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: codeine attending: chief complaint: acute kidney injury major surgical or invasive procedure: none. history of present illness: ms. is a year old woman with history of hypertension, arthritis, asthma, sent by ambulance after found to have cr 4.0 and k+ 6.2 at pcp's office with complaints of malaise and loose stool. she has had poor appetite for last 2 weeks. she has had general malaise and weakness, feeling shaky and weak when standing. she tried taking "dizzy pills," though these symptoms were different from which did not help. denies any fevers, chills, cough, shortness of breath, dysuria, urinary frequency or urgency. she does endorse decreased urination over the last few days. she has had loose pasty stools for a couple of days over the weekend but has not stooled since yesterday; she had pasty stools for 1-2 days last week as well which resolved quickly. no different foods. . in the ed, the initial vital signs were t 98.6 p 80s/40s bp r o2 sat. the patient had complained of a single episode of diarrhea. her only other complaint was malaise. she denied any nausea, vomiting, change in appetite. she received 5 liters of fluid in the emergency department, and was given vancomycin and zosyn for broad coverage. imaging did not support pneumonia or hydronephrosis. as blood pressures remained below 70 sbp, the patient was given a left ij and placed on levophed with instructions to titrate to a map 65 and sbp 90. . in the micu on admission, she appeared well and was mentating well. she was comfortable except for some joint pain she attributed to having lay in bed for several days. she reported that her appetite was improving and asked to eat food. while in the micu, she was ruled out for sepsis and adrenal insufficiency. upon cardiology consult, she received an echo that showed a ef > 75% but severe symmetric left ventricular hypertrophy. once her was thought to be prerenal, she was given 12-15l of fluid. on transfer, her cr had resolved to 1.2. on transfer, her vitals were t 99, hr 65 bp 116/66 rr 20 sao2 100 ra. . on the floor, she was sitting comfortably with her family. she does not report any pain, denies any n/v/d, any chest pain or tightness. she feels well and is very locquacious without any signs of dyspnea. . review of systems: as per hpi. pt also endorses a recent 12lb weight loss as per micu admit note. (-) denies fever, chills, night sweats,. denies headache, sinus tenderness, rhinorrhea or congestion. denied cough, shortness of breath. denied chest pain or tightness, palpitations. denied nausea, vomiting, diarrhea, constipation or abdominal pain. no recent change in bowel or bladder habits. no dysuria. past medical history: pneumococcal meningitis - many years ago, when her daughter was 2 old right shoulder injury - requiring 2 corticosteroid injections recently wound, open - leg tenosynovitis of finger, hand, or wrist carpal tunnel syndrome hypothyroidism, unspec heart failure - diastolic, chronic tte from shows lvef of 60-65% and moderate lvh. tinea pedis edema - periph avascular necrosis - femur, med condyle osteoarthritis - knee right osteoarthritis diverticulosis sciatica medial meniscus tear heart disease - hypertensive benign w/ chf palpitations osteopenia hypertension, essential asthma vertigo social history: lives on ground floor with her son and in law on the floor above her. son works, but daughter in law takes good care of her, cooks for her. walks with walker at baseline for last two years. smoking: never smoker alcohol: no retired receptionist at city ; worked after her husband passed away, not before. family history: non-contributory physical exam: physical exam on admission: vitals: t: 95.8 bp: 123/65 p: 68 r: 12 o2: 98% ra general: alert, oriented, no acute distress, very pleasant, thin elderly woman heent: sclera anicteric, very dry mucus membranes, oropharynx clear neck: supple, no jvd lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: very soft heart sounds, difficult to appreciate distinct s1 and s2 abdomen: soft, non-tender, mildly distended, no rebound tenderness gu: foley in place draining clear urine ext: cool, very trace pulses, no edema, legs diffusely very tender to palpation over lower legs and knees in particular ; also has difficulty moving arms skin: no skin break down on buttocks or sacrum ; very dry flaky skin on lower extremities with venous stasis changes on lower extremities . physical exam on discharge: vitals: t 99 hr 68 bp 110/70 rr 16 o2 100ra general: alert, very chatty, nad heent: nc/at, perrl, eomi, sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad, thyroid wnl lungs: ctab, no wheezes, rales, ronchi cv: rrr, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, nt/nd, +bs, no rebound tenderness or guarding, no hsm ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: alert and oriented to person, hospital and approximate date. cnii-xii intact. sensation intact to light touch. strength in deltoids, in rest of bue, throughout ble. pertinent results: admission results: 12:00am glucose-132* urea n-140* creat-4.0* sodium-125* potassium-5.0 chloride-93* total co2-13* anion gap-24* 12:00am estgfr-using this 12:00am alt(sgpt)-21 ast(sgot)-43* alk phos-49 tot bili-0.4 12:00am lipase-130* 12:00am ctropnt-0.19* 12:00am wbc-4.0 rbc-4.27 hgb-13.2 hct-35.2* mcv-83 mch-31.0 mchc-37.5* rdw-14.4 12:00am neuts-69.7 lymphs-24.1 monos-5.1 eos-0.4 basos-0.6 12:00am plt count-168 12:12am lactate-1.2 01:25am urine color-straw appear-clear sp -1.006 01:25am urine blood-neg nitrite-neg protein-tr glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 01:25am urine rbc-0 wbc-1 bacteria-few yeast-none epi-<1 01:25am urine hyaline-17* 01:25am urine mucous-rare 08:58am pt-13.0 ptt-25.8 inr(pt)-1.1 08:58am ctropnt-0.13* 08:58am ck(cpk)-172 11:11am lactate-1.3 na+-134* k+-3.9 cl--114* tco2-12.3* 11:11am type-central ve po2-43* pco2-29* ph-7.24* total co2-13* base xs--13 comments-adding on 12:10pm urine hours-random urea n-370 creat-23 sodium-67 potassium-6 chloride-63 . images: ct torso: no hydroneprhosis limited due to lack of contrast no renal stone no bowel obstruction cxr: no evidence of pneumonia, left ij crosses midline and prob in azygous . ekg: sinus rhythm, rate 60s, significantly prolonged pr/ av conduction delay, low voltage, poor r wave progression, v5-v6 twave inversions brief hospital course: # shock/hypotension the patient presented with shock that did not initially respond to fluid resuscitation so she was started on norepinephrine. the intial concern was for septic versus cardiogenic versus hypovolemic. she had no fever and no obvious source of infection, making septic shock unlikely. her cvp was low and a tte showed a hyperdynamic left ventricle with an ef >75%, no tamponade or other evidence of cardiogenic shock. she reported essentially no po intake for about two weeks, so hypovolemic shock seemed most likely. she has had no new medications, but her family reports that she takes numerous dietary supplements at home, though they do not know what these are. she received extensive fluid resuscitation for a total of eleven liters. she was weaned off of norepinephrine asymptomatically with systolic blood pressures in the high 90s to 120s. after having stable blood pressures off of pressors for a day, her central venous catheter was removed and she was transferred to the floor. she was hemodynamically stable for the rest of her stay. . # acute renal failure the patient's baseline creatinine appears to be 1.3-1.4 but she presented with a creatinine of 4.0. pre-renal etiology is likely given elevated bun/cr ratio with potential overlying atn. her urine output was excellent throughout her stay and her creatinine fell to 1.2. her cr was stable the following day. . # hematuria after the removal of the foley catheter in the icu, she had a small amount of gross hematuria for the 24 hours following the removal of the catheter. this was acknowledged by the team and was felt to be mild. her hct has been stable and the hematuria should resolve in the next few hours. she had not signs of clot, or dysuria. - recommended urology follow up if hematuria persists . # htn the patient has a h/o htn, borderline, on enalapril 10mg daily and two diuretics at home, but she was hypotensive requiring pressors in the icu, so these medications were held. once she was hemodynamically stable and transferred to the floor, she was resumed, as recommended by the cardiology consult service, on a lower dose of her previous diuretics, furosemide and spironolactone. her enalapril was held briefly for the concern of amyloidosis as the origin of her severe lvh on her echo, but can be resumed on discharge. . # hypothyroidism tsh 5.8, just mildly elevated at pcp office but her home dose was continued in the acute setting. her tsh was 2.6 in-house, which was wnl. her levothyroxine was continued. . # asthma no shortness of breath, lungs are clear with good air movement, and she was written for albuterol and ipratropium as needed. her home asthma medications were continued once she went to the floor. ________________________________ transition to care: - the patient still has a bit of hematuria when she urinates that is likely secondary to the removal of her foley. this should clear over the next several hours. her hct has been stable since then and we are reassured that this is not heavy bleeding and she should be stable to go to rehab. - for primary care physician: per geriatrics consult recommendations recommendations, please follow up with the following for the patient - iron studies, b12, folate, cbc and electrolytes. also, arrange for optho appointment annually. medications on admission: ketoconazole 2 % topical cream apply to affected area in between toes twice daily as directed enalapril maleate 5 mg oral tablet take 2 tablets daily spironolactone (aldactone) 25 mg oral tablet take 1 tablet daily for fluid furosemide 40 mg oral tablet take 1 tablet by mouth in the morning and 1 tablet prn as per directions meclizine 25 mg oral tablet take 1 tablet twice daily as needed for dizziness fluticasone (flovent hfa) 220 mcg/actuation inhalation aerosol use 2 puffs in the am and pm albuterol sulfate (proair hfa) 90 mcg/actuation inhalation hfa aerosol inhaler inhale 2 puffs 3-4 times daily alendronate 70 mg oral tablet take 1 tablet weekly in the am 30 minutes before food do not lie down for at least 30 minutes montelukast (singulair) 10 mg oral tablet take 1 tablet daily levothyroxine 25 mcg oral tablet take one tablet by mouth daily albuterol sulfate 2.5 mg /3 ml (0.083 %) inhalation solution for nebulization use 1 vial via nebulizer three times daily as needed for asthma calcium + d 600 mg (1,500)-200 unit tab qd discharge medications: 1. levothyroxine 25 mcg tablet sig: one (1) tablet po daily (daily). 2. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 3. spironolactone 25 mg tablet sig: 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 6. montelukast 10 mg tablet sig: one (1) tablet po daily (daily). 7. calcium carbonate 200 mg calcium (500 mg) tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day). 8. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 9. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 10. enalapril maleate 10 mg tablet sig: one (1) tablet po once a day. 11. meclizine 25 mg tablet sig: one (1) tablet po once a day. 12. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) puffs inhalation four times a day. 13. alendronate 70 mg tablet sig: one (1) tablet po once a week. 14. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) vial inhalation q6h (every 6 hours) as needed for sob/wheeze. discharge disposition: extended care facility: - discharge diagnosis: primary diagnosis: acute kidney injury . secondary diagnosis: hypotension discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you were admitted to the hospital because you were really dehydrated. you hadn't taken a lot of food and water by mouth. some of your labs were off. you were admitted to the intensive care unit in the hospital and got a lot of liquids in your iv. you labs were a lot better after you got the liquids. you were also seen by some doctors from cardiology, who made some recommendations for the changes in your medications. the following changes were made in your medications: . spironolactone 25mg changed to spironolactone 12.5mg daily furosemide 40mg changed to furosemide 20mg daily . you will be discharged to a rehab facility. please make sure that you follow up with your primary care physician weeks. . please make sure that you drink plenty of water and take food in, even when you are not hungry, so you don't get so dehyrdrated again. followup instructions: please follow up with your primary care physician weeks after you go home. procedure: central venous catheter placement with guidance diagnoses: congestive heart failure, unspecified acute kidney failure, unspecified unspecified acquired hypothyroidism asthma, unspecified type, unspecified paroxysmal ventricular tachycardia other shock without mention of trauma osteoporosis, unspecified gross hematuria chronic diastolic heart failure osteoarthrosis, unspecified whether generalized or localized, lower leg benign hypertensive heart disease with heart failure 

Answer: The patient is high likely exposed to