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: shellfish / ace inhibitors attending: chief complaint: right sided weakness major surgical or invasive procedure: tpa administration history of present illness: pt is a 71 yo woman with h/o dmii, hyperlipidemia, and h/o episode of right facial numbness who presents as a code stroke after developing left sided weakness. she was in her usoh this morning at home when she awoke. she did her morning chores. then at 11 am, she had the acute onset of "something going over me" in her head. she had no vertigo and no rocking feelings. she said it frightened her significantly, but can't describe this feeling better. she had no blurred or double vision with it. no loc or presyncope. she hit her lifeline and sat on her steps. ems found her staring glassy eyed. she noted that she was having trouble making a good fist in the left. she also noted that her left leg was not moving well. she had no ha, but did have the rishing feeling as described above. she had no loc. she was brought in as a code stroke and brought to the ct scanner. a head ct showed no bleeding and cta showed no obvious large vessel occlusion as interpreted by the stroke fellow. the patient refused an mri due to claustrophobia. on exam, she was alert and oriented, but had clear lue and lle weakness, with normal right sided weakness. she also had hemibody sensory loss to temp and pp as well as vib on the left. her language was normal. based on a high clinical suspicion for lacunar subcortical stroke and after a discussion of risks(6-7% risk of ich) and benefits of tpa, then pt and her son agreed to the infusion. she was given 90 mg tpa per protocol. she tolerated this well. she had no exclusionary conditions to lysis. ros: patient denies any fever, nausea, vomiting, headache, dysarthria, dysphagia, dizziness, visual changes, diplopia, hearing changes, chest pain. past medical history: 1. diabetes mellitus type 2 diagnosed ten years ago 2. spinal stenosis and herniated disk status post laminectomies in and , with no significant improvement in symptoms 3. hypercholesterolemia 4. hysterectomy in 5. she had right sided facial "numbness" and some unsteadiness in and was seen by neurology in f/u in without clear diagnosis and the mri/a were normal. 6. angioedema on ace-i. social history: social history: she has a 30 pack year tobacco history. now quit. occasional etoh use. no other drug use. she is separated from her husband. is supportive. pt is a retired nurse. family history: mother died in her late 80s from ca. father with renal failure. brothers with lung cancer and bone cancer. physical exam: vitals:94, 134/50, 21, 96% on ra gen:nad. heent:mmm. sclera clear. op clear neck: no carotid bruits cv: rrr, nl s1 and s2, no murmurs/gallops/rubs lung: clear to auscultation bilaterally ext:no cyanosis/edema neurologic examination: mental status: awake and alert, cooperative with exam, normal affect orientation: oriented to person, place, and date attention: attentive to exam and interview language: fluent with good comprehension and repetition. naming intact. no dysarthria or paraphasic errors no apraxia, no neglect intact calculation intact no extinction to dss cranial nerves: i: not tested ii: pupils equally round and reactive to light, 4 to 3 mm bilaterally. visual fields are full to finger movement. iii, iv, vi: extraocular movements intact bilaterally without nystagmus. v, vii: facial strength intact and symmetric, with ? mild left nlf flattening. has v1-v3 decrease to lt and pp on the left. viii: hearing intact to finger rub bilaterally. ix, x: palatal elevation symmetrical : sternocleidomastoid normal bilaterally. trap decreased on left. xii: tongue midline without fasciculations, intact movements motor: normal bulk and tone bilaterally no tremor unable to do full strength exam given tpa infusion urgency, but pt has 5/5 strength in rue, and 4+/5 ff on left. unable to hold lue up for 5 seconds. in les, holds rle against resistance for 10 seconds. unable to lift lle off of bed. left pronator drift sensation: intact to light touch, pinprick, temperature (cold), vibration throughout right side extremities. on left, has decreased to lt, pp, vibration, and temp in face(v1-v3), arm and leg. reflexes: b t br pa ankle right 2 1 1 2 t left 2 1 1 0 t toes were downgoing bilaterally coordination: normal on finger-nose-finger, rapid alternating movements slightly clumsy on left, ffm normal. gait: not tested due to le weakness. pertinent results: 08:29pm ck(cpk)-163* 08:29pm ck-mb-3 ctropnt-<0.01 11:55am glucose-151* urea n-18 creat-0.8 sodium-141 potassium-4.0 chloride-102 total co2-27 anion gap-16 11:55am ck(cpk)-170* 11:55am ctropnt-<0.01 11:55am ck-mb-4 11:55am calcium-9.8 phosphate-4.0 magnesium-2.1 11:55am wbc-7.7 rbc-4.14* hgb-12.2 hct-35.1* mcv-85 mch-29.5 mchc-34.8 rdw-14.1 11:55am neuts-63.8 lymphs-28.7 monos-4.6 eos-2.5 basos-0.3 11:55am plt count-345 11:55am pt-12.2 ptt-27.1 inr(pt)-1.1 ct perfusion: no abnormal areas of perfusion, ___blood flow/blood volume are noted on the perfusion scan performed. impression: 1. no abnormality noted on the ct perfusion images. 2. pending reconstructions on ct angiography. _____reconstructions on the ct angiography are performed. non-contrast ct study: the posterior fossa structures are normal. the cerebral parenchyma has normal and white matter differentiation. the ventricles and extra-axial csf spaces are unremarkable. the osseous and the soft tissue structures are normal. there is no evidence of mass effect, shift of normally midline structures ct-non contrast s/p tpa: findings: the posterior fossa structures are normal. the cerebral parenchyma has normal and white matter differentiation. there is no evidence of hemorrhage. the ventricles and the extra-axial csf spaces are unremarkable. the osseous and the soft tissue structures are normal. tee: the left atrium is normal in size. a right-to-left shunt across the interatrial septum is seen at rest. an atrial septal defect is present air bubble contrast study positive at rest and with maneuvers). there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the number of aortic valve leaflets cannot be determined. the aortic valve leaflets are mildly thickened. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. there is borderline pulmonary artery systolic hypertension. there is no pericardial effusion. compared with the findings of the prior report (images unavailable for review)of , an atrial septal derfect is now demonstrated. brief hospital course: the patient was admitted to the icu and given tpa within 2 hours of sx onset. the patient refused mri to determine localization of the stroke. post-tpa ct showed no evidence of ich. on the second hospital day, further stroke w/u revealed asd on tee. after administration of constrast, the pt c/o blurred vision. she was promptly laid supine and evaluated by the neurological service. it was found that her vision was impaired relative to her admission baseline, but that the blurriness was rapidly improving. it was felt that her sx were not due to stroke/embolus, but rather likely secondary to contrast rxn or migraine. her vision returned to baseline by the end of the second hospital day. she was then transfered to the floor. on the third hospital day, the pt was cleared for po of normal solids and thin liquids by the speech and swallow service. pt/ot evaluation cleared the patient for d/c to home. had small headache and stat head ct was done to rule out bleed. discharged day 4 and antihypertensives held as patient's blood pressure in adequate range without them and risk of hypoperfusion significant. gave notice to patient's pcp and restarting antihypertensives can be discussed at follow up wednesday. medications on admission: glucotrol 5 daily lipitor 40 glucophage 1500 daily avandia 4 daily toprol xl 100 daily meclizine prn ibuprofen 800 tid norvasc 2.5 daily asa 325 daily diovan 80/12.5 daily topamax, unknown dose discharge medications: 1. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. glipizide 5 mg tab,sust rel osmotic push 24hr sig: one (1) tab,sust rel osmotic push 24hr po daily (daily). disp:*30 tab,sust rel osmotic push 24hr(s)* refills:*2* 3. rosiglitazone 2 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 4. dipyridamole-aspirin 200-25 mg cap, multiphasic release 12 hr sig: one (1) cap po daily (daily): increase to twice a day starting . disp:*60 cap(s)* refills:*2* 5. pneumococcal 7- vacc 16 mcg/0.5 ml syringe sig: one (1) ml intramuscular once (once) for 1 doses. disp:*1 ml(s)* refills:*0* 6. topomax continue your topomax as you were taking it prior. 7. meds do not take your anti-hypertensives (toprol, norvasc) until discussing with your pcp. have been holding them in the hospital and your blood pressure has been fine. you may need to have them restarted in the future if your blood pressure increases. this can be discussed with your pcp, we have notified them. discharge disposition: home with service facility: homecare discharge diagnosis: stroke discharge condition: good. ambulating independtly and cleared for home discharge by pt. discharge instructions: please return to care if you develop any symptoms like those that brought you to the hospital, blurred vision, chest pain, shortness of breath, lightheadedness, dizziness, or any other signs or symptoms of serious illness. you have had a stroke, but you responded well to tpa and have only mild deficits. you are on a new medication aggrenox (see below). you will need to follow up with providers below. if any symptoms of weakness, numbness, visual changes return, then contact your pcp immediately or come to the ed. followup instructions: pcp: , . at 10:45am , md, phd: date/time: 8:30 , md phone: date/time: 8:30 , o.d. phone: date/time: 9:30 procedure: injection or infusion of thrombolytic agent diagnoses: pure hypercholesterolemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled cerebral artery occlusion, unspecified with cerebral infarction 

Answer: The patient is high likely exposed to