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: lethargy, worsening left weakness major surgical or invasive procedure: : right craniotomy for evacuation of hematoma history of present illness: 70 woman who was diagnosed with breast cancer in with metastatic spread to bone. the patient is currently on emcitabine and was to begin cycle 2 on ; however, the patient presented to with complaints of weakness for the past two days. the weakness has been mainly noticed in the ble. imaging revealed right sdh and she subsequently underwent a craniotomy and evacuation of the sdh on . she was discharged to rehab. on she returned to the ed with reported lethargy. ct scan revealed increasing chronic r sdh with increased mls. she was afebrile and wbc=10, but u/a was positive. past medical history: metastatic breast cancer to bone dx'd , colostomy, chf, diverticulitis, htn, hypothyroidism, cdiff, uveitis, depression, anemia of chronic disease, gerd, vit b12 deficiency social history: lives with daughter, , who is the hcp. quit smoking 2yrs ago. prior to admission and current status, patient was walking with a walker. family history: nc physical exam: on admission: o: t:97.2 bp: 148/62 hr: 74 r20 o2sats 99% 2l gen: laying on stretcher, nad. heent: pupils: r surgical/irregular l 3mm-2mm eoms grossly intact extrem: warm and well-perfused. neuro: mental status: lethargic, arouses to voice but requires frequent stimulation to stay awake. orientation: oriented to & year only. (with persistant asking) language: speech slow cranial nerves: i: not tested ii: pupils: r surgical/irregular l 3mm-2mm iii, iv, vi: extraocular movements grossly intact bilaterally without nystagmus. 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: weak bilaterally and difficult to examine 2.2 lethargy. antigravity b/l ue's and withdraws b/l le's. following commands in b/l ue's. sensation: intact to light touch incision- well healing, staples in place on discharge: a&ox3 perrl eoms intact motor: 4-/5 bue, wiggles toes bilateral le incision: c/d/i pertinent results: ct head: impression: increased size of predominantly hypodense right cerebral subdural collection, likely a csf hygroma, with increased shift of midline structures. effacement of suprasellar cistern is new and compatible with early transtentorial herniation. cxr: left lower lobe consolidation could be secondary to pneumonia, aspiration, or atelectasis. pleural effusions are small if any. volume overload is mild. left-sided port-a-cath ends in cavoatrial junction. mediastinal and cardiac contours are normal. ct head postop: decreased right subdural collection, now consisting of fluid and air, with improvement in associated mass effect. no new hemorrhage. chest xray:findings: as compared to the previous radiograph, the pre-existing bilateral pleural effusions have increased. also increased are the signs suggestive of moderate pulmonary edema. increase in extent of the pre-existing retrocardiac atelectasis. unchanged mild cardiomegaly. cardiovascular report ecg study date of 1:58:56 pm sinus rhythm with premature atrial contractions. diffuse non-spefific st-t wave changes. low voltage in the axial leads. compared to the previous tracing of the heart rate is slower and the t wave inversion in leads v2-v3 is more prominent. clinical correlation is suggested. intervals axes rate pr qrs qt/qtc p qrs t 74 176 80 156 echocardiography report conclusions the left atrium is mildly dilated. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef 65%). the right ventricular free wall thickness is normal. the right ventricular cavity is dilated with depressed free wall contractility. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. moderate tricuspid regurgitation is seen (may be underestimated due to the suboptimal nature of this study). there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. ct head w/o contrast study date of 11:37 am findings: the right-sided subdural drainage catheter has been removed. there is no change in the size of the subdural hematoma. there has been reduction in extra-axial pneumocephalus when compared to the prior study. the leftward shift of midline structures is unchanged, approximately 6 mm. the ventricular size and configuration is unchanged from the prior study. there is no evidence of new hemorrhage or acute vascular territorial infarction. the imaged portion of the mastoid air cells and paranasal sinuses are well aerated. impression: no significant interval change since removal of the right subdural drainage catheter. chest (portable ap) study date of 4:25 am mild pulmonary edema has improved, now persisting mainly at the lung bases. moderate left pleural effusion stable. heart size normal. no pneumothorax. infusion port catheter ends in the low svc. heart size normal. no pneumothorax. ct head- 1. status post evacuation of the right subdural hemorrhage. minimally increased right lateral ventricular effacement and increased size of the right subdural collection by measurements. this may be technical as there are no new hyperdense blood products, but small interval reaccumulation cannot be entirely excluded. comments on attening review: there is interval enlargement of the right epidural fluid collection underlying the craniotomy flap, which explains the slightly increased effacement of the right lateral ventricle, compression of the third ventricle, and slightly increased leftward shift of midline structures. the right subdural fluid collection is stable. eeg: impression: this is an abnormal continuous icu monitoring study because of continuous focal slowing and attenuation of faster frequencies in the right hemisphere. there are occasional runs of very rhythmic delta activity or sharp and slow wave discharges in the right posterior quadrant which do not clearly involved in frequency or field. these findings are indicative of a highly potentially epileptogenic focal structural lesion in the right posterior quadrant. the background on the left shows mixed theta and delta activity, suggesting moderate diffuse encephalopathy. there are no definite electrographic seizures. ct head: impression: 1. increased right epidural fluid collection underlying the right craniotomy flap, compared to , with associated increased effacement of the right lateral ventricle, compression of the third ventricle, and slightly increased leftward shift of midline structures. 2. stable right subdural fluid collection. cxr: ng tube tip is coiled in the stomach that is intrathoracic in a moderate hiatal hernia, the tip projects at the level of the hemidiaphragm . cardiac size is top normal, accentuated by low lung volumes. port-a-cath is in standard position. small-to-moderate bilateral pleural effusions with adjacent atelectases are unchanged allowing the difference in positioning of the patient. of note, the atelectasis in the right lower lobe has minimally increased. mild-to-moderate pulmonary edema is stable. eeg: impression: this is an abnormal continuous icu eeg monitoring study because of continuous focal attenuation and prolonged runs of quasi-rhythmic 1 hz delta activity with intermixed sharp waves in the right posterior quadrant. these findings are indicative of a potentially epileptogenic focal structural lesion in the right posterior quadrant. the background shows disorganized mixed delta and theta activities suggestive of moderate to severe encephalopathy of non-specific etiology. compared to the prior day's recording, there are no significant changes. eeg: impression: this is an abnormal continuous icu eeg monitoring study because of continuous focal attenuation and prolonged runs of quasi-rhythmic 1 hz delta activity with intermixed sharp waves in the right posterior quadrant. these runs of delta activity do not evolve into clear electrographic seizures. focal attenuation and runs of delta activity with intermixed sharp waves are indicative of a potentially epileptogenic focal structural lesion in the right posterior quadrant. background activity is characterized by disorganized mixed delta and theta activities indicative of moderate to severe encephalopathy of non-specific etiology. there are no electrographic seizures. compared to the prior day's recording, there are no significant changes. ct head: impression: the right epidural collection is minimally decreased. unchanged subdural collection along the right convexity. stable 9 mm leftward shift of normally midline structures. brief hospital course: ms. was admitted to the neuro icu for frequent neuro checks and blood pressure control with a plan for evacuation of right sdh. she was maintained on cipro for treatment for uti. on she underwent right craniotomy for evacuation of sdh. a subdural drain was placed and set on thumbprint jp suction. postoperatively she was extubated and transferred to the icu. postop head ct showed good evacuation of sd collection without new hemorrhage. pod 1 her hct was noted to be 23 and she was hypotensive to the low 90s. otherwise she was asymptomatic. she was transfused 1 unit prbcs and post transfusion hct bumped to 27. on , the sub dural drain was discontinued. a repeat head ct was performed and was stable. the sqh was restarted after the drain was discontiued. the cardiac echocardiogram, but suggestive of right heart failure. the patient was initiated on midodrine while trying to wean off intravenous vasopressors. on , the foley catheter was discontinued. physical and occupational therapy consults were placed. the intravenous vasopressors were weaned as tolerated. a chest x ray was consistent with mild pulmonary edema which has improved, persisting mainly at the lung bases.moderate left pleural effusion stable. heart size normal. no pneumothorax. infusion port catheter ends in the low svc. heart size normal. overnight she was noted to be more lethargic. a ct was performed which was questionable for slightly enlarging sdh vs positioning. on her exam continued to decline with less left sided movement. another ct was performed which revealed increased mls. she was started on eeg to evaluate for seizures. these findings were conveyed to the family who stated that they would not consent to another surgery if things were to progress to that. she was started on tube feeds. on she remained stable. her sqh was decreased to 5000units due to an increased ptt on am labs. a palliative care consult was called per her primary oncologists recommendation. , a head ct demonstrated worsening changes and the patient exhibited less movement on the left. cxr demonstrated pleural effusions. , a repeat head ct was stable and a family meeting resulted in the decision to progress toward palliative care. , she was transferred to the floor with palliative care following. on her ngt was removed and she was started on a po diet. morphine concentrate was added. the process was initiated to find a discharge facility. on , patient's exam was unchanged. she was eating with assistance and oob to chair. no changes were made to her medication regimen. on , patient was discharged to hospice in stable condition. medications on admission: preadmission medications listed are correct and complete. information was obtained from rehab . calcium carbonate 750 mg po bid 2. citalopram 10 mg po daily 3. diltiazem extended-release 240 mg po daily 4. ferrous sulfate 325 mg po daily 5. furosemide 20 mg po daily 6. levothyroxine sodium 75 mcg po daily 7. metoprolol succinate xl 75 mg po daily 8. miconazole powder 2% 1 appl tp 9. omeprazole 20 mg po daily 10. oxycodone (immediate release) 5-10 mg po q4h:prn pain 11. oxycodone sr (oxycontin) 20 mg po q12h 12. polyethylene glycol 17 g po daily:prn constipation 13. prednisolone acetate 1% ophth. susp. 1 drop both eyes 14. prochlorperazine 10 mg po q8h:prn nausea 15. heparin 5000 unit sc tid start in am on 16. morphine sulfate 2-4 mg iv q3h:prn pain 17. sodium chloride 0.9% flush 3 ml iv q8h:prn line flush peripheral line: flush with 3 ml normal saline every 8 hours and prn. 18. insulin sc sliding scale fingerstick qachs insulin sc sliding scale using reg insulin 19. acetaminophen 325-650 mg po q6h:prn pain/fever 20. docusate sodium 100 mg po bid 21. glucagon 1 mg im q15min:prn hypoglycemia protocol 22. levetiracetam 500 mg po bid 23. cyanocobalamin 1000 mcg im/sc monthly 24. alendronate sodium 4 mg po every 3 months 25. ondansetron 8 mg po q8h:prn nausea 26. vitamin d 50,000 unit po monthly 27. milk of magnesia 60 ml po q12h:prn constipation discharge medications: 1. acetaminophen 325-650 mg po q6h:prn pain/fever 2. calcium carbonate 750 mg po bid 3. citalopram 10 mg po daily 4. ferrous sulfate 325 mg po daily 5. glucagon 1 mg im q15min:prn hypoglycemia protocol 6. docusate sodium 100 mg po bid 7. heparin 5000 unit sc tid start in am on 8. insulin sc sliding scale fingerstick qachs insulin sc sliding scale using reg insulin 9. levetiracetam 500 mg po bid 10. ondansetron 8 mg po q8h:prn nausea 11. oxycodone (immediate release) 5-10 mg po q4h:prn pain 12. polyethylene glycol 17 g po daily:prn constipation 13. prednisolone acetate 1% ophth. susp. 1 drop both eyes 14. sodium chloride 0.9% flush 3 ml iv q8h:prn line flush peripheral line: flush with 3 ml normal saline every 8 hours and prn. 15. levothyroxine sodium 75 mcg po daily 16. miconazole powder 2% 1 appl tp 17. fentanyl patch 37 mcg/h tp q72h 18. midodrine 10 mg po tid 19. morphine sulfate (concentrated oral soln) 10-15 mg po q2h:prn resp distress/pain 20. senna 2 tab po bid:prn constipation 21. alendronate sodium 4 mg po every 3 months 22. cyanocobalamin 1000 mcg im/sc monthly 23. diltiazem extended-release 240 mg po daily 24. furosemide 20 mg po daily 25. milk of magnesia 60 ml po q12h:prn constipation 26. oxycodone sr (oxycontin) 20 mg po q12h 27. prochlorperazine 10 mg po q8h:prn nausea 28. vitamin d 50,000 unit po monthly discharge disposition: extended care facility: - discharge diagnosis: right subdural hematoma discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. 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. ?????? clearance to drive and return to work will be addressed at your post-operative office visit. ?????? make sure to continue to use your incentive spirometer while at home, unless you have been instructed not to. 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, or drainage. ?????? fever greater than or equal to 101?????? f. followup instructions: follow-up appointment instructions you are currently being discharged to hospice. please contact our office if you have any further questions. neurosurgery can be contact by calling . procedure: incision of cerebral meninges enteral infusion of concentrated nutritional substances diagnoses: pneumonia, organism unspecified anemia, unspecified esophageal reflux malignant neoplasm of liver, secondary urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension unspecified acquired hypothyroidism other b-complex deficiencies encounter for palliative care do not resuscitate status secondary malignant neoplasm of lung subdural hemorrhage secondary malignant neoplasm of bone and bone marrow chronic diastolic heart failure colostomy status malignant neoplasm of breast (female), unspecified 

Answer: The patient is high likely exposed to