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: ams major surgical or invasive procedure: intubation history of present illness: at time of encounter patient was intubated, thus history is from patient's wife and prior records. mr. is an 87yo man who was in his usoh until about 10:30am this morning, when he "didn't feel right" while walking to the bathroom. he then lay down again and told his wife he "felt fine," however a short while later he went downstairs and his wife heard a "thud" and found her husband on the floor in the kitchen with a chair overturned on top of him. he told her he was fine but was apparently holding his head. his wife called 911 and when she returned he was unresponsive. no seizure activity noted. per ems the patinet was confused and then one minute later was entirely unresponsive with gcs 3. . there, head ct showed a small l posterior temporal sah, which was confirmed on head mri/a. he was given thiamine and was intubated. he was transferred to for further evaluation. . in the ed, he was sedated with propofol and was seen by neurosurgery who assessed that his sah was too small for operative management, and care was deferred to neurology. he was evaluated by neurology, who believed that his sah was likely traumatic and related to his fall rather than the cause of his fall. electrolytes returned markedly abnormal and the patient reported had a 7 beat run of vtach, followed by wavering heart rates greater than 100 in afib, and then in nsr and in the low 60s. cardiology was in the department, and saw the pt's rhythm strips, declaring that this particular rhythm was unlikely the cause of his syncopal episode. neuro believed that, given his electrolyte abnormalities, the most likely etiology was "metabolic" versus cardiac. they recommended repeat head ct to evaluate his sah, and will assess for need for eeg based on his course and responsiveness. they recommended repleting his electrolytes, however after this recommendation, repeat studies returned and were relatively unremarkable. the er covered with vancomycin and ceftriaxone for possible meningitis, but lp was not performed in the er due to the pt's "changing heart rhythms." he was given a total of 1l of ivf, and he received most of a 40meq iv potassium repletion as well as 20meq of po potassium and 2g iv magnesium. he was transferred to the micu for further management. . ros: unable to perform given intubated. per wife, has not been complaining of headache, has felt very sleepy for last few weeks, no c/o cp, no sob over usual baseline (dyspneic with walking one flight of stairs), no c/o abd pain, no diarrhea, +constipation. no fever/chills/sweats. past medical history: - per prior cardiology note, had an echo with trivial to mild tr, enlarged rv and possibly a pfo. - longstanding exertional dyspnea - has pulmonologist who reportedly has done "multiple tests with no abnormalities" - polymyalgia rheumatica (esr initially 100, now 6) - htn - tias - per wife, 10yrs ago he had a few minutes of unsteadiness - hyperlipidemia - h/o prostate cancer, s/p resection - recent admission for rapid heart rate (wife does not know why) - r postsurgical pupil - mgus - baseline cr 1.4-1.7 in (no earlier levels known) - palpitations - shown to be ventricular premature beats in multiple holter monitors - mitral valve disorder - atrial fibrillation - lumbosacral spondylosis - atrial premature beats - gerd - degenerative disk disease in the thoracic spine. social history: retired engineer at . no etoh/tob/illicits.functions independently. lives home alone with wife. lives in . family history: negative for stroke, seizures physical exam: vs 68, 124/64, 99.5, 16, 100% gen: sedated, intubated. moves l arm and b legs spontaneously, grimaces to sternal rub heent: r surgical pupil, l pupil min reactive, dark blood in og tube cor: rrr, no r/g/m pulm: ctab abd: soft, ntnd, +bs ext: no c/c/e neuro: withdraws all 4 to pain, moves r arm and leg much less than other extremities, b toes upgoing (per neuro note wife said this is baseline increased tone in toes) skin: no obvious rashes gu: yellow urine in foley pertinent results: note that lab draw was repeated and electrolytes were wnl except for low phosphate level. ck/mb/trop negative. wbc 12.7 with no bands and 77% pmns. creatinine at baseline of 1.4 (unchanged from ). . studies: . echo : the left atrium is normal in size. no atrial septal defect or patent foramen ovale is seen by 2d, color doppler or saline contrast (rest injection only). left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef 70%) right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. . head ct : small subarachnoid hemorrhage in left posterior temporal lobe unchanged from study 14 hours prior. mri would be recommended if clinical concern for infarct remains. . cxr: endotracheal tube as above. advance nasogastric tube cm. no acute process. . chest ct with contrast performed for r/o dissection: no evidence of aortic dissection. ascvd. hh. bilateral compressive atelectasis. hepatic and renal cysts. small low density lesion in the spleen consistent with a cyst or hemangioma. - per discussion with radiology resident, also no central pes seen on this study. cannot rule out subsegmental pe given timing of contrast not ideal for this. . head ct: probable small subarachnoid hemorrhage in the left posterior temporal lobe. no other acute abnormalities are detected. there is evidence of chronic ischemia with numerous lacunar infarctions. . repeat head ct: small subarachnoid hemorrhage in the left posterior temporal lobe, without significant change in size from 12:30 p.m. today. findings were posted to the ed dashboard at 10:30 p.m. on . . ct c-spine: 1. no acute traumatic injury in the cervical spine. 2. nasogastric tube coiled in the hypopharynx. . head mr/mra (neuro attg read) from : scattered flair and t2 abnormalities c/w small vessel disease. there was a small sah in the left parieto-temporal region. there were no dwi or t2* abnormalities. his mra was normal with good flow in the va & ba arteries. no aneurysms were noted. . (rads read) increase signal seen in the upper mid brain and medial thalami could be consistent wernicke's encephalopathy in proper clinical setting. clinical correlation recommended. evidence of subarachnoid hemorrhage in the left temporal sulci consistent with the findings seen on the recent ct. mild to moderate brain atrophy and small vessel disease. normal mra of the head. . r shoulder xr: three views of the right shoulder show no fracture, dislocation, bone destruction, or diminution in the acromio-humeral soft tissues. the partially visualized right lung is clear. incidental degenerative changes ac joint and central line catheter via right arm. . ekg: nsr at 70, nl axis, nl intervals, no twi, no stt changes, no qs. also have ekg rhythm strips showing several instances of sinus pauses up to longest of about 2 seconds interspersed with a narrow tachycardia. . ua: blood but negative for infection blood culture: pending serum tox screen negative except for positive benzos urine tox screen negative . . holter monitor : 1. predominantly sinus rhythm with a brief episode of sinus bradycardia to 47 bpm at 9:34 am. normal intervals and no significant pauses. 2. frequent isolated apbs and 2 atrial couplets. 3. moderate isolated ventricular ectopy. 4. one episode of "palpitations" showed sinus tachycardia at 107 bpm with a single isolated apb. 5. compared to day 1 (2-day study), atrial tachycardia was not seen. . stress echo : 1. limited exercise tolerance. 2. no symptoms of chest pressure or chest tightness. 3. no ekg changes of ischemia with exercise performed. 4. echocardiographic images reported separately and attached. . brief hospital course: mr. is an 87m with a history of tia and htn who presented s/p fall with loss of consciousness to and was found to have a small left subarachnoid hemorrhage, a thalamic cva, and atrial fibrillation with rapid ventricular rate. stroke: the patient was admitted to the micu service, intubated from the osh. he was initially started on levofloxacin and vancomycin for possible aspiration, however when sputum cultures were negative antibiotics were discontinued. he quickly weaned from the ventilator and was extubated on when his mental status was improved. eeg showed no epileptiform foci. lumbar puncture was negative for infection, and blood and urine cultures were negative. repeat head imaging showed a cva in the thalami and left caudate nucleus. cva is likely thromboembolic related to atrial fibrillation. echo showed no structural abnormalities and no patent foramen. the patient was followed closely by they neurology team, and he was maintained on heparin drip (asa and plavix were held per neurology recommendations)as well as statin, and he was treated with thiamine and folate. he continued to have waxing and mental status consistent with hospital-related delirium and was treated with haldol prn agitation. his deficits throughout hospital course and at discharge were right sided hemiparesis and eyelid opening apraxia. he had a g-j tube placed and he was transitioned from heparin gtt to lovenox as bridge to coumadin. paroxysmal atrial fibrillation: he had a newly diagnosed atrial fibrillation on admission with rvr. he was treated with metoprolol prn and was started on amiodarone load. he remained in sinus rhythm throughout the remainder of his hospitalization. he was treated with anticoagulation as above (the left sided subarachnoid hemorrhage had resolved radiographically as of ) and was also started on a beta blocker. leukocytosis: wbc 31 on , blood culture on right picc with coag neg staph in sets (likely contaminant). all cultures subsequently are negative to date. c. diff is negative x 3 now. toxin b is still pending. completed 10 day course of flagyl, po vancomycin for empiric treatment of c.diff colitis. also completed 7 day course of vanc/cefepime for hospital acquired pneumonia on . anemia: hct remained stable over the last few days at around 24-25. this is down from his baseline (mid-30s), prior to hospitalization. nevertheless, he has been hemodynamically stable. hemolysis labs were negative. he did have fobt stools on , but no melena or brbpr. he was continued on ppi. he should have a colonoscopy as an outpt when his medical issues become more stable. medications on admission: asa 81mg po qday plavix 75 mg po qday (started after the tia) enalapril 15 po qday metoprolol 25 , started after recent rapid heartrate lipitor 40 mg po qday ditropan wife unsure of dose prednisone tapered down to 7mg daily (has been on for 2 months) prilosec 20mg po daily celexa dose unknown discharge medications: 1. atorvastatin 40 mg tablet : one (1) tablet po daily (daily). 2. prednisone 1 mg tablet : seven (7) tablet po daily (daily). 3. thiamine hcl 100 mg tablet : one (1) tablet po daily (daily). 4. folic acid 1 mg tablet : one (1) tablet po daily (daily). 5. lidocaine hcl 2 % gel : one (1) appl mucous membrane prn (as needed). 6. amiodarone 200 mg tablet : one (1) tablet po daily (daily). 7. enoxaparin 80 mg/0.8 ml syringe : one (1) subcutaneous (2 times a day) for until inr is therapeutic for at least 24 hours days. 8. miconazole nitrate 2 % powder : one (1) appl topical tid (3 times a day) as needed. 9. docusate sodium 50 mg/5 ml liquid : one (1) po bid (2 times a day). 10. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day). 11. heparin flush (10 units/ml) 2 ml iv prn line flush picc, heparin dependent: flush with 10ml normal saline followed by heparin as above daily and prn per lumen. 12. albuterol sulfate 2.5 mg/3 ml solution for nebulization : one (1) inhalation q6hours prn as needed. 13. haloperidol 0.5 mg iv bid:prn agitation 14. warfarin 6 mg tablet : one (1) tablet po once daily at 4 pm. 15. toprol xl 200 mg tablet sustained release 24 hr : one (1) tablet sustained release 24 hr po once a day. 16. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr po bid (2 times a day). discharge disposition: extended care facility: rehab unit at - discharge diagnosis: primary subarachnoid hemorrhage left posterior temporal lobe thromboembolic stroke, left thalamic infarct atrial fibrillation with rapid ventricular rate anemia delirium secondary chronic renal insufficiency hypertension hyperlipidemia polymyalgia rheumatica discharge condition: stable, peg tube in place, afebrile discharge instructions: you were admitted with a stroke and bleed in your head. your bleed was stable on discharge. your stroke is likely from your atrial fibrillation (irregular rhythm). you were treated with several medications including blood thinners and medications for your irregular heart rhythm. in addition, you were found to have an infection and were treated with multiple antibiotics. several important medications have been started for you. these include amiodarone, coumadin and lovenox. it is very important that you take these medications. if you have any of the following symptoms, you should return to the emergency room: fevers, chills, cough, diarrhea, new weakness, headaches or any other serious concerns. followup instructions: we have scheduled an appointment for you with the neurologist who saw you. provider: . & phone: date/time: 1:00 in addition you should schedule an appointment with your primary care provider in the next 2-3 weeks. you should also follow up with cardiology as below. provider: , m.d. phone: date/time: 1:00 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more enteral infusion of concentrated nutritional substances percutaneous (endoscopic) jejunostomy [pej] electroencephalogram diagnoses: pneumonia, organism unspecified anemia, unspecified polymyalgia rheumatica esophageal reflux unspecified essential hypertension acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation personal history of malignant neoplasm of prostate atrial flutter chronic kidney disease, unspecified pulmonary collapse other and unspecified hyperlipidemia acute respiratory failure pneumonitis due to inhalation of food or vomitus cerebral embolism with cerebral infarction home accidents accidental fall from chair cerebral thrombosis with cerebral infarction subarachnoid hemorrhage following injury without mention of open intracranial wound, with no loss of consciousness thoracic spondylosis without myelopathy 

Answer: The patient is high likely exposed to