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 and vomiting. major surgical or invasive procedure: ir-guided tunneled hd catheter hemodialysis history of present illness: 23 y.o. m with h/o htn, ckd, and morbid obesity, presented to ed on with nausea and vomiting x 2-3 weeks, after being found by pcp to have 250. pt had not refilled bp meds. ros at the time notable for malaise but no cp, sob, dizziness, headaches, visual changes, weakness or any other neurological deficits. ed course: # vs: t 99.3, hr 107, bp 246/154, rr 16, o2sat 100% ra. # meds/ivf: 2l ns, labetalol 20 mg iv x 3, labetalol 100 mg po x 3, 1" nitropaste x 3, acetaminophen 1 gram. # labs/studies: --ekg: sinus rhythem 90s, lvh, nl axis, intervals, mm v1-3 likely early repolarization, twi i, l, ?lae. --cr 17 initial floor course: bp improved to 190/110 upon transfer to the floor, but patient reported a new frontal headache. bp elevated despite nitro paste q6h, labetalol 200mg tid, labetalol 400mg po x1, hydralazine 20mg iv x3, furosemide 80mg iv x1. micu course: initial ros positive for persistent headache; negative for nausea, vision changes, cp, sob, abdominal pain or edema. pt received labetalol gtt and po. ir-placed tunneled catheter received, and pt started hd. past medical history: hypertension cri (baseline cr 5) c/b nephrotic range proteinuria hyperlipidemia social history: professional: systems analyst substance use: no current tobacco, alcohol; occasional marijuana use. family history: mother: htn father, died 31: renal failure, expired on hd physical exam: initial pe =========== vs: t 97.9, bp 198/126, hr 84, rr 22, o2sat 100% ra, 341 lbs gen: obese, lying in bed with eyes closed, cooperative, nad heent: op clear, moist, anicteric, perrl, eomi, fundoscopic exam with venous pulsations neck: supple, no lad cv: nl s1 s2, rrr, ii/vi sem lungs: ctab abd: obese, soft, nt ext: no c/c/e neuro: a&o x3, appropriate, cn ii-xii intact to testing, sensations intact, full strength, gait not observed subsequent pe upon transfer out of micu ======================================== vs: t afebrile, bp 194/92, hr 105, rr 18, o2sat 100 on ra gen: nad heent: ncat, mmm, op clear, perrl, eomi, neck supple, no lad cv: rrr, s1 s2, no m/r/g noted by this examiner chest: ctab abd: soft, nt, nd, bs+, obese, no hsm ext: no c/c/e neuro: a&ox3, cn ii-xii intact pertinent results: admission labs: =============== 9.1 13.5 >------< 121 26.2 mcv 82 neuts 76 lymphs 17 monos 3.6 eos 1.9 basos 0.2 139 104 90 -----|-----|------< 107 3.6 17 17.6 ca 8.5 phos 5.4 mg 1.8 alt 17 ast 17 alk phos 96 bili 0.4 lipase 56 serum tox: negative ua: large blood, negative nitrite, protein 500, negative leukocytes, rbc , wbc , granular 0-2, epi urine cr 155 urine na 24 urine osmolality 314 microbiology: ============= 8:38 am urine source: cvs. urine culture (final ): gram positive bacteria. 10,000-100,000 organisms/ml.. alpha hemolytic colonies consistent with alpha streptococcus or lactobacillus sp. studies: ======== renal u.s. impression: limited study with inability to visualize either kidney. if necessary, noncontrast ct may be performed. ekg sinus rhythm. left ventricular hypertrophy with st-t wave changes. the st-t wave changes are more prominent in leads i and avl as compared with prior tracing of with the finding of biphasic t waves in leads i, avl and v6. followup and clinical correlation are suggested. chest (portable ap) frontal chest radiograph: the heart is top normal in size. the pulmonary vasculature is normal. the lungs are clear without focal consolidation, pneumothorax, or pleural effusion. the osseous structures are unremarkable. impression: no acute cardiopulmonary abnormality. brief hospital course: 23 y.o. m with htn, ckd admitted with hypertensive emergency and acute on chronic renal failure. # hypertension: sbp was in the 220s on admission. with patient's blood pressure not being well controlled on the floor, he was transferred to the micu for better bp control with labetalol gtt and hydralazine iv prn. he was transferred back to the floor with sbp from 130s to 170s on labetalol 400 mg po tid. his labetalol was increased to 600 mg tid on the medicine floor, and his sbps ranged from 130-150. he was discharged with this increased dosage. # acute on chronic renal failure: renal followed the patient while he was hospitalized. ultrafiltration was initiated in the micu, and a tunnelled hd line was placed. patient was still making urine. there was no hyperkalemia, encephalopathy, bleeding, or pericarditis. he received hemodialysis 3 times a week while in the hospital. prior to discharge, he was set up with outpatient hemodialysis. he was unable to get venous mapping prior to discharge, and he will need this as an outpatient. # and thrombocytopenia: hct was in the low 20s during the hospital stay. hematology was consulted in the setting of concern for hemolysis with elevated ldh and decreased haptoglobin. no concern for ttp. it was proposed that the might be due to multiple factors including chronic kidney disease and possible hemolysis from shear force from malignant hypertension. his hct remained stable during hospitalization. an adamst13 will need to be followed up as an outpatient. # uti: with 10-100k gram positive alpha hemolytic colonies on ucx. pt was started on ciprofloxacin to complete a 7 day course with instructions to hold ciprofloxacin on hd days until hd is completed. # hyperlipidemia: continued statin. # fen: cardiac diet. repleted lytes prn. # ppx: heparin sc # dispo: home with outpatient hemodialysis. medications on admission: labetalol 200 mg tid (not taking for 1.5 months) phoslo 1 tab po tid with meals (mostly noncompliant) discharge medications: 1. calcium acetate 667 mg capsule sig: two (2) capsule po tid w/meals (3 times a day with meals). disp:*180 capsule(s)* refills:*2* 2. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. ciprofloxacin 750 mg tablet sig: one (1) tablet po once a day for 6 days. disp:*6 tablet(s)* refills:*0* 4. labetalol 300 mg tablet sig: two (2) tablet po three times a day. disp:*180 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: primary diagnosis: 1. malignant hypertension 2. end stage renal disease . secondary diagnosis: 1. 2. thrombocytopenia 3. urinary tract infection 4. hyperlipidemia discharge condition: stable. better controlled blood pressures. afebrile. discharge instructions: you were admitted for very high blood pressures. you were briefly in the micu for iv blood pressure medications and then transferred to the medicine floor. your blood pressure was closely monitored, and your medications were changed for better control. the kidney doctors saw , and you had hemodialysis while in the hospital. you will need hemodialysis 3 times a week. this is being set up for you. you were also seen by the hematology doctors for your (low blood counts) which was felt to be due to your chronic kidney disease. please take your medications as prescribed: 1. please take atorvastatin 20 mg daily 2. please take calcium acetate 1334 mg three times daily with meals 3. please take ciprofloxacin 750 mg daily for 6 more days (on your hemodialysis days, please take this medication after hemodialysis) 4. please take labetalol 600 mg three times daily. this is a very important medication to help control your blood pressure. please keep all your follow up appointments. please make an appointment with , rn for possible fistula at (. please follow up with your primary care physician, . , on at 2:15 pm. call if you need to cancel. you have an appointment with , md (kidney doctor) on thursday, at 8 am. please go to , medical specialties. if you need to cancel/reschedule, please call (. if you have any of the following symptoms, please call your doctor or go to the nearest er: fever>101, chest pain, worst headache in your life, sudden double vision or worsening of vision, constant nausea/vomiting, abdominal pain, or any other concerning symptoms. followup instructions: please follow up with your primary care physician, . , on at 10:00am. call if you need to cancel. please make an appointment with , rn for a possible fistula for hemodialysis at (. you have an appointment with , md (kidney doctor) on thursday, at 8 am. please go to , medical specialties. if you need to cancel/reschedule, please call (. md procedure: hemodialysis venous catheterization for renal dialysis diagnoses: hypertensive chronic kidney disease, malignant, with chronic kidney disease stage v or end stage renal disease thrombocytopenia, unspecified anemia in chronic kidney disease end stage renal disease urinary tract infection, site not specified acute kidney failure, unspecified other and unspecified hyperlipidemia personal history of noncompliance with medical treatment, presenting hazards to health obesity, unspecified leukocytosis, unspecified other non-autoimmune hemolytic anemias 

Answer: The patient is high likely exposed to