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: left sided weakness major surgical or invasive procedure: none history of present illness: mr. is an 83 yo rhm who was in his usoh until this afternoon when he had the sudden-onset of left-sided weakness that led to him falling to the ground. he managed to have a couple of bystanders help him get back on his motor scooter and drive himself home. he went into his apartment and tried to go to the bathroom. he then fell off the toilet and found that he could not get up from the toilet and he called a neighbor. denies head trauma, ha, n/v, vertigo. an ambulance brought him to hospital where a head ct revealed a right thalamocapsular hemorrhage and he was transferred to for further management. his sister reported recent weight loss. no f/c/s/n/v/d, no changes in voice, difficulty swallowing, hearing, dizziness, vertigo, diplopia, blurry vision, headache, or head trauma. past medical history: inguinal hernia orif of hip fx history of mva where he was dragged by a car about 70 years ago social history: lives alone, previously able to care for himself. unmarried. has intermittent contact with two sisters and daughter. denies smoking, drugs, or etoh use. family history: no neurological disease. no ca. mother with diabetes died from chf as complication of parathyroid abnormality. father died at 87 in accident. brother recently admitted to for traumatic intracranial bleed. physical exam: pe: gen, very thin heent at/nc, mmm no lesions, no bruits neck supple, no thyromegaly, no , no bruits chest clear, with slightly decreased bs at right base cvs rrr w/o mgr abd soft, ntnd, + bs, large left sided inguinal hernia. ext no c/c/e. no petechiae, no asterixis, rash over penis, and much of lower extremities. severe nail disease. neuro ms: aa&ox3, appropriately interactive, normal affect, normal fund of knowledge with errors, simple calculations intact, fluent without paraphrasic errors. prosody slow flat. naming, , intact. 0/3 at 5 minutes, with prompting no l/r confusion. normal graphesthesia. able to mimic brushing teeth with either hand. cn: i--not tested; ii,iii-perrla, vff by confrontation, optic discs sharp with normal vasculature; iii,iv,vi-eomi w/o nystagmus, no ptosis; v--sensation intact to lt/pp, masseters strong symmetrically; vii-left facial weakness with sparing of forehead; viii-hears finger rub bilaterally; ix,x--voice normal, palate elevates symmetrically, uvula midline, gag intact; --scm/trapezii ; xii--tongue protrudes midline, slight apraxia motor: normal bulk and tone. no rigidity, no tremor, no bradykinesia strength: left sided hemiplegia. coord: ffm slow on left but accurate. refl: tri brachio pat toe r 2 2 2 2 2 down l 2 2 2 2 2 down : lt, pp, temperature, vibration, and position sense intact. no evidence of extinction. pertinent results: 11:25am blood wbc-9.3 rbc-3.86* hgb-12.5* hct-36.0* mcv-93 mch-32.4* mchc-34.8 rdw-13.6 plt ct-180# 05:15am blood wbc-6.8 rbc-3.73* hgb-11.9* hct-34.9* mcv-93 mch-32.0 mchc-34.3 rdw-13.5 plt ct-115* 05:50am blood wbc-6.9 rbc-3.79* hgb-12.3* hct-35.3* mcv-93 mch-32.4* mchc-34.8 rdw-13.7 plt ct-85* 10:40am blood wbc-11.2* rbc-3.98* hgb-12.7* hct-35.8* mcv-90 mch-31.9 mchc-35.5* rdw-14.0 plt ct-77* 05:15am blood wbc-14.5* rbc-3.79*# hgb-12.0*# hct-34.3*# mcv-91 mch-31.6 mchc-34.9 rdw-14.2 plt ct-67* 01:57am blood wbc-15.4* rbc-2.91* hgb-9.4* hct-26.5* mcv-91 mch-32.3* mchc-35.5* rdw-13.9 plt ct-65* 03:00am blood wbc-19.6* rbc-2.98* hgb-9.8* hct-28.1* mcv-94 mch-32.8* mchc-34.8 rdw-13.4 plt ct-70* 02:30am blood wbc-25.1*# rbc-3.44* hgb-11.2* hct-32.3* mcv-94 mch-32.6* mchc-34.7 rdw-13.4 plt ct-106* 04:58am blood wbc-5.7 rbc-3.66* hgb-12.4* hct-34.2* mcv-93 mch-33.9* mchc-36.3* rdw-12.9 plt ct-118* 07:30pm blood wbc-6.7 rbc-3.78* hgb-12.4* hct-34.0* mcv-90 mch-32.7* mchc-36.4* rdw-13.1 plt ct-117* 11:25am blood plt ct-180# 11:25am blood glucose-110* urean-23* creat-0.7 na-138 k-4.6 cl-104 hco3-27 angap-12 05:15am blood glucose-111* urean-32* creat-1.1 na-139 k-4.4 cl-106 hco3-26 angap-11 05:50am blood amylase-53 10:40am blood alt-102* ast-52* amylase-56 totbili-0.6 02:30am blood ck(cpk)-1600* 01:57am blood ck(cpk)-120 11:25am blood calcium-8.5 phos-3.7 mg-1.8 04:58am blood vitb12-786 04:58am blood %hba1c-5.6 -done -done 04:58am blood triglyc-40 hdl-98 chol/hd-2.1 ldlcalc-98 10:40am blood ammonia-20 04:58am blood asa-neg ethanol-neg acetmnp-neg barbitr-neg tricycl-neg urine culture klebsiella pneumoniae | enterobacteriaceae | | klebsiella pneumoniae | | | ampicillin/sulbactam-- 4 s 4 s <=2 s cefazolin------------- <=4 s <=4 s <=4 s cefepime-------------- <=1 s <=1 s <=1 s ceftazidime----------- <=1 s <=1 s <=1 s ceftriaxone----------- <=1 s <=1 s <=1 s cefuroxime------------ 2 s 2 s <=1 s gentamicin------------ <=1 s <=1 s <=1 s imipenem-------------- <=1 s 2 s <=1 s levofloxacin----------<=0.25 s <=0.25 s <=0.25 s meropenem-------------<=0.25 s <=0.25 s <=0.25 s nitrofurantoin-------- 32 s =>512 r <=16 s piperacillin/tazo----- <=4 s <=4 s <=4 s tobramycin------------ <=1 s <=1 s <=1 s trimethoprim/sulfa---- <=1 s <=1 s <=1 s blood culture klebsiella pneumoniae | ampicillin/sulbactam-- 4 s cefazolin------------- <=4 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s cefuroxime------------ 2 s gentamicin------------ <=1 s imipenem-------------- <=1 s levofloxacin----------<=0.25 s meropenem-------------<=0.25 s piperacillin/tazo----- <=4 s tobramycin------------ <=1 s repeat urine culture <10,000 colonies repeat blood cultures negative for three days. head ct :right basal ganglia 21 x 10 mm intraparenchymal hemorrhage with mild surrounding edema. no prior studies were available for comparison. head ct : stable hemorrhage mri/mra: mri demonstrates the right thalamic hemorrhage, as visualized on the ct scan of . no additional areas of susceptibility artifact are detected. there are no signs of acute infarction. mra demonstrates flow in the major branches of the circle of and no abnormal vascularity. left x-ray knee and hip: no fracture, dislocation, or evidence of hardware loosening. cxr:a feeding tube has been withdrawn slightly in the interval. although the tip still terminates in the stomach, the most proximal portion of the radiodense tip is likely just above the ge junction level. cardiac silhouette is stable in size and demonstrates left ventricular configuration. there has been interval marked improved aeration in the left retrocardiac region with only minimal residual atelectasis remaining. bilateral pleural effusions are improved, resolved on the right and nearly resolved on the left. there are no new or worsening areas of opacification to suggest pneumonia. echo/tte:the left atrium is mildly dilated. a patent foramen ovale or small atrial septal defect could not be excluded by color doppler study. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. there is mild regional left ventricular systolic dysfunction with probable distal septal hypokinesis. overall left ventricular systolic function is borderline depressed. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are mildly thickened. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. moderate (2+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is a trivial/physiologic pericardial effusion. no cardiac source of embolus identifed. brief hospital course: neurology - mr. was admitted to the icu for monitoring once it was discovered that his left-sided was secondary to a right sided thalmocapsular hemorrhage. in the icu, he remained hemodynamically stable however his neurological exam worsened from left sided hemiparesis to essentially, hemiplegia involving most of his left side, including face, arm, and leg. the differential included hypertensive hemorrhage, mass, aneurysm, or hemorrhagic conversion of an embolic. as the patient had little recorded or reportable medical history it is unclear that he had a history of htn, but this was clearly the most likely diagnosis as no mass was observed and the mra was negtive for vascular malformation. he was quite hypertensive at admission, with bps 200/100s requiring iv hydralazine for control. the patient had a deterioration in his mental status after transfer out of the icu. an encephalopathy work-up revealed bilateral pleural effusions thought to be secondary to possible aspiration pneumonia. his antibiotic regimen was changed to levofloxacin and metronidazole and he became alert and oriented within 24 hrs. he should complete another 6 days of levofloxacin and flagyl. physical therapy has been involved with his care and he has been moved to and from his bed to a chair. hba1c, lipids were normal. his trans-thoracic echocardiogram revealed normal ef without vegetations. respiratory - pt intermittently required oxygen by nc. he was diagnosed with bilateral pleural effusions and possible left sided pneumonia which on repeat cxr showed interval resolution. he currently does not have an oxygen requirement. fen/gi - the patient had difficulty swallowing and had been maintained with an ngt for adequate fluid and nutritional intake. speech and swallow recommended: 1. continue with ng tube feedings to maintain nutrition/hydration 2. po diet consistency of nectar thick liquids and purees as a snack only 3. basic aspiration precautions should be followed: a. pt should be awake and alert while eating b. pt should be seated upright in the bed during all meals. he will likely benefit from f/u with a nutrionist in rehab. pt. also with large left inguinal hernia. this is a problem that has not presented acute issues for him. renal/gu - patient admitted with hyophosphatemia and hypomagnesemia which have responded well to both oral and iv supplementation. his recent mg and phos have normalized. he has kept on neuta phos packets . patient was evaluated by urology service for difficulty with foley catheter placement in the icu. a catheter was placed by gu; they recommended a voiding trial and on the catheter was pulled and the patient voided spontaneously. the patient has had microscopic hematuria and gu was made aware of this. their recommendation was that this could be followed up as an outpatient. id - the patient had klebsiella pneumoniae urosepsis. he was initially placed on gentamicin. he subsequently had a drop in his platelets. because the bacteria was also sensitive to ceftriaxone he was switched as there was concern that the thrombocytopenia (low of 65) was secondary to gentamicin. once the gent was discontinued, his platelets subsequently recovered to normal range. he has been treated with levaquin iv and flagyl for 2 days and should complete another 6 days of these two antibiotics for the klebsiella and the pneumonia. heme - thrombocytopenia as mentioned above. pt. had developed anemia and was tranfussed two units of prbcs in the icu. he has since had stable cbcs. his anemia was likely secondary to acute illness. he was placed on heparin 5000 u sc for dvt prophylaxis. musculoskeletal: pt c/o pain in left knee. he underwent x-rays of both knee and left hip earlier in the hospitalization as he presented with a fall. these tests were negative for fracture or change in hardware (secondary to left hip orif in past). podiatry - the patient had severe nail fungus and podiatry debrided the nails. he has been receiveing lachydrin moisturizing cream to his feet for severe dryness. there has been much improvement during his hospital course. dispo - patient has no pcp and would definitely benefit from regular medical follow-up. a phone number for will be provided. the patient will have f/u appointments with urology and neurology/stroke. patient will require long-term assistance with adls and will benefit from inpatient rehabilitation. diagnosis: right thalamocapsular hemorrhage likely secondary to hypertension medications on admission: none discharge medications: 1. potassium & sodium phosphates mg packet sig: one (1) packet po bid (2 times a day). disp:*60 packet(s)* refills:*2* 2. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day): hold for sbp<100 or hr<60. disp:*60 tablet(s)* refills:*2* 3. lansoprazole 30 mg susp,delayed release for recon sig: thirty (30) mg po daily (daily). disp:*900 mg* refills:*2* 4. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 6 days. disp:*18 tablet(s)* refills:*0* 5. ammonium lactate 12 % lotion sig: one (1) application topical (2 times a day). disp:*60 applications* refills:*2* 6. docusate sodium 150 mg/15 ml liquid sig: ten (10) ml po bid (2 times a day). disp:*600 ml* refills:*2* 7. heparin (porcine) 5,000 unit/ml solution sig: one (1) ml injection tid (3 times a day). disp:*90 ml* refills:*2* 8. levofloxacin in d5w 500 mg/100 ml piggyback sig: one (1) intravenous once a day for 6 days. disp:*6 units* refills:*0* discharge disposition: extended care facility: - discharge diagnosis: right thalamocapsular hemorrhage left hemiplegia htn bph discharge condition: fair discharge instructions: please take your medications if you experience new wekaness, trouble speaking or swallowing, chest pain, or palpitations, please inform a physician followup instructions: neurology/stroke - please call to schedule an apopointment with dr. urology f/u for bph for appt. patient will require referral for a pcp as an . the number for helath care assocaites is: procedure: transfusion of packed cells debridement of nail, nail bed, or nail fold diagnoses: anemia, unspecified urinary tract infection, site not specified unspecified essential hypertension mitral valve insufficiency and aortic valve insufficiency hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) sepsis intracerebral hemorrhage pneumonitis due to inhalation of food or vomitus other septicemia due to gram-negative organisms other specified antibiotics causing adverse effects in therapeutic use dermatophytosis of nail 

Answer: The patient is high likely exposed to