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: zosyn attending: chief complaint: found down/unresponsive on the floor major surgical or invasive procedure: ventriculostomy placement history of present illness: mrs. is a 75 yo w with h/o htn, hl, cad who presents with ivh. the patient vomited once the night before admission, but was otherwise normal. she was last seen well at 8am before her husband left for work. he came home at 6pm to find her slumped behind the bedroom door. she opened her eyes and knew who he was. ems arrived. she was reported to have agonal breathing. she was taken to hospital where nchct showed isolated ivh. initial gcs 8. bps 150/80, 188/98, 184/86. initial exam revealed patient unresponsive, pupils pinpoint and nonreactive, withdraws from pain on l side only. toes upgoing bilaterally. she was given ceftriaxone and azithromycin for possible aspiration. the family was given a poor prognosis so decided to make her cmo. she was admitted to the floor, but she soon began to open her eyes and speak, she was aox3, moving all extremities, with a mild r hemiparesis. because of this improvement, the family wanted to pursue more aggressive treatment, and patient was transferred to . ros per patient's husband is negative for headaches, fevers, weakness, speech difficulties, gait difficulties. past medical history: cardiovascular - htn, hl, mild cad hematologic - essential thrombocythemia (on asa) by history, however, this might have progressed over the last years and she might have developed into a polycythemia (jak 2 mutation positive). her hematologist is and she has not established any contact with an hematologist up here. msk - bilateral total hip replacements, s/p thigh/hip abscess/infx requiring iv abx ~ 18 months ago social history: lives with husband. smokes 1 pack/day, no etoh in several years. family history: negative for stroke, ich, aneurysm physical exam: at admission: gen: nad heent: sclera anicteric, mmm cv: rrr no m/r/g pulm: ctab ab: nd/nt ext: no edema neuro: mse: eyes open to voice. oriented to self, states she is in rehabilitation hospital (had been told by nurse where she was 2 minutes earlier), doesnt know month or year. cannot name pen or glasses. repetition intact. comprehension intact. follows midline and appendicular commands (shows 2 fingers on each hand). no obvious neglect. cn: perrl 3 to 2mm and brisk. eomi intact except for limited upgaze (poorly following directions). no nystagmus. face symmetric. tongue midline. motor: normal bulk and tone. limited cooperation with testing. bilateral delts at least 4. r tricep 4, finger ext 5-, finger flex 5 l tri, finger ext/flex 5 bilateral ips, ham, ta, , gastroc at least 3. there is asymmetry in withdrawal of rle to noxious suggestive of weakness. dtr: brisk and 2+ in bilateral , tri, brachiorad, patellar, achilles. toes upgoing. ___________________________________________________________ at discharge: pertinent results: ct/cta head - ct head: little change in bihemispheric subarachonoid hemorrhage and large amount of intraventricular hemorrhage compared to 9 hours prior. cta: no large aneurysm, flow limiting stenosis or other major vasc abnl. carotid artery calcification b/l. final read pending recons. ct/cta head - impression: 1. unchanged intraventricular hemorrhage in all the ventricles, predominantly in the frontal of left lateral ventricle. there is associated dilatation of the lateral and third ventricles. subarachnoid hemorrhage is noted along cortical sulci predominantly along the sylvian fissures. the subarachnoid hemorrhage appears more prominent as compared to the prior ct. 2. no significant abnormality is noted on cta head. no evidence of aneurysm. cxr - impression: emphysema with concomitant pulmonary edema and two discrete basal opacities which are suspicious for aspiration. tte - the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). right ventricular chamber size and free wall motion are normal. the number of aortic valve leaflets cannot be determined. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. there is severe thickening of the mitral valve chordae. mild (1+) mitral regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. impression: mild symmetric left ventricular hypertrophy with vigorous biventricular systolic function. aortic valve sclerosis without stenosis. mild mitral regurgitation. moderate pulmonary hypertension. nchct - 1. expected short interval evolution in intraventricular hemorrhage with persistent dilatation of the lateral and third ventricles. 2. slight expected interval evolution of bihemispheric subarachnoid hemorrhage. nchct - impression: status post placement of right frontal ventricular drain with the tip in the region of foramen of . there remains ventriculomegaly with prominence of temporal horns, not significantly changed from the prior ct. previously noted intraventricular and subarachnoid hemorrhage again noted. ctpa - impression: 1. no evidence of pulmonary embolus. 2. generalized volume overload with bilateral effusions and pulmonary edema. areas of air space opacity may reflect superimposed infection. mri/mra brain - impression: 1. multiple small acute infarcts as described above. there is no associated hemorrhage or mass effect. 2. no interval change regarding the subarachnoid and intraventricular hemorrhage. 3. unchanged diameter of the intraventricular system with unchanged position of the right frontal ventriculostomy catheter. 4. no evidence of vessel occlusion or vasospasm. eeg - (preliminary) no epileptiform activity, diffuse theta-delta slowing, severe diffuse encephalopathic pattern brief hospital course: 75 yo w h/o cad, htn, hl, history of essential thrombocythemia which may have evolved into a polycythemia (jak2+), tobacco use p/w up to 10 hours of depressed level of awareness and r hemiparesis with spontaneous improvement and found to have ivh and very mild sah due to hemorrhage leaking out from the foramen lushkae into the . intraventricular hemorrhage - she was found on the ground on the evening of by her husband. when she arrived at an outside hospital, her exam was very poor: she was nonresponsive, her pupils were described as pinpoint, and she was only minimally withdrawing on the left side. based on her poor exam and large amount of ivh on ct, the osh physicians predicted a poor prognosis and the husband decided to change her code status from dnr to cmo, but her mental status spontaneously improved without major intervention to the point of her arousing, being partly oriented, and following commands. her husband requested that she be transferred to for more aggressive care (if needed). her exam since arrival has fluctuated significantly: at times she was minimally arousable and at other times she remained awake and followed simple commands with only mild right-sided upper extremity-predominant weakness, inattention, and some memory deficits. neurosurgery was consulted but decided to hold off on placing a ventriculostomy while her mental status remained relatively functional. her exam worsened on mainly due to respiratory problems and she was intubated. at this time, neurosurgery decided to place a ventriculostomy; the evd was placed without complication and with maintenance of appropriate icps with minimal change in neurologic exam. during her complicated medical course, her neurologic exam has gradually deteriorated with worsening of her right sided arm and leg weakness and decreased level of awareness (unable to obtain attention, no longer following commands reliably). after several days of delay due to multiple medical complications, she was stable enough to receive an mri of the brain on which shows multiple small right-sided ischemic infarcts (dwi bright, adc dark), extensive subcortical and periventricular white matter disease, and persistence (but improvement) in the degree of intraventricular hemorrhage. the strokes by themselves would not explain her depressed level of consciousness, and thus an eeg was performed due to concerns for potential status epilepticus as she was having rhythmic eyelid contractions and sporadic eye movements. the eeg was negative for seizure activity. given the patient's lack of neurologic improvement and poor prognosis, the patient's husband opted for comfort care. she was made cmo overnight on , placed on a morphine infusion, and she passed away at 0745 on . thrombocythemia, likely polycythemia - she is noted to have a history of thrombocythemia per report, and per prior records from her previous hematologist in , she has the jak2 mutation that is strongly suggestive of polycythemia . we consulted hematology-oncology regarding bleeding risk assessment in case the patient requires further invasive procedures, for which it appears that her thrombocytosis would place her at risk for both thrombosis and hemorrhage (via acquired disease). heme-onc recommended starting hydroxyurea to which the patient's cell counts responded with decreases in all cell lines. pulmonary edema, hemodynamic instability - on , the patient became progressively tachycardic, tachypneic, and hypertensive and required more supplemental o2 to maintain her sao2 in the 90s in the setting of a 500cc fluid bolus given for suspected hypovolemia in the setting of progressive tachycardia. her hemodynamic status normalized with metoprolol, albuterol/ipratropium, oxygen and mild diuresis with furosemide 10 iv. this may have been related to mild volume overload in the setting of likely copd or beta blocker withdrawal from having been off medications during the prehospital obtunded period. however, her respiratory status continued to be tenuous and she was intubated for persistent respiratory distress. she intermittently had episodes of tachynea/tachycardia/hypoxia without any evident cause (clear lungs to auscultation besides upper airway sounds and secretions, no infiltrates on cxr, no cardiac or metabolic causes) which resolved to some degree with sedation with propofol. fever of unknown origin - on , the patient became febrile and had blood, urine, and sputum cultures drawn, all of which have had no growth to date. on , she had a csf culture drawn. she was started on empiric broad-spectrum antibiotics with cefepime and vancomycin; these were stopped when all of her cultures remained negative. it is possible that her fever was central in origin and was the result of temperature regulation dysfunction from the intraventricular hemorrhage. hypernatremia - the patient was mildly hypernatremic at admission to the high 140s, thought to be secondary to hypovolemic hypernatremia. in the setting of large amounts of ivh and no ventriculostomy for decompression, she was permitted to have mild hypernatremia to minimize cerebral edema. however, this progressed during , and the patient was started on ns, then 1/2ns and furosemide to address her hypernatremia which resolved with this treatment. she was kept normovolemic with tube feeds at goal 100 cc/hr. medications on admission: metoprolol succinate 25 daily omega 3 fatty acids (1 tablet daily) aspirin 81 daily (ecotrin) discharge medications: n/a discharge disposition: expired discharge diagnosis: intraventricular hemorrhage, subarachnoid hemorrhage, acute ischemic stroke, polycythemia , hypoxic respiratory failure discharge condition: deceased discharge instructions: n/a followup instructions: n/a md, procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances intravascular imaging of intrathoracic vessels diagnoses: coronary atherosclerosis of native coronary artery obstructive hydrocephalus unspecified essential hypertension atrial fibrillation subarachnoid hemorrhage acute respiratory failure cerebral edema fever, unspecified hyperosmolality and/or hypernatremia other and unspecified coagulation defects cerebral artery occlusion, unspecified with cerebral infarction long-term (current) use of aspirin polycythemia vera 

Answer: The patient is high likely exposed to