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: left sided weakness, blurry vision, facial droop major surgical or invasive procedure: iv t-pa angiography by interventional neurosurgery ct angio and multiple nchcts history of present illness: ** history obtained from chart, co-residents, patient and patient's wife ** patient is a 55 year old right handed male with past medical history of alcohol abuse, ptsd, anxiety, adhd who presented to the ed on for acute stroke. history supplemented by info from girlfriend. patient reports that he fell backwards and hit his head on ice while shoveling snow in the afternoon of new years eve. he then was watching tv just before 20:00 when he had acute onset of blurred vision after coughing. called his girlfriend. she returned home between 20:00 and 20:15. his wife and her friend are both nurses; they report that up to 20:20 pm, patient was complaining of blurred vision, but was able to hold both arms above head, walk, plantar flex. ems called. by time ems arrived around 20:30, he was noted to have right gaze preference, dense left hemiplegia and left neglect. bp 188/104 l, 150/80 right. transported to ed where code stroke called. ed notified at 20:40. patient arrived at at 20:55. stroke team called at 20:56; neurology on site by 21:00. ct ordered at 20:55, done and interpreted by 21:20. cta performed as well. bolus dose tpa started at 21:30. initial nihss 19. fsbg 111. systolic blood pressures in 160s. patient with right gaze preference, left visual neglect, left umn facial palsy, left hemiplegia with no withdrawal to noxious stimuli, mild dysarthria and left neglect. patient improved somewhat after tpa bolus with ability to hold left upper extremity against gravity briefly, hold left lower extremity and provide some resistance, decreased left neglect, ability to gaze toward left, improved speech. however, as of 22:15, symptoms worsened with decreased movement of left side to point of hemiplegia and more pronounced neglect. final interpretation of cta suggestive of right ica occlusion. patient was admitted to the neuro icu with post-tpa protocol orders and placed on neosynephrine to keep sbp 160-170 range x 36 hrs. he underwent angiography by dr. on which showed a right ica dissection and pseudoaneurysm. repeat head ct's after t-pa showed no evidence of bleeding, thus he was placed on a full aspirin. then, on , head ct showed a stroke on the right, less than one-half of the hemisphere, thus it was decided to start him on low dose heparin gtt and coumadin with a goal ptt 40-50. prior to angiograph, tte was done and showed no pfo and no shunt. he passed a swallow study in the icu and thus may eat solid foods. past medical history: 1. anxiety 2. ptsd 3. adhd 4. depression 5. alcohol abuse 6. migraine 7. status post c5-c6 laminectomy and fusion several years ago by 8. diverticulitis, now status post partial colectomy 9. asplenia secondary to trauma incurred during vietman 10. multiple sharpnel injuries while in vietmam, - no mri!! social history: divorced. lives with female partner for past 15 years. 2 biologic and 1 adopted child. works as a real estate broker. smokes 1ppd for many years. history of alcohol abuse but no etoh for 6 weeks. no drug use. family history: adopted physical exam: exam upon transfer to floor: tc 97.8 tm 100.1 bp 155/128 hr 85 nsr rr 17 o2 sat 96% ra i/o: 2743/3750, los +550cc gen: nad, pleasant, conversant chest: cta bilat cv: rrr without mur extrem: no edema ms: awake, alert, fluent, repeats, prosody normal, orients well to the left (improved, no neglecct), no apraxia (brushes teeth) cn: no field cut, pupils 4->2mm bilat, eomi, left face droop, midline tongue motor: - left arm: 0/5 throughout, hypotonic - left leg: externally rotated, some adduction but otherwise no movement - right side: full strength : + extinction to dss on left, very little sensation to lt on left arm, withdrawl to pain left leg. right side normal. dtrs: br tri pat ach right 2 2 2 2 1 left 2 2 2 2 1 toe left upgoing, toe right downgoing. gait: not tested pertinent results: as of cbc: 10/44/301 diff 57/25/11 chem: 140/4.2/108/27/8/0.8/119 cal 8.6, phos 2.5, mag 1.9 ptt: 68 (on heparin), inr 1.1 esr: 5 : pending chol 151, ldl 97, hdl 47, tg 63 tox: acetaminophen 8.6 ruled out for mi blood cx pending tte: the left atrium is normal in size. the right atrium is dilated. left ventricular wall thickness, cavity size, and systolic function are normal (lvef 60-70%). the right ventricular cavity is dilated. right ventricular systolic function is normal. the aortic valve is not well seen. the mitral valve leaflets are structurally normal. there is no pericardial effusion. air bubble contrast imaging did not demonstrate the presence of right-to-left shunt across the interatrial septum, but the study is technically suboptimal. the presence of right heart chamber enlargement raises the suspicion of the presence of an atrial septal defrect with left-to-right shunt, but this abnormality was not demonstrated on limited color-flow imaging. nchct: : 1. continued evoluation of a known right mca territory infarct. 2. no intracranial hemorrhage. : 1. acute right middle cerebral artery territory infarct. 2. no intracranial hemorrhage identified. 3. stable ventricle size. : no definite intracranial hemorrhage is seen on this study performed 90 minutes after a contrast-enhanced study. contrast enhancement limits evaluation for subtle intra or extra-axial hemorrhage. ct angio head : 1. occlusion of the right internal carotid artery distal to the bifurcation of the common carotid artery within the neck. there is, however, reconstitution of flow within the intracranial right internal carotid artery and middle cerebral artery branches, possibly from collateral flow through the anterior communicating artery. 2. /white matter distinction is preserved. brief hospital course: 55 yo man with right ica dissection and occlusion, s/p t-pa on . transfer to the floor. exam: left hemiparesis (plegia in the arm, but paresis in the leg with some adduction), improved left visual neglect and left sided sensation. this patient was given t-pa without complication on . his blood pressure was maintained with neosynephrine while in the icu. ct angio revealed right ica occlusion. (patient cannot have mri 2o2 srapnel). angiography on showed right ica dissection with pseudoaneurysm. he was given asprin, then transitioned to iv heparin drip and coumadin on after repeated nchcts showed no hemorrhage and < of right hemisphere involved in the stroke. once coumadin is theraputic (inr 2-2.5), then heparin can be discontinued. the dissection was likely caused by his fall onto the ice while shoveling, however esr and were sent as part of the work up. esr 5, pending. upon transfer to the floor, florinef was started to keep sbp > 120. this should be continued for another week (d/c on ). he complained of a headache, occipital, radiating to the front of the head, reproducible with pressure applied to greater occipital nerve. most likely etiology is occipital neuralgia s/p fall on ice. given percocet for the pain and compazine (to prevent emesis as could worsen dissection). neurontin should help pain as well. cholesterol panel: 157, tg 63, hdl 47, ldl 97. glucose was tightly controlled. tte showed no pfo, no veggitations or clot. he passed a bedside swallow eval and was placed on a heart healthy diet. he was evaluated by pt/ot. to be discharged to rehab. re: psych meds, neurontin was restarted and antabuse was continued. ritalin was held. prophylaxis - pneumoboots, ppi, riss, on heparin drip full code medications on admission: medications prior to admission: wellbutrin 400 ritalin 20 antabuse thiamine 1 neurontin prn insomnia, up to 1000 mg discharge medications: 1. prochlorperazine 10 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for nausea: take prophylactically with percocet for nausea. :*30 tablet(s)* refills:*0* 2. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed for pain. :*30 tablet(s)* refills:*0* 3. senna 8.6 mg tablet sig: two (2) tablet po bid (2 times a day) as needed for constipation. :*60 tablet(s)* refills:*0* 4. gabapentin 400 mg capsule sig: one (1) capsule po bid (2 times a day). :*60 capsule(s)* refills:*2* 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). :*60 capsule(s)* refills:*2* 6. multivitamin capsule sig: one (1) cap po daily (daily). :*30 cap(s)* refills:*2* 7. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). :*30 tablet(s)* refills:*2* 8. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). :*30 tablet(s)* refills:*2* 9. disulfiram 250 mg tablet sig: 0.5 tablet po daily (daily). :*15 tablet(s)* refills:*2* 10. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed for pain. :*30 tablet(s)* refills:*0* 11. bupropion hcl 100 mg tablet sustained release sig: two (2) tablet sustained release po bid (2 times a day). :*120 tablet sustained release(s)* refills:*2* 12. guaifenesin 100 mg/5 ml syrup sig: 5-10 mls po q6h (every 6 hours) as needed. :*250 ml(s)* refills:*0* 13. gabapentin 400 mg capsule sig: two (2) capsule po hs (at bedtime). :*60 capsule(s)* refills:*2* 14. warfarin sodium 2.5 mg tablet sig: one (1) tablet po hs (at bedtime). :*30 tablet(s)* refills:*2* 15. fludrocortisone acetate 0.1 mg tablet sig: one (1) tablet po daily (daily): discontinue on . :*30 tablet(s)* refills:*2* 16. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). :*30 tablet, delayed release (e.c.)(s)* refills:*2* 17. insulin regular human 100 unit/ml solution sig: per sliding scale units, regular insulin injection qachs: sliding scale: bg 151-200: 2 units bg 201-250: 4 units bg 251-300: 6 units bg 301-350: 8 units bg 351-400: 10 units bg >= 401: 12 units and call physician. :*qs units, regular insulin* refills:*2* 18. heparin sod (porcine) in d5w 100 unit/ml parenteral solution sig: nine hundred (900) units per hour intravenous continuous infusion: check ptt q 6 hours after starting or adjusting heparin and qd thereafter; adjust dose for target ptt of 45-55. :*qs units per hour* refills:*2* discharge disposition: extended care facility: & rehab center - discharge diagnosis: rt sided mca stroke as complication of rt. ica dissection with peudoaneurysm. discharge condition: stable - left hemiplegia of face arm and leg (mild adduction of left leg is present). left neglect improved. passed swallow evaluation. discharge instructions: - discontinue florinef in one week on - check inr frequently, goal 2-2.5 followup instructions: provider: scan where: ra (/ complex) radiology phone: date/time: 11:30 provider: scan where: ra (/ complex) radiology phone: date/time: 11:45 note - do not eat any food or drink for three hours before the above radiology appointments. provider: , md where: neurology phone: date/time: 1:00 procedure: injection or infusion of thrombolytic agent arteriography of cerebral arteries percutaneous angioplasty of extracranial vessel(s) percutaneous insertion of carotid artery stent(s) diagnoses: alcohol abuse, unspecified dysthymic disorder dissection of carotid artery other acquired absence of organ attention deficit disorder with hyperactivity fall from other slipping, tripping, or stumbling other late effects of cerebrovascular disease, facial weakness posttraumatic stress disorder occlusion and stenosis of carotid artery with cerebral infarction hemiplegia, unspecified, affecting nondominant side other syndromes affecting cervical region 

Answer: The patient is high likely exposed to