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: aricept / zinc attending: chief complaint: head trauma major surgical or invasive procedure: endotracheal intubation history of present illness: 89 yo female with dementia transferred from after being found to have subdural hematoma with midline shift. per nursing home documentation it is believed the patient was assaulted by another nh resident. she was brought to where she was intubated for airway protection and transferred for neurosurgery evaluation. notably, pt had dnr in place. per the ed note the patient had no focal neurologic findings prior to intubation. neurosurgery recommended surgical intervention, however, the family believes this is not compatible with her goals of care. they are asking that the patient be extubated and made comfort measures only. in the ed her vitals were 97.6 131/64 63 100 vented. she received a dilantin load and was sedated with fentanyl and versed. past medical history: dementia htn diverticulitis hypercholesterolemia social history: resident of emeritus at in (. family history: nc physical exam: physical exam on admission vs: temp: bp:111/60 hr:63 rr:11 o2sat: 100 gen: intubated, sedated heent: 1mm pupils, mildly reactive (1-2mm), c-collar in place resp: cta b/l with good air movement throughout cv: rr, s1 and s2 wnl, no m/r/g abd: nd, +b/s, soft, nt, no masses or hepatosplenomegaly ext: 1+ le edema skin: right periorbital echymosses and swelling neuro: pupils reactive, + weak gag physical exam on discharge vs: tm 99.5, tc 98.4, hr 92 (78-92), bp 147/86 (130-172/76-90), rr22, o2sat 90% on 3l gen: non-intubated, awake, alert, not oriented, on nc heent: perrla, mucous membrane moist neck: supple cv: rrr, difficult to appreciate any m/r/g masked by patient's mumbling resp: ctab in anterior lung field with good air movements abd: soft, nt, nd, bs present ext: warm, dry, 2+ dp pulses bilaterally neuro: perrla, moving all limbs, does not follow commands pertinent results: labs: - cbc with diff: wbc-13.4* rbc-3.62* hgb-10.4* hct-31.7* mcv-88 mch-28.8 mchc-32.8 rdw-14.3 plt ct-227 neuts-71.2* lymphs-21.5 monos-4.0 eos-2.8 baso-0.5 - chem 10: glucose-121* urean-13 creat-0.7 na-143 k-3.2* cl-109* hco3-24 calcium-8.2* phos-1.6* mg-1.9 - abg: type-art rates-14/18 tidal v-500 peep-5 fio2-40 po2-147* pco2-35 ph-7.47* caltco2-26 base xs-2 intubat-intubated - cbc with diff: wbc-15.5* rbc-3.95* hgb-11.2* hct-34.2* mcv-87 mch-28.3 mchc-32.6 rdw-14.8 plt ct-453* neuts-87* bands-0 lymphs-8.0* monos-4 eos-0 baso-1 - chem 10: glucose-160* urean-17 creat-1.4* na-138 k-3.9 cl-104 hco3-19* calcium-8.4 phos-3.7 mg-1.9 - phenyto-17.6 images: cxr portable 1: the endotracheal tube is with tip terminating just at the orifice of the right mainstem bronchus. the lungs are clear. there are no pleural effusions or pneumothorax. cardiomediastinal contours demonstrate tortuosity of the thoracic aorta and mild cardiomegaly. pulmonary vascularity is normal. there are extensive degenerative changes involving the thoracolumbar spine. impression: endotracheal tube with tip just at the orifice of the right mainstem bronchus and can be withdrawn by 4 cm for more optimal positioning. cxr portable 2: in comparison with the earlier study of this date, the endotracheal tube has been pulled back so that the tip lies approximately 2.7 cm above the carina. however, the tube is directly positioned at the right wall of the trachea. remainder of the heart and lungs is essentially unchanged. there has also been placement of a nasogastric tube. the side hole appears to be just distal to the esophagogastric junction. ct c-spine impression: no acute fracture or malalignment. multilevel degenerative disease as noted above. ct head 1. no interval change in the appearance of the left subdural hematoma with stable 6-mm rightward midline shift. 2. stable appearance of the bilateral nondisplaced nasal bone fractures. cxr portable: the cardiomediastinal and hilar contours are stable. there is prominence of right hilum. there has been interval development of retrocardiac opacity. no effusions or pneumothorax. impression: interval development of retrocardiac opacity. this may represent atelectasis, although infection cannot be excluded. brief hospital course: 89 yo female with dementia transferred from osh for traumatic sdh on and discharged on . # sdh: ocurred in setting of trauma at her nursing home. neurosurgery initially recommended surgical intervention given sdh>1cm. pt's daughter (hcp) declined surgery given her mother has not wanted aggressive medical interventions. pt had a repeat head ct 12 hrs after the first head ct which did not show interval change. she was given dilantin load and kept on dilantin tid for seizure ppx with the goal of bp maintained < 140. following extubation, pt alert and interactive. mental status remains altered from baseline which certainly could be related to sdh but is likely also a manifestation of delirium. patient will complete a 7 day course of dilantin to end at the end of . sdh can be monitored clinically. comfort care is the goal per family. # intubation: pt intubated at for airway protection. she was extubated on without complications. pt has been firmly dnr/dni and per hcp would not want re-intubation. # aspiration pneumonitis/pneumonia. while in the micu, patient was suspected to have aspiration pneumonia and was treated with unasyn - . she was placed on a dysphagia diet. however, she had episodes of loose bowel movement, nausea and vomiting with repeat cxr showing retrocardiac opacification, suggesting aspiration pneumonia vs. pneumonitis. discussion of restarting antibiotics was made with patient's hcp, and she felt strongly that her mother would prefer not to have escalation of care at this point. no antibiotics was started. patient's respiratory symptoms and lowered o2 saturation was treated with o2 supplement and morphine as needed. she tolerated well. this can be monitored clinically. discussion was made with family regarding her diet, and daughter agrees to trials of oral food at this time, knowing that she has increased risk of aspiration. however, if patient continues to exhibit signs of aspiration, will hold off on po food and readdress this with her family about diet. # metabolic acidosis, noted on after the event mentioned above. no additional monitoring was done after discussion with family regarding goal of care. # acute renal failure, noted on after the event mentioned above, likely result of nausea, vomiting, and loose bowel movement. she was given continuous iv fluid. no additional monitoring was done after discussion with family regarding goal of care. # hypertension. this is patient's baseline. however, she was given lisinopril and amlodipine for blood pressure control when she was able to tolerate oral medications. her medications were switched to iv metoprolol on given symptoms of nausea and vomiting. she may resume the oral medications as she transition to hospice. # dementia: held namenda and celexa given altered mental status while she was in the hospital. patient may continue to take her regular home medications. # goals of care: hcp, feels strongly that her mother should not have aggressive medical interventions and is transitioning her mother to a long term facility with hospice. would highly recommend on-going discussion with family about not rehospitalize should ms. condition deteriorates or to re-aspirate. medications on admission: asa 81mg daily namenda 10mg simvastatin 80mg qhs lisinopril 40mg razadyne 4mg robitussin ac qid:prn celexa 10mg daily amlodipine 5mg daily discharge medications: 1. lisinopril 40 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 2. acetaminophen 500 mg tablet sig: 1-2 tablets po every six (6) hours as needed for fever or pain. disp:*30 tablet(s)* refills:*2* 3. citalopram 20 mg tablet sig: 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. quetiapine 25 mg tablet sig: 0.5 tablet po hs (at bedtime) as needed for agitation. disp:*30 tablet(s)* refills:*0* 5. namenda 10 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* 6. razadyne 4 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* 7. simvastatin 80 mg tablet sig: one (1) tablet po at bedtime. disp:*30 tablet(s)* refills:*2* 8. lorazepam 2 mg/ml concentrate sig: one (1) ml po every six (6) hours as needed for anxiety or agitation. disp:*30 ml* refills:*0* 9. atropine 1 % drops sig: two (2) drops ophthalmic every four (4) hours as needed for secretions: drop under the tongue. disp:*5 ml* refills:*0* 10. amlodipine 10 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 11. phenytoin 100 mg/4 ml suspension sig: one hundred (100) mg po twice a day for 1 days: you will complete the course of seizure prophylaxis through . disp:*200 mg* refills:*0* 12. morphine sulfate 20 mg/ml 5 mg (0.25 ml) by mouth or under the tongue every 4 hours as needed for severe pain, mild pain that is persistent or increasing and not responding to acetaminophen, or for breathlessness. discharge disposition: extended care facility: house (hospice home) - discharge diagnosis: traumatic subdural hematoma end-stage dementia aspiration pneumonitis/pneumonia acute renal failure metabolic acidosis hypertension discharge condition: mental status: confused - always. level of consciousness: lethargic but arousable. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: you were admitted to for bleeding into the brain (subdural hemorrhage). you were evaluated by neurosurgery who recommended nonoperative management with medicines instead of surgery and follow up ct head in 4 weeks. while in the hospital, there was a concern of pneumonia acquired from aspiration. you were treated with a a course of antibiotic for this possible infection. later, you had episode of nausea and vomiting with lab results showing inflammatory response. a repeat chest x ray shows that there could be inflammation in the lung from the vomit or a pneumonia, but after a lengthy discussion with your daughter, it was decided not to restart another course of antibiotics because of the transition into comfort care. your diet was discussed with your daughter, and it was thought that you can try to have food, but if you again show signs of aspiration, this will need to be address again with your daughter. please note the following changes in your medications: - please start dilantin 100 mg, suspension, by mouth, twice a day through , which would be the completion of a 7 day course seizure prophylaxis. - please start acetaminophen 500 mg tab, 1-2 tabs, by mouth, every 6 hours as needed for pain. - please start quetiapine (seroquel) 12.5 mg, 0.5 tab of 25 mg tab, by mouth, at bed time as needed for agitation. - please increase amlodipine to 10 mg, 2 tabs of the 5 mg tabs, by mouth, once a day. - please stop aspirin 81 mg, 1 tab, by mouth, once a day, because of the bleeding in your head. - please decrease lisinopril to 40 mg, 1 tab, by mouth, once a day. - please start morphine 0.25 ml (5 mg), by mouth or under the tongue every 4 hours as needed for severe pain or breathlessness. - please start lorazepam 1 mg, by mouth, every 6 hours as needed for anxiety or agitation - please start atropine 1% drops, 2 drops, under the tongue, ever 4 hours as needed for secretions. you can ask the hospice staff to assit you with symptom management. followup instructions: because of your goal to hospice care, no follow-up appointment is made. however, if you feel strongly about following up with neurosurgery, you may arrange a follow up with neurosurgery ( in 4 weeks and requset that a ct of the head be scheduled. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours diagnoses: acidosis pure hypercholesterolemia unspecified essential hypertension acute kidney failure, unspecified pneumonitis due to inhalation of food or vomitus encounter for palliative care alzheimer's disease dementia in conditions classified elsewhere without behavioral disturbance subdural hemorrhage following injury without mention of open intracranial wound, with no loss of consciousness assault by unspecified means late effects of injury purposely inflicted by other person 

Answer: The patient is high likely exposed to