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: penicillins / oxycontin attending: chief complaint: headache, vertigo major surgical or invasive procedure: none history of present illness: 69 year-old man with a history of hypertension, dyslipidemia, atrial fibrillation (on baby aspirin), cad, and s/p mitral valve repair presents with sudden onset of headache and vertigo since 1:30 pm, and transferred here from an osh for the finding of a right cerebellar and left occipital hypodensity on ct head. the patient was in his usual state of health until 1:30 pm yesterday, when he developed sudden onset of headache and vertigo. the headache was located frontally and occipitally and maximal at onset. he states that it was alternatingly sharp and dull, but constant over the past 30 hours. it generally improved with lying down and worsened with standing and coughing. the pain kept him awake overnight. he vomited yesterday in association with the headache and vertigo, but has had little appetite to eat since that time. with regard to the vertigo, he states that its onset arrived with the headache. he noted the "room spinning" and it stopped after a few minutes of lying down. like the headache, it seemed to worsen with standing. in fact, he states that the vertigo would persist for as long as he assumed the standing position. as his symptoms persisted, he went to hospital for further evaluation. he reportedly had a normal cbc, cmp, and ekg. however, head ct showed a reported 4 cm right cerebellar hypodensity with mass effect on the 4th ventricle and a smaller possible left occipital hypodensity as well. he was subsequently transferred to for further evaluation and management. here he has received tylenol and compazine with improvement of his headache to . he has no vertigo while lying down still. review of systems: son reports chronic problems with balance that have worsened dramatically over the past day or so. his speech is slurred at baseline is now perhaps slightly more so, though his son is not entirely sure. has chronic dry cough. otherwise, no vision or auditory difficulties/abnormalities, difficulties with comprehension, facial droop, dysphagia, numbness, tingling, or weakness. past medical history: -atrial fibrillation (has not had this in quite some time, per patient. cardiologist is dr. of .) -hypertension -dyslipidemia -coronary artery disease -s/p mitral valve replacement -chronic lumbar spine problems, s/p disc repair (fusion) -gerd -kidney disease, unspecified -s/p turp -s/p left ear surgery -left knee fracture with associated sensory disturbances below the left knee social history: lives with son in . has 10 pack year history of tobacco use, but quit 40 years ago. has a history of alcohol and drug abuse, but has been sober for 15 years. denies history of ivdu. family history: no stroke, denies family history of illness physical exam: vitals: t 98.0 f bp 160/92 p 48 rr 16 sao2 98 ra general: nad, disheveled elderly gentleman heent: nc/at, sclerae anicteric, mmm, no exudates in oropharynx, edentulous neck: supple, no nuchal rigidity, no bruits lungs: clear to auscultation cv: regular rate and rhythm, no mmrg abdomen: soft, non-tender, non-distended, bowel sounds present ext: warm, no edema, pedal pulses appreciated, toenails overgrown skin: no rashes neurologic examination: mental status: awake and alert, able to relay coherent history, cooperative with exam, normal affect oriented to person, place, but thinks it is "" attention: can say months of year backward with one error (skips ) language: fluent, dysarthric speech, no paraphasic errors, naming, comprehension, repetition intact calculation: can determine 7 quarters in $1.75 no evidence of apraxia or neglect cranial nerves: fundoscopic exam difficult; visual fields are full to confrontation. pupils equally round and reactive to light, 4 to 3 mm bilaterally. extraocular movements intact with exception of restricted upgaze, no nystagmus. facial sensation intact bilaterally. facial movement normal and symmetric. hearing intact to finger rub bilaterally. palate elevates midline. tongue protrudes midline, no fasciculations. trapezii full strength bilaterally. motor: normal bulk throughout. increased tone versus poor relaxation in all four extremities. slight left pronator drift. no tremor. d t b we fif ip q h ta edb right 5 5 5 5 5 5 5 5 5 5 5 4 4 left 5 5 5 5 5 5 5 5 5 5 5 4 4 sensation: reduced pp below left knee. reduced vibration below left ankle. reduced jps to toes bilaterally. light touch and cold sensation intact throughout. reflexes: b t br pa pl right 3 3 3 3 0 left 3 3 3 3 0 toes were withdrawal bilaterally. coordination: no intention tremor noted. no dysmetria on fnf or hks bilaterally. normal cerebellar check reflex. has prominent truncal ataxia upon sitting up. head thrust test negative. gait: slow initiation, wide-based requiring assistance, extremely ataxic after just two steps. pertinent results: 10:50am blood wbc-9.6 rbc-4.07* hgb-12.1* hct-36.3* mcv-89 mch-29.7 mchc-33.3 rdw-14.2 plt ct-296 06:40am blood wbc-10.0 rbc-4.09* hgb-12.3* hct-36.0* mcv-88 mch-30.0 mchc-34.2 rdw-14.2 plt ct-300 03:24am blood wbc-9.1 rbc-4.24* hgb-13.0* hct-37.3* mcv-88 mch-30.7 mchc-34.9 rdw-14.2 plt ct-324 03:30pm blood wbc-9.3 rbc-4.19* hgb-12.6* hct-37.2* mcv-89 mch-30.0 mchc-33.8 rdw-14.2 plt ct-338 03:30pm blood neuts-80.4* lymphs-15.6* monos-3.8 eos-0.1 baso-0.1 10:50am blood plt ct-296 06:40am blood plt ct-300 06:40am blood pt-12.9 ptt-27.0 inr(pt)-1.1 03:24am blood plt ct-324 03:24am blood pt-12.8 ptt-24.6 inr(pt)-1.1 04:15pm blood pt-13.1 ptt-24.0 inr(pt)-1.1 03:30pm blood plt ct-338 10:50am blood glucose-117* urean-10 creat-1.0 na-143 k-4.2 cl-110* hco3-25 angap-12 06:40am blood glucose-105 urean-12 creat-1.0 na-142 k-3.3 cl-107 hco3-27 angap-11 03:24am blood glucose-98 urean-10 creat-1.2 na-145 k-4.8 cl-111* hco3-23 angap-16 03:30pm blood glucose-128* urean-10 creat-1.0 na-143 k-4.0 cl-107 hco3-24 angap-16 03:24am blood ck(cpk)-484* 03:30pm blood alt-10 ast-18 ld(ldh)-171 ck(cpk)-154 alkphos-38* totbili-0.5 03:24am blood ck-mb-5 ctropnt-<0.01 05:31pm blood ctropnt-<0.01 10:50am blood calcium-9.3 phos-3.5 mg-1.9 06:40am blood calcium-8.8 phos-3.6 mg-1.8 03:24am blood calcium-9.5 phos-2.8 mg-2.0 cholest-165 03:30pm blood albumin-4.3 03:24am blood %hba1c-5.7 03:24am blood triglyc-151* hdl-44 chol/hd-3.8 ldlcalc-91 03:30pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg brief hospital course: this 69 yo m was transferred from osh for monitoring of his new right cerebellar infarct, which was substantial in size. he was monitored in the icu for 48 hours and where serial ct and mr studies of the brain showed stable infarct and edema. he was then transferred to the general stroke floor. there, pt's vertigo had resolved with no evidence of nystagmus on physical exam, however headache persisted intermittently. pt's speech remained dysarthric and quite difficult to understand, however, per pt's son, this is his baseline. coumadin was held for 72 hours for concern of cerebellar hemorhage risk, and was then resumed at 72 hours. he is still subtherapeutic and will need serial pt/inr to titrate for goal of . pt had had a questionable hx of afib in the past, and this was confirmed when pt had a limited episode of af over the night of . over this same night, pt had an episode of transient desaturation to ~90%, and there was concern for aspiration, so he was made npo with a subsequent bedside swallow eval which was equivocal for aspiration. video swallow eval was ordered. pt continued to work with pt/ot during his inpatient admission and was referred to subacute rehab for further mgmt. medications on admission: -aspirin 81 mg daily -simvastatin 20 mg qhs -tricor 145 mg daily -sotalol 80 mg -lisinopril 40 mg daily -amlodipine 10 mg daily -metoprolol 100 mg -omeprazole 40 mg daily -trazodone 100 mg qhs -ultram 50 mg tid prn pain -mirtazapine 30 mg qhs -nortriptyline 45 mg qhs -stool softener -calcium and vitamin d supplement discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h prn as needed for pain or fever. 2. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 3. aspirin 325 mg tablet sig: one (1) tablet po daily (daily): to be stopped when inr therapeutic on coumadin. 4. aspirin please stop patient's aspirin when inr becomes therapeutic to on coumadin. 5. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 6. fenofibrate micronized 145 mg tablet sig: one (1) tablet po daily (). 7. docusate sodium 100 mg tablet sig: one (1) tablet po bid (2 times a day). 8. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day) as needed for constipation. 9. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 10. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po bid (2 times a day). 11. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). 12. sotalol 80 mg tablet sig: 0.5 tablet po bid (2 times a day): hold for sbp < 100 or hr < 50. 13. warfarin 2 mg tablet sig: two (2) tablet po qhs (once a day (at bedtime)): titrate for goal inr of . 14. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 15. ondansetron hcl (pf) 4 mg/2 ml solution sig: one (1) injection q8h (every 8 hours) as needed for nausea: prn n/v. 16. prochlorperazine edisylate 5 mg/ml solution sig: one (1) injection q6 hrs prn as needed: ha or n/v. discharge disposition: extended care facility: - discharge diagnosis: right cerebellar stroke discharge condition: stable discharge instructions: you have had a stroke. in order to prevent recurrance of stroke, it is important to modify your risk factors. you have been placed on coumadin, an antithrombotic , in order to thin your blood. please return to the er if you experience any sudden weakness, change in sensation, visual change, headache, change in speech, or anything else that concerns you seriously. followup instructions: follow up with pmd: , neurological follow up with dr. : . md, procedure: diagnostic ultrasound of heart diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux unspecified essential hypertension atrial fibrillation heart valve replaced by other means cerebral artery occlusion, unspecified with cerebral infarction cerebral atherosclerosis 

Answer: The patient is high likely exposed to