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: history of present illness: the patient is a 79 year old woman brought in by her daughter after a fall with head trauma and possible loss of consciousness. the patient has recently had twelve previous falls in the past year. past work ups for these falls include of hearts on which showed no recorded events and an echocardiogram on which revealed an ejection fraction of greater than 60 percent. normal rv. mildly thickened arteriovenous. mildly thickened mitral valve with 1+ mr; 1+ tricuspid regurgitation and borderline hypertension. an mri of the head on showed mild to moderate cerebral atrophy with diffuse mild to moderate areas of chronic microvascular infarction. tsh on was 4.1. the patient reportedly has baseline gait instability. she is supposed to use a walker but does not. she has a positive history of seizure disorder ten years ago and was on dilantin ten years ago. she has no seizures since then and hasn't taken dilantin for over ten years. the patient denies chest pain, orthopnea, paroxysmal nocturnal dyspnea or palpitations. review of systems: on review of systems, the patient has urinary incontinence which often happens with a urinary tract infection. she has increasing urgency, increasing fatigue. she reportedly had increasing edema recently and was placed on hydrochlorothiazide within the last year. the patient reports decreased p.o. intake for the last day and decreased appetite. past medical history: 1. the patient reportedly had black lung and is status post right pneumonectomy in . 2. depression. 3. hypertension. 4. history of seizures, status post head injury. 5. hypothyroidism. 6. questionable alzheimer's disease. 7. osteoporosis of the right hip. 8. questionable peptic ulcer disease. 9. status post total abdominal hysterectomy. 10. gastroesophageal reflux disease. 11. left pulmonary nodule. 12. carotid stenosis. 13. recurrent urinary tract infections. 14. hypercholesterolemia. allergies: allergies include zestril and atenolol. medications: 1. zoloft 150 mg q d. 2. elavil 10 mg q d. 3. hydrochlorothiazide 25 mg q d. 4. premarin .3 q d. 5. lipitor 5 q d. 6. levoxyl 88 mcg q d. 7. percocet prn. 8. aspirin q d. social history: she lives with her husband with a family nearby in the surrounding three apartments. no tobacco or alcohol use. the patient's code status is dnr/dni. family history: she has siblings with coronary artery bypass graft, myocardial infarction. son with pulmonary hypertension. history of passive tobacco exposure. physical examination: her temperature was 97.0; blood pressure, 150/92; pulse, 64; respiratory rate, 16; satting 94% on room air. the patient is an elderly woman with mild confusion in no acute distress lying in bed. she has a bruise on the skull with dried blood. pupils are equal, round, and reactive to light. extraocular movements intact. oropharynx, clear. neck, supple. no lymphadenopathy. no bruit. regular rate and rhythm. s1, s2. no murmurs. lungs, clear to auscultation bilaterally. abdomen, soft, nontender, nondistended. positive bowel sounds. extremities, no cyanosis, clubbing or edema. 2+ dorsalis pedis pulses bilaterally. neurological examination, alert and oriented to hospital, self and name. not oriented to day and date. cranial nerves ii through xii are intact. strength, normal in upper and lower extremities. sensation, intact to light touch. deep tendon reflexes, 2+, symmetric bilaterally. laboratories on admission: white blood count, 13.6; 76% neutrophils; 13% lymphs; 9% monos. hematocrit, 44.3. platelets, 417. chemistry, sodium, 135; potassium, 4.3; chloride, 94; bicarbonate, 31; bun, 23; creatinine, 0.8; glucose, 131; magnesium, 1.7. urinalysis on admission was specific gravity, 1.02; glucose negative; negative ketones, negative blood, negative nitrite, trace of leukocyte esterase. ph, 5.9. negative, bili. 0 red blood cells. 21 to 50 white blood cells. many bacteria and no yeast. electrocardiogram showed normal sinus rhythm, rate 84. normal axis. r in v1; questionable q in v1. no acute st changes. head ct revealed microvascular disease in the white matter, a large hematoma of the right paroccipital region. no fracture, no hemorrhage. c spine revealed no fracture. positive degenerative joint disease. hospital course: 1. the patient was admitted to medicine. she was found to have pyuria and started on ciprofloxacin. that evening, she fell in her room and although she couldn't recall the fall, her neurologic status was felt to be unchanged. head ct at that time was again negative. early the next morning she fell again on the floor without explanation given by the patient. this third head ct performed showed a 2 cm right frontal hemorrhage, left frontal hemorrhage, likely both subarachnoid and subdural. a small right parietal subdural hemorrhage near the cerebral vertex, lacunar in the lentiform nuclei, chronic microvascular infarction as previously seen. the patient was evaluated by neurosurgery who recommended admission to intensive care unit for close follow up and reversal of coagulopathy. of note, inr actually on admission was 1.7. the patient was sent to the sicu and treated with vitamin k and fresh frozen plasma. her inr reversed from 1.7 to 1.1. the patient had a c spine ct done which showed marked degenerative changes in c5 through 6, c6 through 7, with moderate spondylitic ridges, prominent left sided facet joint degeneration causing moderate spinal cord compression. bilateral neuroforaminal narrowing of 2 to 3 mm, subluxation of c3 to c4, c4 to c5, which was unchanged compared to mri on . no fractures were noted. neurosurgery recommended repeat neurological examinations and keeping her systolic blood pressure greater than 150. all sedatives were avoided. the patient was kept npo and her coagulopathy was reversed. on subsequent neurological examinations, the patient remained stable. she was transferred back to the floor. after transferring back to the floor, the patient was stable for several days, but then seemed to have fluctuating mental status. repeat ct of the head was done which showed stable right frontal and right parietal intraparenchymal hemorrhage. stable right st subdural hematoma and stable small right temporal subarachnoid hemorrhage along with a nondisplaced left occipital fracture. the patient remained on the floor for the rest of the hospital course. her neurological examination was stable. her blood pressure was maintained between 140s and 160s. in order to accomplish this, the patient was started on norvasc with hydralazine ridden for systolic blood pressures greater than 160. as work up for possible causes of her fall, the patient had another echocardiogram performed. echocardiogram was read as left ventricular wall thickness. cavity size and systolic function, normal. left ventricular ejection fraction, greater than 55%. right ventricular chamber size and free wall motion, normal. aortic root, mildly dilated. ascending aorta is mildly dilated. the aortic valves are mildly thickened. there is no aortic valve stenosis. no aortic regurgitation. mitral valve leaflets are mildly thickened. mitral regurgitation is present but cannot be quantified. there is moderate pulmonary artery systolic hypertension. 2. the patient's sodium was noted to fall following head trauma. this was believed to be due to intracerebral sodium wasting syndrome. the patient was placed on fluid restriction, however, her sodium continued to fall. fluid restriction was decreased from 1,000 cc per day to 750 cc per day. the patient was also started on salt tablet. as her mental status seemed to be waxing and , she was monitored very closely during this time. hydrochlorothiazide was also thought to be involved in the hyponatremia and was discontinued. over the next several days, her hyponatremia, after reaching 120, slowly rose and corrected itself to 130 by the time of discharge. the hydrochlorothiazide continues to be withheld and the patient continues to be on fluid restriction, however, this has been eased to 1,500 cc per day at the time of discharge. the patient should follow up with her primary care physician in one week to check on sodium levels. 3. urinary tract infection - the patient was initially started on ciprofloxacin for urinary tract infection, however, cultures came back positive klebsiella which was resistant to ciprofloxacin. she was switched to ancef. she completed a seven day course of ancef. repeat cultures were negative. 4. blood pressure - the patient's blood pressure was, at times, difficult to control. this was felt to be due to her anxiety and headaches. the patient was initially tried on atenolol but then switched to norvasc with hydralazine for elevated blood pressures. the patient blood pressure remained well controlled on this regimen, however, near the end of her hospital course, it was slightly higher. the patient was increased to 10 mg p.o. q d of norvasc at the time of discharge. she should follow up with her primary care physician in one week. she will also be continued on 10 mg of hydralazine q.i.d. in the interim. further decisions on blood pressure management will be left to outpatient setting. 5. headaches - the patient had several severe headaches following her head trauma. due to her waxing and mental status, narcotics were initially withheld, however, as her mental status improved, it was felt that her pain was best managed with oxycodone. the patient was initially on one tablet of oxycodone q 4 hours, however, this was insufficient. it was increased to two tablets q 4 to 6 hours along with 1,000 mg of tylenol q.i.d. the patient headaches slowly improved during the hospital course. she will be discharged the tylenol and one to two tablets of oxycodone q 4 to 6 hours prn with instructions to limit use of the narcotics if possible. 6. during the end of the hospital course, the patient had problems with urinary retention. the patient had several voiding trials, however, failed. the patient was started on urecholine. she will be discharged without the foley. her daughter was instructed on how to properly do straight catheterization technique. the patient will be straight catheterized. she will be follow up with urology on , at which time further management of her urinary retention will be addressed. 7. rehabilitation - the patient was seen by physical therapy who initially felt the patient would require a short term rehabilitation stay, however, the patient and family was against this. they prefer getting rehabilitation at home. over the hospital course, the patient's ambulation improved to the extent that physical therapy felt the patient would be ok to go home as long as she had some home physical therapy established. vna will be established upon discharge in order for home physical therapy to occur. condition on discharge: stable. discharge medications: 1. norvasc 10 mg p.o. q d. 2. oxycodone one to two tablets p.o. q 6 hours prn. 3. colace 100 mg p.o. b.i.d. 4. urecholine 50 mg p.o. q.i.d. 5. tylenol 1,000 mg p.o. q 6 hours. 6. hydralazine 10 mg p.o. q 6 hours. 7. levoxyl 88 mcg p.o. q d. 8. zoloft 150 mg p.o. q d. 9. lipitor 5 mg p.o. q d. 10. elavil, aspirin and premarin are currently being held. aspirin especially can be restarted at a later date if the patient's neurological status remains stable. this will be left up to her primary care physician. follow up: the patient is to follow up with her primary care physician, . . the patient is instructed to call dr. and arrange for follow up appointment in the next week. the patient has also been scheduled for urology visit with dr. . number is . the appointment is scheduled for , at 10:00 a.m. at building, . , m.d. dictated by: medquist36 procedure: closure of skin and subcutaneous tissue of other sites diagnoses: urinary tract infection, site not specified unspecified essential hypertension friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site open wound of scalp, without mention of complication abnormality of gait retention of urine, unspecified other disorders of neurohypophysis fall from other slipping, tripping, or stumbling closed fracture of base of skull with cerebral laceration and contusion, with no loss of consciousness 

Answer: The patient is high likely exposed to