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: loss of conciousness, -temporal hemianopsia with total blindness to right eye major surgical or invasive procedure: attmpted coiling of a-comm aneurysm clipping of a-comm aneursym multiple cerebral angiograms placement of external ventricular drain removal of external ventricular drain history of present illness: ms. is a 47 yo rh f w/ no significant pmh who was transferred from an osh for evaluation of a sah found on ct. 10 days prior to presentation, she developed an abrupt onset severe headache. she was also nauseated, vomited and had photophobia. she waited for 3 days but her symptoms did not improve so she went to see her pcp. states that she was sent home and so she decided to take motrin 800mg around the clock. her symptoms did not improve therefore she went back to see her physician . she was given a prescription for an analgesic per her report and was driving to the pharmacy when she had a surge of pain followed by loc. her next memory is being found by ems who took her to an osh. there she was found to have a sah and transferred here for further evaluation. in the ed here, she was initially able to see from both eyes but then noted loss of vision in her r eye as well as "blurry" vision in her l eye. when these symptoms presented she was emergently taken to ct and cta which showed a aneurysm of the anterior circulation with bleeding. past medical history: pmh: per omr s/p cholecystectomy, common bile duct exploration social history: sh: -spanish speaking only -lives with sister and daughter -works at airport -no drugs, occasional etoh, smokes cig/day x 20 yrs family history: fh: -grandmother: dm, htn -grandfather: mi physical exam: on arrival o: t: 98.9 bp: 138/79 hr: 10 r 14 o2sats 100% ra gen: wd/wn, comfortable, nad. heent: pupils: 1.5mm bilaterally eomi initially, then cniii partial palsy on l neck: mild nuchal rigidity lungs: cta bilaterally. cardiac: rrr. s1/s2. abd: soft, nt, bs+ extrem: warm and well-perfused. neuro: mental status: awake and alert, cooperative with exam, normal affect. orientation: oriented to person, place, and date. language: speech fluent with good comprehension and repetition. no dysarthria or paraphasic errors (per translator) cranial nerves: i: not tested ii: pupils equally round and reactive to light, to 1.5 mm bilaterally. r eye total blindness even to light iii, iv, vi: extraocular movements intact bilaterally without nystagmus initially, however later she had decreased r eye adduction v, vii: facial strength and sensation intact and symmetric. viii: hearing intact to voice. ix, x: palatal elevation symmetrical. : sternocleidomastoid and trapezius normal bilaterally. xii: tongue midline without fasciculations. motor: normal bulk and tone bilaterally. no abnormal movements, tremors. strength full power throughout. no pronator drift sensation: intact to light touch reflexes: b t br pa ac right 1 1 1 2 1 left 1 1 1 2 1 toes downgoing bilaterally on discharge: awake alert and oriented x 3 cn ii-xii intact except for right eye= completely blind, left eye with temporal hemionopsia, right pupil non reactive. speech clear, no facial asymmetry, no drift, motor full, sensation grossly intact. pertinent results: ct head w/o contrast 9:06 am ct head w/o contrast reason: assess size of ventricles medical condition: 47 year old woman with sah evd clamped reason for this examination: assess size of ventricles contraindications for iv contrast: none. head ct history: 47-year-old woman with subarachnoid hemorrhage with ventricular drain clamped, assess for change in size of ventricles. technique: contiguous axial images of the head were obtained from the skull base to the vertex. findings: comparison is made to . again seen is a ventricular shunt via left frontal approach with tip of the catheter within the region of the right foramen of . the ventricles are re-expanded bilaterally, and there has also been decrease in size of the right extra-axial fluid collection as well as improved edema of the right frontal and basal ganglial infarcts. therefore, the increase in size of the ventricles likely is due to decreased mass effect with improvement in the subfalcine herniation as opposed to clamping of the ventricular shunt. again seen is a small hypodensity along the ventricular shunt tract involving the left frontal lobe as before. the basal cisterns, especially the quadrigeminal plate and ambient cisterns are better visualized suggestive of improved edema. tiny amounts of pneumocephalus are again seen. coil pack is again seen within the anterior communicating artery aneurysm. post-surgical changes of the right scalp are again noted. impression: since , decrease in size of right extra-axial collection and decreased edema of the right basal ganglia/frontal lobe infarct, with improvement in the subfalcine herniation and improvement in mass effect of the lateral ventricles. the basal cisterns are better visualized suggestive of improved cerebral edema. chest (portable ap) 8:48 am chest (portable ap) reason: eval cvl position medical condition: 47 year old woman with possible inadvertent withdrawal of cvl, meds appear to be collecting subcutaneously reason for this examination: eval cvl position indication: 47-year-old female with possible inadvertent withdrawal of central venous line. comparison: . single portable upright chest radiograph: the right subclavian catheter has been pulled back and now resides projecting over the right subclavian vein. there is no pneumothorax. the cardiomediastinal silhouette is stable and unremarkable and the lungs are clear. cta head w&w/o c & recons 9:45 am cta head w&w/o c & recons; ct brain perfusion reason: ** cta/ctp** as per dr. protocol contrast: optiray medical condition: 47 year old woman with acom sah, s/p clipping reason for this examination: ** cta/ctp** as per dr. protocol contraindications for iv contrast: none. indication: 47-year-old status post acom clipping. comparison: ct perfusion . technique: continuous axial images of the brain were obtained before and following administration of 100 cc iv optiray contrast. multiplanar mip and volume-rendered cta reformats were displayed. mean transit time blood flow and blood volume were assessed by dynamic imaging. findings: non-contrast head ct: acom aneurysm clip with associated metallic artifact is noted. again seen is a hypoattenuating area within the right temporal and inferior frontal lobe consistent with evolving infarct. there is also expanding and increasingly conspicuous hypoattenuation within the right basal caudate, putamen, and internal capsule consistent with new/progressive infarction of this region. high-density right extra-axial fluid collection with small locules of air is unchanged measuring 13 mm in greatest diameter. there is slightly increased mass effect on the subjacent sulci and increasing transtentorial and subfalcine herniation with leftward midline shift of 8 mm, previously 7 mm. left ventriculostomy catheter terminates within the left lateral ventricle at the midline and the ventricles are stable in size. there is worsening effacement of the suprasellar and ambient cisterns consistent with increasing mass effect. the 13-mm subgaleal fluid collection overlying the right frontal craniotomy is stable. cta of the head: the cervical portions of the carotid arteries, vertebral arteries, and basilar artery are patent. there is improved opacification in the circle of and its major branches. specifically, there is marked improvement of vasospasm involving the distal right m1 and right m2 segments of the mca. there is improvement in vasospasm of the a1 segments bilaterally (right greater than left) though the right a1 segment still shows moderate vasospasm. the a2 segments bilaterally also demonstrate markedly improved caliber. the left mca and its branches are unremarkable. the bilateral pca arteries are also unremarkable. ct perfusion: there is patchy perfusion abnormality with decreased blood volume in the bilateral temporal lobes and also right frontal lobe, which likely relate to vasospasm. impression: 1. new/progressive infarction within the right basal ganglia. 2. increasing mass effect and transtentorial herniation with worsening effacement of the suprasellar and ambient cisterns. 3. improving vasospasm within the right mca, and bilateral a1 and a2 segments of the aca. there is, however, persistent moderate vasospasm within the a1 segments, in close proximty to the acom aneurysm clip. findings were discussed with the neurosurgical team at 5:00 p.m. on . transcath therapy 12:15 pm reason: ? vasospasm contrast: optiray medical condition: 47 year old woman with aca s/p clipping pod7 reason for this examination: ? vasospasm type of study: left common carotid arteriogram, left internal carotid arteriogram, left vertebral arteriogram, right common carotid arteriogram, and right internal carotid arteriogram. staff: dr. . fellow: dr. . dr. , the attending interventional neuroradiologist, was present and supervised throughout the procedure. indication: 47-year-old female status post surgical clipping of an anterior communicating artery aneurysm, now post-operative day number seven. rule out vasospasm. comparison: . technique: written informed consent was obtained from the patient's daughter after discussing the indications for the procedure, the risks of the procedure, and the alternative management. the discussed risks include stroke, loss of vision and/or speech which may be temporary or permanent, with possible treatment with stents and/or coils if needed. additionally the indications, risks, and alternative management for possible intervention was explained. the patient was brought to the interventional neuroradiology suite and placed on the biplane table in the supine position. both groins were prepped and draped in the usual sterile fashion. a pre-procedure timeout was performed using two patient identifiers and verifying the procedure to be performed. access to the right common femoral artery was obtained using a 19-gauge single-wall needle with 1% lidocaine mixed with sodium bicarbonate for local anesthetic. a 0.35 wire was introduced through the needle, and the needle was removed. a 5 french vascular sheath was placed over the wire and connected to a saline infusion (mixed with heparin 500 units in 500 cc of saline) with a continuous drip. through the sheath, a 4 french berenstein catheter was introduced and connected to a continuous saline infusion (mixed with heparin 1000 units in 1000 cc of saline). the following vessels were selectively catheterized, and arteriograms were performed from the following locations: right common carotid artery, right internal carotid artery, left vertebral artery, left common carotid artery, and left internal carotid artery. after review of the study, the catheter and the sheath were withdrawn. hemostasis was achieved using manual compression. the patient tolerated the procedure well without any immediate post-procedure complications. findings: right common carotid artery: the bifurcation is normal. there is no evidence of a vascular malformation. right internal carotid artery: the cervical, petrous, cavernous, and supraclinoid segments of the internal carotid artery are normal. there is a surgical clip identified in the region of the anterior communicating artery with no residual aneurysm identified. there is mild stenosis of the m1 segment of the middle cerebral artery and moderate stenosis of the m2 middle cerebral artery branches. additionally there is moderate stenosis of the a1 segment of the anterior cerebral artery with a focus of luminal irregularity in its proximal portion. there is decreased parenchymal phase blood flow identified within the right anterior watershed vascular distribution. at this point, the decision was made for an intervention. 5 mg of verapamil was gently infused selectively into the right internal carotid artery over 1 minute. a right internal carotid artery angiogram was then repeated at approximately 10 minutes after the infusion of verapamil which demonstrated residual mild-to-moderate narrowing of the right a1 segment of the anterior cerebral artery, and right m1 and m2 segments of the middle cerebral artery. left vertebral artery: the left vertebral artery and the left posterior inferior cerebellar artery appear unremarkable. there is no reflux identified into the right vertebral artery. the basilar artery appears unremarkable. 5 mg of verapamil was gently infused selectively into the left vertebral artery over 1 minute. left common carotid artery: the bifurcation is normal. there is no vascular malformation. left internal carotid artery: the cervical, petrous, cavernous, and supraclinoid segments of the left internal carotid artery are normal. there is mild narrowing of the a1 segment of the left anterior cerebral artery. the left middle cerebral artery as well as its major branches appear unremarkable. a surgical clip is identified in the region of the anterior communicating artery with no residual aneurysm seen. 5 mg of verapamil was gently infused selectively into the left internal carotid artery over 1 minute. a post-infusion angiogram the left internal carotid artery demonstrates mild narrowing of the a1 segment of the anterior cerebral artery. moderate sedation: 100 mcg of intravenous fentanyl and 4 mg of intravenous versed were administered in divided doses by a registered nurse, who was monitoring the patient throughout the 2 hour and 15 minute intraservice time. please refer to the nursing record for further detail. impression: 1. status post surgical clipping of an anterior communicating aneurysm with no residual aneurysm identified. 2. moderate narrowing of the right m1 and m2 segments of the middle cerebral artery and right a1 anterior cerebral artery, and mild narrowing of the left a1 segment of the anterior cerebral artery consistent with vasospasm. 5 mg of verapamil was selectively infused into the right internal carotid, left vertebral, and left internal carotid arteries for a total of 15 mg of verapamil. post- infusion angiogram demonstrated residual mild-to- moderate narrowing of the right m1 and m2 segments of the middle cerebral artery and right a1 segment of the anterior cerebral artery and residual mild narrowing of the a1 segment of the anterior cerebral artery. cardiology report ecg study date of 1:55:18 pm artifact is present. sinus rhythm. the p-r interval is short without evidence of pre-exciation. possible non-specific st-t wave changes. compared to the previous tracing st-t wave changes are new. read by: , h. intervals axes rate pr qrs qt/qtc p qrs t 89 112 78 338/388 58 56 51 radiology final report mr head w/o contrast 4:18 am mr head w/o contrast; mra brain w/o contrast reason: sah, please eval optic chiasm medical condition: 47 year old woman with large sah in chiasm, loosing vision reason for this examination: sah, please eval optic chiasm contraindications for iv contrast: none. history: 47-year-old female with subarachnoid hemorrhage, acom aneurysm, with total vision loss on the right and blurriness on the left. comparison: cta head of . technique: multiplanar t1- and t2-weighted imaging sequences were obtained through the brain without administration of iv contrast. 3d time-of-flight mr arteriography was also performed. mri/mra of brain: again seen is subarachnoid hemorrhage along the right insular sulci, the basilar cisterns, and the suprasellar cistern. a cluster of punctate regions of increased flair signal may represent extension of the subarachnoid hemorrhage into perivascular spaces. no other region of hemorrhage is noted. the size of the hemorrhage is unchanged from the cta of one day prior. there is no region of infarction, no shift of midline structures, and no evidence of mass. mild hydrocephalus remains. again seen is an aneurysm of the anterior communicating artery which measures up to 10 mm long with a region of increased signal within the aneurysm which may represent a thrombus. the aneurysm is superior to the optic chiasm and indents the anterior portion of the chiasm. the orbits and optic nerves otherwise appear normal. no other aneurysms are seen on the mra. the paranasal sinuses and mastoid air cells are clear. no osseous or soft tissue abnormality is otherwise seen. impression: 1. subarachnoid hemorrhage in the basal cisterns and the right sulci unchanged from cta of one day prior. 2. acom aneurysm superior to chiasm extends inferiorly to indent the anterior portion of the optic chiasm. no other aneurysm seen. 3. mild hydrocephalus, unchanged. radiology final report carotid/cervical bilat 2:51 pm reason: cerebral angiogram - eval for bleeding contrast: optiray medical condition: 47 year old woman s/p clipping of acomm reason for this examination: cerebral angiogram - eval for bleeding procedure: right common carotid arteriogram, left common carotid arteriogram. staff: dr. and dr. . dr. , the attending physician, present and supervising throughout the procedure. indication: 47-year-old woman with subarachnoid hemorrhage, status post surgical clipping of the anterior communicating artery aneurysm. technique: written informed consent was obtained after discussing the indications for the procedure, there risks of the procedure, and alternative management. the discussed risks included stroke, loss of vision and speech, temporary or permanent, with possible treatment with stents and coils if needed. the patient was brought to the interventional neuroradiology suite and placed on the biplane table in supine position. both groins were prepped and draped in the usual sterile fashion. a preprocedure timeout was performed using two patient identifiers. the patient had an indwelling sheath in the right common femoral artery from the pre-operative cerebral angiogram. through the sheath, a 5 french ii catheter was introduced and connected to a continuous saline infusion (mixed with heparin 1000 units in 1000 cc of saline.). the following vessels were selectively catheterized, and arteriograms were performed from the following locations: right common carotid artery, left common carotid artery. after review of the films, the catheter and the sheath were withdrawn. hemostasis was obtained with an angio-seal device. the patient tolerated the procedure well without immediate complications. findings: right common carotid artery: the visualized external carotid arterial branches appear unremarkable. right internal carotid artery: the cervical, petrous, cavernous and supraclinoid segments are normal. the right middle cerebral artery is normal. there is no residual filling of the previously noted aneurysm of the anterior communicating artery. there is no narrowing of the a1 segment of the right anterior cerebral artery. the remainder of the anterior cerebral artery appears normal. left common carotid artery: the visualized external carotid arterial branches appear unremarkable. left internal carotid artery: the cervical, petrous, cavernous and supraclinoid segments are normal. the left middle cerebral artery is normal. there is no filling of the previously noted aneurysm of the anterior communicating artery. there is no narrowing of the a1 segment of the left anterior cerebral artery. the remainder of the anterior cerebral artery appears normal. medications: the procedure was performed under general anesthesia. impression: no residual filling of the clipped aneurysm of the anterior communicating artery. no narrowing of the a1 segments of the right or left anterior cerebral arteries. radiology final report cta head w&w/o c & recons 11:25 pm cta head w&w/o c & recons reason: sah, ms changes contrast: optiray medical condition: 47 year old woman with osh with sah, headache for 10 days reason for this examination: eval for sah contraindications for iv contrast: none. history: 47-year-old female with headache for ten days and transferred from outside hospital with subarachnoid hemorrhage. comparison: no prior exam is available for comparison. technique: contiguous axial images were obtained through the brain without contrast material. subsequently, rapid axial imaging was performed through the brain during infusion of iv optiray contrast material. multiplanar maximum intensity projection images were then obtained. 3d volume-rendered images are pending. ct head without iv contrast: regions of high density along the right sulci, the basal cisterns, and the suprasellar cisterns are consistent with subarachnoid hemorrhage on the right. there is extension of this hyperdense material into the sella. there is mild hydrocephalus. otherwise, there is no evidence of mass, edema, shift of normally midline structures, or large vascular territory infarction. no fractures are seen. the frontal sinuses are not pneumatized. otherwise, the paranasal sinuses and the mastoid air cells are clear. cta head: there is an 8 x 5 mm anterior communicating artery aneurysm which points inferoposteriorly in the suprasellar region and extends into the sella. slight attenuation of the right more than left middle cerebral arteries may represent vasospasm. no other aneurysm is seen. the carotid and vertebral arteries and their major branches are otherwise patent, without evidence of focal stenosis or vascular abnormality. impression: 1. subarachnoid hemorrhage along right insular sulci, basal cisterns, and suprasellar cistern. 2. 8 x 5-mm acom aneurysm extends inferoposteriorly into the sella. slight attenuation of the mcas may represent some amount of vasospasm. please note: this is an incomplete list of radiological studies for this pt. this represents at minimum the original, latest and list of individual studies that the pt had during this hospital stay. brief hospital course: pt was admitted to the neurosurgery service after presenting with continued headache and right eye blindness. neuro: exam followed q 1 hour during icu stay. icp monitored via external ventricular drain system. csf diversion through evd for hydrocephalus ivh/sah. ultimately pt tolerated having system removed on without further hydrocephalus or elevated icp's. pt had cta and cerebral angiogram on arrival. endovascular coiling of a-comm aneurysm was attempted and unsuccessful. she was brought to the operating for a formal open craniotomy for aneurysm clipping on hospital day #1. subsequent cta's/ctp's and cerebral angiograms were performed based on pt clinical exam and icp's. she was started on nimodipine on hospital day number one. she is due to finish her 21 day course on . she was treated for intermittent bouts of vasopsasm with injection therapy during angiography as well as triple h therapy. some resultant cerebral infarcts were noted during imaging (see final diagnosis / discharge worksheet). she was started on antiepileptics (dilantin) on her day of arrival and was switched to keppra as it was questioned that dilatin may have been a fever source for her. mannitol and solumedrol doses were tapered to off without episode. cv: no issues during this hospitalization. resp:pt was intubated for the intial angiogram and subsequent surgery - she was extubated the following day and tolerated it well. id: the pt had fever during her stay. cultures were sent periodically according to temp's including csf from the evd system. medications were switched to rule out source of temp. her cultures were negative including a mrsa and vre screen. she did have a uti / e.coli noted on hosp day #1 and this was treated. no additional fever source was identified. renal: no issues during this hospitalization. endo: - placed on sliding scale coverage for glucose control during icu stay ppx: -placed on pneumoboots, ssi, h2 blocker, fen: pt originally had ngt feeds and was ultimately advanced to regular diet wihtout incidence. general - she was seen by pt and ot services. code status: full code / during entire hospital stay she was seen by clinic x 2 - she was unable to participate in the full ophto exam - she will see them in follow up medications on admission: meds: -prn motrin discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h () as needed. 3. levetiracetam 1,000 mg tablet sig: one (1) tablet po twice a day for 3 months. disp:*180 tablet(s)* refills:*0* 4. percocet 5-325 mg tablet sig: 1-2 tablets po every four (4) hours. disp:*40 tablet(s)* refills:*0* discharge disposition: home with service facility: homecare discharge diagnosis: sah with a-comm aneurysm right frontal cva right eye blindness / left eye visual field cut right basal ganglia infarct uti discharge condition: neurologically stable visual field deficit discharge instructions: discharge instructions for craniotomy/head injury ?????? have a 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, excessive bending ?????? you may wash your hair only after sutures and/or staples have been removed ?????? you may shower before this time with assistance and use of a shower cap ?????? increase your intake of fluids and fiber as pain medicine (narcotics) can cause constipation ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, ibuprofen etc. ?????? if you have been prescribed an anti-seizure medicine, take it as prescribed and follow up with laboratory blood drawing as ordered - clearance to drive will be discussed at your post hospitalization office visit. call your surgeon immediately if you experience any of the following: ?????? new onset of tremors or seizures ?????? any confusion or change in mental status ?????? any numbness, tingling, weakness in your extremities ?????? pain or headache that is continually increasing or not relieved by pain medication ?????? any signs of infection at the wound site: redness, swelling, tenderness, drainage ?????? fever greater than or equal to 101?????? f followup instructions: please call to schedule a follow up with dr in 6 weeks. please follow up in the clinic in 4 weeks at you will need a repeat opthomologic exam - your disability with regards to your vision cannot be determined unitl the ophtomology exam can be completed. please call dr. office for your letter of disability. procedure: venous catheterization, not elsewhere classified clipping of aneurysm arteriography of cerebral arteries arteriography of cerebral arteries intravascular imaging of intrathoracic vessels diagnoses: obstructive hydrocephalus urinary tract infection, site not specified subarachnoid hemorrhage compression of brain 

Answer: The patient is high likely exposed to