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: nph major surgical or invasive procedure: : insertion of right vp shunt(re-do) history of present illness: this is a 66 year old male with nph. he had a vp shunt placed on with dr. . this was removed on for infection and he was treated with a course of iv antibiotics. past medical history: 1. parkinson's disease 2. nph 3. diabetes mellitus 4. hypertension 5. hypercholesterolemia 5. cad - s/p cabg 7. l ulnar nerve surgery 8. melanoma 9. cva . dementia 11. vps placement () social history: patient lives at nursing home for the last 3-4 months. his wife and daughters live in . he was a tax accountant but retired ?4 months ago, secondary to difficultly performing his job. mr. wife (cell: ) family history: no history of stroke or heart disease per patient. o/w nx physical exam: on discharge: he is awake and oriented but has minimal speech. his left hemiplegia remains. he follows commands with his right side. perrla, face symmetrical. incisions clean, dry, intact. pertinent results: ct head : impression: 1. interval placement of a ventriculostomy catheter with unchanged ventriculomegaly, small pneumocephalus. 2. chronic small vessel ischemic disease and moderate global atrophy. brief hospital course: mr. was admitted to the neurosurgery service on . he underwent replacement of right vp shunt. post-op head ct showed expected post-op changes. he was transferred to the floor on . his vp shunt was interrogated at the bedside. the valve was determined to be at 1.5. he had a mildly elevated temperature of 100.1 on . ua was without bacteria. urine culture is pending. he had a slight nonproductive cough that seemed unrelated to feeding. is was recommended. he was medically cleared to return to his nh and was transferred on . medications on admission: 1.omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 2.senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 3.docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4.divalproex 125 mg capsule, sprinkle sig: three (3) capsule, sprinkle po bid (2 times a day). 5.carbidopa-levodopa 25-100 mg tablet sig: one (1) tablet po tid (3 times a day). 6.citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 7.clonidine 0.1 mg tablet sig: one (1) tablet po tid (3 times a day). 8.donepezil 5 mg tablet sig: two (2) tablet po hs (at bedtime). 9.lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). 10.glyburide 5 mg tablet sig: one (1) tablet po once a day. 11.amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 12.carvedilol 3.125 mg tablet sig: two (2) tablet po bid (2 times a day). 13.heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) units injection tid (3 times a day). 14.bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po once a day. 15.metformin 500 mg tablet sig: one (1) tablet po twice a day. 16.ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po twice a day. 17.simvastatin 40 mg tablet sig: one (1) tablet po once a day. discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain/fever. 2. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 5. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 6. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 1-2 puffs inhalation q4h (every 4 hours) as needed for wheeze. 7. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 8. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 9. clonidine 0.1 mg tablet sig: one (1) tablet po tid (3 times a day). 10. carvedilol 6.25 mg tablet sig: one (1) tablet po bid (2 times a day). 11. divalproex 125 mg capsule, sprinkle sig: three (3) capsule, sprinkle po bid (2 times a day). 12. glyburide 5 mg tablet sig: one (1) tablet po daily (daily). 13. lisinopril 20 mg tablet sig: two (2) tablet po daily (daily). 14. donepezil 5 mg tablet sig: two (2) tablet po hs (at bedtime). 15. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 16. carbidopa-levodopa 25-100 mg tablet sig: one (1) tablet po tid (3 times a day). 17. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). discharge disposition: extended care facility: life care center of discharge diagnosis: normal pressure hydrocephalus discharge condition: neurologically stable discharge instructions: general instructions wound care ?????? you or a family member, or nurse your wound every day and report any of the following problems to your physician. ?????? keep your incision clean and dry. ?????? you may wash your hair with a mild shampoo 24 hours after your are removed. ?????? do not apply any lotions, ointments or other products to your incision. ?????? do not drive until you are seen at the first follow up appointment. ?????? do not lift objects over 10 pounds until approved by your physician. usually no special is prescribed after a craniotomy. a normal well balanced is recommended for recovery, and you should resume any specially prescribed you were eating before your surgery. medications ?????? take all of your medications as ordered. you do not have to take pain medication unless it is needed. it is important that you are able to cough, breathe deeply, and is comfortable enough to walk. ?????? do not use alcohol while taking pain medication. ?????? medications that may be prescribed include: o narcotic pain medication such as dilaudid (hydromorphone). o an over the counter stool softener for constipation (colace or docusate). if you become constipated, try products such as dulcolax, milk of magnesia, first, and then magnesium citrate or fleets enema if needed). often times, pain medication and anesthesia can cause constipation. ?????? if you have been prescribed dilantin (phenytoin) for anti-seizure medicine, take it as prescribed and follow up with laboratory blood drawing in one week. this can be drawn at your pcp??????s office, but please have the results faxed to . if you have been discharged on keppra (levetiracetam), you will not require blood work monitoring. ?????? if you were on a medication such as coumadin (warfarin), or plavix (clopidogrel), or aspirin, prior to your surgery, do not resume use until seen in the clinic. ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, and ibuprofen etc, as this can increase your chances of bleeding. activity the first few weeks after you are discharged you may feel tired or fatigued. this is normal. you should become a little stronger every day. activity is the most important measure you can take to prevent complications and to begin to feel like yourself again. in general: ?????? follow the activity instructions given to you by your doctor and therapist. ?????? increase your activity slowly; do not do too much because you are feeling good. ?????? you may resume sexual activity as your tolerance allows. ?????? if you feel light headed or fatigued after increasing activity, rest, decrease the amount of activity that you do, and begin building your tolerance to activity more slowly. ?????? do not drive until you speak with your physician. ?????? do not lift objects over 10 pounds until approved by your physician. ?????? avoid any activity that causes you to hold your breath and push, for example weight lifting, lifting or moving heavy objects, or straining at stool. ?????? do your breathing exercises every two hours. ?????? use your incentive spirometer 10 times every hour, that you are awake. when to call your surgeon: with any surgery there are risks of complications. although your surgery is over, there is the possibility of some of these complications developing. these complications include: infection, blood clots, or neurological changes. call your physician immediately if you experience: ?????? confusion, fainting, blacking out, extreme fatigue, memory loss, or difficulty speaking. ?????? double, or blurred vision. loss of vision, either partial or total. ?????? hallucinations ?????? numbness, tingling, or weakness in your extremities or face. ?????? stiff neck, and/or a fever of 101.5f or more. ?????? severe sensitivity to light. (photophobia) ?????? severe headache or change in headache. ?????? seizure ?????? problems controlling your bowels or bladder. ?????? productive cough with yellow or green sputum. ?????? swelling, redness, or tenderness in your calf or thigh. call 911 or go to the nearest emergency room if you experience: ?????? sudden difficulty in breathing. ?????? new onset of seizure or change in seizure, or seizure from which you wake up confused. ?????? a seizure that lasts more than 5 minutes. important instructions regarding emergencies and after-hour calls ?????? if you have what you feel is a true emergency at any time, please present immediately to your local emergency room, where a doctor there will evaluate you and contact us if needed. due to the complexity of neurosurgical procedures and treatment of neurosurgical problems, effective advice regarding emergency situations cannot be given over the telephone. ?????? should you have a situation which is not life-threatening, but you feel needs addressing before normal office hours or on the weekend, please present to the local emergency room, where the physician there will evaluate you and contact us if needed. follow-up appointment instructions ?????? please return to the office in days (from your date of surgery) for removal of your and a wound check. although we try to be thorough, we may miss or staples. be sure to point out any incisions, which may be covered by clothing at the time of suture/staple removal. this appointment can be made with the nurse practitioner. please make this appointment by calling . if you live quite a distance from our office, please make arrangements for the same, with your pcp. ?????? please call ( to schedule an appointment with dr. , to be seen in _______weeks. ?????? you will / will not need a ct scan of the brain with / without contrast. ?????? you will / will not need an mri of the brain with/ or without gadolinium contrast. followup instructions: general instructions wound care ?????? you or a family member should your wound every day and report any of the following problems to your physician. ?????? keep your incision clean and dry. ?????? you may wash your hair with a mild shampoo 24 hours after your are removed. ?????? do not apply any lotions, ointments or other products to your incision. ?????? do not drive until you are seen at the first follow up appointment. ?????? do not lift objects over 10 pounds until approved by your physician. usually no special is prescribed after a craniotomy. a normal well balanced is recommended for recovery, and you should resume any specially prescribed you were eating before your surgery. medications ?????? take all of your medications as ordered. you do not have to take pain medication unless it is needed. it is important that you are able to cough, breathe deeply, and is comfortable enough to walk. ?????? do not use alcohol while taking pain medication. ?????? medications that may be prescribed include: o narcotic pain medication such as dilaudid (hydromorphone). o an over the counter stool softener for constipation (colace or docusate). if you become constipated, try products such as dulcolax, milk of magnesia, first, and then magnesium citrate or fleets enema if needed). often times, pain medication and anesthesia can cause constipation. ?????? if you have been prescribed dilantin (phenytoin) for anti-seizure medicine, take it as prescribed and follow up with laboratory blood drawing in one week. this can be drawn at your pcp??????s office, but please have the results faxed to . if you have been discharged on keppra (levetiracetam), you will not require blood work monitoring. ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, and ibuprofen etc, as this can increase your chances of bleeding. activity the first few weeks after you are discharged you may feel tired or fatigued. this is normal. you should become a little stronger every day. activity is the most important measure you can take to prevent complications and to begin to feel like yourself again. in general: ?????? follow the activity instructions given to you by your doctor and therapist. ?????? increase your activity slowly; do not do too much because you are feeling good. ?????? you may resume sexual activity as your tolerance allows. ?????? if you feel light headed or fatigued after increasing activity, rest, decrease the amount of activity that you do, and begin building your tolerance to activity more slowly. ?????? do not drive until you speak with your physician. ?????? do not lift objects over 10 pounds until approved by your physician. ?????? avoid any activity that causes you to hold your breath and push, for example weight lifting, lifting or moving heavy objects, or straining at stool. ?????? do your breathing exercises every two hours. ?????? use your incentive spirometer 10 times every hour, that you are awake. when to call your surgeon: with any surgery there are risks of complications. although your surgery is over, there is the possibility of some of these complications developing. these complications include: infection, blood clots, or neurological changes. call your physician immediately if you experience: ?????? confusion, fainting, blacking out, extreme fatigue, memory loss, or difficulty speaking. ?????? double, or blurred vision. loss of vision, either partial or total. ?????? hallucinations ?????? numbness, tingling, or weakness in your extremities or face. ?????? stiff neck, and/or a fever of 101.5f or more. ?????? severe sensitivity to light. (photophobia) ?????? severe headache or change in headache. ?????? seizure ?????? problems controlling your bowels or bladder. ?????? productive cough with yellow or green sputum. ?????? swelling, redness, or tenderness in your calf or thigh. call 911 or go to the nearest emergency room if you experience: ?????? sudden difficulty in breathing. ?????? new onset of seizure or change in seizure, or seizure from which you wake up confused. ?????? a seizure that lasts more than 5 minutes. important instructions regarding emergencies and after-hour calls ?????? if you have what you feel is a true emergency at any time, please present immediately to your local emergency room, where a doctor there will evaluate you and contact us if needed. due to the complexity of neurosurgical procedures and treatment of neurosurgical problems, effective advice regarding emergency situations cannot be given over the telephone. ?????? should you have a situation which is not life-threatening, but you feel needs addressing before normal office hours or on the weekend, please present to the local emergency room, where the physician there will evaluate you and contact us if needed. follow-up appointment instructions ?????? please return to the office in days (from your date of surgery) for removal of your and a wound check. although we try to be thorough, we may miss or staples. be sure to point out any incisions, which may be covered by clothing at the time of suture/staple removal. this appointment can be made with the nurse practitioner. please make this appointment by calling . if you live quite a distance from our office, please make arrangements for the same, with your pcp. ?????? please call ( to schedule an appointment with dr. , to be seen in 4 weeks. ?????? you will need a ct scan of the brain with / without contrast. procedure: ventricular shunt to abdominal cavity and organs diagnoses: pure hypercholesterolemia unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status paralysis agitans personal history of malignant melanoma of skin idiopathic normal pressure hydrocephalus (inph) 

Answer: The patient is high likely exposed to