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: syncope major surgical or invasive procedure: none history of present illness: the pt. is an 85 year-old right-handed female who presented on after she experienced a syncopal episode. the pt is unclear of the events surrounding her hospitalization, therefore the history is primarily per the pt's daughter. the pt was home alone last night until her daughter returned at approximately midnight. at that time, her daughter found her sitting in a chair, too weak to get up, incontinent of stool. when the daughter attempted to get the pt out of the chair to clean her, she slumped back into the chair, became minimally responsive, and had a "blank stare" for approximately 5 minutes. there was no evidence of abnormal jerking movements. her daughter noted that her left eye looked "droopy." the pt does not recall the events, but did feel that after she was found by her daughter and before ems arrived, her speech seemed "slurred." ems arrived shortly after she was found by her daughter. at that time, she was described as alert, oriented x 3. she was brought to the ed for evaluation. ed notes document "4-/5 strength of upper and lower extremities." she was admitted to the medicine service for work- up of syncope and physical therapy. the primary medicine team noted that the pt had severe bilateral proximal muscle weakness. the pt stated that this had been present since the prior evening. she offered no other complaints at the time of the neurology consult. specifically, the pt denied headache, loss of vision, blurred vision, diplopia, dysphagia. she denied vertigo. she denied difficulties producing or comprehending speech. she denied focal numbness, parasthesiae. she did admit to progressive difficulty with her gait and multiple falls over the past year. . on review of systems, the pt. denied recent fever or chills. no night sweats or recent weight loss or gain. denied cough, shortness of breath. denied chest pain or tightness, palpitations. denied nausea, vomiting, diarrhea, constipation or abdominal pain. no recent change in bowel or bladder habits. no dysuria. denied arthralgias or myalgias. past medical history: 1. esrd on hd (m/w/f since ) 2. h/o afib with rvr 3. right kidney ras 4. htn 5. hypothyroidism 6. dual chamber ppm () for bradycardia with attempts at rate control for afib 7. echo- 1+ mr, lvef 60% in 8. aaa- noted 9. h/o chf 10. r ij dialysis line place 11. multiple mechanical falls social history: lives with and cares for daughter who is mentally disabled. strong support system in her other daughter who is a hemodialysis nurse. quit smoking in . no etoh. family history: non-contributory physical exam: vitals: t: 96.1 p: 71 r: 16 bp: 117/56 sao2: 96% 3l general: awake, alert, nad. heent: nc/at, no scleral icterus noted, mmm, no lesions noted in op neck: supple, bilateral carotid bruits appreciated. no nuchal rigidity or cervical spine tenderness pulmonary: lungs cta bilaterally without r/r/w cardiac: rrr, paced, nl. s1s2, ii/vi hsm at rusb abdomen: soft, nt/nd, normoactive bowel sounds, no masses or organomegaly. extremities: no c/c/e bilaterally, 1+ radial, dp and pt pulses b/l. skin: multiple ecchymoses noted over bilateral upper and lower extremities. . neurologic: -mental status: alert, oriented x 3. cannot perform or dow backward. language is fluent with intact repitition and comprehension. there were no paraphasic errors. pt. was able to name both high and low frequency objects. able to read without difficulty. speech was not dysarthric. pt. was able to register 3 objects and recall at 5 minutes. there was no apraxia or neglect. . -cranial nerves: olfaction not tested. perrl 3 to 2mm and brisk. vff to confrontation. there is no ptosis bilaterally. fundoscopic exam limited by corneal clouding. eomi without nystagmus. sensation intact to light touch over face. left nasolabial fold flat. hearing intact to finger-rub bilaterally. palate elevates symmetrically in midline. 5/5 strength in trapezii and scm bilaterally. tongue protrudes in midline; no fasciculations. . -motor: normal bulk, tone throughout. no adventitious movements noted. no asterixis noted. no myoclonus noted. . delt bic tri wre ffl fe io ip quad ham ta l 2 4+ 4 5 5 4+ 4+ 3 5 4 4+ 5 4 r 2 4 4 5 5 4+ 4+ 3 5 4 4+ 5 4 . -sensory: no deficits to light touch, pinprick, vibratory sense, throughout. no extinction to dss. . -coordination: no intention tremor, dysdiadochokinesia noted. fnf could not be accurately performed secondary to proximal muscle weakness. . -dtrs: 2+ biceps, triceps, brachioradialis, 1+ patellar and 0 ankle jerks bilaterally. plantar response was mute bilaterally. . -gait: deferred. pertinent results: admission labs: 09:10am ck-mb-notdone ctropnt-0.19* 01:50am ck(cpk)-85 ck-mb-notdone ctropnt-0.16* . 01:50am wbc-12.2* rbc-3.65* hgb-11.9* hct-39.8 mcv-109*# mch-32.5* mchc-29.8* rdw-17.8* 01:50am neuts-91.8* bands-0 lymphs-5.8* monos-2.3 eos-0.2 basos-0 01:50am plt count-78*# 01:50am pt-13.1 ptt-28.6 inr(pt)-1.1 01:50am calcium-9.5 phosphate-2.8 magnesium-1.5* 01:50am glucose-108* urea n-21* creat-3.9*# sodium-141 potassium-5.7* chloride-103 total co2-27 anion gap-17 09:10am alt(sgpt)-24 ast(sgot)-21 ld(ldh)-305* ck(cpk)-41 alk phos-129* tot bili-0.4. . cxr (): there is again present a dual lead left-sided cardiac with leads in stable position. a large bore right-sided dialysis catheter is again present with the tip terminating in the right atrium. there has been interval development of bilateral small pleural effusions with associated atelectatic changes. there is mild interstitial prominence without overt edema. linear atelectatic changes are also noted in the left mid lung zone. the osseous structures are stable. . nccth : findings: there is no intraparenchymal or extra-axial hemorrhage. there is no shift of normally midline structures, mass effect or hydrocephalus. scattered periventricular and subcortical white matter hypodensities are again noted consistent with mild chronic small vessel ischemic change. the visualized paranasal sinuses and osseous structures are within normal limits. impression: no intracranial hemorrhage or mass effect. . nccth (): new small focal hypodensity in left frontal periventricular location, likely a small focus of evolving infarction. no intracranial hemorrhage, midline shift, or change in ventricle size. . nccth (): no evidence of intracranial hemorrhage or edema. further evolution of tiny left periventricular white matter area of infarction. . carotid series: 1. appearance suggestive of complete occlusion of the left common, internal, and external carotid arteries in the neck. 2. significant plaque at the origin of the right internal carotid artery, associated with a severe stenosis, estimated between 80 and 99% in diameter reduction. 3. tardus parvus flow pattern in the left vertebral artery. antegrade flow in the right vertebral artery. . tee: thickened, calcified mitral valve with torn chordae and possible partial flail. at least mild to modertae mitral regurgitation. a valvular vegetation cannot be excluded. if clinically indicated, a tee may better characterize the basis and severity of mitral valve disease. compared to the prior study (tape reviewed) dated , prolapsing, torn mitral chordae are new. the degree of mitral regurgitation appears similar (may be underestimated). . there has been placement of an endotracheal tube, with the tip terminating within 1.5 cm of the carina. the cuff of the tube appears slightly overdistended. a large bore dialysis type catheter, permanent and feeding tube remain in place, not significantly changed in position. cardiac and mediastinal contours are stable. there is persistent vascular engorgement and there has been interval worsening of bilateral central alveolar pattern in both lungs. moderate to large left and moderate right pleural effusions are again demonstrated with interval slight improvement in the left pleural effusion. cxr: pulmonary edema. brief hospital course: the patient is a 85 yo woman w/ esrd on hd, afib, s/p pacer, who has been having multiple falls and presented again with a fall possibly secondary to syncope. the patient is a 85 yo woman with htn, afibb, esrd, , hypothyroidism, multiple falls who was admitted after a syncopal episode, accompanied by slurred speech and a blank stare. she was initially admitted to the medicine for syncopal workup, and noted to have weakness 8/28. she was seen by the stroke team at that point. then on she became almost non-verbal, not following commands, with bloodpressure in the 110's (normally 140's). a repeat ct-head showed a l-frontal hypodensity consistent with a small stroke. she was transferred to the icu for pressure support, to keep her sbp>140. . neuro: the patient initially responded to the pressors in that she became more alert. she remained unable to follow complicated commands and continued to be encephalopathic. she was able to move both legs, as well as her left arm (limited to movement in her hands), but not her right arm. as these findings could not be explained by her stroke, a ct of the neck was done and cervical spinal stenosis was ruled out. it remained unclear why she was not able to move her arms. contributing factors might have been her bilateral rotator cuff injury, or the extensive lacerations involving her arms that might have induced pain. us carotids showed: occlusion l-ica; 80-99% stenosis r-ica; nl-rt vert. flow; backfilling in lt vert. these abnormalities make the patient very vulnarable to decreased blood pressure. stenting of the r-ica was recommended in wks with angio in 2 months. eeg showed diffuse slowing with in addition focal slowing on l (fronto-central region) with sharp features. this is consistent with encephalopathy. in the course of the hospitalization, due to accompanying medical problems (see below), full pressor support and fluid boluses became insufficient to maintain her blood pressure at a for the patient acceptable level. following these medical problems, the patient's neurological status deteriorated. after discussion with the patient's family, it was decided to make her comfortable, but only after it was tried to reverse her condition with full support, including intubation. . haematology: platelets dropped to 17 over the course of the hospital stay. heparin abs: negative. asa was avoided. hct continued to drop as well. . cardiovascular: a tte showed a flailing mitral valve. a tee to r/o vegetations/embolic source was deferred by the family. levophed was given to keep bp up and she was started midodrine. amiodarone was continued for afibb. . infectious disease: wbc trended up. as a cellulitis (arm lacerations) was suspected, she was started on vancomycin and gentamycin. zosyn was added on after her bloodcultures were positive. she did not respond to these medications. . renal: the patient was maintained on hd sat, tue, thurs. this regimen was changed to cvvh after her condition deteriorated. the renal team followed the patient closely. . endo: she was maintained on an iss and fsbs. levothyroxine was continued for hypothyroidism. . arterial occlusion upper extremity: heparin gtt was started after a cloth was noted in her right upper extremity. this was stopped after her plt dropped to 35.000 (heparin abs negative). the family did not want aggressive intervention. . respiratory: the patient was intubated in am for respiratory failure, likely secondary to sepsis. . fen: ngt was place and tube feeds were started. . proph: protonix . code: made cmo . . the patient expired . the family was present and did not opt for autopsy. medications on admission: caco3 500mg qach metop 25mg levoxyl 75mg qday amiodarone 200mg qday nephrocaps calcitriol 0.25mcg qday ecasa 325 mg qday tramadol 25mg po bid discharge disposition: expired discharge diagnosis: 1. stroke 2. renal failure 3. atrial fibrillation 4. flailing mitral valve 5. sepsis 6. cellulitis 7. respiratory failure 8. carotid stenosis 9. hypothyriodism 10. hypotension 11. anemia 12. thrombocytopenia discharge condition: expired discharge instructions: expired followup instructions: expired procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube enteral infusion of concentrated nutritional substances hemodialysis arterial catheterization transfusion of packed cells transfusion of platelets infusion of vasopressor agent diagnoses: thrombocytopenia, unspecified mitral valve disorders severe sepsis unspecified acquired hypothyroidism atrial fibrillation occlusion and stenosis of carotid artery without mention of cerebral infarction hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease acute respiratory failure septic shock cellulitis and abscess of upper arm and forearm cardiac pacemaker in situ cerebral artery occlusion, unspecified with cerebral infarction diastolic heart failure, unspecified staphylococcal septicemia, unspecified other specified disorders of circulatory system 

Answer: The patient is high likely exposed to