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: penicillins / lisinopril / morphine / oxycodone-acetaminophen / shellfish derived attending: chief complaint: transfer from osh with right putamen intracranial hemorrhage major surgical or invasive procedure: tube placement history of present illness: the pt is a 51 year-old woman with pmhx of htn, esrd, uterine malignancy, history of l periventricular white matter infarct and dm2 who presented from for an ich that is likely hypertensive in etiology. per records, the patient was at her baseline earlier on , then went to dialysis in the afternoon. when she returned home, she had a rightward gaze and "wasn't acting right", so her family called ems (arond 8pm). she was brought to where a nchct was completed that showed a 4.1cm r lentiform ich w/ 4mm of midline shift. her bp at was initially in the 230's, and she was given iv labetalol 20mg x2 with good effect. she was then transferred to for further evaluation. in the ed, she was seen by neurosurgery who felt that there was no intervention to be done (per dr. , and recommended admission to the neurology service. unable to complete ros as pt is intubated and sedated. however, records the patient had been c/o a headache when she returned home from dialysis. past medical history: - esrd due to hypertension, diabetes, hd since mwf, left av fistula - infarct of unknown timing in left periventricular white matter - hemochromatosis with grade 1 varices and cirrhosis. - diabetes type 2, on insulin. - osteoporosis. - c. diff infection. - cardiomyopathy, followed by dr. . - drop attacks and falls. social history: works as a secretary at the irs. she lives with her husband and friend. tobacco, alcohol, or drug use. family history: dm - in mother and 1 sisters. 2 sisters and mom passed away young. physical exam: physical exam on admission: vitals: t: 98.6 p: 66 r: 16 bp: 129/63 sao2: 99% on ra general: intubated, sedated (even off propofol, midazolam given recently) heent: nc/at, no scleral icterus noted, mmm neck: supple, no carotid bruits appreciated. no nuchal rigidity pulmonary: lungs cta bilaterally without r/r/w cardiac: rrr, nl. s1s2, no m/r/g noted abdomen: soft, nd, normoactive bowel sounds, no masses or organomegaly noted. extremities: no c/c/e bilaterally, 2+ radial, dp pulses bilaterally. skin: no rashes or lesions noted. neurologic: -mental status: patient intubated and sedated. not following commands. -cranial nerves: i: olfaction not tested. ii: perrl 1.5 to 1mm and brisk. funduscopic exam difficult due to small size of pupils, but what was visualized revealed no papilledema, exudates, or hemorrhages. iii, iv, vi: unable to test. v: unable to test vii: ett in place, unable to test viii: unable to test ix, x: gag intact. : unable to test xii: ett in place, unable to test -motor: normal bulk, tone throughout. no pronator drift bilaterally. no adventitious movements, such as tremor, noted. withdraws the rue and rle briskly to noxious. does not withdraw the lue or lle to noxious but does localize (grimaces and moves the r-side). -sensory: withdraws to noxious as above -dtrs: tri pat ach l 1 1 1 1 0 r 1 1 1 1 0 plantar response was mute bilaterally. -coordination: unable to test -gait: deferred physical exam on discharge: pertinent results: labs on admission: 01:05am wbc-9.4 rbc-4.75 hgb-12.3 hct-39.2 mcv-82 mch-25.8* mchc-31.3 rdw-17.0* 01:05am pt-12.1 ptt-29.8 inr(pt)-1.1 01:05am fibrinoge-434* 01:05am asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 01:05am tsh-4.9* 01:05am osmolal-301 01:05am triglycer-211* hdl chol-27 chol/hdl-6.1 ldl(calc)-97 01:05am albumin-4.3 calcium-8.1* phosphate-5.3* magnesium-2.1 cholest-166 01:05am ck-mb-4 ctropnt-0.09* 01:05am lipase-79* 01:05am alt(sgpt)-18 ast(sgot)-29 ld(ldh)-292* ck(cpk)-213* alk phos-100 tot bili-0.4 01:05am urea n-25* creat-4.4* 01:16am glucose-341* na+-136 k+-3.6 cl--93* tco2-30 11:14am ck-mb-4 ctropnt-0.08* imaging: nchct findings: there is a parenchymal hematoma centered in the right external capsule, displacting the right lentiform nucleus medially, and extending into the corona radiata, which measures 3.9 x 1.7 cm (2:18), not significantly changed in size. the extent of surrounding edema is also unchanged. there is no new intracranial hemorrhage. there is mild effacement of the frontal and body of the right ventricle, and a minimal leftward shift of the septum pellucidum, also unchanged. there is no herniation. the basal cisterns are not compressed. sulci are more prominent than would be expected for the patient's age, indicating cerebral atrophy. bilateral mastoid air cells and visualized paranasal sinuses are clear. there is evidence of right cataract surgery. the bones are unremarkable. impression: parenchymal hemorrhage centered in the right external capsule and corona radiata, displacing the lentiform nucleus medially, with mild associated mass effect, unchanged compared to approximately 4 hours earlier. while this could represent a hypertensive hemorrhage, a vascular malformation or a mass could also be considered. the latter possibilities could be investigated by mri/mra, if clinically warranted. chest x-ray there is moderate cardiomegaly. the mediastinum is widened. there is mild pulmonary edema. if any, there are small bilateral pleural effusions. ng tube tip is in the stomach. labs on discharge: brief hospital course: ms. is a 51 year-old woman with pmhx of htn, esrd, uterine malignancy, history of l periventricular white matter infarct and dm2 who presented from with left sided weakness, aphasia and was found to have an ich that is likely hypertensive in etiology. # neuro: patient was eating dinner when suddently her left and and face "felt funny." per her friend who was present, she was unable to speak and could not stand up from her chair. friend called 911. sbp at osh was in the 230s on arrival. head ct was obtained and showed a right putaminal hemorrhage. the bleed was most likely in the setting of hypertension (of note, a recent discharge summary from stated that her home labetalol dose was 300mg po bid; however on admission her home dose was reportedly 100mg po bid). other possibilities would be a hemorrhagic conversion of a stroke (although this is a less likely location for that) or bleeding into a malignancy, but again this is less likely than hypertensive hemorrhage given the location and elevated bp on arrival to the osh. her neurological exam on admission was notable for minimal movement of her l-side to noxious stimuli, which would fit with her r ich location. she was admitted to the neuro icu for further evaluation and workup. aspirin/simvastatin were held in the setting of a bleed. shortly after arrival in the icu, she was successfully extubated. her blood pressure was initially quite well controlled on labetalol 100mg po bid. on hd #5 she became persistently hypertensive to sbp 170s so amlodipine 5mg po daily was added to her antihypertensive regimen. in addition, due to increased lethargy and possible ?eye opening apraxia during hospitalization, she was started on modafinil to increase her alertness -- this seemed to be helpful. on discharge, her neuro exam was notable for dense hemiparesis of left face, arm and leg and severe dysarthria and dysphagia with preserved mental status. for her continued dysphagia, patient underwent placement on . # id: on (hd #3) patient spiked fever to 101.4. she was noted to have extremely purulent-appearing respiratory secretions, and in setting of severe dysphagia s/p stroke etiology was felt most likely to be aspiration pneumonia vs. hcap vs. vap (the latter being less likely as duration of intubation was <24 hours). she was empirically started on vancomycin, cefepime and levaquin to cover for hcap vs. aspiration pneumonia and rapidly defervesced. sputum cultures grew out , her vancomycin was discontinued. as her sputum culture grew out pan-sensitive ecoli, antibiotics were narrowed to levaquin and she completed her 10 day course on . after her placement, she had low grade temperature to 99.9 and leukocytosis to 13, so blood cultures were drawn. however, as her temperature improved on its own, leukocytosis was thought to be more reactive and no further antibiotics were given. # cardiovascular: patient had likely hypertensive ich in setting of sbp 230. her home labetalol dose was 100mg po bid on admission. this initially controlled her bp well; amlodipine 5mg daily was later added when she became persistently hypertensive to 170s on hd #5. of note, pt also had significant cardiomegaly and pulmonary vascular congestion noted on tte. she very likely has chf secondary to hypertension. she remained euvolemic during hospitalization, with volume status controlled via hemodialysis. simvastatin was initially held given her hypertensive iph, but it was restarted later. her goal blood pressure was placed at sbp below 160 # endocrine: patient's home simvastatin was held in setting of hypertensive ich given friability of cerebral vasculature s/p hemorrhagic stroke, but restarted at later date. her home insulin was continued for her iddm. # renal: patient has esrd secondary to dm ii and htn, on hd mwf. continued hd while in house. continued home sevelamer, nephrocaps. per renal recs, added calcium acetate tid as phosph binder. # fen/gi: patient repeatedly failed speech and swallow tests during hospitalization secondary to stroke-related dysphagia and lethargy. as she failed her speech/swallow evaluation even after improvement in , was placed on . ===================== transitions of care: -code/contact: full, confirmed. sister and husband : . is disabled and unable to visit often, so prefers phone updates. blood pressure control with goal sbp in 110-160s medications on admission: (per last discharge summary ): -nephrocaps 1 capsule daily -glargine 33 units qhs -labetalol 300mg po bid -sevelamer 800mg po bid with meals -simvastatin 20mg po qhs -acetaminophen 500mg po during dialysis mwf -asa 81mg po daily -bisacodyl 5-10mg po qhs prn constipation -omeprazole xr 20mg po daily -miralax 17g po daily prn constipation discharge disposition: extended care facility: hospital - discharge diagnosis: acute issues: 1. hemorrhagic stroke 2. hospital acquired pneumonia chronic issues: 1. end-stage renal disease, on hemodialysis 2. high blood pressure 3. insulin dependent diabetes discharge condition: mental status: confused - sometimes. level of consciousness: lethargic but arousable. activity status: out of bed with assistance to chair or wheelchair. neurologic status: eyes closed most of the time, opens to loud voice or touch. occasionally requires noxious stimuli to arouse. oriented to place, time and person and has some recall of recent events. l visual field deficit. l facial droop and some dysarthria. rue/rle moves briskly to noxious stimuli, lue is plegic. lle has some movements on the bed but is not antigravity. discharge instructions: ms. , you were admitted to the icu after suffering a hemorrhagic stroke (brain hemorrhage). we believe this stroke was most likely caused by extremely high blood pressure. the stroke resulted in near-complete paralysis of your left face, left arm and left leg. it also made swallowing difficult for you, so you were started on tube feeds and had tube placed for long term feeding. you developed pneumonia after leaving the icu, which may have been caused by aspiration of oral secretions: this was treated with iv antibiotics. you are being discharged to a rehab. please attend the follow-up appointment listed below with neurologist dr. . once you are discharged from rehab you should also follow up with your pcp. followup instructions: call your primary care physician and make follow up appointment once you are discharged from the rehab. department: neurology when: tuesday at 3:30 pm with: , m.d. building: campus: east best parking: garage procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours enteral infusion of concentrated nutritional substances hemodialysis percutaneous [endoscopic] gastrostomy [peg] diagnoses: other primary cardiomyopathies end stage renal disease obstructive sleep apnea (adult)(pediatric) renal dialysis status anemia, unspecified congestive heart failure, unspecified cirrhosis of liver without mention of alcohol intracerebral hemorrhage personal history of malignant neoplasm of other parts of uterus other and unspecified hyperlipidemia pneumonitis due to inhalation of food or vomitus disorders of phosphorus metabolism long-term (current) use of insulin osteoporosis, unspecified cerebral edema other acquired absence of organ pneumonia due to escherichia coli [e. coli] personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits obesity, unspecified dysarthria esophageal varices in diseases classified elsewhere, without mention of bleeding personal history of malignant neoplasm of other gastrointestinal tract leukocytosis, unspecified hemiplegia, unspecified, affecting unspecified side acquired absence of both cervix and uterus long-term (current) use of aspirin history of fall personal history of methicillin resistant staphylococcus aureus diabetes with renal manifestations, type ii or unspecified type, uncontrolled dysphagia, unspecified conjunctivitis, unspecified hypertensive heart and chronic kidney disease, unspecified, with heart failure and chronic kidney disease stage v or end stage renal disease other symbolic dysfunction 

Answer: The patient is high likely exposed to