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: codeine / valsartan attending: chief complaint: feeling "lousy" major surgical or invasive procedure: craniotomy for evacuation of l sdh history of present illness: pt is a 86 yo m with pmhx sig. for afib on coumadin, cad, dm2 who presented to the ed on with weakness. he was recently admitted here from with pneumonia and was treated with 5 day course of levofloxacin. he was feeling pretty good for days. he still had a residual cough with clear phelgm. then, he started to feel lousy again. his cough got slightly worse, no worsening sob. he has become weaker, generalized, with poorer po intake. he states he just wasn't thirsty. no chest pain. he has occ. palpitations, which are not new. no n/v/abdominal pain/diarrhea/constipation. no fevers, chills, night sweats. . in the ed, initial vs were: 97 49 151/94 16 100. exam is sig. for bibasilar crackles. cxr is stable. labs were sig. for elevated cr to 1.3. he received 2l ivfs. . on the floor, he just feels tired. . further history in the morning revealed that he has some trouble describing his symptoms, but does say that he feels like he has been having trouble using his right hand to eat, pick up objects, etc for ~24 hours. he does say that he had a pcp but does note that he did not call his pcp last night when feeling poorly, and is not able to say why. yesterday, he started to feel lousy again. he told night float that his cough got slightly worse, but this morning he says that he thinks his cough is overall better. he denies worsening sob. he has become weaker, generalized to everywhere, with poorer po intake. when asked why, he states he just wasn't thirsty. denies chest pain. he has occasional palpitations, which are not new (known afib). no n/v/abdominal pain/diarrhea/constipation. no fevers, chills, night sweats. he does note that he feels more down lately, particularly with respect to an ongoing disagreement with his son whom he has not seen in 3 weeks . past medical history: 1. atrial fibrillation, on coumadin 2. coronary artery disease, s/p mi years ago 3. cerebral vascular accident 4. diabetes mellitus, type ii 5. hypertension 6. hypercholesterolemia 7. gastroesophageal reflux disease 8. osteoarthtritis 9. anemia 10. bilateral cataract surgeries 11. history of microscopic hematuria 12. erythrodermic ctcl (mycosis fungoides, mf) 13. prostate adenocarcinoma s/p xrt and lupron social history: pt lives in , housing. he has vna service that sets up his medications. he states that his children recently have "turned their backs" on the patient whent he (pt) refused to move to . he has a son in who he has not spoken to in 3 weeks. he does speak with his daughter in ca, who he thinks updates his daughter-in-law of his situation. he quit smoking and etoh 30 yrs ago, previously was a 1 pack q3 days. family history: mother died in her 30s and father at 89, but doesn't know what the cause was. no strokes or mi. physical exam: vitals: t: 96.2, bp: 133/74, p: 51 (51-76), r: 18, o2: 99 on ra general: no acute distress, alert, oriented heent: sclera anicteric, mm slightly dry, oropharynx clear neck: supple, jvp normal, no lad lungs: overall clear throughout, no wheezes. occasional coughing productive of white/clear sputum. cv: irregularly irregular, no murmurs abdomen: soft, non-tender, non-distended, bowel sounds present ext: warm, well perfused, 1+ pulses, no edema neuro: ms in bues and bles. cn ii-xii intact. does have intact sensation in both upper and lower extremities. intact finger to nose on l, impaired on r. impaired pincer grasp on r, but hand strength bilaterally. rapid alternating movements intact bilaterally. speech fluent but with frequent word-finding difficulties/substitutions (once/sentence). pertinent results: cbcs: 07:19pm blood wbc-6.4 rbc-3.93* hgb-10.3* hct-31.6* mcv-80* mch-26.3* mchc-32.7 rdw-19.6* plt ct-331 07:00am blood wbc-5.5 rbc-3.94* hgb-9.8* hct-31.3* mcv-79* mch-24.9* mchc-31.4 rdw-19.3* plt ct-281 07:30am blood wbc-6.1 rbc-4.10* hgb-10.2* hct-32.4* mcv-79* mch-25.0* mchc-31.6 rdw-18.9* plt ct-289 07:30am blood wbc-5.4 rbc-4.03* hgb-10.3* hct-32.4* mcv-81* mch-25.6* mchc-31.8 rdw-19.5* plt ct-321 coags: 08:28pm blood pt-31.3* ptt-36.5* inr(pt)-3.1* 07:30am blood pt-32.2* ptt-32.7 inr(pt)-3.2* 07:30am blood pt-29.3* ptt-31.3 inr(pt)-2.9* 02:55pm blood pt-21.4* ptt-28.0 inr(pt)-2.0* lytes: 07:19pm blood glucose-65* urean-23* creat-1.3* na-141 k-3.4 cl-105 hco3-26 angap-13 07:00am blood glucose-65* urean-17 creat-1.1 na-138 k-3.9 cl-105 hco3-28 angap-9 07:30am blood glucose-105* urean-15 creat-1.0 na-139 k-3.8 cl-104 hco3-29 angap-10 07:30am blood glucose-129* urean-13 creat-0.9 na-140 k-3.5 cl-104 hco3-29 angap-11 lfts: 07:00am blood alt-12 ast-20 ld(ldh)-214 alkphos-58 amylase-74 totbili-0.9 card enzymes: 07:19pm blood ck(cpk)-122 02:55pm blood ck(cpk)-81 07:19pm blood ctropnt-0.01 02:55pm blood ck-mb-notdone ctropnt-<0.01 tsh/b12: 07:00am blood tsh-0.83 07:00am blood vitb12-593 . ekg: : sinus rhythm with ventricular and supraventricular premature depolarizations. left axis deviation. possible left ventricular hypertrophy. possible left anterior fascicular block. diffuse non-diagnostic repolarization abnormalities. compared to the previous tracing of there is no diagnostic change. . imaging: cxr : ap erect and lateral views of the chest: little change in right basilar opacity at the cardiophrenic angle and left base is consistent with atelectasis. there is no pleural effusion or pneumothorax. the heart size is normal. aorta is slightly unfolded, but the mediastinal silhouette is otherwise unremarkable. hilar contours and pulmonary vasculature are unremarkable. impression: no acute intrathoracic abnormality. . mri head : findings: there is a very large left cerebral hemispheric mixed t1 and t2 signal intensity subdural hemorrhage effacing the left cerebral hemispheric sulci, but causing, at most only a mm of rightward subfalcine herniation. the signal pattern of the subdural hemorrhage suggests a prominent area of acute bleeding, located posterior to the coronal suture. on the axial flair images, there may be a very thin right frontal subdural hemorrhage, without overt mass effect. there are a few small areas of restricted diffusion within the left parietal lobe subcortical region, subjacent to the acute hemorrhagic component of the subdural hemorrhage. this finding could indicate acute brain ischemia. there are very extensive areas of high t2 signal within the white matter of both cerebral hemispheres, consistent with chronic small vessel infarction. the principal vascular flow patterns are identified. there is moderate bilateral maxillary and prominent bilateral ethmoid sinus, as well as mild frontal sinus and sphenoid sinus mucosal thickening, all consistent with an ongoing inflammatory process. conclusion: large left cerebral convexity subdural hemorrhage, which has developed since the prior head ct scan. dr. has already contact the requesting physician, her of these findings, as well as other is noted in the above report. dr. indicated that emergency neurosurgical consultation is mandated. please see above report for additional findings. . ct head : findings: there is confirmation of the presence of a large left cerebral convexity subdural hemorrhage, with verification of the acute components of this hemorrhage positioned posterior to the left coronal suture. there is negligible subfalcine herniation, but likely mild effacement of the left lateral ventricle. low-density zones within the left basal ganglia, and to a lesser extent the periventricular white matter of the cerebral hemispheres again reflect chronic small-vessel infarction. there is prominent atherosclerotic calcification of the cavernous internal carotid arteries, and to a lesser extent the distal left vertebral artery at the level of the foramen magnum. conclusion: large left cerebral convexity subdural hemorrhage, including some acute components. once again, emergency neurosurgical consultation is mandated. . ct head pm: prelim: no evidence of tonsillar (or any other) herniation . ct head w/o contrast status post left frontoparietal craniotomy and subdural hematoma evacuation, expected frontal pneumocephalus is visualized with a draining tube in place, persistent effacement of the sulci with no evidence of shifting or deviation of the midline structures. mild residual subdural blood is identified at the left parietal convexity, contiguous followup is recommended. brief hospital course: mr. is an 86 yo m with past medical history significant for afib on coumadin, cad, dm2, htn, h/o of cva and recent pneumonia who presents with feeling "lousy" and right-handed weakness. . #. generalized weakness: the onset of symptoms was initially unclear at patient's initial presentation. he appeared slightly volume-depleted, and was noted to have been taking in poor pos due to poor appetite. he was given iv fluids overnight after admission, and his cr improved. per information from caretakers at his facility, the right hand weakness was new but of uncertain onset. they stated that he had generally looked unwell since returning from the hospital on and had mostly stayed in his room. on exam, he had actually good strength, but difficulty with specific motor movements in the hand. pt and ot were consulted and saw the patient on . there was concern of delirium versus subacute stroke for the cause. tsh and b12 were normal. his blood sugars were controlled with an insulin sliding scale. the decision was made to do an mri of his head. this was completed by early morning of , and was significant for large l subdural hematoma (see below). . # subdural hematoma: found on mri . patient without history of falls or head trauma; had been on coumadin for some time given atrial fibrillation. inr on admission was elevated, so coumadin was initially held. it was re-started on , and held again on . after the finding of sdh, a stat ct head was performed which demonstrated both old and new areas of bleeding. a neurosurgery consult was called. he was given 10 mg vitamin k and 2 units of ffp. q 4 neuro checks and telemetry monitoring were initiated. he was started on keppra 500 and prednisone 40 mg daily. a final read of the mri was also notable for acute to subacute strokes in the l parietal lobe. a neurology consult was called as well, and their recommendations were similar. the patient was noted to have periodic bradycardic events to the 30s as well as bps to 130-140/90s, and given concern for worsened bleeding, a stat head ct was performed. this demonstrated no evidence of herniation. at this point the decision was made to transfer the patient to the neurosurgery service and the step-down unit on 11. . .. . . #. community-acquired pneumonia: the patient had completed a 5 day course of levofloxacin. his symptoms and cxr seemed to be improving, so he was not given any further antibiotics. he was given a cough suppressant as needed. . #. acute renal failure: on admission, the patient had a creatinine of 1.3 from a baseline creatinine of around 1.0. this was felt to be likely secondary to pre-renal causes. he was given iv fluids, and his creatinine gradually came back down to 1.0. his hctz was held and the decision to re-start can be re-considered as an outpatient. . #. atrial fibrillation: chads2 score 5. on admission, the patient was being treated with warfarin with an inr goal of .5 per records. warfarin was held, then restarted, then held again for supratherapeutic inrs. following the discovery of the subdural, it was stopped and his anticoagulation was reversed. aspirin was also stopped. . #. coronary artery disease: the patient is s/p mi in past. he did not have any ischemic signs or symptoms on admission or throughout his hospitalization. he was initially continued on aspirin, imdur, atorvastatin and hctz was stopped. later aspirin stopped. he had negative troponins and cks upon presentation. his ekg was at baseline. . #. diabetes mellitus type ii: given the concern that the patient had low blood sugars on his electrolyte panels in the ed, and may have been taking his home medications incorrectly, these were held on admission, and he was placed on an insulin sliding scale. . #. erythrodermic ctcl (mycosis fungoides): the patient is followed by hematology. as an outpatient, he is on methotrexate therapy. following discussion with the nurse practitioner working with his heme/onc doctor, his methotrexate was held during this admission given his other medical concerns. he should follow up with this provider as an outpatient. patient was readmitted s/p presenting feeling "lousy". he was found to have a l acute on chronic sdh. he has a history of a-fib and was on coumadin at presentation. patient was taken to the or for evacuation of l sdh on . post operatively patient appeared to have a r droop presumed to be from weakness and r side weakness. he was also observed to have episodes of bradycardia where cardiology was consulted. there recs were to continue care currently, restart coumadin when able, and follow up with cardiology as an out patient. on , patient was alert and oriented x2 and rue deltoid, biceps/triceps and full strength on l side. his subdural drain was removed and he was transferred to the floor. on , patient was accessed by pt was it was determined that he was safe to go to rehab. patient continues to be alert and oriented x 3 with prompting, moving all extremities, some r deltoid weakness 3/5. incision is clean, dry and intact with staples in place. medications on admission: atorvastatin 80 mg po hs fexofenadine 60 mg po bid as needed for rhinorrhea. folic acid 1 mg po daily lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily) as needed for pain. aspirin 81 mg po daily hydrochlorothiazide 12.5 mg po daily benzonatate 100 mg po tid isosorbide mononitrate 60 mg tablet sustained release 24 hr po daily methotrexate docusate sodium 100 mg po bid zolpidem 5 mg po at bedtime. miralax 17 gram/dose powder sig: one (1) packet po once a day. tamsulosin 0.4 mg po at bedtime. hydroxyzine hcl 25 mg po four times a day as needed for itching. metformin 500 mg po twice a day. glipizide 10 mg po twice a day. fluticasone nasal spray twice a day. coumadin 7.5 mg tue-sun, 5 mg mon discharge medications: 1. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 2. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 3. isosorbide mononitrate 60 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 5. polyethylene glycol 3350 17 gram/dose powder sig: one (1) po daily (daily) as needed for constipation. 6. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po hs (at bedtime). 7. insulin lispro 100 unit/ml solution sig: one (1) subcutaneous asdir (as directed). 8. guaifenesin 100 mg/5 ml syrup sig: 5-10 mls po q6h (every 6 hours) as needed for cough. 9. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed for wheezes. 10. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed for wheezes. 11. famotidine 20 mg tablet sig: one (1) tablet po q12h (every 12 hours). 12. hydromorphone 2 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 13. butalbital-acetaminophen-caff 50-325-40 mg tablet sig: tablets po q6h (every 6 hours) as needed for headache. 14. hydrochlorothiazide 12.5 mg capsule sig: one (1) capsule po daily (daily). 15. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). 16. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 17. prednisone 10 mg tablet sig: one (1) tablet po daily () for 5 days. 18. prednisone 5 mg tablet sig: one (1) tablet po daily () for 5 days. discharge disposition: extended care facility: at for nursing & rehab discharge diagnosis: l sdh discharge condition: mental status: confused - sometimes level of consciousness: alert and interactive activity status: ambulatory - independent discharge 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. ?????? if you were on a medication such as coumadin (warfarin), or plavix (clopidogrel), or aspirin, prior to your injury, you may safely resume taking this after it has been discussed with dr. at your follow up visit. ?????? if you have been prescribed dilantin (phenytoin) for anti-seizure medicine, take it as prescribed and follow up with laboratory blood drawing in one week. this can be drawn at your pcp??????s office, but please have the results faxed to . if you have been discharged on keppra (levetiracetam), you will not require blood work monitoring. ?????? 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 ??????please return to the office in days(from your date of surgery) for removal of your staples/sutures and/or a wound check. please make this appointment by calling . if you live quite a distance from our office, please make arrangements for the same, with your pcp. ??????please call ( to schedule an appointment with dr. , to be seen in 4 weeks. ??????you will need a ct scan of the brain without contrast. procedure: incision of cerebral meninges diagnoses: anemia, unspecified esophageal reflux pure hypercholesterolemia unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified atrial fibrillation personal history of malignant neoplasm of prostate coronary atherosclerosis of unspecified type of vessel, native or graft compression of brain long-term (current) use of anticoagulants subdural hemorrhage cerebral artery occlusion, unspecified with cerebral infarction 

Answer: The patient is high likely exposed to