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: confusion, vomiting major surgical or invasive procedure: cerebral angiogram intubation extraventricular drain placement vp shunt placement history of present illness: 52 y old man who presented following acute onset of confusion while driving. apparently was able to talk with relative but relative noted he was confused. pulled off the road. developed acute onset headache with nausea and vomiting. . the patient was reviewed at where ct scan showed l thalamic bleed with extension of blood to lateral and thrid ventricles. mr was intubated there and tranferred to for further treatment. . assessed by neurosurgery. ct here showed findings as above. cta negative for arteriovenous malformation or subarachnoid hemorrhage. preoperatively weak on r side. the patient was taken to the or for bilateral burr holes, and ventriculostomy drains. increased icp. transferred to icu for monitoring. . systems: recent endocrine review note states had been experiencing bilateral hand numbness for 6 months with occassional le numbness past medical history: diabetes diagnosed in 17y ago-poorly treated -hba1c 15. -diabetic retinopathy with hemorrhages seen () s/p laser treatments -probable diabetic neuropathy (paraesthesias) hypertension diagnosed in hyperlipidaemia appendectomy social history: married, 4 children. immigrated from in . speaks cantonese. truck driver, produce. tob: 60 pack year +. etoh: 1-2 beers per week. family history: mother-diabetes insulin from 35-40y, with retinopathy; htn, hypercholesterolaemia father-colon ca physical exam: on admission: t-97.3 bp-107/57 (once up to 139/-, mostly 100s-110 systolic) hr-92 rr-14 o2sat-100% 40%fio2 fs 170 . gen: lying in bed, intubated and ventilated heent: moist oral mucosa cv: rrr, nl s1 and s2, no murmurs/gallops/rubs lung: 5cm peep rate 12 clear to auscultation bilaterally abd: +bs soft, nontender, old appendectomy scar rlq ext: no edema, cool . neurologic examination (propofol running): . bilat external ventricular drains at 10cm,draining serosanguinous fluid. . mental status: withdrawing to nailbed pressure l side. not opening eyes. no vocalisations. . cranial nerves: pupils equally round and sluggisly reactive to light, 2 to 1.5 mm bilaterally. facial movement symmetric. . motor: normal bulk bilaterally. intermittent fine tremor bilat upper limbs. tone increased bilat le. fixed contracture at r elbow unable to extend beyond about 120 deg and resistance to flexion associated with previous injury. . no response of rue rle to nail bed p. lue withdraws and lle dorsiflexion at ankle to nailbed pressure. . reflexes: +2 l biceps, 1+ brachio and triceps on l; 1+ biceps on r and absent brachio/triceps on r. symmetric patella 2+, absent ankles. toes mute bilaterally . coordination/gait/romberg: not tested pertinent results: ct brain acute hemorrhage in the left thalamus with surrounding vasogenic edema, mass effect, and mild shift of normally midline structures, and dissemination of the hemorrhage into bilateral anterior horns, third ventricle, aqueduct, and fourth ventricle. multiple air fluid levels in paranasal sinuses as described above, representing sinus disease. . cta left thalamic and intraventricular hemorrhage. prominent veins in the left hippocampus, could represent a developmental venous anomaly. if this patient is not felt to have a hypertensive hemorrhage, an angiogram should be performed to evaluate for arteriovenous shunting, in which case, an arteriovenous malformation could be considered. . admission labs urine: rbc->50 wbc-0-2 bacteria-rare yeast-none epi-0 blood-lg nitrite-neg protein-100 glucose-250 ketone-neg bilirubin-neg urobilngn-neg ph-8.0 leuk-neg color-straw appear-clear sp -1.008 . wbc-13.8* rbc-4.43* hgb-13.1* hct-37.8* mcv-85 mch-29.6 mchc-34.7 rdw-14.2 plt count-240 neuts-86.0* lymphs-10.0* monos-2.3 eos-1.3 basos-0.3 pt-11.6 ptt-29.9 inr(pt)-1.0 alt(sgpt)-21 ast(sgot)-25 alk phos-70 amylase-85 tot bili-1.0 glucose-219* urea n-22* creat-1.1 sodium-140 potassium-4.4 chloride-101 total co2-27 anion gap-16 hgb-10.4* calchct-31 glucose-198* lactate-1.2 na+-139 k+-3.5 cl--110 . angiogram : findings: no intraparenchymal arteriovenous malformations were seen. there are no aneurysms, stenoses, or occlusions. right external carotid artery injection demonstrates an arteriovenous fistula from the distal branches of the right internal maxillary artery / ethmoidal arteries are seen to the ophthalmic veins and the cavernous sinuses bilaterally. . impression: no intraparenchymal arteriovenous malformations. relatively small arteriovenous fistula is noted from the distal branches of the right internal maxillary artery / ethmoidal arteries with drainage into the ophthalmic vein and cavernous sinus. . head ct post op : findings: an intraventricular drain enters the brain via a right frontal burr hole, traversing the septum pellucidum and terminating at the level of the left cerebellar peduncle. the ventricles appear smaller than on prior ct scan. the amount of blood layering in bilateral occipital horns is unchanged. the appearance of the brain and paranasal sinuses is otherwise unchanged. . impression: interval replacement of the right intraventricular drain as described above with resultant decrease in ventricular prominence brief hospital course: 52year old gentleman with background of diabetes, and hypercholesterolaemia, with htn diagnosed in , admitted with a l thalamic bleed with extension to ventricular system. . neuro: pt was initially admitted to neurosurgery service. l thalamic hemorrhage was about 10cc with extension to lateral and 3rd ventricles on imaging (see results above). bilateral evds were placed on and revised . cefazolin prophylaxis was continued while evds in place. mental status improved and pt was extubated without incident on , and transferred to neurology step down unit on . evd was clamped and pt. developed increased icps to 30s, so vp shunt was placed with no complications on . post-op head ct showed decrease in ventricle size after shunt placement (see results above). he had no seizures in house. he was initially given phenytoin for seizure prophylaxis, which was titrated down prior to discharge. he should continue to be titrated off over the next 2 weeks (100 mg through , then 100 qd through , then off). bp was cotrolled with metoprolol iv -> po and hydralazine iv prn to maintain maps < 110. angiogram was performed and showed no evidence of aneurysm, but did show a small arteriovenous fistula from the distal branches of the right internal maxillary artery / ethmoidal arteries with drainage into the ophthalmic vein and cavernous sinus. ent was consulted about this and felt that it needed no acute intervention. this should be revisited by neurology in follow up. the location of the hemorrhage was most consistent with a hypertensive bleed and as angiogram showed no other lesion this was felt to be the most likely cause of the hemorrhage. . on the floor pt. was evaluated by pt and ot, who recommended rehab, and speech, who felt that pt. was safe for advancement from tube feeds to a soft solid diet with thin liquids, which he tolerated well. pt. should be reassessed by speech at rehab and advanced to a full diet if appropriate. . on day of discharge pt. had grip strength on the right, increased tone in his right arm, and some flexion of his right arm with pain, although he was unable to lift the r arm off the bed. he had decreased tone and umn pattern weakness in his right leg but was able to lift it against gravity. he had r facial droop. he was awake and alert and conversing with his family in cantonese. medications on admission: meds: (from quinsy note ) metformin 1700mg qam 850mg qpm actos (pioglitizone) 45mg qd glipizide 10mg atorvastatin 40mg po qd discharge medications: 1. glipizide 5 mg tablet sig: two (2) tablet po bid (2 times a day). 2. insulin nph human recomb 100 unit/ml cartridge sig: fourteen (14) units subcutaneous qam. 3. insulin nph human recomb 100 unit/ml cartridge sig: ten (10) units subcutaneous qpm. 4. regular insulin sliding scale please check fs qidachs and administer insulin per sliding scale attached 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 6. metoprolol tartrate 25 mg tablet sig: three (3) tablet po tid (3 times a day). 7. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 8. phenytoin sodium extended 100 mg capsule sig: one (1) capsule po bid (2 times a day) for 6 days: through . 9. dilantin 100 mg capsule sig: one (1) capsule po once a day for 7 days: . discharge disposition: extended care facility: - discharge diagnosis: left thalamic cerebral hemorrhage with infarction (stroke) hypertension discharge condition: stable, left arm and leg weakness discharge instructions: please call your doctor or go to the er if you develop any headache, blurry vision, double vision, fever, chills, nausea, vomiting, worsening weakness or numbness in your arms or legs, or any other symptoms that concern you. followup instructions: neurology: dr. , tuesday at 3:00, , , 8. please call prior to the appointment to update your information. neurosurgery: dr. , . dr. office will call you with an appointment, please call his office if you don't hear from them in the next week. primary care: please call dr. at to set up a follow up in the next 2-4 weeks md, procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours enteral infusion of concentrated nutritional substances arteriography of cerebral arteries ventricular shunt to abdominal cavity and organs ventricular shunt to extracranial site nec replacement of ventricular shunt gingivoplasty diagnoses: tobacco use disorder unspecified essential hypertension polyneuropathy in diabetes intracerebral hemorrhage other and unspecified hyperlipidemia acute respiratory failure long-term (current) use of insulin late effects of cerebrovascular disease, hemiplegia affecting unspecified side cerebral artery occlusion, unspecified with cerebral infarction background diabetic retinopathy diabetes with neurological manifestations, type ii or unspecified type, uncontrolled communicating hydrocephalus mechanical complication of nervous system device, implant, and graft diabetes with ophthalmic manifestations, type ii or unspecified type, uncontrolled 

Answer: The patient is high likely exposed to