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: patient recorded as having no known allergies to drugs attending: chief complaint: intracranial hemorrhage major surgical or invasive procedure: none history of present illness: history of present illness: 73 yo man with htn, type 2 dm, and regular etoh use who was found down this morning by his son-in-law, adjacent to his bed, awake, talkative, unable to move the left side, especially the left arm. apparently, the patient's roomate had heard the patient knocking on his own door (which is just next to his bed),specifically requesting for his son-in-law, as he was not dressed. when found, the patient initially refused to go to the hospital but ems was called and he was taken to good smaritan/ where his sbp was in the 220s - it was lowered with iv labetalol. a nchct showed a right sided thalmocapsular hemorrhage, the patient was intubated for airway protection and transferred here for neurosurgical evaluation. here he received a repeat head ct/cta and neurosurgery evaluated him - they are not intervening at this time. his blood pressure has been managed with labetalol. he received protonix for blood noticed when placing og tube, this subsequently cleared with lavage. his daughter has noted that he is poorly compliant with his blood presure medication. he saw his pcp last week and bp was elevated. past medical history: htn type 2 dm gout social history: drinks etoh daily, sometimes to inebriation. quit tobacco 30 years ago. no drug use. takes care of own adls. family history: unknown physical exam: examination (off propofol for 5 minutes): afebrile hr 62 (sr) bp 151/72 rr 16 (peep 5; cmv) general appearance: intubated heart: regular rate and rhythm without murmurs, rubs or gallops lungs: clear to auscultation bilaterally. abdomen: soft, nontender extremities: no clubbing, cyanosis or edema neurological: unresponsive to voice. pupils 1.5 bilat and minimally reactive. corneal reflexes present bilaterally. nasal tickle response intact bilaterally. ocrs seem to be present. gag present. grimaces and coughs to noxious stimulation of sternum, left arm, left hand, left leg. unclear if there is facial asymmetry. moves right arm and leg in response to noxious stimuli. localizes anoxious stimuli with right arm. withdraws left leg to noxious (?reflexive). left arm flaccid paralysis. reflexes 2 bilat., appear symmetrical. plantar responses extensor bilaterally. pertinent results: 1:00p 136 102 11 161 4.0 26 1.2 ca: 8.0 mg: 1.7 p: 3.0 alt: 14 ap: 93 tbili: 0.4 alb: 3.0 ast: 20 ldh: dbili: tprot: : 89 lip: 40 5.6>11.8/34.8<252 n:71.0 l:21.5 m:4.3 e:2.4 bas:0.9 pt: 12.2 ptt: 25.6 inr: 1.0 imaging: nchct (1:10pm): findings: an approximately 20 x 29 mm hemorrhage is noted within the posterior aspect of the right thalamic area, extending across the posterior limb of the right internal capsule into the adjacent right lentiform nucleus. there is a moderate amount of extension of hemorrhage within the choroid plexus of the right lateral ventricle, with a minimal amount of layering of free intraventricular blood in the occipital horns. there is no subfalcine herniation. there is a small amount of edema anterior to the hemorrhage itself. there is no hydrocephalus. there is extensive atherosclerotic calcification involving the cavernous portions of both internal carotid arteries. no overt extracranial abnormality is seen other than moderate bilateral ethmoid sinus mucosal thickening, presumably inflammatory in origin. conclusion: moderate-sized right-sided thalamic/internal apsule/lentiform nucleus hemorrhage, with intraventricular extension as noted above. addendum: there is a 1 cm linear calcification adjacent to the anterior aspect of the left temporal lobe cortex, presumably dystrophic dural calcification. nchct (10:00am): no change from the prior examination of . no new emorrhage. c-spine ct: findings: there are no fractures or dislocations. there are large flowing anterior osteophytes consistent with diffuse idiopathic skeletal hyperostosis. the spinal canal appears without disc compression. there are mild posterior osteophytes at c4-c5 and c6-c7 which cause minimal spinal canal narrowing. the patient is intubated. there is a small amount of right apical atelectasis. impression: no fractures or dislocations. diffuse idiopathic skeletal hyperostosis. bilateral ue doppler (): filling defects (clot) and no flow seen in the right cephalic vein in the region of the antecubital fossa. no thrombus identified in the deep veins. cxr: (1/20)1. endotracheal tube 2.5 cm superior to the carina. 2. indistinct opacity at left lower lung base could represent scarring vs. atelectasis. ()interval appearance of small left effusion. retrocardiac atelectasis or consolidation. subsegmental atelectasis right base. (1/23)1. dobbhoff tube in appropriate position. 2. persistent small pleural effusion and left lower lobe atelectasis. () interval removal of endotracheal tube, otherwise no significant change. () no significant interval change. () 1. tip of left-sided picc line within right atrium, 1.5-2 cm below the superior cavoatrial junction. chest cta (): 1. no evidence of pulmonary embolism. 2. multiple subcentimeter mediastinal lymph nodes and a right hilar lymph node measuring up to 1.3 cm. these lymph nodes do not meet ct criteria for pathologic enlargement, however, should be followed closely on future exams. brief hospital course: 73y/o rh male with right thalamic hemorrhage. neuro: he was initially admitted to the icu for close neurologic monitoring and blood pressure control (goal sbp <160). his thalamic hemorrhage is thought to be hypertensive in origin. cta done and was negative for vascular malformations. he was placed on ciwa scale with concern on etoh withdrawal but did not display any signs or symptoms of withdrawal during his hospital course. he had a repeat head ct 24 hours from admission which showed no interval change. eeg was done on hospital day #1 for concern of decreased responsiveness and right arm shaking, but did not show any evidence of epileptiform activity. his exam remained stable with variable confusion, severe dysarthria, left sided inattention, left hemiplegia. repeat ct on showed stable appearance of the hemorrhage. his examination at discharge was still significant on left sided weakness and inattention. otherwise he was awake, alert, slightly dysoriented, fluent speech. followed simple commands. l facial droop. trace muscle contraction at left limbs. right limbs seemed to be good strength. limited r hand opening due to gout. he will continue to have inhouse pt, ot and st at rehabilitation facility. he should be started on coumadin in 3 weeks (goal inr ) for future stroke prevention given pafib (see below). cv: patient had goal map<130. he was started on po metoprolol but required prn labetolol and hydralazine iv. he required occasional lasix infusions for elevated cvp. he was also started on lisinopril and hctz during this admission for improved bp control. doses were titrated to achieve optimum bp control. on , he was noted to be in rapid afib with rvr. this responded initially to iv metoprolol and iv diltiazem, however the effect of the medications was short lived and he ultimated required a diltiazem drip for rate control on . his beta blocker was titrated for improved rate control. he converted to sinus rhythm on the evening of and the diltiazem drip was discontinued. he has remained in sinus rhythm since. given new onset of paf, he will need to be started on coumadin for stroke prevention. coumadin may be started in 3 weeks. resp: patient extubated on hod 4. he developed fever and lll pna which is being treated with antibiotics. he also has had pulmonary vascular congestion which required lasix on several occasions during his admission. on , he became tachypnic in the setting of afib. a cta chest was done to r/o pe and was negative. tachypnea subsequently resolved. fen/gi: tube feeds were intiated as patient thought to be too drowsy to comply with po feeds and failed swallow evaluation x2. as his mental status improved, however, he was able to be re evaluated and passed a swallow evaluation on . he has been tolerating po diet since. id: patient had fever of 100 degrees on hod 4 and got cxr (neg for infiltrates but showed left ll infiltrate serial ucxs, bcxs were all negative. sputum cultures grew gram positive cocci and gnr; later identified as enterobacter aerogenes. he was initially started on vancomycin and cipro for aspiration pneumonia. he continued to spike fevers and antibiotic coverage was broadened to vanc/levo/flagyl. his central line was removed and sent for culture. all cultures have been negative thus far and he has been afebril since . endo: he was initially maintained on riss. on , he was restarted on glipizide 2.5mg . gout: he complained of hand and right arm pain which he felt was due to gout. on , he was restarted on colchicine and received indomethacin for pain. renal function was monitored carefully for co-administration of indomethacin and acei. dvt ppx: he was kept on pneumoboots with sc heparin. he had a rue ultrasound to evaluate persistent rue swelling which showed no flow in right cephalic vein but no evidence of deep vein thrombosis. medications on admission: family does not know the name of his medications but he takes anti-hypertensives, medication for diabetes, and medication for gout. discharge medications: 1. albuterol sulfate 0.083 % solution : one (1) inhalation q6h (every 6 hours) as needed. 2. thiamine hcl 100 mg tablet : one (1) tablet po daily (daily). 3. acetaminophen 325 mg tablet : one (1) tablet po q4-6h (every 4 to 6 hours) as needed for pain. 4. folic acid 1 mg tablet : one (1) tablet po daily (daily). 5. vancomycin in dextrose 1 g/200 ml piggyback : one (1) g intravenous q 12h (every 12 hours) for 7 days. 6. metoprolol tartrate 50 mg tablet : three (3) tablet po tid (3 times a day). 7. lisinopril 40 mg tablet : one (1) tablet po daily (daily). 8. insulin regular human 100 unit/ml solution : sliding scale injection asdir (as directed). 9. colchicine 0.6 mg tablet : one (1) tablet po daily (daily). 10. levofloxacin 500 mg tablet : one (1) tablet po q24h (every 24 hours). 11. glipizide 5 mg tablet : 0.5 tablet po bid (2 times a day). 12. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 13. indomethacin 25 mg capsule : one (1) capsule po tid (3 times a day) for 3 days. 14. metronidazole 500 mg tablet : one (1) tablet po tid (3 times a day). 15. hydrochlorothiazide 50 mg tablet : one (1) tablet po daily (daily). 16. heparin lock flush (porcine) 100 unit/ml syringe : one (1) ml intravenous daily (daily) as needed. 17. vancomycin in dextrose 1 g/200 ml piggyback : 1000 (1000) mg intravenous q 12h (every 12 hours). 18. hydralazine 20 mg/ml solution : ten (10) mg injection q6h (every 6 hours) as needed for prn. discharge disposition: extended care facility: hospital discharge diagnosis: right thalamic hemorrhage atrial fibrillation left lower lobe pneumonia (aspiration pneumonia) discharge condition: stable/improved: discharge examination: awake, alert, slightly disoriented, fluent speech. followed simple commands. l facial droop. trace muscle contraction at left arm and leg. discharge instructions: please return to ed asap, if you experience strong headache, new weakness, numbness, change in vision, hearing, difficulty in speech. please follow up with your pcp to continue to control your hypertension, diabetes (hba1c<6.5) and hyperlipidemia (ldl<55). please have follow up at neurology clinic. coumadin should be started for future stroke prevention (in 3 weeks) given pafib followup instructions: please follow up with dr. , md, phd: date/time: 2:00 please follow up with your pcp after discharged from rehabilitation. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified enteral infusion of concentrated nutritional substances diagnoses: unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled gout, unspecified atrial fibrillation pneumonitis due to inhalation of food or vomitus unspecified intracranial hemorrhage 

Answer: The patient is high likely exposed to