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: headache and gait instability major surgical or invasive procedure: bilateral burr hole evacuation of subdural hematomas history of present illness: 82 y/o male in previously good health who slipped in the shower on . he denies loss of consciousness, but developed a headache. he also denies weakness, numbness, tingling, visual changes, or dizziness before or after fall. he was taken to outside hospital where head ct revealed bilateral acute subdural hematomas; 8mm on the right side and 7mm on the left side with associated 2mm left to right midline shift. he was admitted to the neurosurgery service for observation, but did not require operative management. he was discharged to home with home pt in place. over the past week, his family noticed he had more difficulty with ambulation and concentration. he was also more lethargic, and demonstrated mild dysarthria. upon return to ed, repeat head ct did not reveal acute bleeding, but midline shift from left to right has increased to approximately 6mm. bilateral frontal and parietal subdural fluid collections are still present. . he underwent bilateral burr hole evacuation on . his post-operative course was complacated by lethargy, waxing/ mental status and difficulty following commands. he was transferred to the micu for worsening tachypnea and hypoxemia. in the micu, he was briefly intubated, treated for hospital-acquired aspiration pna (initially on vanomycin and pip-tazo, but currently on pip-tazo alone). a cta was negative for pe. an echocardiogram demonstrated preserved lv function. he was extubated succesfully on . he passed speech and swallow evaluation. past medical history: hearing loss diverticulitis hyperlipidemia . pshx: unknown surgery for diverticulitis - social history: married, lives with wife. very active prior to recent fall. no alcohol, smoking, or drug use. family history: non-contributory physical exam: exam upon admission: gen: wd/wn, comfortable, nad. heent: pupils: bilaterally eoms intact neck: supple. lungs: cta bilaterally. cardiac: rrr. s1/s2. abd: soft, nt, bs+ extrem: warm and well-perfused. neuro: mental status: awake and alert, cooperative with exam, normal affect. orientation: oriented to person, place, and date. recall: objects at 5 minutes. language: speech fluent with good comprehension and repetition. naming intact. mild dysarthria. cranial nerves: i: not tested ii: pupils equally round and reactive to light, to mm bilaterally. visual fields are full to confrontation. iii, iv, vi: extraocular movements intact bilaterally without nystagmus. v, vii: facial strength and sensation intact and symmetric. viii: hearing to voice diminished bilaterally; hearing aid in place. ix, x: palatal elevation symmetrical. : sternocleidomastoid and trapezius normal bilaterally. xii: tongue midline without fasciculations. motor: normal bulk and tone bilaterally. no abnormal movements, tremors. strength full power throughout. no pronator drift sensation: intact to light touch, propioception, pinprick and vibration bilaterally. toes downgoing bilaterally coordination: normal on finger-nose-finger, rapid alternating movements, heel to shin pertinent results: cta chest: 1. no evidence of pulmonary embolus. 2. nodular and ground-glass opacities at the lung bases which could represent sequela of aspiration or evolving infectious process. 3. small bilateral pleural effusions. . ct c-spine: 1. severe degenerative changes involving the cervical spine as described. grade 1 anterolisthesis at the c2-3 level. 2. opacification of the left mastoid air cells, which may reflect mastoiditis. . echo: poor image quality. the left atrium is normal in size. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. the overall lvef is probably preserved. right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the aortic valve leaflets are severely thickened/deformed. significant aortic stenosis is present (not quantified due to poor image quality). trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. impression: calcific as (could not quanitfy due to poor image quality). if clincially indicated, a repeat study when extubated is suggested. . ct head: 1. essentially stable appearance of bilateral subdural hematomas, without significant interval change compared to examination six days prior. no shift of midline structures or hemorrhage. 2. opacification of the left mastoid air cells, which may reflect mastoiditis. . ct head: 1. evolving and enlarging bilateral subdural hematomas most of which appears chronic with few scattered acute hemorrhagic foci as described above. 2. rightward subfalcine herniation of 7 mm, worse than prior study. brief hospital course: 82yo m with recent sdh s/p burr hole evacuation, transferred to micu for hypoxemia, tachypnea likely hospital-acquired aspiration pna and briefly intubated; now extuabted since . . # respiratory failure: during his post op course on the neurosurgical service on the floor, he became tachypneic and hypoxic. medical consult was called. cxr from suggested new rll opacity and stable lll opacity, a cta (showed bilateral opacities in lung bases suggesting pna, likely aspiration. he was started on vanco/zosyn on for hap. of note, the cta on was also negative for pe so as not to suggest acute thromboembolism as a cause of his respiratory failure. additionally, he was ruled out for acute mi with cardiac enzymes x3 and tte showed a preserved lvef, signifiant as, trace ar, 1+ mr. a head ct showed essentially stable appearance of bilateral subdural hematomas, without significant interval change compared to examination six days prior; no shift of midline structures or hemorrhage. thus, this finding made neuro cause of resp failure less likely. he clinically responded well to the vanco and zosyn and was successfully extubated on . sputum cultures grew only oropharyngeal flora and blood cultures were negative. the patient was initially noted to have a poor cough, therefore there was concern for continued aspiration risk. however on the pt passed speech and swallow and his oxygen requirement continued to lessen. in light of negative cultures vanco was d/ced on . he was briefly transitioned to levofloxacin/flagyl given most likely etiology of his respiratory failure was an aspiration event and although afebrile, his wbc count increased so he was changed back to zosyn for the completion of his antibiotic course. he will complete a 10 day course of antibiotic treatment on . he should currently be maintained on aspiration precautions, however speech and swallow reevaluation on day of discharge advanced him to ground solids and thin liquids with po meds crushed; he should have 1:1 supervision with meals to maintain standard aspiration precautions and assist with feeding. further diet advancement will be determined by repeat speech and swallow evaluation upon discharge. he is maintaining oxygen saturation in the mid to high 90s on 2l nc currently. . # fever: as outlined above likely pulmonary infection as he defervesced with treatment and with concomitant improvement in his respiratory status. urine and blood cultures were negative and his burr hole surgical sites were without evidence of infection. as above, he will complete course of zosyn on . . # somnolence/delirium: post op course was initially complicated by lethargy, waxing/ mental status and attention as well as difficulty following commands. beginning on the patient's mental status markedly improved so that on and therafter he has been awake and alert, and able to recognize family. he has continued to improve daily so that he is now alert and oriented and follows commands and responds to questions appropriately. . # subdural hematoma: patient initially presented on with headache following fall on the previous day was observed and nonsurgically managed and was discharged on . he then represented to osh on with subacute difficulty ambulating and lethargy at which time he was found to have increasing midline shift. thus, he was transferred to for further management and is s/p bilateral bur hole evacuation on by of neurosurgery. post operatively he remained on the neurosurgical service until developing respiratory distress at which time he was transferred to the micu and then to the general medical service. repeat head cts throughout his stay have consistently showed stability of his subdural hematomas. he should be continued on keppra until his follow up appointment with neurosurgery on at which time continuation of this medication will be decided. repeat ct head will be performed on prior to his follow up appointment. . # aortic stenosis: "significant as" was called on echo while inpatient however it was not quantified due to poor image quality. he has been without lightheadedness, chest pain nor evidence of chf during his hospitalization. he should however, have repeat tte as an outpatient in order to further quantify his aortic stenosis. . # bradycardia and hypotension: briefly on while in the icu, bps 80/30s with hr to the 30s. hr improved with stimulation and hypotension responded to 1000cc bolus. felt likely physiologic given timing at night and responsive to waking. atropine was placed at bedside and pacer pads on patient however bradycardia and hypotension spontaneously resolved. following this brief episode of hypotension he was then hypertensive around time of extubation. given his hr markedly improved and he became hypertensive, he was started on metoprolol (bradycardia was brief and resolved on its own) and received iv lasix x1 on with great response. would continue to watch for bradycardia with htn as sign of increased icp, however no sign of sdh progression on multiple studies and is currently normotensive with normal hr (60-80s). . # hypertension: peri-extubation, he was noted to be hypertensive. he was started on metoprolol by the icu team with good response in his blood pressure. this will be continued upon discharge. . # anemia: hct on was normal and no prior labs in our system prior to that. most recently his hct has been stable in the low to mid 30s. likely due in part to small amount of blood loss perioperatively. additionally, iron studies were c/w aocd. b12 and folate were normal. . # fen: passed speech and swallow at which time he was started on pureed, nectar diet which has since been advanced to ground solids and thin liquids. oral medications should be crushed. he must remain on 1:1 sitter with meals to enforce strict aspiration precautions. his diet can be further advanced pending repeat speech and swallow evaluation. his po intake should be monitored as he may require supplemental nutrition if he is unable to take in enough calories by mouth. . # hematuria: slightly blood tinged urine was noted on day of discharge following mild foley trauma. urine was without evidence of infection. foley catheter should be removed upon arrival to rehab and voiding trial performed. . # code: full. medications on admission: 1. acetaminophen prn 2. docusate sodium 100 mg 3. phenytoin sodium extended 100 mg po tid 4. dilaudid 2 mg po every four 4 hours prn discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 2. famotidine 20 mg tablet sig: one (1) tablet po q12h (every 12 hours). 3. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed. 4. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 5. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 6. levetiracetam 500 mg tablet sig: 1.5 tablets po bid (2 times a day). 7. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 8. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 9. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed. 10. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed. 11. zosyn 4.5 gram recon soln sig: 4.5 grams intravenous every eight (8) hours for 3 days: to complete course on . discharge disposition: extended care facility: - discharge diagnosis: bilateral subdural hematomas aspiration pneumonia delirium anemia hypertension discharge condition: stable, maintaining normal o2 saturations on 2l nc, afebrile, with marked improvement in mental status. discharge instructions: you were admitted with increased lethargy and gait instability and were found to have worsening subdural hematomas. you underwent burr hole evacuation of your subdural hematomas by neurosurgery. during your postoperative course, you experienced respiratory distress and required transfer to the medical intensive care unit and intubation. you have been treated with antibiotics (course to be completed on ) and improved markedly so that you were successfully extubated and transferred to the regular medical floor. . you will need continued agressive physical and occupational therapy in order to regain your strength and increase your activity. . you will need to follow up with neurosurgery as an outpatient. you will need a repeat ct scan of your head on the as outlined below. you should continue keppra in the meantime. . please call your doctor or return to the emergency department if you development headache, changes in your vision, lightheadedness/dizziness, focal numbness/tingling/weakness, fevers/chills, worsening cough or shortness of breath, chest pain or any other symptoms that concern you. followup instructions: 1. provider: scan phone: date/time: 2:00 2. provider: , md phone: date/time: 3:00 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours incision of cerebral meninges insertion of endotracheal tube enteral infusion of concentrated nutritional substances diagnoses: anemia of other chronic disease unspecified essential hypertension acute posthemorrhagic anemia aortic valve disorders other and unspecified hyperlipidemia acute respiratory failure pneumonitis due to inhalation of food or vomitus unspecified hearing loss unspecified accident hypoxemia injury to bladder and urethra, without mention of open wound into cavity subdural hemorrhage following injury without mention of open intracranial wound, with no loss of consciousness fall from other slipping, tripping, or stumbling delirium due to conditions classified elsewhere diverticulosis of colon (without mention of hemorrhage) home accidents dysphagia, unspecified 

Answer: The patient is high likely exposed to