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 48-year-old caucasian male with history of hypertension, hypoglycemia, end stage renal disease requiring hemodialysis for the past three years with failed cadaveric renal transplant who was found on passed out in his car by police. at that time he was noted to be extremely somnolent and when awakened by the police, he took sugar pills on the scene. prior to that he had not been to hemodialysis in at least 5 days. the patient was brought to the emergency room by police where he was originally in the psych area and was declining blood draws. blood work revealed a potassium of 7.8, bun 101 and creatinine of 14.6. he was seen emergently by renal consult and was rapidly prepared for hemodialysis. in the emergency room he was given two amps of d50, one amp of calcium, 5-10 units of insulin, 1 mg ativan and kayexalate for hyperkalemia. ekg was notable for wide paced beats with two qrs morphologies. there were t wave inversions present in leads 1, 2, avl, avf, v4, v5. st elevations were present in 2, 3, avf, v3 through v6. serum tox screen was negative. arterial blood gases revealed ph of 7.35, and lactate of 1.101. telemetry in the er was notable for a wide fast beats which were thought to be originally ventricular tachycardia. he was started empirically on an amiodarone drip. at that time he was transferred to the micu for further stabilization. in the micu he was emergently dialyzed for hyperkalemia and uremia. post dialysis potassium was noted to be 8.1 and thought secondary to the effects of d50 insulin and bicarb. on he was dialyzed once again with potassium of 4.7 the morning of . micu course was notable for hypoglycemia as low as 9. he had known history of hypothyroidism, hypoglycemia and adrenal insufficiency and thought to be in a great amount of stress. at this time he was given stress doses of iv steroids. hypoglycemia was managed initially with d50, then d10 drip and then d5 with subsequent improvement of hypoglycemia. d50 drip was finally discontinued on when he left the micu. the patient's altered mental status improved during his micu course. he was seen by neurology who believed that his altered mental status was secondary to metabolic derangement including uremia, hypoglycemia and recent heroin use. eeg was obtained to rule out non convulsive status. results from the eeg are still pending. at this time he was transferred to the service for further management. past medical history: 1) hypoglycemia. 2) hypertension, poorly controlled. 3) status post pacemaker aicd secondary to prolonged qt syndrome. 4) history of heroin use. 5) mitral valve endocarditis. 6) end stage renal disease on hemodialysis for the past three years. 7) patient is status post cadaveric transplant in which has failed. 8) hepatitis c. 9) hypothyroidism. 10) recurrent c. diff infection. 11) history of pancreatitis. 12) status post multiple av fistulograms and balloon angioplasties. patient has right cubital av fistula which is still usable. 13) cholelithiasis. 14) status post gunshot wound in . 15) history of small bowel obstruction. allergies: ativan, sulfa, erythromycin, neurontin and tagamet. the patient does not know reactions to these medications. medications: levoxyl 100 mcg po q d, minoxidil 2.5 mg po q d, phos-lo 2 mg po tid, labetalol 500 mg po bid, prednisone 10 mg alternating with 7.5 mg qid, nephrocaps 1 mg po q d, norvasc 10 mg po q d. meds on transfer from the unit include: renagel 800 mg po tid, levoxyl 100 mcg po q d, nephrocaps one capsule po q d, kayexalate prn, clindamycin 300 mg po q 6 hours, hydrocortisone 50 mg iv q 8 hours and d50 drip. laboratory data: on transfer, cbc showed white count of 7.9, hematocrit 38.2, platelet count 177,000, chem 7 showed a sodium of 132, potassium 6.1, chloride 93, co2 24, bun 54, creatinine 12.4, blood sugar 205, potassium 6.1, calcium 9.2, phosphorus 8.1, magnesium 1.8. tsh was 1.8. physical examination: on transfer vital signs, temperature 98.6, pulse 85, blood pressure 120/55, respiratory rate 13. in general, this is a thin african american male lying in bed, in no acute distress. heent: arcus senilis bilaterally, extraocular movements intact, pupils are equal, round, and reactive to light, oropharynx clear, jvd approximately 10 cm. cardiovascular, regular rate and rhythm, paced, normal s1 and s2, 3/6 systolic murmur in the lower left sternal border, radiating to the right carotid. lungs, mild right basilar crackles. abdomen, normoactive bowel sounds, nontender, non distended, old left lower quadrant cadaveric transplant in place. extremities, clean, dry and intact, no swelling. neuro, alert and oriented times three. hospital course: 1. renal: repeat potassium the night of transfer was 4.1. labs the morning of showed a potassium of 4.1, bun 48 and creatinine 10.3. he has undergone two days of hemodialysis and will likely no longer need emergent dialysis. he will need to resume his normal schedule of dialysis when he is discharged. 2. neurology: mr. had altered mental status, likely secondary to uremia, hypoglycemia, recent heroin use. patient's mental status seemed to be back to baseline and neurology consult was signed off. 3. cardiovascular: in the micu mr. ' pacemaker and icd was interrogated by the electrophysiology service. they could not find any indication of prior ventricular tachycardia in the last few days. he was kept on telemetry with no further abnormalities. 4. endocrine: mr. was continued on levoxyl for his hypothyroidism. he was also restarted on his home dose of steroids 10 mg alternating with 7.5 mg every other day. fingersticks were continued to be checked q 2 hours for the next four hours after which mr. refused further fingersticks. blood sugar on morning of was noted to be 79-91. 5. id: mr. had chest x-ray which showed possible retrocardiac opacity. this suggested possibly aspiration in the setting of altered mental status. he was started on levaquin and flagyl for one day and then switched to clindamycin on . repeat chest x-ray showed no infiltrate or effusions. on all antibiotics were discontinued. disposition: mr. will be discharged home. he will follow-up with his primary care physician and renal physician for normal hemodialysis schedule. all home medications will be restarted at this time. discharge diagnosis: 1. uremia secondary to non compliance. 2. hypoglycemia. 3. adrenal insufficiency. 4. end stage renal disease on hemodialysis. 5. heroin use. discharge medications: levoxyl 100 mcg po q d, minoxidil 2.5 mg po q d, phos-lo 2 mg po tid, labetalol 500 mg po bid, prednisone 10 mg alternating with 7.5 mg q d, nephrocaps 1 tab po q d, norvasc 10 mg po q d. dr. dictated by: medquist36 procedure: hemodialysis diagnoses: hyperpotassemia unspecified acquired hypothyroidism hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease automatic implantable cardiac defibrillator in situ opioid abuse, unspecified 

Answer: The patient is high likely exposed to