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: called by emergency department to evaluate ich major surgical or invasive procedure: none history of present illness: mr. is a 79-year-old right-handed man with a history of left cea on who presents with acute onset language impairment, found to have a left occipital hemorrhage. the history begins on the weekend before , about 3 weeks prior to this. he was at that time driving alone on the and went off the road. apparently, it's thought that he lost consciousness, causing him to lose control. when ems found him, he was awake, but reportedly "confused" and has no memory of the events for several hours after the event. based on this, he was apparently diagnosed with a tia. in the work-up for the tia, he was found to have 98% stenosis of his right carotid and at least 90% of the left. he underwent right cea shortly thereafter, and had a left cea performed on , both at . after this second cea he was doing well except for some constipation. this afternoon, he told his wife he was not feeling well (not further elaborated on) and went quickly to the bathroom. he apparently had a bowel movement, but was in the bathroom for a while. his wife called for him, but initially got no answer. he then flushed the toilet and came out of the bathroom on his own, but said nothing to his wife, only at her. his wife believes he did not understand what she was saying to him, as he was not doing as she asked. she led him to bed. she noted that he was "wobbling" back and forth, but did not run in to anything. she called her daughter, his doctor, and then ems. ems found his initial bp in the field to be 240/110. he was taken by ems to , where a head ct showed a hyperdensity in the left occipital lobe about 1 cm x 0.5 cm, surrounded by hypodensity. his maximum bp was 270/150, and he received 10 mg labetalol. he was seen by a neurologist, who noted right eye deviation and thought he was having a seizure, so the pt received dilantin 1.6 g iv. he developed "son respirations" and was intubated, receiving ativan 0.5 mg, etomidate 20 mg/succ 80 mg/lidocaine 100 mg/vecuronium 12 mg at , 2 mg versed, and 2 mg morphine. after administration of all this medication, his bp dropped into the 80s systolic, coming up when propofol was held for a few minutes. in our ed, he received propofol gtt and tylenol 650 mg pr for fever to 101.4. formal ros is not possible; per his wife, he was not complaining of anything other than constipation past medical history: motor vehicle accident ~ due to loc diagnosed with "tia" after losing consciousness while driving (no known focal features, so unclear what this diagnosis was based on) s/p right cea late s/p left cea htn dm2 gout report by family that he has a renal cyst(?) seen on torso ct at time of mva trauma work-up. social history: former smoker but quit many years ago. no etoh use. former jewelry salesman. family history: nc physical exam: vitals: t: 99.3 (101.4 max) p: 91 r: 16 bp: 157/80 (83/50-175/93) sao2: 100% ac general: intubated, off propofol for 10 minutes. heent: anicteric. surgical wound on left neck with surrounding edema and erythema, tense to palpation. pulmonary: lungs cta bilaterally without r/r/w cardiac: rrr, 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 pulses bilaterally. neurologic: -mental status: opens eyes to voice, follows one-step commands, but grossly inattentive, requiring frequent stimulation. -cranial nerves: i: olfaction not tested. ii: perrl 2 to 1.5mm. appears not to blink to threat. iii, iv, vi: eomi without nystagmus. v: not tested. vii: no facial droop, facial musculature symmetric. viii: hearing intact to voice. ix, x: intubated, gag intact. : not tested. xii: not tested. -motor: normal bulk throughout. slightly spastic tone in b les. does not cooperate with fst but moves all extremities antigravity with apparently equal vigor. -sensory: withdraws from light touch in all 4 ext. -dtrs: tri pat ach l 2 1 1 1 0 r 2 1 1 1 0 plantar response was flexor bilaterally. -coordination & gait: could not be tested due to patient's somnolence. pertinent results: 07:39am glucose-211* urea n-23* creat-1.2 sodium-142 potassium-3.7 chloride-99 total co2-33* anion gap-14 07:39am ck(cpk)-64 07:39am ck-mb-notdone ctropnt-0.11* 07:39am calcium-9.1 phosphate-4.3 magnesium-1.9 cholest-162 07:39am %hba1c-6.3* 07:39am triglycer-160* hdl chol-42 chol/hdl-3.9 ldl(calc)-88 07:39am osmolal-300 07:39am phenytoin-4.8* 07:39am wbc-10.5 rbc-3.35* hgb-11.4* hct-30.8* mcv-92 mch-34.1* mchc-37.0* rdw-13.5 07:39am plt count-256 10:46pm glucose-187* urea n-21* creat-1.4* sodium-137 potassium-4.3 chloride-96 total co2-31 anion gap-14 10:46pm estgfr-using this 10:46pm ck(cpk)-72 10:46pm ck-mb-notdone ctropnt-0.17* 10:46pm calcium-9.3 phosphate-4.6* magnesium-2.0 10:17pm type-art rates-/16 tidal vol-500 peep-5 o2-100 po2-445* pco2-47* ph-7.41 total co2-31* base xs-4 aado2-244 req o2-47 -assist/con intubated-intubated 09:05pm urine hours-random 09:05pm urine gr hold-hold 09:05pm wbc-13.0* rbc-3.72* hgb-12.7* hct-34.8* mcv-94 mch-34.3* mchc-36.6* rdw-13.6 09:05pm neuts-89.6* lymphs-6.3* monos-3.3 eos-0.7 basos-0.2 09:05pm plt count-250 09:05pm pt-12.8 ptt-21.4* inr(pt)-1.1 09:05pm urine color-yellow appear-clear sp -1.010 09:05pm urine blood-mod nitrite-neg protein-100 glucose-neg ketone-15 bilirubin-neg urobilngn-0.2 ph-6.0 leuk-neg 09:05pm urine rbc-* wbc-0-2 bacteria-rare yeast-none epi-0-2 mri brain with and without contrast: markedly motion degraded study. subacute hematoma in the left occipital lobe with mild leptomeningeal enhancement which may reflect hyperemia secondary to subacute hematoma. no convincing underlying mass lesion is noted; however, recommend followup imaging after resolution of acute blood products for better assessment. cta head with and without contrast: no convincing evidence for an avm. there is very slight hyperemia in the region of the prior hemorrhage. recommend attention on followup imaging. irregularity and diminutive appearance of the basilar artery may reflect a combination of atherosclerotic disease and fetal type pca distribution on the left. echo: the left atrium and right atrium are normal in cavity size. left ventricular wall thickness, cavity size, and global systolic function are normal (lvef>55%). due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis. trace aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. the pulmonary artery systolic pressure could not be determined. there is a very small inferolateral pericardial effusion without evidence for hemodynamic compromise. impression: suboptimal image quality. normal biventricular cavity sizes with preserved global biventricular systolic function. eeg: this is an abnormal routine eeg due to the presence of diffusely slow background and periodic left temporal sharp activity. there was also an electrographic seizure seen broadly over the left hemisphere with no associated clinical correlate. nchct: there is a small focus of intraparenchymal hemorrhage in the left occipital lobe adjacent to an area of edema involving the posterior watershed of the left cerebrum. compared to the earlier study, the involved area of predominantly vasogenic edema is less well defined and less extensive. the findings do suggest a hypoperfusion pattern considering the distribution and given history of recent carotid endarterectomy. therefore the small focus of hemorrhage must be presumably hemorrhagic conversion. mri with diffusion-weighted sequence is recommended to assess for elements of acute ischemia. ekg: sinus rhythm. non-specific st-t wave changes. no previous tracing available for comparison. intervals axes rate pr qrs qt/qtc p qrs t 93 172 94 360/417 66 -29 44 brief hospital course: mr. is a 79-year-old right-handed man with a history of left cea on who presented with acute onset language impairment, found to have a left occipital hemorrhage. his exam neurological exam was non focal. the hemorrhage was most likely due to a hyperperfusion syndrome conversion although an an underlying mass can not be ruled out. given the recent cea, a hyperperfusion syndrome is indeed most likely (patient was also found to have a fetal pca on head cta). patient was intubated in icu for a few days. because of his fever on admission and change in behavior, he was treated empirically with acyclovir. because there was a history suggestive of a seizure at the osh and here eeg showed diffusely slow background and periodic left temporal sharp activity, patient was loaded with dilantin and had levels checked regularly. he will need to have his dilantin level followed-up as outpatient. when extubated and transferred to the wards, patient was agitated, requiring olanzapine. his mental status improved over time, being alert and oriented to time and place upon discharge. he is also being treated for hospital acquired pneumonia with vancomycin and ceftriaxone (he will need another week of antibiotics to complete 14 day-course). medications on admission: asa 81 mg po daily lisinopril 40 mg po daily metformin 1000 mg po daily allopurinol 100 mg po daily amlodipine 2.5 mg po daily janumet 50-500 mg po qpm discharge medications: 1. dilantin extended 100 mg capsule sig: two (2) capsule po three times a day: you should have your levels checked with pcp . disp:*180 capsule(s)* refills:*2* 2. lisinopril 40 mg tablet sig: one (1) tablet po once a day. tablet(s) 3. metformin 1,000 mg tablet sig: one (1) tablet po once a day. 4. amlodipine 2.5 mg tablet sig: one (1) tablet po daily (daily). 5. vancomycin 1,000 mg recon soln sig: one (1) intravenous every twelve (12) hours for 7 days. 6. ceftriaxone 1 gram piggyback sig: one (1) intravenous once a day for 7 days. 7. janumet 50-500 mg tablet sig: one (1) tablet po qpm. 8. allopurinol 100 mg tablet sig: one (1) tablet po once a day. 9. haldol 5 mg/ml solution sig: 0.5 mg injection qpm mrx1 as needed for sundowning, agitation. 10. acetaminophen 325 mg tablet sig: 1-2 tablets po every six (6) hours as needed for fever or pain. 11. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 12. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 13. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). discharge disposition: extended care facility: - discharge diagnosis: - small left occipital intracranial hemorrhage; probably due to hyperperfusion - left lower lobe pneumonia - abnormal electroencephalogram discharge condition: stable discharge instructions: you were transferred to this hospital with confusion, difficulty speaking. you had recently undergone a left carotid endarterectomy your head ct showed a small left occipital intracranial hemorrhage thought to be due to hyperfusion syndrome. you are being treated with a 2 week course of iv vancomycin and ceftriaxone for a retrocardiac opacity and presumed hospital acquired pneumonia. you are also on dilantin due to left temporal spikes and an electrographic seizure seen on long term monitoring by electroencephlogram. you should continued on dilantin until your follow-up in clinic. you should follow-up in clinic. further brain imaging may be necessary. you should have your dilantin level checked with your pcp (level goal ). please take medications as prescribed. please keep your follow-up appointments. if you have any worsening or worrying symptoms, please contact your pcp or return to the emergency room. followup instructions: pcp: , m.d. phone: please follow-up with your pcp 1-2 weeks of discharge. neurology: , m.d. ( clinic) phone: date/time: 1:30 md, procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours arterial catheterization diagnoses: pneumonia, organism unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled gout, unspecified other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits other postprocedural status aphasia hematuria, unspecified unspecified intracranial hemorrhage central nervous system complication nonspecific abnormal electroencephalogram [eeg] 

Answer: The patient is high likely exposed to