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: inability to speak or move right side major surgical or invasive procedure: mri/mra peg echo history of present illness: mr. is a 67-year-old right-handed man with a history of cad, hyperlipidemia, paf not anticoagulated, and lung cancer in remission who presents with acute onset aphemia and right hemiplegia. he was last seen normal at 10 pm last night by his daughter; his wife had already gone to bed. when his wife awoke the next morning, she found him at about 6 am lying face down on the floor, unable to speak or move his right side. his daughter came over, and thought he seemed sleepy, but noted he did look up at her when she was there. ems was called and brought him immediately to ed. nih stroke scale score was 16: 1a. level of consciousness: 1 1b. loc question: 2 1c. loc commands: 0 2. best gaze: 0 3. visual fields: 0 4. facial palsy: 2 5a. motor arm, left: 0 5b. motor arm, right: 4 6a. motor leg, left: 0 6b. motor leg, right: 4 7. limb ataxia: 0 8. sensory: 0 9. language: 3 10. dysarthria: un 11. extinction and neglect: 0 formal ros is not possible. his daughter reports that last night he was sitting on the edge of his bed apparently uncomfortable, but did not complain of anything and otherwise was normal. past medical history: - cad s/p mi and angioplasty - paroxysmal atrial fibrillation (per last cardiology note, "he has had atrial fibrillation when he gets acutely sick with copd flares with pneumonias. however, he has been in sinus rhythm in the recent past.") - rul sclc s/p chemo and radiation , in remission - copd - hyperlipidemia - "probable dm" social history: former heavy smoker, ppd for 20-30 years, but quitin years ago with lung cancer diagnosis. family history: his mother died from a heart disease at the age of 75. his father died from a throat cancer at the age of 52. physical exam: vitals: t: 97.9 p: 88 reg r: 20 bp: 136/95 sao2: 100%ra general: awake, cooperative, nad. labored breathing, with significant upper airway sounds. heent: nc/at, no scleral icterus noted, mmm, no lesions noted in oropharynx. neck: hard collar in place. pulmonary: loud upper airway sounds. cardiac: rrr, nl. s1s2, no m/r/g noted abdomen: obese. soft, nt/nd, normoactive bowel sounds, no masses or organomegaly noted. extremities: no c/c/e bilaterally, 2+ radial, dp pulses bilaterally. skin: no rashes or lesions noted. neurologic: -mental status: awake and alert. no speech production. follows one-step commands, both appendicular and midline. nods yes/no to orientation questions appropriately. -cranial nerves: i: olfaction not tested. ii: perrl 2.5 to 2mm and brisk. vff to threat. funduscopic exam limited by miosis. iii, iv, vi: eomi without nystagmus. normal saccades. v: facial sensation intact to light touch. vii: partial right facial droop. viii: hearing intact to finger-rub bilaterally. ix, x: palate elevates symmetrically. : 5/5 strength in trapezii and scm bilaterally. xii: tongue protrudes in midline. -motor: normal bulk. flaccid in right ue and le. no pronator drift on left. no adventitious movements, such as tremor, noted. no asterixis noted. delt bic tri wre ffl fe ip quad ham ta gastroc l 5 5 5 5 5 5 5- 5 5- 5 5 r 0 0 0 0 0 0 0 0 0 0 0 withdraws right le to pain, no movement of r ue. -sensory: grossly, he nods that he can feel light touch throughout. -dtrs: tri pat ach l 2 2 2 2 1 r 0 0 0 1 1 plantar response was flexor bilaterally. -coordination: not tested on right. on left, no intention tremor, no dysdiadochokinesia noted. no dysmetria on fnf. -gait: unable due to right hemiplegia. pertinent results: 06:01am blood wbc-8.9 rbc-4.50* hgb-14.4 hct-41.5 mcv-92 mch-32.0 mchc-34.7 rdw-13.2 plt ct-281 06:00am blood wbc-9.9 rbc-4.51* hgb-14.7 hct-41.7 mcv-92 mch-32.6* mchc-35.3* rdw-13.3 plt ct-279 08:35am blood wbc-11.5* rbc-4.90 hgb-15.2 hct-45.5 mcv-93 mch-31.0 mchc-33.3 rdw-13.6 plt ct-267 06:15am blood wbc-9.4 rbc-4.21* hgb-14.1 hct-38.6* mcv-92 mch-33.4* mchc-36.5* rdw-12.9 plt ct-247 06:45am blood wbc-9.1 rbc-4.18* hgb-13.6* hct-38.2* mcv-91 mch-32.5* mchc-35.6* rdw-13.1 plt ct-263 02:27am blood wbc-9.7 rbc-4.18* hgb-13.7* hct-37.9* mcv-91 mch-32.7* mchc-36.1* rdw-13.1 plt ct-263 07:30am blood neuts-79.6* lymphs-13.4* monos-5.7 eos-0.8 baso-0.4 06:01am blood pt-15.9* ptt-27.1 inr(pt)-1.4* 06:00am blood pt-16.1* ptt-26.3 inr(pt)-1.4* 02:27am blood pt-16.6* ptt-28.4 inr(pt)-1.5* 07:30am blood pt-16.0* ptt-28.1 inr(pt)-1.4* 06:01am blood glucose-138* urean-33* creat-0.7 na-142 k-4.0 cl-107 hco3-26 angap-13 06:00am blood glucose-132* urean-33* creat-0.8 na-140 k-4.2 cl-103 hco3-27 angap-14 08:35am blood glucose-173* urean-27* creat-0.8 na-137 k-4.5 cl-101 hco3-28 angap-13 06:15am blood glucose-204* urean-22* creat-0.8 na-137 k-4.2 cl-100 hco3-27 angap-14 02:27am blood glucose-165* urean-15 creat-0.8 na-136 k-4.0 cl-103 hco3-24 angap-13 07:30am blood glucose-246* urean-15 creat-0.7 na-135 k-3.8 cl-97 hco3-26 angap-16 07:30am blood alt-33 ast-40 ck(cpk)-234* alkphos-120* totbili-0.5 02:27am blood ck-mb-3 ctropnt-<0.01 06:01am blood calcium-9.0 phos-3.4 mg-2.3 07:30am blood albumin-4.4 calcium-9.3 phos-2.8 mg-2.0 06:45am blood triglyc-147 hdl-40 chol/hd-3.7 ldlcalc-80 07:30am blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg ct head: 1. dense left middle cerebral artery with loss of definition of insular region indicative of an evolving infarct. 2. perfusion defect in the left middle cerebral artery territory with increased transit time and decreased blood volume suggestive of an evolving infarct. 3. ct angiography of the neck demonstrates complete occlusion of the left internal carotid artery in the neck with calcification at the bifurcation. 60-70% stenosis of the right internal carotid artery is seen at the bifurcation. 4. cta of the head demonstrates filling defect in the left middle cerebral artery m1 segment with diminished flow in the distal left mca territory. mri: acute left sided basal ganglia and anterior mca territory infarcts. no hemorrhage. clot in the middle cerebral artery region. echo: suboptimal image quality. preserved left ventricular systolic function. no intracardiac shunt with saline contrast injected at rest (unable to cooperate with maneuvers). brief hospital course: pt was initially admitted to the neuro-icu for observation following his acute infarct. an mri showed an acute infarct in left mca territory. this was likely cardio-embolic as he was noted to be in a-fib upon admission. he was started on aspirin but anticoagulation was not initiallly started because of the size of the lesion and risk for hemorrhagic conversion. his exam slowly improved and he became more alert. despite being more alert he failed multiple swallow evaluations and had a g-tube placed on . he was started on coumadin after the g-tube was placed. he should stay on aspirin 81mg until his coumadin becomes therapeutic (inr ). medications on admission: asa 325 mg po daily metoprolol 50 mg po bid simvastatin 10 mg po qhs ntg sr 2.5 mg po bid atrovent 17 mcg 2 puffs qid albuterol 90 mcg 2 puffs q6h prn flovent 220 mcg 2 puffs proair discharge medications: 1. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for temp > 100.4 or pain. 2. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 3. nitroglycerin 2.5 mg capsule, sustained release sig: one (1) capsule, sustained release po q12h (every 12 hours) as needed. 4. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 5. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed. 6. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 7. warfarin 5 mg tablet sig: one (1) tablet po once daily at 4 pm. 8. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 9. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for temp > 100.4 or pain. 10. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 11. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 12. nitroglycerin 2.5 mg capsule, sustained release sig: one (1) capsule, sustained release po q12h (every 12 hours) as needed. 13. fluticasone 110 mcg/actuation aerosol sig: four (4) puff inhalation (2 times a day). 14. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 15. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed. 16. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 17. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 18. warfarin 5 mg tablet sig: one (1) tablet po once daily at 4 pm. 19. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 20. heparin (porcine) 5,000 unit/ml solution sig: one (1) ml injection tid (3 times a day). discharge disposition: extended care facility: - discharge diagnosis: left mca infarct afib discharge condition: right hemiparesis, global aphasia discharge instructions: you were admitted for right sided weakness and difficulty speaking. this was caused by a stroke which was likley due to a blood clot from your heart. you will need to take coumadin to prevent blood clots in the future. followup instructions: provider: scan phone: date/time: 9:45 provider: function lab phone: date/time: 9:10 provider: , m.d. phone: date/time: 9:30 dr. - call for appointment info md, procedure: enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled chronic airway obstruction, not elsewhere classified atrial fibrillation personal history of malignant neoplasm of bronchus and lung personal history of tobacco use other and unspecified hyperlipidemia cerebral embolism with cerebral infarction dysphagia, unspecified 

Answer: The patient is high likely exposed to