34.2 rdw-15.1 12:10am neuts-65.0 lymphs-25.1 monos-5.9 eos-3.1 basos-1.0 12:10am plt count-228 12:10am pt-12.8 ptt-37.8* inr(pt)-1.1 12:10am urine color-yellow appear-clear sp -1.011 12:10am urine blood-neg nitrite-neg protein-25 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-7.0 leuk-neg 12:10am urine rbc-0 wbc-0-2 bacteria-none yeast-none epi-<1 . discharge: 08:03am blood wbc-5.7 rbc-2.94* hgb-9.4* hct-28.4* mcv-97 mch-32.1* mchc-33.3 rdw-15.7* plt ct-228 08:03am blood glucose-103* urean-28* creat-1.0 na-146* k-3.8 cl-107 hco3-34* angap-9 . imaging: mra head : . ct head no contrast : findings: previously seen subarachnoid hemorrhage at the vertex and intraventricular hemorrhage in the occipital horns has resolved. a right frontal approach intraventricular shunt catheter is seen, ending in unchanged position at the right foramen of . the ventricles are only minimally dilated and unchanged from . no large acute territorial infarction. the -white matter differentiation is well preserved. there is a hypoattenuating lesion at the right globus pallidus, likely lacunar infarct. the paranasal sinuses are clear and well aerated. mild opacification of the right mastoid air cells. left mastoid air cells are clear. no fracture. impression: resolved intracranial hemorrhage. . cxr pa lat : findings: re-demonstrated are calcified mediastinal and hilar lymph nodes, stable since as well as a left mid lung zone granuloma. there are right lower lobe opacities, new compared to and , representing atelectasis or pneumonia. large aortic arch and descending aorta, unchanged. no large pleural effusion and no pneumothorax. a left subclavian line ends at the mid svc. tracheostomy tube ends 4.3 cm above the carina. a ventriculoperitoneal shunt and g tube are seen. impression: slightly worsened right lower lobe opacities might likely represents pneumonia, much less likely atelectasis. . cxr port : ap chest compared to through , there has been no appreciable change since . given elevation of the right lung base, opacification in the right lower lobe is as likely to be atelectasis as pneumonia. left lower lobe and the remainder of the lungs clear. moderate-to-severe cardiomegaly stable, but increased since . tracheostomy tube in standard placement. the vp shunt catheter is traceable over the upper chest, but indistinct in the abdomen. tracheostomy tube in standard placement. no pneumothorax. . microbiology: cvc tip cx negative blood cx negative to date blood cx negative to date brief hospital course: assessment/plan: mr. is a 63-year-old gentleman with a pmhx significant for recent acomm aneurysmal rupture () s/p neurosurgical intervention with multiple complications including vp shunt placement, aspiration pneumonia, and failure to wean from vent (now with trach collar and peg) admitted from rehab with headache, hypertension, and agitation. . . # hyperactive delirium: mr. continued to sun-down and become agitated in the evenings. he was confused with wax and . he was usually alert and oriented to person only, but was able to say the year occasionally. he has no recollection of the events during the last month (i.e. ich). the etiology of the delirium was thought secondarily to ich, resolving pneumonia and possibly benzodiacepine use. infection was ruled out with ct of the head, neurosurgery evaluation of the vp shunt, serial blood cultures, ua, chest x-ray and urine culture. electrolytes were within normal range and normal renal function. patient was moving bowels approximately every other day and had good urine output. patient was admitted with a right subclavian line, which was erythematous in the insertion site in the skin. it was removed and culture was negative. patient was afebrile during the stay. a geriatrics consultation was obtained for management of delirium. his medications were minimized. his tethers were minimized. a one on one sitter was maintained at all times. olanzapine was initiated and titrated to a dose of 5mg qam and qhs given at 8pm. for acute agitation he recieved olanzapine 2.5mg po q6hrs prn and haldol 1mg iv daily prn for refractory agitation. he was reoriented. his lab draws were minimized. a bowel regimen was maintained. soft restraints were utilized when indicated. we are trying to minimize waking him up at night try to normalize his day-night cycle. . #h/o right lower ext and bilateral upper ext dvt diagnosed on : an mra brain was done on the evening of , which ensured that the anterior communicating artery aneurism was obliterated by coiling given that we were considering full anticoagualtion. the final read is pending and will have to be followed up. the decision was made to anticoagulate with coumadin 5mg daily for a therapeutic inr of . anticoagulation will have to continue for at least 3 months (without a bridge) from the date that he becomes therapeutic. we will contact the rehab facility to relay any changes in this plan. . # hypertension: on admission, mr. systolic blood pressures were in the 160-170 range. hydralazine was given in spot doses during hospital days one and two. his metoprolol was uptitrated. amlodipine and captopril were added to his regimen. his systolic blood pressures on discharged were in 130 range. captopril can be increased as needed. target bp <140/90 mmhg. . # h/o pneumonia: during his last admission ending on , mr. was discharged on vanc/zosyn. appears as though antibiotics were started on . a 10-day course would have finished on . since mr. remained afebrile, asymptomatic, and without leukocytosis, antibiotics were not administered during this admission. . # headache: resolved on hospital day 2 without intervention. a neurosurgical consult was obtained upon admission. as per neurosurgical consult, there was no change from prior physical exam and no concern for urgent neurosurgical intervention. a ct head showed no acute process and resolution of his previous sah. the patient remained afebrile and without leukocytosis and a lumbar puncture was not done. the vp shunt was functioning properly per neurosurgery. . # fen: no ivf, replete electrolytes, tube feeds per nutrition consultation included: tubefeeding: fibersource hn full strength; starting rate: 70 ml/hr; do not advance rate goal rate: 70 ml/hr residual check: q4h hold feeding for residual >= : 200 ml flush w/ 100 ml water q4h other instructions: please bolus free water 250cc q 6hrs. thankyou . # prophylaxis: subcutaneous heparin, no indication for ppi, bowel regimen. . # access: peripherals # code: full code # communication: hcp (wife) medications on admission: colace 100mg erythromycin opt ont .5% ou qid heparin 5000 sq tid lansoprazole 30mg ngt daily levetiracetam 1000mg pgt metoprolol 37.5mg pgt senna prn trazodone 50mg qhs at 2100 multi-vitamin acetaminophen 650 q6hr prn bisacodyl 10mg prn hydralazine 10mg pgt q6hrs prn sbp>160 hydromorphone 2mg pgt q6hrs prn lorazepam .5mg pgt qid prn ondansetron 4mg iv q8hrs prn trazodone 50mg q4hrs prn at night only for insomnia zyprexa 2.5mg po prn agitation (spot dosing) discharge medications: 1. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 2. levetiracetam 500 mg tablet : two (2) tablet po bid (2 times a day). 3. docusate sodium 50 mg/5 ml liquid : one (1) po bid (2 times a day). 4. captopril 12.5 mg tablet : two (2) tablet po tid (3 times a day). 5. amlodipine 5 mg tablet : two (2) tablet po daily (daily). 6. metoprolol tartrate 50 mg tablet : one (1) tablet po bid (2 times a day). 7. olanzapine 5 mg tablet, rapid dissolve : 0.5 tablet, rapid dissolve po q6h (every 6 hours) as needed for agitation. 8. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization : one (1) inhalation q6h (every 6 hours) as needed for wheeze, sob. 9. olanzapine 5 mg tablet : one (1) tablet po hs (at bedtime). 10. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) as needed for constipation. 11. acetaminophen 650 mg tablet : one (1) tablet po tid (3 times a day). 12. bisacodyl 10 mg suppository : one (1) suppository rectal hs (at bedtime). 13. olanzapine 5 mg tablet, rapid dissolve : one (1) tablet, rapid dissolve po qam (once a day (in the morning)). 14. ondansetron 4 mg iv q8h:prn nausea/vomiting 15. coumadin 5 mg tablet : one (1) tablet po once a day: continue for therapeutic inr of . will need at least 3 months of treatment after that date or as directed by a doctor. 16. haldol decanoate 100 mg/ml solution : one (1) mg intramuscular q1hr prn as needed for agitation refractory to zyprexa: maximum of 3mg per 24 hour period. . 17. labs please check inr on sunday . target inr for dvts. patient on coumadin. discharge disposition: extended care facility: - discharge diagnosis: hyperactive delerium hypertension discharge condition: mental status: confused - sometimes. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: dear mr. : it was a pleasure taking care of you at . you were admitted to the hospital because you had a headache, hyperactive delerium, and high blood pressure. your headache resolved and a ct scan of your head did not show anything concerning. your high blood pressure was treated with two new medications (see below), which worked well. the geriatricians helped us in treating your delerium with medications, including olanzapine, and other ergonomic and practical measures. a mra of your brain was done, which showed your aneurysm has healed well. you were started on coumadin 5 mg daily for anticoagulation for your clots. you will need to follow up for your inr until therapeutic and to be anticoagulated for 3 months. please make these changes to your home medications: -stop erythromycin eye drops -increase metoprolol tartrate to 50mg -start tylenol 650mg tid around the clock -stop trazodone -stop hydralazine -start amlodipine 10mg daily -start captopril 25mg tid -start zyprexa 5mg in the morning, 5mg in the evening at 8pm, and 2.5mg q6hrs prn agitation -start haldol 1mg iv daily prn agitation -stop lorazepam -start bisacodyl suppository daily -stop subcutaneous heparin -start coumadin 5mg daily until you reach a therapeutic inr between and continue coumadin for at least 3 months from that date. -stop dilaudid followup instructions: please make an appointment to follow-up with your pcp immediately after your stay at rehab. in addition, you have the following appointment: department: neurosurgery when: thursday at 9:15 am with: , md building: lm campus: west best parking: garage procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube interruption of the vena cava percutaneous [endoscopic] gastrostomy [peg] arteriography of cerebral arteries arteriography of cerebral arteries ventricular shunt to abdominal cavity and organs arterial catheterization temporary tracheostomy closed [endoscopic] biopsy of bronchus bronchoscopy through artificial stoma ventricular shunt to extracranial site nec endovascular (total) embolization or occlusion of head and neck vessels diagnoses: anemia, unspecified obstructive hydrocephalus pure hypercholesterolemia unspecified protein-calorie malnutrition other convulsions subarachnoid hemorrhage acute respiratory failure dermatitis due to drugs and medicines taken internally fever, unspecified headache malignant essential hypertension acute venous embolism and thrombosis of deep vessels of proximal lower extremity encephalopathy, unspecified hyperosmolality and/or hypernatremia unspecified transient cerebral ischemia acute venous embolism and thrombosis of unspecified deep vessels of lower extremity hydantoin derivatives causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to