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: sulfa(sulfonamide antibiotics) attending: chief complaint: right ich major surgical or invasive procedure: : diagnostic cerebral angiogram : right hemicraniectomy for decompression : diagnostic cerebral angiogram : cerebral angiogram with onyx embolization of r mca aneurysm history of present illness: 56 y/o female with a pmh significant for mitral valve prolapse, migraine headaches, a lung abscess who was admtted to hospital on with new onset afib with rapid ventricular response. she received plavix, aspirin and lovenox. she was discharged on lovenox. she attended a dinner party today at 5:30 pm, was complaining of a severe headache which she thought was a migraine, layed down until 8 pm at which time she woke up, vomited and was found to have left sided weakness and a facial droop. she was taken to hospital where a ct of the head was obtained and showed a right frontal parietal intracerebral hemorrhage. she was transferred to . in our ed she received dilantin 1gm iv x1 and mannitol 50mg iv x1. past medical history: mitral valve prolapse, migraine headaches, lung abscess, newly diagnosed afib with rapid ventricular response. social history: smokes 1 ppd x >30 years. she denies the use of alcohol or illicit drugs. family history: unknown physical exam: on admission: o: t: bp:118 /91 hr:135 r 19 o2sats 100ra gen: wd/wn, lethargic heent: ncat reaction sluggis, neck: supple. lungs: cta bilaterally. cardiac: irregular, afib with rvr abd: soft extrem: warm and well-perfused. neuro: cranial nerves: i: not tested ii: with left facial droop. pupils: right pupil larger than left. right pupil reactive to light 3mm-2mm; left pupil iii, iv, vi: extraocular movements intact bilaterally without nystagmus. v, vii: left facial droop. viii: hearing intact to voice. ix, x: palatal elevation : unable to asses. : sternocleidomastoid and trapezius : unable to asses. xii: left deviation. mental status: drowsy, opens eyes to voice, follows commands; cooperative with examination. orientation: oriented to person, place, and date. . language: slurred speech, labored and slow. motor: normal bulk and tone bilaterally. no abnormal movements, tremors. moves right ue and le extremity freely on command. no spontaneous movement of the left ue or le. sensation: intact on the right ue and le. decreased sensation in the left ue and le. handedness: right discharge exam: avss nad speech normal and full with moderate word finding difficulty comprehension intact right gaze preference, neck spasmotic toward left. follows commands on right full strength in right delt//tri/is/quad/ham/gs/ta hemiplegic on left. withdraws to noxious stimuli. craniotomy flap is soft and full incision c/d/i, no erythema, edema or drainage. absorbable sutures in place. pertinent results: ecg: irregular supraventricular tachycardia. there is organized atrial activity. this could be atrial fibrillation, atrial flutter with variable block, multifocal atrial tachycardia. there is leftward axis, left ventricular hypertrophy, and intraventricular conduction delay of left bundle-branch block type pattern. no previous tracing available for comparison. clinical correlation is suggested. cta head: impression: 1. large right frontal intraparenchymal hemorrhage, with significant peri-hemorrhagic edema and subarachnoid hemorrhage, with approximately 4-mm shift of midline. 2. cta images show a 4 x 5 mm hyper-attentuating focus, arising from a distal mca branch, highly concerning for a mycotic aneurysm given the location. echo: impression: suboptimal image quality. critical aortic valve stenosis. mild symmetric left ventricular hypertrophy with preserved regional and global biventricular systolic function. ecg: irregular supraventricular tachycardia. since the previous tracing the rate is faster and there is now more prominent aberration with single more leftward axis. since the previous tracing the rate is faster and st-t wave abnormalities are more prominent. clinical correlation is suggested. ecg: sinus bradycardia. left ventricular hypertrophy. st-t wave abnormalities. intraventricular conduction delay of left bundle-branch block type. since the previous tracing sinus bradycardia is now present, axis is less leftward, st-t wave abnormalities less prominent, qtc interval more prolonged. ct head: impression: overall, stable extent of right frontal parenchymal and extensive subarachnoid hemorrhage, with approximately 5 mm leftward shift of midline structures, previously was 4 mm. note added in attending review: noted is early formation of a blood/fluid level within the large hematoma (2:24), which may relate to anticoagulation. also, again noted (as on the preceding cta) is apparent retained contrast material within a rounded structure in the distal aspect of the right sylvian cistern (2:15-16), which may represent a partially-thrombosed aneurysm of the m3 segment of the mca, as suggested by the cta. ct head: impression: 1. immediately status post extensive right frontovertex craniectomy with expected post-surgical changes. there is herniation of the abnormal brain through the craniectomy defect, with some improvement in the degree of leftward subfalcine herniation. 2. large right frontal parenchymal hematoma is slightly larger, with stable associated edema. 3. internal blood/fluid level and overlying and cisternal subarachnoid hemorrhage, as before. cxr: et tube tip is in standard position, 4.8 cm above the carina. left subclavian catheter tip is at the cavoatrial junction. ng tube tip is in the stomach, out of view. cardiac size is top normal, is accentuated by the projection. left lower lobe opacity is likely atelectasis. aspiration or pneumonia cannot be totally excluded. cta head: impression: 1. post-status right fronto-vertex craniectomy. similar large intraparenchymal right frontal intraparenchymal hemorrhage, without evidence of interval hemorrhage. minimal residual 1-mm leftward shift, unchanged. 2. unchanged 5 mm likely-mycotic aneurysm at the distal right mca branch. angio: impression: underwent single vessel diagnostic angiography, which reveals recanalization of a right m3 division 5 mm x 4 mm pseudoaneurysm. given the recent history of surgery, heparing could not be administered. due to the high risk of thrombosis, further therapy could not be provided at this time. these findings were discussed with the healthcare proxy, , and the patient's son immediately following the procedure. cxr: findings: in comparison with the study of , the monitoring and support devices remain in place. cardiac silhouette again is at the upper limits of normal in size without definite vascular congestion or pleural effusion. retrocardiac opacification is consistent with some volume loss in the left lower lobe. angio: impression: ms. underwent cerebral angiography and onyx embolization of a right m3 branch dissecting pseudoaneurysm with complete exclusion of the aneurysm from flow. there is spontaneous retrograde dissection of the distal cervical internal carotid artery, which was observed over a period of thirty minutes and seen to remain unchanged. aspirin 325 mg was also administered for this. ct head findings: patient is status post right frontal craniectomy with stable pneumocephalus along the right frontal convexity. again noted is a large intraparenchymal hemorrhage centered at the right frontal region. the size of the hemorrhage is approximately unchanged from previous study. the onyx material is seen within the hemorrhage from onyx aneurysm embolization which is new from previous exam. there is persistent perihemorrhagic edema and adjacent subarachnoid hemorrhage. there is persistent partial effacement of the right lateral ventricle and right-sided sulci with minimal residual leftward shift. no intraventricular hemorrhage extension is noted. visualized paranasal sinuses are clear. the globes are unremarkable. conclusion: interval onyx aneurysm embolization with stable appearance of right frontal intraparenchymal hemorrhage and stable post-craniectomy changes. cta head impression: 1. there is no evidence of vasospasm. 2. post-surgical changes consistent with right frontal craniotomy with slightly decreased pneumocephalus along the right frontal convexity. 3. slightly increased perihemorrhagic edema with greater extracalvarial expansion of the right frontal parenchyma, consistent with transgaleal brain herniation. stable minimal residual leftward shift. there is no evidence of intraventricular hemorrhage. cerebral angiogram: ms. underwent diagnostic cerebral angiography, selective catheterization of a superior division of the m2, and infusion of 10 mg of verapamil for further treatment of vasospasm with some resultant improvement. there is an unchanged appearance of cervical segment ica dissection. abd xr - dobbhoff tube with distal tip in the stomach. - dobbhoff tube has been pulled back and the tip is in the distal stomach/antrum. evaluation of the lungs is limited due to the projection. still diffuse opacities in the left perihilar region and lower lobes bilaterally, left greater than right, are present and unchanged. these opacities have wide radiologic differential diagnosis include aspiration pneumonia and asymmetric pulmonary edema. the component of pulmonary edema has minimally improved prior study. ecg sinus bradycardia. since the previous tracing no significant change brief hospital course: pt was admitted to the neurosurgical service, icu for close neurological observation. she recieved protamine to reverse her elevated inr. she was taken to the angio suite for a cerebral angiogram. no aneurysm was found. the patient was hemodynamically unstable during the procedure and the anesthesia team consulted cardiology. she was started on a dilt drip for her afib rvr, which was eventually converted to po. on she was taken to the operating room and underwent a right decompressive hemicraniectomy. this was performed without complication. she had tcd's for vasospassm monitoring and an echo per cards request. the tee revealed critical as but stable ef. she also underwent a cta which was suggestive of a right mca aneurysm. she returned for another cerebral angiogram but the attempt at coiling was unsuccessful. she was again hemodynamically unstable at times during the procedure and was started on pressors and amiodarone. on she was neurologically stable. she was seen by the cardiology team who did not recommend valvuloplasty at this time and suggested a cardioversion. prior to this being performed the patient converted on her own to nsr. she was again taken for a cerebral angiogram and the aneurysm was successfully embolized using onyx. she was started on aspirin 325mg and her bp was liberalized. daily tcd's were ordered. on she was successfully extubated in the afternoon. she recieved one unit of blood for a hct of 25. on , patient was febrile and placed on a cooling blanket. blood, urine, and sputum cultures were sent along with a bal. gram positive rods and cocci were seen in the sputum sample and the patient was treated with vancomycin and zosyn for presumed vap. on % and mannitol were discontinued. her i/os were grossly positive and her ivf were decreased to reduce her cardiac/ respiratory risk. a cta head that showed mild vasospasm in the right mca. one bottle from blood cultures sent grew gram positive cocci and rods. in the afternoon she had an episode of increased secretions, desat to 87%, hr up to 90's (from 60's) requiring bagging and suctioning. the patient returned to baseline and remained stable. on , patient was taken to the angio suite for evaluation of for vasospasm and she recieved intra-arterial verapamil to her right mca for spasm. on , pt again had episodes of afib which responded to lopressor iv. on , patient was extubated without incident. she remained stable and was transferred to floor in stable condition. on , cardiology was consulted and they recommended decrease amio from 400 mg to 200 mg, dilt from 30 mg->15 qid. on , cardiology recommended diltiazem to be discontinued. on patient had had several episodes of bradycardia with borderline hypotension,cardiology recommended decreasing amiodrone to 200mg daily. she will have a follow up appointment with dr. in 3 weeks. on through , patient's vital signs were stable. pt continued to report discomfort in the neck related to the spasm. flexeril and tizanidine were started and helped relieve the symptoms partially. rehab screening was begun and the patient was discharged in stable condition to rehabilitation on . all questions were answered and the patient expressed readiness for discharge. medications on admission: atenolol asa lovenox discharge medications: 1. acetaminophen (liquid) 650 mg po q6h:prn temp>99 2. amiodarone 200 mg po daily 3. aspirin 325 mg po daily 4. atorvastatin 20 mg po daily 5. cyclobenzaprine 10 mg po qid tortacolis 6. docusate sodium 100 mg po bid 7. heparin 5000 unit sc tid 8. levetiracetam oral solution 500 mg po bid 9. nimodipine 30 mg po q2h hold for sbp<90 10. oxycodone (immediate release) 5 mg po q4h:prn pain 11. senna 1 tab po hs 12. tizanidine 4 mg po tid torticollis discharge disposition: extended care facility: - discharge diagnosis: right frontal iph cerebral edema with compression mca aneurysm critical aortic stenosis afib with rvr lvh hemiparesis vap sepsis respiratory failure vasospasm discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: angiogram with embolization and/or stent placement dr. medications: ?????? take aspirin 325mg (enteric coated) once daily. howevery, you must hold aspirin therapy 7 days prior to your second stage surgery which is planned for at 7:30am. ?????? you make take tylenol or prescribed pain medications for any post procedure pain or discomfort. - do not take any aspirin, plavix, ibuprofen, naproxen, motrin starting 7 days prior to your scheduled surgery as these drugs can contribute to bleeding. - heparin sc should be held the night and morning before surgery. 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) ?????? your incision may be left uncovered, unless you have small amounts of drainage from the wound, then place a dry dressing or band aid over the area that is draining, as needed ?????? 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 followup instructions: - you have an appointment in the cardiology clinic with dr. : date/time: 4:00. their clinic is on the in the building on the . - you should return to clinic with dr. in on , at 11am. you will need a ct head prior to your appointment and it is scheduled for 10am that same day. at that time, discussion regarding the second stage of your procedure will take place. - currently your cranioplasty surgery for replacement of the bone flap is scheduled for at 7:30am. you should not have anything to eat or drink after midnight the night before and you should arrive at 6am on the day of surgery. you must hold your aspirin therapy 7 days prior to surgery. appointments and radiology listed below: provider: , md phone: date/time: 4:00 provider: scan phone: date/time: 10:00 provider: , md phone: date/time: 11:00 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more incision of cerebral meninges insertion of endotracheal tube arteriography of cerebral arteries arteriography of cerebral arteries endovascular embolization or occlusion of vessel(s) of head or neck using bioactive coils diagnoses: other postoperative infection unspecified septicemia atrial fibrillation aortic valve disorders subarachnoid hemorrhage sepsis intracerebral hemorrhage compression of brain other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other specified cardiac dysrhythmias pneumonitis due to inhalation of food or vomitus cerebral edema late effects of cerebrovascular disease, hemiplegia affecting unspecified side ventilator associated pneumonia migraine, unspecified, without mention of intractable migraine without mention of status migrainosus acute respiratory failure following trauma and surgery 

Answer: The patient is high likely exposed to