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: no known allergies / adverse drug reactions attending: chief complaint: headache, increased lethargy major surgical or invasive procedure: : vp shunt insertion history of present illness: 33m who is well known to our service who c/o headache and family felt he was more lethargic at rehab. he was brought to and a head ct was done but as they did not have previous imaging to compare to the patient was transferred to . past medical history: evd placement angiogram with coiling of r vertebral artery aneurysm tracheostomy peg multiple bronchoscopies aspiration pneumonia ards htn social history: prior to his initial admission he was a single, independent, well educated gentleman who lived at his parent's home. no tobacco, etoh, or recreational drugs. worked out regularly. currently was at rehab. family history: non-contributory physical exam: pre-op: neuro: mental status: awake and lethargic, not as interactive as he is known to be, cooperative with some of the exam, but eyes closing as i speak to him. orientation: patient not responding to questions, closes eyes recall: unable to language: unable to assess, trach, no pmv in place. cranial nerves: i: not tested ii: pupils equally round and reactive to light, 4 to 2mm bilaterally. iii, iv, vi: extraocular movements intact bilaterally without nystagmus. v, vii: face symmetric. viii: hearing intact to voice. ix, x: palatal elevation symmetrical. : unable to assess xii: unable to assess motor: remains deconditioned. no abnormal movements, tremors. follows commands with all four extremities and is antigravity with all four. sensation: intact to light touch on discharge: awake, eo spont, perrl, r 6th nerve palsy, oriented to self, mae antigravity, rle weaker, but has ip movement. follows intermittent simple commands. pertinent results: head ct : impression: essentially unchanged diffuse ventricular dilatation as described above. the ventriculostomy catheter is appropriate close to the foramen of . head ct : impression: slight interval improvement in hydrocephalus, though the lateral third and fourth ventricles remain dilated. cxr : residual area of consolidation in the right mid lung has not changed since . lung volumes are lower. lungs otherwise clear. heart size top normal, unchanged. no pulmonary edema or pleural effusion. tracheostomy tube in standard placement. shunt catheter traverses the right neck, chest and upper abdomen. right pic line can be traced as far as the junction of the brachiocephalic veins. head ct : unchanged ventricle size as compared to . brief hospital course: 33m s/p vp shunt placement and was admitted to the icu post-operatively where he remained stable and was transferred to the step down unit the next day. vancomycin was started on as it appeared he was being treated for pneumonia at rehab for 14 days. his tube feeds were restarted but patient had some emesis, a dulcolax suppisitory was given and he had a bowel movement. we also continued to follow his serum k and increased his po k intake. patient also continued with hypertension and tachycardia and medication changes were made with good effect. a repeat head ct was obtained on which showed no change. exam remained stable. patient was offered a bed at and was discharged on . medications on admission: 1. senna 8.6 mg tablet sig: one (1) tablet po hs (at bedtime). 2. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed). 3. polyvinyl alcohol-povidone 1.4-0.6 % dropperette sig: drops ophthalmic prn (as needed) as needed for dryness. 4. white petrolatum-mineral oil 56.8-42.5 % ointment sig: one (1) appl ophthalmic prn (as needed) as needed for dryness. 5. calcium carbonate 500 mg/5 ml (1,250 mg/5 ml) suspension sig: one (1) po tid (3 times a day). 6. acetaminophen 650 mg/20.3 ml solution sig: one (1) po q6h (every 6 hours) as needed for fever. 7. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 8. haloperidol 5 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for agitation. 9. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 10. ibuprofen 100 mg/5 ml suspension sig: one (1) po q6h (every 6 hours) as needed for fevers. 11. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 12. isosorbide dinitrate 10 mg tablet sig: one (1) tablet po tid (3 times a day). 13. potassium chloride 10 meq capsule, extended release sig: three (3) capsule, extended release po bid (2 times a day). 14. lisinopril 30 mg tablet sig: one (1) tablet po daily (daily). 15. lisinopril 10 mg tablet sig: one (1) tablet po once (once) for 1 doses. 16. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 17. metoprolol tartrate 50 mg tablet sig: two (2) tablet po tid (3 times a day). 18. dextrose 50% 12.5 gm iv prn hypoglycemia protocol 19. hydralazine 10 mg iv q6h:prn sbp>160 hold for hr>100 20. heparin flush (10 units/ml) 2 ml iv prn line flush picc, heparin dependent: flush with 10ml normal saline followed by heparin as above daily and prn per lumen. 21. sodium chloride 0.9% flush 10 ml iv prn line flush temporary central access-icu: flush with 10ml normal saline daily and prn. 22. therapeutic multivitamin liquid sig: one (1) tablet po daily (daily). 23. metoclopramide 10 mg tablet sig: one (1) tablet po qidachs (4 times a day (before meals and at bedtime)). 24. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 25. glucagon (human recombinant) 1 mg recon soln sig: one (1) recon soln injection q15min () as needed for hypoglycemia protocol. 26. spironolactone 25 mg tablet sig: one (1) tablet po daily (daily). 27. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 28. potassium chloride 20 meq packet sig: one (1) packet po tid (3 times a day). discharge medications: 1. oxycodone-acetaminophen 5-325 mg/5 ml solution sig: ml po q4h (every 4 hours) as needed for pain. 2. calcium carbonate 500 mg/5 ml (1,250 mg/5 ml) suspension sig: one (1) po tid (3 times a day). 3. docusate sodium 50 mg/5 ml liquid sig: two (2) po bid (2 times a day). 4. isosorbide dinitrate 10 mg tablet sig: one (1) tablet po tid (3 times a day). 5. spironolactone 25 mg tablet sig: one (1) tablet po daily (daily). 6. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 7. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain/fever. 8. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily). 9. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po bid (2 times a day). 10. metoclopramide 10 mg tablet sig: one (1) tablet po qidachs (4 times a day (before meals and at bedtime)). 11. hydralazine 25 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for sbp >160 or dbp >100. 12. lisinopril 20 mg tablet sig: two (2) tablet po daily (daily). 13. potassium chloride 20 meq packet sig: one (1) packet po bid (2 times a day). 14. vancomycin 1000 mg iv q 12h discharge disposition: extended care facility: - discharge diagnosis: hydrocephalus r vertebral artery dissection l cerebellar infart pneumonia dysphagia chronic hypokalemia adrenal adenoma discharge condition: mental status: confused - always. level of consciousness: lethargic but arousable. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: general instructions ?????? have a friend/family member check your incision daily for signs of infection. ?????? take your pain medicine as prescribed. ?????? exercise should be limited to walking; no lifting, straining, or excessive bending. ?????? you may wash your hair only after sutures and/or staples have been removed. if your wound closure uses dissolvable sutures, you must keep that area dry for 10 days. ?????? you may shower before this time using a shower cap to cover your head. ?????? increase your intake of fluids and fiber, as narcotic pain medicine can cause constipation. we generally recommend taking an over the counter stool softener, such as docusate (colace) while taking narcotic pain medication. ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, and ibuprofen etc. ?????? if you were on a medication such as coumadin (warfarin), or plavix (clopidogrel), or aspirin, prior to your injury, you may safely resume only after receiving clearance from your neurosurgeon. followup instructions: ?????? please follow up with dr. in 6 weeks with a head ct. please call to make this appointment. - you were diagnosed with an andrenal adenoma on mri imaging during your hospital stay. you will need to follow up with your primary care physician and for this. the endocrinolgy team would like to see you in the clinic in one month. please call dr. for an appointment: . procedure: ventricular shunt to abdominal cavity and organs diagnoses: pneumonia, organism unspecified obstructive hydrocephalus unspecified essential hypertension hypopotassemia gastrostomy status tracheostomy status benign neoplasm of adrenal gland other late effects of cerebrovascular disease, dysphagia dysphagia, unspecified 

Answer: The patient is high likely exposed to