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: dysarthria major surgical or invasive procedure: egd push enteroscopy history of present illness: the pt is a 64 year-old left handed gentleman with multiple medical problems including pfo/complex atheroma in the descending aorta, lymphoma s/p chemotherapy, hepatitis b, diabetes mellitus, s/p right bka (), who was at recovering from recent admission for bka and e coli bacteremia. he was last seen well at 6am on the day of admission. at 6:15am he was noted to be dysarthric with right facial and arm weakness. code stroke called at 8:20am. patient arrived shortly afterwards and was seen immediately. nihss on arrival to was 10. later found to have right homonymous hemianopia, left arm drift as well. ct was negative for hemorrhage. cta showed what appeared to be drop off signal of the basilar with minimal flow in bilateral pcas. he was given iv t-pa at 9:06am, estimated weight of 170 pounds. bolus 7mg, 62.6 mg infusion x 1 hr. guaiac was trace positive pre t-pa. no change in exam after t-pa immediately. of note, at 11am, fluency and dysarthria are noted to be improved, as he raised his right arm off the bed without difficulty. past medical history: 1. reactivation hepatitis b, on entecavir 2. tee in shows complex atheroma in descending aorta. the interatrial septum is aneurysmal. a left-to-right shunt across a small secundum atrial septal defect was seen. 3. central retinal artery occlusion r eye - pt developed central retinal artery occlusion likely embolic event. 4. lymphoma - lymphoplasmacytoid lymphoma; treated with fludaribine, five cycles in . since then has been seen by dr. and has not required further therapy. 5. insulin dependent diabetes - has had for many years. treated with humalog-lente combination 16 u am, 22 u pm. has had multiple dm complications including l eye retinopathy, gastroparesis, peripheral neuropathy complicated by several bouts of le cellulitis. creatinine at baseline is 0.8-1.0 6. low albumin - unclear etiology, has ranged from 1.9-3.5 over last several years. question of possible nephrotic syndrome; may be related to diabetes but unclear. 7. acoustic schwanoma - treated with gamma knife radiation at osh. 8. gastritis, duodenitis 9. pvd 10. hypertension 11. right bka due to pvd c/b e coli bacteremia and uti with pseudomonas 12. anemia - iron def and anemia of chronic inflammation 13. chronic malnutrition and 2 months of diarrhea, on tpn, multiple gi ulcers, no lymphoma seen on biopsies, but still undergoing w/u 14. b12 deficiency on im replacement social history: the pt is married, with 2 kids. has remote history of tobacco use (35 pack year history). social alcohol drinker. retired dentist. family history: father died in after amputation for gangrene (unclear origin). mother died unclear reason, had . physical exam: vitals: 118/60, 60 nsr (at ), bp during ct was 112's, and after tpa was 140's. t 100.2 rectal. fs 212 by ems. 99% 2lnc. gen: elderly man, anxious skin: no rash heent: nc/at, anicteric sclera, dry mm neck: supple, no carotid bruits chest: normal respiratory pattern, cta bilat anteriorly cv: regular rate and rhythm without murmurs (difficult to fully appreciate right now) abd: softly distended, +bs, multiple bruises extrem: right bka, left edema 1+ to knee. + scrotal edema. . neuro: via russian translator mental status: patient is alert, awake, mildly anxious. oriented to person, place - "ho", not time (he tries to sign out some kind of number). language is nonfluent with good comprehension for 2 step commands in russian, repitition intact (albeit he wispers the words), + severe dysarthria for pa/ta/ka sounds. further mental status testing not obtained at this time, but does not appear to neglect one side or the other, blinks bilaterally. he motions well with his hands when trying to communicate. . cranial nerves: i: deferred ii: visual fields: right homonomous hemianopsia. fundoscopic exam: discs flat, fundi clear, no hemorrhages or exudates. pupils: 2->1 mm, consenual constriction to light. iii, iv, vi: eoms full, gaze conjugate. + left beating horizontal nystagmus in primary gaze and worse when looking to the left. no ptosis. v: facial sensation intact over v1/2/3 to light touch and pin prick. vii: right lower facial droop viii: not tested ix, x: dysarthric labial/lingual/gutteral sounds. trouble coughing. : not tested xii: originally was off to the left, but later midline . sensory: originally he had decreased sensation on the left, but later he said it was normal bilaterally to lt and pin. very poor vibration testing - intact at the knees and knucles (barely) of the hands. . motor: diffusely wasted bulk esp distally in hands, normal tone. no fasciculations. + right pronator drift. no adventitious movements. right hemiparesis - he is barely able to lift right arm to gravity, and cannot lift right leg to gravity. . strength: delt tri fe ff ip qd ham df pf rt: 3 3 3 4+ 5 2 amputated left: 4 4 4 5 5 4 5 4- 4 5 . reflexes: absent, upgoing toe on the left, ampuation on the right. . coordination: + dysmetria on finger-to-nose on the left, too weak to tell on the right. unable to test legs. . gait: not tested pertinent results: 04:14pm wbc-11.0 rbc-2.87* hgb-8.5* hct-25.5* mcv-89 mch-29.8 mchc-33.4 rdw-17.6* 04:14pm plt count-702* 09:00am urine color-yellow appear-clear sp -1.027 09:00am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 08:40am glucose-196* urea n-44* creat-0.6 sodium-136 potassium-4.7 chloride-109* total co2-19* anion gap-13 08:40am ck(cpk)-26* 08:40am ck(cpk)-26* 08:40am ck-mb-notdone ctropnt-0.04* 08:40am ck-mb-notdone 08:40am calcium-7.2* phosphate-4.8* magnesium-2.2 08:40am asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 08:40am wbc-14.7* rbc-3.59* hgb-10.6* hct-32.1* mcv-89 mch-29.5 mchc-33.1 rdw-17.6* 08:40am plt count-938*# 08:40am pt-11.5 ptt-22.7 inr(pt)-1.0 . . radiologic data cta brain (): 1. thrombosis of the distal basilar artery. 2. no definite evidence of infarct. mri/mra brain (): 1. acute left pica territorial infarct involving the inferior aspect of the left cerebellar hemisphere. no other diffusion abnormality identified. 2. narrowing of the left pica at its verterbral artery take-off that may indicate underlying plaque versus, less likely, dissection. 3. distal right vertebral artery irregularity and narrowing distal to the right pica, likely relating to underlying atherosclerotic disease. relatively right vertebral artery throughout its course that may be secondary to an origin stenosis. cxr (): lungs remain quite low with most pronounced atelectasis at the medial lung bases. upper lungs clear. heart size normal. no pleural effusion. mra neck (): the 2d time-of-flight mra demonstrates normal flow signal in the carotid and vertebral arteries. the gadolinium-enhanced mra of the neck demonstrates irregularity of the flow signal in the proximal right vertebral artery on the projection images. there is also diminished flow signal intensities seen in the right vertebral artery compared to the left side. there is narrowing of the distal right vertebral artery as seen on the previous cta of . brief hospital course: 1. posterior circulation stroke: as discussed in the hpi, the pt was given intravenous tpa in the ed. basilar artery embolism was felt to be most likely secondary to right vertebral artery atherosclerotic disease. early in the course of the hospital stay, dysarthria resolved. he continued to have congruous incomplete homonymous hemianopia on the left and mild left-sided weakness. repeat mri on hospital day three demonstrated small lesions in the distribution of the pca bilaterally. mra of the neck was also performed at that time and was negative for dissection. as he was judged to be a high risk for bleeding from intestinal ulcers (as discussed below), the decision was made to place the pt on anti-platelet as opposed to anticoagulation. therefore he was placed on aggrenox. in addition, he was placed on a statin and low-dose beta blocker. at the time of discharge, neurologic examination was notable for left congruous incomplete homonymous hemianopia, dysmetria (left>right), left sided weakness in an umn pattern. he should undergo aggressive pt upon discharge. 2. blood loss anemia/gastrointestinal bleeding: the pt's hematocrit dropped to 25.5 after tpa (was initially 32.1). he was transfused with prbcs and went to 26, transfused again and went to 30. he had many guaiac positive stools. he was placed on double-dose ppi. the gastroenterology service was consulted and an egd was performed on hospital day three. this revealed mosaic appearance, erythema and erosion in the whole stomach; reticular, granularity and nodularity in the whole duodenum; ulcer in the first part of the duodenum; otherwise normal egd to third part of the duodenum. as no clear evidence of source of bleeding was identified, push enteroscopy was performed on hospital day six and revealed friability, scalloping, atrophied villi in the jejunum (biopsy); ulcers in the proximal jejunum and mid jejunum (biopsy); nodularity and atrophy in the whole duodenum; mass in the distal bulb (biopsy); edematous, boggy mucosa and erosion in the antrum and stomach body. he was judged to be at high risk for bleeding from the ulcers identified. his hematocrit was cycled post-push enteroscopy and remained stable in the 26-30 range. at discharge, his hematocrit was 26.4. this was discussed with the gastroenterology service. they recommended to continue to follow his hematocrit upon discharge to rehab, and noted that further work-up will be deferred to an outpatient basis. 3. uti: the pt was found to have a urinary tract infection as part of a fever work-up. he was treated with a seven day course of bactrim ds (which was completed on the day prior to discharge). 4. fen: the pt was maintained on daily tpn in addition to clear liquids (due to gi bleeding, as discussed above). of note, he suffers from hypoalbuminemia of unknown etiology. during his stay in the icu, he was aggressively given ivf. as a result, he developed ascites and scrotal edema which began to gradually improve at the time of discharge with gentle diuresis. his diet should be slowly advanced as tolerated after discharge. medications on admission: mirtazapine 7.5 qhs ondansetron prn iron 325mg po daily metoprolol 50mg po daily vitamin b12 1000mcg im q month calcium carbonate trypsin/balsam/ to le entecavir 0.5mg po daily glycerin/bisacodyl/lactulose/senna/loperamide prn tylenol prn trazodone 25mg po prn riss ecasa 325mg po daily plavix 75mg po daily sc heparin 5000 u daily discharge medications: 1. entecavir 0.5 mg tablet sig: one (1) tablet po daily (daily). 2. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 3. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 4. dipyridamole-aspirin 200-25 mg cap, multiphasic release 12 hr sig: one (1) cap po bid (2 times a day). 5. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po twice a day. 6. vitamin b12-vitamin b1 100-1 mg/ml solution sig: 1000mcg intramuscular once a month. 7. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po once a day. 8. dolasetron 12.5 mg/0.625 ml solution sig: one (1) intravenous q8h (every 8 hours) as needed. 9. metoprolol tartrate 25 mg tablet sig: tablet po twice a day. 10. simethicone 80 mg tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day) as needed for abdominal pain/distention. discharge disposition: extended care facility: & rehab center - discharge diagnosis: -posterior circulation infarcts -blood loss anemia due to gastrointestinal bleed discharge condition: stable. neurologic examination notable for for left congruous incomplete homonymous hemianopia, dysmetria (left>right), mild (4+/5) left sided weakness in an umn pattern. discharge instructions: please continue all medications as prescribed. please attend all follow-up appointments. if you experience increasing weakness, visual or speech difficulties or other concerning symptoms, please call your primary care doctor or return to the emergency department for evaluation. followup instructions: provider: , md phone: date/time: 9:45 please follow-up with your pcp within the next 7-10 days. neurology: provider: , md, phd: date/time: 3:00 gastroenterology: please call dr. office at to arrange a follow-up appointment within the next month. md, procedure: parenteral infusion of concentrated nutritional substances other endoscopy of small intestine injection or infusion of thrombolytic agent esophagogastroduodenoscopy [egd] with closed biopsy diagnoses: urinary tract infection, site not specified acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled other malignant lymphomas, unspecified site, extranodal and solid organ sites ostium secundum type atrial septal defect long-term (current) use of insulin other disorders of plasma protein metabolism below knee amputation status viral hepatitis b without mention of hepatic coma, acute or unspecified, without mention of hepatitis delta occlusion and stenosis of basilar artery with cerebral infarction occlusion and stenosis of vertebral artery with cerebral infarction late effects of cerebrovascular disease, disturbances of vision edema of male genital organs chronic or unspecified gastrojejunal ulcer with hemorrhage, without mention of obstruction homonymous bilateral field defects chronic duodenal ulcer without mention of hemorrhage or perforation, without mention of obstruction 

Answer: The patient is high likely exposed to