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: penicillins attending: chief complaint: seizures major surgical or invasive procedure: none history of present illness: the pt is a 67 year-old woman with a pmh of gsw, shunt and subsequent seizures. she was reportedly in her usoh this morning when she fell and was then witnessed to have "gtc" lasting 20-25 minutes as well as earlier briefer seizures the specifics of which are not known. she is afebrile and her exam reveals l sided weakness and spasticity consistent with her pmh of brain injury. i am not able to access for nuchal rigidity given her c collar but she does not have a brudzinski sign. her work-up to date has included a negative ua and cxr as well as normal electrolytes and liver fxn. her wbc at the osh was 8 and here it is 14. this may be due to her seizures or intubation, however underlying infection must be evaluated. she will therefore need a tap of her shunt in the ed. she will also need a shunt series to evaluate for shunt malfunction given her prior history of shunt failure causing seizures. she also has a mildly elevated troponin which may be due to demand ischemia from her prior tachycardia, however i will check her ce to evaluate for an nstemi. given her presentation and low tegretol level of 6 at the osh, she may have seized merely from being subtherapeutic on her aed. infection or structural etiologies including meningitis, shunt failure or other infections will need to be evaluated as well. will therefore admit to neuro icu for further care. past medical history: pmh: - gsw in years ago to the head, burr holes at the time and a shunt, unsure if metal residual brain - one history of shunt failure and seizures 7 years ago - l sided weakness at baseline from gsw and uses a cane and "shuffling gait"; limited short term memory and minimal insight - seizures per report generalized, has been associated with shunt failure - ? htn - l mastectomy for breast ca, no hx of mets 3 years - abm surgery ? peg given the scars on her abm - bilateral hip replacements social history: -ex husband her shot her -lives with support -etoh: not her hcp -tobacco: not per hcp -drug use: not per hcp family history: non-contributory physical exam: physical exam upon admission vitals: t: 99.4 (pr) p: 90 r: bp: 141-187/85-87 sao2: 100% on et general: intubated, off sedation heent: nc/at, no scleral icterus noted, et in place, some blood at nare; palpable burr holes which are easily depressable neck: in c collar; no brudzinski pulmonary: lungs cta bilaterally without r/r/w cardiac: rrr, nl. s1s2, no m/r/g noted abdomen: soft, nt/nd, + bs but multiple scars, with mastectomy of the l breast and several well healed abm incisions extremities: lle pitting edema skin: no rashes neurologic: this exam is done 5 minutes off of propofol -mental status: initially drowsy and difficult to arouse, moving her r leg intermittently (non-rhythmically); 5 minutes later she as able to follow basic commands (squeezes with r hand, opens eyes, shows 1 finger) and nod y to simple questions inconsistently. cn i: not tested ii,iii: no blink to threat bilaterally, pupils 1.5->1mm bilaterally, unable to visualize fundi due to miosis iii,iv,v: no dolls, no nystagmus v: + corneals and nasal tickle bilaterally vii: no gross facial asymmetry but very difficult to assess as pt has et in place viii: ua ix,x: + gag : ua xii: ua (et in place) motor: normal bulk and tone on the r arm and leg, l arm and leg have increased tone and atrophy; moves r arm and leg spontaneously but not the l side (even to nox stim) reflex: no clonus tri bra pat an plantar c5 c7 c6 l4 s1 cst l 2+ ----------- 1 up r 1------------- 0 flexor -sensory: withdraws to nox stim on the r arm and leg but not the l side -coordination: na -gait: na pertinent results: eeg impression: a markedly abnormal portable eeg due to the persistent and frequent spike and sharp and slow wave bursts in the right anterior quadrant and due to the irregular slowing in the left central region as well as the mildly slow background. the right anterior quadrant sharp wave activity suggests an acute structural lesion in the right anterior quadrant, likely with epileptogenic potential. nevertheless, the discharges did not become rapid enough or evolve so as to suggest an ongoing seizure during the course of this recording. the left-sided slowing suggests an additional subcortical dysfunction there. the background reflected the use of the propofol early in the recording and a subsequent mild encephalopathy later. eeg impression: abnormal eeg due to the presence of persistent frequent spike and sharp slow waves bursts in the right temporal region as well as irregular slowing in the left central region and a mildly slow background. the right temporal activity suggests an area of epileptogenesis. the left central slowing indicates an area of subcortical dysfunction. the generalized background slowing is indicative of mild encephalopathy. medications, metabollic disturbances and infection are among the most causes. there is no area ongoing seizure during this recording. head ct impression: 1. no hemorrhage. 2. the distal tip of the shunt terminates in the frontal of the right lateral ventricle with no signs of hydrocephalus. 3. diffuse encephalomalacic changes of the brain in a linear pattern, bullet fragments inside the brain and bilateral skull defects are most likely related to the bullet injury. 4. depressed fracture fragment of the left frontal area. shunt series findings: at least two separate craniotomies are identified. there is a shunt catheter extending to the central cerebrum through a right posterior burr hole. catheter tubing extends through the soft tissues of the posterior scalp and occiput to the right neck where there is a single loop. the catheter then traverses and projects over the midline chest, coursing into the abdomen with the tip is located in the left upper quadrant. there is a coiled presumably remnant catheter in the right hemipelvis. incidental note is made of left base atelectasis and at least four lamellated calcified gallstones. total hip replacements are also incidentally noted. impression: shunt catheter as described above. no discontinuity is noted. incidental findings as above. echo cardiogram : the left atrium is elongated. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are structurally normal. mild (1+) mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. impression: mild symmetric left ventricular hypertrophy with preserved global and regional biventricular systolic function. mild mitral regurgitation. no pericardial effusion. ekg sinus rhythm. left axis deviation. left anterior fascicular block. no previous tracing available for comparison. sinus rhythm. left axis deviation. left anterior fascicular block. there is a late transition that is probably normal. compared to the previous tracing of there is no significant change left lower extremity ultrasound: the left common femoral, superficial femoral and popliteal veins demonstrate normal waveforms, augmentation and flow and compressibility. there is no intraluminal thrombus. impression: no evidence of dvt in the left lower extremity. 08:54pm ck(cpk)-477* 08:54pm ck-mb-14* mb indx-2.9 ctropnt-0.17* 04:15pm type-art tidal vol-550 o2-40 po2-124* pco2-31* ph-7.49* total co2-24 base xs-2 -assist/con intubated-intubated 03:44pm urine hours-random 03:44pm urine bnzodzpn-neg barbitrt-neg opiates-neg cocaine-neg amphetmn-neg mthdone-neg 01:15pm glucose-83 urea n-18 creat-0.6 sodium-137 potassium-3.5 chloride-99 total co2-26 anion gap-16 01:15pm estgfr-using this 01:15pm alt(sgpt)-22 ast(sgot)-34 ck(cpk)-280* alk phos-69 tot bili-0.6 01:15pm lipase-23 01:15pm ck-mb-10 mb indx-3.6 01:15pm ctropnt-0.25* 01:15pm albumin-3.8 phosphate-2.3* magnesium-1.9 01:15pm asa-neg ethanol-neg carbamzpn-5.2 acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 01:15pm wbc-14.5* rbc-4.26 hgb-13.6 hct-37.9 mcv-89 mch-31.8 mchc-35.8* rdw-13.6 01:15pm neuts-87.1* lymphs-8.2* monos-4.5 eos-0.1 basos-0.1 01:15pm pt-11.7 ptt-20.1* inr(pt)-1.0 01:15pm plt count-304 12:55pm urine color-yellow appear-clear sp -1.014 12:55pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-15 bilirubin-neg urobilngn-neg ph-7.0 leuk-neg brief hospital course: neurologically: the pt is a 67 year-old woman with a pmh of gsw, shunt and subsequent seizures, who was admitted for convulsive status epilepticus and her initial tegretol level was low at 5.2. she was successfully extubated and transferred to the neurology floor. the tegretol was changed to xr formulation and increased to 600mg and she did not have additional seizures. her initial eeg showed frequent epileptiform discharges in the r anterior quadrant although no clear electrographic seizures were seen. after the medication adjustment, a repeat eeg was done and showed persistent discharges but signficantly improved and were much less frequent. a shunt series demonstrated no obstruction or evidence of dysfunction. initially, on exam she was lethargic and slow to answer and had profound left arm and leg weakness, which were likely postictal phenomenon, as this improved with time. the r arm and leg strength improved to baseline and she was able to ambulate with a cane and assistance. her physical exam upon discharge: slow to answer, but alert and responsive. oriented to place and person, not to time. moderate left hemiparesis with strength of in lower and upper extremities. she stated that she has an outpatient neurologist who has been following her and she will follow him after discharge. 2) cv: -troponins elevated but trending downward -tte mild symmetric left ventricular hypertrophy with preserved global and regional biventricular systolic function. mild mitral regurgitation. no pericardial effusion -monitor on telemetry with variable elevated heart rate with no identified cause. pcp was and no previous history of tachicardia 3) resp: -extubation without complications -monitor for aspiration pna 4) renal: -no active issues, replete lytes as needed 5) endo: -normoglycemia 6) fen/gi: -patient had feeding by ngtube, passed on swallow test and diet with restriction was initiated. 7) id: - csf no signs of infection -negative blood & urine cx medications on admission: - amlodipine 5mg po qd - gabapentin 600mg po qd - detrol la 4mg po qd - tegretol xr 40mg po bid - folic acid 1mg po qd - clindamycin 150mg po qd ? - spironolactone 25mg po qd discharge disposition: extended care facility: - discharge diagnosis: seizures vp shunt discharge condition: stable. no further seizures discharge instructions: you were admitted to this hospital after having seizures. you have history of epilepsy and vp shunt placement. during your admission no signs of infection was noted. no evidence of shunt mal-function was detected. you will be transfered to rehabilitation facility to continue your care. followup instructions: please contact your pcp dr for a follow up appointment and to referal for a neurologist. also, you need to follow up with a neurologist. please call neurological at to schedule a follow up. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours diagnoses: personal history of malignant neoplasm of breast abnormality of gait hip joint replacement presence of cerebrospinal fluid drainage device history of fall epilepsia partialis continua, without mention of intractable epilepsy late effects of injury purposely inflicted by other person other musculoskeletal symptoms referable to limbs memory loss late effect of intracranial injury without mention of skull fracture 

Answer: The patient is high likely exposed to