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: tetracycline attending: chief complaint: seizure major surgical or invasive procedure: intubation history of present illness: patient is a 63 yo woman with pmh of htn, dm, morbid obesity, hemorrhagic stroke 2 yrs ago, afib off coumadin who presents after episode of seizure vs. syncope with family. she and her husband are in town from ct visiting son and had just gone to a performance. following this they went to a restaurant to get a late night meal, and en route there noted her to be normal in the car. once they got to the restaurant, the patient ordered her meal correctly, but hortly thereafter was not making sense with her speech. this was around 11 pm. she was speaking actual words and was not dysarthric but her peech didn't make sense. they recall that one phrase was something about "ice cream" and much of her speech was about food. her son seemed to notice a slight facial droop around this time and pointed it out to the patient's husband. this non-sensical speech went on or about 45 minutes without any improvement and the patient seemed ompletely unconcerned about this. the son asked his father if this sort of behavior occured frequently with her. they tried asking her if she had a headache and once she said yes, and another time said o. then, suddenly, she threw her head and body back in the chair, onvulsed at the arms for seconds to a minute, and then fell to the left. her husband was able to break her fall and she did not strike her head. once on the ground she continued to convulse briefly and then stopped. at this point she was gurgling, and not moving. she was not speaking or following commands. . she did have a seizure in the context of her ich. her son noted an event over a year ago where on the phone she suddenly had non-sensical speech similar to today's. that event resolved spontaneously. . in the ed she was found to have persitent altered mental status and wasintubated for airway protection. she was evaluated by the neurology consult service who felt that the symptoms were concerning for left sided stroke. the evalution was notable for +ua for uti. a chest xray showed concern for widenen mediastinum which prompted a cta chest which was negative for dissection. a ct head was negative for hemorrhage or mass effect. no mri was obtained . pt was loaded with dilantin (1g iv x 1) although neuro suggested 1.5g. pt got pre and post ct hydration with bicarbonate. . ros: patient cannot offer past medical history: 1. hemorrhagic stroke 2 yrs ago. patient had headache and went to bed. woke confused and en route to hospital became aphasic. while there at the hospital coded according to husband and had to be intubated. he doesn't know it it was a cardiac vs. respiratory failure. following the stroke, she was noted to be slightly weaker right than left. 2. dm, recent diagnosis 3. morbid obesity 4. afib off coumadin 5. osa on cpap 6. depression 7. diastolic heart failure 8. hypertension social history: retired rn. remote tobacco. no etoh. lives with husband. family history: mother had in late life and lived to 92. physical exam: vs: t 98.6 bp 130/80 p 50 100% on ac 500x14, peep 5, fio2 60% gen: intubated and sedated heent: left eye echymosis. pupils 3-4 mm and equally reactive to light. thickened right cornea and injected sclera bilaterally r>l. mmm. neck: unable to assess for jvd given size of neck and intubation chest: ctab anteriorly without w/c cv: bradycardic and irregularly irregular, no m/r/g abd: obese, s/nd/hypoactive bowel sounds. no appreciable organomegaly ext: no c/c/e. pedal pulses 1+ and equal bilaterally skin: no rashes neuro: withdraws all four limbs to pain, shifts body with sternal rub. reflexes 2+ rue, 1+lue, 1+ le bilaterally. + gag reflex, brain-stem reflexes intact. with propofol weaned was interactive trying to speak over ventilator, moved all extremities to command pertinent results: urinalysis 21-50 whites, many bacteria, le, n neg . studies: cxr - apparent widening of the upper mediastinum. an aortic injury cannot be excluded. consider ct as indicated. enlarged cardiac silohuette with evidence of pulmonary edema as described. ett tube positioned low (1.3 cm above carina) . ct c-spine - cervical spondylosis with anterior osteophytes are most prominent at c5/6. no fracture or dislocation identified. . cta chest - no aortic dissection, huge cardiomegaly with coronary calcifications, rt pleural effusion, bronchial thickening with basilar consolidation versus atelectasis, some diffuse ground glass pattern. . mri/a head/neck: no evidence of hemorrhage, masses, mass effect, edema or midline shift. bilateral periventricular white matter demonstrates hyperintensity on flair and t2-weighted imaging suggestive of chronic microangiopathic ischemic disease. the sulci and the ventricles appear normal in caliber, configuration, and morphology. no hydrocephalus is noted. no diffusion abnormalities are noted. no areas of abnormal contrast enhancement are seen. bilateral sphenoid sinus demonstrates air-fluid levels suggestive of sinusitis. mucus retention cysts are noted in bilateral maxillary sinuses. the osseous, soft tissue structures and visualized portions of the orbits are unremarkable. . ekg afib with bradycardia (rate 49), normal axis, qtc 540. diffuse twi. . bedside eeg: this is an abnormal portable eeg in the waking and drowsy states due to intermittent mixed frequency slowing noted broadly over the right hemisphere suggesting an underlying area of subcortical dysfunction in that region. in addition, the background was mildly slowed and disorganized, consistent with a mild encephalopathy, suggesting bilateral subcortical or deep midline dysfunction. medications, metabolic disturbances, and infections are among the common causes of encephalopathy. there were no epileptiform features and no electrographic seizures were noted. . 04:07pm glucose-101 urea n-14 creat-1.0 sodium-136 potassium-2.8* chloride-99 total co2-26 anion gap-14 04:07pm calcium-8.5 phosphate-3.7 magnesium-1.8 brief hospital course: 69 year old woman with history of l-sided hemorrhagic stroke, dm2, atrial fibrillation, and obesity presenting with acute altered mental status. . #seizure: pt admitted with seizure in the setting of presumed . symptoms of aphasia/werneke's type speech make l-sided temporal likely with resultant seizure. the patient was intubated in the ed due to concern over airway protection and loaded with dilantin. mri without stroke. upon arrival to the icu she had full motor strength and was attempting to communicate over the ventilator which suggested against a large territory stroke. the patient had an mri on hd 2 which did not show stroke, and she was subsequently extubated. her dilantin was changed to keppra for ease of administration. because of her atrial fibrillation, the was presumed to be a result of not being anticoagulated. the patient was advised by the neurology team that she should be on coumadin but the patient declined and wanted to discuss this with her pcp first, she was started instead on a full dose aspirin. with regards to her seizure activity, this was felt to be or possibly due to her uti causing a lowered seizure threshold. she was started on dilantin, which was changed to keppra and she was treated with 3 days of augmentin. carotid ultrasound was without significant stenosis b/l. follow up scheduled with her primary neurologist dr. of to discuss course of keppra and to determine driving restrictions. . # cardiac: atrial fibrillation with mild bradycardia likely from atenolol. and after recovery from stroke, hr was stable in 60-80s on atenolol. she also ruled out for miwith 3x cardiac enzymes . # pulmonary - inititally, intubated for airway protection in setting of change in mental status. sucessfully extubated without complication. however, she did have desaturations to 88% while on nc 2-4l concerning for hypoventilation vs copd. chest ct abnormal with suggestion of possible pulmonary edema and atelectasis vs rll infiltrate. hypozia resolved with gentle diuresis though she does at times require low level of oxygen with aggressive physical therapy. she should have an outpatient chest ct in months to evaluate for resolution and may need work up for copd with pft's if she has persistent resting desaturations. . # diabetes mellitus - new dx previously treated with diet and exercise. continue insulin sliding scale with plan deferred to md regarding starting oral hypoglycemics. #osa: continue cpap at 12cm/h2o . # uti: may be responsible for seizure, fully treated with augmenting. # prophy - sq heparin, ppi # code - full medications on admission: atenolol 50 mg po daily fluoxetine 20mg po daily lasix 20mg po daily prilosec 20mg po daily lisinopril 5mg po daily simvastatin 20mg po daily folate 1g po daily kcl 10 meq po daily discharge disposition: extended care facility: montowese skilled nursing facility discharge diagnosis: seizure chf exacerbation discharge condition: stable discharge instructions: please continue physical therapy and be sure to follow up with your neurologist re: whether to start coumadin. return to er with seizure, weakness or other concerning symptoms. followup instructions: chest ct in months to ensure that infiltrates have resolved. please follow up with your primary neurologist dr. at 10:45am at the , , phone: (. if family wants to change appt to the office of dr. they cal call . md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube diagnoses: obstructive sleep apnea (adult)(pediatric) urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation other convulsions morbid obesity personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits hyperosmolality and/or hypernatremia unspecified transient cerebral ischemia chronic diastolic heart failure 

Answer: The patient is high likely exposed to