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: penicillins attending: chief complaint: seizures elevated blood pressures major surgical or invasive procedure: none history of present illness: the patient is a 20 year old female with h/o esrd secondary to sle. she is currently on hd through a l ij tunnelled catheter on mwf @ . she was dialysed on the day of admission and at the end of dialysis her her post hd bp was 230-240s and she also experienced a bitemporal headache with blurry vision. also, she described transient cp sensation for 1 minute at hd. . in ed she was noted to have sbp to 250s and was given phentolamine x2, clonopine po and patch, hydralazine with minimal effect. a ct head showed no evidence of bleed. a nipride gtt was started with some effect with sbp falling transiently to 190. . on arrival to micu, pt was switched to labetalol gtt out of concern for potential toxicity on nipride. labetalol was effective initially but pt did have sbp to 230. pt had witnessed, tonic clonic seizure for 30 seconds with + tongue biting and spontaneous resolution + post-ictal state. pt had repeat head ct negative and neuro eval who found pt neurologically intact and recommended holding on dilantin and getting mr head with gad in am to r/o posterior leukoencephalopathy . pt had second seizure lasting 2-3 minutes and was given 2mg iv ativan with good effect. dilantin iv 1gm load given. additional labs returned with phos at 1.1 so po and iv repletion started. * past medical history: esrd lupus on hd since through left tunneled cath sle htn- with hx hypertensive crisis hocm hx ttp pregnancy termination in ttp social history: lives with mom and 14 year old brother occasional etoh, no tobacco, heroin, cocaine family history: aunts with hypertension grandmother died of myeloma several men with prostate cancer physical exam: t 95.7 hr 93-110 bp 185-234/100-155 rr11-20 o2 sat 99-100% gen: sleeping in bed, nad, easily arousable neck: supple, normal rom, no thyromegaly, no bruit cv: rrr, nl s1 and s2, 2/6 sem lung: clear to auscultation bilaterally abd: +bs, soft, nontender ext: no edema neurologic examination: mental status: awake and alert, cooperative with exam. oriented to person, place, and date. she has mild attention problems, can say backwards-but takes several attempts and made one mistake on last try. speech is fluent with normal comprehension and repetition; naming intact. no dysarthria. registers , recalls at 5min. no evidence of apraxia or neglect fundus exam: no papilledema and no retinal hemorrhages bilaterally. cn ii-xii symmetrical and intact motor: normal bulk bilaterally. tone normal. no observed myoclonus or tremor tri wf we fe ff ip h q df pf te tf r 5 5 5 5 5 5 5 5 5 5 5 5 5 5 l 5 5 5 5 5 5 5 5 5 5 5 5 5 5 sensation: intact to light touch, pinprick, vibration and proprioception throughout. reflexes: b t br pa ach right 2 2 2 2 2 left 2 2 2 2 2 grasp reflex absent toes were downgoing bilaterally coordination: normal on finger-nose-finger, heel to shin pertinent results: 08:44pm pt-14.8* ptt-40.3* inr(pt)-1.4 05:27pm pt-14.1* ptt-150 is hig inr(pt)-1.3 11:40am glucose-94 urea n-16 creat-3.9* sodium-141 potassium-3.9 chloride-95* total co2-32* anion gap-18 11:40am ck(cpk)-97 11:40am ck-mb-4 ctropnt-0.02* 11:40am hcg-<5 11:40am asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 11:40am wbc-6.0 rbc-5.15 hgb-15.7 hct-47.8 mcv-93 mch-30.5 mchc-32.8 rdw-17.8* 11:40am neuts-75.7* lymphs-18.0 monos-5.1 eos-0.6 basos-0.6 11:40am hypochrom-1+ anisocyt-1+ macrocyt-1+ 11:40am plt count-141* * admission head ct: impression: no evidence of acute intracranial hemorrhage or mass effect. * admission chest x ray: no abnormalities * ecg: sinus tachycardia with slowing of the rate as compared to the previous tracing of . biatrial enlargement and new t wave inversion in lead avl with dissociated st-t wave flattening in lead i. * head mri: abnormal t2 and flair signal within both occipital and parietal lobes in a pattern suggestive of posterior reversible encephalopathy syndrome * knee x ray: normal l knee. brief hospital course: a/p 20 yo f with esrd on hd who p/w hypertensive crisis and has new onset seizure . 1) hypertensive emergency her blood pressure was controlled with a labetaolol drip and she was then transitioned to po labetalol. she was also continued on the clonidine patch. in light of her complaints of chest pain we were reassured by her ecg and by her flat cardiac enzymes. . 2) new onset seizure we thought that her new onset seizures were probably due to her severely elevated blood pressure but other diagnoses including lupus cerbritis were also considered. an mri with gadolinium was obtained. it demonstrated abnormal t2 and flair signal within both occipital and parietal lobes in a pattern suggestive of posterior reversible encephalopathy syndrome. we consulted the rheumatology service who thought that her presentation was more consistent with hypertensive encephalopathy rather lupus cerebritis. she was loaded with dilantin. with dilantin loading and control of her blood pressure she did not have a recurrence of her seizures. . 3) lupus: she was continued on her plaquenil and prednisone. . 4) esrd she continued to receive regulary scheduled hemodialysis. . 5) knee pain: on the day of discharge the patient complained of l knee pain. on physical exam she was afebrile, the knee was slightly warm and tender to the touch without obvious effusion. an x ray of the knee was read as normal. she had full range of motion but it was painful but she was able to bear weight on it. she was instructed to use tylenol prn for pain and to return o the clinic or emergency room should she develop worsening knee pain, fevers or chills. . communicaton: the patient and the patient's mother were extensively counselled about the patient's disease. she demonstrated an understanding of the importance of good medical compliance with therapy and keeping appointments. medications on admission: 1. clonidine tts 1 patch 1 ptch td qwed started in ed 2. folic acid 1 mg po daily 3. heparin 5000 unit sc tid 4. prednisone 10 mg po daily 5. hydroxychloroquine sulfate 200 mg po bid 6. labetalol hcl 200 mg po tid start: in am wean labetalol gtt as tolerated, hold for sbp<150 7. lisinopril 40 mg po daily start: in am order date: @ 1712 discharge medications: 1. hydroxychloroquine sulfate 200 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 2. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. lidocaine-aloe 0.5 % gel sig: appl topical every six (6) hours as needed for pain. disp:*1 vial* refills:*0* 4. prednisone 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. clonidine hcl 0.1 mg/24 hr patch weekly sig: one (1) patch weekly transdermal qthur (every thursday). disp:*10 patch weekly(s)* refills:*2* 6. levetiracetam 250 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 7. labetalol hcl 200 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 8. lisinopril 20 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 9. naproxen 500 mg tablet sig: one (1) tablet po three times a day as needed for pain. disp:*20 tablet(s)* refills:*0* 10. protonix 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* discharge disposition: home discharge diagnosis: primary hypertensive encephalopathy and new onset seizures lupus nephritis end stage renal disease on hemodialysis secondary: h/o thrombotic thrombocytopenic purpura. discharge condition: good, without headaches or blurry vision, blood pressure well controlled and at her baseline. discharge instructions: please take all of your medications as prescribed. please attend all of your follow up appointments. as we discussed it is extremely important that you take all of your blood pressure medications as instructed. * please return to the emergency room of your pcp's office if you have severe headache, blurry or worsening vision or seizures. * it is crucial to your health that you attend all of your follow up appointments!!!! * please return to the emergency room or your pcp's office or office at if you experience worse knee pain, swelling, fevers or chills. followup instructions: provider: , md where: lm center phone: date/time: 11:20 provider: , md where: dermatology phone: date/time: 1:45 provider: , .d., ph.d.: medical specialties phone: date/time: 10:00 test for consideration post-discharge: beta-2 microglobulin. please call for a follow up appointmnt with neurology in months. please call dr. at for an appointment in 10 days. md procedure: hemodialysis diagnoses: systemic lupus erythematosus anemia, unspecified other convulsions hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease hypertensive encephalopathy 

Answer: The patient is high likely exposed to