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: no known allergies / adverse drug reactions attending: chief complaint: seizures, personality changes major surgical or invasive procedure: intubation, history of present illness: patient is a 40 year old man with a pmhx s/f newly diagnosed dm and recent admission for hhs/dka who presented to the emergency room with a tonic clonic seizure after acting inappropriate at home with periods of inattention and depersonalization. today mr. was found by his family to be violent and acting inappropriately after several episodes of "staring into space" and arm flailing. ems was called after a witnessed seizure, and upon ems arrival he was found to be seizing. at the ed, he was found to have persistent tonic-clonic seizures. he was found to be acidemic to 6.8 with a bicarb of 8. he was intubated for airway protection in light of his mental status, was given 1gm of dilantin and 6mg of ativan as well as 2l iv ns. he was also found to have a leukocytosis to 17.6. urine was negative for ketones, and glucose elevated at 338. he was then transitioned to propofol and bicarbonate drips and transferred to the ed. med flight gave him fentanyl 200mcg, . in the ed, he was seen by neurology who felt his seizures were secondary to poorly controlled dm and recommended admission to the micu. . review of systems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denies cough, shortness of breath, or wheezing. denies chest pain, chest pressure, palpitations, or weakness. denies nausea, vomiting, diarrhea, constipation, abdominal pain, or changes in bowel habits. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes or skin changes. past medical history: dm osa non-compliant with cpap htn hld b12/vit d deficiency social history: patient is a policeman who is currently on leave for personal issues. he lives alone. currently, his girlfriend denies that he drinks alcohol, smoking, or illicits. family history: father with dm and epilepsy physical exam: upon admission: vitals: t: 99.2 bp: 131/82 p: 76 r: 18 o2: 99% on psv 5/5, fio2 100% general: intubated sedated gentleman, does not respond to verbal or painful stimuli heent: sclera anicteric, dry mm, oropharynx clear, eomi, pinpoint pupils/midline, neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation anteriorly bilaterally, no wheezes, rales, ronchi abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly gu: foley inserted with copious amounts of clear urine ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: intubated/sedated, pinpoint pupils, doll's head maneuver with eomi, no clonus, appropriate bulk/tone pertinent results: admission labs: 02:16am blood wbc-13.6* rbc-3.36* hgb-10.4* hct-30.9* mcv-92 mch-30.8 mchc-33.5 rdw-12.5 plt ct-111* 02:16am blood urean-12 creat-1.4* 06:21am blood glucose-124* urean-13 creat-1.7* na-140 k-3.9 cl-108 hco3-24 angap-12 02:16am blood ck(cpk)-4566* 06:21am blood calcium-7.4* phos-4.5 mg-3.0* 02:31am blood freeca-0.97* 02:31am blood glucose-200* lactate-4.9* na-136 k-4.1 cl-107 07:55am blood %hba1c-16.5* eag-427* 06:02pm blood caltibc-168* vitb12-1117* folate-9.3 hapto-218* ferritn-1103* trf-129* discharge labs: 06:50am blood wbc-8.8 rbc-3.66* hgb-11.3* hct-32.9* mcv-90 mch-30.9 mchc-34.4 rdw-13.3 plt ct-167 06:50am blood glucose-92 urean-10 creat-2.5* na-148* k-3.8 cl-113* hco3-25 angap-14 06:50am blood ck(cpk)-2947* pertinent results: chest x ray: previous mild pulmonary edema has cleared. lungs are low in volume, but caliber of the pulmonary vasculature and cardiac silhouette is probably normal. left infrahilar consolidation could be pneumonia or atelectasis and should be followed. et tube is in standard placement. nasogastric tube passes into the stomach and out of view. no pneumothorax or pleural effusion. mri head (preliminary read): no acute intracranial abnormality. no abnormality identified on the mri to explain the patient's seizures. renal ultrasound: the right kidney measures 12.1 cm, the left kidney measures 10.6 cm without evidence of hydronephrosis, stones, or masses. the urinary bladder is normal. impression: no hydronephrosis. ct sinus/mandible: findings: there is anterior dislocation of the right mandibular condyle and anterior subluxation of the left mandibular condyle, which appears partially reduced compared to yesterday's outside hospital head ct. there is no evidence of fracture. aerosolized secretions are seen in the left frontal sinus and left ethmoid air cells. mucosal thickening is seen in the ethmoid air cells bilaterally and maxillary sinuses bilaterally. air-fluid levels and mucosal thickening are seen in the sphenoid sinuses bilaterally. the ostiomeatal complexes are occluded bilaterally. soft tissue thickening of the uvula and posterior pharynx is noted. this study is not optimized for evaluation of intracranial structures; within this limitation, no large abnormalities are detected. impression: 1. anterior dislocation of the right mandibular condyle and anterior subluxation of the left mandibular condyle without evidence for acute fracture. 2. aerosolized secretions in the left frontal sinus and left ethmoid air cells with air-fluid levels in the sphenoid sinuses bilaterally, which are likely secondary to retained secretions from recent intubation. however, acute sinusitis cannot be excluded. 3. soft tissue thickening of the uvula and posterior pharynx, which likely represents edema secondary to recent intubation. eeg: no evidence of seizure activity. focal slowing consistent with toxic metabolic syndrome. 02:16am urine bnzodzpn-pos barbitrt-neg opiates-neg cocaine-neg amphetmn-neg mthdone-neg 02:16am asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg blood cultures: pending uurine culture: no growth (final) brief hospital course: mr. is a 40 year old with a past medical history significant for newly diagnosed diabetes and recent admission for hhs versus dka at an osh who presented with status epilepticus and poorly controlled diabetes. # status epilepticus: presumed secondary to electrolyte disturbances secondary to dka/hhs decreasing the patient's seizure threshold. there was no clear source of infection and the patient was without localizing symptoms; infection was not thought to explain the patient's symptoms, and no lumbar puncture was done. preliminary read of the eeg shows generalized slowing while on propofol drip. neurology followed the patient through hospital course. patient was weaned from keppra through the hospitalization, and on day of discharge this medication was discontinued. brain mri was done which showed no structural abnormality of the brain to explain seizures. patient had no further seizure activity while hospitalized. he was discharged with outpatient neurology follow-up scheduled. # altered mental status: patient was admitted intubated and sedated. he was weaned off sedation, and upon arrival to the floor, the patient's mental status was noted to have waxing/ attention. patient's mental status improved through the admission with correction of his hyperglycemia. # dm: excellent control was maintained through hospital admission with 20 units of nph/regualr (70/30) twice daily. patient received teaching regarding the importance of compliance and careful control of his blood sugars. patient is being discharged home on above regimen with follow-up arranged at . # acute kidney injury: patient admitted with serum creatinine 1.4 which increased to 3.1. acute kidney injury was thought to be multifactorial related to poor oral intake and rhabdomyolysis in the setting of tonic-clonic seizures. ck was elevated in the 5000s was noted to be down trending on day of discharge. however, the cr slowly rose and then slowly improved, suggesting possible atn, although there is no prolonged hypotension documented, and he never required pressors. patient made good urine output in the latter part of the admission. renal ultrasound showed no hydronephrosis. follow-up regarding serum creatinine will need to be done on an outpatient basis. by day of discharge, patient's serum creatinine had trended down to 2.5. # mild thrombocytopenia: etiology is unclear but may be related to critical illness. platelets trended up to 167 by time of discharge. he was not on medications that would cause thrombocyotpenia. of note, thrombocytopenia developed prior to heparin administration so is unlikely secondary to hit. patient without evidence of dic on labs. ttp/hus in the setting of renal failure was ruled out. # anemia: previously diagnosed with b12 deficiency though baseline was unknown. records of the patient's hematocrit/hemoglobin were unable to be obtained during the admission. b12 level was high on this admission. iron studies are consistent with anemia of chronic inflammation. folate was within normal limits. anemia remains stable through admission with h/h 11.0/32.4. it is unclear why this apparently healthy host would have anemia of chronic disease. retic count is depressed with suggestive a myelosuppressive state, though the patient is not currently on medications that would cause a myelosuppressive state. # fever and leukocytosis: afebrile since admission to the floor. patient had fever to 100.2 at midnight on . likely secondary to seizures, but differential also includes infectious etiology such as pneumonia (given possible rul infiltrate on cxr with poor inspiration). however, his respiratory status markedly improved and he his on ra, and there was no indication for further work-up. leukocytosis was thought to be secondary to stress response from seizure and dka/hhs. wbc trended down on day of admission. urine culture was negative. final blood cultures were still pending on day of discharge. # jaw dislocation: likely occurred during intubation. there is no fracture see on ct of the mandible. was consulted during the admission. no acute intervention was warranted. the patient was placed on a soft, pureed diet while in house with instructions to continue this while at home. patient will be contact with follow-up appointment by . # rule out acs: given acute neurologic event, cardiac risk factors, and diffuse st elevations on ekg there was concern for acs. troponins were negative times three during this admission, so no further action was taken, especially in absence of chest pain. # osa: he carries a diagnosis of osa but is not compliant with cpap. encouraged compliance with cpap during hospitalization. #transition of care issues: - follow-up with neurology as an outpatient regarding seizure activity. patient will also have outpatient routine eeg done. these appointments have been scheduled. - follow-up with regarding patient's diabetes. - follow-up with primary care physician on regarding recent hospitalization and follow-up of patient's chemistry panel with serum creatinine to ensure that serum creatinine continues to trend down. - follow-up with oral/maxillary/facial surgery regarding jaw dislocation. patient will be contact by with appointment time and date. - follow-up of pending blood cultures medications on admission: asa 81mg insulin 70/30 20 units vitamin b12 500mg daily calcium plus vitamin d discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. vitamin b-12 500 mcg tablet sig: one (1) tablet po once a day. 3. calcium 500 with d 500 mg(1,250mg) -400 unit tablet sig: one (1) tablet po once a day. 4. insulin nph & regular human 100 unit/ml (70-30) suspension sig: twenty (20) units subcutaneous at breakfast daily. 5. insulin nph & regular human 100 unit/ml (70-30) suspension sig: twenty (20) units subcutaneous at dinner daily. discharge disposition: home discharge diagnosis: primary diagnosis: tonic-clonic seizures secondary diagnosis: rhabdomyolysis acute kidney injury insulin dependent diabetes hypertension hyperlipidemia anemia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to because of seizures. we believe the cause of your seizures was due to electrolyte imbalance influenced by your underlying diabetes. an mri of your head was done to determine if there was a brain abnormality that was causing your seizures, but no abnormality was identified. you are not being discharged home on anti-seizure medications. however, you do have follow-up with neurology for a routine eeg as an outpatient (once discharged from the hospital). your eeg has been scheduled for , at 3:00pm. your hair must be clean and dry. please eat lunch before the eeg. the office is located on 5. given that you recently had a seizure, you are not permitted to operate a motor vehicle for the next 6 months unless you are medically cleared by the neurologist, with whom you have follow-up. when you were intubuated, your jaw was dislocated. you were seen by the oral surgeons who had recommended correcting the dislocation however before the procedure could be performed your jaw returned to position without surgical intervention. for the next two weeks, it is important that you do not eat foods that require chewing and that you avoid yawning. the oral surgeons will call you regarding a follow-up appointment in the next 2 weeks. your kidneys sustained an injury after the seizures known as rhabdomylosis. your serum creatinine, a marker of your kidney function, is improving. please avoid taking ibuprofen whiel your kidneys recover from injury. please have your primary care doctor follow-up your kidney function at your next appointment on . please take all medications as instructed. note the following medication changes: none. please keep all follow-up appointments as scheduled. followup instructions: you already have an appointment scheduled with your primary care doctor on janurary 9th. keep this appointment. . name: , np location: diabetes center address: one place, , phone: when: tuesday, , 2:00 pm department: neurology when: wednesday at 4:30 pm with: drs. & building: sc clinical ctr campus: east best parking: garage md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours diagnoses: thrombocytopenia, unspecified obstructive sleep apnea (adult)(pediatric) anemia, unspecified acute kidney failure with lesion of tubular necrosis toxic encephalopathy unspecified essential hypertension other b-complex deficiencies other and unspecified hyperlipidemia acute respiratory failure long-term (current) use of insulin grand mal status hyperosmolality and/or hypernatremia rhabdomyolysis unspecified vitamin d deficiency diabetes with ketoacidosis, type ii or unspecified type, uncontrolled other specified misadventures during medical care closed dislocation of jaw 

Answer: The patient is high likely exposed to