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: fall, convulsions major surgical or invasive procedure: intubation and mechanical ventilation eeg lumbar puncture attempted history of present illness: 82 year-old right-handed woman with a history of prior stroke and dementia who presented with alteration in consciousness. the history is per the primary team, the medical record, and the pt's family. she had been in her usual state of health until three days pta. at that time, she was at home and experienced a fall that was witnessed by one of her daughters. daughter is not sure if the fall was mechanical or unprovoked. she later said, however, that after she fell, she was "shaking on the ground." specifically, she was not responsive and was seen to be rhythmically shaking the arms and legs for roughly 5 minutes. after this she was somewhat somnolent, but did not seem weak. the next day, she complained of a headache. more significantly, however, the pt's daughters noted that she became progressively more somnolent and withdrawn. she seemed to stare ahead at people and not respond appropriately. her speech was unintelligible. she was not eating, drinking, or taking her medications. her daughters also noticed that the right side of her face seemed to "droop." as this persisted, her daughters took her to an osh for evaluation this morning. at the osh, she was described as "alert and nonverbal." she was found to have a temperature of 99.6f and initial bp was 161/60mmhg. labs were notable for an inr 2.5, and were otherwise normal except for bun of 29. she underwent ct of the head which revealed small right subdural hematoma (8 to 9mm). she received 2 units of ffp, 5mg of sc vitamin k, and was loaded with 1g of phenytoin. she was transferred to for neurosurgical evaluation. she was intubated on arrival to , and was given 2 units of proplex. neurosurgery consultation was requested. the pt was unable to offer a review of systems, however her daughters noted that she had no recent complaints other than headache for the past two days. past medical history: stroke, per daughters over 20 years ago. at that time, she presented with inability to speak; daughter cannot remember if there was weakness as well. she was treated with warfarin at that time, then restarted on the coumadin for unknown reasons several years ago. dementia: per daughters, at baseline she is able to recognize her loved ones, feed herself, ambulate. she requires help with washing and iadls. s/p pacemaker placement hypertension gout social history: she lives at home with one of her daughters. she has no history of tobacco, alcohol, or illicit drug use. she is originally from . family history: notable for mother with stroke. physical exam: on admission: vitals: t: 100.2f p: 63 r: 16 bp: 115/58 general: lying in bed with eyes closed, intubated. heent: nc/at, no scleral icterus noted, mmm, no lesions noted in oropharynx neck: no jvd or carotid bruits appreciated. no nuchal rigidity pulmonary: lungs with transmitted upper airway sounds bilaterally cardiac: difficult to auscultate over breath sounds, but apparently rrr, and no murmur heard abdomen: soft, nt/nd, normoactive bowel sounds extremities: no c/c/e bilaterally, 1+ radial, dp pulses bilaterally. skin: no rashes or lesions noted. neurologic: mental status: opens eyes transiently to noxious stimuli. does not follow commands. cranial nerves: perrl 3.5 to 2.5mm. funduscopic exam was technically limited as pt resisted eye opening, but revealed no papilledema, exudates, or hemorrhages. eomi difficult to assess secondary to forceful eye closure. corneal reflex and nasal tickle present bilaterally. no overt facial asymmetry (but difficult to tell given ett in place). gag reflex intact. motor: normal bulk throughout. tone mildly increased in lower extremities. withdraws to noxious stimuli in all four extremities. no adventitious movements noted. no myoclonus noted. sensory: grimaces to noxious stimuli in all four extremities and sternal rub. dtrs: tri pat ach l 2 2 2 3 4 r 3 3 3 3 3 plantar response was extensor bilaterally. pertinent results: admission labs: 08:59pm blood wbc-5.7 rbc-3.10* hgb-9.9* hct-27.6* mcv-89 mch-31.8 mchc-35.7* rdw-14.4 plt ct-170 08:59pm blood neuts-70.9* lymphs-21.8 monos-6.1 eos-0.7 baso-0.4 08:59pm blood pt-20.1* ptt-31.5 inr(pt)-1.9* 08:59pm blood glucose-144* urean-29* creat-1.5* na-143 k-3.3 cl-100 hco3-32 angap-14 01:00am blood alt-18 ast-27 ld(ldh)-209 ck(cpk)-166* alkphos-112 amylase-86 totbili-1.3 01:00am blood lipase-14 01:00am blood albumin-3.7 calcium-9.4 phos-2.8 mg-2.2 : ct head without iv contrast: 1. right subdural hematoma in the temporal parietal region. no midline shift or significant mass effect. 2. encephalomalacic change in the left mca distribution, consistent with an area of prior infarction. 3. cavernous internal carotid artery calcification bilaterally. there is asymmetric enlargement of the left ica at this location, suggesting aneurysmal dilatation. : ct head without contrast: a cavum septum pellucidum et vergae is present and is a normal variant. again noted is right-sided subdural hematoma extending along the right convexity in the temporoparietal region which is unchanged in size or character. there is unchanged effacement of the surrounding sulci with associated mass effect. no intracranial hemorrhage is identified. a large area of low attenuation within the left posterior frontal and temporal lobes is visualized reflecting encephalomalacic changes from prior infarction. there is no shift in normally midline structures. extensive calcification of the carotid arteries in their cavernous course is present. no abnormalities are noted within the osseous structures or soft tissues. impression: this study is unchanged from previous. there is a right subdural hematoma in the temporoparietal region with mild effacement of the adjacent sulci and mild regional mass effect without shift of normally midline structures. encephalomalacic change in the left middle cerebral artery distribution is consistent with prior infarction. : portable ap chest radiograph: the et tube tip is positioned within the mid to lower trachea, approximately 2 cm above the carina. there is an ng tube seen, with the tip in the stomach. the patient has a pacemaker overlying the left hemithorax, with leads positioned within the right atrium and ventricle. there is a lead overlying the right hemithorax, with the tip positioned within the ventricle. there is cardiomegaly. the lungs are clear. no pleural effusions or pneumothorax is seen. the pulmonary vasculature is within normal limits. the soft tissue and osseous structures are unremarkable. impression: et tube and ng tube in satisfactory position. cardiomegaly. eeg : this is an abnormal portable eeg due to the presence of frequent epileptiform sharp and slow wave discharges seen over the left parietal temporal aregion and due to right temporal sharp and slow wave discharges seen independently and less frequently. in addition, the background is slow and disorganized. the first two abnormalities suggest cortical dysfunction in the left parietal temporal region as well as right temporal cortical dysfunction. the third abnormality suggests deep, midline subcortical dysfunction and is consistent with a mild encephalopathy. regarding epilepsy, the frequent epileptiform discharges increase the risk of seizures. during this 20 minute recording, there was no clear seizure activity recorded. echo: the left atrium is dilated. the right atrium is markedly dilated. a left-to-right shunt across the interatrial septum is seen at rest. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the ascending aorta is mildly dilated. the aortic valve leaflets are moderately thickened. there is mild aortic valve stenosis. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is moderate/severe mitral valve prolapse. moderate (2+) mitral regurgitation is seen. the mitral regurgitation jet is eccentric. the tricuspid valve leaflets are mildly thickened. moderate to severe tricuspid regurgitation is seen. there is no pericardial effusion. upper extremity us: picc line in the left basilic vein with no flow seen in the basilic, but good flow in the brachial, axillary and subclavian veins on the left, and normal flow in the deep veins of the right upper extremity. cspine ct with contrast: 0.9 x 0.7 cm left extradural mass with displacement and mild indentation on the cord at c2-3 level. the differential includes hematoma, phlegmon, and tumor. recommend to repeat at least six hours without iv contrast to evaluate the baseline appearance and assess for contrast enhancement. cspine ct without contrast: small extradural mass at the level of the c2-3 vertebrae. this likely represents a calcific tumor such as a meningioma. the presence of an epidural hematoma, although possible, is less likely due to the focal nature of this high-density area. chest/abdomen/pelvic ct: 1. bilateral pleural effusions, greater on the left than on the right. 2. marked cardiomegaly with biatrial enlargement, extensive atherosclerotic coronary artery calcifications, and pacemaker seen. 3. tortuous abdominal aorta with extensive atherosclerotic calcification, no evidence of aortic aneurysm. focal area of dilatation of the right common iliac artery. 4. multiple low-attenuation lesions within the liver, the largest of which is most likely a cyst. multiple smaller lesions are too small to be characterized. if the patient has a known malignancy, or risk factors for hepatocellular carcinoma, three-month followup with dedicated liver imaging is recommended. lower extremity us: no evidence of bilateral lower extremity deep venous thrombosis. eeg: markedly abnormal portable eeg due to the low voltage slow background with generalized bursts of slowing and background suppression and with multifocal areas of sharp wave discharges. these sharp waves were frequent on the left side early in the recording. the slow background and generalized phenomena suggest a widespread encephalopathy. there were also multifocal sharp waves seen frequently. these suggest multifocal cortical areas of dysfunction with potential epileptogenesis. infection is one possible cause but multifocal vascular disease is another. there were no prolonged discharges to suggest ongoing seizures, at least during the course of this recording. brief hospital course: 82yo woman with a history of stroke and dementia who presented with alteration in consciousness, exam notable for severe encephalopathy, intact brainstem reflexes, and bilateral lower extremity hyperreflexia with clonus. her history is very convincing for a fall with a seizure and resulting subdural hematoma. it is most likely that she had a seizure, either focal in her lower extremities or generalized, which caused the fall; the fall caused the subdural. her fever likely due to an underlying infection which may have precipitated the seizure, but she does have a source for a seizure given her prior stroke, and she has evidence for bilateral epileptiform discharges on her eeg. while the fever is unlikely secondary to a meningitis, lumbar puncture was unsuccessful and so she was treated empirically with ampicillin, vancomycin, and ceftriaxone for a fourteen day course. her altered consciousness was likely due to cns injury in a patient with a previous stroke and dementia. she was initially intubated for concern in the ed of inability to protect her airway. she was admitted to the icu. she was treated with dilantin for seizure prophylaxis. focal rhythmic jerking of her rle was seen on . eeg was performed and showed bilateral frequent epileptiform sharp and slow wave discharges over the left parietal temporal region and right temporal region (less commonly), but no seizures. coumadin was held given the hemorrhage, and sbp maintained below 150. she had a repeat head ct, which was stable. she was continued on ampicillin, ceftriaxone, and vancomycin. hsv was thought to be very low probability so the acyclovir started on admission was discontinued. she was extubated on and called out to the floor. once transferred to the floor, she had the following medical problems: 1) neuro: after transfer, she did not have clinical seizures but did have impaired alertness. an eeg was obtained, which was abnormal. she was continued on her dilantin. it was noticed that she was not moving all of her extremities well. the right sided weakness could be explained by the old left mca stroke; however, her left side was weak as well. a cervical spine ct was obtained, which showed a calcified mass at c2/c3 thought likely to be due to a hematoma. no intervention was performed. because there were some concerns that the fevers may be secondary to the dilantin, it was discontinued and she was started on keppra. a repeat eeg was 2) cv: her blood pressure medications were titrated to maintain normal bps. on a cxr on because of some symptoms of respiratory distress, there were concerns that there was a pericardial effusion; therefore, an echo was obtained which was showed no pericardial effusion and good ef. 3) id: because of concerns of meningitis, an lp was attempted initially but unsuccessful. she was started on vancomycin, ampicillin, and ceftriaxone for infectious coverage. patient had low grade temperatures and cxr was hazy; therefore, flagyl was started for possible aspiration pneumonia. she continued to have fevers with a mild leukocytosis and elevated esr and crp. because of her generalised edema, ultrasounds of her upper and lower extremities were obtained to look for dvt and found to be negative. infectious disease was consulted and recommended slowing discontinuing the antibiotics. her ampicillin, vancomycin, and ceftriaxone were dicontinued on . flagyle was discontinued on . as part of their recommendations, a torso ct was obtained, which was negative. on , she started having fevers again and was recultured. 4) fen/gi: patient had multiple electrolyte disturbances during her course incluing hypernatremia, hypokalemia, hypophosphatmemia. they were corrected based on her daily blood chemistries. patient received nutrition through an ng tube. she had an elevated bun/cr as well as edema in all her extremities with high input compared to output. internal medicine was consulted and recommended decreasing her free water intake as well as restarting her lasix. 5) pulm: there were some concerns of aspiration pneumonia that was treated with a course of flagyl. she remained on nasal cannula. 6) heme: patient was anemic and labs were consistent with iron deficiency anemia. since she also needed volume, she was transfused 2 units of prbcs. 7) psychosocial: updates were given to the family and they decided to make her dnr/dni. early morning around midnight, she had some - respirations and subsequently passed away. family has agreed to an autopsy. medications on admission: warfarin 2.5mg po daily lasix 80mg po daily vasotec 10mg po daily cochicine 10mg po daily lorazepam prn discharge medications: none discharge disposition: expired discharge diagnosis: subdural hemorrhage, clinical seizure, demential, previous stroke, s/p pacemaker placement, hypertension, gout discharge condition: expired discharge instructions: none followup instructions: none 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 transfusion of packed cells transfusion of other serum diagnoses: congestive heart failure, unspecified unspecified essential hypertension gout, unspecified other convulsions unspecified fall hypopotassemia pneumonitis due to inhalation of food or vomitus disorders of phosphorus metabolism iron deficiency anemia, unspecified cardiac pacemaker in situ hyperosmolality and/or hypernatremia unspecified late effects of cerebrovascular disease other specified paralytic syndrome subarachnoid hemorrhage following injury without mention of open intracranial wound, unspecified state of consciousness edema benign neoplasm of vertebral column, excluding sacrum and coccyx 

Answer: The patient is high likely exposed to