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: unresponiveness major surgical or invasive procedure: -r-hemicraniotomy history of present illness: given pt's mental status, she was unable to give a history, so history from pt's nephew and medical record. . hpi: 83 year-old woman with a history of afib on coumadin, htn, cad, high cholesterol, dm presents with left hemiplegia, right gaze deviation, and decreased responsiveness for an unknown amount of time. . nephew reports that he last saw pt on and she was doing well. home health aide saw pt on , and pt also doing well. nephew says that he called her on sunday as he usually does since he usually lays out allof her pills for the week. she did not answer, and he left a message, which he reports is not that unusual. he called her again last night as he had not heard from her, and left another message. he then received phone call today from home health agency that the aide was at apartment and could hear noises inside but pt did not answer door. nephew called 911 and went to her house. . per ems report, pt found lying on her back in bed. she was minimally resposnive, only responding to pain with minimal right- sided movement. she did not move her left side. breathing was shallow, radial pulse was irregular and weak, capillary refill was poor, skin was hot and diaphoretic. vitals in the field were 230/100, hr 88-92, rr 24-29, fsbs 209. . on arrival in , pt remained minimally responsive with left- sided plegia. she was therefore intubated for airway protection. she was tachycardic to the 170s with unclear rhythm, possibly aflutter vs svt, with bp 160s. she was given 6mg adenosine to slow hr and try to identify rhythm. she then dropped bp to 60s systolic despite ivf and was cardioverted x2 at 200j. hr slowed to 100s with sinus rhythm and pacs and sbp 100s. . ros: unable given mental status/intubation past medical history: 1. diabetes, type 2 2. afib on coumadin, on amio in past 3. h/o aflutter, s/p dccv 4. pulmonary htn 5. htn 6. cad s/p nstemi 7. chf/cardiomyopathy fen-phen, stopped drug . most recent echo with ef 55-60%, 2+ mr, 2+ tr, mild lvh 8. obesity 9. hypercholesterolemia 10. sleep-disordered breathing social history: lives alone. she denies use of alcohol, tobacco, or illicit drugs. her nephew is her health care proxy. family history: ++stroke--sister age 69-70, nephew age 34 physical exam: t 100.5 bp 230/110-->60s/20s-->100s/40s hr 170s-->100s rr 20-24, shallow o2 sat 100% nrb general: appears stated age, minimally responsive heent: nc/at sclera anicteric. dry mm neck: supple. lungs: clear to auscultation anterolaterally cv: irreg, nl s1, s2, no murmur. 2+ carotids without bruit abd: soft, nontender, normoactive bowel sounds extr: mild edema, poor cap refill, weak radial pulses . neurologic examination: (pre-intubation) mental status: opens eyes to loud voice/stimulation. right gaze deviation. shows thumb to command, moves toes to command. minimal verbal output. drifts back to sleep without continued stimulation. . cranial nerves: did not blink to threat, bilaterally. pupils equally round and reactive to light, 3 to 2 mm bilaterally. right gaze deviation, but does cross midline on doll's. severe left facial droop. decreased corneal on left. . motor: normal tone, bulk bilaterally. no fasciculations or tremor. moves right side spontaneously and to command, at least distally. left arm and leg plegic with no spontaneous movement or to command, and only very minimal foot withdrawal to noxious. . sensation: withdraws/localizes noxious on right. grimaces and increased right-sided movmements to noxious on left though no motor response. . reflexes: dtrs decreased but symmetric at biceps, absent at br, patellar, ankle. toes were mute bilaterally . unable to assess coordination and gait given mental status. pertinent results: 03:22pm wbc-15.2*# rbc-4.74 hgb-13.9# hct-44.7 mcv-94 mch-29.3 mchc-31.0 rdw-15.1 03:22pm neuts-70.9* lymphs-22.7 monos-5.8 eos-0.3 basos-0.4 03:22pm plt count-221 03:22pm pt-16.0* ptt-21.5* inr(pt)-1.7 03:22pm triglycer-157* hdl chol-83 chol/hdl-3.1 ldl(calc)-144* 03:22pm tot prot-7.3 albumin-4.0 globulin-3.3 calcium-9.6 phosphate-4.1 magnesium-2.4 cholest-258* 03:22pm alt(sgpt)-18 ast(sgot)-42* ck(cpk)-261* alk phos-61 amylase-66 tot bili-1.1 03:22pm glucose-169* urea n-42* creat-1.5* sodium-153* potassium-4.0 chloride-110* total co2-28 anion gap-19 05:18pm %hba1c-6.9* -done -done . ct head without contrast : there are multiple large right-sided right frontal hematomas. adjacent areas of low attenuation extend to and involve the cortex. the distribution is in the anterior cerebral artery and anterior division of the middle cerebral artery territory. these findings could be consistent with a hemorrhagic stroke given the appearance and distribution. there is 5 mm worth of leftward midline shift. the perimesencephalic cisterns are preserved. there are a few small areas of subarachnoid blood within the left frontal region. incidental note is made of a large left maxillary retention cyst or polyp. impression: multiple large hematomas within the right frontal lobe could be consistent with a hemorrhagic infarct but vascular malformation and neoplasm are not excluded. minimal midline shift. perimesencephalic cisterns are intact. . carotid series: unremarkable exam. no stenosis in the extracranial carotid arteries. . tte: the left atrium is elongated. the right atrium is moderately dilated. no atrial septal defect or patent foramen ovale is seen by 2d, color doppler or saline contrast with maneuvers. there is mild symmetric left ventricular hypertrophy with normal cavity size and systolic function (lvef>55%). no masses or thrombi are seen in the left ventricle. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild to moderate (+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. the estimated pulmonary artery systolic pressure is normal. there is a small pericardial effusion. there are no echocardiographic signs of tamponade. . ct head without contrast : there is a large area of low attenuation in the right frontal, parietal, and temporal lobes, consistent with an infarction, which demonstrates slightly decreased mass effect compared to , consistent with evolution of infarction. previously noted multifocal blood products within this infarction appear less dense than previously. there is no evidence of acute rebleeding. the soft tissues overlying the right craniectomy site are not significantly changed. the frontal of the right lateral ventricle is less compressed. periventricular white matter hypodensity in the left cerebral hemisphere appears unchanged. decreased mass effect associated with the large right middle and anterior cerebral territory infarction. evolution of blood products within the infarction without evidence of rebleeding.compared with the findings of the prior report (tape unavailable for review) of , significant pulmonary hypertension is no longer detected. otherwise, probably no change. brief hospital course: the patient is an 83 yo woman with a h/o dm, htn, chol, cad, chf, afib on coumadin, who was found in her apt on bed, with left hemiplegia and right gaze deviation. as she was minimally responsive whe was intubated. a head ct showed a right aca/superior division mca stroke with hemorrhagic transformation. cxr suggested lll atelectasis vs consolidation. . neuro: exam upon dishcarge: the patient can be woken up. she has an eye opening aparaxia, which makes it impossible for her to open her eyes to command. she is able to wiggle her r-toes and squeeze her r-hand/show her r thumb when asked. she has hemiplegia in her l-arm and leg, with only minimal movement in her l-leg to noxious stimuli and no movement in her l-arm. the patient is non-verbal. the patient underwent a r-hemicraniotomy as a 1cm midline shift was noted shortly after presentation. the skull is currently preserved in her abdominal wall. repositing of the skull by neurosurgery should be planned for in wks after the craniotomy (see follow up appointment). to protect her brain, she should wear a helmet. in addition, she is on seizure prophylaxis (dilantin; goal 15-20; please follow level regularly taking into account her albumin level). she will need to be on prophylaxis for a few years. an mri/mra should be scheduled in weeks to look for a possible underlying cause of the stroke. repeat ct's of the head ( and (/8) showed no interval change apart from progressive reduction of the edema. cta of carotids showed no stenosis and a tte did not show a thromboembolic source or wall motion abnormalities. . respiratory: the patient remained dependent on ventilator support. she tolerated cpap well, but has episode of apnea (30sec) that might be central of origin. she was trached on . please continue tracheotomy care. . cardiovascular: the patient has a history of afibb. she was in nsr during most of the hospitalization but returned to on . at this point the metoprolol was increased. amiodarone was not give as her rate remained well controled. coumadin should be kept on hold given the large intracranial hemorrhages. aspirin may be restarted for secondary stroke prophylaxix in 4 weeks. . endocrine: the patient has dm. she was maintained on a iss and nph 18 units in am and 18 units pm. her fsbs were reasonably controlled. further adjustments to the nph should be made depending on her fsbs. . infectious disease: the patient received cefazolin peri-operative. she was started on levaquin for a lll pna. she developed a fever on after which her cvl was discontinued (bacteremia). final results of the cultures are pending. a picc line was inserted and other lines d/c-ed at that point. levaquin to be continued for 4 more days. . haematology: the patient's hct dropped to 26.6 on . there were no signs of gi bleed and this drop might have been related to the bacteremia that was noted that day. her hct has remained stable otherwise around 30. she received gi prophylaxis. . renal: upon admission her creatinin and sodium were markedly elevated secondary to dehydration. creatinin and sodium normalized slowly after sufficient rehydration. the patient needs diuresis prn, based on her daily weigth. . prophylaxis: please continue penumo boots, ppi, heparin sc tid and a bowel regimen (including senna, dulcolax and colace). . fen: tube feeds per peg tube at goal rate. peg placed . picc placed . . code: full; hcp is nephew cell , home medications on admission: coumadin 3, ambien 10, hydralazine 50 q6h, cozaar 100, lasix 40, metoprolol 25 tid, metformin 500 , lipitor 20, asa 81, mvi, calcium, colace, senna discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) 5000 units injection tid (3 times a day): until patient mobilized. 2. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 3. nystatin 100,000 unit/ml suspension sig: 5-10 mls po qid (4 times a day) as needed. 4. miconazole nitrate 2 % powder sig: one (1) appl topical tid (3 times a day) as needed. 5. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 6. docusate sodium 100 mg capsule sig: one (1) capsule 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. 8. acetaminophen 160 mg/5 ml solution sig: one (1) 650 po q4-6h (every 4 to 6 hours) as needed for fever. 9. polyvinyl alcohol 1.4 % drops sig: 1-2 drops ophthalmic prn (as needed). 10. phenytoin 50 mg tablet, chewable sig: two (2) 100mg po tid (3 times a day). 11. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 4 days. 12. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po bid (2 times a day): hold for sbp<90. 13. insulin regular human subcutaneous 14. heparin flush cvl (100 units/ml) 1 ml iv daily:prn 10ml ns followed by 1ml of 100 units/ml heparin (100 units heparin) each lumen qd and prn. inspect site every shift 15. furosemide 20 mg iv bid 16. metoprolol 5 mg iv q4h:prn administer for afib control to keep hr below 100. 17. insulin nph human recomb 300 unit/3 ml insulin pen sig: one (1) 10 untis subcutaneous twice a day: please monitor fsbs closely and adjust dose if needed; have riss in place for corrections until nph dose is adequate. 18. protonix 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po twice a day. discharge disposition: extended care discharge diagnosis: 1. stroke with hemorrhagic conversion 2. s/p craniotomy 3. diabetes 4. hypertension 5. paroxysmal atrial fibrillation 6. bacteremia 7. pneumonia discharge condition: fair; dense l-hemiplegia; eye opening apraxia; non-verbal. discharge instructions: -trach: continue care; try to wean -peg: continue care -picc line placed : fine for use; care per protocol -s/p r-craniotomy: do not touch/press her r-head -note that skull is stored in her abdomen -please provide pt, prevent contractures in her neck and l extremities. -fsbs, continue iss, fsbs; adjust nph further -continue seizure prophylaxis followup instructions: please check dilantin levels weekly. corrected level, based on albumin, . . please follow up with neurosurgery: office appointment at 10.30. please call to confirm the appointment, to get further instructions and information, or to re-schedule the appointment if needed. . please follow up at the clinic with dr. /dr. in 3 months. please call to schedule an appointment and to receive instructions. . please schedule a mri-mra of the head for follow up. this can be done when she is seen at the clinic. md, procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] atrial cardioversion temporary tracheostomy other incision of brain transfusion of packed cells other repair of cerebral meninges transfusion of other serum other craniectomy diagnoses: pure hypercholesterolemia mitral valve disorders congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified unspecified protein-calorie malnutrition atrial fibrillation candidiasis of mouth intracerebral hemorrhage compression of brain acute respiratory failure pneumonitis due to inhalation of food or vomitus hyperosmolality and/or hypernatremia hemiplegia, unspecified, affecting unspecified side 

Answer: The patient is high likely exposed to