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: hypoxia, volume overload major surgical or invasive procedure: hemodialysis history of present illness: 43 yo m with iddm, esrd on hd, poorly controlled htn, h/o numerous admissions for l flank pain (extensive w/u neg) and for hypertensive urgency, initially presented to ed with acute on chronic l flank pain, epigastric pain, and "chest tightness"/sob. he also reported cough productive of green sputum x 2 days, as well as nausea/vomiting and not being able to tolerate po's since the evening of presentation. he had not missed any hd treatments. . ed: initial vitals t 97.9, hr 91, bp 203/99, rr 20 and o2sat 75% on ra. the patient treated for hypertensive emergency/urgency with captopril 25 mg po and started on nitro gtt. the patient became hypoxic while lying in trandelenberg for line placement with o2 sats 89-90% on ra (improved with few liters of nc). the patient continued to be tachypneic with rr in 20's and was placed on bipap briefly in the ed. he also received morphine sulfate for flank pain, ondansetron, furosemide 40mg iv. rej was placed for access, because no other access could be obtained. ces trop baseline 0.21, ck 564. mbi wnl. also hyperkalemic to 6.7. renal recommended dialysis overnight. . ros: on the ros, pt c/o ha that strated after presentation to the ed. no vision changes. no fever/chills. no contacts at home. no urinary symptoms (making small amount of urine) or bowel habits changes. past medical history: 1. dm1 x 17 years, hba1c 7.0 2. esrd, on hd t,th,sa at dialysis 3. htn, poorly controlled 4. r foot operation - bone excision 5. r foot ulcer 6. depression with h/o sa and psych hospitalizations 7. esophagitis on egd with negative h. pylori 8. h/o l flank pain since with multiple admissions and extensive work-up and no organic etiology for pain found 9. diastolic chf: lvef >55% by echo in social history: lives with mother in subsidized housing. has four children. former floor tech. no smoking, etoh, drugs. family history: diabetes in multiple relatives on both sides physical exam: vs: t 96.7; bp 202/108l hr100; rr 21; o2 sat 96% on 2l nc general: awake, tired, getting dialyzed, nad heent: anicteric sclera, perrl, op clear, mmm neck: supple, jvd about 10, r ej in place pulm: crackles bilaterally, no wheezes cv: rrr, nl s1/s2, no mrgs abd: + bs, soft, nd, (+) left flank ttp ext: wwp, 1+ le edema neuro: aando x 3, appropriate, cn 2-12 , no focal gross motor or sensory deficits. pertinent results: admission laboratories: 08:08pm wbc-6.1 rbc-4.08* hgb-11.2* hct-35.2* mcv-86 mch-27.5 mchc-31.9 rdw-16.8* plt ct-195 neuts-70.9* lymphs-20.3 monos-5.2 eos-2.4 baso-1.2 glucose-109* urean-62* creat-10.1*# na-136 k-6.7* cl-102 hco3-16* angap-25* calcium-9.1 phos-4.6* mg-2.0 alt-18 ast-20 ck(cpk)-564* alkphos-80 amylase-37 totbili-0.4 enzymes: ck-mb-16* mb indx-2.8 ctropnt-0.21* ck(cpk)-388* ck-mb-12* mb indx-3.1 ctropnt-0.24* chest (pa & lat) 9:07 pm, radiology read: there is cardiomegaly. there are markedly increased interstitial markings, with smaller more alveolar opacities at both bases. there are small bilateral effusions. findings are compatible with pulmonary edema and small pleural effusions. old films to confirm resolution after treatment is recommended. . echo (): the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef 70%). there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. compared with the findings of the prior study (images reviewed) of , the findings are similar. brief hospital course: a/p: 42m with dm1, esrd on hd, htn, presented to the ed with hypertensive crisis and sob c/w fluid overload, s/p emergent hd in the micu, subsequently called out to the floor. the following issues were investigated during this hospitalization: . # hypertension: pt. has a history of poorly controlled blood pressure and this episode was thought to be due to his inability to tolerate medications secondary to nausea/vomiting. bp improved after hd and patient was on all of his outpatient antihypertensives on discharge. . # sob. likely pulmonary edema in the setting of hypertensive urgency/emergency. pt also reported a cough productive of green sputum raising concern for pulmonary infection, but no fevers elevated wbc were observed during his hospitalization. cxr showed improvement in pleural effusion s/p hd, but could not rule out consolidation. given lack of symptoms as described, patient was not started on antibiotics. an echo performed showed no significant changes from prior. patient was also ruled out for an mi with elevated (given esrd), but stable troponins. with conitnued hd, patient had no additional complaints of shortness of . . # esrd c/b hyperkalemia: patient underwent dialysis successfully, the first emergent session notable for removal of 5 kg. he was then continued on his regular regimen of dialysis while in-house with no complications. . # mental status: patient was noted to be occasionally somnolent, which per hd staff, has occurred before. still, given his persistent somnolence, klonopin, which the patient was receiving for anxiety, was witheld with noted improvement. patient was oriented x 3, awake and alert, able to follow commands and well-related on discharge. . # dmi: patient was maintained on his outpatient regimen of nph with hiss initially, but his pm nph was decreased from 30 to 15 u given some episodes of hypoglycemia. . # depression: patient was maintained on his outpatient citalopram 20mg daily. medications on admission: (per last d/c summary): 1. lisinopril 40 mg qd 2. aspirin 325 mg qd 3. nifedipine 120 mg po qd 4. gabapentin 300 mg po qhd 5. metoclopramide 10 mg po qidachs 6. calcium acetate 667 mg 2 po tid 7. pantoprazole 40 mg qd 8. mirtazapine 15 mg po qhs 9. citalopram 20 mg po qd 10. docusate sodium 100 mg 11. metoprolol succinate 200 mg po qd 12. doxepin 50 mg po hs 13. clonazepam 0.5 mg po tid 14. lanthanum 1000 mg po tid 15. clonidine 0.2 mg/24 hr patch weekly 16. benzonatate 100 mg po tid 17. lidocaine 5 %(700 mg/patch) 18. insulin (70-30) suspension 15 units before breakfast and 10 units before dinner. 19. simethicone 80 mg po qid discharge medications: 1. lisinopril 20 mg tablet sig: two (2) tablet po daily (daily). 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 3. nifedipine 60 mg tablet sustained release sig: two (2) tablet sustained release po daily (daily). 4. gabapentin 300 mg capsule sig: one (1) capsule po qhd (each hemodialysis). 5. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 6. calcium acetate 667 mg capsule sig: two (2) capsule po tid w/meals (3 times a day with meals). 7. mirtazapine 15 mg tablet sig: one (1) tablet po hs (at bedtime). 8. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 9. metoprolol succinate 100 mg tablet sustained release 24 hr sig: two (2) tablet sustained release 24 hr po daily (daily). 10. doxepin 25 mg capsule sig: two (2) capsule po hs (at bedtime). 11. clonazepam 0.5 mg tablet sig: one (1) tablet po tid (3 times a day). 12. clonidine 0.2 mg/24 hr patch weekly sig: one (1) patch weekly transdermal qtues (every tuesday). 13. lanthanum 500 mg tablet, chewable sig: two (2) tablet, chewable po tid w/meals (3 times a day with meals). 14. metoclopramide 10 mg tablet sig: 0.5 tablet po qid (4 times a day). disp:*60 tablet(s)* refills:*2* 15. colace 100 mg capsule sig: one (1) capsule po twice a day. 16. insulin (70-30) suspension 15units before breakfast and 15 units before dinner 17. outpatient occupational therapy potassium check on please fax to: , r. md phone: fax: discharge disposition: home discharge diagnosis: hypertensive urgency/pulmonary edema discharge condition: stable discharge instructions: you were seen and evaluated for high blood pressure and fluid overload, which were thought to be due to a need for urgent hemodialysis. hemodialysis was performed successfully and you are now safe for discharge home. take all of your medications as directed. important: your insulin regimen has been changed, please take 70/30 as follows- 15units at breakfast and 15units at suppertime (not at bedtime). keep all of your follow-up appointments. . you will need to have labwork done on (potassium check). . call your doctor or go to the er for any of the following: chest pain, shortness of , lightheadedness or headache, fevers/chills, nausea/vomiting or any other concerning symptoms. followup instructions: provider: , center - non billing phone: date/time: 9:00 provider: , md phone: date/time: 8:30 md procedure: hemodialysis diagnoses: hypertensive chronic kidney disease, malignant, with chronic kidney disease stage v or end stage renal disease hyperpotassemia end stage renal disease congestive heart failure, unspecified depressive disorder, not elsewhere classified hypoxemia diastolic heart failure, unspecified diabetes with renal manifestations, type i [juvenile type], uncontrolled 

Answer: The patient is high likely exposed to