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: shunt failure major surgical or invasive procedure: r vp shunt revision history of present illness: 57 year old female, past history significant for long-standing vp shunt and recent shunt revision, presents to the ed on , with worsening occipital headaches, blurry vision, and neck pain over a three-day period. shunt shows prompt refill. patient had recently undergone laparoscopic vp shunt revision on after developing hydrocephalus secondary to outflow obsturction casused by a csf pseudocyst in the abdomen.intraoperative findings had included moderate adhesions in theruq and an intraperitoneal cyst surrounding the tip of the catheter, posterior to the liver. past medical history: 1. hydrocephalus(unclear etiology) s/p vps and revision (13yrs, 7yrs ago)-done in , s/p distal shunt revision . 2. headache, migraine 3. gerd 4. depression 5. osteoporosis 6. add social history: social hx: resides at home with husband and adult child. family history: unkown physical exam: exam on admission: o:x1 t:98.2 bp: 110/80 hr: 80 r: o2sats: 97% ra gen: significantly underweight patient, somnolent but arousable. heent: pupils: round, equal and bilaterally reactive to light eoms: bilateral upward gaze palsy neck: stiff, movement limited and painful. patient is unable to touch chin to chest, unable to move neck fully from side to side cardiac: regular rate and rhythm, clear s1/s2 noted. abd: soft, nt, bs+. pseudocyst not appreciated on palpation. extrem: warm and well-perfused. neuro: ( see below ) mental status: patient is drowsy, but can be aroused. cooperative with exam, somewhat flattened and withdrawn affect. orientation: oriented to self, could not recall date, location, or current president. recall: language: speech fluent with good comprehension and repetition. naming intact. no dysarthria or paraphasic errors. cranial nerves: i: not tested ii: pupils equally round and reactive to light, 5 to 3 mm bilaterally. visual fields are full to confrontation, integrity of vision has decreased, according to patient. iii, iv, vi: patient has upward gaze palsy, other eomi's intact v, vii: facial strength and sensation intact and symmetric. viii: hearing intact to voice. ix, x: palate elevation is symmetrical. : sternocleidomastoid and trapezius normal bilaterally. xii: tongue midline without fasciculations. motor: normal bulk and tone bilaterally. no abnormal movements, tremors. strength full power throughout.slight right pronator drift. toes downgoing bilaterally coordination: finger-to-nose movements are slow, significant left sided dysmetria. shunt valve with brisk filling on compression. are preped with betadine and 20 cc of csf aspirated and sent off. exam on discharge: as above - however, alert and appropriate. improving upward gaze palsey. pertinent results: labs on admission: 04:40pm blood wbc-6.8 rbc-3.85* hgb-12.9 hct-38.3 mcv-99* mch-33.5* mchc-33.7 rdw-12.5 plt ct-267 04:40pm blood neuts-64.5 lymphs-27.9 monos-4.3 eos-2.1 baso-1.2 04:40pm blood pt-11.8 ptt-27.7 inr(pt)-1.0 04:40pm blood glucose-104* urean-16 creat-0.7 na-141 k-4.5 cl-107 hco3-28 angap-11 02:04am blood calcium-9.2 phos-2.6* mg-2.0 labs on discharge: complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 06:33 6.7 3.44* 11.3* 33.7* 98 32.9* 33.6 12.5 277 basic coagulation pt, ptt, inr 06:33 12.1 34.4 1.0 chemistry renal & glucose glucose urean creat na k cl hco3 angap 06:33 911 9 0.8 144 4.2 107 31 10 ------------------ imaging: ------------------ ct abdomen : reaccumulation of loculated csf psudocyst along r lobe of liver w/ distal tip of vp within it shunt series : findings: total of six images were provided including ap and lateral views of the skull, ap view of the neck, chest, abdomen and lateral view of the chest. there is a right-sided ventriculostomy catheter exiting the right frontal bone with shunt travelling inferiorly through the right neck soft tissues and anteriorly through the right hemithorax into the upper abdomen where the tip is located just beneath the right hemidiaphragm. there is no evidence of shunt discontinuity aside from the lucent segment at the level of the skull. incidental imaging of the chest is unremarkable. bowel gas pattern is also unremarkable. impression: unremarkable shunt series. please refer to ct abdomen performed subsequently for additional findings. head ct : impression: 1. stable appearance of mildly enlarged ventricles following right vp shunt revision. no intracranial hemorrhage. stable encephalomalacia along the catheter tract. 2. chronic small vessel ischemic change brief hospital course: patient is a 57f admitted via the ed with complaints of worsening occipital headaches, blurry vision, and neck pain over a three-day period. she had recently been admitted at the end of and had the distal portion of her vps revised, as she had a pseudocyst accumulating there. shunt series imaging was performed, which was unrevelaing. ct of the abdomen showed a reaccumulation of pseudocyst at the distal tip of the abdominal catheter. she was admitted to the neurosurgery icu for frequent neurochecks pending revision surgery. on , patient appeared lethargic and 20cc of csf aspirated using sterile technique. she was taken to the or to have the r vp shunt revision. post operatively, patient appeared more alert. she was oriented to herself and place, but issues with date. she followed complex commands and was full strength. repeat head ct revealed no new hemorrhage. she was transferred to the floor. she was evaluated by pt, who determined she was stable enough to go home without any services. she was discharge on . medications on admission: - adderall ( 10 mg tablet, 2x a day ) - buproprion ( 150 mg 2x a day ) - vitamin b12 - desmopressin - divalproex ( 250 mg tablet, 1x a day ) - darcovet n-100, - simvastatin ( 40 mg tablet ) - trazodone discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain/fevers. 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 3. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 4. bupropion hcl 75 mg tablet sig: two (2) tablet po bid (2 times a day). 5. divalproex 250 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po bid (2 times a day). 6. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*30 tablet(s)* refills:*0* 7. nicotine 14 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily). discharge disposition: home discharge diagnosis: hydrocephalus, shunt failure discharge condition: neurologically stable discharge instructions: general instructions wound care ?????? you or a family member should inspect your wound every day and report any of the following problems to your physician. ?????? keep your incision clean and dry. ?????? you may wash your hair with a mild shampoo 24 hours after your are removed. ?????? do not apply any lotions, ointments or other products to your incision. ?????? do not drive until you are seen at the first follow up appointment. ?????? do not lift objects over 10 pounds until approved by your physician. usually no special is prescribed after a craniotomy. a normal well balanced is recommended for recovery, and you should resume any specially prescribed you were eating before your surgery. medications: ?????? take all of your medications as ordered. you do not have to take pain medication unless it is needed. it is important that you are able to cough, breathe deeply, and is comfortable enough to walk. ?????? do not use alcohol while taking pain medication. ?????? medications that may be prescribed include: -narcotic pain medication such as dilaudid (hydromorphone). -an over the counter stool softener for constipation (colace or docusate). if you become constipated, try products such as dulcolax, milk of magnesia, first, and then magnesium citrate or fleets enema if needed). often times, pain medication and anesthesia can cause constipation. ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, and ibuprofen etc, as this can increase your chances of bleeding. activity: the first few weeks after you are discharged you may feel tired or fatigued. this is normal. you should become a little stronger every day. activity is the most important measure you can take to prevent complications and to begin to feel like yourself again. in general: ?????? follow the activity instructions given to you by your doctor and therapist. ?????? increase your activity slowly; do not do too much because you are feeling good. ?????? you may resume sexual activity as your tolerance allows. ?????? if you feel light headed or fatigued after increasing activity, rest, decrease the amount of activity that you do, and begin building your tolerance to activity more slowly. ?????? do not drive until you speak with your physician. ?????? do not lift objects over 10 pounds until approved by your physician. ?????? avoid any activity that causes you to hold your breath and push, for example weight lifting, lifting or moving heavy objects, or straining at stool. ?????? do your breathing exercises every two hours. ?????? use your incentive spirometer 10 times every hour that you are awake. when to call your surgeon: with any surgery there are risks of complications. although your surgery is over, there is the possibility of some of these complications developing. these complications include: infection, blood clots, or neurological changes. call your physician immediately if you experience: ?????? confusion, fainting, blacking out, extreme fatigue, memory loss, or difficulty speaking. ?????? double, or blurred vision. loss of vision, either partial or total. ?????? hallucinations ?????? numbness, tingling, or weakness in your extremities or face. ?????? stiff neck, and/or a fever of 101.5f or more. ?????? severe sensitivity to light. (photophobia) ?????? severe headache or change in headache. ?????? seizure ?????? problems controlling your bowels or bladder. ?????? productive cough with yellow or green sputum. ?????? swelling, redness, or tenderness in your calf or thigh. call 911 or go to the nearest emergency room if you experience: ?????? sudden difficulty in breathing. ?????? new onset of seizure or change in seizure, or seizure from which you wake up confused. ?????? a seizure that lasts more than 5 minutes. important instructions regarding emergencies and after-hour calls ?????? if you have what you feel is a true emergency at any time, please present immediately to your local emergency room, where a doctor there will evaluate you and contact us if needed. due to the complexity of neurosurgical procedures and treatment of neurosurgical problems, effective advice regarding emergency situations cannot be given over the telephone. ?????? should you have a situation which is not life-threatening, but you feel needs addressing before normal office hours or on the weekend, please present to the local emergency room, where the physician there will evaluate you and contact us if needed. followup instructions: follow-up appointment instructions ??????please return to the office in days (from your date of surgery) for removal of your and a wound check. although we try to be thorough, we may miss or staples. be sure to point out any incisions, which may be covered by clothing at the time of suture/staple removal. please make this appointment by calling . if you live quite a distance from our office, please make arrangements for the same, with your pcp. ??????please call ( to schedule an appointment with dr. , to be seen in 3 months. ??????you will need a ct scan of the brain without contrast. procedure: incision of peritoneum ventriculopuncture through previously implanted catheter diagnoses: obstructive hydrocephalus esophageal reflux osteoporosis, unspecified surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation bipolar disorder, unspecified attention deficit disorder without mention of hyperactivity other specified disorders of peritoneum other complications due to nervous system device, implant, and graft 

Answer: The patient is high likely exposed to