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: the patient is a 79-year-old female with multiple medical problems including old stroke in (with residual visual field cut in the right eye), hypertension, history of mitral regurgitation, hypercholesterolemia, and depression who presented status post two witnessed generalized tonic-clonic seizures. per the patient's family, the patient complained of right arm numbness and left arm weakness, headache, and right visual field deficit, followed by the onset of a generalized tonic-clonic seizure at home. the patient was originally seen at an outside hospital where she had a witnessed second generalized tonic-clonic seizure. the patient was intubated for airway protection. she was given ativan and was loaded with dilantin. the patient was then transferred to . after intubation the patient was given further sedation, and the rest of the dilantin was infused. the patient had an episode of transient hypotension with systolic blood pressures of 70, and she was started on a dopamine drip, after which her blood pressure normalized and she was able to be weaned off the dopamine. the patient arrived at with systolic blood pressures in the 170s. a head computed tomography at the outside hospital showed no evidence of hemorrhage, or mass effect, or hydrocephalus. a chest x-ray at the outside hospital was read as having evidence of pneumonia. the patient was also found to have a urinary tract infection, and she was given ceftriaxone at the outside hospital. the patient's arterial blood gas on admission to revealed a ph of 143, pco2 of 38, and a po2 of 242. in the emergency department, the patient was found to have an inr of 4.9. the patient was transferred to the neurology intensive care unit. past medical history: 1. hypertension. 2. hypercholesterolemia. 3. depression. 4. history of mitral regurgitation. 5. status post appendectomy. 6. degenerative joint disease. 7. status post bilateral total knee replacement. 8. seasonal allergies. 9. history of a remote stroke with residual upper visual field cut in the right eye. 10. history of retroperitoneal bleed. medications on admission: (outpatient medications included) 1. lipitor 20 mg by mouth once per day. 2. potassium chloride 10 meq by mouth once per day. 3. zoloft 100 mg by mouth once per day. 4. vioxx 12.5 mg by mouth once per day 5. coumadin (dose unknown); status post bilateral total knee replacement. physical examination on presentation: physical examination revealed the patient's temperature was 96.9 degrees fahrenheit, her blood pressure was 173/70, her heart rate was 67, and her oxygen saturation was 100% on synchronized intermittent mandatory ventilation with an fio2 of 100%, a tidal volume of 700, rate of 14, positive end-expiratory pressure of 5, and a pressure support of 5. in general, the patient was intubated. she was lying in bed with her eyes closed. she opened eyes to voice. she did not follow commands. head, eyes, ears, nose, and throat examination revealed no scleral icterus or injection. the mucous membranes were moist. the neck was supple. heart was regular in rate and rhythm. normal first heart sounds and second heart sounds. a holosystolic murmur radiating to the axilla. lung examination revealed coarse breath sounds bilaterally. no crackles or rales. the abdomen was soft and nondistended. no organomegaly. extremity examination revealed mild nonpitting edema bilaterally. there were venous stasis changes in the bilateral lower extremities. positive surgical scars on the knees bilaterally. neurologic/mental status examination revealed the patient opened eyes to voice and to sternal rub. she did not follow most of the commands; however, she would wiggle her toes on command but only in the right lower extremity. cranial nerve examination revealed pinpoint pupils which were 1.3 mm but reactive and symmetric. no eye deviation. positive corneal reflexes. motor revealed brisk withdrawal to noxious stimuli in the lower extremities bilaterally. positive withdrawal in the bilateral upper extremities briskly. reflexes were brisk and symmetric. the toes were upgoing bilaterally. sensation examination revealed coordination and gait were unable to be assessed. pertinent laboratory values on presentation: laboratories on admission revealed her sodium was 137, potassium was 4.5, chloride was 104, bicarbonate was 21, blood urea nitrogen was 30, creatinine was 0.9, and her blood glucose was 183. creatine kinase was 97. troponin was less than 0.01. her white blood cell count was 9.3, her hematocrit was 40.1, and her platelets were 212. her inr was 3.2 at the outside hospital. negative toxicology screen. pertinent radiology/imaging: chest x-ray revealed no focal opacities. mild pulmonary edema. magnetic resonance imaging diffusion-weighted imaging revealed a small lesion approximately 10 mm in length in the occipital lobe above the lateral ventricles. no acute bleed. suggestive of ischemic stroke in a right frontal distribution. concise summary of hospital course by issue/system: 1. status post cerebrovascular accident issues: the patient was transferred to the neurology intensive care unit and was extubated the day following her admission. however, due to respiratory failure the patient was reintubated and remained intubated for a prolonged period of time (until ). the patient's diffusion-weighted imaging was suggestive of an ischemic stroke; however, the patient presented with a supratherapeutic inr of 4.9. therefore, the workup included a transesophageal echocardiogram which showed no evidence of endocarditis, mild aortic regurgitation and mitral regurgitation, and complex atheroma of the ascending aorta. the patient also had an extensive workup for vasculitis and connective tissue disease. the patient's vasculitis workup was negative. her connective tissue disease workup was negative for leukos anticoagulant, normal homocystine, negative double-stranded dna, normal compliment levels, negative anticardiolipin, normal rheumatoid factor, mildly positive antinuclear antibody (with a titer of 1:160), and erythrocyte sedimentation rate of 35. the patient underwent a cerebral angiogram which showed no evidence of vasculitis; however, it did show three left fusiform aneurysms of ica and pcom with the largest being 12 mm of the left ica as well as fibromuscular dysplasia over the temporal arteries. as far as future stroke prophylaxis, the patient was treated with aspirin and pravastatin. no anticoagulation was continued in the setting of intracerebral aneurysm. 2. status post two generalized tonic-clonic seizures: the patient was started on keppra. the patient did not experience further seizure activity. it was thought to be seizures in the context of ischemic stroke. the patient was to continue on keppra and to be seen by an outpatient neurologist. 3. mental status change issues: after being extubated on ; and upon transfer to the general nursing floor; the patient continued having waxing and mental status changes which were much improved at the end of her hospitalization. it was thought that the mental status changes was multifactorial; including status post cerebrovascular accident, as well as a toxic metabolic etiology, status post prolonged medical intensive care unit stay complicated by ventilator-associated pneumonia and a urinary tract infection. the patient had an electroencephalogram which showed a slowing consistent with a toxic metabolic etiology, and no seizure activity. the patient's course was discussed extensively with the family. the patient likely has underlying dementia in addition to a generalized confusional state in the hospital. the patient would benefit from a behavioral neurologic evaluation when all other conditions are stabilized. 4. left ica aneurysm issues: the patient was seen by inpatient neurosurgery team. the patient was to be followed up by dr. to be evaluated for elective coiling of the largest of the aneurysms. no anticoagulation will be started at the present time. 5. new onset atrial fibrillation with a rapid ventricular response issues: the patient developed rapid atrial fibrillation while in the intensive care unit. the patient was started on metoprolol as well as amiodarone. since that time, the patient has remained in a sinus rhythm. the patient had a transesophageal echocardiogram without evidence of thrombus. the patient was not continued on coumadin secondary to the finding of intracranial aneurysm. the patient did not have evidence of atrial fibrillation after transfer from the intensive care unit. the patient was to follow up with dr. as an outpatient. the patient was to continue metoprolol and amiodarone at present. 6. congestive heart failure issues: the patient developed fluid retention of more than 6 liters positive while in the intensive care unit. the patient was given lasix and acetazolamide, and she diuresed quite well. the reason for the congestive heart failure was felt to be secondary to fluid overload as well as possible diastolic dysfunction. the patient had a normal systolic ejection fraction and was ruled out for a myocardial infarction by enzymes. upon discharge, the patient was close to her dry weight. the patient was to continue by mouth lasix at rehabilitation with close monitoring of her fluid status and eventual tapering of the lasix dose. 7. history of ventilator-associated pneumonia issues: the patient had combination of ventilator-associated pneumonia and aspiration pneumonia. the patient was treated with ceftriaxone and flagyl in the intensive care unit with resolution of the pneumonia and improvement of her symptoms. 8. methicillin-resistant staphylococcus aureus bacteremia issues: the patient had one blood culture out of four positive for methicillin-resistant staphylococcus aureus at the outside hospital. the patient completed a course of vancomycin and has subsequently had sterile cultures. 9. renal issues: the patient had a stable blood urea nitrogen and creatinine and has closely monitored urine output with a good diuresis response to lasix. since the patient was found to have fibromuscular dysplasia over tuberal arteries, the patient underwent an abdominal ultrasound to rule out fibromuscular dysplasia of the renal arteries. the patient was to undergo a magnetic resonance angiography to better evaluate for possible renal artery stenosis and fibromuscular dysplasia of the renal arteries; however, the patient became anxious and did not tolerate the study. this study was to be repeated during the rehabilitation. 10. questionable adrenal mass issues: one of the patient's chest computed tomographies revealed fullness in the patient's adrenals. we attempted to obtain a magnetic resonance imaging of the abdomen to evaluate the adrenal glands; however, the patient did not tolerate this study. this was to be followed up by an outpatient abdominal magnetic resonance imaging. 11. code status: do not resuscitate/do not intubate. 12. disposition issues: the patient has been screened for rehabilitation placement and was to be discharged today to . the patient's family is aware of the patient's course. i had an extensive discussion with the patient's son regarding the patient's condition. condition at discharge: condition on discharge was stable. discharge status: the patient was to be discharged to rehabilitation. discharge diagnoses: 1. right frontal ischemic stroke. 2. status post encephalopathy. 3. intracranial aneurysms. 4. fibromuscular dysplasia of vertebral arteries. 5. status post generalized tonic-clonic seizures. 6. ventilator-associated pneumonia. 7. new onset atrial fibrillation. 8. congestive heart failure. 9. status post respiratory failure. 10. history of methicillin-resistant staphylococcus aureus bacteremia; treated with vancomycin (no need for contact precautions). 11. bacterial urinary tract infection; treated. 12. fungal urinary tract infection; the patient is on diflucan. 13. reactive thrombocytosis. 14. questionable fullness in adrenal glands on chest computed tomography. medications on discharge: 1. bisacodyl 5-mg tablets two tablets by mouth once per day as needed. 2. subcutaneous heparin 5000 units subcutaneously q.12h. 3. aspirin 325 mg by mouth once per day. 4. pravastatin 20 mg by mouth once per day. 5. amiodarone 400 mg by mouth twice per day. 6. miconazole nitrate powder one application twice per day. 7. nystatin ointment one application topically twice per day. 8. tylenol 325-mg tablets one to two tablets by mouth q.4-6h. as needed. 9. metoprolol 100 mg by mouth twice per day. 10. ipratropium bromide solution one nebulizer q.6h. as needed. 11. potassium chloride 40 meq by mouth once per day. 12. keppra 750 mg by mouth twice per day. 13. lansoprazole 30 mg by mouth once per day. 14. colace 100 mg by mouth twice per day. 15. lactulose 50 ml by mouth once per day. 16. fluconazole 100 mg by mouth once per day (times two days). 17. lasix 80 mg by mouth q.a.m. and 40 mg by mouth q.p.m. discharge instructions/followup: 1. the patient was instructed to follow up with dr. (neurosurgery) on at 2 p.m. 2. the patient was instructed to follow up with dr. ; the patient was to call to schedule the next available appointment within the next month. 3. the patient was instructed to follow up with dr. on at 3 p.m. 4. the patient was instructed to follow up with dr. on at 2:30 p.m. , m.d. dictated by: medquist36 d: 16:05 t: 17:07 job#: procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more diagnostic ultrasound of heart insertion of endotracheal tube enteral infusion of concentrated nutritional substances thoracentesis thoracentesis arteriography of cerebral arteries diagnoses: pneumonia, organism unspecified congestive heart failure, unspecified atrial fibrillation other convulsions pulmonary collapse acute respiratory failure pneumonitis due to inhalation of food or vomitus cerebral artery occlusion, unspecified with cerebral infarction diastolic heart failure, unspecified 

Answer: The patient is high likely exposed to