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: no known allergies / adverse drug reactions attending: chief complaint: reason for consult: intraparenchymal hemorrhage major surgical or invasive procedure: cerebral angiogram and embolization of feeding vessels history of present illness: history is obtained from mr. wife who is fluent in english. by the time of this note, he remains sedated and intubated. mr. is a 72 y.o. right handed russian speaking gentleman with a history of hypertension, bilateral glaucoma with decreased vision, prostate cancer without any treatment or intervention ( 3+3), who presents from an outside hospital with 2 gtcs and a finding of multiple intraparenchymal hemorrhages. mr. was in his usual state of health this morning. him and his wife were on vacation at , he went for a swim at around 09:00 am, and was feeling fine. on their way back home, his wife recalls that she was unable to understand what he was saying. his words came out correctly, but were all out of context, and his speech did not make sense. she did not recall dysarthria. he was able to understand her and obey most commands. it is unclear whether he had a headache or not. when they arrived home, he told his wife that he was not feeling well. he called his son, and seemed to be disoriented and confused over the phone. all of a sudden, he had full body shaking lasting for 1 minute, and lost consciousness. his wife does not recall that it started in one limb or the other or whether there was an aura. she immediately called 911. he was still unconscious by the time they arrived. in the ambulance, he had another gtc. per outside hospital report, he received 5mg ov valium and the seizure stopped. he remained unresponsive on arrival to cap hospital. he was intubated, received 250 mcg of fentanyl, 5mg of versed. head ct was done and showed mulitple intraparenchymal hemorrhages, in the left temporal and left occipital lobes. he was transferred by med flight to for further treatment. en route, he received iv dilantin, but since the solution crystallized, he only got 500mg instead of the 1 gram. unable to obtained detailed r.o.s due to patient's mental status, but he had been in his usual state of health except for the speech changes mentionned above. past medical history: -prostate cancer, low volume 6 (3+3), folled by dr. from urology, no treatment as of yet. diagnosed 2-3 years ago. mri of prostated done in showed no evidence of malignancy. bone scan in showed multiple areas of tracer uptake most consistent with degenerative changes. -glaucoma: reported to be legally blind. -hypertension: managed with codiovan. -gerd -hyperlipidemia -recurrent hemarthrosis in his knees -question of ankylosing spondilitis -question of extra-pulmonary tuberculosis (stated on earlier visits that he had tuberculosis of the ankles as a child) social history: retired civil engineer. lives with his wife, and is independent with his adls. does not drive because of his poor vision. never smoked. drinks alcohol only occasionally. family history: negative for cancers physical exam: exam on admission: (off propofol) vitals: t 98.8 p: 56-82 r: 14-18 bp: 110/151/65-72 sao2: 100% general: intubated, appears confused and agitated, trying to self-extubate. required hand restraints. heent: nc/at, no scleral icterus noted, mmm, no lesions noted in oropharynx neck: supple, no carotid bruits appreciated. no nuchal rigidity pulmonary: lungs cta bilaterally without r/r/w cardiac: rrr, nl. s1s2, no m/r/g noted abdomen: soft, nt/nd, normoactive bowel sounds, no masses or organomegaly noted. extremities: no c/c/e bilaterally, 2+ radial, dp pulses bilaterally. skin: no rashes or lesions noted. neurologic: -mental status: awake and alert, responsive and turns to voice. follows commands including "stick out your tongue, move your r/l u/l es" unable to test expressive language given the tube. patient does not seem to recognize his son by the bedside. -cranial nerves: i: olfaction not tested. ii: pupils are pinpoint, 1cm on the left, 2cm on the right and sluggish. he looks to the right and to the left. unable to test for visual neglect. iii, iv, vi: eomi without nystagmus. normal saccades. vii: no facial droop (exam limited due to presence of the tube) viii: hearing intact to calling his name. ix, x: palate elevates symmetrically. gag reflex is present. : 5/5 strength in trapezii and scm bilaterally. xii: tongue protrudes in midline. -motor: normal bulk, tone throughout. no adventitious movements, such as tremor, noted. no asterixis noted. unable to test individual muscle groups, patient very agitated and had to place back on propfol as ed not comfortable extubating him. he moves all extremities at least against gravity. he fights examiner strongly. -sensory: no deficits to light touch grossly. unable to check for dss. reflexes: dtrs : 2 tri 2 2 patellar 0 achilles 0 toes mute left: 2 tri 2 2 patellar 0 achilles 0 toes mute -coordination: no intention tremor exam on discharge: vs: t 98.8 bp 124/77 hr 57 rr 18 o2sat97% gen: nad, comfortable awake, alert. no formal mental status exam can be performed in light of pt's severe aphasia. cranial nerves appear grossly nonfocal. strength intact within the limits of the possible examination pertinent results: 03:40am blood wbc-11.7* rbc-3.67* hgb-11.6* hct-35.1* mcv-96 mch-31.6 mchc-33.1 rdw-14.6 plt ct-142* 03:45pm blood wbc-14.6* rbc-3.77* hgb-12.0* hct-36.5* mcv-97 mch-31.8 mchc-32.8 rdw-14.5 plt ct-141* 03:45pm blood neuts-89.9* lymphs-6.2* monos-3.2 eos-0.5 baso-0.1 03:45pm blood pt-11.0 ptt-21.7* inr(pt)-1.0 03:45pm blood fibrino-226 03:40am blood glucose-159* urean-16 creat-0.9 na-143 k-3.4 cl-108 hco3-25 angap-13 03:40am blood alt-12 ast-30 alkphos-123 totbili-0.9 03:40am blood albumin-3.9 calcium-8.2* phos-2.6* mg-2.1 05:21am blood type-art temp-36.7 po2-77* pco2-41 ph-7.42 caltco2-28 base xs-1 03:50pm blood po2-60* pco2-42 ph-7.33* caltco2-23 base xs--3 comment-green top 03:50pm blood glucose-133* lactate-3.5* na-140 k-3.7 cl-110* calhco3-22 cxr : frontal chest radiographs: an endotracheal tube terminates 4.9 cm above the carina. an orogastric tube termiantes within the stomach. the heart is mildly enlarged. the lung volumes are very low. there is central pulmonary vascular congestion with mild interstitial edema. there appears to be slight overinflation of the endotracheal cuff. severe bibasilar atelectasis is present, and an underlying consolidation cannot be excluded. there is no pneumothorax. small left pleural effusion is present. impression: 1. et tube terminating 4.9 cm from the carina. the endotracheal tube cuff appears slightly overinflated. 2. orogastric tube within the stomach. 3. severe bibasilar atelectasis and small left pleural effusion. underlying consolidation cannot be excluded. ct head : findings: there are three left parenchymal hematomas, increased in size since the prior study. there is a 2.2 x 1.7 cm left parietal hematoma, previously 2.0 x 1.6 cm, which has a hematocrit level on the current and prior studies. there is a left temporal hematoma, 3.7 x 5.2 cm, previously 3.5 x 3.5 cm, with a new hematocrit level superiorly. there is a left occipital 2.1 x 1.9 cm hematoma, previously 1.5 x 1.9 cm, with a new hematocrit level. there is complete compression of the temporal and occipital horns of the left lateral ventricle, and partial effacement of its atrium and body. there is mild effacement of the ambient cistern adjacent to the mid brain (2a:12). there is no shift of midline structure, and no compression of the third ventricle. no osseous abnormality is identified. a right anterior ethmoid air cell is opacified. impression: significant interval enlargement of the left temporal hematoma. mild interval enlargement of the smaller left parietal and occipital hematomas. these findings were discussed with dr. (neurology) by phone at 6:50 p.m., , by dr. . comment on attending review: given the lobar nature of the hematoma, diagnostic considerations include amyloid angiopathy, vascular malformation(s), and underlying masses. recommend mri and mra for further evaluation. mri/mra brain & neck : findings: brain mri: there are areas of acute hemorrhage seen in the left temporal and occipital region. there is mild surrounding edema identified. on post-gadolinium images, several linear areas of enhancement seen in the area of hemorrhage as well as subtle peripheral enhancement seen and subtle enhancement in the inferior portion of the hematoma. in addition, several corkscrew vascular structures are seen along the left cerebellar hemisphere. there are also somewhat prominent flow voids identified in the left suboccipital region on t2-weighted images, series 11, image 2. post-gadolinium images also demonstrate increased vascular structures in the suboccipital region on the left, best visualized on series 25, image 40. the venous sinuses are patent. subtle fleeting filling defects in the left transverse sinus could be secondary to arachnoid granulations and are not likely due to thrombosis and as visualized on the mp-rage post-gadolinium images. there is no other abnormal area of enhancement seen. no acute infarct identified. the mra of the head is limited but demonstrate no vascular occlusion. mra of the neck is limited due to delays in acquisition. although some flow is visualized in the carotid arteries, the evaluation for stenosis is limited. impression: 1. left temporo-occipital hemorrhages with several linear vascular structures in the area as well as in the left cerebellar hemisphere. the combination of findings described above is suspicious for an arteriovenous fistula unless proven otherwise by cerebral angiography. alternatively, an underlying mass can also be suspected if the angiography proves to be negative. in that situation, a followup study should be obtained in four weeks for further assessment. no other areas of enhancement or acute infarct seen. the mra of the head and neck demonstrate no vascular occlusion, but are limited for evaluation for stenosis or aneurysms. cta head : non-contrast head ct: again demonstrated are the three left parenchymal hematomas with hematocrit levels, in the temporal, parietal and occipital lobes, respectively, all stable in size from the prior study. no new hemorrhage is seen. there is complete compression of the temporo-occipital horns of the left lateral ventricle, and partial effacement of its body, unchanged. there is mild effacement of the left ambient cistern, unchanged. there is no shift of the normally midline structures. no osseous abnormality is identified. anterior right ethmoid air cells are opacified. head and neck cta: the contrast bolus timing is suboptimal, markedly limiting evaluation. the intracranial internal carotid and vertebral arteries, and their major branches, are grossly unremarkable. the external carotid vasculature is suboptimally assessed. the abnormal blood vessels in the left cerebral hemisphere and left cerebellum, seen on the preceding mri and suspicious for dural avf, are poorly seen on this exam. large blood vessels are again seen in the left occiputal scalp. impression: 1) stable left parenchymal hemorrhages. 2) technically inadequate cta. however, a conventional angiogram would be the study of choice to evaluate for an arteriovenous fistula. cerebral angiogram and embolization : final report date of service: . preoperative diagnosis: probable dural arteriovenous fistula. attending: assistant: , m.d. and , nurse practitioner. anesthesia: general endotracheal. procedure performed: left vertebral arteriogram, left common carotid arteriogram, left external carotid arteriogram,left middle meningeal artery arteriogram, left occipital artery arteriogram. interventional procedures performed: 1. coil and onyx embolization of distal right middle meningeal artery. 2. onyx embolization of right occipital artery branches 3. coil embolization of left transverse and sigmoid sinuses with cashmere and axium coils. angio-seal closure of the right common femoral artery. details of the procedure: the patient was brought to the angiography suite after the procedure was explained to the patient's wife and written informed consent was obtained. iv sedation was given, and the patient was put under general anesthesia. following this both groins were prepped and draped in usual sterile fashion. access was gained to the right common femoral artery using seldinger technique and a 6 french long vascular sheath was placed in the right common femoral artery. the left vertebral artery was then selectively catheterized using catheter and angled glidewire, and an angiogram was performed. the left common carotid artery was then catheterized. through this catheter, two exchange-length control wires were placed, and a 7 french 90-cm shuttle sheath was placed into the distal common carotid artery. through this, using a combination of multiple catheters and multiple wires, the left external carotid artery was accessed using a 5 french cobra 1 catheter and over a glidewire. this was then exchanged over an exchange-length glidewire for a 057 dac. super-selective access was then obtained of distal middle meningeal branches with a synchro-2 wire and sl-10 microcatheter which were passed across the point of fistula into a venous pouch adjacent to the left transverse sinus. multiple cashmere coils were then placed within this traversing the fistulous connection. control angiogram through the dac demonstrated multiple other feeders to the av fistula, and thus the catheter was exchanged for a rapid transit and further embolization was undertaken within two distal middle meningeal branches with onyx 18 with good penetration into the nidus. attention was then turned to the left occipital arterial supply, and a rapid transit catheter and gold-tip glidewire advanced into a dominant supplying artery, and embolization was undertaken with onyx. central angiogram at this point demonstrated further occipital arterial supply from very small feeders which we were not able to embolize, and thus at this point we decided to perform embolization from the venous side. access was gained to the left common femoral vein with a 6 french sheath, and under careful guidance, access was gained to the left internal jugular vein using a vert catheter and angled glidewire. an echelon catheter and x-pedion wire were then used to cross a stenotic portion of the transverse sigmoid sinus junction and into the left transverse sinus. embolization was then undertaken with multiple coils including axium 3d, cashmere, and gdc, with good result. followup angiography was performed which demonstrated near-complete occlusion of the complex fistula. a common femoral arteriogram was then performed, and an 8 french angio-seal closure device was used to close the arteriotomy in the right groin. the venous puncture was closed with direct manual pressure. the patient tolerated the procedure well without immediate complications and was sent to the icu in stable condition. findings: left vertebral arteriogram: left vertebral arteriogram demonstrates normal filling of the vertebrobasilar system with good reflux into the right vertebral artery. there is early filling of the left transverse sinus. the posterior meningeal branch of the left vertebral artery supplies a dural av fistula which is better delineated on subsequent angiograms, with note made of early retrograde cortical venous drainage which is seen to fill the superior sagittal sinus. there is no aneurysm or venous pouch identified on this study. left common carotid arteriogram: there is normal filling of the cervical, petrous, cavernous, and supraclinoid portions of the left internal carotid artery, with normal filling of the left anterior and middle cerebral arteries. the external carotid arterial system is hypertrophied, with especially prominent middle meningeal and occipital branches feeding a large dural av fistula in the region of the left transverse sinus, with early anterograde drainage seen into the left transverse sinus and jugular vein, as well as retrograde drainage into two large cortical veins which eventually empty into the mid superior sagittal sinus. left middle meningeal artery arteriogram: shows hypertrophied branches supplying the dural fistula primarily ending in the transverse sinus. left occipital artery arteriogram: shows numerous small branches supplying the dural av fistula through transosseus branches. left common carotid artery artriogram following embolization: following embolization, stagnant flow is seen within the occipital and middle meningeal arteries. there is no evidence of dural av fistula. there is no early venous drainage as was noted previously. the left transverse sinus and sigmoid sinuses are completely occluded. venous drainage of the left cortex is seen seen through multiple cortical veins entering the superior sagittal sinus. impression: underwent cerebral angiography and embolization of a complex ( iii) dural av fistula with embolization of arterial supply from left middle meningeal, left occipital, and left vertebral arteries, as well as venous embolization of the left transverse and sigmoid sinuses. brief hospital course: 72 yo rh russian man with pmh of prostate cancer ( 6, followed by dr. , htn and hld, flighted from hospital after developing sudden fluent non-sensical speech and 2 gtcs on . found to have multiple l sided intraparenchymal hemorrhage (parietal, temporal and occipital). he was intubated for decreased level of arousal but was successfully extubated on , , called out to the floor on . the multiple left-sided intraparenchymal hemorrhage were thought to be secondary to avf, so pt underwent angiographic embolization on , with embolization of most but not all feeder vessels. #neuro: - continue levetiracetam 1 g for seizure precautions - s/p conventional cerebral angiogram. will need repeat cerebral angiogram in 1 month. f/u arranged with dr. on . #id: concern about pulmonary tuberculosis: ct chest yesterday demonstrated no lesions consistent with pna or tuberculosis, so have d/c'd tuberculosis precautions and further w/u. quantiferon gold was sent prior to this, and is pending. - urine cx positive for , complete tmp-smx x 7 days (day 1 = ) #cv: hld and htn; - have been holding home antihypertensives with prn hydralazine for bp management. has been at goal bp.have not needed to restart home meds as bp has been normal in house. #pulm: intubated for decreased arousal on after gtc x2, successfully extubated on , doing well on room air. #hem: -had hematoma s/p angiogram. h/h now stable. #ophth: glaucoma - continue home glaucoma medications #gi: -gerd: substitute omeprazole while in house. restart esomeprazole on discharge. #fen: passed bed-side swallow test - on soft cardiac diet medications on admission: apraclonidine (dosage uncertain) bimatoprost (dosage uncertain) doxazosin - 2 mg tablet - 3 tablet(s) by mouth at bedtime esomeprazole magnesium - 40 mg capsule, delayed release(e.c.) - 1 capsule(s) by mouth once a day finasteride - 5 mg tablet - 1 tablet(s) by mouth daily pilocarpine hcl - dosage uncertain simvastatin - 20 mg tablet - 1 tablet(s) by mouth at bedtime valsartan - 160 mg tablet - 1 tablet(s) by mouth once a day discharge medications: 1. apraclonidine 0.5% 1 drop right eye tid 2. calcium carbonate 500 mg po qid:prn heartburn 3. carbamide peroxide 6.5% 5-10 drop ad duration: 2 days 4. dorzolamide 2%/timolol 0.5% ophth. 1 drop right eye 5. finasteride 5 mg po daily 6. levetiracetam 1000 mg po bid 7. lumigan *nf* (bimatoprost) 0.03 % ou qhs * patient taking own meds * 8. pilocarpine hcl *nf* 4 % od hs apply inch ribbon in the lower conjunctival sac daily at bedtime * patient taking own meds * 9. sulfameth/trimethoprim ds 1 tab po bid duration: 7 days discharge disposition: extended care facility: discharge diagnosis: intraparenchymal hemorrhagic complex dural arterio-venous fistula discharge condition: mental status: confused - always. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to hospital after suffering speech problems and 2 generalized seizures. before being flown over here, you were at hospital, where you were intubated. ct of your head showed multiple bleeds in your brain. during the work-up of your strokes, we discovered that you had multiple arterio-venous fistulas in your brain, so you underwent angiographic embolization on . this "plugged up" most (but not all) of the blood vessels that were feeding the arterio-venous malformation. you will need to undergo repeat angiography in 1 month. we have set up follow-up for you in neurosurgery clinic with dr. , who did your angiogram. we have also set up follow-up for you in neurology clinic with dr. , who was your inpatient attending. followup instructions: provider: , md phone: date/time: 11:10 provider: , prostate cancer care np date/time: 11:30 provider: , md phone: date/time: 1:00 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours enteral infusion of concentrated nutritional substances arteriography of cerebral arteries endovascular (total) embolization or occlusion of head and neck vessels diagnoses: thrombocytopenia, unspecified esophageal reflux urinary tract infection, site not specified unspecified essential hypertension other convulsions unspecified glaucoma intracerebral hemorrhage constipation, unspecified other and unspecified hyperlipidemia cerebral aneurysm, nonruptured pneumonitis due to inhalation of food or vomitus malignant neoplasm of prostate aphasia physical restraints status 

Answer: The patient is high likely exposed to