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: history of present illness: baby boy is a former 26 and week, 725-gram, male born at 6:57 a.m. on . primary obstetrician is dr. . delivering obstetrician is dr. . primary pediatrician is dr. ( ). the mother is a 36-year-old gravida 3, para -a1. past obstetrical history: remarkable for in fertilization twin pregnancy in complicated by iufd of one twin at 25 weeks gestation. the other twin did not deliver until 38 weeks and is well. mother's medical history was remarkable for crohn's disease treated with sulfasalazine. the pregnancy was reported to be uncomplicated until the day prior to delivery when an ultrasound performed by dr. revealed absent diastolic flow. estimated fetal weight was 819 grams and normal amniotic fluid noted. the mother was admitted to the where again, after diastolic flow was noted, fetal heart monitor tracing revealed some spontaneous mild decelerations. the tracing improved. the mother was treated with betamethasone and monitored closely. early on the morning of delivery further fetal heart rate decelerations prompted an emergency cesarean section. apgar scores were 7 at one minute and 8 at five minutes. the baby was intubated in the delivery room at approximately five to six minutes of life because of shallow respiratory effort. physical examination on presentation: ruddy, pink, appropriate for gestational age but slightly growth restricted appearing male at 26 weeks gestation infant. birth weight was 726 grams (20th to 25th percentile), discharge weight was 3.390, admission length was 31.5 cm (15th percentile), transfer length was 48.5 cm, head circumference was 23 cm (greater than 10th percentile), discharge head circumference was 35.5 cm. admission vital signs revealed a temperature of 95.8, heart rate was 156, respiratory rate on ventilator 50s, and blood pressure was 38/40 with a mean of 26. head, eyes, ears, nose, and throat examination revealed anterior fontanel was soft and flat. sutures were mobile. the palate was intact to palpation. the facies were normal. eyes were not fused. respiratory examination revealed breath sounds were equal but decreased with occasional high-pitched rhonchi. good respiratory effort. cardiovascular examination revealed normal first heart sounds and second heart sounds intensity. no murmurs. perfusion was good. the pulses were strong. the abdomen was soft with mild distention. no organomegaly noted. a three vessel cord. genitourinary revealed hypospadias, urethral opening present on ventral surface of the penis, testes up bilaterally. neurologically, active with good tone for gestational age. symmetrical examination, webbed fourth and fifth toes on right foot. pertinent laboratory values on presentation: dextrose stick on admission was 39. ventilator settings immediately post surfactant 20/5 and a rate of 25 and 40% fio2. initial blood gas was 7.3/39/158/20. ventilator settings were weaned immediately. summary of hospital course by issue/system: 1. respiratory: the infant ultimately received two doses of surfactant and remained on the conventional ventilator and then transitioned to high-frequency ventilator on day of life (dol) two, which he remained on until day of life 43. he then again transitioned to the conventional ventilator and was weaned to continuous positive airway pressure by day of life 62 (35 and 3/7 weeks gestation). on day of life 82, he transitioned to nasal cannula. he currently is on nasal cannula 500 cc, 100%,with sats >94. his last arterial blood gas on was 7.36/56/64/35/5. a chest x- ray on showed low lung volumes and diffuse bilateral opacities of chronic lung disease. his baseline respiratory ra te is 40's to 80s. because of his chronic lung disease he was started on diuril on dol 21 after a trial of once a day lasix. he receives diuril 65 mg q12= 40 mg/kg/day and kcl supplements 4.5 meq every 8 hours=3meq/kg/day he was evaluated by dr. of pulmonary medicine, . recommendations are for nco2 of 500 cc, continue diuril and kcl supplements, monitor electrolytes, minimize occurrence of ger with zantac and reglan. follow up appointment is outpatient on at 4:30 pm the baby did receive methylxanthine treatment with caffine citrate , and this was discontinued on (day of life 79). 2. cardiovascular: on day of life one, the baby had a presumed patent ductus arteriosus for which he received one course of indomethacin. he had a follow-up echocardiogram on which showed no patent ductus arteriosus. on , he had a repeat duct check because of the severity of illness that showed no patent ductus arteriosus. on , again a repeat echocardiogram with no patent ductus arteriosus. on , he was again symptomatic. he received one dose of the second course of indomethacin and then had an echocardiogram which showed no patent ductus arteriosus and left pps. the subsequent two doses were held, and he again had an echocardiogram on which showed no patent ductus arteriosus with normal ventricular function. an echo was also obtained on to assess cardiac function and rule out pulmonary hypertension. there was no evidence of pulmonary hypertension and cardiac function was normal. his baseline heart rate is 140s to 180s with systolic blood pressures in the 70s to 80s, diastolic blood pressures in the 40s, and mean pressures in the 50s. he does have an intermittent murmur that was thought to be pps. follow up cardiology appointment is to be arranged 1-2 months after discharge with dr. at tch, . 3. fluids/electrolytes/nutrition: the baby initially had a double lumen umbilical venous catheter and an umbilical artery catheter. this stayed in until day of life six when he then had a peripherally inserted central catheter line inserted which stayed in place until day of life 24. his initial hypoglycemia responded to boluses of glucose and a continuous infusion of glucose. on day of life 7 , trophic feedings were introduced, and he slowly increased to full enteral feedings by day of life 30. caloric density was increased to 32 calories with promod by , and his nutrition laboratories were followed per routine. he was noted to have an elevated alkaline phosphatase which peaked on at 1033 which resulted in an extensive workup including a renal ultrasound which showed renal calculi in the collecting system bilaterally with no obstruction. serial x-rays of the anterior/posterior views of the proximal and distal forearm including the wrists and the knees which showed no fracture with some concern for a irregularity and fraying of the metaphysis, which is consistent with early subtle metaphyseal abnormalities and possible underlying bone disease. this resulted in an endocrine consultation and an extensive workup. he also had a renal consultation, and the results of both consultations showed nephrocalcinosis, and ultimately, familial hyperphosphatasia. the alkaline phosphatase should return to normal without any sequelae. the nephrocalcinosis will need to be followed. his enteral feedings were altered. vitamin d was started. he had additional hmf removed, and his last alkaline phosphatase normalized to 788 on . he currently is feeding neosure 26(by concentration) at 130-150 cc/kg/d as mom has stopped pumping. he is also receiving supplemental ferrous sulfate 0.25 ml by mouth once per day of 25 mg/ml. this equals 2 mg/kg per day. he was previously receiving supplemental sodium chloride when he was getting mostly breast milk, and this has been discontinued for several weeks. last electrolytes on revealed sodium was 137, potassium was 4.9 chloride was 102, bicarbonate was 27, blood urea nitrogen was 21, and his creatinine was 0.2, ca 10.5, po4 6.5, alk phos 778. during the extensive workup, his liver function tests were slightly elevated, and these are beginning to normalize. aspartate aminotransferase on was 150. alanine-aminotransferase was 80. ggt was 145 (with the normal range being 80 to 61). endocrine follow up apt. with dr. 1-2 months after discharge 4. gastrointestinal: the baby initially exhibited elevated bilirubin levels with a peak of 5.3/0.3 on day of life one. he responded to phototherapy and ultimately had his phototherapy discontinued on day of life seven. the rebound bilirubin was 2.5/0.3/2.2. another bilirubin on day of life ten was 1.4/0.7/0.7. on had inguinal hernia repair by dr. at tch. follow up . also of note on exam is a hypospadius which will be followed b y dr. for staged repair at a later date. renal:renal consultation was obtained in conjunction with endocrine for nephrocalcinosis.follow up renal ultrasound showed bilateral nephrocalcinosis, not significantly changed from previous study (2 days), persistent asymmetry in size l>r, normal arterial and venous flow to both kidneys, and no interval development of hydronephrosis or hydroureter. 5. hematology: the baby was b positive and negative. he received 5 blood transfusions during his admission; the last being on for a hematocrit of 23. hematocrit on was 35. 6. sepsis: initially, the baby had a sepsis evaluation because of his premature delivery and respiratory distress. he had a white blood cell count of 3.2 (6 polys, 0 band, and 93 lymphocytes). his platelet count was 130,000. his admission hematocrit was 50. repeat complete blood count on day of life one showed a white blood cell count of 2.9 (31 polys and 0 bands), his platelets were 104,000, and his hematocrit was 55. he had a blood culture sent on admission. he was started on ampicillin and gentamicin. he did have some thrombocytopenia with a platelet count drop down to 83,000 by day of life four. once his platelet count stabilized, he did have a lumbar puncture that showed 160 red blood cells, 0 white blood cells, a protein of 184, and a glucose of 110. he received a 10-day course of ampicillin and gentamicin, and then because of continued concern for infection on repeat complete blood count he had a white blood cell count of 11.8 (56 polys and 9 bands), his platelet count was 181,000, and his hematocrit was 30. he had a repeat blood culture sent. his original blood cultures never did grow out any organisms. he was started on a course of vancomycin and gentamicin and had a 4-day course. his condition stabilized. a repeat complete blood count was benign, and the antibiotics were discontinued. he then had another sepsis evaluation on day of life 19 which was benign. he did receive 48 hours of ampicillin and gentamicin at that time. on day of life 52, he had a sputum sent which was negative for ureaplasma and mycoplasma. on day of life 52, he had a blood culture and complete blood count sent for increased work of breathing which was within normal limits. because of nasal congestion, he was started on a short course of afrin and dexamethasone drops which assisted him in reducing swelling in his nasal passage and improving his oxygen requirement. currently, he has no issues related to infection. 7. neurology: his initial head ultrasound showed asymmetry of the ventricles, left slightly greater than right. subsequent serial head ultrasounds on , , and showed no intraventricular hemorrhage and no periventricular leukomalacia. the baby's clinical examination is appropriate for gestational age. he responds to containment measures and nesting. he loves being held, and his parents enjoy holding him. 8. sensory/audiology: audiology screening was performed with automated auditory brain stem responses and was passed. 9. ophthalmology: eye examinations serially have been done with the last one on . right-sided, stage i , zone 3 for 5 o'clock hours and left side stage ii, zone 3, 1 o'clock hours. plan to follow up in two weeks with dr. . 10. psychosocial issues: as stated above, the parents are quite involved. they visit daily and look forward to recovery after surgery and transition home with his sister. condition on transfer: stable. discharge disposition: home with family . primary pediatrician: dr. (, ); fax care recommendations: 1. neosure 26 as above 2. medication: a. diuril 65 mg po bid b. kcl 4.5 meq po q12 c. reglan 0.25 mg po q8 d. zantac 6.4mg po q8 e. ferrous sulfate (25mg/ml) 0.3 ml po daily 3. car seat position screening passed 4. immunizations: the baby has received hepatitis b vaccine on and . dtap on . hib on . inactivated poliovirus on . pneumococcal 7 valiant conjugate vaccine on . due for 4 month immunizations. immunizations recommended: synagis respiratory syncytial virus prophylaxis should be considered from through for infants who meet any of the following three criteria: (1) born at less than 32 weeks gestation; (2) born between 32 and 35 weeks gestation with 2/3 of the following: plans for day care during respiratory syncytial virus season, with a smoker in the household, neuromuscular disease, airway abnormalities, or with school-age siblings; and/or (3) with chronic lung disease. influenza immunization should be considered annually in the fall for preterm infants with chronic lung disease once they reach six months of age. before this age, and for the first 24 months of the child's life, immunization against influenza is recommended for household contacts and out of home caregivers to protect the infant. discharge follow-up appointments: 1. primary care md, , . 2. endocrine with dr. (telephone number ). 3. dr. (telephone number ). 4. dr. of ophthalmology. 5. area early intervention 6. infant follow-up and . 7. caregroup vna 8. o2/ monitor co-ne home therapy 1 9. dr. , cardiology discharge diagnoses: 1. a former 26 and 4/7 weeks premature male. 2. respiratory distress syndrome with chronic lung disease. 3. status post presumed sepsis. 4. status post patent ductus arteriosus; treated medically. 5. hypospadias. 6. webbed fourth and fifth toes on the right foot. 7. status post bilateral inguinal hernias, repaired 8. familial hyperphosphatemia. 9. nephrocalcinosis. dr., 50-595 dictated by: medquist36 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more spinal tap incision of lung parenteral infusion of concentrated nutritional substances insertion of endotracheal tube enteral infusion of concentrated nutritional substances non-invasive mechanical ventilation other phototherapy prophylactic administration of vaccine against other diseases transfusion of packed cells bilateral repair of inguinal hernia, not otherwise specified diagnoses: single liveborn, born in hospital, delivered by cesarean section respiratory distress syndrome in newborn neonatal jaundice associated with preterm delivery patent ductus arteriosus extreme immaturity, 500-749 grams septicemia [sepsis] of newborn 25-26 completed weeks of gestation inguinal hernia, without mention of obstruction or gangrene, bilateral (not specified as recurrent) anomaly of lung, unspecified 

Answer: The patient is high likely exposed to