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: left sided weakness major surgical or invasive procedure: intravenous tpa thrombolysis history of present illness: pt is a 69 yo cantonese speaking right handed female w/ pmhx sig for congenital r esotropia and hyperlipidemia who p/w acute l flaccid paralysis. the history was obtained through the daughter who acted as the interpreter. pt was in usoh this am when ~ 6:30 she went to the bathroom. the husband then heard pt collapse in the bathroom. when he found her she had a left facial droop and could not move her left side at all. per report of husband and her daughter the patient was fully conscious during this event. the daughter came to the house and ems was called. the patient was brought to the ed via ambulance at 9:00 am. pt initial nihss was 7 in ed. she was taken for cta that showed no ich. iv tpa was administered at 9:25 am. nihss - 7 loc responsiveness - 0 loc ?'s - 0 loc commands - 0 best gaze - 0 visual field - difficult to assess facial paresis - 2 l arm - 2 r arm - 0 l leg - 1 limb ataxia - 0 sensory - 0 language - 0 dysarthria - 1 neglect - 1 pt denies headache, visual changes, nausea, vomiting, fevers, chills, night sweats, bowel/bladder incontinence. past medical history: as above, osteoporosis social history: lives with husband in a senior living community. illiterate. cantonese speaking. works in produce section of market. no etoh/tobacco family history: father - stroke physical exam: t 96.0; bp 147/47; p 89; rr 25; 95% general: lying in bed nad heent: ncat, moist mucous membranes neck: supple, no carotid bruit pulmonary: cta b/l cardiac: regular rate and rhythm, with no m/r/g carotids: no blood flow murmur abdomen: soft, nontender, non distended, normal bowel sounds extremities: no c/c/e. neurological exam: mental status: a & o x3. fluent speech with no paraphasic or phonemic errors. adequate comprehension. follows simple and multi-step commands. repetition intact. able to name low and high frequency objects. extinguishes to dss. cranial nerves: i: not tested ii: perrl, 4-->2mm with light. vff. iii, iv, vi: eomi. no nystagmus. v, vii: facial sensation intact, l umn facial droop. viii: hearing intact b/l to finger rubbing. ix, x: palatal elevation symmetrical. : scm xii: tongue midline without fasciculations. motor: normal bulk. normal tone. no pronator drift. delt tri we wf fe ff ip qd ham df pf edb rt: 5 5 5 5 5 5 5 5 5 5 5 5 5 5 left: 4+ 4+ 5 4+ 5 4 5 5- 5 5- 4+ 5 5 5 sensation: intact to pinprick, light touch, vibration, and position sense. does not extinguish to double simultaneous stimulation reflexes: bic t br pa ac right 2 2 2 3 2 left 2 2 2 2 2 left toe up, right toe down. coordination: fnf intact. pertinent results: wbc 8.6 hct 41.8 plt 285 n:73.5 l:22.7 m:3.3 e:0.2 bas:0.3 138 101 15 - - - - - - gluc 157 3.3 23 0.7 alt: 94 ap: 46 ast: 74 pt: 10.9 ptt: 20.3 inr: 0.9 imaging: cxr: no acute process seen. ct/cta head : no intracranial hemorrhage or mass effect is identified. the ventricles are symmetric, and there is no shift of normally midline structures. the -white matter differentiation is preserved. the density of the brain parenchyma is within normal limits. several scattered foci of low attenuation seen in the cerebral periventricular white matter are consistent with chronic small vessel infarction. the visualized portions of the paranasal sinuses are well aerated. cta of the circle of : the tributaries of the circle of demonstrate patency, without evidence of occlusion, aneurysms or arteriovenous malformations. cta of the neck: the vertebral arteries and carotid arteries demonstrate normal caliber and patency, without any significant stenosis identified. scattered small lymph nodes are noted within the posterior triangles of the neck bilaterally, which do not meet ct criteria for enlargement. visualized portions of the lung apices are normal. impression: 1. no findings of intracranial mass effect or hemorrhage identified on the non-contrast head ct scan. 2. normal cta of the circle of , carotid and vertebral arteries. echo: the left atrium is elongated. left ventricular wall thicknesses and cavity size are normal. there is mild global left ventricular hypokinesis, without regional left ventricular wall motion is normal. right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the aortic valve is bicuspid. the aortic valve leaflets are mildly thickened. there is moderate aortic valve stenosis (area 0.8-1.19cm2) the mitral valve leaflets are structurally normal. there is no mitral valve prolapse. estimated pulmonary pressures are normal. there is no pericardial effusion. impression: mild global left ventricular systolic dysfunction. congenitally-bicuspid aortic valve with moderate aortic stenosis. mildly dilated aortic root. head ct : no change from the prior examination of , in the subcortical and periventricular white matter hypodensities in the right frontal and parietal lobes. . carotid ultrasound : no carotid stenosis bilaterally. pertinent labs at time of discharge: 12:59am blood hcv ab-negative 12:59am hbsag-negative hbsab-positive igm hbc-negative igm hav-negative 12:59am blood triglyc-178* hdl-46 chol/hd-5.7 ldlcalc-179* 12:59am blood %hba1c-6.4* 05:30am blood alt-73* ast-57* alkphos-41 totbili-1.5 brief hospital course: 70 year old woman with history of hypercholesterolemia presents with sudden onset left sided weakness at 6:30 am that was witnessed by her husband. she awoke feeling normally, and her husband later heard her collapse in her bathroom. at presentation her nihss was 7. her symptoms localized to r fronto-parietal area, likely a branch of the r mca. mechanism of the infarct was not clear, but thought to be likely embolic. the patient was administered intravenous t-pa for thrombolysis. 1) neuro: the patient received 5.3 mg bolus of iv t-pa at 9:28 am followed by infusion of 47.9mg over 1 hour. she was admitted to the neuroicu following tpa administration with neuro checks q15 min x 2 hr post tpa, then q30 min x 6h, then q1h x 16h, then per routine. symptoms of left sided weakness resolved completely following tpa administration. ct at 24 hrs following tpa was unchanged. cta performed on admission (full read available above) was without abnormality. telemetry monitoring revealed normal sinus rhythm. carotid doppler studies without stenosis. she was transferred to the neurology floor for 24hrs of monitoring without event. neurologic exam at time of discharge was remarkable only for congenital right sided esotropia. she was discharged on aspirin 325mg daily and atorvastatin for stroke secondary prevention. - she will follow up with dr. in the neurology department in 1 month. 2) cardiovascular: echocardiogram to look for cardioembolic source showed ef 50% mild global hypokinesis and moderate aortic stenosis. there was no evidence of pfo. cardiac enzymes to rule out myocardial infarction were negative. risk factors: -her blood pressures were well-controlled during this hospitalization without therapy. -hemoglobin a1c was 6.4. -total cholesterol 261, triglyceride 178 and cldl 179- she was started on atorvastatin 10mg daily, and will require follow up lft's and fasting lipid profile in weeks for goal ldl < 70. 3) lft elevation: alt/ast were 94/74, then 73/57 on repeat 24hrs later. hepatitis panel was sent revealing past exposure to hepatitis b. hep c negative. no active hep a or b infection. normal bilirubin. - she will require follow up liver function testing as an outpatient in 1 month with the initiation of atorvastatin during this hospitalization. medications on admission: fosamax 70 mg q week fish oil calcium 500 mg vit d 50,000 1x/mo discharge medications: 1. atorvastatin 10 mg tablet sig: one (1) tablet once a day. disp:*30 tablet(s)* refills:*0* 2. aspirin 325 mg tablet sig: one (1) tablet daily (daily). 3. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable bidwm (2 times a day (with meals)). 4. vitamin d 50,000 unit capsule sig: one (1) capsule once a month. 5. alendronate 70 mg tablet sig: one (1) tablet once a week. discharge disposition: home discharge diagnosis: right middle cerebral artery territory acute cerebrovascular attack with tpa thrombolysis discharge condition: neurological exam within normal limits. prior left esotropia. no residual left sided weakness or ataxia s/p tpa administration. discharge instructions: you were admitted for an acute stroke involving the left side of your body. you were administered tpa to dissolve the clot that had formed in your brain and you had complete resolution of your symptoms. you were monitored for bleeding complications for 48hrs without any events. . please take an aspirin each day. you were also started on atorvastatin to lower your cholesterol. your primary care doctor will need to follow up you liver function tests on this medication. . call your doctor or 911 if you experience any weakness, numbness, tingling, dizziness, uncontrolled bleeding, chest pain, shortness of breath or any other concerning symptoms. followup instructions: you have an appointment to see dr. neurology department on at 11am on the of the building on . (office phone ) you also have appointments with: , m.d. phone: date/time: 9:30 procedure: injection or infusion of thrombolytic agent diagnoses: pure hypercholesterolemia unspecified essential hypertension cerebral embolism with cerebral infarction 

Answer: The patient is high likely exposed to