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: history of present illness: the patient is a 31-year-old man with history of diabetes for about six years, who presented with nausea and vomiting. the patient states that he was in his usual state of health until the morning prior to admission when he woke up and had nausea and vomiting. he continued to have extensive vomiting throughout the rest of the day stating he vomited approximately 20 times. he had mild improvement by the evening prior to admission, however, upon awaking on the day of admission, he again had severe nausea and vomiting. he is unable to take any p.o. foods or liquids. he also stated that his vomitus had coffee ground-like material in it. he denies any bright red blood in the vomitus. the patient denies any use of drugs or alcohol several days prior to these symptoms. he denies any unusual foods. he denies any recent travel. he also denies any abdominal pain or diarrhea. patient states that since he started vomiting, he has had a very bad sore throat. he denies any cough or shortness of breath. he states that he has been taking his insulin regularly. he states that he only checks his fingersticks every other day or so, and has not checked it since the nausea and vomiting began. the patient states that he does not regularly see a doctor nor he does he have regular followup for his diabetes. he denies any complications of diabetes except for erectile dysfunction. he denies any numbness or tingling in the extremities. he denies any visual changes. past medical history: 1. diabetes mellitus type 1 (diagnosed approximately six years ago). patient is on stable insulin regimen as below. he has no known complications, although he does complain of erectile dysfunction currently. 2. lyme's disease: diagnosed six years ago and treated. patient presented with arthritis symptoms. 3. attention-deficit disorder. 4. history of oral herpes ulcers. medications on admission: 1. insulin: 8 units of nph and 8 units of regular before breakfast and before dinner. 2. ritalin 20 mg q.d. allergies: no known drug allergies. social history: the patient works as a fisherman and lives in . he smokes approximately cigarettes per week and has been doing so for five years. he drinks alcohol only occasionally on the weekends. he has occasional marijuana use. the patient is heterosexual and is in a monogamous relationship. he does have a history of unprotected sexual intercourse. family history: noncontributory. physical exam on admission: vital signs: temperature 100.1, blood pressure 121/54, pulse 112, respiratory rate 24, and o2 saturation is 100% on room air. in general, the patient is a middle-age man in no apparent distress. is well appearing. heent exam is significant for erythema in the oropharynx with dry mucous membranes. pupils are equal, round, and reactive to light. sclerae are anicteric and noninjected. tympanic membrane examination: cerumen was noted in the left ear canal with clear right ear canal. lung exam was clear to auscultation bilaterally. heart exam showed tachycardia with a regular rate, normal s1, s2 and no murmurs. abdomen was benign. the patient had emesis, which was gastroccult positive. extremities showed no edema with good distal pulses. neurologic exam was intact. rectal exam showed no stool in the vault with normal prostate and normal rectal tone. laboratories on admission: cbc showed a white count of 36 with a differential of 81% neutrophils, 2% bands, and 12% lymphocytes, hematocrit was 47.9, platelets 561. chem-7 notable for a sodium of 141, potassium 5.8, chloride of 93, bicarbonate of 9, bun of 23, and creatinine of 1.6 with a glucose of 730. the anion gap was 39. arterial blood gas was 7.09/19/158. coagulation studies were within normal limits. lactate was 4.6. free calcium was 1.2. chest x-ray did not show any acute processes. ekg showed normal sinus rhythm at 111 beats per minute with normal axis and normal intervals with no st-t wave changes. summary of hospital course by issue: 1. diabetic ketoacidosis: the patient was admitted with a diagnosis of diabetic ketoacidosis. he was admitted to the icu. he was given extensive iv fluid hydration with normal saline. he was also started on insulin drip with q.1h. fingersticks. once his blood glucose went below 200, insulin drip and hydration, patient's iv fluids were changed to d5 normal saline to prevent hypoglycemia as he was continued on insulin drip. the exact etiology of the patient's diabetic ketoacidosis was unclear. has no severe infection. however, he did have question of gastroenteritis, and as stated below, he has possibility of candidal esophagitis, although this would not be expected to cause him to go into diabetic ketoacidosis. cultures did not show any evidence of infection. patient received his insulin drip for approximately 24 hours. at that point, his anion gap was closed. after he began to eat, the insulin drip was shut off, and the patient was placed on a standing regimen of insulin. the initial regimen was nph in the morning and evening with the sliding scale of regular insulin. this was suggested after the patient was called out of the icu and put on the regular floor. initially the patient had elevated blood sugars in the 200s. however, his insulin regimen was increased giving him 34 units of nph in the morning with 10 units of regular and 15 units of nph with 8 units of regular before dinner. on this regimen, the patient's blood sugars were well controlled in the low 100's even after he resumed a somewhat normal diet. the patient's anion gap remained closed during the rest of the hospitalization. in terms of general diabetes management, the patient was consulted by nutrition for diabetic diet teaching. he was also counseled by his physicians on the importance of tight blood sugar control and close followup with his outpatient primary care provider. 2. upper gi bleed: the patient had evidence of upper gi bleed given coffee-ground emesis and gastroccult-positive emesis. gi was consulted, and an egd was performed. the egd showed erosive esophagitis with possibility of candidal esophagitis. there was also evidence of gastritis in the fundus and stomach body. the patient's hematocrit remained stable during the hospital admission. his candidal esophagitis was treated with three days of fluconazole and nystatin swish and swallow. he continued to have significant pharyngeal pain upon swallowing either liquids or solids. this was thought to be due to a combination of erosive esophagitis from extensive emesis that he had several days prior to admission and the candidal esophagitis. the patient received minimal relief with viscus lidocaine or nystatin. he was therefore put on iv morphine so that he could eat, and his blood sugars could be better stabilized. prior to discharge, he was transitioned over to p.o. morphine and tolerated this well. he was discharged with p.o. narcotics with continued pain management so that he can eat regularly. it was expected that his symptoms of pain would resolve on its own as his esophagitis resolves. 3. acute renal failure: patient's acute renal failure was thought to be due to hypovolemia from his diabetic ketoacidosis. once he was volume repleted with iv fluids, his creatinine returned to baseline. 4. nutrition: as stated above, the patient had a nutrition consult for diabetic diet teaching. because of his odynophagia, he was placed on a diet of puree solids and diabetic shakes. he tolerated this well reasonably well when he was taking pain medication. 5. candidal esophagitis: the patient was treated for candidal esophagitis as stated above with fluconazole and nystatin swish and swallow. though it was possible that patient's candidal esophagitis was secondary to poorly controlled diabetes, there is also concern for hiv especially the potential etiology for the diabetic ketoacidosis. patient also wished to have hiv testing even though he was low risk. hiv antibody was sent and was negative. patient was given post-test counseling, and advised that if he feels that he is at risk, then he should be tested. 6. code status: patient was full code on admission and at discharge. discharge status: the patient was discharged to home. discharge condition: patient is in good condition. he is afebrile, stable and tolerating p.o. discharge diagnoses: 1. diabetic ketoacidosis. 2. diabetes mellitus type 1. 3. candidal esophagitis. 4. acute renal failure. discharge medications: 1. nystatin swish and swallow 5 ml p.o. t.i.d. for three more days after discharge. 2. protonix 40 mg p.o. q.d. 3. insulin nph 34 units in the morning and 15 units in the p.m. before breakfast and dinner. 4. insulin regular 10 units before breakfast and 8 units before dinner. 5. vicodin 5-500 mg tablet one tablet one p.o. q.4-6h. as needed for pain for seven days. 6. insulin syringe. 7. lancets. 8. test strips. discharge instructions and follow-up plans: patient was instructed to adhere to a strict diabetic diet. is recommended that he continue to take soft puree solids until his odynophagia improves. he was instructed to call his doctor or return to the hospital if he is unable to eat and take fluids. with regards to his insulin regimen, the patient was instructed to check his blood sugars by fingerstick at least 4x a day before meals and at bedtime, occasionally after meals. he was told to do this vigorously for approximately two weeks and then his diabetic control could be reassessed when he visits his pcp. patient was aware of symptoms he gets before becoming hypoglycemic and is aware that he needs to take juice if he does have these symptoms. the patient will follow up with his new primary care provider, . at . he is instructed to call to make an appointment at the first available date. he will be referred to the diabetes center by his pcp. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified other endoscopy of small intestine diagnoses: tobacco use disorder acute kidney failure, unspecified diabetes with ketoacidosis, type i [juvenile type], not stated as uncontrolled hemorrhage of gastrointestinal tract, unspecified candidal esophagitis lyme disease arthropathy associated with other infectious and parasitic diseases, site unspecified attention deficit disorder without mention of hyperactivity 

Answer: The patient is high likely exposed to