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: codeine attending: chief complaint: headache major surgical or invasive procedure: : left craniectomy and evacuation of hematoma : trach placement : egd w/ gastric biopsy history of present illness: 68f who was camping in and went to bed around 1230am and was fine at that time. at approximately 230am she awoke with a severe sudden onset headache and informed her husband. she was nauseous and diaphoretic at that time but did not vomit. she was taken to hospital where she became altered and was intubated for declining mental status and sirway protection. she underwent a ct scan of the head which showed a large left occipital iph with intraventricular extension. while at the osh she was also noted to develop hypothermia and an enlarging left pupil. she received mannitol, lasix, and decadron and was transported to for further care. she arrives intubated and not sedated. her left pupil was reported as 4mm and nr upon arrival. unable to obtain review of systems past medical history: seasonal allergies social history: lives with husband normally in but camps each summer in in a trailer which is where she currently was. no tobacco family history: cva in mother, father, and grandmother physical exam: gen: intubated, not sedated heent: pupils: r 3mm and minimally reacts. l 6mm and nr eoms: unable to assess neck: supple. lungs: cta bilaterally. cardiac: rrr. s1/s2. abd: soft, bs+ extrem: warm and well-perfused. neuro: mental status: no response to commands, not sedated orientation, language, recall: unable to assess secodnary to clinic status cranial nerves: i: not tested ii: r 3mm minimally reacts l 6mm nr iii-xii: unable to assess motor: localizes with rue, no mvmt lue, w/d bilateral lower extremities sensation: unable to assess toes mute bilaterally coordination: unable to assess physical exam upon discharge: eo to noxious stimuli perrl + flinch to threat mae's spontaneously (l ue > r ue) r ue does not withdraw to stimuli but moves spont. incision- well healing except small area, mid incision that was moist and minimally opening on but this dry and closed on . pertinent results: cta head: findings: i concur with dr. analysis, but also there is substantial expansion of the hemorrhage, consisting of multiple new foci within the more anterior aspect of the left temporal lobe, completely effacing the left temporal , likely accounting for her observation of increasing mass effect. ct angiography of the head reveals no area of hemodynamically significant stenosis or within the limitations of this technique, an aneurysm or other vascular malformation. there does not appear to be any observable pathological vascularity in the area of the hemorrhage. however, it is to be acknowledged that the mass effect associated with the hemorrhage could obscure pathological vessels, by reason of compression of these structures. ct head: findings: there has been interval performance of a left frontal-temporal crainectomy, resulting in reduction in the extent of right sided subfalcine herniation. there also appears to have been partial removal of the hemorrhage, with contiguous gas bubbles likely reflecting surgery in the left parietal component of the hemorrhage. no change in ventricular size is seen, nor the extent of the intraventricular hemorrhage. ct head: impression: 1. slight decrease of the midline shift to the right. 2. slight increase of the extracranial fluid collection overlying the craniectomy site containing air and hemorrhage. 3. no acute territorial infarction, significant transtentorial herniation or new foci of intracranial hemorrhage. chest cta: impression: 1. no evidence of pulmonary embolism. 2. smooth interlobular septal thickening with ground-glass opacities of aerated lungs, compatible with pulmonary edema. neurogenic pulmonary edema is considered, given the patient's clinical history of recent intracranial hemorrhage. 3. large dependent right upper lobe and bilateral lower lobe consolidations could reflect dependent edema, but coexisting aspiration pneumonia should be considered. 4. small bilateral pleural effusions. head ct: impression: 1. no change in appearance of large left parietal and occipital intraparenchymal hematomas, blood layering along the tentorial leaflets, with an intraventricular extension. there is no evidence of new hemorrhage or new large vascular territorial infarction. 2. minimal transgaleal herniation in the posterior aspect of the craniectomy site. 3. slight increase in rightward shift of midline structures. gastric biopsy pathology: acute, ulcerative gastritis with numerous broad, ribbon-like, non-septate hyphal forms morphologically compatible with zygomycosis. pas-d and gms stains demonstrate the ribbon-like fungal hyphal forms previously seen on h&e-stained sections. mri cspine: multilevel degenerative disease. at c4-5, minimal retrolisthesis and a posterior endplate osteophyte ridge result in flattening of the ventral spinal cord and moderate spinal canal narrowing. uncovertebral and facet arthropathy results in approximately moderate bilateral neural foraminal narrowing. at c5-6, there is a posterior endplate osteophyte ridge, greater on the left, with flattening of the left ventral spinal cord and moderate narrowing of the left aspect of the spinal canal. there are uncovertebral osteophytes resulting in approximately moderate neural foraminal narrowing, worse on the left. eeg: impression: this is an abnormal video eeg due to the presence of a slow background with bursts of generalized slowing which represents a moderate encephalopathy and a left frontal breach rhythm due to skull defect. there were frequent left frontal central epileptiform discharges, often appeared as prolonged pleds at 1 hz for the majority of the recording, indicative of highly epileptogenic cortex. however, there was evolution of these discharges to suggest discrete electrographic seizures. ct abd/pelvis: impression: 1. no other sites of infection identified within the abdomen and pelvis. possible gastric wall thickening in the fundus vs. retained food should be correlated with recent egd. 2. improved bibasilar atelectasis with increased moderate-sized bilateral pleural effusions and persistent mild pulmonary edema. mri brain: impression: 1. acute/sub-acute infarct involving the splenium of corpus callosum secondary to posterior pericallosal vascular compromise from herniation. punctate focus of possible slow diffusion in the right parietal white matter suggesting a tiny infarct. 1. slight interval increase in the size of fluid overlying the craniectomy site. no interval change in the shift of midline structures. 2. large left parietal and occipital hematomas are redemonstrated with blood overlying the tentorium and blood in the lateral ventricles. 3. interval increase in mucosal thickening and fluid in the left mastoid air cells and new mild inflammatory changes in the right mastoid air cells, sphenoid sinuses, and maxillary sinuses. ct abd/pelvis: impression: 1. no other sites of infection identified within the abdomen and pelvis. possible gastric wall thickening in the fundus vs. retained food should be correlated with recent egd. 2. improved bibasilar atelectasis with increased moderate-sized bilateral pleural effusions and persistent mild pulmonary edema. eeg: impression: this is an abnormal video eeg due to the presence of a slow background which represents a moderate encephalopathy and generalized delta frequency slowing which represents deep midline dysfunction. the left hemisphere showed persistently increased amplitude and sharper contours indicative of a breach rhythm such as can be seen in skull defect. additionally, there was focal left frontal or diffuse left hemisphere delta frequency slowing which represents focal subcortical dysfunction. there were frequent left frontal central sharp discharges and there were long periods of left hemisphere periodic lateralized epileptiform discharges (pleds) occurring at 1 hz frequency which represents highly epileptogenic cortex, without any clear clinical change. no clear electrographic seizures were seen. gastric bx pathology: gastric body type mucosa with focal active inflammation and fibrin deposition. numerous aggregates of fungal organisms with the same morphology as described in previous biopsies (s11-24004g) are present. pas and gms stains examined. eeg: impression: this is an abnormal video eeg due to the presence of a slow background which represents a moderate to severe encephalopathy, along with a left frontal breach rhythm due to skull defect. it is also abnormal due to the presence of left frontal and left hemisphere epileptiform discharges, which occurred as left hemisphere periodic lateralized epileptiform discharges, or pleds, at 1 hz frequency for the majority of the recording. these finding indicates highly epileptogenic cortex, but no clear evolution of the discharges were seen to suggest electrographic seizures. this pattern alternated with left hemisphere rhythmic delta and theta frequency activity with embedded left frontal spikes. of note, there was significant electrical artifact in the left hemisphere which obscured some portions of the study. eeg: impression: this is an abnormal video eeg due to the presence of frequent left frontocentral or left hemisphere epileptiform discharges, which occurred as prolonged runs of pleds at 1hz, indicatve of epileptogenic cortex. however, no clear electrographic seizures were seen. focal mixed delta and theta frequency slowing was also seen in the left hemisphere indicative of subcortical dysfunction. there were six pushbutton activations without any clear clinical change concerning for seizure activity and without any change on eeg. the background was slow and disorganized, consistent with a moderate encephalopathy. eeg: impression: this is an abnormal video eeg due to the presence of frequent and nearly continuous left hemisphere periodic lateralized epileptiform discharges, or pleds, occurring at 1 hz frequency which represents highly epileptogenic cortex. alternating with this pattern were brief periods of delta and theta mixed frequency slowing with some continued left hemisphere sharp wave discharges notably between 12:15 and 12:30 as well as 17:30 and 19:30. the focal slowing reflect subcortical dysfunction. there was left posterior quadrant increased amplitude and faster activity which represents a breach rhythm such as due to skull defect. there were no electrographic seizures seen in this recording. ct head: impression: interval evolution of intracranial hemorrhage with stable rightward mass effect, and fluid collection in the hemicraniectomy bed. lenis: impression: no evidence of dvt in the left lower extremity. cxr: a tracheostomy tube is present. compared with , 5:19 a.m. and allowing for differences in technique, i doubt significant interval change. again seen is a tracheostomy tube, cardiomegaly, and diffuse opacities in both lungs, with increased retrocardiac density and obscuration of the left hemidiaphragm. the appearance would be compatible with pulmonary edema, with or without associated pneumonia. brief hospital course: pt was taken emergently from the emergency room to the or for emergent neurosurgical intervention. she underwent a craniotomy and evacuation of the hematoma. she tolerated the procedure well, remained intubated and was transferred to the icu. on pod#1 her mannitol was weaned and she was extubated. she initially remained stable but in the early morning on she developed desaturations and respiratory distress which required reintubation. cxr revealed bilateral consolidations therefore a bronchoscopy was performed by the sicu team. she was also noted to be hypernatremic so she was started on free water boluses. on , neurology consult was obtained who thought there may be decreased movement on one side, so a repeat head ct was obtained, which was stable. on , the patient's family met with the sicu team and nsurg team and agreed to proceed with tracheostomy and peg. additionally, she remained intermittently febrile and so was started on vancomycin, cefepime, and tobramycin for vap. on , a tracheostomy was performed but the peg was aborted due to a large gastric ulcer in the body of the stomach, at the proposed site for the peg. an h.pylori was sent which was negative. a gastric biopsy was positive for invasive zygomycosis. id was consulted. on , she had an mri of the cspine done for a question of upper extremity weakness, no major spinal etiology was noted. she was febrile on and was pancultured. she was bolused with dilantin for a low therapeutic level. on she was once again bolused with dilantin. an ab/pelvic ct was obtained per id recommendations. eeg from showed some seizure activity. she was also started on ambisome for presumed zygomycosis infection. on , patient recieved another dilantin bolus and keppra was added to her medications. neurology is concerned that patient continues to seize. on , her dilantin goal was increased to 20-25. her corrected level was currently 15.2, so a 500mg bolus of dilantin was administered. on examination, patient remained unchanged. id recommends vancomycin, ambisome, and cefepime for her treatment of zygomycosis. on , patient was seen to be 5 liters positive, question if extra fluid in iv antibiotics. pharmacy was consulted to help reduce amount of fluid mixed with antibiotics. dilantin was changed to iv for better absorption and an additional 100mg iv was given. her current level corrected was found to be 18.0. on , a ct chest shows worsening plueral effusion, bal done, spiked temp. 300mg bolus dilantin and standing dose increased to 150mg tid. on , dilantin level was 16.5 corrected, reloaded with 350 mg dilantin, febrile - fever w/u ordered. she was started n a 2 week course of linezolid for a blood culture with staphylococcus, coagulase negative. on , febrile, ua neg, lasix given for pulm edema seen on cxr, informal bedside echo showed good function on her dilantin goal was changed to 10-20 and she remained stable on she again was stable in the icu on her dilantin level was 6.0 and per the epilepsy team her dilantin elvels were no longer being chased. on she remained stable an has been afebrile since the evening of on she was awaiting a rehab bed and remained neurologically stable. on a bed was offered and she was cleared for rehab. medications on admission: zyrtec, colace, mvi, other vitamins discharge medications: 1. senna 8.8 mg/5 ml syrup : one (1) tablet po bid (2 times a day). 2. docusate sodium 50 mg/5 ml liquid : one (1) po bid (2 times a day). 3. bisacodyl 5 mg tablet, delayed release (e.c.) : two (2) tablet, delayed release (e.c.) po daily (daily). 4. acetaminophen 650 mg/20.3 ml solution : po q6h (every 6 hours) as needed for pain. 5. glucagon (human recombinant) 1 mg recon soln : one (1) recon soln injection q15min () as needed for hypoglycemia protocol. 6. chlorhexidine gluconate 0.12 % mouthwash : fifteen (15) ml mucous membrane tid (3 times a day). 7. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization : one (1) neb inhalation q6h (every 6 hours) as needed for wheeze. 8. ipratropium bromide 0.02 % solution : one (1) neb inhalation q6h (every 6 hours) as needed for wheeze. 9. nystatin 100,000 unit/ml suspension : five (5) ml po qid (4 times a day) as needed for thrush. 10. heparin (porcine) 5,000 unit/ml solution : one (1) ml injection tid (3 times a day). 11. levetiracetam 100 mg/ml solution : twenty (20) ml po bid (2 times a day). 12. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 13. quetiapine 25 mg tablet : one (1) tablet po bid (2 times a day). 14. linezolid 600 mg/300 ml parenteral solution : three hundred (300) ml intravenous q12h (every 12 hours): continue for 2 weeks day 1=. 15. amphotericin b liposome 50 mg suspension for reconstitution : three y (350) mg intravenous q24h (every 24 hours): continue for 1 month (day 1= )will decide in id f/u whether to change to po. 16. fosphenytoin 50 mg pe/ml solution : four (4) ml injection q8h (every 8 hours). 17. insulin regular human 100 unit/ml solution : one (1) injection asdir (as directed). discharge disposition: extended care facility: for the aged - macu discharge diagnosis: intracranial hemorrhage s/p craniotomy cerebral edema gastric ulcer dysphagia respiratory failure pneumonia zygomycosis pulmonary edema fever seizure discharge condition: mental status: confused - always. level of consciousness: lethargic but arousable. activity status: bedbound. discharge instructions: general instructions ?????? have a friend/family member check your incision daily for signs of infection. ?????? take your pain medicine as prescribed. ?????? exercise should be limited to walking; no lifting, straining, or excessive bending. ?????? your wound closure uses dissolvable sutures. ?????? you may shower. ?????? increase your intake of fluids and fiber, as narcotic pain medicine can cause constipation. we generally recommend taking an over the counter stool softener, such as docusate (colace) while taking narcotic pain medication. ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, and ibuprofen etc. ?????? you have been prescribed dilantin (phenytoin) for anti-seizure medicine, take it as prescribed and follow up with laboratory blood drawing in one week. this can be drawn at your pcp??????s office, but please have the results faxed to . you have also been discharged on keppra (levetiracetam), you will not require blood work monitoring. ?????? clearance to drive and return to work will be addressed at your post-operative office visit. ?????? make sure to continue to use your incentive spirometer while at home, unless you have been instructed not to. followup instructions: neurosurgery: ??????please call ( to schedule an appointment with dr. , to be seen in 4 weeks. ??????you will need an mri of the brain with gadolinium contrast. gi: ?????? you need a repeat egd in weeks. they will see you in clinic prior to this to reevaluate you. they will call you with the date and time of this appointment with dr. . if you do not hear about this appointment, please call (. until this time you will continue to be fed via ng/nj tube. infectious disease: ?????? you are to continue with linezolid for a total of 2 weeks (day 1= ). you are to continue with ambisome for 1 month. after your repeat egd they will decide whether this can be changed to po. you will follow up in the clinic after your repeat egd. they will call you with the date and time of this appointment with dr . if you do not hear from them please call ( to check on the scheduling process. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances other bronchoscopy temporary tracheostomy closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus other incision of brain esophagogastroduodenoscopy [egd] with closed biopsy other repair of cerebral meninges other craniectomy injection or infusion of oxazolidinone class of antibiotics video and radio-telemetered electroencephalographic monitoring diagnoses: pneumonia, organism unspecified unspecified essential hypertension intracerebral hemorrhage other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure acute respiratory failure cerebral edema hyperosmolality and/or hypernatremia accidents occurring in residential institution subdural hemorrhage surgical or other procedure not carried out because of contraindication zygomycosis [phycomycosis or mucormycosis] other amyloidosis dysphagia, unspecified unspecified cerebrovascular disease acute gastric ulcer without mention of hemorrhage or perforation, without mention of obstruction 

Answer: The patient is high likely exposed to