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: meperidine / codeine / doxycycline / amoxicillin / clavulanic acid attending: chief complaint: r sided weakness major surgical or invasive procedure: none history of present illness: mrs. is a 55-year-old right-handed woman presenting with right hemiplegia, aphasia on a background of numerous medical problems, including prior left mca stroke, left carotid endarterectomy, dyslipidemia, hypertension, aortic and peripheral atherosclerosis, spondylosis. she was in her usual state of health this morning, when her grandson went to school at around 8 am. he returned home at 3 pm and neighbour visited - no answer and unable to get into the house. fd broke into home. patient on floor, leaning to left, unable to speak and with right-sided weakness. 911 was called and she was then taken to . there, ct head showed a dense left mca and hypodense tissue in the basal ganglia. despite a possible long latency form onset, it was thought that transfer to may allow intervention if a penumbra was present. thus, she was transferred for perfusion imaging and possible intervention. review of systems was negative except as above. past medical history: past medical history: - anal cancer, constipation, prior proctitis - lichen sclerosis - peripheral vascular disease - squamous cell cancer - history of substance abuse - not specified - aortic atherosclerosis - tobacco use - urinary tract infection, prior - abdominal pain - constipation - goiter - pulmonary nodule - diagnosis of renal insufficiency, recent creatinine 0.7 however - prior anemia - squamous skin cancer - low back pain, lumbosacral and possible cervical spondylosis - hypertension - hyperlipidemia - son reports prior 'tia's' pmhx obtained from patient's son and records social history: smoking: yes, smokes 1.5-2 ppd. alcohol: occasional - in past. drugs: unknown. living situation: independent, lives with grandson. functional baseline: independent. family history: son doesn't know if his mgm had stroke. son not sure of vascular disease. physical exam: admission physical exam: physical exam: vitals: 98.5, 136/81, 79, 19, 97% ra gen: middle aged woman lying in bed in mils distress trying to reposition herself heent: large surgical scar on l neck pulm: cta-b anteriorly cv: rrr abd: soft, nt, nd ext: no peripheral edema . neuro exam: ms - follows short commands, difficulty producing speech, but can answer yes, no and sure appropriately, but is unable to name, read, may have some issues with comprehension, makes many paraphasic errors cn - r facial droop, eomi, perrl motor - plegus in rue and rle, with external rotation on rle, mild triple flexion in rle to painful stim reflexes - r biceps and r patella hyperreflexic, otherwise 2 and symetrical throughout sensory - intact to painful stimuli bilat coordination/gait - deferred pertinent results: admission labs: 05:15pm blood wbc-9.1 rbc-4.37 hgb-14.6 hct-42.7 mcv-98 mch-33.4* mchc-34.1 rdw-12.8 plt ct-167 05:15pm blood neuts-87.0* lymphs-8.0* monos-4.2 eos-0.6 baso-0.2 06:10pm blood pt-11.8 ptt-24.1 inr(pt)-1.0 06:10pm blood glucose-106* urean-6 creat-0.7 na-139 k-3.9 cl-104 hco3-23 angap-16 06:10pm blood alt-12 ast-15 ld(ldh)-213 ck(cpk)-97 alkphos-109* totbili-0.2 06:10pm blood ck-mb-4 ctropnt-<0.01 06:10pm blood albumin-4.2 calcium-9.0 phos-2.7 mg-1.7 cholest-300* 06:10pm blood triglyc-129 hdl-48 chol/hd-6.3 ldlcalc-226* 06:10pm blood tsh-0.47 05:26pm blood glucose-110* na-141 k-4.9 cl-107 calhco3-21 imaging: ct/cta/ctp: impression: 1. noncontrast ct demonstrates cytotoxic edema in the left basal ganglia. ct perfusion indicates acute infarction in the left basal ganglia and frontal lobe, with ischemic penumbra in the left temporal lobe. 2. complete occlusion of the cervical and intracranial left internal carotid artery, and of the m1 and m2 segments of the left middle cerebral artery. there is reconstitution of flow in the distal branches of the middle cerebral artery. 3. exophytic left frontal scalp skin lesion. please correlate with physical exam. ct head repeat: impression: slight interval evolution of hypodensity in left mca distribution consistent with infarction. no midline shift or hemorrhagic transformation. transthoracic echo: no pfo, asd, or cardiac source of embolism seen. mild symmetric left ventricular hypertrophy with normal global and regional biventricular systolic function. brief hospital course: mrs. is a 55-year-old right-handed woman, presenting with right hemiplegia and aphasia on a background of numerous medical problems, including prior left mca stroke, left carotid endarterectomy, dyslipidemia, hypertension, aortic and peripheral atherosclerosis and spondylosis. laboratory studies and imaging, taken together with the above findings suggest either embolic or in situ thombosis of the left carotid with propagation to the left mca. there was infarcted tissue that matched the exam. . # neurologic: patient was initially admitted to the icu for better control of blood pressure. she was started on a pr full dose aspirin. she remained stable and her repeat head ct the next day showed no hemorrhagic transformation so she was transferred to the sdu. her neurologic exam remained stable. she appears to have a global aphasia but with some preserved comprehension. she was able to follow some simple commands, midline more than appendicular, but was unable to name or repeat. she was able to sing happy birthday with some dysarthria but was able to produce mostly correct words. her right arm and leg remained hemiplegic. she initially failed her bedside swallow eval and was maintained npo with meds crushed in puree with maintenance ivf. she passed repeat eval on and was advanced to a pureed diet with nectar thick liquids. we decided to keep her on aspirin, we may reconsider further antiplatlet or anticoagulants in the future. echo was normal. # psychiatric: her home dose trazodone and quetiapine were restarted on after she passed her swallow eval. # cardiovascular: we held patient's metoprolol initially to allow for bp autoregulation but restarted this at her home dose upon discharge. # code status: dnr/dni transitional care issues: ms. will need intensive pt/ot and speech therapy in order to improve her level of functioning. medications on admission: - trazodone 100-200 mg qhs - quetiapine 600 mg qhs - carisprodol 350 mg tid:prn pain - b12 1000 mcg qd - topical betamethasone - lidocaine 5 % topical - plavix 75 mg qd - lisinopril 40 mg qd - hctz 12.5 mg qd - triamcinolone injection - famciclovir 125 mg qd - atorvastatin 80 mg qd discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 2. nicotine 21 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily). 3. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 4. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain / temp. 5. trazodone 100 mg tablet sig: 1-2 tablets po hs (at bedtime) as needed for insomnia. 6. miconazole nitrate 2 % powder sig: one (1) appl topical qid (4 times a day) as needed for fungal rash. 7. quetiapine 300 mg tablet sig: two (2) tablet po qhs (once a day (at bedtime)). 8. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 9. cyanocobalamin (vitamin b-12) 1,000 mcg tablet sig: one (1) tablet po daily (daily). 10. metoprolol tartrate 100 mg tablet sig: one (1) tablet po once a day. 11. lisinopril 40 mg tablet sig: one (1) tablet po once a day. 12. hydrochlorothiazide 12.5 mg tablet sig: one (1) tablet po once a day. 13. famciclovir 125 mg tablet sig: one (1) tablet po once a day. 14. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). discharge disposition: extended care facility: hospital - discharge diagnosis: left mca stroke complete left carotid occlusion discharge condition: mental status: awake and alert, +global aphasia with some preserved comprehension, follows some simple commands level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: dear ms. , you were admitted to on with difficulty speaking and right sided weakness. you were found to have a stroke on the left side of your brain. your stroke is likely related to blockage of your left carotid artery. an echocardiogram showed no source of embolus. you will need rehab and speech therapy in order to regain your prior level of functioning. we made the following changes to your medications: we kept you on a full dose aspirin. if you experience any of the below listed danger signs, please call your doctor or go to the nearest emergency department. it was a pleasure taking care of you during your hospital stay. followup instructions: the following appointment has been made for you in our stroke clinic: provider: , .d. phone: date/time: 1:30 you should also follow up with your primary care doctor within 1-2 weeks. procedure: central venous catheter placement with guidance diagnoses: tobacco use disorder unspecified essential hypertension atherosclerosis of aorta peripheral vascular disease, unspecified constipation, unspecified other and unspecified hyperlipidemia personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits do not resuscitate status aphasia lumbosacral spondylosis without myelopathy goiter, unspecified cervical spondylosis without myelopathy personal history of malignant neoplasm of rectum, rectosigmoid junction, and anus occlusion and stenosis of carotid artery with cerebral infarction solitary pulmonary nodule flaccid hemiplegia and hemiparesis affecting dominant side 

Answer: The patient is high likely exposed to