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: ivp dye, iodine containing attending: chief complaint: acute stroke major surgical or invasive procedure: intubated mri surface echo carotid echo history of present illness: code stroke called at 4:40am, i arrived in ed at 4:45, patient arrived by at 4:52am. history is per ems and his er physician . at and her documentation; also per family, who is now present at 6am. 69yo m h/o htn, hyperlipidemia, dm2 visiting from who went to bed well at 11:30pm last night. his wife was awoken at 2:45am to find him moving about in bed, "as if in pain", with his eyes open and without rhythmic activity that would suggest a seizure. he was not speaking. she called ems. the family noted that he was not moving his right arm and leg; they noted no facial asymmetry or droop. on ems arrival, fsg was 195 and the patient was globally aphasic. at , prior to intubation/sedation/paralytics, he was non-verbal and not following commands. he had his eyes open but visual fields were not tested. eom were full and though his exam was documented as "r neglect" dr. clarified that she used this phrase to characterize the fact that when his left arm was lifted he held it antigravity, but when the right was lifted it drifted slowly back to the bed. there was no difference in responsiveness in relation to the side stimulated, no eye/head/gaze deviation to suggest visuospatial neglect. he did not have spontaneous movement by her report and did not localize to pain. in radiology, he vomited copiously and was intubated for airway protection, given lidocaine, fentanyl, vecuronium, succinylcholine and ativan at 3:25am. head ct was positive only for chronic left caudate lacune; it was negative for ich or signs of acute stroke (it is here on hard copy, however, and cannot be windowed to look for more subtle signs of infarction). ekg showed nsr @ depressions. here in our ed, my exam takes place 10 minutes after he was last given sedatives, which included fentanyl/ativan. subsequent to my exam, he was bucking the vent and was given 1mg versed; in response to this, his systolic bp dropped to the 60's and he was given iv fluid boluses and started on dopamine, with subsequent improvement to sbp 130's. he was subsequently stabilized and brought to mri at 6:30am. by report, he has had no headache, n/v, cp or f/c recently. no history of stroke. past medical history: htn dm2 hyperlipidemia s/p cholecystectomy social history: sh: quit smoking 3yrs ago. no etoh/drugs family history: fh: brother with cardiac disease physical exam: vs 97.4 89 160-170's at osh; here 60-130's sbp 97% gen intubated off sedation heent nc/at, no scleral icterus noted, mmm, no lesions noted in oropharynx neck supple, no carotid bruits appreciated. no nuchal rigidity lungs cta bilaterally cv rrr, nl s1s2, no m/r/g noted abd soft, nt/nd, normoactive bowel sounds, no masses or organomegaly noted ext no c/c/e b/l skin no rashes or lesions noted neuro ms does not open eyes to verbal or noxious stimuli. no verbal output. does not follow commands. cn perrl 2mm and non-reactive. funduscopic exam revealed no papilledema, exudates, or hemorrhages. no response to oculocephalic maneuver. corneal reflex and nasal tickle absent bilaterally. no overt facial asymmetry, but this is difficult to assess with the et tube in place. gag reflex intact. motor normal bulk throughout. r arm flaccid. no adventitious movements noted. no asterixis noted. no myoclonus noted. moves his left arm spontaneously and antigravity; no other spontaneous movement noted. l arm withdraws to pain; no other limbs do so. sensory as above reflexes tri pat ach l 2 2 2 2 1 r 3 3 3 2 1 plantar response was flexor bilaterally. pertinent results: labs at osh: sma with cr 1.9, glu 190 cbc unremarkable (hct 39) inr 1.1 ck, trop neg x 1 ua neg for uti tests ekg: nsr @ 99bpm, st depressions in inferolateral leads imaging nchct at osh (here on hard copy): old l caudate lacune. no sign of ich, mass effect, midline shift, or sign of acute infarction mri: impression: acute left aca infarct. mra: left a2 segment thrombotic occlusion consistent with patient's acute left aca infarct. these findings were relayed to the ed via the online wet read dashboard. echocardiogram : the left atrium is normal in size. no atrial septal defect or patent foramen ovale is seen by 2d, color doppler or saline contrast at rest. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity is small. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. no masses or thrombi are seen in the left ventricle. left ventricular systolic function is hyperdynamic (ef 70-80%). there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the number of aortic valve leaflets cannot be determined. the aortic valve leaflets are mildly thickened. there is no valvular aortic stenosis. the increased transaortic gradient is likely related to high stroke volume. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. suboptimal image quality - patient unable to cooperate. video swallow study : video oropharyngeal swallow: study was done in conjunction with the speech and swallow division. multiple consistencies of barium were administered to the patient under constant video fluoroscopy. oral phase was abnormal, with impaired bolus formation, moderate oral residue, and prolonged mastication, with ap tongue thrusting. there was mild retention in the valleculae with swallowing, but this was cleared with subsequent swallows, and there was no penetration or aspiration with any consistency barium. impression: mild oral dysphagia. no evidence of penetration or aspiration. ct abdomen : impression: 1. markedly distended urinary bladder with air within it. correlate with history of instrumentation. 2. large amount of dense material (from prior barium study) within the rectum, likely representing constipation. 3. scattered diverticula within the colon without evidence of diverticulitis. 4. small right kidney (approximately 7.6 cm) may be due to chronic scarring, but other etiologies including renal artery stenosis should be considered. brief hospital course: neuro: patient arrived intubated and sedated. he was admitted to the neuro-icu. ct with findings as above. mri showed findings consistent with acute left aca infarct. blood pressure was controlled with prn lopressor and enaliprilat. he was outside window for iv tpa and ia tpa and did not receive this therapy subsequently. patient was started on aspirin 300mg daily. was extubated in icu and tolerated well. was transferred to neurology floor on stroke service . was abulic but on the floor began following commands correctly appearing to have good comprehension. hba1c was 6.3 and regular insuling sliding scale was used to control blood sugars instead of oral therapy. statins were initiated lipitor 10mg daily. blood pressure was managed with lisinopril 10mg daily and prn doses of enaliprilat. surface echo was negative for clot source and carotid echo was clean but with report of possible subclavian steal (unrelated to patient's infarct). swallow evaluation was adequate bedside and video swallow showed that swallowing function was nml. he was transferred to the floor where he continued to work with pt and ot. he made some improvement with his neurological exam as was able to mouth words appropriately and had some antigravity movement of his right wrist extensors and finger extensors prior to discharge. cvs: ruled out for mi with 3 serial enzymes. echo showed no evidence of pfo, asd or cardioembolic source. he had some left ventricular hypertrophy with ef 70%. no other cardiac issues. resp: tolerated extubation well. no other respiratory issues. endo: patient has been restarted on metformin 500 mg po bid and prn coverage with regular insulin sliding scale. hba1c 6.3%. id: patient had noted distended bladder on ct abdmomen with probable urinary retention on . ua was ordered but not sent. he should have a ua and ucx sent on arrival to rehabilitation facility. gu: patient had 2 days of vomiting with unimpressive lfts and amylase/lipase (mild elevations noted with vomiting). he had a ct abdomen (see results section for full read) which showed diverticulosis and distended bladder with air and urine (air likely from foley placed in the past). urology was called but not officially consulted. this service recommended clean intermittent catheterization if concern of urinary retention continues. they also recommended starting patient on flomax and sending psa which was done. patient should follow-up in clinic in 2 weeks but appointment could not be made because of lack of insurance. ua and ucx needs to be sent on arrival to rehab facility. if there continues to be concern for urinary retention, urology inpatient consultation should be obtained. patient currently receives cic and prn. renal: no acute renal issues. gi: patient initially needed tube feeds but passed swallow study with video imaging. he had episodes of vomiting on with elvated amylase and lipase (thought to be secondary to vomiting) and trended down with cessation of po intake. he restarted po intake on with good tolerance. medications on admission: meds at home: crestor glucophage perindopril discharge medications: 1. heparin (porcine) 5,000 unit/ml solution : one (1) injection tid (3 times a day). 2. atorvastatin 10 mg tablet : one (1) tablet po daily (daily). 3. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 4. lisinopril 10 mg tablet : one (1) tablet po daily (daily). 5. aspirin 325 mg tablet : one (1) tablet po daily (daily). 6. bisacodyl 5 mg tablet, delayed release (e.c.) : two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 7. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) as needed. 8. metformin 500 mg tablet : one (1) tablet po bid (2 times a day). 9. ranitidine hcl 150 mg tablet : one (1) tablet po bid (2 times a day) for 1 days. 10. tamsulosin 0.4 mg capsule, sust. release 24 hr : one (1) capsule, sust. release 24 hr po hs (at bedtime). discharge disposition: extended care facility: & rehab center - discharge diagnosis: right aca stroke discharge condition: patient has non-fluent aphasia (no vocalization). has right facial, 0/5 deltoid, biceps, tricep, ip, q, h weakness. has right wrist extensor and finger extensor strength. he can write, read and follows all commands. discharge instructions: please follow-up with appointments and take medications as instucted. followup instructions: neurology clinic. provider: , md phone: date/time: 10:30 am (please call to confirm your appointment) please call to schedule urology appointment: at in 2 weeeks md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours enteral infusion of concentrated nutritional substances diagnoses: urinary tract infection, site not specified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled other and unspecified hyperlipidemia retention of urine, unspecified cerebral artery occlusion, unspecified with cerebral infarction aphasia hemiplegia, unspecified, affecting unspecified side 

Answer: The patient is high likely exposed to