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: headache, nausea major surgical or invasive procedure: placement of ivc filter. history of present illness: this is an 83 yo rh woman with history of dvts on coumadin, breast cancer, htn, hypercholesterolemia, who was transferred from osh with an intracerebral hemorrhage. the history is per patient and her daughters. . the patient had sudden onset of a horrible headache 48 hrs ago prior to arrival at , frontal and bitemporal, constant, aching, not associated with any fever, neck pain, weakness or numbness. the headache persisted. the following day the patient was very nauseated, with multiple bouts of bilious emesis. on the day of presentation she did not recognize her daughter, left the freezer door open, and thus her family brought her to hospital. . bp at osh was 176/64, and a head ct showed a 5x4cm hemorrhage in the right parietal lobe with two hypodensities in the left frontal lobe. inr 2.04 and she was given 2 u ffp, 10mg vit k, and transferred to . here inr was 1.8, got 3 more units of ffp and inr went down to 1.3. sbp was in the 180's and thus labetolol gtt was started -> bp down to 140's. repeat head ct showed stable right parietal bleed (per neurosurgery attending dr. . she was loaded with dilantin 1 gram as well for shaking in her arm. . patient denies any fever, chills, preceeding weakness, numbness, visual changes, prior history of stroke or seizures, recent illnesses. no h/o fall or trauma. past medical history: 1. htn 2. hypercholesterolemia 3. dvts (multiple) on coumadin, inr difficult to control per daughters, recent inr was in the range of 4. 4. breast cancer s/p lumpectomy, xrt and tamoxifen. no chemotherapy. no recurrence known. 5. left hip replacement. 6. recent history of elevated wbcs. social history: -very active woman -lives in an apt in a family members house, independent in all adls -widowed, 5 kids. -formerly worked as a pt assistant. -no tob/etoh/drugs. family history: -brother with lymphoma, many family members with cad. -son and daughter with , pe physical exam: at admission: vitals: 99.4, 64, 178/44, 18, 100% on 2lns gen: elderly woman in nad, sitting upright in a stretcher with eyes closed intermittantly skin: no rash heent: nc/at, anicteric sclera, dry mm neck: supple, no carotid bruits, no lad chest: normal respiratory pattern, cta bilat. no axillary lad cv: regular rate and rhythm without murmurs abd: soft, nontender, nondistended, +bs, no hsm extrem: no edema, warm and well perfused. a line in right arm. neuro: mental status: patient is alert, awake, pleasant affect and slightly disinhibited behavior. oriented to person, place, time and president. fair attention - names moyb quickly, pauses at , and continues to name the rest of the months. tells a coherent story. language is fluent with good comprehension, repitition, naming of body parts, no dysarthria. no apraxia (brushes hair), no neglect (names all in the room). able to calculate, no left/right mismatch. registration objects. recalls objects after 3 minutes. . cranial nerves: i: deferred ii: visual fields: left homonomous hemianopsia. fundoscopic exam: discs flat, fundi clear, no hemorrhages or exudates. pupils:3->2 mm, consensual constriction to light. iii, iv, vi: eoms full, gaze conjugate. + nystagmus that fatigues (s/p dilantin load), no ptosis. v: facial sensation intact over v1/2/3 to light touch and pin prick. vii: symmetric face viii: hearing not intact to finger rubs ix, x: symmetric elevation of palate : scm and trapezius bilaterally xii: tongue midline without atrophy or fasciulations. . sensory: normal touch, vibration, pinprick. no extinction to double simultaneous stimulation. . motor: some wasting of small hand muscles, mild increased tone in legs. no fasciculations or drift. no adventitious movements. no asterixis. strength: delt tri we wf fe ff ip qd ham df pf toe left:5 5 5 5 5 5 5 4 5 4 5 5 5 . reflexes: no grasp, glabellar, snout, palmomental. no jaw jerk. br tri pat ach toes rt: 3 3 3 4 0 up left: 3 3 3 4 0 up . coordination: normal finger-to-nose, rams. . gait: not tested given on labetolol gtt. . exam upon transfer from icu to floor: vitals: 101.6, 74-86,109-153/37-57, 18, 100% on 2lns gen: elderly woman in nad, sleeping, arousable, needs prompting to stay awake skin: no rash heent: nc/at, anicteric sclera, moinst mmm neck: supple, no carotid bruits, no lad chest: normal respiratory pattern, cta bilat. no axillary lad cv: regular rate and rhythm without murmurs abd: soft, nontender, nondistended, +bs, no hsm extrem: edema 1+ bilaterlly, pitting, warm and well perfused. neuro: mental status: patient is drowsy, needs continues prompting, perseverating, answers most questions "yes, yes" oriented to person, place (after orientation), time (only after re-orientation) attention: needs continues prompting; language is fluent with good comprehension, repitition, naming of body parts (but calls l-arm the r-arm), no dysarthria. some neglect (not able to point/count all people in the room; might be related to poor attention. registration items (date/month/year). recalls pieces of information in 5 minutes. . cranial nerves: i: deferred ii: visual fields: dense left homonomous hemianopsia. pupils:3->2 mm, consenual constriction to light. iii, iv, vi: eoms full, gaze conjugate. no ptosis. v: facial sensation intact over v1/2/3 to light touch and cold vii: symmetric face viii: hearing intact to finger rubs ix, x: symmetric elevation of palate : scm and trapezius bilaterally xii: tongue midline without atrophy or fasciulations. . sensory: exam unreliable as she answers almost every question with yes: touch, vibration, pinprick normal. extinction to double simultaneous stimulation. . motor: some wasting of small hand muscles, mild increased tone in legs. no fasciculations or drift. resting tremor in r-hand. strength: delt tri we wf fe ff ip qd ham df pf toe left:5 5 5 5 5 5 5 4 5 4 5 5 5 . reflexes: + grasp. br tri pat ach toes rt: 1 1 1 1 0 up left: 1 1 1 1 0 up . coordination: normal finger-to-nose, rams, hts. . gait: not tested; patient drowsy pertinent results: labs/radiology: na 143, k 3.7, cl 107, bicarb 26, bun 19, cr 0.8, gluc 109 cbc: 20/36/168, mcv 92 diff: 39n, 2 bands, 55l, 4 monos, 0 eos, 1+ aniso, poiklo, macrocy, microcy, ovalocy, tear-drop. inr 1.8->1.3 now ua: mod blood, 30 prot, 50 ket, r, wbc, occ bact, 0 epi ck 83, mb nd, trop <0.01 . cxr: 1. right hilar fullness, which may indicate lymphadenopathy. 2. increased interstitial markings bilaterally, which may represent mild pulmonary edema, atypical pneumonia, or less likely, bilateral lymphangitic spread of tumor. . nchct at 3pm: 1. large intraparenchymal hemorrhage arising from right temporoparietal, occipital regions. no definite evidence of intracranial metastasis on this non-contrast examination. 2. extension of hemorrhage into lateral ventricles and subarachnoid space. . nchct at 9pm: there has been no significant change in the extent of the large right temporoparietal and occipital lobe intraparenchymal hemorrhage. this measures approximately 3.9 x 4.7 cm, which is essentially unchanged. intraventricular hemorrhage is again noted, as are small foci of blood along the falx. no hydrocephalus or significant shift of midline structures is seen. . nchct: there has been no appreciable change in size or surrounding edema of the large right temporoparietal intraparenchymal hemorrhage, with extension into the right lateral ventricle. blood layering in the left occipital has been resorbed. again seen are several tiny foci of hemorrhage adjacent to the falx, unchanged from prior studies. there is subarachnoid blood and isolated sulcus at the extreme left vertex, new from the prior study. there is no hydrocephalus or shift of normally midline structures. . : mri: this is a limited study with motion degraded t1 sagittal images obtained. the area of hemorrhage is identified in the right posterior temporoparietal region as seen on the ct of . . eeg: : this is an abnormal portable eeg due to the presence of slow and disorganized background rhythm with generalized bursts of delta frequency slowing. these findings suggest a mild encephalopathy. brief hospital course: this is an 83 yo woman with history of breast cancer, htn, and high cholesterol, and dvts on coumadin who presents with headache x 48 hours and emesis. the patient was admitted to the neuro icu with an intracranial hemorrhage. after 3 days she was transferred to the floor. . 1. neurological: intracranial hemorrhage: the neurological exam at admission was significant for a left homonomous hemianopsia and mild left leg weakness in an upper motor neuron pattern. no papilledema was seen on fundi exam. ct showed an intracerebral hemorrhage in the right parietal lobe with some surrounding edema. there is a question of two other hyperdensities in bilateral frontal lobes as well. repeat head ct 6 hrs later is stable, without signs of enlargement, hydrocephalus, or shift. there was a question of whether the intracranial bleed was into a mass lesion. mri of the head with and without gadolinium did not demonstrate a mass, but follow-up mri in weeks was recommended to re-evaluate once hemorrhage has partially resorbed. given the breakthrough of the hemorrhage into the ventricular system, the patient was monitored closely for signs of hydrocephalus. neurosurgery was consulted and recommended no operative management. they recommended beginning a mannitol drip, for a few days only, and to start the patient on dilantin for seizure prophylaxis. patient had been started on phenytoin for seizure prophylaxis, at a dose of 100 mg tid. patient was sub therapeutic in dilantin level and did not have any seizures during this time. she also developed a rash to dilantin. therefore, dilantin was discontinued. an eeg showed no epileptiform discharges but was remarkable for mild encephalopathy. patient's left homonymous hemianopsia remained stable and the encephalopathy, noticeable by inattentiveness and sleepiness, slowly improved. . 2. cardiovascular: while in the icu, patient's elevated blood pressure was managed with labetalol gtt (goal <140). she was then weaned off the drip and started on atenolol 100 mg. she ruled out for mi. no events were noted per telemetry. her blood pressure goal was <140 sbp. . 3. hematology: a) the patient was on coumadin for dvt. the supra therapeutic inr was decreased by multiple units of ffp and vit-k. in the setting of history of hypercoagulability, and a new rle dvt, an ivc filter was placed by vascular surgery, as coumadin is contraindicated at this point. given a positive family history for dvt and pe, a hypercoagulable workup should be considered. b) the patient was noted to have an increased wbc. she was seen by hematology/oncology for rule out cll. peripheral blood flow cytometry study revealed involvement by a cd5 positive, cd23 positive, cd20 (dim) b-cell lymphoproliferative disorder, immuonphenotypically consistent with chronic lymphocytic leukemia. there was no recommendation for treatment at the present time, however, wbc count will be followed as an outpatient. . 4. pulmonary: chest xr on admission demonstrated hilar fullness which was concerning for mass. a ct-chest showed no evidence for pulmonary or hilar masses. . 5. id: the patient was febrile during the acute phase, and was found to have an elevated white count and a urinalysis suggesting a uti. the patient had a foley catheter in place for the first 5 days of her hospital stay. the patient was treated with levofloxacin 500 mg qd. also, due to the possibility of line infection, her left subclavian central line which was placed at the time of admission, was removed and the tip was sent for culture. access was maintained through a peripheral iv in her right arm. . 6. renal: the patient was noted to have a renal cyst on chest-ct. the patient is known to have this cyst for 4 years which has not changed in size. primary care doctor will repeat a mr abdomen with contrast in a few months. . 7. fen: patient was evaluated by speech and swallow after the acute phase, and her diet was advanced accordingly. she tolerated a cardiac diet. . 8. disposition: pt/ot consult obtained, recommended short term rehabilitation. placed at center. . 9. full code. hcp = (daughter) . medications on admission: meds: (doses not known) lasix atenolol zocor coumadin 7 or 8 mg each night (goal ). discharge medications: 1. heparin sodium (porcine) 5,000 unit/ml solution sig: one (1) injection (2 times a day). 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. atenolol 100 mg tablet sig: 1.5 tablets po daily (daily): please adjust dose to keep sbp<150. 4. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 5. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 4 days. 6. acetaminophen 650 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. 7. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical qid (4 times a day) as needed. 8. diphenhydramine hcl 25 mg capsule sig: one (1) capsule po q6h (every 6 hours) as needed. discharge disposition: extended care facility: for the aged - discharge diagnosis: 1. intracranial hemorrhage, right temporoparietal lobe 2. urinary tract infection 3. chronic lymphocytic leukemia 4. renal cyst 5. hypertension 6. deep venous thrombosis lower extremity discharge condition: good discharge instructions: follow up mri head with gad in weeks. please continue to take all medications as prescribed. follow up with your pcp after discharge from rehab. please have your electrolytes checked at rehab (k and mg). followup instructions: 1. please f/u at the stroke clinic (dr. /dr. ). please call to update your demographics, schedule the appointment and to receive directions. 2. please call for mri/mra brain with contrast appointment and make sure it is before the visit with neurology. 3. please follow up with your primary care physician after discharge from rehab. you will also need a mri abdomen with gadolinium to look at the kidney as this could not be scheduled while you were in the hospital. procedure: venous catheterization, not elsewhere classified interruption of the vena cava phlebography of other intra-abdominal veins using contrast material diagnoses: urinary tract infection, site not specified personal history of malignant neoplasm of breast intracerebral hemorrhage cyst of kidney, acquired acute venous embolism and thrombosis of unspecified deep vessels of lower extremity 

Answer: The patient is high likely exposed to