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 attending: chief complaint: altered mental status; left frontal subdural hematoma major surgical or invasive procedure: none history of present illness: ms. is an 86 year old woman with dm2, coronary artery disease with prior pci, and ckd v on hemodialysis who was transferred from osh to yesterday for subdural hematoma. patient was originally admitted to hospital on with chest pain and a suggestion of subtle ecg changes. troponin t was mildly elevated at 0.04-0.05. she had reportedly been having intermittent chest pain for several days prior to admission as well as some mild disorientation. while at osh, she was put on iv heparin and nitroglycerin with resolution of her chest discomfort. she also had transient dyspnea which was relieved with albuterol/ipratropium nebulizers and bipap. she was taken for cardiac catheterization yesterday morning at osh which reportedly showed stability of her known coronary artery disease; specifically, there was a 90% stenosis at the ostium of d1, 10-20% in-stent restenosis in the lad, and a proximal 40% rca stenosis which had negative pressure wire testing. . following the catheterization at osh, she reportedly had some change in her mental status. a head ct showed a 7 mm left-sided subdural hematoma along the cerebral convexity with 5 mm of midline shift at the septum pellucidum. because of these events, she did not undergo scheduled hemodialysis yesterday, and was transferred to the ed for neurosurgery eval. . records report an intention to give protamine sulfate, though it??????s unclear if it was given prior to transfer. upon arrival to the ed, she was noted to be ??????a&ox3??????. a head ct showed a 6 mm ??????subacute?????? left subdural hematoma along the cerebral convexity. neurosurgery saw her and recommended serial examination, loading with phenytoin 1000 mg iv, and a followup ct in the morning. she received iv morphine for complaints of a headache and became transiently hypotensive (sbps in the 80s) with some worsening delirium; another head ct was unchanged compared to the one on arrival to . she received insulin, dextrose, and kayexelate for mild hyperkalemia. she received one bag of a platelet transfusion due to her recent antiplatelet therapy. she was admitted to micu yesterday. . while she was in micu, patient was comfortable, denied any discomfort. she was mildly somnolent but awakened easily and responded appropriately to questioning, though she was somewhat tangential and distractible. patient underwent hemodialysis today. her repeat head ct showed no significant change in sdh, and her neuro exam had no focal deficits, so she was transferred to medicine floor for continued monitoring. . upon arrival to the medicine floor, patient was alert and orientated x3. she said she has been having chronic intermittent headaches (she attributes it to her known meningioma), but currently she has no headache. she has no other complaints. she denies feeling confused. no fever, chills, nausea, vomiting, diarrhea, constipation, abdominal pain. no shortness of breath or chest pain. no dysuria. no vision changes. . of note, patient states that she fell 3 weeks ago. she said she tripped on something while walking on the carpet, and fell. she denied loc, and her husband was the witness. she didn't check her glucose level at the time. she had no sz, no loss of bowel and urinary control, no post-ictal confusion. past medical history: - coronary artery disease with pci to lad in with drug-eluting stent - hypothyroidism (? prior thyroidectomy) - chronic systolic chf from ischemic cardiomyopathy (lvef 35-40%) with severe tricuspid regurgitation and moderate mitral regurgitation - anemia - prior gi bleeding from avms - dm2 - hypertension - hyperlipidemia - prior tia and stroke - known meningioma at left cerebellar peduncle - pulmonary hypertension - ckd v on hemodialysis every mon, wed, fri - mrsa foot ulcers; recently started vancomycin at hemodialysis - bilateral cataract surgery - prior hysterectomy - prior cholecystectomy social history: tobacco: quit 40 years ago alcohol: denies drugs: denies family history: noncontributory physical exam: vital signs: t 99.2, hr 99, bp 140/49, 20, 95% on ra general: pleasant, well appearing, in nad heent: normocephalic, atraumatic. no conjunctival pallor. no scleral icterus. perrla/eomi. mmm. op clear. neck supple, no lad, no thyromegaly. no carotid bruits. cardiac: regular rhythm, normal rate. normal s1, s2. systolic murmur heard at apex and llsb, radiating to apex. no carotid radiation. lungs: diffuse wheezing and rhonchi bilaterally in all lung fields abdomen: nabs. soft, nt, nd. no hsm. extremities: no edema or calf pain, 2+ dorsalis pedis/ posterior tibial pulses. skin: ulcer at left big toe and right 4th toe. neuro: a&ox3. appropriate. cn 2-12 grossly intact. decreased sensation to light touch at lower legs and feet. deltoids, biceps, 4- triceps, wrist extensors. right ip, 3+/5 left ip, hamstring and quadriceps. df, pf and te difficult to assess pain. + reflexes, equal bl. normal coordination. gait assessment deferred psych: listens and responds to questions appropriately, pleasant pertinent results: admission labs: 04:10pm blood wbc-10.0 rbc-3.40* hgb-11.1* hct-35.1* mcv-103*# mch-32.6* mchc-31.6 rdw-15.8* plt ct-174 04:10pm blood neuts-81.2* lymphs-9.3* monos-2.8 eos-6.2* baso-0.5 04:10pm blood pt-12.1 ptt-24.7 inr(pt)-1.0 04:10pm blood glucose-167* urean-33* creat-5.6* na-133 k-5.8* cl-87* hco3-30 angap-22* 04:10pm blood ck(cpk)-24* 04:10pm blood ck-mb-notdone ctropnt-0.06* 04:10pm blood calcium-10.3* phos-6.3* mg-2.1 10:26pm blood vanco-14.6 -------------------- discharge labs: 08:45am blood wbc-8.0 rbc-3.04* hgb-10.2* hct-31.1* mcv-102* mch-33.6* mchc-32.9 rdw-15.4 plt ct-199 08:45am blood glucose-112* urean-15 creat-3.2*# na-139 k-4.1 cl-95* hco3-34* angap-14 04:10pm blood ck(cpk)-24* 06:15am blood ck(cpk)-43 09:25am blood ck(cpk)-49 03:00pm blood ck(cpk)-38 11:35pm blood ck(cpk)-29 06:20am blood ck(cpk)-35 04:10pm blood ck-mb-notdone ctropnt-0.06* 06:15am blood ck-mb-2 ctropnt-0.11* 09:25am blood ck-mb-notdone ctropnt-0.14* 03:00pm blood ck-mb-notdone ctropnt-0.13* 11:35pm blood ck-mb-notdone ctropnt-0.14* 06:20am blood ck-mb-notdone ctropnt-0.14* 06:20am blood calcium-10.6* phos-4.6* mg-1.8 06:30am blood vitb12-690 folate-greater th 06:30am blood %hba1c-6.0* head ct (- 16:15): subdural blood layers over the left cerebral convexity, measuring approximately 6 mm in depth. this blood is isodense to minimally hyperdense with respect to the brain parenchyma, suggesting subacute age. there is only minimal bowing of the septum pellucidum to the contralateral side. ventricles and sulci are slightly enlarged consistent with parenchymal volume loss. periventricular white matter hypodensity reflects chronic microvascular infarction. small calcifications are present in the basal ganglia bilaterally. hyperdense material seen within the intracranial vasculature suggests previous contrast-enhanced imaging study, presumably done at an outside institution. there is a hyperdense extra-axial lesion seen within the left cerebello-pontine angle, measuring 11 x 16 mm, most consistent with a meningioma (provided history indicates that there was a previous diagnosis of intracranial meningioma). there is no fracture. the mastoid air cells are clear. visualized paranasal sinuses are unremarkable except for minimal right sphenoid sinus mucosal thickening. . head ct (- 20:26): no significant change. . head ct (): no significant change. . head ct (): 1. resolving left subdural hematoma. 2. interval bleed in posterior fossa has resorbed and redistributed. 3. extra-axial lesion at cp angle cistern c/w meningioma appears decreased in size and attenuation likely secondary to resorption and redistribution of posterior fossa blood. . ecg: ecg (- 16:17): sinus rhythm at 69 bpm, normal axis, normal intervals, t-wave inversions in i/, depressions in ii/iii/avf and v4-v6, j-point elevations in v1-v2 . cxr (): 1. mild pulmonary edema with small bilateral pleural effusions. 2. retrocardiac opacity, likely atelectasis. brief hospital course: 86 year old woman was transferred from osh to after being found to have a left frontal subdural hematoma following diagnostic cardiac catheterization at osh. # subdural hematoma: patient underwent 4 head cts during this hospital stay, which showed stable sdh. patient was seen by neurosurgery, who recommended no surgical intervention given stable appearance of sdh. neurosurgery also recommended to continue to hold aspirin for 10 days and plavix indefinitely. however, on day 5 off aspirin and plavix, patient developed substernal chest pain, and after extensive discussion with neurosurgery, we restarted aspirin at 162mg daily, and continued to hold plavix. the last head ct done on when patient was restarted on aspirin showed improvement compared to the one obtained on . she was also started on phenyton 100mg q8h for seizure prevention. patient was on q2-4h neuro checks, and she was neurologically intact during this hospital stay. patient had no headache either. patient was seen by physical therapy, who recommended that patient be discharged to rehab. # coronary artery disease: patient has h/o coronary artery disease with pci to lad in with drug-eluting stent. patient presented to osh on with chest pain, and her cardiologist, dr. , at hospital, and she had a cardiac catheterization on which showed stable coronary artery disease (90% stenosis at ostium of d1, 10-20% instent restenosis in lad des, and 40% stenosis in rca). no intervention was performed. patient was then developed ams while on a heparin gtt and found to have a subdural hematoma. she was intially chest pain free during the intial part of her hospital stay here, but then developed substernal chest pain on . ekg showed some dynamic changes, and trop-t increased from baseline 0.06 to 0.14 which then plateaued. ck was flat. after discussing with neurosurgery, we restarted aspirin 162mg daily, but continued to hold plavix. we also changed metoprolol to toprol 100mg qpm, continued diltiazem 180mg qam, and changed simvastatin to atorvastatin 80mg daily. she then developed 2 more episodes of chest pain, each time responsive to sublingual ntg and morphine. patient was seen by cardiology who recommended to continue the current medical management, and give ntg prn for chest pain. # wheezing on exam: patient was found to have diffuse wheezing on lung exam. she states she has had wheezing for many years. she denies h/o asthma or copd, but given patient's h/o smoking, question whether pt has a component of copd. she does use albuterol inhaler at home. # hypertension: patient was initially hypotensive in the ed in the setting of getting morphine, so anti-hypertensives have been held. her blood pressure medications were later restarted, which include valsartan 160 mg , isosorbide mononitrate 90 mg , diltiazem xr 180mg qam, metoprolol (changed to toprol 100mg qpm). # hyperlipidemia: patient's simvastatin 40mg daily was changed from atorvastatin 80mg daily. # chronic systolic chf: osh tte from showed ischemic cardiomyopathy (lvef 35-40%) with severe tricuspid regurgitation and moderate mitral egurgitation. patient had no failure symptoms here in the hospital, and she was not on lasix. # esrd on hd: patient on hemodialysis mon, wed, fri, which was continued during this hospital stay. her outpatient nephrocaps and lanthanum were continued. # chronic anemia: baseline hct 34. likely multifactorial from esrd and anemia of chronic disease. her hct was stable during this hospital stay. # diabetic ulcers on both feet: patient was noted to have an ulcer at left 1st toe, and another ulcer between the right 3rd and 4th toe. wound care was consulted who recommended further workup to rule out osteomyelitis. we obtained a foot x-ray was concerning for osteomyelitis, but in a different location than her diabetic ulcers. the patient's outpatient vascular surgeon and podiatrist were contact who had already started her on vancomycin were made aware and did not recommend inpatient work up at this time, but that he would follow up with the pt on discharge. additionally, the inpatient vascular team was called and deferred to the the pt's outpatient surgeon. we also contact the patient's podiatrist, who commented that patient was noted have purulent material draining from foot ulcer in the beginning of . the wound culture grew out mrsa, and patient has been getting vancomycin with hemodialysis session since . he also recommended that her work up could be completed as an outpatient, therefore, further consultation with the inpatient podiatry team was deferred. she was continued on vancomycin after hd and will follow up with her vascular surgeon and podiatrist. # dm2 uncontrolled with complication: patient was continued on nph (dose adjusted to 10u qam and 4u qhs) and insulin sliding scale. her glucose was well-controlled during this hospital stay. # hypothyroidism: home dose levothyroxine was continued. # fen: no ivfs were given. patient's electrolytes were monitored and repleted prn. she received regular diabetic renal diet, and she tolerated pos well. # ppx: patient received ppi and bowel regimen. she wore pneumoboots for dvt prophylaxis. # code: dnr/dni medications on admission: home medications: - levothyroxine 137 mcg daily - nph insulin 12 units qam, 8 units qpm - aspirin 81 mg daily - clopidogrel 75 mg daily - lanthanum 500 mg tid with meals - nephrocaps daily - premarin 0.625 mg daily - omeprazole 20 mg daily - valsartan 160 mg - isosorbide mononitrate 90 mg - diltiazem xr 180 mg daily - metoprolol 25 mg - simvastatin 40 mg daily - tramadol 50 mg daily - vitamin c 1000 mg daily - zinc oxide 50 mg daily - vitamin e 400 units daily - vancomycin at dialysis . transfer medications: - insulin sliding scale - levothyroxine 137 mcg daily - nph insulin 10 units qam, 8 units qpm - aspirin 81 mg daily - clopidogrel 75 mg daily - lanthanum 500 mg tid with meals - nephrocaps daily - premarin 0.625 mg daily - pantoprazole 40 mg daily - valsartan 160 mg - isosorbide mononitrate 90 mg - diltiazem xr 180 mg daily - metoprolol 25 mg - simvastatin 40 mg daily - tramadol 50 mg daily - vitamin c 1000 mg daily - zinc oxide 50 mg daily - folic acid 1 mg daily - vitamin e 400 units daily - heparin infusion (stopped prior to transfer) - albuterol/ipratropium nebs discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po twice a day: hold if diarrhea . 2. levothyroxine 137 mcg tablet sig: one (1) tablet po daily (daily). 3. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 4. acetaminophen 500 mg tablet sig: two (2) tablet po q 8h (every 8 hours) as needed for headache. 5. lanthanum 500 mg tablet, chewable sig: three (3) tablet, chewable po tid w/meals (3 times a day with meals). 6. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 7. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical qid (4 times a day) as needed for itching. 8. nph insulin human recomb 100 unit/ml cartridge sig: ten (10) units subcutaneous qam. 9. nph insulin human recomb 100 unit/ml cartridge sig: four (4) units subcutaneous at bedtime. 10. humalog 100 unit/ml cartridge sig: sliding scale subcutaneous qachs. 11. valsartan 160 mg tablet sig: one (1) tablet po bid (2 times a day). 12. isosorbide mononitrate 30 mg tablet sustained release 24 hr sig: three (3) tablet sustained release 24 hr po bid (2 times a day). 13. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed) as needed for chest pain. 14. atorvastatin 40 mg tablet sig: two (2) tablet po daily (daily). 15. phenytoin sodium extended 100 mg capsule sig: one (1) capsule po q 8h (every 8 hours). 16. aspirin 81 mg tablet, chewable sig: two (2) tablet, chewable po daily (daily). 17. ciprofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 4 days. 18. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 19. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 20. metoprolol succinate 100 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po qpm (once a day (in the evening)). 21. diltiazem hcl 180 mg capsule, sustained release sig: one (1) capsule, sustained release po qam (once a day (in the morning)). 22. zofran 2 mg/ml solution sig: four (4) mg intravenous every 4-6 hours as needed for nausea. discharge disposition: extended care facility: rehab discharge diagnosis: primary diagnoses: subdural hematoma coronary artery disease . secondary diagnoses: end-stage renal disease on hemodialysis (m, w, f) hypothyroidism chronic systolic chf dm2 hypertension hyperlipidemia prior tia and stroke mrsa foot ulcers; recently started vancomycin at hemodialysis discharge condition: stable, afebrile, no focal neurological deficits, stable subdural hematoma on head ct, alert and oriented. patient has substernal chest pain intermittently, responsive to sublingual nitroglycerine. discharge instructions: it was a pleasure to be involved in your care, ms. . you were admitted to because of head bleed. you had four cat scans of your head while you were in the hospital, which showed resolving head bleed. the blood will most likely go away with time. you were seen by neurosurgery who recommended that you take anti-seizure medications to prevent any seizure associated with the blood in your head. you should follow up with neurosurgeon, dr. , at in 4 weeks (see below for your appointment). your blood thinners including aspirin and plavix were initially held but aspirin was restarted after you developed chest pain. to prevent more head bleeds, we suggest that you discontinue plavix indefinitely. you developed chest pain while you were in the hospital. you had a small heart attack. we restarted your aspirin, and adjusted your heart medications to best medically manage your chest pain. we asked cardiology to see you, who recommended that you continue medical management, and take sublingual nitroglycerine as needed for chest pain. you were seen by wound care for your foot ulcers. we got an x-ray for your feet, which showed no obvious bone infection. we did not do a mri because your vascular surgeon, dr. , would like to do those studies when he sees you after discharge. your medications have been changed. - please take phenytoin for seizure prevention until you see the neurosurgeon, dr. , here at on - please take aspirin 162mg daily for now - please stop taking plavix - we changed your short-acting metoprolol to toprol 100mg every afternoon - we decreased your diltiazem from 180mg daily to 120mg every morning - we changed from simvastatin to atorvastatin 80mg daily - please continue antibiotic, ciprofloxacin, until for your urinary tract infection followup instructions: we have made an appointment for you to see dr. , your primary care doctor, on , at 1:45pm. we have also set up an appointment for you to see your cardiologist, dr. , on monday, , at 1:30pm, for post-discharge follow-up. we also made an appointment for you to see a neurosurgeon, dr. , here at on at 2:30pm, to follow up on the head bleed. please arrive at 2:00pm for a head cat scan before you see him. we have also made an appointment for you to see your vascular surgeon, dr. , on at 9:00am. we tried to make an appointment for you to see your podiatrist, dr. . , but nobody picked up the phone. please call dr. at to make an appointment to see him within the next two weeks. procedure: hemodialysis diagnoses: hyperpotassemia anemia in chronic kidney disease end stage renal disease renal dialysis status subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery urinary tract infection, site not specified congestive heart failure, unspecified unspecified acquired hypothyroidism other chronic pulmonary heart diseases percutaneous transluminal coronary angioplasty status pulmonary collapse hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease ulcer of other part of foot other specified forms of chronic ischemic heart disease compression of brain other and unspecified hyperlipidemia long-term (current) use of insulin benign neoplasm of cerebral meninges chronic systolic heart failure methicillin resistant staphylococcus aureus in conditions classified elsewhere and of unspecified site subdural hemorrhage diabetes with other specified manifestations, type ii or unspecified type, uncontrolled 

Answer: The patient is high likely exposed to