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: right arm weakness, slurred speech major surgical or invasive procedure: none history of present illness: patient is an 84 year old female nursing home resident with pmh of dvt , htn, gerd, dermatitis. she awoke this morning at 0540 with right arm weakness, slurred and inappropriate speech and bladder/bowel incontinence. she was noted to have said "i think i'm having a stroke". there was no associated fall or trauma. was reportedly aphasic and weak in the right upper extremity initially, but these deficits resolved at some point as noted in the osh records. en route, she reportedly desaturated to 88%, was put on face mask and improved, but required cpr for some reason. it is not known at this time if she was receiving cpr for cardiac arrest or respiratory arrest. . ct at osh showed intracranial hemorhhage. inr was found to be 6.4 (takes coumadin for h/o dvt this year). she was given ffp and transferred. . she was electively intubated at the osh () and arrived here to intubated but not sedated. on initial evaluation by neurology er resident, she was noted to be unresponsive, moving all four extremities spontaneously (l>r), with brain-stem reflexes intact and withdrawing x4 to pain. repeat inr here at at 0830 showed inr of 3.2. patient was given 2 vials of proplex. 3rd inr is pending at this time. . past medical history: dvt , htn, gerd, bipolar, dementia, chronic bladder issues, oa, b/l knee pain with partial knee replacement in past. dermatitis. undocumented, but according to son, has history of "golf-ball sized" meningioma in the left part of brain. was seen by a neurosurgeon last year who did not want to operate. history from chart and partially from son who is unclear on some details of pmh. social history: nh resident. son lives nearby. otherwise unknown. family history: unknown physical exam: t-97.3 bp-118/78 hr-72 rr-12 (vented) o2sat: 100% gen: lying in bed, intubated, vented, sedated. no spontaneous movements. left arm slightly more flexed at elbow than right. no posturing. heent: nc/at, moist oral mucosa. neck: in c-spine hard collar. cv: distant heart sounds. rrr, nl s1 and s2, no murmurs/gallops/rubs lung: slight ronchi bilaterally. no crackels/wheezes. abd: +bs soft, nontender. ext: no edema. no lesions. neurologic examination: mental status: intubated. off propofol, exam shows no response to voice commands. withdraws all four extremities to pain (left greater than right) but no localization of pain. no spontaneous movements. perrla 2-->1 bilaterally. dolls eyes difficult to assess as in hard collar. corneal reflexes present bilaterally. tone moderately rigid in bilateral upper extremities. reflexes 2+ at brachrad/biceps/triceps/patella. plantar response extensor on right, mute on left. . no adventitious movements. . pertinent results: admission labs: 08:30am urine rbc-0-2 wbc-21-50* bacteria-many yeast-none epi- renal epi-0-2 urine hyaline-0-2 08:30am urine blood-sm nitrite-pos protein-tr glucose-neg ketone-150 bilirubin-neg urobilngn-neg ph-6.5 leuk-mod 08:30am urine color-yellow appear-hazy sp -1.018 08:30am pt-30.5* ptt-33.8 inr(pt)-3.2* 08:30am hypochrom-1+ anisocyt-normal poikilocy-normal macrocyt-normal microcyt-normal polychrom-normal 08:30am neuts-84* bands-7* lymphs-6* monos-3 eos-0 basos-0 atyps-0 metas-0 myelos-0 08:30am wbc-14.5* rbc-3.82*# hgb-12.3# hct-33.8*# mcv-88# mch-32.2* mchc-36.5* rdw-13.7 plt count-276 08:30am acetone-moderate 08:30am calcium-9.5 phosphate-1.4* magnesium-1.8 08:30am ck-mb-notdone ctropnt-<0.01 ck(cpk)-42 08:30am glucose-117* urea n-25* creat-0.7 sodium-141 potassium-3.4 chloride-102 total co2-20* anion gap-22* 09:25am freeca-1.19 lactate-0.9 09:25am type-art ph-7.37 intubated-intubated 12:00pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-150 bilirubin-neg urobilngn-neg ph-6.0 leuk-neg 12:00pm urine color-straw appear-clear sp -1.012 12:30pm pt-13.7* ptt-23.9 inr(pt)-1.2* 12:30pm asa-neg* ethanol-neg acetmnphn-9.8 bnzodzpn-neg barbitrt-neg tricyclic-neg 12:30pm tsh-1.3 albumin-4.4 12:30pm ck-mb-4 ctropnt-<0.01 12:30pm alt(sgpt)-22 ast(sgot)-61* ck(cpk)-125 alk phos-81 tot bili-0.5 05:33pm pt-18.0* ptt-29.8 inr(pt)-1.7* 10:14pm pt-22.8* ptt-35.1* inr(pt)-2.3* 10:14pm ck-mb-notdone ctropnt-<0.01 ck(cpk)-72 . admission ct head: ct of the brain without intravenous contrast: a large left frontoparietal intraparenchymal hemorrhage is again noted. there is questionable minimal increase in prominence of the caudal portion of the hemorrhage in comparison with the examination of several hours earlier. the degree of hypodensity surrounding the inferior portion of the hemorrhage also appears minimally increased, consistent with slight increase in edema. the degree of left to right subfalcine herniation is unchanged. there is no hydrocephalus or evidence of transtentorial herniation. bilateral cerebral periventricular white matter hypodensity is consistent with chronic small vessel ischemic change. there is no evidence of extra-axial hemorrhage. . bone windows demonstrate no evidence of fracture within the surrounding osseous structures. the mastoid air cells and visualized portions of the paranasal sinuses are normally pneumatized. . impression: left frontoparietal intraparenchymal hemorrhage, questionably minimally increased along its caudal aspect, without change in degree of mass effect. . ct c spine: 1. no fracture or malalignment seen. 2. extensive degenerative disc disease as well as multilevel djd. . follow up ct: stable left frontoparietal intraparenchymal hemorrhage. no change in degree of mass effect . eeg : abnormality #1: throughout the recording there were frequent bursts of mixed frequency slowing with a generalized distribution. there were also occasional bursts of bitemporal mixed frequency slowing. abnormality #2: background rhythm was usually disorganized. it was often somewhat slow, in the hz range although there were some faster frequencies. the background did react to external stimuli with some apparent alerting. hyperventilation: could not be performed. intermittent photic stimulation: could not be performed. sleep: no normal waking or sleeping morphologies were seen. cardiac monitor: showed a generally regular rhythm. impression: abnormal portable eeg due to the bursts of generalized slowing with additional bitemporal mixed frequency slowing. these findings suggest multifocal subcortical abnormalities. vascular disease is a relatively common cause of such findings. in addition, the background was disorganized and usually somewhat slow, suggesting a concomitant encephalopathy. there were no areas of prominent and persistent focal slowing, and there were no clear epileptiform features. . bilateral lenis: 1. no evidence of acute dvt. 2. evidence of prior dvt of the left popliteal vein. . mri/mra brain: findings: as noted on the prior ct, there is an acute 4 cm left frontoparietal intraparenchymal hematoma. there is a small amount of subdural blood present over the anterior left temporal lobe. there is mass effect upon the atrium of the ipsilateral lateral ventricle. however, there is no significant midline shift or herniation. there are no additional foci of abnormal magnetic susceptibility to indicate other microhemorrhages. there are multiple t2 hyperintensities within the subcortical white matter of both cerebral hemispheres due to chronic microvascular infarct. . this study is slightly limited by patient motion artifact. there is no slow diffusion to indicate an acute infarct. . impression: large intraparenchymal left frontoparietal acute hematoma with a tiny amount of subdural blood along the left middle cranial fossa. . there is no evidence of other microhemorrhages. . no acute infarct. chronic microvascular infarct. . mra: normal brain mra, but limited by motion. . eeg : time samples: throughout the recording, there is continuous slowing of the left hemisphere in the mixed hz delta and hz theta frequency range. there were no clear epileptiform discharges seen throughout the recording. background: over the left hemisphere is more disorganized and represented a lower voltage gradient. the right hemisphere is mildly disorganized but reaches normal alpha frequency ranges. sleep: normal transitions of the sleep architecture were not seen. cardiac monitor: normal cardiac rhythm with a rate of 84 bpm. there was a continuous widespread qrs complex seen. automatic seizure detections: there were no entries in these files. automatic spike detections: there were 103 entries in these files. all entries represent movement and muscle artifact. pushbutton events: there was one pushbutton at the beginning of the recording which represented a system's test. impression: this is an abnormal discontinuous 24-hour long term eeg monitoring due to the presence of continuous slowing over the mixed delta and theta frequency range over the entire left hemisphere. there were no clear epileptiform discharges or seizure activity recorded. a widespread qrs complex was noted. . eeg : time samples: throughout the recording, there is a persistent moderate voltage slowing in the hz delta frequency range and intermittent theta frequency slowing over the entire left hemisphere with left temporal emphasis. as the study progressed, there are initially isolated sharp features over the left temporal region with phase reversing around t3 and runs of semi-rhythmic 5 hz theta frequency slowing in the left central region lasting up to 20 seconds. beginning in the early evening of the recording, there are frequent semi-rhythmic sharp and slow wave and spike slow wave discharges seen phase reversing around f7 and t3, secondarily spreading over the entire left hemisphere. the frequency of these discharges vary between 1 and 2 hz lasting from 1 a.m. to the end of the recording at 10 a.m. on . automatic seizure detections: there are three entries in these files. all events represent fast eye movements. there was no clear seizure activity recorded. automatic spike detections: there were 79 entries in these files. the majority of these entries represent muscle artifact. there were also a few sharp wave discharges over the left temporal region captured. please see above. pushbuttons: there were no entries in this file. sleep: normal transitions of the sleep architecture were not seen. cardiac monitor: there is a normal cardiac rhythm with a rate of 90 bpm. there are prolonged widespread qrs complexes alternating with normal qrs complexes seen. impression: this is an abnormal 24-hour discontinuous eeg telemetry due to the presence of prolonged epileptiform sharp and spike slow wave discharges seen over the left fronto-temporal region spreading over the entire left hemisphere. this finding was persistent for at least nine hours through the end of the recording. additionally, there is continuous delta frequency slowing over the entire left hemisphere. this finding suggests cortical and subcortical structural abnormalities. over the 24-hour eeg recording, there are described discharges over the left hemisphere which became more frequent and persistent but there were no clear seizures recorded. widespread qrs complexes alternating with normal qrs complexes were noted. . eeg : abnormality #1: throughout the recording, there are intermittent bicentral sharp slowing seen independently occasionally followed by a slow wave. abnormality #2: there is increased voltage gradient over the entire left hemisphere with a diffuse mixed theta and delta frequency slowing. there is no clear anterior-posterior voltage gradient on both hemispheres. the background is slow in the hz theta frequency range and disorganized. the superimposed fast activity in the beta frequency range is noted. background: as above. hyperventilation: was not performed due to the patient's clinical condition. intermittent photic stimulation: was not performed because this was a portable study. sleep: normal transitions of the sleep architecture were not seen. cardiac monitor: normal cardiac runs of widespread qrs complexes followed by normal qrs complexes were seen. impression: this is an abnormal portable eeg due to the presence of intermittent, independent, bicentral sharp slowing and sharp slow wave discharges and due to slow and disorganized background rhythms with diffuse theta frequency slowing and increased voltage gradient over the entire left hemisphere. the background slowing suggests cortical/ subcortical dysfunctions and a mild encephalopathy. epileptiform discharges represent most likely cortical dysfunction in central parietal regions. superimposed fast activity is most likely due to medication effect. given the patient's clinical history and eeg findings, eeg monitoring might be of benefit. . ct head : comparison with the prior study of , reveals reduction in the density of the large hemorrhage, but negligible change in its degree of mass effect or surrounding edema. once again, there is considerable compression of the posterior aspect of the body of the left lateral ventricle as well as the atrium. the minimal subfalcine herniation is unaltered. no new area of intracranial hemorrhage is identified. . there is moderate mucosal thickening within the posterior aspect of the left ethmoid sinus, which has evolved since the prior study. the finding likely relates to the intubated status of the patient. . tte : the left atrium is mildly dilated. there is mild (non-obstructive) focal hypertrophy of the basal septum. the left ventricular cavity size is normal. there is mild to moderate regional left ventricular systolic dysfunction with akinesis of the mid antero-septum, distal lv and apex. no masses or thrombi are seen in the left ventricle. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. the left ventricular inflow pattern suggests impaired relaxation. the tricuspid valve leaflets are mildly thickened. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. . brief hospital course: pt. was admitted to the neuro icu. was intubated at the outside hospital. bp was initially maintained below 140 with labetalol iv, and repeat imaging showed stability of the hemorrhage. inr was corrected with ffp and proplex. over the first 24 hours, her exam was felt to be out of proportion with findings on ct. however, she did receive narcotics at the osh and was found to have uti on admission both of which could account for a change in neurological status. propofol was weaned and narcotics held. on day 2 she was noted to be much more awake and following commands. she was able to raise left arm and leg anti-gravity and was noted to be moving all four extremities spontaneously (l>r). her mental status continued to improve and she was transferred to the floor . failed multiple bedside swallow exams and was npo with ng in place. . on the floor mental status continued to improve, although pt. failed a repeat bedside swallow evaluation. aspirin was restarted. she finished a 7 day course of levofloxacin for uti. . on had gtc seizure in the early morning hours. witnessed by physician who reported as upper extremities and face involvement. received 2mg iv ativan without any change. after another 1mg ativan converted to rue and face only. gtc portion estimated to have been about 20 minutes. after another 1+1 ativan she gradually slowed the rue movement but facial twitching continued. was loaded with 1 gram iv dilantin and movements ceased after about an hour. vitals were all initially stable with tachycardia, but became hypotensive in post-ictal period. patient received 5mg ativan and 1gram dilantin in total. she was not on seizure prophylaxis up until this point. was not following any commands but withdrew all four extremities to noxious stim. transferred back to icu for hypotension. dilantin discontinued as she had cyanotic fingertips which was presumably as a reaction to the dilantin (purple glove syndrome). was loaded on depakote and maintained with iv doses qid. was following commands at 24 hours although very somnolent. after 48 hours was more awake and near baseline. was transferred back to the floor . . on the floor depakote was continued, and dose titrated up as levels were low. depakote levels should be checked qod at rehab and dose titrated accordingly. pt. worked with pt and ot who recommended acute rehab. she failed another swallow evaluation. her swallowing was discussed several times with her son and hcp, , who felt that he did not want to subject his mother to a peg tube at this juncture, and was hopeful that with more time she would pass a swallow evaluation. we discussed with him that there was a chance that she may not to regain her swallowing abilities, which he understood, but he maintained that he wanted to give her more time before making the decision to proceed with peg. she should continue to be evaluated by speech and swallow at rehab, and if she continues to fail peg tube will need to be readdressed with him. . neuro exam on discharge was significant for diffuse mild l sided weakness ( in all muscles groups), trace movement of r ankle but 0/5 strength of all muscle groups on the right, and some inattention and perseveration, as well as problems following complex commands. . cvs: cardiovascularly ruled out for mi with serial enzymes. no significant events on telemetry. was hypotensive to 80s/50s and initially did not respond to fluid boluses (3 boluses of 500cc ns each). on arrival to icu received additional 500 cc bolus and pressures corrected to acceptable level. pressors not initiated. ruled out again for mi with serial enzymes. had echo (please see results section) which showed mild to moderate regional left ventricular systolic dysfunction with akinesis of the mid antero-septum, distal lv and apex, ef 35%. she should have a repeat tte when she is more medically stable to f/u these findings. bp stable for several days with no iv boluses required prior to discharge. . resp: intubated at osh. extubated after 48 hours without complications. heme: inr was initially corrected with ffp and proplex. serial inrs were performed and she required a few additional units of ffp over the first 48 hours. she also received some vitamin k sc. inr was stable at 1.0-1.2 after hod #3. . gi: failed multiple swallow evals and ng placed. received tube feeds throughout hospitalization. ppi for prophylaxis. decision for peg . id: had uti on admission which was treated with iv levaquin for 7 days. . renal: no issues this admission. . medications on admission: meds at nh: erythromycin ointment to eyes qhs first 5 days of each month dulcolax sup prn coumadin 4mg po daily namenda 5mg po daily mvi daily remeron 45mg daily mom 30cc daily prn tyelnol 650mg daily prn discharge medications: 1. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed): please administer prior to meals per sliding scale attached. 2. memantine 5 mg tablet sig: one (1) tablet po daily (). 3. multivitamin capsule sig: one (1) cap po daily (daily). 4. docusate sodium 150 mg/15 ml liquid sig: one (1) po bid (2 times a day). 5. lansoprazole 30 mg susp,delayed release for recon sig: one (1) po daily (daily). 6. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed. 7. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 8. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 9. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 10. valproate sodium 250 mg/5 ml syrup sig: 7.5 ml po q6h (every 6 hours). discharge disposition: extended care facility: & rehab center - discharge diagnosis: 1) left frontoparietal intraparenchymal hemorrhage 2) generalized tonic-clonic seizure discharge condition: stable, tolerating medications discharge instructions: 1) please return for increasing weakness, trouble speaking, inability to take medications, uncontrolled bleeding, vomiting and fevers. 2) please attend all appointments 3) take all medications as prescribed. followup instructions: your pcp will visit you at your nursing home. please have your nursing home call upon your arrival. . your have a neurology appointment with dr. and his fellow (dr. , wed at 1pm. hospital building . for more details can call # . md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours enteral infusion of concentrated nutritional substances transfusion of other serum diagnoses: other iatrogenic hypotension esophageal reflux urinary tract infection, site not specified other convulsions intracerebral hemorrhage benign neoplasm of cerebral meninges personal history of venous thrombosis and embolism anticoagulants causing adverse effects in therapeutic use bipolar disorder, unspecified pneumonia due to other specified bacteria 

Answer: The patient is high likely exposed to