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: this is a 50-year-old male with type 2 diabetes for 30 years and end-stage renal disease (on peritoneal dialysis) who was at the rehabilitation but presented to the emergency department on with increasing abdominal pain, subjective fevers for two weeks, decreased oral intake and urine output, as well as lethargy. at , he was found to be afebrile with a blood pressure of 84/palp with a white blood cell count of 20.4 (with 85% polys and 7.9% lymphocytes), and a sodium of 128. he also had a potassium of 3.8, a bicarbonate of 24, glucose of 219, an albumin of 1.9, and a blood urea nitrogen of 35, and a creatinine of 5.9. a tap of the peritoneal fluid revealed 360 white blood cells, 40 red blood cells (with 69% polys, 23% monocytes, and 7% lymphocytes). the patient was afebrile in the emergency department, but as his systolic blood pressure remained in the 70s to 90s, he was transferred to the medical intensive care unit. he received ceftazidime and flagyl in the emergency department. in the medical intensive care unit, he received aggressive intravenous fluid repletion and was started on cefotaxime 2 mg intravenously q.d. while continuing his peritoneal dialysis. when peritoneal cultures came back growing candidiasis albicans, the antibiotics were discontinued on , and it was changed to fluconazole 200 mg intravenously q.24h. through the dialysate on and flucytosine 2 mg times one orally initially and then changed to 1 mg p.o. q.d. was added on . in the medical intensive care unit, systolic blood pressures were 90 to 110 with low oxygen saturations of 90% (question secondary to increased amount of intravenous fluids he received), so he was transferred to the floor on . his white blood cell count had decreased to 11.8. he had remained afebrile with stable blood pressures. he was then transferred to our service on the ( medicine), as he went to the operating room today for peritoneal dialysis catheter removal (surgeon was dr. ) as well as hickman replacement in order to undergo hemodialysis tomorrow. blood cultures from and were no growth to date. also, he recently bumped his left foot stump and had some mild bleeding at the site with some purulent fluid. this was swabbed, and the culture was sent on . so far there has been no growth to date. he also has had asterixis with occasional disorientation at times (per the previous team). today when we first met him (on ), he was status post right hickman placement and peritoneal dialysis removal, doing well. he states he has decreased abdominal pain today compared to yesterday ( has decreased to in intensity). he currently denies shortness of breath, chest pain, dizziness, nausea, vomiting, and diarrhea. he has not had a bowel movement since but is refusing to take lactulose. he denies headache, numbness, tingling, and pain at the hickman site or his legs. he urinated one times yesterday (usually goes twice per day). he has some appetite and is less confused now. past medical history: 1. type 2 diabetes for 30 years; complicated by end-stage renal disease, retinopathy, perineuropathy (now insulin dependent). 2. end-stage renal disease (on peritoneal dialysis). 3. hypertension. 4. peripheral vascular disease; status post left below-knee amputation. 5. gastroesophageal reflux disease. 6. depression; his psychiatrist is dr. (telephone number ). 7. hepatitis b. 8. question of hepatitis c. 9. charcot right foot. 10. chronic obstructive pulmonary disease. 11. status post pacemaker placement. 12. syncope. allergies: the patient has no known drug allergies. medications on transfer: (transfer medications to the our service) 1. reglan 10 mg p.o. q.i.d. 2. seroquel 150 mg p.o. q.h.s. 3. senna two tablets p.o. q.h.s. 4. trazodone 100 mg p.o. q.h.s. 5. compazine 10 mg p.o. q.4-6h. as needed. 6. colace 100 mg p.o. b.i.d. 7. protonix 40 mg p.o. q.d. 8. regular insulin sliding-scale. 9. tylenol as needed. 10. subcutaneous heparin. 11. calcium carbonate 500 mg p.o. t.i.d. 12. flucytosine 1 g q.d. 13. fluconazole 200 mg intravenously q.d. (via the peritoneal dialysate). 14. lactulose 30 mg p.o. t.i.d. (the patient currently refuses). 15. tylenol with codeine one to two tablets q.6h. as needed. 16. sevelamer 1600 mg p.o. t.i.d. 17. seroquel 500 mg p.o. q.4-6h. as needed. 18. bisacodyl 10 mg p.r. q.d. 19. epogen 8000 units on monday and friday. 20. nph 15 units in the morning and 7 units at night. 21. effexor-xr 225 mg p.o. q.d. 22. klonopin 1 mg p.o. q.h.s. medications at home: 1. prevacid 30 mg p.o. q.d. 2. reglan 10 mg p.o. q.i.d. 3. effexor 150 mg p.o. q.d. 4. seroquel 150 mg p.o. q.h.s. 5. senna two tablet p.o. q.h.s. 6. renagel 1200 mg p.o. b.i.d. 7. trazodone 100 mg p.o. q.h.s. 8. tylenol q.4.h. as needed for pain. 9. tylenol 650 mg p.o. q.4h. as needed. 10. klonopin 1 mg p.o. q.h.s. 11. colace 100 mg p.o. b.i.d. 12. epogen 5000 units tuesday and friday. 13. humalog 40 units given at 7:30 in the morning and 15 units at 4:30 p.m. pertinent laboratory data on presentation: laboratories from revealed white blood cell count was 11.2, hematocrit was 26.3, and platelets were 196. sodium was 130, potassium was 3.4, chloride was 91, bicarbonate was 24, blood urea nitrogen was 34, creatinine was 5.5, and blood glucose was 299. calcium was 7.5, phosphorous was 5.7, magnesium was 2.1. free calcium was 0.99. alt was 16, ast was 28, alkaline phosphatase was 128, ld was 251, total bilirubin was 0.9. microbiology: 1. blood cultures times one plus fungal, no growth to date. 2. blood cultures times two plus fungal, no growth to date. 3. blood cultures times two, no growth to date. 4. wound culture of the left stump revealed no polys, no organisms, no growth to date. 5. peritoneal fluid was positive for albicans. radiology/imaging: 1. chest x-ray from showed no change from the study from . increased density at the right base medially; most likely poor inspiration and compressive atelectasis. no congestive heart failure. 2. a computed tomography of the abdomen and pelvis on showed positive free fluid and free, consistent with peritoneal dialysis. no focal collections. no bowel abnormalities. positive cholelithiasis without cholecystitis. social history: he lives with (his girlfriend). she is his health care proxy. smoked one pack per day since the age of 19. he has a remote history alcohol, heroin, and cocaine use. the patient is adopted. physical examination on presentation: physical examination revealed temperature was 98, heart rate was 96, blood pressure was 100/58, respiratory rate was 20, oxygen saturation was 90% on room air, and the patient was refusing oxygen by nasal cannula, as he was asymptomatic. in general, awake, alert, and oriented times three. in no acute distress. head, eyes, ears, nose, and throat examination revealed anicteric. normocephalic and atraumatic. pupils were equal, round, and reactive to light. cardiovascular examination revealed a regular rate and rhythm. a 2/6 systolic ejection murmur. chest revealed right hickman in place. nontender and no erythema or discharge. respiratory examination revealed clear to auscultation bilaterally. neck revealed there was no jugular venous distention. the abdomen revealed increased bowel sounds. nontender and nondistended. a dressing over the left lower quadrant was clean, dry, and intact. a soft belly. extremities revealed left below-knee amputation with a scabbed over wound with some minimal serosanguineous drainage and minimal erythema and 2+ lower extremity edema over the right foot and ankle. there was a superficial ulcer on the right lower extremity. neurologic examination revealed subtle asterixis. alert and oriented times three. assessment: this is a 50-year-old male with type 2 diabetes (complicated by end-stage renal disease on chronic peritoneal dialysis for the last nine months) and status post a left below-knee amputation who presented to the emergency department on from rehabilitation with sepsis (?) secondary to peritonitis. on day of anti-fungal treatment the peritoneal dialysis catheter was removed, and a right hickman was placed, and he was started on hemodialysis. hospital course: mr. was started on hemodialysis and tolerated this well. he was given calcium carbonate with meals as a phosphate binder. he was followed by dr. (his nephrologist). 1. cardiovascular: his blood pressures remained low on the floor; ranging from 70s to 122 at time after his dialysis. however, they were asymptomatic and responded to a normal saline bolus. he had anywhere from 1.5 kg to 2 kg removed on the hemodialysis that he went to on and on . after this, his blood pressure was noted to be asymptomatically low. 2. infectious disease: for peritonitis, his fluconazole was changed from intraperitoneal to intravenous, and the dose was changed to 200 mg every 48 hours secondary to his renal insufficiency. he was continued on the oral flucytosine. at the time of this dictation (on ) he had been afebrile for the last three to four days, and his white blood cell count had decreased to 8.2 by . his abdominal examination was much improved, and he was complaining of minimal abdominal pain by . also, please note that his epogen was changed, and he will be receiving it at dialysis from now on. for his new wound on his left leg stump, the cultures from it were negative, and it was no longer draining purulent fluid, and looked like it was going to heal. he was not started on antibiotics for this at this time. 3. anemia: his hematocrit had been stable but low (ranging from 25 to 29) which seems to be his baseline. his epogen was increased during this admission to 8000 units two times per week, and he will now be receiving this at hemodialysis. 4. endocrine system: his blood sugars have been somewhat poorly controlled, but by the end of his stay, his blood pressures were ranging from the 100s to the low 200s on nph 15 units at breakfast and 7 units at dinner with a regular insulin sliding-scale. 5. pulmonary system: the patient had persistently low oxygen saturations (in the 90s) when he first came to our service, but was asymptomatic. he had a chest x-ray that did not show any evidence of congestive heart failure on , and he had no clinical signs of fluid overload. they continued to take off 1 kg to 2 kg in dialysis as well. by the end of his admission, his oxygen saturations were ranging from 94% to 98% on room air, and this transient decrease in his oxygen saturations might have been secondary to his aggressive intravenous fluid repletion in the medical intensive care unit. 6. psychiatry: the patient was originally taken off his psychiatric medications, and after the previous intern's discussion with his psychiatrist (dr. he was replaced on his seroquel, trazodone, and klonopin q.h.s. he has had increasing depression over his illness and had several times been quite irritable on occasion. however, this improved slightly when he was back on some of his psychiatric medications and improved with redirecting him. 7. gastrointestinal system: for his constipation, he was refusing to take lactulose but agreed to dulcolax p.r. which did work for him. 8. disposition: the patient has been stable on our service for several days on hemodialysis. he will likely need to go back to a rehabilitation facility; perhaps , which is where he was previous to this admission. at the time of this dictation (on ) we were waiting to find out where he will go, and any updates on his hospital course will be dictated by the next intern who will be taking over my service on . , m.d. dictated by: medquist36 procedure: hemodialysis venous catheterization for renal dialysis peritoneal dialysis removal of peritoneal drainage device incision of peritoneum diagnoses: esophageal reflux chronic airway obstruction, not elsewhere classified depressive disorder, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease hypotension, unspecified other candidiasis of other specified sites diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled peritonitis in infectious diseases classified elsewhere 

Answer: The patient is high likely exposed to