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: penicillins / keflex / haldol attending: chief complaint: ha major surgical or invasive procedure: r craniotomy cerebral angiogram left central line right craniectomy and wound washout with drain placement history of present illness: 57 yo rhm with hx hld, niddm presents after sudden onset headache. while sitting down patient developed sudden-onset bifrontal headache, diaphoresis, and blurry vision, and yawning he soon developed chest pain and shortness of breath as well. the symptoms were at full intensity for approximately 30 minutes before they began to subside. he originally went to , found to have a r parietotemporal hemorrhage and transferred to for further care. at the osh he was given 10 mg labetalol x2 and his subsequent blood pressure was 156/92 (pre-med bp unavailable in records but max sbp was 160), and was given 1000 mg dilantin and fentanyl. currently he reports a headache and reports the chest pain and shortness of breath have resolved. he denies any weakness or numbness and no seizures. no history of trauma. past medical history: hld dm2 social history: social hx; works in a machine shop. drinks 2-3 beers daily, more on weekends. occasional tobacco, no drugs. family history: family hx; mother with niddm, father with aortic and abdominal aneurysms. no history of stroke, seizure, or hemorrhages. physical exam: physical exam; vs; 138/70 92 16 gen; middle-aged male, lying in stretcher, nad cv; rrr, +s1,s2, no murmurs pulm; cta b/l abd; soft, nt, nd extr; no edema neuro; -mental status: alert, oriented x 3. able to relate history without difficulty. attentive, language is fluent with intact repetition and comprehension. normal prosody. there were no paraphasic errors. pt. was able to name both high and low frequency objects. speech was not dysarthric. able to follow both midline commands. -cranial nerves: i: olfaction not tested. ii: perrl 2mm--> 1.5mm r and l. l homonymous hemianopia. iii, iv, vi: eomi with horizontal nystagmus, r>l normal saccades. v: facial sensation intact to light touch. vii: no facial droop, facial musculature symmetric. 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: normal bulk, tone throughout. no pronator drift bilaterally. no adventitious movements, such as tremor, noted. no asterixis noted. delt bic tri wre ffl fe ip quad ham ta edb l 4+ 5 5 5 5 4+ 4+ 5 5 5 5 5 5 r 5 5 5 5 5 5 5 5 5 5 5 5 5 -sensory: intact to light touch throughout. extinguishes to dss on l. -dtrs: tri pat ach l 2 2 2 2 1 r 2 2 2 2 1 plantar response was flexor bilaterally. -coordination: fnf intact b/l. on discharge: pertinent results: cta head w&w/o c & recons study date of 5:54 pm 1. large right temporal intraparenchymal hematoma extending to the parietal lobe as well. moderate surrounding vasogenic edema, with mass effect as described above. mild increase compared to the most recent study of , performed at osh. 2. patent major intracranial arteries of the anterior and the posterior circulation without focal flow-limiting stenosis, occlusion, or obvious aneurysm or vascular malformation. however, any vascular/neoplastic lesion obscured by the hematoma cannot be assessed on the present study. followup evaluation after resolution of the hematoma can be considered for better assessment. 3. right cerebellar dva. associated another dva in the region of the hematoma cannot be completley excluded based on the findings on mri performed subsequently. 4. focus of calcification in the left palatine tonsil may relate to chronic inflammation. this can be correlated with direct visualization in the ent examination to exclude any associated focal lesion and if necessary, mri, as the left palatine tonsil is bulkier than the right (series 3, image 10). ct head w/o contrast study date of 12:53 pm 1. post-craniectomy changes including pneumocephalus and subcutaneous gas, with moderate-to-large amount of air in the anterior and medial cranial fossa. 2. decrease in size of hemorrhage, with gas collection in its place, but residual rim of surrounding hemorrhage. 3. no interval development of hydrocephalus, increase in mass effect, or increase in left shift of midline structures. ct head w/o contrast study date of 3:51 am the patient is again noted to be status post right parietal craniectomy. there is interval resolution of pneumocephalus since 8 days prior. small hyperdense foci within the resection bed are less dense in some areas, indicating continued evolution of blood products. no definite new focus of hemorrhage is seen. again, there is hypodensity along the right temporoparietal lobes; however, there appears to be slight decreased mass effect with slight decreased sulcal effacement along the right superior convexity, and also with decreased mass effect on the right occipital and temporal horns. there is no shift of normally midline structures, effacement of the basal cisterns, or near large vascular territory infarction. no interval development of hydrocephalus is seen. there is improvement in partial opacification of the paranasal sinuses, now with residual mild opacification of the sphenoid sinuses. the mastoid air cells remain aerated. impression: 1. areas of hyperdensity within the right posterior parietal lobe in the post right parietal craniectomy surgical bed demonstrate continued evolution, without definite new focus of hemorrhage or interval development of hydrocephalus. hypodensity persists in the right temporoparietal lobes, with slight decrease in mass effect. attending note: there remains herniation of brain paranchyma through the craniectomy defect. a focus of hyperdensity (2:22) appears new and could be new petecheal area of hemorrhage. no hematoma. brief hospital course: pt was transferred in from osh after report of sudden onset headache at home on . osh imaging showed right temporal-perietal hemorrhage. pt was transferred to for further care. he was loaded with dilantin at the osh and was started on keppra here. he underwent cta of the brain on admission. on hospital day #1 he was taken to the or for evacuation of iph. upon removal of his pin system he had a 45 second episode of pea. this resolved he was transferred to the icu. postop ct scan imaging was stable. on upon examination in the icu, the patient is delarious on exam and moving all extremities w/out following commands. there is a question of an aspiration pneumonia on chest xray and the patient is started on a course of antibiotics consisting of ciprofloxacin and vancomycin. there is a question of subclinical seizures as the cause of , eeg is obtained and shows on patient spiked a fever overnight, 102.6 and was pancultured for infecious process. blood and urine cultures are pending. he is able to follow commands on his r side, withdraws to noxious stimuli in lle, but no movement observed in lue. on he continued to have fevers and his wound was fluctuant and purulent fluid was draining from the wound. he was then brought to the or where he had a washout and the bone flap was removed. he was also covered with antibiotics per id. the wound culture grew out e. coli. he was extubated on day #2 and had a bal for sputum sampling. he exam slowly improved. during picc line evaluation it was thought that his ue's were very swollen. ue dopplers were performed and he was found to have superficial thrombi in the lue. the rue was evaluated with a doppler study. this revealed******* on , right shoulder xray was performed for pt c/o pain. this was negative. on exam the patient was unchanged. the patient was able to follow simple commands and perform simple verbalization. on , the patient was transferred to stepdown. the patient was intermittently aggitated. seroquel was increased due to patient aggitation. : agitation controlled on seroquel. daily ekg's were followed without evidence of prolonged qt interval. hematology was consulted for persistant thrombocytosis and they felt that it was reactive from trauma of surgery and infection. on , allergy team was consulted for desensitization for his anaphylactic reaction to cephalosporins. they were in communication with the id department. they wish to desensitize him for use of ceftriaxone instead of iv medications. his metoprolol was discontinued per the desens. protocol. on he was transfered to the icu for this desensitization. his neuro exam improved to completely oriented with no motor deficit. he suffered no complications from this procedure and he returned to the floor. a repeat head ct was performed on . this showed some areas of herniation with some parietal hyper and hypodensities. on , he had a single complaint of chest pain. ekg and cardiac enzymes were done and found to be normal, negative for any acute process. pain was then relieved after a bowel movement. on , sutures and staples were removed from the cranial wound, and he was discharged to rehab facility. medications on admission: metformin 500 mg omeprazole 20 mg daily lipitor 40 mg daily discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) : two (2) tablet, delayed release (e.c.) po daily (daily). 2. levetiracetam 500 mg tablet : three (3) tablet po bid (2 times a day) as needed for seizure prophylaxis. 3. thiamine hcl 100 mg tablet : one (1) tablet po daily (daily) as needed for etoh abuse. 4. folic acid 1 mg tablet : one (1) tablet po daily (daily) as needed for etoh abuse. 5. senna 8.8 mg/5 ml syrup : one (1) tablet po bid (2 times a day). 6. docusate sodium 100 mg capsule : one (1) capsule po bid (2 times a day). 7. alum-mag hydroxide-simeth 200-200-20 mg/5 ml suspension : 15-30 mls po qid (4 times a day) as needed for heartburn. 8. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 9. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization : one (1) inhalation q6h (every 6 hours) as needed for wheeze. 10. clonidine 0.1 mg tablet : three (3) tablet po tid (3 times a day). 11. nystatin 100,000 unit/ml suspension : five (5) ml po qid (4 times a day) as needed for oral thrush. 12. heparin (porcine) 5,000 unit/ml solution : one (1) injection tid (3 times a day). 13. metformin 500 mg tablet : one (1) tablet po bid (2 times a day). 14. quetiapine 100 mg tablet : 0.5 tablet po tid (3 times a day). 15. lorazepam 1 mg tablet : one (1) tablet po bid (2 times a day) as needed for prn agitation. 16. sodium chloride 1 gram tablet : one (1) tablet po bid (2 times a day). 17. diphenhydramine hcl 12.5 mg/5 ml elixir : one (1) po q6h (every 6 hours) as needed for prn pruritis. 18. metoprolol tartrate 50 mg tablet : 2.5 tablets po tid (3 times a day). 19. acetaminophen 325 mg tablet : 1-2 tablets po q4h (every 4 hours) as needed for pain/fever. 20. butalbital-acetaminophen-caff 50-325-40 mg tablet : tablets po q4h (every 4 hours) as needed for headache. 21. hydromorphone 2 mg tablet : 1-2 tablets po q6h (every 6 hours) as needed for severe headache, break thru pain. 22. ceftriaxone 2 gm iv q24h duration: 4 weeks start: @ 23. heparin flush (10 units/ml) 1 ml iv prn line flush temporary central access-floor: flush with 10 ml normal saline followed by heparin as above daily and prn. 24. regular insulin sliding scale per nursing sheet. discharge disposition: extended care facility: - discharge diagnosis: large rt posterior temporal hemorrhage / right craniotomy alcohol intoxication alcohol withdrawal pea respiratory failure post op wound infection r craniectomy right temporal avm lue superficial thrombi cephalic and basilic veins./ discharge condition: neurosurgically stable discharge instructions: discharge instructions for craniotomy/head injury ?????? have a family member check your incision daily for signs of infection ?????? take your pain medicine as prescribed ?????? exercise should be limited to walking; no lifting, straining, excessive bending ?????? you may wash your hair as sutures have been removed. ?????? increase your intake of fluids and fiber as pain medicine (narcotics) can cause constipation ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, ibuprofen etc. ?????? you have been prescribed keppra for antiseizure prophylaxsis. this will not require any bloodwork monitoring. ?????? clearance to drive and return to work will be addressed at your post-operative office visit call your surgeon immediately if you experience any of the following: ?????? new onset of tremors or seizures ?????? any confusion or change in mental status ?????? any numbness, tingling, weakness in your extremities ?????? pain or headache that is continually increasing or not relieved by pain medication ?????? any signs of infection at the wound site: redness, swelling, tenderness, drainage ?????? fever greater than or equal to 101?????? f followup instructions: your sutures and staples have been removed prior to discharge. please call to schedule an appointment with dr. to be seen in 4 weeks. you will need a ct scan of the brain without contrast procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified incision of cerebral meninges enteral infusion of concentrated nutritional substances arteriography of cerebral arteries reopening of craniotomy site diagnoses: esophageal reflux tobacco use disorder other postoperative infection unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled compression of brain other and unspecified hyperlipidemia pneumonitis due to inhalation of food or vomitus alkalosis other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation other complications due to other vascular device, implant, and graft iron deficiency anemia, unspecified staphylococcus infection in conditions classified elsewhere and of unspecified site, other staphylococcus other disorders of neurohypophysis subdural hemorrhage other and unspecified alcohol dependence, continuous alcohol withdrawal delirium personal history of methicillin resistant staphylococcus aureus essential thrombocythemia other musculoskeletal symptoms referable to limbs 

Answer: The patient is high likely exposed to