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: slurred speech, vomiting major surgical or invasive procedure: tracheostomy, peg placement history of present illness: 80 yo m with pmh of htpertension and dyslipidemia who was last seen well by his wife at 6:30 this morning when he left with the dog for a walk and to buy the newspaper. about one hour later she heard the knob moving several times without success to open the door from outside. she opened the door and found mr. sitting down on the step with a very slurred speech. he also vomitted at this time. he could not stand up, however, she did not notice which side of the body was weak. she called 911 and he was taken to where he was found to have slurred speech, left facial droop and left hemiparesis. his vitals there were: t 97.5 hr 96 bp 148/79 sat 97%. head ct showed old r frontal infarct and suspicion for r mca stroke. nihss there: 16. he received tpa at 8:30 am. he was also found to have pneumonia and was started on ceftriaxone and azythromycin. his ekg showed sinus rythm, @92, right bbb. past medical history: -htn -dyslipidemia social history: retired, used to be an electrial engineer, no hx of smoking or alcohol abuse. his wife reports he has been more forgetful for the past years, however, he continues to perform his daily activities regularly. family history: unknown physical exam: t-97.5 bp-148/79 hr-96 rr-18 91%o2sat on 3l gen: lying in bed, nad heent: nc/at, moist oral mucosa neck: no tenderness to palpation, normal rom, supple, no carotid or vertebral bruit back: no point tenderness or erythema cv: rrr, nl s1 and s2, no murmurs/gallops/rubs lung: clear to auscultation bilaterally abd: +bs soft, nontender ext: no edema neurologic examination: mental status: awake, eyes closed. oriented to person, place, and date. dysarthric; naming intact; non-fluent. good comprehension, follows commands such as squeezing hands but did not open his eyes spontaneously during the whole exam. cranial nerves: pupils equally round and reactive to light, 4 to 2 mm bilaterally. visual fields are full to confrontation. extraocular movements intact bilaterally, no nystagmus. decreased sensation on left fave v2-v3. left facial weakness umn pattern. hearing intact to finger rub bilaterally. palate elevation symmetrical. sternocleidomastoid and trapezius normal bilaterally. tongue midline, movements intact motor: tri wf we fe ff ip h q df pf te tf r 5 5 5 5 5 5 5 5 5 5 5 5 5 5 l 0 0 0 0 0 0 0 0 0 0 0 0 0 0 triple flexion on left leg on noxious stimuli; no movement on left arm. sensation: decreased sensation to light touch, temperature on left arm and leg reflexes: biceps 1+ bl; triceps 1+ bl; patellar 2+ on left and 1+ on right side; achilles 1+ bl. toes upgoing bilaterally coordination: patient did not cooperate with finger tapping or finger to nose exam pertinent results: 02:34am blood wbc-7.4 rbc-3.90* hgb-12.5* hct-34.9* mcv-90 mch-31.9 mchc-35.7* rdw-14.3 plt ct-174 12:54am blood wbc-10.1 rbc-3.89* hgb-12.5* hct-34.4* mcv-88 mch-32.1* mchc-36.3* rdw-14.3 plt ct-166 01:39am blood wbc-10.6 rbc-4.01* hgb-12.7* hct-35.5* mcv-89 mch-31.6 mchc-35.7* rdw-14.3 plt ct-141* 02:10am blood wbc-11.0 rbc-3.83* hgb-12.4* hct-34.7* mcv-91 mch-32.4* mchc-35.8* rdw-14.0 plt ct-141* 02:12am blood wbc-11.3* rbc-4.02* hgb-13.0* hct-36.3* mcv-90 mch-32.4* mchc-35.8* rdw-14.7 plt ct-139* 12:28am blood wbc-16.3* rbc-4.65 hgb-14.6 hct-42.4 mcv-91 mch-31.4 mchc-34.4 rdw-14.5 plt ct-168 03:21pm blood wbc-14.7* rbc-5.04 hgb-16.0 hct-46.2 mcv-92 mch-31.7 mchc-34.5 rdw-14.2 plt ct-195 02:10am blood neuts-84.4* lymphs-9.6* monos-5.7 eos-0.3 baso-0.1 02:34am blood pt-13.9* ptt-40.7* inr(pt)-1.2* 12:54am blood pt-14.3* ptt-42.4* inr(pt)-1.2* 08:22am blood pt-13.8* ptt-33.2 inr(pt)-1.2* 04:10pm blood pt-13.3 ptt-60.5* inr(pt)-1.1 10:21am blood pt-13.7* ptt-55.5* inr(pt)-1.2* 02:12am blood pt-14.9* ptt-33.6 inr(pt)-1.3* 03:21pm blood pt-14.9* ptt-32.7 inr(pt)-1.3* 02:34am blood glucose-124* urean-30* creat-0.7 na-136 k-4.0 cl-101 hco3-29 angap-10 12:54am blood glucose-119* urean-25* creat-0.8 na-137 k-3.6 cl-101 hco3-28 angap-12 01:05pm blood glucose-114* urean-25* creat-0.8 na-136 k-3.6 cl-101 hco3-26 angap-13 01:39am blood glucose-116* urean-27* creat-0.8 na-133 k-4.7 cl-99 hco3-26 angap-13 04:10pm blood glucose-122* urean-27* creat-0.7 na-137 k-3.5 cl-102 hco3-26 angap-13 02:10am blood glucose-136* urean-29* creat-0.8 na-135 k-3.7 cl-104 hco3-25 angap-10 02:12am blood glucose-99 urean-27* creat-0.9 na-136 k-4.2 cl-105 hco3-24 angap-11 10:39pm blood glucose-116* urean-26* creat-0.9 na-138 k-4.2 cl-106 hco3-26 angap-10 02:06pm blood glucose-119* urean-30* creat-1.0 na-138 k-4.3 cl-104 hco3-25 angap-13 12:28am blood glucose-153* urean-34* creat-1.3* na-139 k-4.9 cl-106 hco3-22 angap-16 03:21pm blood glucose-145* urean-33* creat-1.2 na-141 k-4.5 cl-102 hco3-26 angap-18 02:12am blood ck(cpk)-104 08:32pm blood ck(cpk)-111 02:06pm blood ck(cpk)-127 08:55am blood ck(cpk)-143 12:28am blood ck(cpk)-121 02:12am blood ck-mb-7 ctropnt-0.23* 08:32pm blood ck-mb-7 ctropnt-0.23* 02:06pm blood ck-mb-9 ctropnt-0.25* 08:55am blood ck-mb-11* mb indx-7.7* ctropnt-0.23* 12:28am blood ctropnt-0.23* 03:21pm blood ck-mb-9 ctropnt-0.18* 02:34am blood calcium-8.3* phos-3.0 mg-2.0 12:54am blood calcium-8.2* phos-4.1 mg-2.0 01:39am blood calcium-8.3* phos-3.2 mg-1.9 04:10pm blood calcium-8.4 mg-1.8 02:10am blood calcium-8.0* phos-2.0* mg-2.0 02:12am blood calcium-8.2* phos-2.2* mg-2.2 02:06pm blood calcium-8.4 phos-2.8# mg-2.0 12:28am blood calcium-8.6 phos-4.5 mg-2.0 03:21pm blood calcium-9.3 phos-4.3 mg-1.9 cholest-216* 03:21pm blood triglyc-97 hdl-58 chol/hd-3.7 ldlcalc-139* 08:45am blood osmolal-284 06:10pm blood osmolal-287 05:50am blood osmolal-289 12:54am blood osmolal-286 07:56pm blood osmolal-286 01:05pm blood osmolal-286 07:34am blood osmolal-286 01:39am blood osmolal-284 05:50am blood vanco-8.7* 06:32am blood vanco-14.1 06:19am blood vanco-13.3 cta head/neck : impression: 1. subtle loss of -white matter differentiation in the right frontal lobe and right insula consistent with right mca occlusion. 2. above findings are corroborated by cta findings of complete occlusion of the right ica and m1 segment of right mca. 3. secretions within the trachea and left mainstem bronchus with associated ground glass opacity within the dependent portions of the visualized upper and superior segment of the lower lobes bilaterally which raises the possibility of aspiration. 4. mild pulmonary edema. 5. multiple sub-4-mm pulmonary nodules for which no followup is needed if there is no history of malignancy. mri brain : impression: 1. significant increase in the size of the previously noted right mca territory infarct, which now involves the entire right middle cerebral artery territory including the basal ganglia and internal capsule with mild-to- moderate mass effect on the right lateral ventricle. no acute hemorrhage within. 2. two punctate foci of increased dwi signal in the occipital lobes, in the cortex, are of uncertain significance, and too small to be accurately characterized. attention can be paid to this on followup study. 3. non-visualization of flow void in the supraclinoid ica, mca on the right side, representing the known occlusion. dedicated mra not performed on the present study. 4. paranasal sinus disease as described above. nchct : impression: 1. increase in the right mca territory area of infarction, with mild mass effect on the right lateral ventricle. 2. no acute hemorrhage. 3. unchanged appearance of the dense right middle cerebral artery consistent with thrombus within. please note that dedicated ct is not performed on the present study. 4.paranasal sinus disease as above nchct : impression: 1. evolving right mca infarct with increased edema and mass effect with new shift of the normally midline structures leftward. no hemorrhagic transformation or herniation. 2. new right pca infarct. nchct : impression: continued evolution of right mca and right pca territory infarction with continued slight increased edema and mass effect on the right lateral ventricle with slight increase in leftward shift of normally midline structures. no new hemorrhagic transformation seen. there is likely early right subfalcine herniation. nchct : impression: continued evolution of right mca and pca territory infarction with slightly worsened mass effect including increase in leftward shift. carotid u/s : impression: 1. high-resistance flow in the right internal carotid artery without diastolic flow consistent with the distal right internal carotid artery occlusion seen on the ct of . the degree of stenosis in the proximal right internal carotid artery is mild with non elevated peak systolic velocities although the exact degree of proximal stenosis is difficult to quantitate due to the presence of the distal occlusion 2. less than 40% stenosis in the left internal carotid artery. tte : the left atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is severe global left ventricular hypokinesis with relative preservation of the basal anterior and basal inferolateral walls (lvef = 25 %). no masses or thrombi are seen in the left ventricle. right ventricular chamber size is normal with hypokinesis of the apical free wall. the aortic root is mildly dilated at the sinus level. the aortic valve leaflets are mildly thickened. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. there is mild-moderate pulmonary artery systolic hypertension. there is no pericardial effusion. impression: mild symmetric left ventricular hypertrophy with severe global hypokinesis. right ventricular free wall hypokinesis. mild aortic regurgtitation. mild mitral regurgitation. pulmonary artery systolic hypertension. dilated aortic root. in the absence of a history of systemic hypertension, an infiltrative process (e.g., amyloid, -fabry's disease) should be considered. brief hospital course: this 80 m was evaluated at for dysarthria and vomiting and found to have a large r-mca stroke. he was given iv tpa and was transferred to for futher care. he was admitted to the icu. his cta showed complete occlusion of the r-ica and proximal segment of m1 branch of the r-mca. over the course of 3 days he developed significant edema and swelling. he was started on mannitol on and this was weaned to off by as his subsequent head ct's stabilized. he sustained a new small r-pca stroke on . he was found to have atrial fibrillation. at times he also has atrial flutter. mr. was started on heparin with a goal ptt of 40-60. he was then started on coumadin on . he had a surface echo which showed no thrombus or atheroma, but was notable for an ef of 25%. his course was complicated by a suspicion for pna, and he received a 2-week course of cipro. he recevied a tracheostomy and peg tube on . he was transferred to the step-down unit on , at which time, his exam was notable for ongoing flaccid left hemiparesis and eyelid apraxia. while on the stroke floor he has been clinically stable with no significant events. he became therapeutic on coumadin and his heparin drip was stopped. medications on admission: -aspirin 81mg -hydrochlrothiazide (unknown dose) discharge medications: 1. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 2. aspirin 300 mg suppository sig: one (1) suppository rectal daily (daily). 3. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 3 days. 4. docusate sodium 50 mg/5 ml liquid sig: two (2) po bid (2 times a day). 5. senna 8.8 mg/5 ml syrup sig: one (1) tablet po bid (2 times a day) as needed. 6. bisacodyl 10 mg suppository sig: one (1) suppository rectal hs (at bedtime) as needed. 7. famotidine 20 mg tablet sig: one (1) tablet po q12h (every 12 hours). 8. metoprolol tartrate 100 mg tablet sig: 1.25 tablets po three times a day. 9. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day) as needed. 10. metoprolol tartrate 10 mg iv q6 hr prn sbp>160 11. warfarin 2 mg tablet sig: two (2) tablet po daily (daily). discharge disposition: extended care facility: for the aged - macu discharge diagnosis: left mca/pca infarct discharge condition: stable discharge instructions: you were admitted because of a large stroke affecting the left side of your brain. you will need to go to a rehab facility for continuation of your therapies. followup instructions: provider: , md phone: date/time: 11:00 please call your pmd for a referral and then call dr. prior to your visit procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy diagnoses: pneumonia, organism unspecified unspecified essential hypertension unspecified protein-calorie malnutrition atrial fibrillation atrial flutter other and unspecified hyperlipidemia acute respiratory failure long-term (current) use of anticoagulants cerebral embolism with cerebral infarction facial weakness muscle weakness (generalized) status post administration of tpa (rtpa) in a different facility within the last 24 hours prior to admission to current facility 

Answer: The patient is high likely exposed to