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, left sided numbness and left sided vision loss major surgical or invasive procedure: infusion of tpa history of present illness: neurology at bedside for evaluation after code stroke activation within: 1 minutes time (and date) the patient was last known well: 15:15 (24h clock) nih stroke scale score: 7 t-: yes time t-pa was given bolus;19:26 and infusion;19:27(24h clock) i was present during the ct scanning and reviewed the images instantly within 20 minutes of their completion. nih stroke scale score was 7: 1a. level of consciousness: 0 1b. loc question: 0 1c. loc commands: 0 2. best gaze: 0 3. visual fields: 2 4. facial palsy: 1 5a. motor arm, left: 1 5b. motor arm, right: 0 6a. motor leg, left: 0 6b. motor leg, right: 0 7. limb ataxia: 0 8. sensory: 1 9. language: 0 10. dysarthria: 0 11. extinction and neglect: 2 neurology resident consult note reason for consult:code stroke hpi: mr is a 64 year old right handed man presenting as a code stroke after sudden development of right eye pain and left sided numbness. he was playing solitaire today at 15:15, when he started having left sided visual problems and left sided numbness. he drove himself to hospital and was having some pain behind his right eye. he went to hospital and his finger stick was 101, temp 97.3, pulse 98, resp 18, bp 191/87, o2 sat of 98%. he got a bag of normal saline, fentanyl, and zofran. he has a history of aneurysm s/p clipping at in without subsequent problems. was evaluated by neurosurgery who did not feel an intervention or tpa was currently indicated and was transferred to . while in transit he got a bag of normal saline, fentanyl, and zofran. upon initial evaluation he had an nihss of 7 (2 for left visual field loss, 1 for mild facial palsy, 1 for left pronator drift, 1 for mild hemisensory loss, and 2 for inattention to the left). currently he states he has a headache but is unaware of any deficits or why things are occuring. on ros patient states he had nausea and vomiting and diarrhea for the past week, and went to the ed at this past wednesday but has been feeling better the past 2 days. he denies any other weakness, numbness, dysarthria, or neurologic symptoms just pain behind his right eye. besided the recent fevers, nausea, vomiting, he denies any other sob, cp, or other general symptoms. past medical history: htn, aneurysm in s/p cliping social history: lives alone, no children, smoke pack per day, drinks socially, no illict drug use. family history: no family history of strokes or aneurysms physical exam: physical exam: vitals 97.3, pulse 98, resp 18, bp 191/87, o2 sat of 98% : general: awake, cooperative, nad. heent: nc/at, no scleral icterus noted, mmm, no lesions noted in oropharynx neck: supple pulmonary: lungs cta bilaterally without r/r/w cardiac: rrr, nl. s1s2, no m/r/g noted abdomen: soft, nt/nd, no masses or organomegaly noted. extremities:warm and well perfused skin: no rashes or lesions noted. . neurologic: -mental status: alert, oriented x 3. able to relate history without difficulty. inattentive requring frequent redirection. language is fluent with intact repetition and comprehension. normal prosody. there were no paraphasic errors. pt. had no anomia if object placed in right visual field. able to read right half of sentenses without difficulty. speech was not dysarthric. able to follow both midline and appendicular commands. +neglect to the left hemispace. -cranial nerves: i: olfaction not tested. ii: perrl 3 to 2mm and brisk. left hemianopsia, appears worse in the inferior quadrant iii, iv, vi: eomi without nystagmus. normal saccades. v: facial sensation intact to light touch. vii: mild left facial at time of presentation but resolved after ct viii: hearing intact to finger-rub bilaterally. ix, x: palate elevates symmetrically. : 5/5 strength in trapezii and scm bilaterally. xii: tongue protrudes in midline. . -motor: normal bulk, tone throughout. initial left pronator drift that resolved after ct scan. delt bic tri wre ffl fe ip quad ham ta l 5 5 5 5 5 5 5 5 5- 5- r 5 5 5 5 5 5 5 5 5- 5- . -sensory:left hemibody sensory deficit to pinprick. left leg completely desensitized to pinprick, left upperextremity can feel the pin but less than the right side. he has agraphestesia in the left hand. -dtrs: tri pat ach l 2 2 2 2 2 r 2 2 2 2 2 plantar response was flexor bilaterally. . -coordination: no dysmetria on fnf . -gait: defferred pertinent results: admission labs: 06:15pm blood wbc-15.4* rbc-4.55* hgb-14.5 hct-44.3 mcv-97 mch-31.9 mchc-32.8 rdw-12.9 plt ct-428 06:15pm blood pt-10.6 ptt-25.8 inr(pt)-1.0 06:15pm blood fibrino-252 06:39am blood glucose-94 urean-17 creat-1.1 na-140 k-4.4 cl-111* hco3-21* angap-12 06:39am blood alt-34 ast-18 ld(ldh)-165 ck(cpk)-31* alkphos-53 totbili-0.3 06:15pm blood ctropnt-<0.01 06:39am blood ck-mb-1 ctropnt-<0.01 06:39am blood albumin-3.3* calcium-8.5 phos-3.8 mg-2.7* cholest-137 06:39am blood %hba1c-5.5 eag-111 06:39am blood triglyc-94 hdl-28 chol/hd-4.9 ldlcalc-90 06:15pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 08:15pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-5.0 leuks-neg 08:15pm urine color-straw appear-clear sp -1.039* 09:28pm urine bnzodzp-neg barbitr-neg opiates-neg cocaine-neg amphetm-neg mthdone-neg 8:15 pm urine urine culture (final ): no growth. discharge labs: 04:50am blood wbc-12.0* rbc-4.41* hgb-13.3* hct-42.4 mcv-96 mch-30.2 mchc-31.4 rdw-12.6 plt ct-429 04:50am blood glucose-111* urean-19 creat-1.2 na-139 k-4.3 cl-107 hco3-25 angap-11 04:50am blood calcium-9.1 phos-4.2 mg-2.4 reports: ekg: baseline artifact. non-specific st-t wave change. compared to tracing #1 no diagnostic change. rate pr qrs qt/qtc p qrs t 72 202 92 358/379 57 12 18 chest film: single ap portable view of the chest was obtained. no focal consolidation, pleural effusion, or pneumothorax is seen. the cardiac silhouette was not enlarged. the aortic knob is calcified. no displaced fracture is seen. impression: no acute cardiopulmonary process. ct/ctp/cta head/neck: increased mean transit time with decreased cerebral blood volume and blood flow on the right occipital lobe, consistent with infarction in the right posterior cerebral artery vascular territory as described in detail above. the patient is status post aneurysm clipping via left frontotemporal craniotomy. there is no evidence of acute intracranial hemorrhage or mass effect. atherosclerotic calcifications are visualized in the carotid cervical bifurcations, causing severe narrowing at the origin of the right internal carotid artery. echo: the left atrium and right atrium are normal in cavity size. no atrial septal defect or patent foramen ovale is seen by 2d, color doppler or saline contrast with maneuvers. the estimated right atrial pressure is 0-5 mmhg. the estimated cardiac index is normal (>=2.5l/min/m2). right ventricular chamber size and free wall motion are normal. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the estimated pulmonary artery systolic pressure is high normal. there is an anterior space which most likely represents a prominent fat pad. impression:trace aortic regurgitation with mild aortic valve sclerosis. no definite structural cardiac source of embolism identified. carotid u/s: right ica 70-79% stenosis, left ica 60-69% stenosis. mri head: subacute infarction in the right pca territory without evidence of hemorrhagic transformation with a possible involvement of the choroidal anterior artery territory. brief hospital course: me. was examined emergently in the ed of and was found to have a dense left homonymous hemianopia. preliminary stat ct imaging showed the presence of hypoperfusion in a right pca distribution. his case was discussed with the attending stroke neurologist and informed consent was obtained for tpa administration, for which there were no apparent contraindications. tpa was administered without any acute complications, and he was admitted to the icu for post-tpa monitoring with q1hr neuro checks, etc. as he remained hemodynamically stable and with stable neurologic examinations, he was transferred out of the icu. his left visual field cut became less dense over time, but at the time of discharge, he still had quite a significant visual field cut. several studies were done to work up his stroke. we obtained the make/model number of his aneurysm clips from (he has a history of a left ica and left acomm aneurysm clipped by from ), and with this information, we were able to obtain an mri of his head, which identified a single area of restricted diffusion in the right pca distribution. several days of telemetry monitoring did not identify any evidence of atrial fibrillation. his cta done on admission did identify scattered atherosclerotic lesions in his intra and extracranial blood vessels, including the internal carotid arteries. a carotid us did show right ica stenosis of 70-79% and left ica stenosis of 60-69%. however, these bilateral stenoses were not the cause of his posterior circulation infarct. these bilateral ica stenoses will need to be monitored for plaque progression in the future. his ldl returned elevated and he was started on statin therapy, and was of course also placed on a daily aspirin as secondary prophylaxis against future strokes. he was counseled extensively on the importance of quitting smoking cigarettes. an echocardiogram was performed which did not reveal any obvious embolic source and no obvious valvular pathology. given his left visual field cut, he was strictly advised not to drive prior to having a formal ophthalmological examination with visual field testing. in addition, he was given information about the drivewise program, which is a comprehensive evaluation of one's driving abilities following a variety different physical and neurologic disabilities. at the time of discharge, he was able to ambulate independently, had no focal neurologic signs (other than a resolving left visual field deficit) and was cognitively intact. transitional issues: - holter monitor - neurology follow up - eye examination with formal visual field testing medications on admission: cozaar 50mg discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 2. oxycodone 5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for headache. disp:*20 tablet(s)* refills:*0* 3. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). disp:*60 tablet(s)* refills:*1* 4. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). disp:*60 tablet, chewable(s)* refills:*1* 5. cozaar 50 mg tablet sig: one (1) tablet po twice a day. discharge disposition: home discharge diagnosis: ischemic stroke hypertension tobacco abuse history of brain aneurysm s/p clipping discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge neurological examination: slight anisocoria (l>r), full eom, left homonymous hemianopia with intact sensation and strength throughout discharge instructions: dear mr. , it was a pleasure taking care of you during this hospitalization. you were admitted to the neuro-intensive care unit and the neurology wards of the for symptoms of headache, left sided numbness and left sided visual loss that you experienced while playing solitaire. through a series of interviews, physical examinations, laboratory tests and neuroimaging studies, we determined that you sustained a stroke in the right occipital region of your brain. the cause of this stroke was likely related to atherosclerosis or plaques in the arteries of your brain that be caused by risk factors such as high blood pressure, high cholesterol and smoking. as we were able to identify your stroke relatively quickly, you received tpa or tissue plasminogen activator therapy (a "clotbusting" medication) that at times can improve the symptoms of stroke. - we have made some changes to your medications as listed below. please take your medications as prescribed, and do not hesitate to contact us should you have any questions or concerns. we have started on you a daily aspirin and a cholesterol lowering medication called atorvastatin. for your headache, we have prescribed you oxycodone. oxycodone can sometimes cause constipation, for which we have prescribed you a stool softener called docusate. continue to take cozaar as you were previously doing. - we expect that your headache will get better over time. to reduce the impact of these headaches, we ask that you stay well hydrated, eat regular meals, have regular sleep cycles and avoid pain medications on a daily basis. - some strokes, such as the one you sustained, can affect your ability to drive. we have referred you to a program at called drivewise, which is a comprehensive assessment conducted by skilled therapists who are able to certify your ability to drive safely. please be sure to follow up with them. their phone number is , and they will contact you to set up an appointment. - please come to the nearest ed should you have any of the below listed unexplained symptoms. - we have organized a follow up appointment for you to see dr. , who is your primary care physician. ask that you take these records with you as well as all your current medications at that time. we have asked dr. office to set up a referral for you to see a neurologist closer to your home town. please be sure that this is set up at your next visit with dr. . - smoking is an important modifiable risk factor for strokes. please try to cut down or quit smoking. your pcp can talk with you further about tips or medications that can help with this. followup instructions: please follow up with dr. , your primary care physician : fax: , 3:45pm , ma: procedure: injection or infusion of thrombolytic agent diagnoses: tobacco use disorder unspecified essential hypertension cerebral artery occlusion, unspecified with cerebral infarction homonymous bilateral field defects 

Answer: The patient is high likely exposed to