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: sulfonamides / macrodantin / codeine / norvasc / hydralazine / heparin agents attending: chief complaint: anemia and acute renal failure major surgical or invasive procedure: renal biopsy placement of pheresis catheter plasma exchange , , hemodialysis bronchoscopy central line placement history of present illness: year-old female with hypertension admitted with acute renal failure secondary to hydralazine-induced glomerulonephritis (p-anca positive). patient was initially nonresponsive to steroids, plasma exchange, and was started on hemodialysis on . she received her second hd treatment on . during both treatments l ivf was removed. both renal and rheumatology have followed patient to date. cyclophosphamide was considered, but not started given concern for toxicity due to age. . overnight, patient developed oxygen requirement, initially hypoxic to 90% on room air at rest, 85% with ambulation. oxygen delivery was increased progressively from 3l to 6l nasal cannula. she appeared volume overloaded on exam and cxr. she was given lasix 40mg iv x2 with minimal urine output. nebulizers were tried with minimal relief. renal was called re: urgent dialysis, which was not possible. additionally, given rapid progression of hypoxia, renal suspected etiology other than volume overload alone. of note, patient also with hemoptysis this morning on multiple occasions - largest approximately 1 teaspoon bright red blood. given progressive hypoxia and increased work of breathing, patient is transferred to for further management. . hospital course also complicated by lower gi bleed, anemia, coagulopathy, uti. on , patient developed lgib in context of constipation and straining for bowel movement. gi was consulted. based on recent colonoscopy, transient diverticular bleed was suspected. ischemic colitis was also considered given underlying vasculitis. patient also with chronic anemia. she has required 2 prbc transfusions during this hospital course. patient also with uncomplicated uti treated with ciprofloxacin po x3 days on admission. . on arrival to , was with o2 saturation 100% on 100% o2 shovel mask. she complained of shortness of breath, fatigue. she was urgently intubated given respiratory distress. past medical history: hepatitis b secondary to transfusion () hypercholestremia hypertension carotid stenosis s/p endartarectomy arthritis, s/p right thr () gastritis prolapsed bladder s/p bladder suspension breast cyst social history: lives in apartment above daughter's home. well-supported by family. active prior to admission - capable in all adls. per daughter, no tobacco, alcohol, or illicit drug use. formerly worked at . family history: unknown physical exam: on admission : pt is at baseline per daughter who is with pt pt is awake and responds appropriately. able to tell me it is but unable to correctly tell me month or date or identify name of president. 97.8 197/77 78 14 99%ra cv-rrr lungs - cta bilat abd - soft, nt, nd, no guarding ext - no c/c/e . on admission to (prior to intubation) : 96.8, 95, 169/112, 20, 91% shovel mask 100% general: labored respirations with use of accessory muscles heent: sclera anicteric, dry blood at mucous membranes and in mouth, no site of active bleeding neck: supple, jvp difficult to assess given accessory muscle use lungs: rhoncherous throughout with crackles to midlung fields bilaterally; no wheezes; decreased breath sounds at bases bilaterally cv: heart sounds hindered by rhonchi; regular, no murmurs appreciated abdomen: distended; hypoactive bowel sounds; nontender gu: no foley ext: warm, well-perfused; 2+ radial and dp pulses; 1+ lower extremity edema to knees bilaterally pertinent results: na 134 / k 4.5 / cl 102 / co2 19 / bun 60 / cr 3.6 / bg 134 alt 16 / ast 33 / alk phos 58 / tuberculosis .4 lipase 73 ca 9.4 / mg 2.6 / phos 4.3 inr 1.3 / ptt 64 cxr no acute cardiopulmonary process. unchanged large hiatal hernia as noted. renal us - no evidence of hydronephrosis. normal-appearing kidneys. renal us with dopplers - normal arterial and venous flow to the bilateral kidneys. renal biopsy: pauci-immune crescentic glomerulonephritis in the setting of anca positivity. rle ultrasound: no right lower extremity dvt. cxr: in comparison with study of , there has been substantial enlargement of the cardiac silhouette with pulmonary vascular congestion and bilateral pleural effusions. cxr: impression: worsening hydrostatic pulmonary edema. early followup is recommended. cxr: impression: improved pulmonary edema which is now moderate, stable bibasilar pleural effusions with satisfactory position of the et tube and right central venous line. brief hospital course: yo female with history of hypertension was admitted with acute renal failure, coagulopathy, and microscopic hematuria of unclear etiology. 1. acute renal failure initially, the etiology of her acute renal failure was unclear. initial evaluation with urine electrolytes, renal ultrasound, and renal ultrasound with doppler evaluation made pre-renal etiology or post-renal etiology less likely. urine sediment was generally unremarkable. renal biopsy was pursued and demonstrated crescentic glomerulonephritis in the setting of anca positivity. etiology of her renal failure was found to be hydralazine-related pauci-immune glomerulonephritis. shortly after admission, she was started on hemodialysis and did not demonstrate any signs of renal recovery. the decision was made not to continue dialysis. 2. coagulopathy. her inr was slightly elevated to 1.3 on admission and had minimal improvement with vitamin k administration. ptt remained markedly elevated. mixing study and lupus anticoagulant testing was performed and were both positive. however, the diagnosis of lupus anticoagulant was not deemed relevant to the above diagnosis. 3. anemia: patient was found to have anemia related most likely to anemia of chronic disease and chronic kidney disease. 4. hypertension. patient was initially continued on her home regimen for hypertension with the exception of her which was held due to renal failure. however, when anca came back as positive, her hydralazine was discontinued given the known association between pauciimmune anca positive glomerulonephritis and hydralazine usage. she was then placed on labetalol with improvement in her blood pressure. 5. diffuse alveolar hemorrhage during this admission, she developed an oxygen requirement and hemoptysis, concerning for diffuse alveolar hemorrhage. she was started on high dose steroids and cytoxan with remarkable improvement in her respiratory status from intubation to being on room air. 6. gi bleding patient had an episode of gi bleeding during this admission thought likely related to hemorrhoids, diverticuli, or ischemia in the setting of vasculitis. these symptoms did not recur during her hospitalization. 7. thrombocytopenia platelet count declined and patient was found to be hit positive. her platelet count remained between 80-150. 8. goals of care prior to admission, patient was living independently with some help from her daughter. over the course of her admission, she became remarkably weak and dependent for her activities of daily living, in addition to being dialysis dependent. after extensive discussion with her family, she was transitioned to comfort care and the plan was for her to be sent home with hospice. prior to discharge, she was noted to be in more respiratory distress, with shallow respirations. removal of her central line was required before discharge, and in discussion with the family about the risks of taking the patient off the floor for the procedure, it was determined that the goal of getting the patient home was worth the risk. while in the ir suite, the patient expired. medications on admission: medications at home: (taken from admission h&p) valsartan 320mg po daily asa 81mg po daily hydralazine 100mg po tid hctz 25mg po daily simvastatin 20mg po daily metoprolol 25mg po bid citalopram 10mg po daily (started ) ferrous sulfate 325mg (65mg iron) tab just d/c'ed recently by pcp discharge disposition: home with service facility: hospice discharge diagnosis: 1. hydralazine related pauci-immune glomerulonephritis 2. acute renal failure requiring hemodialysis 3. gi bleeding 4. diffuse alveolar hemorrhage 5. heparin induced thrombocytopenia 6. dysphagia discharge condition: expired discharge instructions: procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube hemodialysis venous catheterization for renal dialysis venous catheterization for renal dialysis other bronchoscopy closed [percutaneous] [needle] biopsy of kidney incision with removal of foreign body or device from skin and subcutaneous tissue therapeutic plasmapheresis injection or infusion of biological response modifier [brm] as an antineoplastic agent diagnoses: anemia in chronic kidney disease end stage renal disease pure hypercholesterolemia urinary tract infection, site not specified acute posthemorrhagic anemia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease acute respiratory failure other antihypertensive agents causing adverse effects in therapeutic use hypoxemia hemorrhage of gastrointestinal tract, unspecified other and unspecified coagulation defects delirium due to conditions classified elsewhere nephritis and nephropathy, not specified as acute or chronic, with other specified pathological lesion in kidney hip joint replacement heparin-induced thrombocytopenia (hit) acute edema of lung, unspecified arteritis, unspecified acute kidney failure with other specified pathological lesion in kidney microscopic hematuria 

Answer: The patient is high likely exposed to