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: seizure major surgical or invasive procedure: intubation/extubation, mechanical ventilation central venous line placement history of present illness: 67 y/o f dm1, ckd, hyperlipidemia who presents with acute onset seizure. patient presented to ed to be evaluated for nausea, vomiting, diarrhea felt to be secondary gastroenteritis. during her ed course patient became less responsive (oriented to name only) and started seizing (fingerstick 297). per report her gaze was deviated and left arm shaking. patient recieved 4 mg ativan total and eventaully seizure broke. however during this time she was intubated to protect her airway. prior to seizure patient was recieving ciprofloxacin for ? pyelonephritis, however per report only received several minutes worth. evalauted who recommended mri, eeg and felt this could be secondary to infection versus pres. initial vs were: t 95.6 p 45 bp 243/88 r 18 o2 sat 99 ra. patient's blood pressure ranged from 136/49-231/88). past medical history: 1. sciatica with h/o laminectomy. 2. dm1 for 36 years, on insulin pump, with gastroparesis, ckd, peripheral neuropathy 3. hypercholesterolemia 4. h/o cp in , cardiac cath clean - sx's felt to be ?spasms, recent wnl 5. htn 6. hiatal hernia 7. s/p hysterectomy 8. hypothyroidism 9. autonomic dysfunction 10.ckd ii, baseline creat 1.3-1.5 11.pad s/p recent fem-tib bypass rle 12. depression 13. dvt 14. esophagus egd 15. orthostatic hypotension secondary to autonomic dysfunction 16. pvd social history: per omr as patient intubated on arrival home: lives with husband occupation: retired secretary tobacco: quit smoking in , previously with 60-80 ppy history (1.5-2ppd x 40 years) etoh: denies drugs: denies family history: mother - coronary artery disease with mi in her 50s, died at age 84 father - coronary artery disease with mi in her 60s, died at age 82 physical exam: general: sedated, moves limbs spontaneously, withdraws to pain, intermittently squeezes hand to voice. heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: pupils 2mm b/l and reactive to light. moves all limbs spontanenously. dtr patella +. toes downgoing, left toes neither direction. pertinent results: ct head w/o contrast study date of : no acute intracranial hemorrhage or large infarct. if there is suspicion for other acute intracranial processes, mr can be ordered. . ct abdomen/pelvis : bilateral perinephric stranding without renal perfusion abnormality. markedly distended urinary bladder. correlation with ua is recommended.. . cxr : no acute intrathoracic process. . ekg: normal axis. hr 76. lateral changes most likely secondary to lvh. . trop-t: <0.01, ck 60 . 135 95 24 372 agap=23 4.2 21 1.1 . pt: 12.8 inr: 1.1 . 88 8.5 > 13.6 < 198 41.0 n:93.2 l:3.2 m:2.9 e:0.5 bas:0.2 . serum tox negative, urine pos for benzos otherwise neg . eeg: pending . mri head: pending final read. prelim read - no acute intracranial processes brief hospital course: 67 y/o f dm1, ckd, hyperlipidemia who presents with diarrhea, vomiting and developed witnessed seizure in ed. . # peripheral disease - pt was a known patient of dr. and was seen by the team after admission. she was noted to have resting pain in her lower extremities and was worked up for this issue. noninvasive studies were c/w peripheral disease and the patient was taken to the angio suite where she underwent angiography and balloon angioplasty of her previously existing graft. she tolerated the procedure and recovered from anesthesia without complication. she was observed postoperatively and was discharged to home with a creatinine of 1.0 . # seizure: no prior history per omr or family. unlikely to be secondary to electrolyte abnormalities (na normal on admission) and hypoglycemia (glucose normal). less likely to be alcohol withdrawal or illicit medications as no prior history and serum/urine toxicology essential normal. patient recently suffering from gastroenteritis, certain viral etiologies can infect csf and result in menigitis. other etiologies on the differential include structural mass or cva but ct head and mri head were within normal limits. eeg (24 hour) was performed, per recs, which showed preliminarily no seizure activity, positive encephalopathy. lumbar puncture was performed which was negative for meningitis. patient's citalopram, gabapentin, lorazepam, reglan and chantix were initially held for possibility of lowering seizure threshold. they were slowly added back, starting with gabapentin and reglan as patient clinically improved. . # diarrhea, vomiting: most likely gastroenteritis. however based on cad/dm history patient was ruled out for inferior mi and ekgs within normal limits. . # hypertension: seizure could be result of pres (posterior reversible encephalopathy syndrome). htn as outpatient significantly lower, sbp100-154. patient's bp dropped from 230 to 130 in ed following propofol. once extubated, patient's blood pressures climbed to sbp180s which, per patient, is her baseline. she was resumed on her home lisinopril 10mg daily and given hydralazine 10mg iv as needed while in the micu for management of her blood pressures. . # chronic pain: gave iv morphine during micu stay. of note, has pcp in , who rx's 40 mg qam, 10 mg qpm & oxyocodone 5-10 mg daily prn. restarted patient on 10 mg with good effect . # dm1: continued on long acting glargine and insulin sliding scale, recs. . # hypercholesterolemia: simvastatin 40 mg qpm . # hypothyroid: continued levothyroxine. . # ckd: creatinine around baseline 1.2-1.5. . # depression: hold meds that decrease seizure threshold. . # autonomic orthostatic hypotension: nacl 2 gram was discontinued in setting of hypertension. . # code: full . medications on admission: calcitriol 0.5 mcg capsule(s) by mouth once a day citalopram 40 mg tablet 1 (one) tablet(s) by mouth once a day clopidogrel 75 mg tablet 1 tablet(s) by mouth once a day cyclosporine 0.05 % dropperette 2 drops to both eyes twice a day erythromycin 5 mg/gram ointment apply to both eyes gabapentin 800 mg tablet 1 tablet(s) by mouth qam insulin glargine 100 unit/ml solution 12 units at bedtime insulin lispro 100 unit/ml cartridge on insulin pump basal rate; 12am-4am 0.25 units hr 4a 0.15 units hr 5a 0.60 unit hr 8am 0.70 unit hr 8pm 0.50 unit hr 10pm 0.40 unit hr levothyroxine 75 mcg tablet 1 tablet(s) by mouth daily lorazepam 0.5 mg tablet 1 tablet(s) by mouth qpm metoclopramide 10 mg tablet 1 (one) tablet(s) by mouth 30 minutes before meals oxycodone 5 mg tablet tablet(s) by mouth daily as needed for pain oxycodone 10 mg tablet sustained release 12 hr 4 tablet(s) by mouth in the morning and 1 tab by mouth in the evening pantoprazole 40 mg tablet, delayed release (e.c.) 1 tablet(s) by mouth once a day simvastatin 40 mg tablet 1 tablet(s) by mouth qpm chantix 81mg calcium carbonate 1500 mg qd vitamin b12, folate mvi fish oil nacl 2 gram . allergies: codeine discharge medications: 1. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. levothyroxine 75 mcg tablet sig: one (1) tablet po daily (daily). disp:*qs tablet(s)* refills:*2* 3. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*qs tablet(s)* refills:*2* 4. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). disp:*30 tablet, chewable(s)* refills:*2* 5. citalopram 20 mg tablet sig: two (2) tablet po daily (daily). disp:*qs tablet(s)* refills:*2* 6. omega-3 fatty acids capsule sig: one (1) capsule po daily (daily). disp:*qs capsule(s)* refills:*2* 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*qs tablet, delayed release (e.c.)(s)* refills:*2* 8. calcium carbonate 500 mg tablet, chewable sig: three (3) tablet, chewable po daily (daily). disp:*qs tablet, chewable(s)* refills:*2* 9. multivitamin tablet sig: one (1) tablet po daily (daily). disp:*qs tablet(s)* refills:*2* 10. metoclopramide 10 mg tablet sig: one (1) tablet po qidachs (4 times a day (before meals and at bedtime)). disp:*qs tablet(s)* refills:*2* 11. calcitriol 0.25 mcg capsule sig: one (1) capsule po daily (daily). disp:*qs capsule(s)* refills:*2* 12. cyanocobalamin 500 mcg tablet sig: two (2) tablet po daily (daily). disp:*qs tablet(s)* refills:*2* 13. oxycodone 10 mg tablet sustained release 12 hr sig: one (1) tablet sustained release 12 hr po qhs (once a day (at bedtime)). disp:*qs tablet sustained release 12 hr(s)* refills:*2* 14. oxycodone 10 mg tablet sustained release 12 hr sig: two (2) tablet sustained release 12 hr po qam (once a day (in the morning)). disp:*qs tablet sustained release 12 hr(s)* refills:*2* 15. gabapentin 400 mg capsule sig: two (2) capsule po qam (once a day (in the morning)). disp:*qs capsule(s)* refills:*2* 16. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*qs tablet(s)* refills:*2* 17. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). disp:*qs tablet(s)* refills:*2* 18. miconazole nitrate 2 % cream sig: one (1) appl topical (2 times a day). disp:*qs * refills:*2* 19. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). disp:*qs tablet(s)* refills:*2* 20. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*qs capsule(s)* refills:*2* 21. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*qs tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: peripheral disease claudication discharge condition: mental status:clear and coherent level of consciousness:alert and interactive activity status:ambulatory - independent discharge instructions: division of and endovascular surgery lower extremity bypass surgery discharge instructions what to expect when you go home: 1. it is normal to feel tired, this will last for 4-6 weeks ?????? you should get up out of bed every day and gradually increase your activity each day ?????? unless you were told not to bear any weight on operative foot: you may walk and you may go up and down stairs ?????? increase your activities as you can tolerate- do not do too much right away! 2. it is normal to have swelling of the leg you were operated on: ?????? elevate your leg above the level of your heart (use pillows or a recliner) every 2-3 hours throughout the day and at night ?????? avoid prolonged periods of standing or sitting without your legs elevated 3. it is normal to have a decreased appetite, your appetite will return with time ?????? you will probably lose your taste for food and lose some weight ?????? eat small frequent meals ?????? it is important to eat nutritious food options (high fiber, lean meats, vegetables/fruits, low fat, low cholesterol) to maintain your strength and assist in wound healing ?????? to avoid constipation: eat a high fiber diet and use stool softener while taking pain medication what activities you can and cannot do: ?????? no driving until post-op visit and you are no longer taking pain medications ?????? unless you were told not to bear any weight on operative foot: ?????? you should get up every day, get dressed and walk ?????? you should gradually increase your activity ?????? you may up and down stairs, go outside and/or ride in a car ?????? increase your activities as you can tolerate- do not do too much right away! ?????? no heavy lifting, pushing or pulling (greater than 5 pounds) until your post op visit ?????? you may shower (unless you have stitches or foot incisions) no direct spray on incision, let the soapy water run over incision, rinse and pat dry ?????? your incision may be left uncovered, unless you have small amounts of drainage from the wound, then place a dry dressing over the area that is draining, as needed ?????? take all the medications you were taking before surgery, unless otherwise directed ?????? take one full strength (325mg) enteric coated aspirin daily, unless otherwise directed ?????? call and schedule an appointment to be seen in 2 weeks for staple/suture removal what to report to office: ?????? redness that extends away from your incision ?????? a sudden increase in pain that is not controlled with pain medication ?????? a sudden change in the ability to move or use your leg or the ability to feel your leg ?????? temperature greater than 100.5f for 24 hours ?????? bleeding, new or increased drainage from incision or white, yellow or green drainage from incisions followup instructions: provider: , dpm phone: date/time: 9:50 provider: lab phone: date/time: 2:30 provider: , md phone: date/time: 3:30 please also make an appointment with your primary care provider to follow your blood pressure in the next 1-2 weeks. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube angioplasty of other non-coronary vessel(s) arteriography of femoral and other lower extremity arteries procedure on single vessel diagnoses: other and unspecified noninfectious gastroenteritis and colitis pure hypercholesterolemia acute kidney failure, unspecified unspecified acquired hypothyroidism hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified other convulsions atherosclerosis of native arteries of the extremities with rest pain diabetes with peripheral circulatory disorders, type i [juvenile type], not stated as uncontrolled diabetes with neurological manifestations, type i [juvenile type], not stated as uncontrolled gastroparesis orthostatic hypotension chronic kidney disease, stage ii (mild) peripheral autonomic neuropathy in disorders classified elsewhere 

Answer: The patient is high likely exposed to