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: g-tube placement history of present illness: hpi: 87 year old russian speaking only woman with pmh afib, on coumadin (inr 1.3), breast cancer, htn, hypercholesterolemia who was found down on the floor with slurred speech, not moving her left side of the body. son reports that she went to the kitchen at 10:30am to prepare some food. he heard a noise and a scream. the son is disabled himself and called ems. ems found her on the floor, having vomited, with slurred speech, left facial weakness and not moving the left side of her body. she was brought to er here where bp 174/81 hr 98. her inr was 1.3, as she had been holding her coumadin for recent cataract surgery. her ct head showed an area of hypodensity in r mca territory with perfusion deficits. cta showed occlusion in m1. she was given tpa 0.9mg/kg. nihss level of consciousness 0 loc questions 1 loc commands 1 best gaze 2 visual fields 2 facial paresis 2 r/l arm motor 3 r/l leg motor 3 limb ataxia 0 sensory 1 best language 0 dysarthria 2 neglect/inattention 2 past medical history: hypothyroidism hypertension (bp at pcp visit was 172/72 with a repeat of 160/80)) dyslipidemia atrial fibrillation (prescribed coumadin) anxiety breast ca: s/p lumpectomy and radiation therapy for invasive ductal carcinoma and 3cm lymphatic invasion. social history: lives with son. is a paraplegic and she is his primary caregiver. family history: not obtained physical exam: t-98.6 bp-174/81 hr-98 rr-18 o2 sat 98% on 2l gen: lying in bed, nad heent: nc/at, moist oral mucosa neck: no tenderness to palpation, normal rom, supple, no carotid or vertebral bruit back: no point tenderness or erythema cv: rrr, nl s1 and s2, no murmurs/gallops/rubs lung: clear to auscultation bilaterally abd: +bs soft, nontender ext: no edema neurologic examination: mental status: awake and alert, with a russian-interpreter she could say she was in the hospital, but not the date. she was very dysarthric. she could follow simple and complex commands such as touch you left ear with the right hand. she was innatentive; could not say backwards and frequently felt asleep. she could not name pen or key. she had a left side neglect. cranial nerves: pupils equally round and reactive to light, 4 to 2 mm bilaterally; r gaze deviation. left umn facial weakness. hearing intact to finger rub bilaterally. palate elevation symmetrical. sternocleidomastoid and trapezius normal bilaterally. tongue midline, movements intact motor: decreased tone in left arm and leg. patient had normal purposeful movements with right arm and leg; some spontaneous distal movements of the left arm and leg. sensation: she withdraws to noxious stimuli on the right and has some minimal withdrawal on the left. pertinent results: 04:45am blood wbc-11.6* rbc-3.85* hgb-11.7* hct-36.0 mcv-94 mch-30.3 mchc-32.5 rdw-13.1 plt ct-231 05:25am blood neuts-83.3* lymphs-13.1* monos-3.3 eos-0.1 baso-0.1 04:45am blood pt-14.4* ptt-27.8 inr(pt)-1.2* 04:45am blood glucose-151* urean-18 creat-0.6 na-139 k-4.2 cl-101 hco3-28 angap-14 11:42am blood ck(cpk)-268* 11:42am blood lipase-49 11:42am blood ck-mb-5 ctropnt-<0.01 04:45am blood calcium-9.1 phos-3.8 mg-1.9 04:45am blood calcium-9.1 phos-3.8 mg-1.9 02:11pm blood %hba1c-6.0* 11:42am blood triglyc-204* hdl-32 chol/hd-6.1 ldlcalc-122 11:42am blood tsh-1.6 06:50am blood vanco-13.3 ct brain perfusion study date of 11:36 am impression: 1. ct perfusion study indicates infarction of the entire middle cerebral artery territory on the right. this infarction is occult on the conventional noncontrast ct study at this time, indicating acuity. 2. complete occlusion of the right middle cerebral artery. eccentric thrombus in the petrous, cavernous and supraclinoid portions of the right internal carotid artery. 3. no significant cervical arterial abnormalities. 4. right thyroid lobe nodule measuring 1 cm. suggest ultrasound for futher evaluation when the patient is stable, if not performed previously. brief hospital course: ms. is an 87 year old russian speaking woman with a history of atrial fibrillation, breast cancer, hypertension, hypercholesterolemia who was found down on the floor with slurred speech, not moving her left side of the body. # right mca infarct: on arrival, the patient was noted to have a she has a left neglect, right eye deviation, left facial weakness and a left hemiparesis. head ct showed an area of hypodensity in r mca territory with perfusion deficits. cta showed occlusion in m1. nihss was 19. as she was within the three hour window from onset time; she was given tpa 0.09mg/kg. over the next 24 hours, she was monitored in the icu with little improvement in symptoms. repeat head ct showed extensive r mca territory infarct, with edema, resulting in compression of the r lateral , but no evidence of hemorrhagic conversion or herniation. serial head cts remained stable. her infarct was likely secondary to an embolic event in the context of being subtherapeutic on coumadin prior to her recent cataract surgery. her a1c was 6.0%, and her ldl was 122, for which she was started on simvastatin. exam at discharge was notable for left sided weakness and neglect, worse in the arm than in the leg, with flattening of the left nasolabial fold. # atrial fibrillation: ms. had a history of atrial fibrillation and was prescribed coumadin. her pcp and son reported that the patient was not compliant with medications at home, and had also been instructed to stop her coumadin in the context of her recent cataract surgery. inr on presentation was 1.3. given the extent of her stroke and concern for hemorrhagic conversion, anticoagulation was initially held. given the extensive size of her infarct, and significant risk for hemorrhagic transformation, coumadin was held, but can be safely restarted on . an echocardiogram demonstrated no sign of thrombus. # hypertension: antihypertensives were initally held to allow for autoregulation. she was later started on metoprolol, and her regimen should continue to be adjusted for a goal sbp<140 # pneumonia: on the patient became febrile, and was found to have an aspiration pna. she was started on vancomycin, cefepime and ciprofloxacin, which should be continued through . # recent left cataract surgery (): the patient was evaluated by ophthalmology who found no sign of infection. they recommended continuing predforte drops in a taper: qid x1wk (), tid x 1wk (), x 1wk (), qday x1 wk () # fen: the patient was cleared by speech and swallow for po intake, but there was concern that she was no going to be able to meet her full nutritional needs. a g-tube was placed on , and she should continue tube feeds, however as she recovers further, a po trial with calorie counts should be attempted. # code status: full, based on extensive discussion with the patient's son and health care proxy. medications on admission: coumadin 3mg qd atenelol 100mg qd simvastatin 20mg qd amlodipine 10mg qd niaspan er 500mg qhs enalapril 20mg qd akwatears 2 drops in each eye 3 times a day levothyroxine 112mcg qd clonazepam 0.5mg prn anxiety calcium + vitamin d vitamin e (son states that the only medication she takes regularly is the coumadin. she is prescribed the rest but does not take them). discharge medications: 1. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 2. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours). 3. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 4. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 5. prednisolone acetate 1 % drops, suspension sig: one (1) drop ophthalmic qid (4 times a day) as needed for cataract surgery for 1 weeks: through . 6. prednisolone acetate 1 % drops, suspension sig: one (1) drop ophthalmic tid (3 times a day) as needed for cataract surgery for 1 weeks: from . 7. prednisolone acetate 1 % drops, suspension sig: one (1) drop ophthalmic (2 times a day) as needed for cataract surgery for 1 weeks: from . 8. prednisolone acetate 1 % drops, suspension sig: one (1) drop ophthalmic daily (daily) for 1 weeks: from . 9. metoprolol tartrate 25 mg tablet sig: one (1) tablet po q8h (every 8 hours). 10. oxycodone 5 mg/5 ml solution sig: five (5) mg po q6h (every 6 hours) as needed for pain. 11. docusate sodium 50 mg/5 ml liquid sig: one (1) dose po bid (2 times a day). 12. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 13. polyethylene glycol 3350 17 gram/dose powder sig: one (1) dose po daily (daily) as needed for constipation. 14. ciprofloxacin 400 mg/40 ml solution sig: four hundred (400) mg intravenous every twelve (12) hours for 4 days. 15. vancomycin in dextrose 1 gram/200 ml piggyback sig: one (1) gm intravenous q 12h (every 12 hours) for 4 days. 16. cefepime 2 gram recon soln sig: two (2) gram injection q12h (every 12 hours) for 4 days. 17. heparin, porcine (pf) 10 unit/ml syringe sig: one (1) ml intravenous prn (as needed) as needed for line flush. discharge disposition: extended care facility: hospital discharge diagnosis: primary: right mca stroke aspiration pneumonia secondary: atrial fibrillation discharge condition: left sided hemiparesis, with left sided neglect. able to move right arm and leg spontaneously, left foot shows occasional small spontaneous movements. left sided upgoing toe. left arm and leg retract from pain within the plane of the bed, not antigravity. discharge instructions: you were admitted with left sided weakness. you were found to have a large right sided stroke. this was likely due to having atrial fibrillation on not being therapeutic on your coumadin. your coumadin should be restarted on , with a goal inr of .5. you also have pneumonia, and should continue taking antibiotics through . if you have worsening headache, new weakness, or other concerning symptoms, please return to the nearest ed for further evaluation. followup instructions: you have the following follow-up appointment: provider: . & dr. phone: date/time: 10:30 md, procedure: venous catheterization, not elsewhere classified enteral infusion of concentrated nutritional substances injection or infusion of thrombolytic agent percutaneous [endoscopic] gastrostomy [peg] diagnoses: unspecified essential hypertension unspecified acquired hypothyroidism atrial fibrillation personal history of malignant neoplasm of breast compression of brain other and unspecified hyperlipidemia pneumonitis due to inhalation of food or vomitus long-term (current) use of anticoagulants personal history of noncompliance with medical treatment, presenting hazards to health cerebral embolism with cerebral infarction hemiplegia, unspecified, affecting unspecified side 

Answer: The patient is high likely exposed to