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: shellfish / scopolamine attending: chief complaint: headache major surgical or invasive procedure: decompression craniectomy for chiari malformation with duraplasty history of present illness: 36 yo f with a long-standing history of fronto-occipital headaches previously treated with nsaids and sumatriptan, also been seen at the pain clinic with trials of lidocaine and ketorolac infusions as well as injections of lidocaine and steroids all to no avail, recently started on amitryptiline 10 mg po daily. she notes a history of headaches since adolescence and these have continued to progress. she complains of a constant headache of moderate severity which is bilateral and fronto-occipital. however, whenever she performs any type of valsalva including coughing, sneezing, or heavy lifting, she notes a different, more severe headache mostly occipital in nature with associated nausea, vomiting, photo/phonophobia and flashing lights sensation. she underwent an mri on which showed a chiari i malformation. this was followed by an mri c-spine which showed no syringomyelia. past medical history: past medical history hyperthyroid no meds past surgical history -t&a -ear tubes -bilateral urethral stents as a child -orthopedic surgery to r leg (4 total) social history: nurse, married, 2 children, social etoh, no tobacco but significant 2nd hand smoke growing up, no illicits family history: ruptured cerebral aneurysm requiring surgery in 50s, copd, cad, ureteral reflux resulting in esrd requiring kidney transplant; f: htn, dm; other family: various cancers including a brain tumor in an uncle in his 80s physical exam: gen: wd/wn, comfortable, nad. heent: full rom of neck, no maxillary sinus tenderness neck: supple. no palpable lymphadenopathy neuro: mental status: awake and alert, cooperative with exam, normal affect. language: speech fluent with good comprehension. no dysarthria or paraphasic errors. cranial nerves: i: not tested ii: pupils round iii, iv, vi: extraocular movements 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: normal bulk and tone bilaterally. no abnormal movements, tremors. strength full power throughout. no pronator drift sensation: intact to light touch, propioception, pinprick and vibration bilaterally. reflexes: b t pa ac all normal coordination: normal on finger-nose-finger, rapid alternating movements, heel to shin exam upon discharge: awake, a+ox3 perrl, eomi face symmetric no drift hard collar in place mae's with full strengths dissolvable sutures, well healing pertinent results: mr head w/ contrast limited contrast-enhanced mri for pre-operative planning demonstrates a stable appearance of a chiari type 1 malformation with marked descent of peg-like cerebellar tonsils and associated crowding of the cervicomedullary junction, which demonstrates a kinked appearance. ct head w/o contrast status post decompression for chiari malformation with occipital craniectomy and c1 posterior arch resection without evidence of hemorrhage. mri : impression: expected postoperative appearance status post chiari i decompression surgery. no evidence of hemorrhage or infarction. the dural venous sinuses remain patent. the major intracranial flow voids are preserved. brief hospital course: pt was admitted electively through sda for decompressive craniectomy for chiari malformation. pt underwent the procedure and awoke from anesthesia without difficulty. she was extubated and fully recovered in the icu. she was placed in a hard aspen collar and should continue to wear it for 2 week post operatively. post op check, patient reported neck pain and was placed on a morphine pca. ct head showed multiple foci of pneumocephalus, but no acute hemorrhage. on , patient was nonfocal on examination except for neck pain with movement. the pca was discontinued and foley removed. she was encouraged to be oob and was transferred to the floor. mri head was done which showed post op changes. on , patient reported pain in the base of the neck. pt was consulted and patient's medications were adjusted. she was cleared for discharge from pt. on the patient continued to have significant discomfort in her neck. medications were adjusted. her foley was discontinued but she had post void urinary retention x2. this was treated with straight catheterizations. a u/a was checked and negative. on the patient's pain was more controlled and she was voiding without difficulty. she was cleared for discharge home at that time. medications on admission: amitryptiline 10 mg po daily, clonazepam 0.25 mg po qhs prn insomnia, magnesium and riboflavin supplements, prilosec prn gerd, aleve 500 mg prn but basically takes this daily discharge medications: 1. docusate sodium 50 mg/5 ml liquid sig: one (1) 100 mg cap po bid (2 times a day): take while taking narcotic pain medications, to prevent constipation. disp:*30 100 mg cap* refills:*2* 2. amitriptyline 10 mg tablet sig: one (1) 10 mg tab po hs (at bedtime). 3. clonazepam 0.5 mg tablet sig: one (1) 0.25 mg tab po qhs (once a day (at bedtime)) as needed for insomnia. 4. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) 20 mg capsule, delayed release(e.c.) po daily (daily). 5. multivitamin tablet sig: one (1) tablet po daily (daily). 6. acetaminophen 500 mg tablet sig: two (2) 500 mg tablets po q6h (every 6 hours) as needed for pain: max 4000 mg daily. disp:*30 500 mg tablets* refills:*2* 7. methocarbamol 500 mg tablet sig: 1.5 500 mg tablets po qid (4 times a day). disp:*60 tablets* refills:*0* 8. trazodone 50 mg tablet sig: 0.5 50 mg tablet po hs (at bedtime) as needed for insomnia. 9. oxycodone 5 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*60 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: chiari i malformation discharge condition: patient in good physical and neurologic condition without any new neurologic deficits. she is at her baseline normal mental status, and is ambulatory. 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. ?????? you should continue to wear your hard cervical collar for 2 weeks. ?????? 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. do not drive before you are cleared by your surgeon. ?????? make sure to continue to use your incentive spirometer while at home, unless you have been instructed not to. ?????? you should continue to wear the hard collar for 10 days post surgery. you may remove it for bathing and when in bed if it is uncomfortable. 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 ??????please return to the office in days(from your date of surgery) for a wound check. this appointment can be made with the nurse practitioner (). please make this appointment by calling . ?????? please call ( to schedule an appointment with dr. , to be seen in 3 months. you will need to have an mri of the brain (without contrast) prior to your clinic visit with dr. . procedure: other exploration and decompression of spinal canal other repair of cerebral meninges diagnoses: esophageal reflux compression of brain retention of urine, unspecified headache 

Answer: The patient is high likely exposed to