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: leaning to the left major surgical or invasive procedure: n/a history of present illness: hpi: ms is a 78 year-old right-handed woman on coumadin and asa for history of cva, 4 years ago who presents from an osh s/p fall last night with a new iph. history obtained from son and . patient has expressive aphasia and r hemiplegia from a stroke in . last night around 1:30 pm she got up to use the bathroom. son found her propped between wall and comode. he helped her back to bed and she seemed only to complain of her right elbow. this morning when the health aides arrived they noted her listing to the left which was her former strong side. with this concern they took her to an osh. head ctwas done at osh which showed a 3cm iph. she was given 2 units of ffp and 5mg vitamin k and then transferred to for further managment. otherwise she has had no other complaints. she did fall, injuring her back 3-4 months ago. she also had a significant pneumonia over the winter, but otherwise has been recently healthy. she denies headache, visual changes. denies focal numbness, parasthesiae. no bowel or bladder incontinence or retention. uses a hemiplegic walker for ambulation. she also eats normal foods, without aspiration. on general review of systems, the pt denies recent fever or chills. no night sweats or recent weight loss or gain. denies cough, shortness of breath. denies chest pain or tightness, palpitations. denies nausea, vomiting, diarrhea, constipation or abdominal pain. no recent change in bowel or bladder habits. no dysuria. denies arthralgias or myalgias. denies rash. past medical history: neurologic - ischemic stroke (l mca w/residual r hemiplegia, broca's aphasia) cardiovascular - cad/mi (no stents), chf, htn, hl, s/p ppm placement (for sick sinus syndrome) endocrine - dm2 (on insulin), hypothyroidism psychiatric - depression other - recurrent falls social history: former smoker, 25 years ago, has home health aids and a visiting nurse twice a week no etoh or illicit drugs family history: stroke (mother) physical exam: at admission: physical exam: vitals: t:98.9 p:74 r:18 bp:138/40 sao2:98% general: awake, cooperative, nad. heent: nc/at, mmm, no lesions noted in oropharynx neck: supple, pulmonary: lungs cta bilaterally without r/r/w cardiac: paced rhythm, abdomen: soft, nt/nd, extremities:warm and well perfused skin: multiple purpura neurologic examination: gcs:15 level of arousal -4 best verbal -5 best motor -6 mental status exam: awake and alert . oriented to month, date, hospital ( by nodding) attentive, and able to complete tasks speech was nonsensical language is nonfluent, unable to repeat, but able to comprehend. could point to the appropiate picture on stroke card able to follow both midline and appendicular commands. there was no evidence of left-right confusion as the patient was able to accurately follow the instruction to tough right ear with left hand. -cranial nerves: i: olfaction not tested. ii: perrl 3 to 2mm and brisk. she reacted to threat bilaterally. iii, iv, vi: eomi without nystagmus. v: facial sensation intact to light touch. vii: right facial droop. viii: hearing intact to finger-rub bilaterally. ix, x: palate elevates symmetrically. : 5/5 strength in trapezii and scm bilaterally. xii: tongue protrudes in midline. -motor: rue: minimal movement of bicep in plane of gravity rle: can get ip up against gravity about . however, unable to sustain lue. appears weak 5- in delt, tricep lle: 4 in ip -sensory: felt noxious and vibration in all 4 extremities -dtrs: tri pat ach l 2 2 2 2 1 r 2 2 2 2 1 plantar response was extensor bilaterally. -coordination: no dysmetria on fnf on left ___________________________________________________________ pertinent results: nchct impression: 1. interval mild increase in the size of a right parenchymal hemorrhage as described above. a few small hypodense foci within may relate to ongoing hemorrahage. causes may include trauma, coagulopathy, amyloid angiopathy, underlying lesion, etc. 2. changes in the left frontal lobe can be subacute-chronic. these can be better assessed with mr, mra if not contra-indicated after clinical correlation. 3. diffuse sclerosis of the bones- correlate with metabolic parameters. cxr findings: the lung volumes are normal. there are no pleural effusions. borderline size of the cardiac silhouette. the slightly increased vascular diameter and the multiple interstitial bilateral markings suggest mild-to-moderate pulmonary edema. no focal parenchymal opacity suggesting pneumonia. valvular ring calcifications. right pectoral pacemaker in situ. nchct 1. no significant interval change from prior study. foci of parenchymal hemorrhage in the right temporoparietal region and right inferior insular cortex, unchanged from prior study with no areas of new hemorrhage. 2. area of hypodensity in the left frontal lobe likely representing prior infarcts. 3. correlate clinically for need of further workup for underlying cause of hemorrhage, that is possibly best evaluated via mri. tte - the left atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is mildly dilated given small body size. regional left ventricular wall motion is normal. there is mild global left ventricular hypokinesis (lvef = 40-45%). there is no ventricular septal defect. the right ventricular cavity is mildly dilated with normal free wall contractility. the ascending aorta is mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. there is no aortic valve stenosis. trace aortic regurgitation is seen. there is moderate thickening of the mitral valve chordae. severe (4+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate tricuspid regurgitation is seen. there is no pericardial effusion. impression: severe mitral regurgitation. mildly dilated left ventricle with at least mild global systolic dysfunction. moderate tricuspid regurgitation. moderate to severe pulmonary hypertension. nchct impression: no interval change in known right temporoparietal and inferior insular cortex intraparenchymal hemorrhages. no new hemorrhage. sputum cx - mssa urine cx - klebsiella brief hospital course: 78 yo w h/o prior l mca stroke (residual rhemiplegia, aphasia), dm2, past tobacco use, s/p ppm p/w l-sided weakness s/p fall on , resulting in a r iph and small sah. intraparenchymal hemorrhage - she was noted the next morning to be leaning primarily to her left (her strong side) and was subsequently brought to the hospital where the hemorrhage was found on imaging. she was awake and oriented (could nod yes or no) and had new mild left sided weakness () with her prior residual productive aphasia and r face, arm, and leg weakness. she was transferred to for further care after receiving ffps and vitamin k. her inr was 2.7 prior to 2 units of ffps and 1.9 after, so she was given an additional 2 units of ffps. while in the ed, she experienced a brief 2 minute convulsive seizure and was subsequently started on levetiracetam 500 q12h. her repeat nchct at that time showed a very small amount of expansion from her prior outside hospital nchct. her repeat nchcts on and showed no further expansion of the iph/hematoma or sah. her inr has remained stable in the 1.2-1.3 range. her neurologic exam had been challenging as she was originally very hyperactive and agitated off sedation and subsequently has been more lethargic (possibly due to quetiapine 50 which was administered to reduce agitation); she does not attend to the examiner or follow commands reliably and may have had a component of delirium. her hemorrhage and neurologic exam remained stable throughout the rest of her hospitalization, but her overall mental status was very poor with regards to interactivity with her environment. her multiorgan failure were the primary determinants of her prognosis. systolic heart failure and hypoxic respiratory failure - she was given furosemide when being infused with ffps to help prevent volume overload but her uop did not respond appropriately; she became hypoxic later in the evening of while in the icu and was intubated for respiratory support. a tte performed on showed an lvef of 40-45% with 4+ mr and 2+ tr; the ef was felt to be an overestimate in the setting of her severe valvular disease. she was treated with iv furosemide boluses and vasodilated with amlodipine and prn hydralazine. cardiac ischemia - the patient has had elevation of her cardiac troponins from 0.06 to a maximum of 4 in the setting of her iph and metabolic abnormalities, possibly suggesting demand ischemia versus nstemi. however, given her hemorrhage, we were unable to thrombolyse or anticoagulate her, so she was medically optimized with aspirin, beta blockade, statin therapy, and oxygenation. acute on chronic renal failure - in the setting of the patient's systolic heart failure, the patient's ckd worsened with a maximum cr of 3.8. optimization of her systolic function stabilized her renal dysfunction. of note, the patient had expressed that she would not want to go on dialysis. hyperglycemia/hypoglycemia/diabetes - she was hyperglycemic to the 300s-400s on the first night of admission and was treated with insulin which brought her glucose down to the 40s transiently; she was started on d5ns to maintain her glucose levels in the 100-200 range. she has intermittently been hyperglycemia and has intermittently required insulin infusions. goals of care - multiple discussions have taken place with (the patient's son), (the patient's daughter), and the patient's grandchildren regarding her hemorrhage, her multi-organ system dysfunction, and the possibility of tracheostomy and gastrostomy placement in the context of the patient's wishes for goals of care (which unfortunately are not known). the patient had expressed the willingness to go to a long term care facility (nursing home) but also had declined dialysis, making it difficult to tell whether she would want long-term or permanent mechanical ventilation or enteral feeding through a peg if it allowed her to live. after further discussion and time with the patient, the family decided to make her cmo on . she was transferred to the neurology floor on a morphine infusion, and she passed overnight on . medications on admission: -levoxyl 125 mcg qd -colace -mvi lantus 16 units at bedtime, humalog 5 units at breakfast humalog 8 units at dinner, ?simvastin 10mg (son doesn't think she takes this) norvasc 10mg qd imdur 90mg qd coumadin 7mg qd metoprolol 25mg asa 81mg qd rocaltrol 0.5mcg qd proair 2 puffs q6h prn sob ferrous sulfate 325mg procrit units every 2 weeks. missed last dose on lasix 40mg qm, w, f lidoderm patch qd zoloft 125mg qd discharge medications: n/a discharge disposition: expired discharge diagnosis: intracerebral hemorrhage acute on chronic systolic heart failure mitral regurgitation/mitral valve disease acute on chronic renal failure diabetes mellitus type 2, uncontrolled hypoxic respiratory failure discharge condition: deceased discharge instructions: n/a followup instructions: n/a md procedure: 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 arterial catheterization closed [endoscopic] biopsy of bronchus diagnoses: anemia in chronic kidney disease end stage renal disease subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery mitral valve disorders urinary tract infection, site not specified congestive heart failure, unspecified friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site acute kidney failure, unspecified unspecified acquired hypothyroidism unspecified fall subarachnoid hemorrhage personal history of tobacco use depressive disorder, not elsewhere classified intracerebral hemorrhage hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other and unspecified hyperlipidemia acute respiratory failure long-term (current) use of insulin old myocardial infarction cardiac pacemaker in situ secondary hyperparathyroidism (of renal origin) ventilator associated pneumonia acute on chronic systolic heart failure late effects of cerebrovascular disease, aphasia home accidents diabetes with ketoacidosis, type i [juvenile type], uncontrolled other and unspecified intracranial hemorrhage following injury without mention of open intracranial wound, with no loss of consciousness subarachnoid hemorrhage following injury without mention of open intracranial wound, with no loss of consciousness late effects of cerebrovascular disease, hemiplegia affecting dominant side 

Answer: The patient is high likely exposed to