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: right cerebellar hemorrhage major surgical or invasive procedure: suboccipital crani for evacuation of the right cerebellar hemorrhage right frontal evd placement history of present illness: this is a 73 year old man with hypertension and vascular disease transferred from hospital with reported cerebellar hemorrhage. he reportedly was brought to the osh after developing nausea, vomiting, and diaphoresis at his apartment complex. he arrived complaining of a headache; the nursing notes says he was awake and speaking and denied cp/sob on arrival. he was markedly hypertensive on arrival -- bp was recorded initially as 232/132 (vs otherwise unremarkable). cbc and coags were normal (inr 0.9 and no known h/o a/c); bmp was pending. ecg remarkable for obvious lvh (voltage criteria) and ?rbbb (rsr' in iii), with nsr. he was given zofran and labetalol, and when his systolics remained elevated in the 200s, he was started on a nitroprusside drip. he was taken for nchct, which showed a 3cm right cerebellar hemorrhage. at some point during this initial evaluation, he became acutely non-responsive, so he was intubated (induced with etomodate and succinylcholine, also fentanyl) and med-flighted here to . he was continued on the nipride gtt en route, and paralyzed for transport using rocuronium and propofol gtt. he arrived here around 21:30 with bp 267/131, down to 168/96 with increased nitroprusside gtt rate. he was flaccid (paralyzed). the ed resident informed me that someone had commented on "asymmetric pupils" at some point, but the personell said that his pupils were 2mm and equal the entire trip (they were this size of smaller, non-reactive, on my arrival to the ed a few minutes after his arrival). past medical history: 1. hypertension 2. renal artery stenosis 3. aaa endovascular repair c/b r ext iliac pseudoaneurysm, also s/p repair 4. peripheral vascular disease 5. nephrolithiasis 6. hyperlipidemia 7. copd social history: lives alone, ex wife lives in u.s. but the rest of extended family resides in . he is primarily arabic speaking, but understands some english. no tobacco. family history: non-contributory physical exam: on admission: mental status: sedated / non-responsive. does not blink or track. later, as paralytic lifted, he grimaced inconsistently to noxious stimulation and spontaneously moved his right shoulder and both legs. -cranial nerves: pupils are equally small (1.5-2mm), round, and non-reactive to light (?"pontine" pupils). no good view for fundoscopy (small pupils). no doll's eye response initially. eyes mid-position with no movement. initially, no corneal response or response to nasal tickle. later, bilateral weak eyelash-blink responses and legs moved to bilateral nasal tickle. face was symmetrically lax; when he later furrowed his brow to noxious stimulation, it elevated symmetrically. initially, no gag or cough; later strong cough (tracheal suction) and weak gag (gentle ett-wiggle). initially, not over-breathing the vent and not initiating full breaths on cpap. -motor: initially, flaccid x all extremities and axially. later, spontaneous minimal movements of rue and bilatearl les. at discharge: awake, alert to self, hospital, month. following all commands. mae with full strengths. incision well healed. pertinent results: head ct : findings: centered within the right cerebellum, there is a 5.4 x 3 cm hyperdense hemorrhage with surrounding edema (previously 2.8 x 3 cm); this hemorrhage crosses the cerebellar vermis into the left cerebellar hemisphere. hyperdense blood is seen within the fourth ventricle extending up into the third ventricle. the lateral ventricles and third ventricle are dilated measuring up to 4.4 cm. hyperdense blood is seen layering within the occipital horns bilaterally. there is no significant shift of normally midline structures. the basal cisterns inferiorly are obliterated. the posterior fossa is expanded with mass effect on the brainstem. the cerebellar tonsils are at the level of the foramen magnum. no acute fracture is seen. the visualized portions of the paranasal sinuses and mastoid air cells are well aerated. retained secretions are noted in the nasopharynx. impression: large parenchymal hemorrhage centered in the right cerebellar hemisphere with intraventricular extension, mass effect, and hydrocephalus as above, increased since 2 hours prior. head ct 1. interval occipital craniectomy with increased but residual hyperdense blood in the cerebellum and ventricles; evaluation of mass effect is suboptimal on this study due to portable technique. 2. interval placement of a right frontal approach ventricular catheter with persistent hydrocephalus. ct head impression: 1. interval significant decrease of the hydrocephalus with normal size of the lateral ventricles and with the evd in place. 2. increase of subarachnoid hemorrhage in the both temporal and occipital lobes, likely due to redistribution of the intraventricular hemorrhage. 3. compared to the most recent prior study from , unchanged amount of hemorrhage in the fourth ventricle and the cerebellar hemispheres. ct head overall stable examination without significant hydrocephalus in the setting of external ventricular drain. parenchymal hemorrhage centered in the right cerebellum with extension into the fourth ventricle and biparietal/bitemporal subarachnoid hemorrhage, similar to 20 hours prior. ct head 1. interval removal of the right transfrontal ventriculostomy catheter with hyperdensity along catheter tract, representing minor parenchymal hemorrhage with trace intraventricular extension. 2. otherwise, the appearance is largely unchanged with biparietal and bitemporal subarachnoid blood, likely redistributional, related to the right cerebellar hemispheric hemorrhage with fourth ventricular extension, status post occipital craniectomy. ct head unchanged right cerebellar hemorrhage with intraventricular extension into the fourth ventricle. unchanged biparietal and bitemporal subarachnoid blood. unchanged minor parenchymal hemorrhage along the prior ventriculostomy catheter tract. unchanged ventricle size. no evidence of vascular territorial infarction lenis impression: no evidence of deep venous thrombosis in the lower extremities. chest xray : pa and lateral radiograph demonstrates unremarkable mediastinal, hilar and cardiac contours. lungs are clear. previously noted pulmonary edema has resolved. small bilateral pleural effusions noted. left subclavian line tip is terminating in the mid-to-distal superior vena cava. no pneumothorax. lower extremity doppler ultrasound : no evidence of deep vein thrombosis in either right or left lower extremity. lenis : no evidence of deep vein thrombosis in either leg. nchct: : impression: 1. increased prominence of the extra-axial csf spaces, particularly evident in the right posterior fossa and right frontal region. this may be related to volume loss from surgery, but the patient should be followed for intracranial hypotension with clinical correlation. indentation on the right cerebellar hemisphere from the right posterior fossa extra-axial fluid collection. 2. expected evolution of intracranial hemorrhage with decreased density of right cerebellar hemispheric hemorrhage, and near complete resolution of subarachnoid and ventriculostomy catheter tract hemorrhage. brief hospital course: pt was taken to the or emergently for suboccipital craniectomy and evacuation of ich. prior to this procedure a r frontal evd was placed without difficulty. he did recieve 2 units of platelets for his use of plavix. post operatively he remained intubated and was taken to the icu for further care including sbp control and q1 neurochecks. his evd was kept at 15cm above the tragus. on post op exam he was not following commands but moved everything to noxious. his pupils were equal and reactive. a head ct on the morning of showed good evacuation of ich and decreased hydrocephalus. on he was extubated without difficulty. he was noted to be awake and alert to self, following commands and moving all extremities with full strength. on , the patient experienced respiratory issues overnight into am. bipap ventilation was started at 930 am. teh patient was given lasix. a cxr was consistent with worseing consolidation and empiric antibiotic therapy was initiated for for ventilatory aquired pneumonia. the wbc level was 17.2 from 14.8 on . the external ventricular drain exhibited poor output of 4cc from 7-9am. the evd was distally/proximally flushed and the extrenal ventricular drain decreased to 10 and left open. icps were correlating with patient's activity and were . a nchct was performed which was consistent with good placement evd and no hydrocephalas. emergent reintubation at 1230pm for poor ventilatory status. a triple lumen placed. and a bronchcoscopy was performed at the bedside and a bal was sent. on , the patient's exam improved and he was able to follow some simple commands. the external ventricular drain was discontinued as there was no drainage of csf from the evd and the patient's 4th ventircle was noted to be patent on head ct. there staples were placed for closure. on , the patient neurological exam was improved and he was able to follow commands in all four extremities with full strength. eyes were open sponanteously, pupils were equal and reactive. the patient was electively extubated after diuresis with lasix. he tolerated extubation well. the steroids were discontinued as the patient has pneumonia and cdiff concurrently. he was agitated on and seroquel was increased. in the evening he did well on q2 hr neuro checks. he was less agitated. staining was noted on his pillowcase and there was a concern for csf leak. a clean dressing was applied and scant staining only was noted. he had no sign of hydrocephalus on . he was more oritented and appropriate. orders to the sdu were done. pt and sw were consulted. on , patient was transferred to the step down unit. his evd staples were removed. his catheter was removed, but unfortnately patient was unable to void on his own requiring him to undergo a straight catheterization. on his dressing remained clean and dry without evidence of leak and the patient continued to improved neurologically. he worked with pt and was found to be orthostatic. on he continued to improve and worked with pt and began being screened for rehab. attempts were made to contact the family in but three numbners were disconnected. he had some hypotension on that responded to fluid bolus. he was stable on . on his abdomen was found to be distended and post void bladder scan revealed 1000cc remaining in the bladder so a foley was replaced and the patient was started on flomasx. his creatinine bumped on to 2.1 (baseline elevated > 1.3) likely due to mild dehydration as his oral intake was poor. he was given a fluid bolus and placed on low iv maintenence fluids. his labs were trended. on his creatinine decreased to 1.8, and we again attempted to remove his foley. his sutures were removed on .....he had screening lenis on that were again negative for dvt. he remained stable - . disposition planning continues. a stool sample was sent on which was negative for cdiff. on he remained stable and his creatinine was done to 1.7 from 2.0 he was seen by ot and c/o dizziness - he vomited x 1 with ? of some small blood tinged mucus. this was discarded and not seen by staff. he did vomit again while oob to chair without any blood. labs and ct were ordered after reviewing omr. his ct was stable with no changes. quetiapine dosing was decreased by half. on he continued to have nausea and poor po intact. nutrition was consulted and stool was sent for c-diff. nystatin and second alpha blocker were discontinued. on the patient was orthostatic when he got up with pt. he was given an ivf bolus and standing ivf due to his continued poor po intake. he was started on calorie counts. on he was neurologically stable. he continued to have abdominal discomfort despite c-diff negative x3. stool o+p were sent, although discomfort is likely just due to history of + cdiff. laboratory values were stable. throughout his hospital course, he coninued to have episodes of nausea with occasional vomiting. this responded well to zofran and fluid resuscitation. on , he remained stable. his po intake remained poor and the psychiatry team was consulted as it was felt his poor po intake could be a result of depression. the psychiatry team recommended starting remeron to help with sleep/wake cycle. on a foley catheter d/c trial was once again initiated but the pt failed to void so it was replaced. the urology team was consulted since this was the 4th time he failed. they recommended keeping the foley in place for an additional 6 days then following up in the urology clinic. the patient continued to remain stable awaiting his family's arrival from . on the patient's ex-wife arrived and worked with pt/ot. teaching was initiated on how to care for the patient upon leaving the hospital. he remained stable on . he continued to await disposition to an extended care facility. he had another repeat lenis on which showed no evidence of dvt. a ct head was obtained on which showed expected evolution of intracranial hemorrhages. no acute infarct or hemorrhage. no evidence of hydrocephalus. on the patient failed another voiding trial and the foley catheter was replaced. on urology was re-consulted for persistent failure to void. they continued to recommend a urodynamic study as an outpatient. they also recommended intermittent catheterization, which is preferred over indwelling foley catheter but this was not possible due to patient's lack of participation. on the patient and his ex-wife worked with pt and ot with the help of an interpreter and he was cleared for discharge. he is afebrile, vss, and neurologically stable. patient's pain is well-controlled and the patient is tolerating a good oral diet. pt's incision is clean, dry and inctact without evidence of infection. patient is ambulating safely over short distances and has been given a wheelchair for longer distances. medications on admission: 1. plavix 2. simvastatin 3. amlodipine 4. labetatlol 5. lisinopril 6. cardura (doxazosin) 7. percocet 8. ambien 9. atrovent 10. advair 11. miralax 12. colace 13. vitamin c discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. doxazosin 1 mg tablet sig: two (2) tablet po hs (at bedtime). 3. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 4. labetalol 200 mg tablet sig: two (2) tablet po tid (3 times a day). 5. mirtazapine 15 mg tablet sig: 0.5 tablet po hs (at bedtime). disp:*15 tablet(s)* refills:*2* 6. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 7. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 8. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. megestrol 400 mg/10 ml (40 mg/ml) suspension sig: one (1) po daily (daily). disp:*1 bottle* refills:*2* 10. advair diskus 250-50 mcg/dose disk with device sig: one (1) inhalation inhalation once a day. 11. atrovent hfa 17 mcg/actuation hfa aerosol inhaler sig: one (1) inhalation inhalation q6hr as needed for shortness of breath or wheezing. discharge disposition: home discharge diagnosis: right cerebellar hemorrhage intraventricular hemorrhage hydrocephalus cerebral edema confusion c-diff vap respiratory failure requiring intubation hypotension urinary retention nausea vomiting orthostasis malnutrition discharge condition: mental status: confused - sometimes. level of consciousness: lethargic but arousable. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: general instructions ?????? 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. ?????? 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: please follow-up with dr in 4 weeks with a head ct w/o contrast. please call to make this appointment. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours 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 arterial catheterization closed [endoscopic] biopsy of bronchus other incision of brain insertion or replacement of external ventricular drain [evd] diagnoses: obstructive hydrocephalus unspecified protein-calorie malnutrition chronic airway obstruction, not elsewhere classified peripheral vascular disease, unspecified intracerebral hemorrhage nausea with vomiting other and unspecified hyperlipidemia 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 atherosclerosis of renal artery intestinal infection due to clostridium difficile cerebral edema retention of urine, unspecified hyperosmolality and/or hypernatremia ventilator associated pneumonia accidents occurring in residential institution other alteration of consciousness physical restraints status unspecified renovascular hypertension 

Answer: The patient is high likely exposed to