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: topamax / ciprofloxacin attending: chief complaint: right sided weakness major surgical or invasive procedure: administration of iv-tpa history of present illness: hpi: year old russian-speaking only woman with pmh htn, dm, dementia who was found on the floor at 11:30pm, non-verbal and right sided weakness; found to have a l ica and l mca occlusion; s/p iv tpa. patient was last seen well at 11am, she has a diagnosis of alzheimer's disease (at baseline she speaks russian only, not oriented to time, needs care flor dressing; she lives in a nursing home). at 11:30am she was found lying on the floor, non-verbal, moving r side less and with a r facial weakness. her fs was 250 and bp 130/90. she was brought to where bp 138/44 hr 88 rr 20 sat 97%. we called her son and confirmed that she has not had heart attacks, history of brain hemorrhage, gi bleed or recent surgeries. cta showed proximal l mca occlusion and l ica occlusion. as patient was within the time window for tpa, she was given a bolus 7.3mg at 1:54pm and she is undergoing an infusion dose 65.5. we discussed the risks and benefits of intra-arterial procedures with her son, who declined further procedures. nihss: 20 past medical history: -htn -alzheimer's dementia -cad social history: patient has dementia, she has lived at rehab for the past 4 years, she has needed increased care recently. at baseline she speaks russian-only and is not oriented to time family history: nc physical exam: t-97.8 bp-138/44 hr-88 rr-20 97o2sat gen: lying in bed, non-verbal heent: r subgalleal hematoma neck: c-collar cv: rrr, nl s1 and s2, no murmurs/gallops/rubs lung: clear to auscultation bilaterally abd: +bs soft, nontender ext: no edema neurologic examination: mental status: awake and alert, non-verbal, grimaces to noxious stimuli. she does not follow any commands (not even with russian interepreter) cranial nerves: pupils equally round and reactive to light, 4 to 2 mm bilaterally; r facial weakness, no gaze preference, normal doll's, tongue is midline motor: she moves l side spontaneously; no spontaneous movement of r side. she retracts r side on noxious stimuli. reflexes: b t br pa pl right 2 1 2 2 0 left 2 1 1 1 0 r upgoing toe coordination: unable to perform gait: unable to perform pertinent results: admission labs: 141 | 100 | 19 ---------------< 199 3.8 | 25 | 1.0 ck: 128 ck-mb: 21 trop: 0.28 14.0 14.8 >-----< 330 42.5 . imaging: . ct head without contrast (): there is no fracture or hemorrhage. there is a right frontal subgaleal hematoma. the ventricles and sulci overall enlarged consistent with parenchymal involutional change. there is also a pattern of small vessel ischemic change evidenced by periventricular white matter hypodensity. although this is somewhat more prominent on the left, there is no clear evidence of edema. there is no hemorrhage. the visualized paranasal sinuses and soft tissues appear unremarkable. . cta head and neck: the aortic arch demonstrates a normal three-vessel takeoff, but with significantly tortuous brachiocephalic vasculature. there is a severe calcified and soft plaque of the aortic arch. the vertebral arteries and common carotid arteries are patent. however, there is a large amount of soft plaque and calcified plaque at the left carotid bulb, and there is long segment occlusion of the left ica from its origin (3w:139). on the right, there is carotid bulb calcified and soft plaque, and the proximal right ica measures 2 mm in its narrowest dimension (3w:125), compared to 3.5 mm distally (3w:137) representing approximately 40% stenosis. . there is reconstitution of the distal most supraclinoid left ica, with retrograde flow from the a1 segment of the left aca, which is enlarged from collateral flow from the right circulation. the anterior cerebral arteries are patent. however, the left mca and perisylvian branches are smaller in size and number than on the right. the posterior circulation appears normal. . the right lobe of the thyroid gland is not visualized, and tissue with thyroid density in appearance is seen in the right paramedian anterior strap muscles, which may represent an ectopic thyroid gland (3w:1a). there is expected degenerative change, with somewhat exaggerated cervical lordosis and an osteophyte posteriorly arising from c7 causing narrowing of the canal (400b:31). . ct perfusion: extensive left mca territory increased mean transit time and decreased blood flow are seen. although there is matched distributionof decreased cerebral blood volume, the degree of decreased blood volume is not quite matched, especially in the temporal lobe (:30, 112). . impression: 1. largely completed left mca territorial infarction, but evidence of at-risk territory in the anterior left temporal lobe. 2. chronic-appearing long segmental left ica occlusion from its origin through its supraclinoid portion; this may be a substrate for so-called "stump embolus" syndrome. 3. collateral flow in left anterior circulation but decreased size of left mca, and size and number of its distal branches, especially in the perisylvian region. 4. incidentally noted likely ectopic and malrotated right lobe of the thyroid gland. . ct head without contrast (): findings: large area of increasing hypodensity is noted within the left mca territory, especially in the left basal ganglia and insular ribbon, consistent with known left mca territory infarct. there is increased sulcal effacement of the left frontal lobe, consistent with edema. however, there is no shift of midline structures. the ventricles are stable in size and configuration. there is no acute hemorrhage. . since the previous study, the right frontal subgaleal hematoma has markedly increased in size and extends inferiorly over the right and left eyelid and laterally over the midline to the left. . impression: 1. findings consistent with evolving left mca infarct. no acute hemorrhage. 2. markedly enlarged frontal subgaleal hematoma, now extending over to the left and inferiorly over the eyelids bilaterally. . cxr (): findings: clips projecting over the left breast. borderline size of the cardiac silhouette, no evidence of pleural effusions, no pneumonia, no pulmonary edema. no pneumothorax. brief hospital course: ms. is a year old russian-speaking only woman with pmh htn, dm, dementia who was found on the floor at 11:30pm, non-verbal and right sided weakness; found to have a left internal carotid and left middle cerebral artery occlusions. she was admitted to the stroke service from to . . #neuro: given the significant ica and mca occlusions, discussions were held with the patient's sons regarding the risks and benefits of iv tpa, as well as possible intra-arterial interventions. the decision was made to attempt iv tpa, but given her baseline dementia and overall prognosis, the family declined any additional interventions beyond the therapy. iv tpa was given at 13:54, however she showed minimal improvement. futher discussion was held with the family on the following day, and the decision was made to transition the goals of care from cure to comfort. . #cv: on admission the patient was noted to have an elevated troponin at 0.28, with twis in lateral leads. it was unclear whether this represented an nstemi. because of the risk of hemorrhage from tpa, she was not started on anti-platelet agents. she was also noted to have significant episodes of bradycardia, so was not started on a beta-blocker. . #id: she was noted to have a uti on admission. she was initially started on ciprofloxacin in the emergency department, however developed erythema around the iv site. she was then switched to ceftriaxone to be continued through . antiobiotics were subsequently discontinued when the patient's code status was changed to comfort measures only. . #fen: on admission there was significant concern for aspiration, so the patient was kept npo. upon discussion with the family, given her baseline dementia, and poor prognosis following the stroke, the family opted to not place an ng tube or peg. . # code status: as noted above, the team had discussions with both of the patient's sons (one of whom is the health care proxy) regarding the patient's wishes for goals of care. in accordance with ms. wishes, her code status was transitioned to cmo. medications on admission: -aspirin 81mg -lorazepam 05mg q6 -cholecalciferol -glipizide 5mg -htcz 12.5mg -meclizine 25mg -metoprolol 25mg -nifedipine 60mg discharge disposition: extended care facility: for the aged - discharge diagnosis: - stroke in the left middle cerebral artery territory in the setting of a left internal artery occlusion - nstemi - dementia discharge condition: mental staus: unresponsive to voice, touch. ambulatory status: not assessed. discharge instructions: you were admitted to the with inablity to speak and right-sided weakness. neuroimaging revealed evidence of a large stroke in the left middle cerebral artery territory in the setting of a blocked left internal carotid artery. a medicine called t-pa was administered with the hope of dissolving the clots in the blood vessels. unfortunately, the had minimal effect. given your baseline quality of life, and the poor prognosis, goals of care were transitioned from cure to comfort. followup instructions: * please pursue comfort care. md, procedure: injection or infusion of thrombolytic agent diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery urinary tract infection, site not specified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified fall alzheimer's disease dementia in conditions classified elsewhere without behavioral disturbance aphasia contusion of face, scalp, and neck except eye(s) occlusion and stenosis of carotid artery with cerebral infarction hemiplegia, unspecified, affecting dominant side contusion of unspecified site 

Answer: The patient is high likely exposed to