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: dizziness, vomiting, fall major surgical or invasive procedure: none history of present illness: cc: hpi: 89 year old right handed man with type 2 diabetes mellitus, peripheral vascular disease, atrial fibrillation, cad, hld, who presented to after a fall. he was transferred from this afternoon for surgical management of his c2 fracture. the history was recounted by his daughter-in-law (who is also his hcp). mr had his supper last night, and mentioned to his wife that he was not feeling well. his wife thought that he looked pale. he then vomited all of his food that he had just eaten, and complained of the room spinning to his wife. did not complain of a headache, or any pain. his wife helped him on to the couch, and she noticed that he was rigid, and he was slouching to the right on the chair. she had to call his caregiver , to help him sit up. the caregiver thought that he had a viral illness, and gave him a bath and put him to bed. the next morning, he woke up around 5 am. his wife had her back turned when he fell, but he fell approximately 24 inches out of the bed. she activated his medical alert button and he was taken to . according to and , mr had become confused over a period of 2 months. at the osh a ct cspine was done which showed a c2 dens body fracture, and a ct head showed no acute changes. he is on coumadin and at the osh he was given 2 units of ffp and 10units of vitamin k. his was 1.3 at the osh, but instead due to an attempt to reverse him given his status of taking coumadin. he was transferred to for further management of his c2 fracture. when he was assessed by the neurosurgical team, and they heard the history of the prior night, they suggested a repeat head ct. ros: unobtainable from the patient. according to his wife, he had no tinnitus, no change in his speech, no facial droop, memory impairment for several months, and symptoms described above. he had no chest pain, palpitations, dyspnea, fever, new gi or gu symptoms. past medical history: type 2 diabetes mellitus cad hld peripheral vascular disease a-fib on coumadin urinary incontinence after prostate surgery (?) social history: lives with his wife, who is his second wife of 22 years. he used to smoke cigars, but his pack history is unknown. he drinks an occasional beer. he never used recreational drugs. he uses a rollator frame to walk. he has been incontinent of urine since his prostate surgery. pcp: -, medical, family history: mother and father died in their 60s, father died of an mi. unclear what his mother died of. the family are originally from . hcp ( ) physical exam: o: t:97 bp: 165/85 hr:68 r:20 o2sats:98% gen: cachectic, leaning to the left, he has a poor fitting hard collar on obscuring the lower portion of his face. heent: abrasion and ecchymosis on right frontal/pariteal region his oral mucosae are dry. skin: r shin erythema noted peripheral pulses: no posterior tibial or dorsalis pedis bilaterally, rest of the pulses are present. feet are cold. cvs: irregularly irregular heart sounds, with an esm in the aortic area , with radiation to the carotids. resp: fine crackles bilaterally gi: soft, non-tender, no organomegaly, and normal bowel sounds. mental status he is awake, oriented to self. does not know the date or year. he is able to identify his wife but not his daughter-in-law. his primary language is english, but he seemed to understand his family speaking in portuguese better than in english. cranial nerves pupils equally round and reactive to light, 3 to 2 mm bilaterally. shuts his eyes to fundoscopic exam. blinks to threat bilaterally, does not follow commands for extraocular movements. his neck is immobilised so dolls head not attempted. corneal reflexes are in tact bilaterally. facial symmetry is obscured by his hard collar. he is hard of hearing bilaterally. he has a gag reflex, and his tongue is midline. motor: he has geggenhalten bilaterally. he has marked wasting of his legs l>r. he moves all extremities spontaneously strength could not formally be assessed, but his legs are weaker than his arms. sensation: he is too inattentive to do a reliable sensory exam his reflexes are difficult to illicit throughout. toes are mute bilaterally rectal exam normal sphincter control (done by neurosurgery), stool guaiac was negative. pertinent results: 03:00pm blood wbc-9.9 rbc-3.76* hgb-12.6* hct-37.4* mcv-100* mch-33.6* mchc-33.7 rdw-13.6 plt ct-230 03:00pm blood pt-14.9* ptt-24.0 inr(pt)-1.3* 03:00pm blood glucose-278* urean-27* creat-0.9 na-142 k-3.9 cl-101 hco3-26 angap-19 11:19pm blood alt-38 ast-30 ck(cpk)-103 alkphos-112 03:00pm blood ctropnt-0.01 11:19pm blood calcium-9.1 phos-3.2 mg-1.7 cholest-153 01:34am blood %hba1c-pnd 11:19pm blood triglyc-79 hdl-65 chol/hd-2.4 ldlcalc-72 01:34am blood osmolal-320* 11:19pm blood tsh-1.6 11:19pm blood digoxin-0.6* ct head 1. right cerebellar hypodensity consistent with acute/subacute infarct, more conspicuous than on the prior exam. no intracranial hemorrhage. 2. paranasal sinus disease, likely due to ongoing inflammation. 3. right frontal scalp soft tissue swelling and hematoma. ct c-spine 1. transverse fracture through the base of the dens (type 2), although the presence of sclerosis and degenerative changes of the fracture fragments as well as calcification of large posterior pannus suggests a more chronic nature. however, there is mild prevertebral soft tissue swelling at this level, measuring up to 7 mm. 2. prominent posterior pannus at the level of c1-2, resulting in marked canal stenosis and deformity of the thecal sac. additional thecal sac deformity results from degenerative changes between c3 and c7, most severe at c6-c7. if neurological symptoms are referable to these levels, mri is recommended for further evaluation of the spinal cord. 3. bilateral pleural effusions with interstitial pulmonary edema. 4. multilevel bilateral neural foraminal narrowing. ct head pfi: right cerebellar hemisphere infarct with short-interval increase of edema, now with partial effacement of fourth ventricle and ambient cisterns on the right, compatible with slight upward transtentorial herniation on the right. no evidence of midline shift or tonsillar herniation. no new vascular territory infarct. no hemorrhagic transformation. of note, a right frontal subgaleal hematoma appears increased in size and density since the day prior. please correlate clinically. ct head no significant interval change. discharge labs: 139 | 100 | 28 ---------------< 239 4.1 | 29 | 0.7 11.1 9.1 >------< 346 33.8 brief hospital course: mr. is an 89 year old right handed man with type 2 diabetes mellitus, peripheral vascular disease, atrial fibrillation on coumadin with a subtherapeutic inr, cad, hld, who presented to after a fall. he was transferred from this afternoon for surgical management of his c2 fracture. prior to transfer, he was given ffp and vitamin k despite inr 1.3 at time of presentation. prior to his fall, the patient had vomiting and vertigo which was concerning for a posterior circulation event. his memory has been gradually becoming impaired over a period of 2 months. . hospital course by problem; . neurology; the patient was found to have a large right cerebellar hypodensity on ct head consistent with stroke. it was thought this was most likely cardioembolic in the setting of subtherapeutic inr. clinically, it appeared that the stroke preceeded his fall and subsequent dens fracture. he was admitted to the neurology icu for q1h neurochecks. his coumadin was resumed without a bridge and blood pressure was allowed to autoregulate. he was continued on his home statin (ldl was 72), and fingersticks covered with regular insulin sliding scale. hba1c was 7.9%. a repeat ct head was worrisome for partial effacement of fourth ventricle and ambient cisterns on the right, compatible with slight upward transtentorial herniation on the right. he was started on mannitol at 1g/kg x1 then 0.5g/kg q6h. this was discontinued after serum osmolality increased to 320. mannitol was not given after that. the patient's hcp, , confirmed the patient's dnr/dni status and wish against any surgical intervention if his clinical situation worsened. vessel imaging and echocardiogram were not performed as it was unlikely that these studies would change management. exam on discharge was notable for occasionally opening of eyes to voice, although he is not following commands. occasional mumbling, but no understandable speech. will have slight spontaneous movement of hands, inconsistent retraction from pinch in upper extremities, none observed in lower extremities. the patient was found to have a type-2 dens fracture on ct c-spine, likely from his fall out of bed. he was followed by the neurosurgery service who recommended that he continue using the cervical collar at all times for his c2 fracture. he can follow up with dr. at in 6 weeks () with a ct scan of the cervical spine with reconstruction. . id; the patient had a t max of 101.5 pm and mild leukocytosis with wbc 11.2. a cxr showed a question of lll atelectasis vs. pneumonia. blood cultures have been negative. urine cultures grew enterococcus, resistent to tetracycline, but otherwise pan-sensitive, and on he was started on levoquin and clindamycin planned for a 10-day course. on he spiked a temperature of 101.4 and antibiotics were switched to zosyn. he continued to have temperature > 101 and vancomycin was added although stopped on . he is being treated for presumed aspiration pneumonia with zosyn, which should continue through . he has been afebrile since . thus far, blood and sputum cultures have been negative. . respiratory; the patient continued to exhibit increased work of breathing and an abg on was 7.52/39/81. he was transferred to the intensive care unit. he remained on nasal cannula overnight until 5 am when he desaturated on 6l nc and a repeat abg was 7.49/44/55. he was started on humidified o2 at 15l/min. his dni status was confirmed with his hcp. bipap was considered but this has been deferred for now. he has been doing well on 40-50% humidified face mask, with intermittent suctioning. . cv; the patient was continued on a beta-blocker and digoxin for rate control and monitored on telemetry. coumadin was initially resumed with no bridge due to the size of the cerebellar infarct and concern for hemorrhagic transformation with aggressive early anticoagulation. based on the increasing size of infarct, coumadin was discontinued, and he was instead placed on full dose aspirin. he has a follow-up appointment scheduled with dr. in neurology on - phone and the possibility of switching back to coumadin can be readdressed at that time. . abd/gi; the patient had a dobhoff placed for tube feeds. swallowing ability can be reassessed if mental status improves further. a peg was discussed, however given his overall tenuous status, he was not considered a good candidate for placement at this time. this can be readdressed if his condition improves. . goals of care; the patient was transferred back to the step-down unit on . multiple discussions have been had with the patient's hcp and other family members in regards to goals of care. uniform agreement has been had in the patient's dnr/dni and no surgeries, however there has been some debate within the family in regards to peg tube. as per the hcp, the family does not wish to make the patient cmo at this time but would not want any aggressive measures to be done to prolong his life. medications on admission: - coumadin 2 mg on monday & wednesday, and on 4 mg on all other days - colace: - omeprazole: - meformin: 1000mg - metoprolol: 50mg - digoxin: 0.125mg qod - potassium supplements: 10 meq qday - lasix: 40mg qday - lipitor: 10 mg qday discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) units injection tid (3 times a day). 2. docusate sodium 50 mg/5 ml liquid sig: one (1) tablet po bid (2 times a day). 3. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 4. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). 5. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 6. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 7. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 8. digoxin 125 mcg tablet sig: one (1) tablet po daily (daily). 9. insulin regular human 100 unit/ml solution sig: sliding scale injection asdir (as directed): please follow attached sliding scale. 10. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po tid (3 times a day). 11. piperacillin-tazobactam-dextrs 4.5 gram/100 ml piggyback sig: 4.5 gram intravenous q8h (every 8 hours) for 3 days. 12. potassium & sodium phosphates 280-160-250 mg powder in packet sig: one (1) powder in packet po tid (3 times a day) for 3 doses. 13. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 14. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 15. multivitamin tablet sig: one (1) tablet po daily (daily). discharge disposition: extended care facility: rehabilitation hospital discharge diagnosis: primary: cerebellar stroke secondary: atrial fibrillation discharge condition: mental status: confused - always level of consciousness: lethargic activity status: bedbound pupils equal and reactive. will occasionally open eyes in response to stimuli. mumbles but has not produced decipherable speech. minimal response to painful stimuli in lower extremities. occasional slight spontaneous movement in hands. discharge instructions: you were admitted following a fall, with symptoms of dizziness. you were found to have a very large cerebellar stroke. you also have a cervical fracture which is being managed conservatively with a hard c-collar medication changes: -stop taking coumadin, switch to full-dose aspirin if you notice any of the concerning symptoms listed below, please call your doctor or come to the emergency department for further evaluation. followup instructions: neurology: provider: , md phone: date/time: 2:00 md, procedure: enteral infusion of concentrated nutritional substances diagnoses: coronary atherosclerosis of native coronary artery diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation peripheral vascular disease, unspecified pneumonitis due to inhalation of food or vomitus long-term (current) use of insulin closed fracture of second cervical vertebra long-term (current) use of anticoagulants cerebral artery occlusion, unspecified with cerebral infarction fall from other slipping, tripping, or stumbling 

Answer: The patient is high likely exposed to