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: this 69-year-old man was transferred from on the to . he has a history of coronary artery disease, hypertension, hyperlipidemia, prostate and lung cancer with severe carotid stenosis and transient ischemic attacks who is referred now with the abrupt onset of speech difficulty and right-sided weakness. the patient had been hospitalized briefly in with speech difficulty and right-sided weakness. his studies back in showed severe bilateral carotid stenosis and there was thought to be a critical stenosis on the right, a marked stenosis on the left. ct scan was normal and the patient had been on aspirin and was then started on plavix. he was referred to and he was scheduled for a carotid endarterectomy a week prior to his admission. on the day of admission aspirin and plavix had been stopped in anticipation of this upcoming surgery, however, while at home patient fell asleep, complained to his wife of not feeling well and found him a few hours later slumped over in the bed and felt that his speech was slurred and not very comprehensible. he complained of double vision at the time. paramedics reported that he was moving his extremities, however, developed right-sided weakness when he arrived at . medications prior to admission: lipitor, cardia, hydrochlorothiazide, bronchodilators. past medical history: coronary artery bypass graft in . social history: he had been a smoker for the majority of his life though only smoking a few cigarettes a day. he quit in . physical examination: he was awake and fairly alert with fluent speech. no dysarthria. he repeats well and there is no anomia. he follows commands. cranial nerves: pupils were small and reactive to light. fundi were not seen. he had a fairly pronounced vertical gaze palsy. there was suggestion of slight lateral rectus weakness. visual fields were full to confrontation testing. there was mild right central facial weakness. the other cranial nerves were intact. motor examination showed no drift and normal strength to confrontation. fine finger movements were intact but finger-to-nose testing was ataxic, especially on the right. the patient's findings were remarkable for a vertical gaze palsy, maybe a right vi nerve palsy which relates to his complaint of double vision. the patient was transferred to where he was admitted to the hospital, was started on anticoagulation and carotid duplex was performed. he was admitted to the vascular service there and a stroke consult was done. laboratory on admission: white count 13.7, hematocrit 34.6, platelet count 209,000, pt 12.8, ptt 36.4, inr 1.1. sodium 137, potassium 4.0, bun 24, creatinine 1.4. hospital course: the stroke team recommended stopping heparin on his admission day and just continuing on aspirin and plavix with their considering recent strokes. the mri showed acute stroke in the paramedian thalamus and left of the midbrain. he also had small areas of stroke in the cerebellum. they recommended a four vessel angiogram and a carotid endarterectomy on the right carotid and once again the patient was now on the 11th started on heparin. the patient was monitored on the floor where he did continue with double vision and he was prepped for the carotid artery endarterectomy. his repeat carotid ultrasound was completed which shows a narrowing of 80-99% bilaterally of the tardive rppca suggest proximal disease. on the 12th the patient continued with double vision. his blood pressure was in the 140's to 180's and no other distress. the patient was made known to the neurosurgery service where he was to have an angiogram done. on the he had an angiogram which showed greater than 85% left vertebral artery stenosis, an occluded right vertebral artery. he had greater than 85% of the right common carotid bifurcation stenosis, 75% innominate origin stenosis. it was noted that patient had a left groin hematoma after the angiogram where he was monitored closely post-angiogram. he was also on telemetry during this time. he did end up having an ultrasound of the groin to rule out pseudo-aneurysm. the stroke team, the neurology team and the vascular team decided that the patient should have a right carotid endarterectomy and then have a stenting of his left vertebral artery. on the 13th he did have the ultrasound of his left groin which showed no pseudo-aneurysm. the patient was kept on heparin during this time. on the the patient had a right carotid endarterectomy done. he tolerated the procedure well. on postoperative day one he was awake, alert and oriented. incision was clean, dry and intact. he was reevaluated by the stroke service the same day. his blood pressure was 140/46, heart rate 74, respirations 14, temperature 97.8. at that point he was transferred back to neurology service. the patient did receive one unit of red blood cells on the 18th. it was noted on the 19th that he had slight swelling of the surgical scar, otherwise the patient was okay. on the 19th it was noted that that scar had serous fluid. no pus or edema. the site was monitored by the vascular service. the patient's pain was under control with percocet. a follow-up ultrasound on the 20th showed a patent right carotid, small right neck hematoma, no evidence of pseudo-aneurysm. his left groin hematoma was small, however, improving. the patient remained awake, alert and oriented. his neurological status was unchanged. during the postoperative period the patient was on aspirin and plavix. his staples were removed from the surgical neck site on the 21st. the site was dry and intact. he continued to be followed by neurology and neurosurgery. labs on the 23rd showed white count of 7.5, hematocrit of 39.2, 297,000 for platelets. on the 25th patient did have a left vertebroangioplasty and stent. estimated blood loss was minimal. the patient did well with the procedure. he woke up awake, alert and oriented. he had no drift. grasp was bilaterally. lower extremities were full. he remained on heparin post stenting at 800 units an hour and continued on aspirin and plavix. the patient was monitored in the trauma intensive care unit postoperatively. he was kept on a nipride drip to keep his blood pressure less than 140. a rheumatology consult was asked for on the 26th because of right-sided knee swelling. there was no erythema, however, there was increase in warmth. patient was thought to have heterotopic ossification. it was thought not to be an infectious process. patient was already on aspirin. they recommended topical aspirin cream. the patient was monitored in the intensive care unit. on the 27th he continued to need nipride to keep his blood pressure less than 140. he remained neurologically intact. case management was following him at this time. he was moved out of the unit on the 28th. his groin incision was noted to be intact with no infectious process noted. no further hematoma. he remained neurologically intact. his blood pressure was well controlled on oral antihypertensives. physical therapy and occupational therapy were involved in the patient's care and they recommended home physical therapy and also for nursing to follow up with the patient to check blood pressure. rheumatology's final recommendations were prednisone taper, nsaids and some local therapy to his right knee. patient was treated for methicillin-resistant staphylococcus aureus urinary tract infection diagnosed on the . he was started on intravenous vancomycin. infectious disease recommended that he start on dicloxacillin for one week after discharge. discharge medications: include: 1. atorvastatin 20 mg one tablet q. day. 2. __________ 110 mcg two puffs b.i.d. 3. albuterol 90 one to two puffs every q. 4-6h. 4. oxycodone one to two tablets q. 4-6h. 5. aspirin 325 one tablet q. day. 6. plavix 75 mg one tablet q. day. 7. cardizem 240 mg sa one tablet q. day. 8. salmeterol 50 mcg one diskus inhalation q. 12h. 9. lopressor 50 mg twice a day. 10. hydrochlorothiazide 1.5 tabs q. day. 11. doxycycline 100 mg q. 12h. 12. rheumatology recommended a prednisone taper which was given to the patient. 13. motrin 600 mg p.o. t.i.d. was given for the patient's inflammatory process of his right knee. discharge instructions: patient is to follow up with dr. in five weeks. follow up with dr. in one month. he will have home visits from vna nurses to check his blood pressure and a home safety evaluation with physical therapy. , m.d. dictated by: medquist36 procedure: angioplasty of other non-coronary vessel(s) arteriography of cerebral arteries endarterectomy, other vessels of head and neck insertion of non-drug-eluting peripheral (non-coronary) vessel stent(s) diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia unspecified essential hypertension aortocoronary bypass status occlusion and stenosis of multiple and bilateral precerebral arteries with cerebral infarction hematoma complicating a procedure acute, but ill-defined, cerebrovascular disease occlusion and stenosis of vertebral artery without mention of cerebral infarction asthma, unspecified type, unspecified 

Answer: The patient is high likely exposed to