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: ich major surgical or invasive procedure: bronchoscopy x2 tracheostomy peg tube placement history of present illness: the pt is a 72 year-old right-handed woman with a history of hypertension who presented as a transfer from an osh with an ich. . the pt was unable to offer a history at the time of my encounter. therefore, the following history is per the medical record and the pt's husband. . the pt had been otherwise in her usual state of health and was without complaint until approximately 7:30pm on the evening prior to transfer. at that time, she finished her dinner and told her husband that her left leg felt "numb." he noticed that she had some difficulty walking, but was able to do so and went to rest on the couch in their living room. when her husband went back to check on her at around 9pm, he noticed that she had a left facial droop and was slurring her words. he intended to bring her to a local ed, but the pt was initially reluctant. he subsequently called 911 and she was taken to an osh. . at the osh, she was noted to have a flaccid hemiparesis on the left. she underwent a ct scan which showed a right putaminal hemorrhage. reportedly, she became progressively somnolent and was intubated for airway protection (received etomidate, succinylcholine, lidocaine for intubation at 2330). she was subsequently given 4mg of ativan (at 2327 and 2348) and 1g of iv dilantin (at 2330)- no convulsive activity documented. she was also given 15mg of iv labetalol at the osh for bp of 168/108 on arrival. no subsequent vital signs documented. per the ed resident, the pt was given an indeterminate amount of iv ativan en route from the osh (no ems report could be found). . the pt was unable to offer a review of systems. past medical history: -hypertension -hyperlipidemia social history: retired but worked in business, mostly for non-profit organizations. no history of tobacco or illicit drug use. occasional alcohol use. family history: notable for mother with cad. physical exam: vitals: t: 98f p: 50 r: 16 bp: 88/48 sao2: 100% on cmv with fio2 100% general: intubated, lying in bed with eyes closed. heent: nc/at, no scleral icterus noted, mmm, no lesions noted in oropharynx neck: no nuchal rigidity pulmonary: lungs cta bilaterally without r/r/w cardiac: bradycardic, rr, nl. s1s2, no m/r/g noted abdomen: soft, nt/nd, normoactive bowel sounds, no masses or organomegaly noted. extremities: no c/c/e bilaterally, 2+ radial, dp and pt pulses bilaterally. skin: no rashes or lesions noted. . neurologic (at 0100): -mental status: does not respond to verbal command or noxious stimuli. no verbal output. . -cranial nerves: perrl 1.5mm and sluggishly reactive bilaterally. funduscopic exam technically limited due to pupil size. right exotropia (old per husband). eom absent to oculocephalic maneuver. corneal reflex weak bilaterally. no overt facial asymmetry although et tube in place. gag and cough reflex intact. . -motor: normal bulk throughout. tone flaccid throughout. does not withdraw to noxious stimuli in any of the four extremities. no adventitious movements noted. . -sensory: no response to noxious stimuli in all four extremities. . -dtrs: tri pat ach l 1 1 1 1 0 r 2 2 2 1 0 . plantar response was extensor bilaterally. pertinent results: 07:30pm type-art po2-146* pco2-34* ph-7.39 total co2-21 base xs--3 07:30pm lactate-1.8 07:30pm freeca-1.06* 04:54am type-art po2-127* pco2-44 ph-7.35 total co2-25 base xs--1 04:54am lactate-1.9 04:54am freeca-1.07* 04:54am urine color-yellow appear-clear sp -1.015 04:54am urine blood-neg nitrite-neg protein-neg glucose-1000 ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 04:45am glucose-328* urea n-19 creat-0.7 sodium-140 potassium-3.7 chloride-108 total co2-22 anion gap-14 04:45am alt(sgpt)-28 ast(sgot)-23 ld(ldh)-205 ck(cpk)-143* alk phos-67 amylase-51 tot bili-0.6 04:45am lipase-35 04:45am ck-mb-4 ctropnt-<0.01 04:45am albumin-3.5 calcium-7.6* phosphate-3.3 magnesium-1.8 cholest-139 04:45am vit b12-421 folate-15.0 04:45am triglycer-101 hdl chol-61 chol/hdl-2.3 ldl(calc)-58 04:45am tsh-3.5 04:45am phenytoin-10.9 04:45am wbc-13.7*# rbc-3.52* hgb-11.1* hct-32.4* mcv-92 mch-31.6 mchc-34.3 rdw-13.2 04:45am plt count-198 04:45am pt-11.2 ptt-25.6 inr(pt)-0.9 01:04am type-art temp-35.6 rates-20/ tidal vol-450 po2-271* pco2-38 ph-7.42 total co2-25 base xs-0 -assist/con intubated-intubated 12:55am glucose-212* urea n-18 creat-0.6 sodium-141 potassium-3.9 chloride-110* total co2-19* anion gap-16 12:55am wbc-9.0 rbc-3.26* hgb-10.6* hct-30.0* mcv-92 mch-32.5* mchc-35.3* rdw-13.3 12:55am neuts-80.0* bands-0 lymphs-16.0* monos-2.3 eos-1.3 basos-0.4 12:55am hypochrom-normal anisocyt-normal poikilocy-normal macrocyt-1+ microcyt-normal polychrom-normal 12:55am plt smr-normal plt count-193 12:55am pt-13.4* ptt-23.5 inr(pt)-1.2* . . radiologic data mr contrast gadolin 1:27 pm impression: 1. right putaminal hemorrhage without underlying mass, with imaging features strongly favoring a hypertensive etiology. 2. patent circle of and major tributaries. . ct head w/o contrast 12:54 am findings: there is a 4.3 x 4.0 x 2.1 cm parenchymal hemorrhage involving the right putamen and subinsular white matter. noted is a dependent blood-fluid level, dorsally. there is no significant associated shift of normally midline structures. the ventricles appear normal in size and are symmetric. no hemorrhage is identified within the basal cisterns or ventricles. there is no evidence of hydrocephalus. osseous and soft tissue structures are unremarkable. there is fluid within the right maxillary sinus. the orbits are unremarkable. impression: 4.3 x 4.0 x 2.1 cm parenchymal hemorrhage involving the right putamen and subinsular white mater. this is a typical location for hypertensive bleed. . chest (single view) 12:52 am impression: endotracheal and nasogastric tubes in appropriate position. retrocardiac opacity concerning for pneumonia. . eeg impression: abnormal eeg, due to a markedly reduced voltage record with some rare alpha activity biposteriorly in most delayed portions of the record. the precentral beta represents an ativan effect related to medication administered earlier to the patient. the record overall suggests a mild to moderate encephalopathy with excessive drowsiness and slowed and poorly sustained posterior background rhythm's. . ct head w/o contrast 3:41 pm conclusion: no change in the appearance of the brain since . right putaminal hemorrhage with surrounding edema. no evidence of new hemorrhage. . cxr :left subclavian vein catheter and tracheostomy tube appear unchanged in position. there is a left retrocardiac opacity, which appears stable and may represent atelectasis and/or consolidation. there are atelectatic changes at the right lung base. there probably is a small pleural effusion on the left. . cxr : the endotracheal tube and ng tube remain in satisfactory position. there are relatively low lung volumes. there is persistent left lower lobe opacity, which could reflect aspiration or pneumonia. there is also persistent left-sided effusion. no other significant changes are identified. brief hospital course: patient was admitted to the neuro icu, sedated, intubated, and with a diagnosis of r putaminal hemorrhage. differential diagnosis included hypertensive or amyloid hemorrhage, avm rupture or intratumoral bleed. she underwent a head mri which showed a stable hemorrhage and no underlying mass, strongly favoring a hypertensive etiology for the hemorrhage due to its typical location. an eeg suggested mild to moderate encephalopathy with excessive drowsiness and slowed and poorly sustained posterior background rhythm's but no epileptiform activity. her treatment was focused on strict bp control (<140) and seizure prophylaxis. on hospitalization day (hd) 2, patient was still stuporous, likely due to medication effect; a repeat head ct confirmed the hemorrhage was stable. plan was to wean her from the respirator towards extubation, despite a retrocardiac opacification concerning for pneumonia as seen on cxr and treated with levofloxacin (sputum cx : strep. pneumoniae; bld cs: neg.) on hd 3, patient was extubated, but failed to breathe on her own successfully. she continued her levofloxacin for a 7 day course. she had a bronchoscopy performed and there was a concern for possible airway collapse due to tracheomalacia. the interventional pulmonary service saw the patient and repeated a bronchoscopy. they determined that tracheomalacia was not playing a role in her difficulty being extubated. she had 2 more attempts at extubation and failed each time. at this point, the decision was made to place a tracheostomy tube and peg tube. this went well without complication. she was quickly weaned from the vent to a trach mask, but contineud to require frequent suctioning. she then developed a fever and wbc ct elevation again. she had another sputum culture which grew gpcs, so she was started on vancomycin due to concerns that this may be mrsa. she defervesed and her wbc count began to trend down. repeat cxrs showed stable left retrocardiac opacity. she will continue on vancomycin at rehab for 1 week. she was initially loaded with dilantin but developed no evidence of seizure. she was therefore stopped after 10 days of this medication. the patient's mental status had improved significantly after 4-5 days in the hospital. by the time of her tracheostomy, she was wide awake, off sedation, following commands and answering questions/writing well. imaging throughout of her head showed a stable hemorrhage. her exam remained unchanged as well, with good use of her right side, but no use of left side(other than minimal use of her toes and ankle). her arm is not moving at all. she is able to look to the left with left eye, but right eye has old exotropia and does not cross easily to left. on discharge, the patient's lasix dose was halved due to dehydration. this may need to be increased at if she has trouble with fluid overload. medications on admission: -triamterene-hctz -lipitor 10mg po daily discharge medications: 1. artificial tear with lanolin 0.1-0.1 % ointment sig: one (1) appl ophthalmic prn (as needed) as needed for dry eyes. 2. heparin (porcine) 5,000 unit/ml solution sig: one (1) ml injection tid (3 times a day). 3. lansoprazole 30 mg susp,delayed release for recon sig: thirty (30) mg po daily (daily). 4. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po bid (2 times a day): hold for sbp<100, hr<55 . 5. acetaminophen 160 mg/5 ml solution sig: 320-640 mg po q4-6h (every 4 to 6 hours) as needed. 6. albuterol sulfate 0.083 % solution sig: one (1) inhalation q6h (every 6 hours). 7. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 8. docusate sodium 150 mg/15 ml liquid sig: one (1) po bid (2 times a day) as needed. 9. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po bid (2 times a day) as needed. 10. bismuth subg-balsam-znox-resor suppository sig: one (1) suppository rectal prn (as needed). 11. pramoxine-mineral oil-zinc 1-12.5 % ointment sig: one (1) appl rectal prn (as needed). 12. medication insulin sliding scale as per nurse's spread sheet; 13. insulin nph-regular human rec 100 unit/ml (70-30) suspension sig: twenty eight (28) u subcutaneous twice a day: before breakfast and before dinner!. 14. vancomycin 1,000 mg recon soln sig: one (1) intravenous twice a day for 7 days. 15. lasix 20 mg tablet sig: one (1) tablet po once a day. 16. percocet 5-325 mg tablet sig: one (1) tablet po every hours as needed for pain. discharge disposition: extended care facility: & rehab center - discharge diagnosis: ich discharge condition: stable. pt not moving left arm or leg(except for toes). she is not speaking due to tracheostomy. she is otherwise answering questions and following commands. discharge instructions: please tell the staff at if you have any new fever, headache, new weakness, numbness, or tingling, falls, dizziness, or lightheadedness. followup instructions: please follow-up as the doctors arrange for you with your pcp. ----- you can follow-up in the neurology clinic with dr and dr as the staff at rehab arrange. they should call for an appointment for 1 month after your discharge. md, procedure: venous catheterization, not elsewhere classified fiber-optic bronchoscopy enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] other intubation of respiratory tract temporary tracheostomy diagnoses: unspecified essential hypertension intracerebral hemorrhage pulmonary collapse other and unspecified hyperlipidemia acute respiratory failure late effects of cerebrovascular disease, hemiplegia affecting unspecified side pneumococcal pneumonia [streptococcus pneumoniae pneumonia] dehydration 

Answer: The patient is high likely exposed to