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: history of present illness: is a 70 year old female with a past medical history of high cholesterol, mitral valve prolapse, and recent history of falls and unsteady gait. the patient's husband describes approximately two to three months of ill health with symptoms mainly consisting of some dyspnea on exertion, breathing trouble, non-specific weakness and several falls. today, miss fell while on the toilet. the patient denies loss of consciousness. family reports loss of consciousness. the patient was brought to the emergency room at an outside hospital where she was alert and oriented times three and in respiratory distress. she was treated for congestive heart failure and transferred to . here in the emergency room, she was tachypneic and hypertensive, and arterial blood gas revealed ventilatory failure for which she was intubated. in the emergency department, ct scan of the head revealed a question of left frontal early ischemic lesion. neurology was consulted. the patient was treated with additional lasix and triaged to medical intensive care unit. past medical history: 1. mitral valve prolapse. 2. right carotid stenosis. 3. hypercholesterolemia. 4. question of hypertension. 5. breast ca, question tamoxifen. 6. history of unsteady falls. medications: 1. atenolol 25 mg p.o. q. day. 2. zocor 10 mg p.o. q. day. 3. detrol. 4. aspirin. allergies: tamoxifen leads to a rash. social history: the patient lives in , is married, and was in the area visiting family. no tobacco. son, whose name is , has a phone number of . physical examination: on admission, temperature 98.1 f.; heart rate 60 to 70; blood pressure 120/90; respiratory rate, intubated. generally, intubated and sedated. pupils equally round and reactive to light and accommodation. face was symmetrical. neck was supple; increased jugular venous distention to approximately 8 to 9 cm. lungs with bibasilar crackles. cardiac regular with ii/vi at left lower sternal border. abdomen was soft, nontender, nondistended. positive bowel sounds. extremities: warm with good pulses, positive edema. laboratory on admission: white blood cell count of 6,800, hematocrit of 42.8, platelets 199,000. sodium 134, potassium 5.4, chloride 99, co2 of 32, bun 26, creatinine 1.1, glucose 105, alt 188, ast 239, ldh 2137. urinalysis was nitrite positive, positive white blood cells, positive bacteria. cpk went from 138 to 252. arterial blood gas revealed gas of 7.17/103/107. ekg was normal sinus rhythm, normal axis, large p wave in ii, t's decreased in iii, avf and v2 through v5. chest : moderate congestive heart failure, no infiltrates. ct scan of the head showed negative bleed, question left frontal cortex, hypodense, question edema and infarction. brief summary of hospital course: this is a 70 year old female with question of neurological history who presents status post syncope with respiratory distress requiring intubation, intermittent hypertension and evidence of congestive heart failure. ekg and head ct scan was suggestive of ischemic process of the brain. also, urinalysis is suggestive of urinary tract infection. the patient had a right arterial line placed as well as right internal jugular catheter centrally placed. this was done without complications. on , the day of admission, the patient was started on nitroprusside ggt for unstable systolic blood pressure. the patient was continued on a propofol drip, lopressor, zocor, levaquin for urinalysis and zantac for gi prophylaxis. the patient was not aggressively diuresed. chest was revealing of only mild congestive heart failure with oxygen saturations stable. the patient underwent cardiac echocardiogram on , which showed positive left ventricular hypertrophy. no thrombus was seen and ejection fraction estimated at 45% with apical lateral hypokinesis. the patient had an episode in the evening of to , of bloody gastric drainage and was started on protonix 40 mg p.o. twice a day and subcutaneous heparin was discontinued in favor of venodyne. the patient's neurologic examination at this time: the patient squeezes with left hand only and wiggles left toes only. the patient opens eyes to command. an mri/mra performed on , showed hemorrhage into the left frontal infarction with midline shift; no significant carotid stenosis was seen and right frontal area of apparent hemorrhage, the patient's carotids appeared normal on mra. the patient had a transesophageal echocardiogram on , which showed left atrium normal in size. no mass or thrombus was seen in the left atrium or left atrial appendage. no mass or thrombus was seen in the right atrium or right atrial appendage. no asd or patent foramen ovale was seen by 2d color doppler or saline contrast maneuvers. moderate symmetric left ventricular hypertrophy; left ventricle cavity is unusually small. left ventricular systolic function is hyperdynamic with ejection fraction greater than 75%. the right ventricular free wall is hypertrophied. aortic leaflets appear structurally normal; no aortic regurgitation. small pericardial effusion. no vegetations or thrombi were identified compared to trans-thoracic study of . right ventricular function was probably also depressed in the prior study but the right ventricular free wall was less well seen in the prior study. the patient had a head ct scan done on , which showed two areas of hemorrhage: the first was located in the left frontal lobe in the region of the infarction first seen on . the size of the hemorrhage and extensive surrounding edema and mass effect is unchanged from the mri of . the left lateral ventricle is mildly compressed and shifted to the right. there is no hydrocephalus. a second area of hemorrhage is seen as a small 3 mm hyperdense region, high in the sulcus of the parietal lobe. bone windows show fluid levels within the sphenoid sinus; these are unchanged from mri of . no fractures were identified. on , the patient self extubated thought to be secondary to a respiratory muscle weakness and shallow breaths with respiratory rate into the fifties and delta mf. the patient was reintubated and put on assist control. the patient's blood pressure was labile throughout her intensive care unit stay. the patient would have episodes of blood pressure 200 to 100 which would resolve either spontaneously or with lopressor. she would then drop down to the 90s systolic. lability of the blood pressure stabilized throughout her intensive care unit stay. the patient was put on atenolol 12.5 mg p.o. q. day and blood pressure ranged at the end of the micu stay was from 110 to 170 systolic. the patient had no readily appreciated changes in mental status during these episodes. neurology recommended an mr of the cervical spine which was done on , showed no evidence of cord compression or neural impingement. cord signal is normal. the etiology of the patient's failure for extubation was thought to be possibly centrally mediated. the patient had a tracheostomy placed on , without complications. a peg tube was successfully placed on , using standard techniques. an esophagogastroduodenoscopy at the time showed normal egd to the stomach. the patient was started on tube feeds and tolerated them well. the patient's sedation was weaned off and the patient was alert and responsive to questions and commands. the patient had a ct scan of the chest on , to assess for possible primary pulmonary process, and to assess for previous needs for intubation and prolonged ventilation. this study revealed no gross evidence of interstitial lung disease, bibasilar dependent opacities, more prominent on the right lower lobe than the left; may represent atelectasis. a small pericardial effusion and cardiomegaly. on , the patient was changed to a tracheostomy mask with 50% of fio2. the patient tolerated trache mask and was briefly put on respiratory support on the evening of and was switched back to tracheostomy with face mask of fio2 of 50. the patient had original respiratory rate of 40 to 50; this slowly came down into the 20s. repeat arterial blood gas on trache mask revealed no elevated hypercarbia above normal. the patient's ph of 7.39, pco2 of 54, and po2 of 103. the patient's pco2 was in line with previous pco2 while intubated. increased respiratory rate did not lead to respiratory alkalosis and there was no failure of total volume. the patient was discharged to the medical floor on , in stable condition and awaiting placement. condition on discharge: stable. discharge diagnoses: 1. ischemic transformed into hemorrhagic stroke. 2. hypercarbic respiratory failure. discharge medications: 1. zocor 10 mg p.o. q. day. 2. atenolol 12.5 mg p.o. q. day. 3. prevacid 15 mg p.o. q. day. 4. promod with five hour tube feeds at 65 cc per hour. 5. oxygen through her tracheostomy mask to keep oxygen saturation greater than 90%. code status: the patient is full code. disposition: the patient was discharged to rehabilitation facility at . follow-up instructions: 1. the patient should follow-up with neurologist. 2. follow-up with primary care physician. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more diagnostic ultrasound of heart other esophagoscopy insertion of endotracheal tube enteral infusion of concentrated nutritional substances other bronchoscopy percutaneous [endoscopic] gastrostomy [peg] arterial catheterization temporary tracheostomy diagnoses: pure hypercholesterolemia mitral valve disorders urinary tract infection, site not specified congestive heart failure, unspecified intracerebral hemorrhage acute respiratory failure 

Answer: The patient is high likely exposed to