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: patient recorded as having no known allergies to drugs attending: chief complaint: mental status changes hypoglycemia major surgical or invasive procedure: lumbar puncture history of present illness: 56yo rh m h/o alcoholic cirrhosis, diabetes, chronic renal insufficiency p/w hypoglycemia and ams. pt was in usoh till last night. his wife heard him moaning at 2 am. ems was called. his fsg was 30. he recived d50 and fsg went up to 130. he was confused and delirious and was taken to the ed. . in the ed he was founbd to have fever to 101 and was delirious and agitated. his head ct was neg for acute ic process. he underwent lp under conscious sedation. neuro was consulted. he received ctx 2g x 1 and acyclovir 750 mg x 1. ua was neg and cxr showed lll opacity concerning for pna. . his wife reports that he had a episode of hypoglycemia at the time of when he also had a seizure-like activity with it. however at that time his ms to baseline quickly. also she notes that he has coughing on and off for past few days, sometimes bringing up mucus. . ros (per his wife): no night sweats or recent weight loss or gain. denied 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. denied arthralgias or myalgias. denied rash. past medical history: dm with unspecified complication type 2 - type w many complications retinopathy, neuropathy diabetes type: 2 years w/ dm: 4 age of diag: 52 year diag: how diag: classic symptoms patient treats diabetes with: - insulin. patient is on the sliding level insulin plan. alcoholic cirrhosis of liver hyperparathyroidism, secondary, of renal origin joint pain, shoulder gi bleeding alcohol abuse psych factors associated with dm anemia of end stage renal disease awaits renal-liver transplant impotence, organic origin hypofunction, testicular nec chronic kidney disease, stage 3 microalbuminuria hypertension, benign essential social history: on disability. quit etoh 4yrs ago. wife does not know of any illicit drug use. family history: mother/father had diabetes physical exam: vs: 97.6 138/70 89 16 100%/ra gen awake, nad heent nc/at, no scleral icterus noted, mmm, no lesions noted in oropharynx neck supple, no carotid bruits appreciated. no nuchal rigidity lungs cta bilaterally cv rrr, nl s1s2, no m/r/g noted abd soft, nt/nd, normoactive bowel sounds, no masses or organomegaly noted. tympanic ext no c/c/e b/l skin no rashes or lesions noted pertinent results: 06:45am blood wbc-5.5 rbc-3.06* hgb-8.8* hct-27.1* mcv-89 mch-28.8 mchc-32.5 rdw-13.5 plt ct-133* 03:31am blood wbc-5.5 rbc-2.95* hgb-8.6* hct-26.1* mcv-88 mch-29.2 mchc-33.1 rdw-13.6 plt ct-119* 04:27am blood wbc-6.3# rbc-3.86* hgb-11.0* hct-33.9* mcv-88 mch-28.5 mchc-32.5 rdw-14.0 plt ct-187 10:20am blood neuts-81.2* bands-0 lymphs-12.7* monos-5.4 eos-0.6 baso-0.1 12:16pm blood pt-14.7* ptt-37.2* inr(pt)-1.3* 06:45am blood glucose-111* urean-13 creat-1.9* na-138 k-4.1 cl-105 hco3-27 angap-10 04:27am blood glucose-110* urean-19 creat-2.2* na-137 k-4.3 cl-101 hco3-26 angap-14 12:16pm blood alt-16 ast-33 ld(ldh)-152 alkphos-82 amylase-124* totbili-0.3 04:27am blood alt-23 ast-39 alkphos-118* amylase-189* totbili-0.7 06:45am blood calcium-8.6 phos-2.9 mg-2.1 12:16pm blood albumin-3.4 calcium-7.8* phos-2.5* mg-3.6* iron-66 12:16pm blood caltibc-241* vitb12-354 folate-greater th ferritn-157 trf-185* 03:31am blood %hba1c-5.8 04:29am blood ammonia-40 04:27am blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 06:14pm blood lactate-1.6 10:24am blood lactate-2.3* 06:17pm urine color-straw appear-clear sp -1.002 06:17pm urine blood-sm nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-5.0 leuks-neg 10:18pm urine color-yellow appear-clear sp -1.011 10:18pm urine blood-mod nitrite-neg protein-tr glucose-neg ketone-neg bilirub-neg urobiln-neg ph-5.0 leuks-neg 10:18pm urine rbc-88* wbc-1 bacteri-none yeast-none epi-<1 /hpf 10:18pm urine mucous-rare 05:50am urine color-straw appear-clear sp -1.005 05:50am urine rbc-0 wbc-0 bacteri-none yeast-none epi-0 05:50am urine 05:50am urine bnzodzp-neg barbitr-neg opiates-neg cocaine-neg amphetm-neg mthdone-neg 10:00am cerebrospinal fluid (csf) wbc-1 rbc-0 polys-76 lymphs-8 monos-16 10:00am cerebrospinal fluid (csf) totprot-30 glucose-70 10:00am cerebrospinal fluid (csf) herpes simplex virus pcr-pnd blood and urine culture neg to date. csf cultures neg to date. us findings: limited survey of the four quadrants of the abdomen demonstrates no intra-abdominal ascites. incidental note is made of an echogenic liver echotexture and cholelithiasis, which was also present on previous study. impression: no intra-abdominal ascites. cxr: findings: a single portable radiograph is available for review. lung volumes are slightly decreased when compared to previous. fullness within the hilar regions bilaterally is believed secondary to low lung volumes and vascular crowding. there is a subtle opacity within the left lung base. no effusion or pneumothorax is identified. impression: suble opacity in the left lung base which may represent focal atelectasis however correlation with pa and lateral radiographs recommended. otherwise, no acute cardiopulmonary process is detected. noncontrast head ct: multiple attempts were made, however, the patient was not able lie still and various parts of scan are limited by motion. within the limitations, there is no evidence of acute intracranial hemorrhage or major vascular territorial infarct. the ventricles are normal in size and configuration. there are no extra-axial fluid collections. no calvarial fractures identified. there is complete opacification of the right maxillary sinus with mild thickening of the underlying bone, suggesting chronic sinusitis. impression: 1. limited study due to motion. no evidence of acute intracranial hemorrhage or major vascular territorial infarct. 2. chronic right maxillary sinusitis. cxr: findings: in comparison to the previous examination of , there is no relevant change. the pre-existing very subtle parenchymal opacity at the left lateral lung base is slightly smaller than on the previous examination. the lack of contour loss of the left hemidiaphragm, not the left heart border, makes an inflammatory opacity unlikely. no pleural effusion. no signs of fluid overload, no other suspicious pulmonary opacities. the size of the cardiac silhouette is within the upper range of normal, with an accentuated left heart border. impression: in comparison to , there is slight decrease in subtle left- sided opacity. configuration and morphology of this opacity, however, make an inflammatory etiology unlikely. accentuated left heart border. brief hospital course: # h/o dm type 2 / hypoglycemia: from poor po intake from missing dentures. now resolved as her started eating. follow up arranged/ diabetic education provided by nutrition. continue lantus at 6 units at bedtime with humalog coverage only if sugars>200. discussed at length with patient about appropriate meals and education. vna arranged for at home for continual diabetic education. # delirium: resolved. likely related to prolonged hypoglyemia. no signs of infection on lp. did well off antibiotics. per wife, patient's mentation is at baseline. neuro folloed as well. #fever in er: no recurrence. negative culture data to date. antibiotics stopped. # ckd stage : on list for kidney transplant. on renal supplements - calcitriol and lisinopril. # alcoholic cirrhosis: on nadolol. on list for liver transplant. d/w liver team - no indication of acute encephalopathy. # anemia: has a history of varices (banded) in past. guiac neg per icu team. hematocrit stable in hospital. plan hct check with pcp next appt. patient reports he stopped taking oral iron a few weeks back which could be the reason he is now anemic. # post lp headache - resolved with conservative measures. . # thrombocytopenia: dilutional vs hypersplenism. has had low platelets in past. plan to check plts with pcp at next appt. . # hematuria: repeat ua with pcp. from foley trauma. u culture pending. # abnormal cxr: opacity since - as above. defer further evaluation to pcp. medications on admission: multivitamin once a day humalog sliding scale nadolol 40 mg once a day nortriptyline 25 mg once a day lisinopril 20 mg once a day lantus insulin 10 units once a day folic acid 1 mg daily calcitriol 0.5 mg daily amoxicillin before dental work discharge medications: 1. nadolol 20 mg tablet sig: two (2) tablet po daily (daily). 2. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 3. calcitriol 0.5 mcg capsule sig: one (1) capsule po daily (daily). 4. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 5. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 7. insulin glargine 100 unit/ml solution sig: 6 (six) units subcutaneous at bedtime. 8. multivitamin tablet sig: one (1) tablet po once a day. 9. amoxicillin 500 mg capsule sig: four (4) capsule po once: one hour before dental work as recommended by the dentist. 10. nortriptyline 25 mg capsule sig: one (1) capsule po once a day. 11. humalog 100 unit/ml solution sig: as per attached sliding scale subcutaneous four times a day. discharge disposition: home with service facility: homecare discharge diagnosis: hypoglycemia, resolved diabetes mellitus type 1, uncontrolled with complications delirium, resolved alcoholic cirrhosis chronic kidney disease stage 3 discharge condition: stable. discharge instructions: your were admitted for confulsion likely related to very low sugar levels. the low sugar was from missing a meal or eating poorly (while being on insulin). it is very important that you closely monitor your sugars and take regular meals especially since you are on insulin. keep your appointments. you also are advised to follo wup with clinic. nursing services have been set up for you at home (visiting nurses) mainly for diabetic education. return to the hospital if you notice any bleeding, confusion, sweating or other symptoms of concern to you. your platelets and hematocrit counts were low and so please discuss with your primary doctor about getting a blood work done at your visit with him. also discuss with your primary doctor about getting another urine test to look for blood. followup instructions: primary care provider: , md phone: date/time: 2:30. discuss with your primary doctor about checking a bloot test for cbc at that time. clinic: 1. with () on at 1430 hours 2. dr on at 11am provider: phone: date/time: 10:00 provider: , md phone: date/time: 10:00 provider: , md phone: date/time: 10:30 procedure: spinal tap incision of lung diagnoses: acidosis thrombocytopenia, unspecified anemia in chronic kidney disease end stage renal disease nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere alcoholic cirrhosis of liver other and unspecified alcohol dependence, in remission hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure unspecified accident injury to bladder and urethra, without mention of open wound into cavity accidents occurring in residential institution diabetes with other specified manifestations, type ii or unspecified type, uncontrolled diabetes with renal manifestations, type ii or unspecified type, uncontrolled reaction to spinal or lumbar puncture 

Answer: The patient is high likely exposed to