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: found down, unresponsive major surgical or invasive procedure: none history of present illness: 50 yo m with h/o htn, hld, and workup for possible tia (r hand numbness/weakness and brief expressive aphasia)in presented after being found down by his family, at osh had r sided weakness and possible expressive aphasia. he was well yesterday, went to a birthday party last night, drank beer (wife estimates 6 ). he was seen by his family when he came home at 12:30am. at that time he appeared well, was talking and walking normally. he went to bed. at 3:20am, his son who was sleeping in the next room woke up to hearing his father coughing and gagging for ~2 min, then heard a thump. he ran to his father's bedroom and found him laying on the ground beside the bed. his wife, who was sleeping on the couch down stairs, also came up right away. they describe him as alert but agitated, not speaking. he was moving all extremities. legs were crossed at the feet and somewhat stiff, arms and head moving around. they called 911 and he was taken to by ambulance. at hospital, he was found to be nonverbal, moving the lue and lle. he had slight movement of rue with some decorticate posturing of rue. rle was flaccid with no movement. he had a gcs of 8. he was intubated for airway protection. he was afebrile, bp 129/73. ct head showed no bleeding, subacute vs chronic infarct lateral l frontal lobe new since mri . ct neck with degenerative changes c5/6 and c6/7. fell out of bed but no clear evidence of significant trauma. ros: well prior to event as described above. no h/o seizures or strokes. no recent illness. no trauma except fall from bed this evening. past medical history: htn. well controlled, last checked sbp in 110s. hld. last cholesterol ~180. tia workup . presented with r hand numbness x1 day with <1 min of being unable to speak. workup unrevealing. mri with no infarct. arthritis in hip h/o rotator cuff surgery social history: works as a carpenter. married with children. wife and son present today. wife, , works in a special care nursery. smokes 1ppd x 30 years. etoh use 3-4 most days family history: htn, hl, cad physical exam: exam on evaluation at ed at 8:45am. off propofol ~10 minutes. t37.3 hr 86 bp 151/81 o2 100% intubated on ventilator. gen: intubated, lying on bed in ed. skin: no rashes or bruises visible heent: ncat, no conjunctival injection, mucous membranes moist, oropharynx clear. neck: in c-collar resp: clear to auscultation bilaterally cv: regular rate, normal s1/s2, no murmurs, rubs, or gallops abd: bowel sounds present, abdomen soft, non-tender, and non-distended. no hepatosplenomegaly or masses palpable. extrem: warm and well-perfused. no arthralgia. rom full. neuro: ms - opens eyes to voice. follows commands including opening eyes, lifting r then l hand, and wiggling toes. cranial nerves ?????? pupils: r 6-->4mm and l 5-->4mm both briskly reactive. eoms - intact adduction but limited abduction bilaterally, no nystagmus; +corneals, +gag, face appears symmetric but limited evaluation due to ett, protrudes tongue but due to tube difficult to determine if midline. tone - normal strength - moves both ues and distal bilat . minimal proximal movement of rle. rle maybe slightly weaker than l but at least antigravity. reflexes - biceps triceps brachioradialis patellar ankle r 3+ 3+ 3+ 3+ 2+ l 3+ 3+ 3+ 3+ 2+ plantar responses mute bilaterally sensation - responds to painful stimuli and light touch. pertinent results: labs on admission: 07:53am blood wbc-13.6* rbc-4.59* hgb-13.8* hct-39.2* mcv-85 mch-30.1 mchc-35.3* rdw-13.5 plt ct-344 07:53am blood pt-13.9* ptt-31.0 inr(pt)-1.2* 02:20pm blood ret aut-1.4 02:20pm blood glucose-97 urean-13 creat-0.7 na-137 k-4.1 cl-99 hco3-25 angap-17 12:46am blood alt-17 ast-16 ld(ldh)-157 alkphos-86 totbili-0.4 02:20pm blood ck-mb-3 ctropnt-<0.01 02:20pm blood calcium-9.0 mg-2.0 cholest-187 modifiable risk factors: 12:47am blood %hba1c-5.8 02:20pm blood triglyc-273* hdl-37 chol/hd-5.1 ldlcalc-95 toxicology/urine studies: 07:53am blood asa-neg ethanol-93* acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 08:15am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-6.5 leuks-neg 08:15am urine color-yellow appear-clear sp -1.014 imaging: mri/a of brain and neck: mri brain impression: acute left frontal and deep white matter left cerebral hemispheric infarcts are identified. no hemorrhage seen. occlusion of left internal carotid. mra neck impression: occlusion of the left internal carotid beyond the carotid bulb. correlation with previous outside mri of suggests that diminished flow signal in the left carotid was seen previously. therefore, the left carotid occlusion may be superimposed on previously existing abnormality in the carotid bifurcation region. no previous carotid bifurcation imaging is available. clinical correlation with history recommended. mra head: impression: diminished flow in the left middle cerebral artery branches with absence of flow signal in the cavernous and petrous internal carotid arteries. this is secondary to occlusion in the neck. cta neck: impression: long thrombosed segment of the left internal carotid artery beginning from the proximal left ica extending to the cavernous sinus segment, likely chronic in nature. no other vascular abnormalities noted echo the left atrium is mildly dilated. no thrombus/mass is seen in the body of the left atrium. no atrial septal defect or patent foramen ovale is seen by 2d, color doppler or saline contrast with maneuvers. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. no masses or vegetations are seen on the aortic valve. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. no mass or vegetation is seen on the mitral valve. the pulmonary artery systolic pressure could not be determined. there is a trivial/physiologic pericardial effusion. eeg - .this is a subtly abnormal routine eeg due to subtle left fronto-temporal and mid-temporal slowing seen during drowsiness but not present during wakefulness. this is a non-specific finding but could be related to potential cerebrovascular disease. there were no epileptiform features noted on this study. brief hospital course: 50 yo m with h/o htn, hld and a recent tia (r hand numbness/weakness and brief expressive aphasia) in presented with r sided weakness as he was found on the floor of his bedroom, confused and unable to speak coherently. based on initial history and examination there was concern left hemisphere stroke and or seizure with paralysis following or initial event of stroke, followed by seizure and posti-ictal confusion at osh requiring intubation. initial hct at osh was suggestive of a possible l frontal hypodensity. patient was admitted to neuroicu for further evaluation as he was intubated. neuro: he was treated per stroke protocol (bp autoregulation, maintenance of normothermia, normoglycemia). he underwent mri/a of head and neck, which showed acute l frontal, cortical infarct in addition to watershed in a left frontal region. mra showed a complete occlusion from bifurcation to cavernous segment. he was started on heparin gtt given concern for an acute/subacute occlusion (patient did not have significant stenosis on carotid dopplers from evaluation at osh, confirmed w/ faxed report). he underwent cta of neck that confirmed the complete occlusion with extent as above and confirmed collateral flow from opthalmic and circle of to the left side. patient was extubated on hd#1 and had an entirely normal neurological examination, suggestive of latter etiology considered at time of admission (stroke -> sz w/ -> post-ictal confusion). eeg was performed and showed no significant abnormality, with mild occasional focal slowing that may be secondary to underlying vascular disease. he was initially started on a heparin gtt w/ transition to coumadin. he was started on lovenox on his last hospital day and will be on lovenox with a transition to coumadin. his pcp was and the plan was discussed and he will go for his first inr check on friday. the patient will remain on a baby aspirin while he is on coumadin. the current plan is to keep the patient on coumadin for 3 months and then to stop the anti-coagulation and resume his full dose aspirin. he will follow up with us in the stroke clinic. modifiable risk factors: a1c was wnl, and ldl was in high 90s. zocor was initially doubled to 80mg daily but returned to his home dose on discharge. smoking cessation was discussed at length and options provided to patient. reduction of etoh use to 1-2 drinks per day were also addressed. pt. appeared to understand the risks. bps remained in 110 - 130 range while in icu. cv. sbp maintained as above. patient beta blocker was cut in half and he was not hypertensive while in house. he was kept on this lower dose and will be reassessed at his pcp on future visits. his echo was normal and did not show any possible source of emboli medications on admission: aspirin 81mg po qday hctz 25mg po qday metoprolol 50mg po bid simvastatin 40mg po qday motrin prn. takes about 600mg po bid. discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. warfarin 5 mg tablet sig: one (1) tablet po at bedtime: for an inr of between . disp:*30 tablet(s)* refills:*2* 3. hydrochlorothiazide 25 mg tablet sig: one (1) tablet po once a day. 4. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*2* 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 6. enoxaparin 80 mg/0.8 ml syringe sig: one (1) subcutaneous q12hours (): will stop when therapueitc on coumadin with inr . disp:*20 syringes* refills:*2* 7. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). discharge disposition: home discharge diagnosis: primary: left frontal focal and watershed stroke, left internal carotid artery occlusion secondary: htn, hl, tobacco abuse, etoh abuse discharge condition: hemodynamically stable. neurological exam at time of discharge notable for: ms: intact cn: no deficits, eomi, perrla motor: at delt/tri//we/fe b/l in ue, and ip/quad/ham/dorsi/plantar flexors in le b/l no drift sensory: no deficits coordination: intact discharge instructions: you were admitted to as a transfer from another hospital after being intubated and for a concern of a stroke. you underwent mri/ct of your head and neck which confirmed a stroke in the left side of your brain and blockage of an artery in the left side of your neck. this was felt to be likely due to the multiple risk factors you had for stroke: high blood pressure, high cholesterol, smoking, alcohol abuse and lack of exercise. you did not require a surgical treatment for your stroke and remarkably your neurological examination returned to . you were strongly advised to quit smoking and reduce your alcohol intake. if you do not do this, you will likely have another stroke. the following changes were made to your medications: - started on coumadin - will be on lovenox until your inr is between . - your baby aspirin (81mg) was restarted - your metoprolol was decreased by half, this can be increased by your pcp if you are hypertensive at future office visits. - you will likely be on coumadin for about three months, and at that time it will be stopped and you will be started on a full dose of aspirin -> 325mg daily. you were discharged home in stable condition. should you develop any of the signs listed below or any other symptom concerning to you, please call your doctor or go to the emergency room. followup instructions: primary care: we spoke with your pcp about your hospital course and discharge, he informed us that you should call his office when you get home, to set up an appointment for an inr blood test for this friday. his muber is . you will need to have your inr monitored, please stop the lovenox injections when your inr is found to be between . this was also discussed with your pcp neurology: you have an appointment with dr. , on tuesday @ 5:30pm, this is at the - , in the clinical center on the : phone number (. md, procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours diagnoses: tobacco use disorder unspecified essential hypertension other convulsions other and unspecified hyperlipidemia long-term (current) use of anticoagulants alcohol abuse, continuous other specified paralytic syndrome occlusion and stenosis of carotid artery with cerebral infarction 

Answer: The patient is high likely exposed to