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: nausea, vomiting, diarrhea major surgical or invasive procedure: none history of present illness: 87 year-old gentleman with history of esrd on hd, cad, chf, presents with 3 day history of epigastric pain, nausea, vomiting, and diarrhea. he has not had much of an appetite in the last two days and has been spending a lot of time in the bathroom. he notes an uncomfortable feeling in his epigastrum, though is unable to further clarify the character of the pain. patient notes that he has additionally had two days of cough, though denies fevers, sweats headache, dyspnea, sore throat, or myalgias. he has had some mild chills. he has had no known sick contacts. was recently discharged from the hospital on after a 3 day stay for new onset dysarthria and worsening lue weakness. at that time his neurologic symptoms were attributed to poor po intake prior to presentation and representation of prior cva symptoms. vital signs upon presentation to the ed were t 97.6, hr 80, bp 173/65, o2sat 100% 2l. initial labs showed serum potassium of 6.3. did not have peaked t waves on ekg at presentation, though had a qrs prolongation to 120 ms of 100 ms. additionally had new twi in leads v1 and v2. received calcium gluconate, insulin and dextrose, 1 amp bicarb, and aspirin. due to concern for intra-abdominal process, was started on zosyn and vancomycin. received a ct abdomen and ruq u/s that both showed gallstone at gallbladder neck, though no definitive evidence of acute cholecystitis per ultrasound. surgery consulted and felt that empiric antibiotics were appropriate. was given an aspirin due to concern for cardiac process and had a set of cardiac enzymes sent. prior to transfer to the floor vitals were: t 97, hr 81, bp 154/70, rr 20, o2sat 99% 2l nc. ros: (+)ve: nausea, vomiting, epigastric pain, diarrhea, chills, cough, loss of appetite, weight loss, lue weakness (-)ve: fever, sweats, hemoptysis, dyspnea, orthopnea, pnd, constipation, lower extremity edema, myalgias, arthralgias past medical history: 1) esrd on hd (m/w/f) s/p avf placement 2) coronary artery disease s/p balloon angioplasty > 5 years ago 3) cva >10 years ago w/ residual left-sided weakness and left facial droop 4) hypertension 5) congestive heart failure (tte : lvef 35-40%) 6) bph w/ elevated psa 7) nephrolithiasis 8) thrombocytopenia of unclear etiology, stable 9) s/p abdominal surgery for unclear reasons, believed by patient to be gastric cancer resection 10) h/o bell's palsy social history: lives with daughter in , ma. tobacco: quit smoking month ago and used to smoke cigarretes per day for 60 years. etoh: prior use with 3-4 beers per day, but quit >20 years ago not remembering exact date. illicits: denies family history: no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. father died of cirrhosis, mother of cancer (unknown site). physical exam: vital signs: t 97.5, hr 85, bp 158/66, rr 30, o2sat 100% 2l nc general: nad, thin elderly gentleman heent: perrl (3 to 2 mm bilaterally), eomi, bilaterally equal arcus senilis, visual acuity intact with ability to read small text at a distance, neck: no , cardiac: rr, nl s1, nl s2, no m/r/g lungs: basilar crackles clearing partially with cough abdomen: thin, bs+, soft, tender epigastrum and ruq to deep palpation, non-distended, no rebound or guarding extremities: no le edema skin: no rashes neuro: oriented to date, day, place, person. strength 5/5 at hips, knee flexion and extension, ankle dorsiflexion and plantarflexion, strength 5/5 along rue and along lue, lue with palpable thrill over av fistula psych: mood and affect appropriate pertinent results: admission labs: 10:18am wbc-5.4 rbc-4.22* hgb-11.3* hct-36.3* mcv-86# mch-26.8* mchc-31.1 rdw-16.8* 10:18am plt smr-very low plt count-69*# 10:18am neuts-81.3* lymphs-12.3* monos-6.0 eos-0.2 basos-0.2 10:18am ck-mb-notdone ctropnt-0.18* 10:18am glucose-122* urea n-57* creat-8.7*# sodium-146* potassium-6.3* chloride-99 total co2-20* anion gap-33* 10:49am lactate-7.2* 10:18am ck-mb-notdone ctropnt-0.18* 10:18am alt(sgpt)-33 ast(sgot)-47* ck(cpk)-83 alk phos-123* tot bili-0.7 10:18am lipase-10 discharge labs: : wbc-4.8 rbc-4.03* hgb-11.0* hct-33.9* mcv-84 mch-27.2 mchc-32.4 rdw-16.8* plt ct-80* : glucose-129* urean-24* creat-5.4*# na-143 k-3.6 cl-98 hco3-32 angap-17 : ck(cpk)-78 : calcium-8.6 phos-4.0# mg-2.1 : lactate-2.2* chest xray: cardiomegaly, pulmonary edema, and small effusions suggest mild cardiac failure. recommend repeat pa and lateral after diuresis to evaluate for coexistent infection. ct abdomen/pelvis: impressions: small bilateral pleural effusions, right greater than left. distended gallbladder with multiple gallstones, including one in the gallbladder neck. trace pericholecystic fluid and gallbladder wall edema, although without definite gallbladder free wall thickening. cholecystitis is a concern. this can be further evaluated via ultrasound or hepatobiliary scan. extensive atherosclerotic calcifications throughout the aorta and major mesenteric branches, although mesenteric arteries are without stenosis or thrombosis evident. due to suboptimal contrast administration, venous structures are not opacified. however, there are no secondary signs of venous thrombus. there is no evidence of bowel ischemia. very high grade stenosis of the proximal right superficial femoral artery. stable appearance of simple and hyperdense renal cysts. diffusely enlarged prostate gland with prominent median lobe, with multiple proteinaceous/hemorrhagic nodules. this is consistent with bph, although tumor is not definitively excluded. liver or gallbladder ultrasound 1. enlarged but compressible gallbladder with gallstones; stone in the gallbladder neck was not definitely impacted. asymmetric perihepatic gallbladder wall edema. findings are not typical for acute cholecystitis, and are likely because of hepatic dysfunction, possibly from vascular congestion. 2. patent portal vein. smv not well visualized due to overlying bowel gas. brief hospital course: 87 year-old gentleman with history of esrd on hd, cad, chf, who presented with 3 day history of epigastric pain, nausea, vomiting, and diarrhea. #. gastroenteritis and cholelithiasis: he presented with 3 days of nausea, vomiting, diarrhea, and loss of appetite. it was felt to most likely be a gastroenteritis. ct did not show obvious source of infection and no evidence of bowel ischemia. however, the gall bladder had an atypical appearance. follow-up ruq ultrasound did not show acute cholecystitis. surgery was consulted as the clinical picture could suggest an intermittently obstructing stone and biliary colic. he underwent bowel rest, serial lactates, and empiric treatment with unasyn. he was also ruled out for mi and his lactate downtrended. symptoms resolved and patient tolerated a normal diet at discharge. #. hyperkalemia: upon presentation to the ed, his serum potassium was 6.3 and ekg was noted to have qrs prolongation to 120 with recent qrs of 100 on ekg dated . he was given calcium gluconate, bicarb, insulin and d50. repeat potassium in ed was 4.6 prior to transfer to the icu. he underwent hemodialysis overnight and his serum potassium returned to . #. cad: he was ruled out for mi and was continued on isosorbide mononitrate, lisinopril, aspirin, metoprolol, and simvastatin. # chronic renal disease on hd: pt received hd while hosptalized. #. congestive heart failure, systolic: he appeared clinically euvolemic to dry upon examination on discharge, and through admission without evidence of jvp elevation. #. prophylaxis: he was given sc heparin for dvt prophylaxis. #. code status: he was full code during this hospitalization. #. contact: with (daughter) key follow up: on abdominal ct the following were found: 1. very high grade stenosis of the proximal right superficial femoral artery. 2. diffusely enlarged prostate gland with prominent median lobe, with multiple proteinaceous/hemorrhagic nodules. this is consistent with bph, although tumor is not definitively excluded. medications on admission: 1) isosorbide mononitrate 30 mg tablet sr 24 hr 1 po daily 2) lisinopril 5 mg po daily 3) metoprolol tartrate 12.5 mg po daily 4) nitroglycerin 0.3mg tablet, sl 5) omeprazole 40 mg daily 6) simvastatin 40 mg po at bedtime 7) trazodone 50 mg tablet po at bedtime 8) acetaminophen 650 mg po q6hrs as needed for fever or pain 9) aspirin 325 mg po once a day 10) iron aspgl & ps cm-vit c-ca-sa 150 mg-50 mg-50 mg 1 capsule po daily 11) multivitamin tablet 1 po daily 12) acetaminophen-codeine 300 mg-30 mg 1 tablet po at bedtime prn pain 13) docusate sodium 100 mg po bid prn constipation discharge medications: 1. isosorbide mononitrate 30 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). 2. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 3. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 4. omeprazole 20 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po daily (daily). 5. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 6. trazodone 50 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. 7. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 8. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 9. acetaminophen-codeine 300-30 mg tablet sig: one (1) tablet po at bedtime as needed for pain: do not take this medication and consume alcohol. do not take this mediation and drive. . 10. docusate sodium 100 mg capsule sig: one (1) capsule po twice a day. 11. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) sublingual once a day as needed for chest pain: call doctor if you develop chest pain. . 12. multivitamin capsule sig: one (1) capsule po once a day. 13. iron aspgl & ps cm-vit c-ca-sa mg capsule sig: one (1) capsule po once a day. discharge disposition: home with service facility: vna discharge diagnosis: primary: gallstones (symptomatic cholelithiasis) discharge condition: mental status:clear and coherent activity status:ambulatory - requires assistance or aid (walker or cane) discharge instructions: dear mr. , it was a pleasure caring for you while you were hospitalized with abdominal pain, nausea, vomiting, and diarrhea. during your stay evaluation showed that you had a gallstone that was thought to be contributing to this pain. your gallbladder was further evaluated and you were found to not have a gallbladder infection. further, during your hospitalization you received hemodialysis in keeping with your outpatient schedule. at discharge you should follow up with your primary care physician to further discuss the abdominal pain which brought you to the hospital and your other chronic medical problems. will also need to follow up with general surgery regarding these gallstones and the need to have your gallbladder removed. weigh yourself every morning, md if weight goes up more than 3 lbs. no changes were made to your medication regimen. please return to the hospital or contact your physician if your abdominal pain recurrs, you develop chest pain, shortness of breath, blood in your bowel movements, dark black bowel movements, major changes in your bowel or bladder habits, or other changes that concern you. followup instructions: general surgery; , m.d. phone: date/time: 12:30 primary care: , md phone: date/time: 3:50 provider: , .d. phone: date/time: 10:00 procedure: hemodialysis diagnoses: acidosis hyperpotassemia thrombocytopenia, unspecified anemia in chronic kidney disease end stage renal disease renal dialysis status coronary atherosclerosis of native coronary artery congestive heart failure, unspecified hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) systolic heart failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease chronic systolic heart failure calculus of gallbladder without mention of cholecystitis, without mention of obstruction 

Answer: The patient is high likely exposed to