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: left sided numbness and weakness major surgical or invasive procedure: none history of present illness: 60 year-old man with a history of uncontrolled hypertension with sudden onset ~5:10pm of left-sided numbness and weakness. pt reports he was driving home from church when he had sudden onset of "numbness" in his left arm. he describes the numbness as a flaccid feeling, and also decreased sensation. he drove for another ~10-15 minutes and then pulled in to a parking lot. he fell when he tried to get out of the car due ot left leg weakness. a cardiologist was also in the parking lot and called ems. on arrival of ems, bp 240/120, fs 234. pt arrived at ed at 6pm and "code stroke" was initiated. initial bp 235/115. nihss 8. head ct with right basal ganglia bleed so no tpa given. of note, pt did report some strange phenomena, such as "i was totured in the past so the ct may show the implants." he also later told me something like "my feet were implanted by the eastern europeans, they do good work don't they?" 60m h/o untreated severe hypertension and otherwise unknown history (does not see doctors) presents with sudden onset left sided weakness and decreased sensation. exam with left hemibody sensory loss and left-sided weakness of arm>leg>face. most likely localization is deep right subcortical white or grey matter given lack of cortical signs. this is confirmed by right basal ganglia bleed on ct. past medical history: i don't like docotors" 1. hypertension, uncontrolled. pt reports having his bp checked at a health fair at work. "it was so high that the nurse went and got the doctor. but it's really not a problem for me. when it gets high i just have a nose bleed and that relieves the pressure." social history: lives with a friend , who is his health care proxy. as a politician, "i'm running for governor of you know." no tobacco, etoh or drugs. has no family. family history: mother with htn. no stroke, dm. physical exam: pe: t 96 bp 235/118 hr 90s o2 sat 95% ra general: overweight man, in no acute distress heent: nc/at sclera anicteric. op clear neck: supple lungs: clear to auscultation anterolaterally cv: rrr, nl s1, s2, no murmur. 2+ carotids without bruit abd: soft, obese, nontender, normoactive bowel sounds extr: no edema, warm and well perfused neurologic examination: mental status: alert and oriented to person, place and date, cooperative with exam, normal affect attention: can say months of year backward language: fluent, mild dysarthria, no paraphasic errors, naming and repetition intact no neglect. no grasp. cranial nerves: visual fields are full to finger counting. pupils equally round and reactive to light, 3 to 2 mm bilaterally, brisk. extraocular movements intact, no nystagmus. left face severely decreased lt, pin. normal oropharyngeal movement. tongue midline, no fasciculations. sensation: absent light touch, pin felt as dull on left arm and chest and pin absent on left leg. motor: normal bulk. left arm flaccid. no fasiculations. no tremor. left arm plegic, except perhaps some slight movement of finger flexors. left leg: ip nearly full, ham 4, some movement at ankle and toes. reflexes: dtrs 3+ at knees, coordination: finger-nose-finger intact on right. pertinent results: 06:40pm glucose-249* urea n-8 creat-0.9 sodium-138 potassium-5.1 chloride-99 total co2-24 anion gap-20 06:40pm ck(cpk)-161 06:40pm ck-mb-5 ctropnt-<0.01 06:40pm calcium-9.9 phosphate-2.8 magnesium-1.8 06:40pm wbc-9.5 rbc-5.03 hgb-15.2 hct-43.5 mcv-86 mch-30.3 mchc-35.0 rdw-13.0 06:40pm plt count-296 06:40pm pt-11.7 ptt-25.2 inr(pt)-1.0 * * * ct head findings: there is a focal hyperdense area measuring 1.7 cm consistent with intraparenchymal hemorrhage located in the region of the posterior limb of the right internal capsule/basal ganglia. there is associated surrounding edema. there is no evidence of mass effect, shift of normally midline structures, or hydrocephalus. the -white matter differentiation is relatively well preserved. there is no effacement of the sulci or ventricles. bone windows demonstrate no evidence offracture. the visualized paranasal and mastoid air cells are well aerated. impression: focal intraparenchymal hemorrhage in the region of the right basal ganglia/posterior limb of the right internal capsule with adjacent edema. * * * ekg sinus rhythm st junctional depression is nonspecific * * * eeg impression: this is an abnormal 24-hour eeg telemetry due to the presence of slow background rhythm with intermittent bursts of generalized slowing in the delta frequency range bifrontally predominant. in addition, there is independent intermittent slowing over the right fronto-central region with sharp features. the first abnormality represents an encephalopathic pattern most likely due to medication effect. the second abnormality suggests subcortical dysfunction over the right fronto-central region with possible cortical dysfunction. there were no clear epileptiform discharges recorded. * * * echo conclusions: the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. no mitral regurgitation is seen. the left ventricular inflow pattern suggests impaired relaxation. there is no pericardial effusion. no intracardiac mass/thrombus identified (cannot definitively exclude). * * * head ct there has been slight enlargement of the area of low attenuation surrounding the right thalamus suggestive of worsening edema around the right thalamic hemorrhage. small amount of intraventricular hemorrhage is present. there has been mild dilatation of the lateral ventricles since the previous examination especially involving the body and frontal of the lateral ventricle. this might indicate an element of obstructive hydrocephalus due to the intraventricular hemorrhage. no midline shift is seen. there is no other interval change noted. impression: interval mild enlargement of the lateral ventricles suggestive of possible early obstructive hydrocephalus due to the presence of intraventricular hemorrhage. minimal worsening of the edema surrounding the right-sided thalamic hemorrhage since the previous exam of . correlation with neurologic symptoms and followup is recommended. * * * left leg ultrasound findings: grayscale and doppler son of the left common femoral, superficial femoral, and popliteal veins were performed. normal flow, augmentation, compressibility, and waveforms are demonstrated. intraluminal thrombus is not identified. impression: no evidence of dvt. * * * video swallow procedure: video oropharyngeal swallow exam was performed in conjunction with speech and swallow therapy department. varying consistencies of barium were administered under constant video fluoroscopic monitoring. penetration was seen with first teaspoon of nectar-thick liquid and with straw sips of nectar. deep laryngeal penetration was observed with thin liquids. no aspiration was seen but it was felt that patient was at significant risk to aspirate thin liquids or solids secondary to impassability, pharyngeal residue, and swallow delay. for complete details and recommendations, please refer to the complete speech and swallow therapy department note available on careweb. * * * chest x-ray left internal jugular vascular catheter and feeding tube remain in place. the feeding tube has been withdrawn slightly in the interval but still terminates within the stomach. cardiac and mediastinal contours are stable. there has been improved aeration at the lung bases with near complete resolution of bibasilar atelectasis with only very minimal residual left basilar atelectasis remaining. impression: no evidence of pneumonia. brief hospital course: briefly, this is a 60m h/o untreated severe hypertension and otherwise unknown history (does not see doctors) who presented with sudden onset left sided weakness and decreased sensation. exam revealed left hemibody sensory loss and left-sided weakness of arm>leg>face. right basal ganglia/thalamic bleed was noted on ct. the pt was initially admitted to the icu on labetalol gtt. the pt r/o for mi with 3 sets of ce. once the pts bp had stabilized the pts labetolol gtt was weaned off and he was transferred to the neurology service. * * * #neuro/r basal ganglia/thalamic bleed: the likely source of the pts bleed was felt ot be due to uncontrolled htn. his coags were wnl. the pt remained on q 2 hr neuro checks for his first 6 days after admission. his sbp was initially managed aggressively in the icu on labetolol gtt with goal sbp 150-160. after transfer to the floor, his bp was very difficult to control. he was administered iv hydral and iv metoprolol frequently. he was started on metoprolol (ultimately titrated up to 100 mg po tid), captopril (aggressively titrated up to 100 mg tid), as well as norvasc 10 mg po qd (after his bp was still resistant). the pts mental status was noted to wax and wane in an encephalopathic manner. given increased somnolence on , head ct was repeated but revealed no new bleed or change in the old bleed. on , the pts l pupil was noted to be intermittently dilated larger than the r pupil (and more sluggish to constrict to light). head ct was again repeated and revealed no new changes. abg on 35% shovel mask on : 7.39/42/140, which showed his somnolence was not due to any respiratory changes. as per below, ua, ucx, and cxr were unrevealing as sources of his somnolence. during the pts first week after admission, he was often unarousable or arousable to only deep sternal rub. it was noted the pt seemed agitated at night, perhaps contributing to increased daytime somnolence, so the pt was started on zyprexa 5 mg qhs. the pt was noted to be able to spontaneously move his rue and rle, but he did not move his lue or lle. over the course of his stay he was noted to have significant obstructive sleep apnea, likely worsened by his stroke causing decreased pharyngeal tone. he started on cpap of 6 on , and his mental status improved significantly. later on in his stay he began to move his left leg more as well, withdrawing to noxious stimuli, albeit less vigorously than with the right leg. he was still unable to move his left arm at all, and had continued dysarthria, although this was improved from admission. his agitation improved with time as well, and the zyprexa was discontinued, as this was thought to contribute to his somnolence. by the time of discharge he was sleeping a lot, but in general was much more awake, and able to engage in conversation. lastly, he had a repeat head ct on , which was read by radiology as possible indicative of early obstructive hydrocephalus, but upon further review with the neurology team this was not felt to be the case. his bleed was stable on follow-up ct and as his mental status continuously improved no further imaging was performed. . #cv: as per above, the pts bp was initially managed aggressively in the icu on labetolol gtt with goal sbp 150-160. after transfer to the floor, his bp was very difficult to control. he was administered iv hydral and iv metoprolol frequently. he was started on metoprolol (ultimately titrated up to 100 mg po tid), captopril (aggressively titrated up to 100 mg tid), as well as norvasc 10 mg po qd (after his bp was still resistant). he was started on atorvastatin 10 mg po qd for tg 210 and ldl 140. he ruled out for mi. tte revealed the pt has impaired lv relaxation c/w diastolic dysfunction, ef >55%. on he had a tee to evaluate for clot, as he had grown coag negative staph from a peripheral blood culture, but no clot was identified per the cardiology attending. the full read of the tee was pending at the time of discharge. . id: the pts wbc after admission slowly rose to a peak of 18 on with 85% pmn but no bands. the likely source was either a stress response vs infection. ua and ucx were negative, and cxr showed no clear infiltrate or aspiration pneumonitis. on the pts wbc decreased to 13. on he became febrile, and blood and urine cultures were drawn. chest x-ray was negative. his l ij was pulled on . his blood cultures grew coag negative staph in bottles, but it was not known if these were the samples drawn from the line or peripherally. the ij catheter tip did not grow any bacteria. it was unclear if the bacteria represented a contaminant, but we decided to manage conservatively with vancomycin for 7 days. sensitivies of the coag negative staph are still pending at the time of discharge, and he requires 5 more days of treatment with vancomycin. follow up blood cultures have been negative, and the patient has been afebrile for 72 hours. his wbc on the day of discharge was still mildly elevated at 11.9, but the general trend has been downward. . endocrine: the pts glucose was initially poorly controlled in the 200s-300s. his hgb a1c was 11. he was started on riss and nph. his nph was titrated up after the pt was started on tube feeds. at the time of discharge he is getting nph 35 units in the morning and 25 units at night, plus sliding scale insulin as needed. . heme: his hematocrit was stable throughout the admission, and was 34.7 at the time of discharge. his coags were normal throughout. . fen/gi: he was initially tube fed for several days. once his mental status improved he had a video swallow study, and was cleared to take pureed solids and nectar thick liquids, alternating bites with sips, and using a chin tuck. he self-d/c'd the ng tube and ate well with assistance for the last two days prior to discharge. . pulmonary: he exhibited significant obstructive sleep apnea during his admission. his roommate said she occasionally hears him snoring throughout the night, but she doesn't share his room so she is not sure if he has apneic episodes at home. on he was evaluated by pulmonology and placed on cpap of 6. this significantly improved his respiratory status and his level of alertness. at the time of discharge he was on cpap of 6 from 9 pm to 6 am. he will need to have a formal sleep study done as an outpatient, and follow up with a pulmonologist. medications on admission: none discharge medications: 1. docusate sodium 150 mg/15 ml liquid sig: one hundred (100) mg po bid (2 times a day). 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 3. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 4. metoprolol tartrate 50 mg tablet sig: two (2) tablet po tid (3 times a day). 5. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 6. captopril 25 mg tablet sig: four (4) tablet po tid (3 times a day). 7. insulin nph human recomb 100 unit/ml suspension sig: thirty five (35) unit subcutaneous qam. 8. insulin nph human recomb 100 unit/ml suspension sig: twenty five (25) units subcutaneous qpm. 9. heparin (porcine) 5,000 unit/ml solution sig: one (1) ml injection tid (3 times a day). 10. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day) as needed for thrush for 10 days. 11. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 12. vancomycin in dextrose 1 g/200 ml piggyback sig: one (1) g intravenous q 12h (every 12 hours) for 5 days. discharge disposition: extended care facility: hospital - discharge diagnosis: basal ganglia hemorrhage hypertension discharge condition: good discharge instructions: please take all medications and attend all follow-up appointments as instructed. followup instructions: follow up with dr. of clinic in one month. call to do your outpatient registration and make an appointment. provider: , md phone: date/time: 3:30 md procedure: diagnostic ultrasound of heart diagnoses: unspecified essential hypertension intracerebral hemorrhage bacteremia unspecified sleep apnea 

Answer: The patient is high likely exposed to