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: lisinopril attending: chief complaint: lethargy major surgical or invasive procedure: none history of present illness: 80f with hx of htn, dm, hypothyroidism who was recently admitted for left thalamic and right frontoparietal intraparenchymal hemorrhages secondary to cerebral venous thrombosis of unknown etiology. she was discharged on and subsequently readmitted on for altered mental status, thought to be related to uti. she was discharged on on cefpodoxime. she represented to hospital with worsening lethargy at which point urine culture showed extended spectrum resistant klebsiella. she was started on meropenem on to be continued for a 14-day course. she continued to have intermittent episodes of somnolence at the osh. neurology was consulted and an eeg was performed which showed slowing (on prelim read). ct scans were reportedly stable. she was transferred to on for further management. past medical history: hypothyroidism htn gout dm hld social history: had lived alone until recent admission in ; has been in and out of hospitals and rehab since then. family history: no hx of early strokes. physical exam: physical exam on admission: vitals: t96.6 p 57 r 22 o2 97% cpap, bp 132/77 general: sleeping, arouses to loud voice and stimulation, denies pain heent: nc/at neck: supple, no nuchal rigidity pulmonary: lungs cta bilaterally cardiac: rrr abdomen: soft. extremities: no c/c/e bilaterally. skin: no rashes or lesions noted. neurologic: - had her eyes closed. opens to voice. not following any commands. no verbal output now. looks to right and left (tracks). moving all four ext but not giving much effort and not antigravity when testing. i did not apply pain to further test. pupils reactive, equal. face looks symmetric. did not give me a smile. reflex are brisk. no big asymmetry noted. toes equivocal. tone normal. physical exam on discharge: vitals: t 98.9 bp 160/80 hr 70 rr 18 o2 99% on cpap general: awake and alert, lying in bed in nad heent: nc/at, no scleral icterus noted, mmm, no lesions noted in oropharynx neck: supple, no carotid bruits appreciated. no nuchal rigidity. pulmonary: lungs cta bilaterally without r/r/w cardiac: rrr, nl. s1s2, no m/r/g noted abdomen: 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: opens eyes spontaneously, smiles at examiner. able to state name and answer a few yes/no questions. follows both midline and appendicular commands. -cranial nerves: i: olfaction not tested. ii: perrl 2 to 1mm and brisk. iii, iv, vi: eomi full, no nystagmus v: intact to light touch vii: no facial droop, facial musculature symmetric. viii: hearing intact bilaterally. ix, x: palate elevates symmetrically. : poor effort but appears intact xii: tongue protrudes in midline. -motor: normal bulk, tone throughout. no adventitious movements, such as tremor, noted. raises both arms antigravity and provides some resistance on strength testing. raises proximal legs slightly off bed. mild 4/5 weakness in lue and lle. -sensory: responds to light touch throughout -dtrs: tri pat ach l 2 2 2 3 1 r 2 2 2 2 1 strong withdrawal to plantar stimulation bilaterally. -coordination: unable to assess -gait: deferred pertinent results: 03:48am blood wbc-4.9 rbc-3.42* hgb-10.5* hct-33.6* mcv-98 mch-30.7 mchc-31.2 rdw-15.1 plt ct-253 03:48am blood neuts-55.9 lymphs-31.5 monos-6.1 eos-5.9* baso-0.5 03:48am blood plt ct-253 03:48am blood pt-32.1* ptt-56.6* inr(pt)-3.2* 03:48am blood glucose-128* urean-11 creat-0.8 na-145 k-3.5 cl-104 hco3-30 angap-15 08:50am blood alt-14 ast-16 alkphos-60 totbili-0.4 06:09am urine color-yellow appear-hazy sp -1.018 06:09am urine blood-tr nitrite-neg protein-30 glucose-neg ketone-tr bilirub-neg urobiln-2* ph-5.0 leuks-lg 06:09am urine rbc-85* wbc->182* bacteri-none yeast-many epi-0 06:09am urine casthy-12* 06:09am urine mucous-mod cxr : in comparison with the study of , there are continued low lung volumes without vascular congestion or pleural effusion. left central catheter extends to the level of the mid portion of the svc. mri/mrv : 1. new flair/t2 signal abnormalities within the medial parieto-occipital lobes, bilaterally with associated petechial hemorrhage and mild enhancement. areas of slow diffusion within the splenium and right thalamus appear to have progressed to venous infarction (with surrounding cytotoxic edema). these findings are most consistent with changes from subacute-to-chronic venous occlusive disease/venous hypertension 2. residual hemorrhage present within the left thalamus and right frontoparietal lobe. trace hemorrhage remains in the occipital horns of the lateral ventricles. 3. straight sinus better seen on today's study. internal cerebral veins remain less visible, however. eeg : impression: this is an abnormal extended routine eeg due to a moderately slow and disorganized background. there were intermittent generalized blunted sharp wave discharges that at times appeared pseudoperiodic. the latter finding in combination with generalized background slowing is indicative of an underlying moderate encephalopathy. potential causes include but are not limited to: medication effect, metabolic/ toxic, or infectious disturbances. additionally, the brief intermittent bursts of generalized delta slowing of background are indicative of deep midline cerebral dysfunction. cxr : borderline cardiomegaly unchanged. lungs grossly clear. pleural effusions small, if any. left pic catheter ends at the junction of brachiocephalic veins. no pneumothorax. cerebral angiogram : findings: right common carotid artery arteriogram shows that the right common carotid artery is widely patent with no evidence of stenosis at the bifurcation. the intracranial runs demonstrate that the right internal carotid artery fills well along the cervical, petrous, cavernous and supraclinoid portion. both anterior and middle cerebral arteries are seen normally with no evidence of aneurysms or dural av fistula. the external carotid artery branches did not show any evidence of av dural fistula. the venous sinuses are seen in their entirety. the superior sagittal sinus and both transverse sinuses including the torcula is patent. both jugular bulbs are open. the straight sinus is visualized along with the basal vein of . the internal cerebral vein is not seen. right common femoral artery arteriogram shows widely patent right common femoral artery. kub : there is no free air. there is air seen in the small and large bowel and the rectum in a non-specific pattern. a g-tube is in place. there are some degenerative changes in the lower lumbar spine. brief hospital course: ms. was admitted to the neurology service on after being transferred from hospital for further workup of intermittent episodes of somnolence. repeat mri/mrv showed some new areas of signal abnormality in the b/l medial occipital lobes, as well as areas of restricted diffusion in the splenium and r thalamus suggestive of subacute to chronic -occlusion. mrv showed better visualization of the straight sinus as compared with her prior study, but the deep cerebral veins were still unable to be visualized. eeg showed evidence of diffuse encephalopathy but no epileptiform activity. she was also found to have several metabolic disturbances which were likely contributing to her somnolence. she was continued on meropenem for her uti. repeat urine culture showed yeast; per id this was felt to most likely represent colonization. a second ua and culture were performed at the end of her antibiotic course and was clear. she was also treated for hypernatremia to 150. her tsh was 14 on admission; it appeared that her levothyroxine had been stopped for unclear reasons. this was restarted. she was also maintained on cpap for severe osa. an angiogram was performed on to better evaluate her thrombosis and showed clear cerebral venous sinuses with no evidence of thrombosis or occlusion. no interventions were performed. she was restarted on her heparin and coumadin. she was seen by speech and swallow but failed swallow evaluation several times throughout her stay. she was maintainted npo on ivf; we were unable to place an ng tube due to the necessity of her cpap mask. after discussion with her family a peg tube was placed on . tube feeds were started and gradually advanced. on she was witnessed to have brownish-colored emesis which was heme positive. heparin gtt was stopped. she was started on protonix iv. hb/hct remained stable. she was continued on coumadin. tube feeds were restarted at a low rate on and slowly titrated up. she was restarted on all of her home medications. blood pressure began to run high in the 160-180's; she was started on amlodipine 5mg daily in addition to her home atenolol 25mg . her mental status fluctuated somewhat throughout her hospitalization but she gradually began to improve. ritalin was increased to 5mg on . by her discharge she was much more awake and alert, opening her eyes spontaneously, saying a few words, and following some commands. she was seen by pt and ot who recommended acute rehab placement upon discharge. she was discharged to on in stable condition. she will follow up with dr. in clinic. transitional care issues: ms. will require intensive pt and ot to regain her prior level of functioning. she will also need to be followed by speech therapy to assess her swallow function as well as respiratory therapy to continue her cpap treatment. she will require daily inr checks until therapeutic between . ***coumadin should be held on evening of and restarted at 2mg daily on pending repeat inr.*** she will also need monitoring of her potassium and magnesium with repletion as needed. her electrolyte imbalances should improve now that she is on a stable tube feeding regimen. medications on admission: meropenenm 500 iv q 8 start coalce 100 atenolol 25 daily synthroid 0.1 daily ritalin 2.5mg pepcid 20 daily zocor 40 daily riss tylenol prn discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po every six (6) hours as needed for fever or pain. 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day): patient may refuse. hold if patient has loose stools. 3. senna 8.6 mg tablet sig: two (2) tablet po hs (at bedtime). 4. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). 5. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 6. colchicine 0.6 mg tablet sig: one (1) tablet po bid (2 times a day). 7. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 8. methylphenidate 5 mg tablet sig: one (1) tablet po bid (2 times a day). 9. levothyroxine 100 mcg tablet sig: one (1) tablet po once a day. 10. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 11. calcium carbonate 200 mg calcium (500 mg) tablet, chewable sig: one (1) tablet, chewable po twice a day. 12. multivitamin tablet sig: one (1) tablet po daily (daily). 13. atenolol 25 mg tablet sig: one (1) tablet po bid (2 times a day). 14. miconazole nitrate 2 % cream sig: one (1) topical (2 times a day). 15. warfarin 2 mg tablet sig: one (1) tablet po once a day. 16. ipratropium-albuterol 18-103 mcg/actuation aerosol sig: puffs inhalation q6h (every 6 hours) as needed for sob, wheezing. 17. potassium chloride 20 meq packet sig: two (2) packet po once a day. 18. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 19. miconazole nitrate 2 % powder sig: one (1) appl topical qid (4 times a day). 20. pepcid 40 mg/5 ml suspension sig: one (1) po twice a day. discharge disposition: extended care facility: discharge diagnosis: intraparenchymal hemorrhage somnolence hypothyroidism discharge condition: mental status: arouses to voice, answers some yes/no questions, follows some simple commands level of consciousness: lethargic but arousable. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: dear ms. , you were admitted to on with episodes of somnolence. an mri of your brain showed stable appearance of the bleeding in your brain but also showed slight worsening of the abnormalities in your thalamus on both sides (an area important for staying awake). you were also found to have a high sodium level and very low levels of thyroid hormone. you were continued on antibiotics for your urinary tract infection. you were maintained on cpap for your sleep apnea. your sleepiness is likely due to a combination of all of these factors. you had an angiogram performed on to take a better look at the blood clot in your cerebral vein. this showed that the blood clot has dissolved and your vessels are now clear. you were evaluated by speech therapy but continued to have difficulty swallowing during your admission. a peg tube was placed on to help give you nutrition. we made the following changes to your medications: decreased coumadin to 2mg daily increased ritalin to 5mg twice a day to help you stay awake started amlodipine 5mg daily for your blood pressure started potassium 40meq daily for supplementation restarted levothyroxine 100mcg daily for your hypothyroidism if you experience any of the below listed danger signs, please call your doctor or go to the nearest emergency department. it was a pleasure taking care of you during your hospital stay. followup instructions: the following appointment has been made for you in our stroke clinic: provider: , md phone: date/time: 1:00 procedure: enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] arteriography of cerebral arteries diagnoses: obstructive sleep apnea (adult)(pediatric) abnormal coagulation profile urinary tract infection, site not specified unspecified essential hypertension friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism gout, unspecified other and unspecified hyperlipidemia long-term (current) use of anticoagulants osteoarthrosis, unspecified whether generalized or localized, site unspecified rash and other nonspecific skin eruption personal history of venous thrombosis and embolism obesity, unspecified encephalopathy, unspecified hyperosmolality and/or hypernatremia other alteration of consciousness phlebitis and thrombophlebitis of intracranial venous sinuses body mass index 36.0-36.9, adult 

Answer: The patient is high likely exposed to