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: lisinopril / atorvastatin attending: chief complaint: ms changes and seizure major surgical or invasive procedure: none history of present illness: hpi: 70 year old woman with a history of hypertension, diabetes, dementia, cri (1.8) who was recently discharged from the neurology service with a large temporo-parietal bleed in the setting of lovenox now presenting from nursing home with mental status changes and possible seizure activity. believed that ich was secondary to amyloid angiopathy and that surgical intervention would be in vain. pt transferred to rehab on seizure prohphlaxis, but apparently was seizure free during initial hospitalization. pt transitioned from rehab to nursing home yesterday. pt unable to provide history and there is no documentation of event, however, per ems report they witnessed tonic-clonic activity. . review of systems: unobtainable past medical history: -left temporo-parietal bleed -amyloid angiopathy -ckd (1.8) -diabetes "labile" -hypertension -chf (unknown ef) -h/o hyperkalemia -depression -asthma/copd -peripheral neuropathy -dementia -s/p trach social history: -resident of home -no recent history of smoking or alcohol use family history: -unobtainable physical exam: physical exam: vitals: 98.9, 68, 160/71, 77, 98% ra general: comfortable, nad, does not respond to voice, shaking or sternal rub heent: pinpoint pupils, op wnl neck: supple, lungs: ctab anteriorly cv: regular rate and rhythm, s1/s2, no m/r/g abdomen: soft, non-tender, non-distended, na-bowel sounds present, gtube in place ext: warm/dry, no edema neurologic examination: patient does not respond to voice, shaking or sternal rub. has pinpoint pupils. patient not able to cooperate with neuro exam. pertinent results: 08:59am blood wbc-12.5* rbc-3.06* hgb-9.8* hct-30.5* mcv-99* mch-32.1* mchc-32.3 rdw-13.4 plt ct-230 04:15pm blood wbc-7.4 rbc-3.10* hgb-10.3* hct-31.2* mcv-101* mch-33.2* mchc-33.0 rdw-13.3 plt ct-201 04:44am blood wbc-6.2 rbc-2.73* hgb-9.0* hct-27.8* mcv-102* mch-32.8* mchc-32.2 rdw-13.5 plt ct-179 08:59am blood neuts-87.3* lymphs-8.3* monos-4.0 eos-0.2 baso-0.2 08:59am blood pt-12.8 ptt-28.7 inr(pt)-1.1 08:59am blood glucose-333* urean-73* creat-2.6*# na-142 k-5.1 cl-94* hco3-42* angap-11 04:15pm blood glucose-86 urean-55* creat-1.9* na-147* k-4.8 cl-100 hco3-41* angap-11 04:44am blood glucose-331* urean-50* creat-1.9* na-146* k-4.6 cl-96 hco3-43* angap-12 07:45pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 11:51am blood type-art po2-86 pco2-82* ph-7.38 calhco3-50* base xs-18 11:51am blood lactate-2.5* 08:00am urine blood-sm nitrite-neg protein-30 glucose-1000 ketone-neg bilirub-neg urobiln-neg ph-5.0 leuks-neg 08:35am urine blood-mod nitrite-neg protein-30 glucose-1000 ketone-neg bilirub-neg urobiln-neg ph-6.5 leuks-mod 08:00am urine rbc-0 wbc-0-2 bacteri-occ yeast-none epi-0-2 08:35am urine rbc-0-2 wbc- bacteri-mod yeast-none epi-0 08:00am urine casthy-0-2 05:48pm urine bnzodzp-neg barbitr-neg opiates-neg cocaine-neg amphetm-neg mthdone-neg . cxr : 1. no pneumonia. 2. mild volume overload. . head ct : impression: 2.8 x 2.2 cm rounded focus at the site of prior intraparenchymal hemorrhage. there is surrounding decreased attenuation, consistent with edema or malacia. while this could represent resorbing hematoma, this appearance is concerning for a mass lesion and further evaluation could be obtained . cxr : opacity in the right middle lobe, not present on the previous study. findings represent aspiration and/or pneumonia . echo : conclusions: 1. the left atrium is mildly dilated. 2. there is mild symmetric left ventricular hypertrophy with normal cavity size and systolic function (lvef>55%). regional left ventricular wall motion is normal. 3. the mitral valve leaflets are mildly thickened. mild to moderate (+) mitral regurgitation is seen. 4. moderate tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension . cxr : impression: 1. slight improvement in patchy right infrahilar opacity, which may be due to improving asymmetrical edema, focal atelectasis or pneumonia. 2. mild congestive heart failure. . cxr : impression: 1. persistent mild congestive heart failure. 2. right infrahilar opacity is stable and may represent asymmetric edema or may be due to aspiration. . ekg : normal sinus rhythm, rate 70. left-sided early repolarization. compared to the previous tracing of probably no significant change. . cxr impression: no evidence of congestive heart failure or pneumonia. brief hospital course: 70 year old female w/ h/o htn, diabetes, dementia, cri, and recent temporo-parietal bleed presented with ms changes likely secondary to seizure, c/b acute renal failure. . # neuro/resp: patient was admitted with seizures likely d/t temporo-parietal ich with possible mass on ct. was seen by neurology in the er and loaded on dilantin and started on keppra. tox-met workup performed and was negative (negative serum and urine tox screen, neg. ua). it was felt that the patient would benefit from additional imaging of mass to differentiate resolvind hematoma from other mass, but this was not able to be performed because patient was unable to tolerate mri at any point d/t continued agitations hospital stay. patient was on and off agitated throughout her hospital course, and a variety of antipsychotics including olanzapine, risperidone, seroquel, and eventually haldol were used. the patient required level ii restraints for the majority of her hospitalization, renewed daily. psychiatry was consulted, followed the patient, and made recommendations. a fm was used for a couple of days to maintain o2 saturations, but this was stopped for fear of decreasing resp drive and an increasing pco2 (abg showed ph 7.38/86/80, due to metabolic acidosis with significant chronic renal compensation). patient was transferred to micu on for bradycardia, hypotension, and hypoxia. cause unclear although there was some concern for seizure. (patient had initially had evidence of pna on cxr and this was treated with 14 days of abx, but the opacity cleared after two days and it was unclear if she actually had pna). episode resolved on its own without intervention. loaded with dilantin. thought to be d/t cenrally mediated process. ct of head unchanged with no new bleed or mass effect. cardiology consulted and found no evidence of structural heart disease or conduction delay. a breast mass was found on exam in micu, raising concern for etiology of head mass. plan was to work this up further once patient more stable. no pressors required while in micu. transferred to floor. patient remained agitated a frequently desaturated to 70's when agitated, but would bump to 100% with nebs. etiology thought to be combination of asthma/copd, chf, agitation, and decreased respiratory drive. on , pt was noted to be more somnolent with abg 7.16/110/39/51 and was transferred to unit for trial of bipap. etiology hypercarbic respiratory failure secondary to sedation and infection (uti and +blood cultures 1/4) and copd. while in the micu the patient was essentially made comfort care d/t poor prognosis and no improvement with bipap (pt dnr/dni). she was transferred to the floor where sshe continued to decline. family meeting had and it was decided that her chances of returning to a meaningful life or even back to near baseline was minimal, and care was focused on comfort. antibiotics, fs, insulin, and diuretics were stopped on and the patient passed on , likely d/t respiratory arrest. permission to perform autopsy was obtained from health care proxy with specific interest in identifying the intracranial mass. . # arf: pt with ckd and baseline cr 1.8 who presented with acute worsening (cr 2.6). thought to be pre-renal process, possibly secondary to over diuresis. initially ua did not show any evidence of uti, but pt eventually developed klebsiella uti, for which she was treated. during second micu stay there was some concern for urosepsis, and antibiotic coverage was broadened to cover this possibility. for part of her hospitalization the cr returned to baseline with gentle ivf's, but eventually this again worsened and while in the micu the second time she became anuric. . # chf: patient had an unknown ef but was on chronic lasix. lasix was administered on as needed basis, taking into account her renal failure and pulmonary edema potentially contributing to respiratory distress. . # dm: pt initially hypoglycemia (11) in ed after getting 10 units ri for bg ~325 and not receiving tube feeds. throughout hospitalization patient alternated between hypoglycemia and hyperglycemia. followed the patient closely but it was very difficult to control her sugars, especially in setting of receiving intermittent tf's d/t pulling out peg and high residuals. . #hypernatremia: patient fluctuated between normal and hypernatremic, likely because she was unable to take free water d/t agitation and delerium. free water flushes via peg were administered, but high residuals made this difficult. . # htn: outpatient lopressor continued with moderate control . # dementia: acute on chronic. multifactorial. did not improve during hospitalization. . # dnr/dni medications on admission: lasix 40 mg ng qd z 2 days then 20 mg ng qd risperidal 0.5 mg ng qam and 0.75 mg qhs insulin: lantus 10 units qam and nph qpm riss lopressor 37.5 mg ng tid heparin 500 units sc q 12 hrs prevacid 30 mg qd zantact 150 mg mvi colace ng 100 mg duonevs q 4 hrs prn lactulose 30 cc ng q12 hours prn nacl 2 gm with 300 cc h2o h20 300 cc ng celexa 10 mg ng qd . discharge medications: none discharge disposition: expired discharge diagnosis: hypercarbic hypoventilation pna urosepsis copd/asthma acute renal failure dementia discharge condition: deceased discharge instructions: none followup instructions: none md, procedure: venous catheterization, not elsewhere classified enteral infusion of concentrated nutritional substances non-invasive mechanical ventilation arterial catheterization replacement of gastrostomy tube infusion of vasopressor agent diagnoses: obstructive sleep apnea (adult)(pediatric) acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified severe sepsis obstructive chronic bronchitis with (acute) exacerbation other convulsions other persistent mental disorders due to conditions classified elsewhere hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease acute and chronic respiratory failure pneumonitis due to inhalation of food or vomitus long-term (current) use of insulin other septicemia due to gram-negative organisms infection and inflammatory reaction due to other vascular device, implant, and graft streptococcal septicemia delirium due to conditions classified elsewhere late effects of cerebrovascular disease, aphasia 

Answer: The patient is high likely exposed to