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: syncope major surgical or invasive procedure: temporary ppm rij cvl permanent pm history of present illness: 74 f, creole speaking, unclear pmh p/w palpitations and doe. pt came to the usa on . her son states that she was having episodes of suncope in . here he noticed that she was feeling sob while walking upstairs. last night she woke up in middle of night feeling sob. hence he brought her to the er. in the ed, initial vitals 98.2 42 174/37 98/ra. ekg showed complete heart block. ep was consulted. she was admitted to ccu for monitoring with a plan to doa ppm tomorrow am. she has a +ve ua and was given ciproflox 500 po x 1. in the ccu she denies any cp, sob, dizziness, palpitations. on review of systems, she denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. she denies recent fevers, chills or rigors. she denies exertional buttock or calf pain. she c/o increased urinary frequency but denied dysuria cardiac review of systems is notable for absence of chest pain, orthopnea, ankle edema, palpitations. past medical history: unclear although possibly a seizure disorder according to her daughter in law. cardiac risk factors: unclear but was told in past that she needed three vessel cabg social history: she is from . moved to the states on . lives with her son. tobacco, no etoh. family history: there is no family history of premature coronary artery disease or sudden death. physical exam: vs - 98 176/61 34 98/ra gen: wdwn old female in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvd at angle of jaw. cv: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abd: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. ext: no pitting edema but legs look swollen. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ dp 2+ pt 2+ pertinent results: 04:06pm type-art po2-164* pco2-54* ph-7.33* total co2-30 base xs-1 04:06pm lactate-1.1 k+-4.1 03:40pm type-art po2-51* pco2-56* ph-7.31* total co2-30 base xs-0 intubated-not intuba 03:33pm glucose-98 urea n-24* creat-1.1 sodium-141 potassium-8.3* chloride-109* total co2-26 anion gap-14 03:33pm alt(sgpt)-22 ast(sgot)-62* ld(ldh)-852* alk phos-72 tot bili-0.5 03:33pm albumin-3.9 calcium-8.8 phosphate-3.4 magnesium-2.5 03:33pm wbc-7.4 rbc-4.38 hgb-12.1 hct-35.9* mcv-82 mch-27.5 mchc-33.6 rdw-14.4 03:33pm plt count-227 03:33pm pt-11.5 ptt-21.8* inr(pt)-1.0 11:50am urine blood-sm nitrite-pos protein-100 glucose-neg ketone-tr bilirubin-neg urobilngn-neg ph-5.0 leuk-tr 11:50am urine rbc-0-2 wbc-* bacteria-many yeast-none epi- 11:50am urine hyaline-0-2 11:35am glucose-117* urea n-25* creat-1.3* sodium-143 potassium-7.1* chloride-108 total co2-27 anion gap-15 11:35am ck(cpk)-231* 11:35am ctropnt-<0.01 11:35am calcium-9.2 phosphate-3.6 magnesium-2.5 11:35am wbc-7.4 rbc-4.94 hgb-13.1 hct-40.8 mcv-83 mch-26.6* mchc-32.1 rdw-14.2 11:35am neuts-49.3* lymphs-41.1 monos-6.7 eos-2.1 basos-0.8 11:35am plt count-255 11:35am pt-11.9 ptt-23.1 inr(pt)-1.0 ekg demonstrated complete heart block and rbbb. tte : the left atrium is dilated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. the left atrial appendage emptying velocity is depressed (<0.2m/s). there is mild symmetric left ventricular hypertrophy with normal cavity size and global systolic function (lvef>55%). right ventricular chamber size and free wall motion are normal. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild to moderate (+) mitral regurgitation is seen. there is no pericardial effusion. impression: no intracardiac thrombus seen. diffuse, but non-mobile aortic atheromata. eeg : findings: abnormality #1: there were intermittent bursts of left fronto-temporal theta frequency slowing. background: showed a well-formed 8 hz alpha frequency posterior predominant rhythm in wakefulness. the anterior-posterior voltage gradient was preserved. hyperventilation: could not be performed. intermittent photic stimulation: could not be performed. sleep: the patient progressed from wakefulness through drowsiness and achieved stage ii sleep. cardiac monitor: showed a generally regular rhythm with an average rate of 60 bpm. impression: this is an abnormal routine eeg in the waking and sleeping states due to the left fronto-temporal slowing indicative of a subcortical abnormality in this region. vascular disease is among the most common causes in this age group. there were no epileptiform features noted. p-mibi : the image quality is satisfactory although there is attentuation from the patient's left arm. left ventricular cavity size is mildly dilated with a calculated edv of 99 ml. rest and stress perfusion images reveal uniform tracer uptake throughout the left ventricular myocardium. gated images reveal mild global hypokinesis. the calculated left ventricular ejection fraction is reduced at 44%. impression: normal myocardial perfusion. mildly dilated lv with ejection fraction of 44%. brief hospital course: # complete heart block: patient presented with chb. unclear if prior syncopal/seizure episodes were related to this. developed episode of seizure-like activity one hour after admission and temporary pacemaker was placed. tte showed likely ischemic cardiomyopathy which may have contributed to chb versus age-related calcification/fibrosis. had ppm placed later in admission. will follow up with dr. and dr. in the clinic. will follow up for ppm check in 1 week. will be on keflex for 3 days post-procedure for prophylaxis. # htn: stopped ccbs given the heart block and initiated captopril. was also started on beta blocker for presumed cad given wma on tte. prior to discharge bps were well controlled and patient was transitioned to once daily ace and beta blocker. # seizure: patient had witnessed generalized seizure with right-sided tonic/clonic movements and tongue smacking. on tele there were no associated pauses suggesting chb as cause and patient had history of seizures in past. ativan was given and patient stopped seizing. neurology was consulted. keppra was started. eeg showed left frontal temporal lobe abnormalities. neuro thought this was likely old cva which could have been focus for seizure. patient will follow up with neuro as an outpatient. # uti: had c/o urinary frequency on admission. ua positive. started initially on cipro but after seizure changed to bactrim given cipro lowers seizure threshold. urine culture showed pan-sensitive ecoli and patient was continued on bactrim for 7 days. # cad: patient had wma consistent with cad on tte. given the history of a physician telling the patient she needs cabg it was thought the most likely cause of her lv dysfunction would be ischemic and she was thus risk stratified with ldl/stress test. p-mibi showed mild lv systolic dysfunction and no perfusion defects. ldl was above goal at 151 so statin was started. she was continued on asa and started on ace and beta blocker as above. she will follow up with dr. and in cardiology clinic. # cough: patient was recent immigrant from and c/o dry cough chronically. ppd was ordered but was not placed prior to discharge. patient will follow up with new pcp in clinic and have ppd placed there. # emergency contact: # code: full medications on admission: amlodipine 5mg daily nifedipine 20mg daily asa 81 daily discharge medications: 1. toprol xl 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. disp:*30 tablet sustained release 24 hr(s)* refills:*2* 2. lisinopril 10 mg tablet sig: 1.5 tablets po once a day. disp:*45 tablet(s)* refills:*2* 3. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 4. simvastatin 20 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 5. bactrim ds 160-800 mg tablet sig: one (1) tablet po twice a day for 4 days. disp:*8 tablet(s)* refills:*0* 6. keflex 500 mg capsule sig: one (1) capsule po three times a day. disp:*6 capsule(s)* refills:*0* 7. levetiracetam 500 mg tablet sig: two (2) tablet po bid (2 times a day). disp:*120 tablet(s)* refills:*2* discharge disposition: home with service facility: home health care discharge diagnosis: complete heart block seizure disorder urinary tract infection discharge condition: stable discharge instructions: you had complete heart block and a pacemaker was inserted. do not take a shower until after you have your device clinic appt. you may bathe in a tub but do not get the dressing wet. do not lift your left arm over your head or carry more than 5 pounds for 6 weeks. you will be on an antibiotic for the next several days to treat your urine infection and prevent the pacer site from becoming infected. medication changes: 1. stop taking all of your old medicines except aspirin 2. metoprolol: to increase the pumping function of your heart 3. lisinopril: to lower your blood pressure 4. bactrim: an antibiotic for the urine infection and the pacemaker 5. keflex: an antibiotic to prevent an infection near your pacemaker 6. simvastatin: to lower your cholesterol 7. keppra: an anti-seizure medicine . please call the device clinic if you have any fevers, bleeding, swelling, increasing pain at the pacemaker site. call dr. if you have any further episodes of fainting, chest pain, trouble breathing, nausea or any other concerning symptoms. . you have an appt with dr. on . we were unable to book an interpreter at that time. please come with a family member to interpret or reschedule the appt. followup instructions: device clinic phone: date/time: 11:30. clinical center, , , , . primary care: dr. and dr. phone: date/time: at 1:30pm. no interpreter was able to be booked. clinical center, , , . cardiology: dr. and dr. phone: date/time: at 9:00am. clnical center, . . neurology: dr. and dr. phone: ( date/time: office will call you with an appt in weeks. procedure: venous catheterization, not elsewhere classified initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle insertion of temporary transvenous pacemaker system diagnoses: coronary atherosclerosis of native coronary artery urinary tract infection, site not specified unspecified essential hypertension acute kidney failure, unspecified other convulsions atrioventricular block, complete 

Answer: The patient is high likely exposed to