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: no known allergies / adverse drug reactions attending: chief complaint: headache major surgical or invasive procedure: right craniotomy for sdh redo right craniotomy for sdh history of present illness: this is a 71 year old man who presents with approx 1 month of left sided weakness and speech difficulty. this worsened gradually, and initially he felt that it may have just been his neuropathy acting up. he has also been feeling some headaches, which he describes as bifrontal headaches which were helped with motrin. a few days before presentation, his daughter noted that his left arm was becoming clumsy while turning of the lamp or while using a spoon. he also noted that his left leg while dressing. he denied a history of trauma to his head. past medical history: pituitary tumor s/p resection, dmii, neuropathy, obesity s/p gastric bypass surgery, melanoma removal from face and osa social history: he lives with his wife, nonsmoker, no etoh, 3 kids family history: non-contributory physical exam: on admission: gen: wd/wn, comfortable, nad. heent: scar from melanoma rsxn left face pupils: eoms full, no nystagmus neck: supple. extrem: warm and well-perfused. neuro: mental status: awake and alert, cooperative with exam, normal affect. orientation: oriented to person, place, and date. recall: objects at 5 minutes. language: speech fluent with good comprehension and repetition. naming intact. slight dysarthria, no paraphasic errors. cranial nerves: i: not tested ii: pupils equally round and reactive to light, 4to2 mm bilaterally. visual fields are full to confrontation. iii, iv, vi: extraocular movements intact bilaterally without nystagmus. v, vii: facial strength and sensation intact and symmetric. viii: hearing intact to voice. ix, x: palatal elevation symmetrical. : sternocleidomastoid and trapezius normal bilaterally. xii: tongue midline without fasciculations. motor: normal bulk and tone bilaterally. no abnormal movements, tremors. strength full power except 4+/5 left deltoid and ip. no pronator drift sensation: intact to light touch bilaterally. toes downgoing bilaterally handedness: right at discharge: pertinent results: ct head- impression: complex heterogeneous right subdural collection suggestive of mostly subacute subdural hematoma with areas of hyperdensity which may indicate more acute component. right-to-left subfalcine herniation. 9 mm rightward shift of septum pellucidum. cxr ap and lateral views of the chest demonstrate clear lungs without effusion or pneumothorax. the heart size is normal. the mediastinal contours are unremarkable. impression: normal chest. ct head post-surgical changes from recent right frontoparietal craniotomy with right-sided drainage catheter in the surgical bed. the degree of subfalcine herniation, sulcal effacement and local mass effect appears slightly improved compared to most recent examination. cxr in comparison with the study of , there has been placement of an endotracheal tube with its tip approximately 5.5 cm above the carina. nasogastric tube tip appears to extend only to the upper portion of the stomach with the side hole within the lower esophagus. low lung volumes may account for some of the prominence of the transverse diameter of the heart. ct head slight increase in size of previously noted acute subdural hematoma, no change in midline shift. ct head no change when compared to previous scan on lenis - negative for dvt. ct head (post op) 1. decreased size of right subdural hematoma with decreased mass effect. 2. new subarachnoid hemorrhage in the right sylvian fissure and right frontal sulci. ct head slight increase in right frontal wedge-shaped hypodensity with mild increase in size likely related to evolution without a significant increase in mass effect. decrease in the previously noted right sided subdural fluid collection with dense foci. no new hemorrhage. carotid us no evidence of significant carotid artery stenosis bilaterally. echocardiogram the left atrium is normal in size. the right atrium is markedly dilated. 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 ascending aorta is mildly dilated. the aortic valve leaflets (3) are mildly thickened. there is a minimally increased peak transvalvular velocity consistent with minimal aortic valve stenosis. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. there is no pericardial effusion. impression: no cardiac source of embolism identified. preserved global and regional biventricular systolic function. minimal aortic valve stenosis. compared with the prior study dated (images unavailable for review), minimal aortic valve stenosis is appreciated. brief hospital course: on mr. was admitted to the neuro icu and started on keppra for seizure prophylaxsis. he remained stable neurologically and radiologically and was cleared for transfer to the floor on . surgery was scheduled for for craniotomy and evacuation of hematoma. preop and consent were obtained. he proceeded to the or on for a right craniotomy for subdural evacuation. a jp drain was left in place. he remained intubated post-op and he went to ct for a scan that showed some acute blood. he has left sided weakness. he was transfered to the nicu. on , he was extubated and his strength was slowly improving. ct head showed a small amount of acute blood and he was given platelets. in total he received 2 units of platelets and his platelet count remained above 100k. a repeat ct head on showed no change when compared to previous scan. his subdural drain remained in place and was removed in the late afternoon. he was transferred to a step-down bed from the sicu that evening. the morning of the patient had a repeat head ct demonstrating no change in right frontoparietal hyperdensity and no new hemorrhage. the patient mental status waxed and waned over the course of the day. patient failed speech and swallow and it was recommended to keep the patient npo. ng tube was placed in order to get medications and nutrition. on lenis was obtained to rule out dvt which was essentially negative. a repeat head ct showed slight increase in right frontoparietal collection. as a result, a brain mri stroke protocol was obtained as he had not improved neurologically which demonstrated no brainstem hemorrhage. mri head demonstrated the right frontoparietal subdural and subarachnoid hemorrhage with mass effect and midline shift which are unchanged as compared to the prior ct scan. he was taken to the or on for a redo right craniotomy for sdh evacuation. a post-op ct showed improvement with a decreased size of right subdural hematoma with decreased mass effect and a new subarachnoid hemorrhage in the right sylvian fissure and right frontal sulci. the patient was taken to sicu-b after surgery intubated. he remained intubated in the morning with reported seizure activity (right arm and right downward gaze fixation) treated with increased keppra and continuous eeg. the patient was also pan cultured for fever. a ct-scan was re-ordered demonstrating a right frontal infarct. dilantin was added to seizure prophylaxis. vancomycin, tobramycin, and cefepime were added after bronch cx returned positive for gram positive rods and cocci and gram negative rods. urine cultures returned positive for enterococcus. the patient remained intubated with no change in neuro exam overnight. patient continued to have febrile temperatures overnight. the morning of , the patient continued to have seizure episodes. neuroepilepsy was consulted for seizure work-up and recommendations, endocrine service was consulted for work-up of endocrine issues and recommendations, and a repeat head ct was ordered. patient was overnight without seizures and afebrile throughout . urine cultures and bronchalveolar lavage cultures returned with antibiotic sensitivities; antibiotics were tailored as per sensitivity testing. the patient continued to progress in his physical exam with increased movement in his right upper and lower extremit, minimal movement of left upper extremity and withdrawal to pain on left lower extremity, following commands, and opening his eyes to voice. the plan was to begin considering possible extubation. on , the patient continued in the surgical intensive care unit. the ventilator was weaned and the patient was extubated. the patient was weak, but opened his eyes to voice and was oriented to person place and time. the patient was able to move all four extremities antigravity to command. the patient moves the left arm and leg after a delay. the left side is weakner than the right. the patient had a bowel movement. on pt was doing well. he was aox3 and was more interactive with staff and family. he was transferred to the sdu in stable condition. his abx were narrowed to cefepime and the plan was to continue for a total fo 14 days. on a carotid us was done per neuro-vascular service and there was no significant stenosis. he was changed to floor status. on his calcium was repleted. he was neurologically stable. cefepime was changed to bactrim for oral therapy. iv meds were discontinued. he was approved for pt. central line was discontinued. patient taking oral intake without issues. overnight, the patient had no complaints. patient did take out dobbhoff tube despite restraints. his echo was without source of embolus. on the patient was without complaints. his neurologic exam was stable and strength in left upper and lower extremities progressed. patient's restraints were discontinued. lasix were given for signs of fluid overload in lower extremities. his staple were removed in routine fashion. now dod, he is afebrile, vss, and he himproved neurologically. he is tolerating an oral diet without issues. he was evaluated by pt/ot/speech who recommended rehab. on , he was stable for discharge to rehab and will f/u accordingly. medications on admission: bromocritine/clobentasol/lasix40'/hydrocortisone /levothyroxine/testosterone/vit d/multivitamin discharge medications: 1. bromocriptine 2.5 mg tablet sig: 0.5 tablet po daily (daily). 2. clotrimazole 1 % cream sig: one (1) appl topical daily (daily). 3. testosterone cypionate 200 mg/ml oil sig: one (1) intramuscular q2wk (). 4. cholecalciferol (vitamin d3) 1,000 unit tablet sig: one (1) tablet po daily (daily). 5. multivitamin tablet sig: one (1) tablet po daily (daily). 6. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 7. levothyroxine 100 mcg tablet sig: two (2) tablet po daily (daily). 8. codeine sulfate 30 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain, ha. 9. senna 8.8 mg/5 ml syrup sig: one (1) tablet po bid (2 times a day) as needed for constipation. 10. levetiracetam 100 mg/ml solution sig: 1000 (1000) mg po bid (2 times a day). 11. phenytoin 125 mg/5 ml suspension sig: one y (150) mg po q8h (every 8 hours). 12. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical (2 times a day) as needed for pruritis. 13. hydrocortisone 20 mg tablet sig: one (1) tablet po qam (once a day (in the morning)). 14. hydrocortisone 20 mg tablet sig: 0.5 tablet po qpm (once a day (in the evening)). 15. olanzapine 5 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po qhs (once a day (at bedtime)). 16. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 17. sulfamethoxazole-trimethoprim 800-160 mg tablet sig: one (1) tablet po bid (2 times a day): cont until . 18. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for fever, pain. discharge disposition: extended care facility: - discharge diagnosis: subdural hematoma obstructive sleep apnea pituitary insufficiency thrombocytopenia recurrent sdh anemia right frontal infarct post-op fever seizures malnutrition dysphagia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: general instructions ?????? have a friend/family member check your incision daily for signs of infection. ?????? take your pain medicine as prescribed. ?????? exercise should be limited to walking; no lifting, straining, or excessive bending. ?????? you may wash your hair only after sutures and/or staples have been removed. ?????? you may shower before this time using a shower cap to cover your head. ?????? increase your intake of fluids and fiber, as narcotic pain medicine can cause constipation. we generally recommend taking an over the counter stool softener, such as docusate (colace) while taking narcotic pain medication. ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, and ibuprofen etc. ?????? if you were on a medication such as coumadin (warfarin), or plavix (clopidogrel), or aspirin, prior to your injury, you may safely resume taking this after follow up with us ??????you have been discharged on keppra (levetiracetam), you will not require blood work monitoring. ?????? clearance to drive and return to work will be addressed at your post-operative office visit. ?????? make sure to continue to use your incentive spirometer while at home, unless you have been instructed not to. followup instructions: follow-up appointment instructions ??????please call ( to schedule an appointment with dr. , to be seen in 4 weeks. ??????you will need a ct scan of the brain without contrast. md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours incision of cerebral meninges incision of cerebral meninges enteral infusion of concentrated nutritional substances arterial catheterization closed [endoscopic] biopsy of bronchus central venous catheter placement with guidance diagnoses: obstructive sleep apnea (adult)(pediatric) anemia, unspecified urinary tract infection, site not specified unspecified protein-calorie malnutrition other convulsions unspecified fall diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes subarachnoid hemorrhage other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] ventilator associated pneumonia subdural hemorrhage following injury without mention of open intracranial wound, with no loss of consciousness personal history of malignant melanoma of skin hemiplegia, unspecified, affecting unspecified side legal blindness, as defined in u.s.a. other specified bacterial infections in conditions classified elsewhere and of unspecified site, other specified bacteria diabetes insipidus iatrogenic cerebrovascular infarction or hemorrhage other testicular hypofunction bariatric surgery status panhypopituitarism dysphagia, unspecified other facial nerve disorders 

Answer: The patient is high likely exposed to