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: unresponsive, code stroke major surgical or invasive procedure: cta peg placement intubation and mechanical ventilation the use of pressors history of present illness: 68 year old cantonese speaking male with no known significant past medical history who presented to the ed on for acute stroke at 13:40. patient was last seen well at 12:30pm on . per his wife, he went outside to smoke a cigarette. when he did not return after 10-15 minutes, she went out to look for him. found him slumped on ground. per her report, he was awake but not following commands and not verbally responsive. she did note him to move all extremities. ems notified. patient brought to . en route, ekg showed atrial fibrillation. ed notified of possible stroke at 13:30, prior to patient's arrival. code stroke called; neurology resident in room prior to the patient's arrival. patient arrived to ed at 13:40. on nihss exam, not keenly alert, but responsive to noxious stimuli. no verbal output. not following commands. noted to have left gaze preference. flattening of left nasolabial fold. not initially moving left side, but later noted to move these against gravity. triple flexion response in right le and extensor posturing in right ue. patient had shallow respirations in ed and so was intubated for airway protection. went to ct scan at 13:55. no acute hemorrhage identified but dense left mca sign. cta shortly thereafter with occlusion left mca, evolving hypodensity entire left mca territory. given tpa after consent obtained from family at 14:40. dose based on estimated weight of 60 kg; given 53.2 total with 5.3 bolus dose. patient had no improvement in strength after t-pa. his mental status exam was clouded by sedative medications. additionally, patient was given 20mg of iv labetolol for dbp 110 and subsequently dropped sbp to 60's. was started on dopamine gtt for blood pressure support via piv (central line contraindicated after t-pa). past medical history: none, patient did not attend regular medical appointments. pcp is in . last saw him a few months ago for flu vaccine and had normal physical per family. social history: married. lives with wife. 4 children. emigrated from >30 years ago. heavy smoker ~1ppd for many years per family. no alcohol or drug use. family history: not obtained physical exam: tc: afeb bp: 119/96 (60s systolic up to 140/39-104) hr: 97-143 rr: 16 on vent, ac 100%fio2 o2sat.: 100% on vent gen: wd/wn elderly asian male, shallow labored breathing. heent: hyperpigmented papule on left eye lid. nc/at. anicteric. mmm. neck: supple. no masses or lad. no jvd. no thyromegaly. no carotid bruits, but difficult to assess with presence of ventilator background noise. lungs: coarse anterolaterally. no r/r/w. cardiac: irregularly irregular. s1/s2. no m/r/g. abd: soft, nt, nd, +nabs. no rebound or guarding. no hsm. extrem: warm and well-perfused. no c/c/e. neuro: mental status: no verbal output. grimaced to noxious stimuli. would not respond to commands over telephone by chinese interpreter. cranial nerves: pupils equally round and reactive to light, 2 to 1 mm bilaterally. patient will not keep eyes open, so unable to assess visual fields. unable to appreciate fundi. eyes intially left deviated at rest. +doll's, crossed midline. slight flattening of right nasolabial fold. hearing intact to finger rub bilaterally. +gag. tongue midline without fasciculations. motor: normal bulk and tone. initially did not withdraw left side to noxious stimuli, but later moved left arm and leg spontaneously against gravity. right lower extremity externally rotated. had triple flexion response of rle to noxious. extensor posturing of rue to noxious. no antigravity on right side. no adventious movements, tremors. sensation: triple flexion response of rle to noxious. extensor posture of rue to noxious. left side did not initially withdraw, but did so on reexamination. reflexes: b t br pa ac right 3 2 3 3 2 left 2 2 2 3 2 right toe upgoing. left toe downgoing. unable to assess coordination and gait pertinent results: cbc, coags normal. na 141 k 5.5 (hemolyzed) cl 107 hco3 27 bun 16 cr 1.3 cardiac enzymes neg. ua lg blood, rbc cta brain : findings consistent with a thromboembolic stroke involving the left middle cerebral artery. no evidence of hemorrhage. cxr: cardiomegaly and prominence of the interstitial markings suggests pulmonary vascular congestion. no effusion. tte: mild global biventricular hypokinesis without regional dysfunction. ef 45%. trace aortic regurgitation. mild (1+) mitral regurgitation is seen. moderate pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. recommend sbe prophylaxis. carotid us: normal carotids and vertebrals. brief hospital course: mr. was admitted to the icu following iv administration of t-pa 2 hours and 10 minutes after his stroke. he sustained a relatively large left mca stroke, likely secondary to thromboembolism as he was found to be in atrial fibrillation (a new diagnosis). initially he had some bloody ngt output, but this cleared with lavage and his hct remained stable. no complications from t-pa; head ct the next day showed no gross hemorrhage. initially he required pressors (dopamine, then neosynephrine) in the icu for bp support as he was given labetolol in the ed. he was extubated the day after admisison. exam off sedation: awake, alert, not following commands in his native tongue, no verbal output (globally aphasic), right face droop, possibly has a right visual field defect, does blink bilaterally, right hemiplegia but does withdraw right leg to noxious stimuli. right arm continues to extensor posture with pain. tone increased on the right with hyperreflexia. he failed swallow evaluation. thus peg tube was placed on . for the atrial fibrillation he was started on metoprolol for rate control. heart rate still needs monitoring to ensure adequate rate control at current metoprolol dosing; he may need diltiazem added. after peg placed, he was started on coumadin for secondary stroke prophylaxis, though he was not loaded with coumadin given the large size of his stroke. goal inr . his pcp, . in , agreed to follow his inr upon discharge from rehab. ldl elevated at 110, thus statin therapy was initiated. carotid ultrasound normal. hba1c was elevated at 6.3. glucose was controlled during admission with riss. he should have the possible diagnosis of diabetes explored with pcp. tte showed biventricular hypokinesis with an ef of 45%. he should be started on an acei when bp allows, and have an outpatient stress test. ** needs endocarditis ppx prior to dental procedures per tte report. ** he developed a leukocytosis, but this resolved and cxr was negative for infiltrates. on discharge, he still had a global aphasia and dense right hemiplegia with no spontaneous movement of right side. medications on admission: none discharge medications: 1. insulin regular human 100 unit/ml solution sig: varies units injection asdir (as directed). 2. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 3. heparin sodium (porcine) 5,000 unit/ml solution sig: one (1) ml injection tid (3 times a day) as needed for dvt prophylaxis. 4. atorvastatin calcium 10 mg tablet sig: one (1) tablet po daily (daily). 5. acetaminophen 650 mg suppository sig: one (1) suppository rectal q6h (every 6 hours) as needed for pain, fever. 6. warfarin sodium 2 mg tablet sig: one (1) tablet po hs (at bedtime). 7. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 8. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 9. metoprolol tartrate 25 mg tablet sig: one (1) tablet po qid (4 times a day). discharge disposition: extended care facility: - discharge diagnosis: left middle cerebral artery infarction, likely cardioembolic, complicated by dysphagia requiring peg placement atrial fibrillation, new diagnosis hypertension hypercholesterolemia systolic chf, ejection fraction 45% acute renal failure, resolved respiratory failure requiring intubation, resolved discharge condition: stable with global aphasia and right hemiplegia discharge instructions: take all medicines as prescribed. keep all follow-up appointments. call your doctor or return to the ed if you develop new arm lor leg wekaness or difficulty seeing. followup instructions: follow-up with your pcp 1-2 weeks after discharge from rehab. he will manage your atrial fibrillation, hypertension, high cholesterol and will screen you for diabetes. given systolic chf, should also be started on an acei when bp allows, and have an outpatient stress test. follow-up with dr. in clinic in weeks. call to schedule an appointment. md, procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube enteral infusion of concentrated nutritional substances injection or infusion of thrombolytic agent percutaneous [endoscopic] gastrostomy [peg] diagnoses: mitral valve disorders congestive heart failure, unspecified acute kidney failure, unspecified atrial fibrillation systolic heart failure, unspecified acute respiratory failure cerebral embolism with cerebral infarction 

Answer: The patient is high likely exposed to