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: found minimally responsive in bed by family major surgical or invasive procedure: none history of present illness: yo russian speaking woman with afib and chf on coumadin who was last seen well at 12 noon by her grandson, who was then later found at 3pm minimally responsive laying on her bed, thus ems was called. nursing noticed patient was neglecting the right side (staring to the left) and thus a code stroke was called at 3:57pm. patient seen immediately as examiner was in the ed tending to another code stroke. nihss 20 - mute, not following commands, right dense neglect with fixed gaze, right facial droop, right hemiparesis. ct 4:16pm shows left frontal hypodensity, old right occipital infarct. labs pending. no prior h/o strokes, was feeling well earlier today. at baseline, dresses herself but requires help with other activities. cannot walk down stairs on her own. lives with family. full code. past medical history: 1. congestive heart failure with an ejection fraction of 40 to 45% with last echocardiogram in . 2. chronic atrial fibrillation on anticoagulation. 3. hypertension. 4. status post total abdominal hysterectomy. 5. status post appendectomy. 6. arthritis of the knees. 7. bilateral cataract surgeries 8. cri with baseline ~1.7 . echo (): dilated right atrium and left atrium, normal ventricular chamber sizes. mild concentric left ventricular hypertrophy. mildly depressed left ventricular function due to focal inferior-basal hypokinesis to akinesis. mildly thickened 3 leaflet aortic valve with moderate aortic insufficiency. mildly thickened mitral valve with moderate mitral regurgitation. normal tricuspid valve with moderate tricuspid regurgitation and top normal pulmonary artery pressure. small pericardial effusion. social history: lives with extended family, patient actually has no children, former kindergarten teacher, no tob/etoh/drugs ever. russian speaking. full code. family history: no family history of diabetes, coronary artery disease or hypertension. physical exam: vitals: 138/78, 64, 100% nrb -> 96% ra gen: elderly woman in nad laying in stretcher looking to the left heent: nc/at, anicteric sclera, mmm neck: supple, no carotid bruits chest: cta bilat anteriorly cv: irregular irreg rhythm without mur (difficult to appreciate murmurs in the ed) abd: soft, nt/nd extrem: no edema pertinent results: 04:16pm wbc-9.0 rbc-4.17* hgb-13.6 hct-39.2 mcv-94 mch-32.6* mchc-34.6 rdw-14.3 04:16pm ck-mb-2 ctropnt-<0.01 04:45pm pt-24.3* ptt-30.3 inr(pt)-2.4* 08:35am ctropnt-<0.01 04:12am blood wbc-16.3* rbc-3.20* hgb-10.2* hct-30.4* mcv-95 mch-31.9 mchc-33.6 rdw-14.4 plt ct-505* 02:54am blood neuts-83.2* lymphs-9.5* monos-5.3 eos-1.1 baso-0.9 03:32am blood macrocy-1+ 04:12am blood plt ct-505* 02:54am blood fibrino-638*# 04:12am blood glucose-144* urean-40* creat-1.1 na-140 k-3.7 cl-108 hco3-24 angap-12 03:00am blood alt-22 ast-21 alkphos-75 totbili-0.2 03:32am blood lipase-20 03:32am blood probnp-3313* 04:12am blood calcium-7.9* phos-2.5* mg-2.2 08:35am blood %hba1c-6.2* -done -done 05:45am blood triglyc-92 03:32am blood tsh-2.4 03:32am blood digoxin-0.6* 04:16pm blood asa-neg ethanol-neg acetmnp-26.8* bnzodzp-neg barbitr-neg tricycl-neg 04:31am blood type-art po2-144* pco2-42 ph-7.44 calhco3-29 base xs-4 03:58am blood type- temp-38.6 o2 flow-4 po2-134* pco2-46* ph-7.34* calhco3-26 base xs--1 intubat-not intuba 02:06am blood type-art po2-82* pco2-32* ph-7.43 calhco3-22 base xs--1 01:22pm blood type-art temp-37.2 peep-5 fio2-40 po2-153* pco2-32* ph-7.42 calhco3-21 base xs--2 intubat-intubated 03:58am blood lactate-2.4* 03:58am blood lactate-1.4 04:16pm blood lactate-1.6 01:22pm blood freeca-1.18 . head ct: impression: 1. interval evolution of left mca territorial infarct demonstrated by loss of left frontal lobe -white differentiation, local edema with minimal mass effect. 2. stable chronic ischemic changes as described above. . head ct: impression: 1. limited study due to motion artifact. if there is clinical suspicion for acute ischemia, an mri is recommended. 2. stable chronic ischemic changes as described. . carotid doppler: impression: less than 40% stenosis in the bilateral extracranial internal carotid arteries. brief hospital course: aa/p: 93 russian-speaking female s/p large l mca territory stroke intubated due to respiratory distress and increased work of breathing likely caused by aspiration pneumonia. . 1. stroke: the patient was noted to have a grossly abnormal neurologic exam in the ed and was admitted to the neurology service for stroke. head ct ultimately revealed a large l mca stroke. this was a suspected cardioembolic source given the a-fib, although she was therapeutic on coumadin. carotid dopplers were negative. her mental status and neuro exam remained stable over the admission, although she did remain confused, unable to communicate with providers. she was awake, alert moving her extremities. she failed speech/swallow , ng tube was placed. neurologically, she remained stable for the duration of the admission. she was transferred to the micu for respiratory distress on . shw will follow up with neurology as an outpatient, per the discharge paperwork. . 2. respiratory distress; on the patient was noted to be tachypneic and in respiratory distress on the neuro floor. she was transferred to the micu and intubated. she had a presumed aspiration pneumonia, given the stroke and failed swallow study. no organism obtained on sputum. she was treated with a course of vanc/levoflox/flagyl for 7 days. she was extubated successfully at 1200 on . although she continued having a lot of secretions, needing frequent deep suctioning, noted to have poor gag. . 3. afib: she has permanent af, with episodes of rvr. the dig was stopped. rate control was continued with metoprolol. anticoagulation was continued with coumadin, although she required a dose of vitamin k to reverse a supratherapeutic inr, after which coumadin was resumed. . 4. htn: bp meds were titrated daily to acheive target bp 120-130/80s. metoprolol, captopril, isosorbide were used. lasix as well for diuresis for chf. . 5. chf, ef 45-50%: there was a component of overload to the respiratory distress. she was diuresed with lasix. . fen: tube feeds were used given the aspiration risk. for long term, will need dobhoff tube or pediatric ngt. the family was opposed to peg. . ppx: iv ppi, pneumoboots, on coumadin . dispo: micu for now, ? d/c to rehab where frequent suctioning could be performed. . code: dnr, no escalation of care, no cpr, no pressors. do not re-intubate. no trach, no peg. continue current level of care. work toward rehab. medications on admission: meds on transfer: iv levoflox 500q24 iv flagyl 500q8h asa 81 qd digoxin 0.125qd imdur 120 po qd metop 50 po tid iv heparin discharge medications: 1. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 2. insulin per sliding scale to be arranged by accepting md 3. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 4. docusate sodium 150 mg/15 ml liquid sig: one (1) po bid (2 times a day). 5. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed. 6. acetaminophen 325 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. 7. captopril 25 mg tablet sig: two (2) tablet po tid (3 times a day). 8. isosorbide dinitrate 20 mg tablet sig: one (1) tablet po tid (3 times a day). 9. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 10. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 11. warfarin 2 mg tablet sig: one (1) tablet po qodhs (every other day (at bedtime)). 12. metoprolol tartrate 50 mg tablet sig: 2.5 tablets po tid (3 times a day) as needed for afib. 13. sodium chloride 0.9% flush 3 ml iv daily:prn peripheral iv - inspect site every shift 14. sodium chloride 0.9% flush 3 ml iv daily:prn peripheral iv - inspect site every shift 15. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. discharge disposition: extended care facility: for the aged - acute rehab discharge diagnosis: stroke atrial fibrillation respiratory failure discharge condition: stable, requiring periodic suctioning of respiratory secretions discharge instructions: please note that your medication regimen has been changed. you now have a new blood pressure regimen as well as a new coumadin dose. we have stopped the digoxin. you need your inr checked frequently for goal inr 2-2.5. please check c. difficile stool studies and repeat wbc count. consider flagyl therapy if positive. followup instructions: please call to establish neurology follow-up with dr. within 6-8 weeks. ( . please call your primary care physician for appointment witin 1-2 weeks. , l. md procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube diagnoses: congestive heart failure, unspecified atrial fibrillation chronic kidney disease, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease acute respiratory failure pneumonitis due to inhalation of food or vomitus cerebral embolism with cerebral infarction osteoarthrosis, unspecified whether generalized or localized, lower leg other premature beats 

Answer: The patient is high likely exposed to