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: history of present illness: this is a 54 year-old male patient with down syndrome, bilateral deafness, status post two hemorrhagic strokes ( and ) who was noted at home to have altered mental status progressing to unresponsiveness. the patient was initially brought to the hospital where he was intubated and transferred to for further evaluation. a head ct was significant for a left frontal lobe bleed with smaller bleeds in the parietal area, a right lateral ventricle and basal ganglia. an mri was significant for a left frontal bleed and old right parietal/fontal bleeds. the patient's inr was noted to be 1.6 and he was given fresh frozen platelets infusions and vitamin k. neurosurgery evaluated the patient and felt that he was not a surgical candidate and the patient was eventually transferred to the neurology service. the patient was given mannitol 1 gram per kilogram and loaded with dilantin 1 gram. five weeks prior to admission the patient had left hand clumsiness, which improved. he was evaluated with an mri/mra on , which showed subacute right parietal aneurysm. he had a normal tte with an anticardiolipin igg weekly positive at 26.4. past medical history: 1. down syndrome. 2. status post two hemorrhagic strokes, with left sided weakness that resolved, with right sided weakness that has persisted. 3. deaf. 4. hypothyroidism. 5. chronic lower back pain. medications: 1. levothyroxine 150 micrograms po q day. 2. naprosyn. allergies: no known drug allergies. social history: the patient lives at home with his parents and gets assistance with his activities of daily living. he walks with a cane. there is no tobacco or alcohol use. physical examination: vital signs temperature 97.8. blood pressure 107/52. heart rate 66. respirations 12. 100% on room air. general the patient is intubated and sedated with an initial examination performed under anesthesia, the patient exhibited no spontaneous movements. pupils were pinpoint bilaterally and minimally reactive. the patient was unable to follow commands or localize to pain in any extremities. his only response to painful stimuli is biting of the et tube. right lower extremity toes upgoing. left lower extremity toes equivocal. cardiovascular regular rate and rhythm. no murmurs, rubs or gallops. lungs clear to auscultation bilaterally. laboratory: white blood cell count 7.8, hematocrit 32.3, platelets 139, pt 14.7, ptt 26.8, inr 1.6, sodium 141, potassium 3.7, chloride 108, bicarb 29, bun 14, creatinine 0.8, glucose 100. calcium 8.5, phosphate 2.8, magnesium 1.6. tox screen is negative. urinalysis was negative. amylase 86. hospital course: 1. neurological: the patient initially presented to an outside hospital with increasing altered mental status, which progressed to unresponsiveness. head ct and mri significant for a left frontal bleed. the patient was admitted to the neurosurgery intensive care unit. he was loaded with dilantin given decadron for concern for cerebral edema. he remained clinically stable. the neurosurgery team decided that he was not a surgical candidate. the patient was therefore transferred to the neurology service where his dilantin was continued and levels checked. the patient had serial head cts, which showed no evidence of new bleeding or progression of his previous hemorrhage. once extubated the patient became gradually more alert, responsive and interactive. his neurological examination was stable. the etiology of the patient's recurrent intracranial hemorrhages was thought likely secondary to amyloid angiopathy as a previous outpatient workup with protein c, protein s, anticardiolipin and factor 5 liden was normal. 2. hematology: the patient was admitted with a history of two hemorrhagic strokes and noted to have a new intracranial hemorrhage. the patient had been evaluated as an outpatient by a hematologist who considered the etiology of the patient's recurrent bleeds to be likely amyloid angiopathy, which can be seen with down syndrome. the hematology/oncology consult service was contact and felt that amyloid angiography was the most likely cause for the ich, so there was no further workup of coagulopathy rate indicated. the patient was noted to have a edematous right arm and an ultrasound was significant for a deep venous thrombosis. in light of the patient's intracranial hemorrhage and deep venous thrombosis the hematology team recommended treating the patient's elevated inr with 6 units of fresh frozen platelets. the patient was also started on vitamin k injections 10 mg subq q day for five days. a dic profile was checked and noted to be consistent with the patient's deep venous thrombosis. an spep was also recommended for the patient's high igg and iga noted in to rule out monoclonal gammopathy. the patient's right arm thrombosis was treated locally and symptomatically with elevation and heat as there was little concern for a life threatening pulmonary embolus. with 6 units of fresh frozen platelets the patient's inr decreased to 1.3. anticardiolipin antibody igg was noted to be elevated at 44.7. the lupus anticoagulants was negative and beta two lipoprotein is pending at the time of dictation. 3. infectious disease: on the day following admission the patient was noted to have a low grade fever with an increase in white blood cell count. a chest x-ray was obtained, which was thought to be consistent with aspiration pneumonia and he was started on levofloxacin and flagyl. a repeat chest x-ray showed interval improvement in the patient's left lower lobe infiltrate. a urine culture was positive for e-coli. the patient's foley catheter was discontinued and he received a seven day course of levofloxacin for a urinary tract infection. the patient was afebrile for several days, but again began having low grade fevers that were attributed to his right upper extremity thrombosis as well as fresh frozen platelets infusions. the patient was clinically stable, a decreasing white blood cell count with blood cultures that were consistently negative. 4. endocrine: the patient was admitted with a history of hypothyroidism and was continued on his synthroid throughout this admission. 5. fen: the patient was noted to have consistently low potassium and phosphate levels and was continued on neutra-phos two packets t.i.d. he was evaluated by speech and swallow, which was negative for aspiration. he was continued on thin liquids and pureed solids and encouraged to take frequent meals for poor nutritional status. condition on discharge: stable. discharge status: the patient is discharged to an extended care facility where he should continue all medications as prescribed. discharge diagnoses: 1. left frontal lobe ich. 2. down syndrome. 3. deafness. 4. status post hemorrhagic strokes. 5. hypothyroidism. discharge medications: 1. ranitidine 150 mg po b.i.d. 2. levothyroxine 150 micrograms po q day. 3. neutra-phos two packets po t.i.d. 4. dilantin 300 mg po q day to be continued for one month and then titrated down if the patient is asymptomatic. 5. vitamin k 2 mg po q day times two days. follow up: the patient will be followed by the physicians at the extended care facility. the patient's family is instructed to call their primary care physician . to schedule a follow up appointment within one to two weeks after discharge. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube transfusion of other serum diagnoses: urinary tract infection, site not specified unspecified acquired hypothyroidism intracerebral hemorrhage pneumonitis due to inhalation of food or vomitus infection and inflammatory reaction due to other vascular device, implant, and graft phlebitis and thrombophlebitis of upper extremities, unspecified down's syndrome unspecified circulatory system disorder 

Answer: The patient is high likely exposed to