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 49-year-old male with end- stage renal disease secondary to dm type 2, on hemodialysis since , presented for cadaveric renal transplant. on last hemodialysis via left av fistula on the previous day, his dry weight is 148 kg. he is dialyzed every monday, wednesday and friday and has felt well. approximately a month prior to admission, he had a left 3rd finger amputation for an unresolved infection treated with vancomycin. he denies fevers, chills, nausea, vomiting, indigestion, shortness of breath, chest pain, paroxysmal nocturnal dyspnea, constipation or diarrhea. he does not void. allergies: keflex (has hives from that) and morphine (unsure of reaction). past medical history: diabetes type 2, hypertension, end- stage renal disease, left av fistula, obesity, cad status post cabbage in , status post cholesterol and knee surgery, obstructive sleep apnea, wears a cpap machine at night, legally blind in left eye. medications on admission: folic acid 1 mg daily, nexium 20 mg daily, lipitor 20 mg p.o. at bedtime, midodrine 10 mg p.o. daily, sensipar 90 mg p.o. daily, coumadin 4 mg alternating with 3 mg every other day (took 4 mg on the previous evening), aspirin 325 mg daily. these were for afib around the time of his cabg. social history: no alcohol. no tobacco. he quit smoking approximately 20 years prior. no recreational drugs. married with 3 children. physical examination: alert and oriented, very pleasant, no acute distress, obese. heent: perrla, eoms intact, anicteric sclerae. neck: 2+ right carotid and left 1+. no bruits. no lymphadenopathy. short neck. lungs: clear bilaterally. cor: very distant heart sounds. regular. abdomen: obese, nontender and nondistended. active bowel sounds. extremities: no clubbing, cyanosis or edema. skin: left dorsum hand pustule 4 mm. no erythema. bilateral feet red with scaling rash between toes and on the right ankle. neurologic: alert and oriented. cranial nerves grossly intact. toes downgoing bilaterally. strength equal. vascular: left forearm av fistula. positive bruit and thrill with 2+ dp and pt bilaterally. vital signs: temperature 97.1, heart rate 90 beats, bp 107/60, respiratory rate 20, oxygen saturation 99% on room air, glucose 114, weight 148 kg, height 6 feet 3 inches. hospital course: the patient was admitted to the transplant service. he was assessed preoperatively and consented to participate in the belatacept study as a participant. the patient was taken to the or by dr. . the patient underwent cadaveric renal transplant from a deceased donor kidney transplant under general anesthesia. no complications. the patient was intubated and transferred to the recovery room in satisfactory condition. please see operative report for further details. ebl was approximately 400 cc, urine output was 250 cc, and the patient was replaced with iv fluid 3500 cc. he had 2 jp drains placed in his right lower quadrant. one was subcutaneous and a second drain was placed in the retroperitoneum. the patient was recovered in the pacu. the patient was difficult to intubate and he was extubated. he continued on cpap postoperatively and weaned off the vent. a renal duplex was done that demonstrated somewhat limited study due to patient body habitus. no evidence of perinephric fluid collection or hematoma. the upper pole of the kidney was not well visualized. there was no evidence of a fluid collection. the arterial and venous flow was seen within the transplanted kidney. he experienced atn postoperatively with delayed graft function requiring hemodialysis as his creatinine rose to 9 with a baseline of 8.8 on admission. hematocrit decreased to 30.2 postoperatively. he received 1 unit of packed red blood cells and 3 units of ffp postop. he had received 2 units of ffp and 1 unit of platelets preoperatively. he had been on coumadin and aspirin as previously stated. preop coags were pt 18.1, ptt 25.4 and inr 1.7. he received induction immunosuppression which included solu-medrol 500 mg, cellcept and belatacept. he followed the study protocol with a tapering solu-medrol dose. on postop day #4, he received belatacept as well as simulect. consult was obtained for hyperglycemia. his lantus insulin was resumed and his sliding scale was titrated to improve glycemic control. the patient was restarted on midodrine. physical therapy assessed the patient and felt that it was safe to discharge the patient home to resume previously ordered pt for balance and strength. the jp drains were removed. his incision was clean and dry. vital signs remained stable. heparin antibody was sent off as his platelet count had decreased. this was negative. platelets had dropped to 75 and then started to trend back up to 100, and a second platelet count was drawn. this was 96. he was scheduled to receive epogen at hemodialysis as an outpatient for a hematocrit of 26.5 on postop days #5. nephrology followed the patient closely throughout this hospital stay, making recommendations and monitoring of the belatacept study. his diet was advanced. he tolerated this well. his pain was controlled with p.o. pain medication. on postop day #5, he was discharged home in stable condition. he is alert and oriented. his lungs are distant sounding. abdomen was nontender and nondistended. he was passing flatus and tolerating a regular diet. he is ambulatory. discharge medications: 1. bactrim single strength 1 tablet every monday, wednesday and friday. 2. nystatin 5 ml p.o. q.i.d. 3. colace 100 mg p.o. b.i.d. 4. cellcept -mg tabs 2 tabs p.o. b.i.d. 5. valcyte 450 mg p.o. q.48h. 6. prednisone 20 mg p.o. daily per belatacept taper. 7. midodrine 10 mg p.o. t.i.d. 8. vicodin 1-2 tablets p.o. p.r.n. q.4-6h. 9. sevelamer 800 mg p.o. t.i.d. 10. folic acid 1 mg p.o. daily. 11. glargine insulin 22 units subcutaneous at bedtime. 12. humalog insulin per sliding scale. 13. nexium 20 mg p.o. daily. discharge plan: outpatient physical therapy 2-3 times per week for strengthening and balance with left afo. he was scheduled to follow up in the outpatient clinic with dr. on . he was to resume his previously scheduled hemodialysis. labs on discharge included white count 8.6, hematocrit 26.5, sodium 141, potassium 4.5, chloride 97, co2 30, bun 73, creatinine 8.3 and glucose ranged 147-202. his coumadin was on hold pending renal biopsy that was scheduled for , at 8:00 a.m. in day care. , procedure: venous catheterization, not elsewhere classified hemodialysis other kidney transplantation other operations on lacrimal gland transplant from cadaver diagnoses: end stage renal disease hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease long-term (current) use of insulin complications of transplanted kidney diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled 

Answer: The patient is high likely exposed to