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 / tetracycline attending: chief complaint: headache major surgical or invasive procedure: : angiogram with coiling of the r pcomm aneurysm : angiogram with interarterial verapamil to bil acas history of present illness: 51 y/o f with history of hyperlipidemia presents after being found down at home this morning. patient's significant other was able to provide history. he states that patient has been complaining of headache for a couple days and this morning patient was in bathroom when he heard a scream. he ran to the bathroom where he found her laying on the floor in a pool of emesis. he states that at that time patient was disoriented and preservative. ems was called and patient transported to . once at , head ct was done which revealed diffuse sah. cta was done and a r pcom aneurysm was seen. neurosurgery was consulted. patient complained of pain at the base of the head. past medical history: significant other- hyperlipidemia social history: has a son and daughter, +tobacco, +etoh family history: no history of brain aneurysm physical exam: hunt and : 3 : 4 gcs e:4 v:5 motor:6 gen: wd/wn, comfortable, nad. heent: normocephalic pupils: 3-2mm bilaterally eoms: intact neuro: mental status: awake and alert, cooperative with exam orientation: oriented to person, place, and date. cranial nerves: i: not tested ii: pupils equally round and reactive to light,3 to 2 mm bilaterally. visual fields are full to confrontation. iii, iv, vi: extraocular movements intact bilaterally without nystagmus. v, vii: facial strength and sensation intact and symmetric. viii: hearing intact to finger rub bilaterally. ix, x: palatal elevation symmetrical. : sternocleidomastoid and trapezius normal bilaterally. xii: tongue midline without fasciculations. motor: normal bulk and tone bilaterally. no abnormal movements, tremors. strength full power throughout. sensation: intact to light touch. pertinent results: ct/cta head : 1. 5.6 x 3.3 mm saccular aneurysm arising from the right posterior communicating artery. 2. extensive subarachnoid hemorrhage layering within the basilar cisterns. crowding of the cerebellar tonsils at the level of the foramen magnum suggestive of a component of herniation. 3. prominence of the temporal horns may indicate a component of early developing hydrocephalus for which close follow-up is recommended ecg : sinus bradycardia with sinus arrhythmia. poor r wave progression. compared to the previous tracing of irregular sinus bradycardia is new. the qrs changes in leads v3-v4 could be due to lead placement. qt/qtc: 480/457, rate 47, pr 134, qrs 86, p 16, axis: qrs 26, t 29 ct/cta head : findings: there is interval evolution of the diffuse subarachnoid hemorrhage. redistribution of blood within the ventricles. multiple streak artifacts are seen in the suprasellar cistern from the previously placed coils in the right pcom aneurysm. there is mild dilatation of the ventricles as compared to the prior scan suggestive of mild communicating hydrocephalus. cta head: intracranial and internal carotid arteries, vertebral arteries, basilar artery and their major branches are patent with no evidence of stenosis, occlusion, dissection or aneurysm. multiple streak artifacts are seen from the previous coil embolization of right pcom aneurysm. there is mild vasospasm involving bilateral anterior cerebral arteries . impression: interval evolution of diffuse subarachnoid hemorrhage. compared to the previous scan there is mild dilatation of the ventricles suggestive of mild communicating hydrocephalus. there is mild vasospasm involving bilateral anterior cerebral arteries. echo : the left atrium is normal in size. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no pericardial effusion. ecg : sinus bradycardia. delayed precordial r wave transition as recorded on . the rate has increased. otherwise, no diagnostic interim change. rate 58, qt/qtc 426/422, pr 116, qrs 98, p 31, axis: qrs 21, t 24 ct/cta head : findings: ct head: streak artifact from the coil pack in the right posterior communicating artery origin aneurysm slightly limits evaluation at that level. there is decreased extent and density of subarachnoid hemorrhage, with no new hemorrhage. there is stable dilatation of the ventricles compared to . intraventricular hemorrhage seen on has resolved. there is no evidence of new acute major vascular territorial infarct. the visualized portions of the paranasal sinuses and mastoid air cells are clear. osseous structures are unremarkable. cta of the head: compared to the two prior exams, there is decreased caliber of the a1 and a2 segments of the anterior cerebral arteries, and of the m1 segments of the middle cerebral arteries, worse on the right. there is no change in the caliber of the posterior circulation arteries. there is a dominant left vertebral artery. evaluation for residual filling of the previously embolized right posterior communicating artery origin aneurysm is limited by streak artifact from the coil pack. impression: 1. expected evolution of subarachnoid hemorrhage. no new hemorrhage. 2. stable dilatation of the ventricles compared to , suggesting mild communicating hydrocephalus. resolution of intraventricular hemorrhage since . 3. progressive vasospasm of the a1 and a2 segments of the anterior cerebral arteries and of the m1 segments of the middle cerebral arteries, right worse than left. : ct cta ct head: there is no evidence of new hemorrhage, edema or mass effect. subtle hypodensty is noted in the posterior limb of right internal capsule which is more prominent on the present scan (se 2, 15) as compared to the previous scan, which raises possibility of ischemia. streak artifact from the coil pack in the right posterior communicating artery aneurysm limits the evaluation at this level. there is evolution of the subarachnoid hemorrhage seen on prior studies. there is stable dilatation of the ventricles. visualized paranasal sinuses and mastoid air cells are clear. osseous structures appear unremarkable. cta head: the evaluation for residual filling of the previously embolized right posterior communicating artery aneurysm is limited by streak artifact from the coil pack. there is decreased caliber of m2 segment of the right middle cerebral artery which is similar as compared to the previous study. there is decreased caliber of a1 and a2 segments of bilateral anterior cerebral arteries, worse on the right side, but is stable as compared to the prior study. the posterior circulation arteries appear normal. there is left dominant vertebral artery. impression: 1. subtle hypodensty is noted in the posterior limb of right internal capsule, which raises possibility of ischemia. 2. no evidence of new hemorrhage. evolution of the subarachnoid hemorrhage. 3. stable dilatation of the ventricles. 4. stable appearance of m2 segment of right mca and stable vasospasm of a1 and a2 segments of bilateral anterior cerebral arteries, right greater than left. lenis: impression: no evidence of right or left lower extremity dvt. cta head: note is again made of trace subarachnoid hemorrhage and right interal capsule hypodensity (2:16). ventricular caliber is unchanged as is the appearance of the intracranial vasculature. the caliber of the aca's is unchanged as are the mca's. notably, the mca's are improved in caliber when compared to . brief hospital course: 51 y/o f found down this morning by significant other in pool of emesis. patient was transported to . head ct showed diffuse sah and cta was performed which revealed a 6mm r pcom aneurysm. patient was admitted to neurosurgery and transported to the icu for close monitoring. she was taken to angiogram for coiling of r pcom aneurysm. there was no complications and she was taken back to the icu. her sheath was pulled and she remained to have good distal pulses. she remained on bed rest for six hours and then was allowed to move around. on , her exam remained stable. she was oob with physical therapy. on , she was bradycardiac but no intervention was deemed needed. she continued to complain of headaches and a steroid taper was started. her headaches continued and a cta head was ordered on . the cta showed mild vasopsasm. she was pressed to systolic bp 160-200. her exam remained unchanged. we repeated the ct/cta on which showed progressive vasospasm and the patient was taken to angio and received a total of 15mg of intra-arterial verapamil to the bilateral acas. post-angio, her sbp was kept greater than 160 and her exam remained stable. we started formal triple h therapy in the icu with pressors and fluids at a rate of 150cc/hr. her exam remained stable while on vasospasm watch. the morning of she developed hypotension while on the commode to sys of 108. she develped acute left facial assymetry and slurred speech. she was placed back to bed in trendelenburg. we pressed her sys bp to 170 and she had resolution of her symptoms in about 10 minutes time. she remained stable otherwise. on , her sbp was liberalized to be greater than 150 without any complication. on , her sbp was liberalized to be greater than 120 and subsequently on she was liberalized completely to autoregulate at her baseline. no new neurological defecits were appreciated. she was transferred to the step down unit on with telemonitoring. she remained stable medically and neurologically on . on she got a cta head which showed a stable sah and ventricular size. there was improvement in the size of mca. at that time she was considered ready for discharge home. medications on admission: simvastatin 10mg qd, estrogen patch, prometrium 100mg qd, ativan 0.5 prn, motrin prn discharge disposition: home discharge diagnosis: sah right posterior communicating artery aneurysm / ruptured headache cerebral artery vasospasm uti diplopia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: medications: ?????? take aspirin 325mg (enteric coated) once daily. ?????? continue all other medications you were taking before surgery, unless otherwise directed ?????? you make take tylenol or prescribed pain medications for any post procedure pain or discomfort. what activities you can and cannot do: ?????? when you go home, you may walk and go up and down stairs. ?????? you may shower (let the soapy water run over groin incision, rinse and pat dry) ?????? no heavy lifting, pushing or pulling (greater than 5 lbs) for 1 week (to allow groin puncture to heal). ?????? after 1 week, you may resume sexual activity. ?????? after 1 week, gradually increase your activities and distance walked as you can tolerate. ?????? no driving until you are no longer taking pain medications what to report to office: ?????? changes in vision (loss of vision, blurring, double vision, half vision) ?????? slurring of speech or difficulty finding correct words to use ?????? severe headache or worsening headache not controlled by pain medication ?????? a sudden change in the ability to move or use your arm or leg or the ability to feel your arm or leg ?????? trouble swallowing, breathing, or talking ?????? numbness, coldness or pain in lower extremities ?????? temperature greater than 101.5f for 24 hours ?????? new or increased drainage from incision or white, yellow or green drainage from incisions ?????? bleeding from groin puncture site followup instructions: please follow up with dr. in 2 weeks with an mri/mra with and without contrast ( protocol). please call to make this appointment. procedure: arteriography of cerebral arteries arteriography of cerebral arteries injection or infusion of other therapeutic or prophylactic substance endovascular (total) embolization or occlusion of head and neck vessels diagnoses: other iatrogenic hypotension tobacco use disorder urinary tract infection, site not specified subarachnoid hemorrhage other and unspecified hyperlipidemia other specified cardiac dysrhythmias other encephalopathy streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] headache other specified transient cerebral ischemias diplopia other speech disturbance other symbolic dysfunction 

Answer: The patient is high likely exposed to