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 / watermelon / almond oil / hydralazine / cefepime attending: chief complaint: dka, hypertensive urgency, hyperkalemia major surgical or invasive procedure: hemodialysis history of present illness: 34 y/o m with pmhx of dm1, esrd on hd ttr, gastroparesis with frequent hospitalizations for n/v, uncontrolled hypertension and diabetes presented to the ed with n/v and hypoxemic respiratory failure. . began having abdominal pain, nausea, vomiting today, did not take insulin, progressively worsened, came to ed. no fevers. no shortness of breath, no chest pain. states quality of pain identical to previous episodes of gastroparesis, severity is slightly worse, however. . prior to this admission, he states symptoms worse than his usual gastroparesis. afebrile. no sick contacts. recent travel or eating out. last bm this am, normal, nonbloody. . in the ed, initial vitals were: 98.0 110 223/119 16 100%. initial labs were significant for an elevated potassium, creatinine of 11. an ekg demonstrated peaked t waves. he was given insulin 10 units of humulog x 3?, 2mg of calcium gluconate with repeat blood sugar in the 200s. repeat k+ was 4.8. he was subsequently started on an insulin gtt at 7.5 units/hr in d5. he was given zofran 4mg x1, reglan 10mg, morphine 5mg x 2 and dilaudid 1mg iv for management of his abdominal pain and nausea. for management of his hypertension which was labile and ranged from 165-209/109-113 he was given 20mg iv labetolol. admission the icu was requested for management of labile hypertension and insulin gtt. 102 28 165/109 99% on room air. he was comfortable on transfer. . on arrival to the micu he was comfortable in no apparent distress; his blood pressure was 160, his glucose was 246. past medical history: - dm type i since age 19, followed at . complicated by nephropathy, neuropathy, gastroparesis, retinopathy. multiple prior hospitalizations with dka, nausea/vomiting gastroparesis - esrd on hd t/th/s via right arm fistula @ , dry weight 73kg - hypoglycemia - hyperglycemia/dka: requiring insulin gtt - hypertension - nonischemic cardiomyopathy with ef 30-35% - anemia: iron deficiency and advanced ckd - depression - pulmonary hypertension - migraines social history: lives with girlfriend. mother also local. college degree in marketing, worked at previously. tobacco: trying to quit; relapsed and smokes ~1 pack per week etoh: previously drank heavily (30-40 drinks/week) but has not used alcohol since denies other drugs. family history: paternal grandfather had dm2. fh dm1. hypertension in a few family members. and several siblings alive and healthy, without known medical problems. physical exam: admission physical: . general: alert and oriented, pleasant in no apparent distress heent: sclera anicteric, slightly dry oral mucosa, oropharynx clear, eomi, perrl neck: supple, no lad cv: tachycardic, regular rhythm, normal s1 + s2, 3/6 sem lsb, no rubs, no gallops, 18g r ej, 22, l 4th digit lungs: clear to auscultation bilaterally with good air movement and excursion, no wheezing or rhonchi abdomen: soft, nontender, active bowel sounds, no rebound or guarding gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema . pertinent results: admission labs: . 10:50pm blood wbc-11.9*# rbc-4.65# hgb-14.1# hct-43.7# mcv-94 mch-30.3 mchc-32.2 rdw-13.4 plt ct-158 10:50pm blood neuts-94.2* lymphs-3.2* monos-2.0 eos-0.3 baso-0.3 10:50pm blood pt-10.0 ptt-29.9 inr(pt)-0.9 10:50pm blood plt ct-158 10:50pm blood glucose-501* urean-52* creat-11.3*# na-133 k-6.5* cl-89* hco3-16* angap-35* 10:50pm blood alt-21 ast-33 alkphos-181* totbili-0.4 10:50pm blood lipase-78* 10:50pm blood albumin-4.9 11:06pm blood lactate-3.4* . imaging: : ct abd/pelvis: impression: 1. no acute process in the abdomen and pelvis. 2. moderate cardiomegaly and mild pulmonary edema. cxr: impression: no focal lung consolidation. moderate cardiomegaly and mild pulmonary edema, slightly improved from . . brief hospital course: 34 y/o m with dm1, gastroparesis, htn, non-ischemic cardiomyopathy (ef30-35%), admitted to the micu with diabetic ketoacidosis and abdominal pain c/w gastroparesis, hypertensive urgency. # dka- dm1 since age 19. history of uncontrolled blood glucose, also with gastroparesis and frequent n/v. bglc on transfer to micu 246. anion gap = 29 on arrival to ed. **icu course: the patient presented initially with hyperglycemia, but no initial gas to confirm acidosis, this was treated in the ed and blood sugars had normalized and the gap had closed appreciably, he was initially on an insulin drip which was discontinued the next morning when he began taking pos; he had labile blood sugars on hd2 likely due to nausea after his glargine dose and then attempting to correct for the resulting hypoglycemia. he had normalized by the morning of hd3 and was tolerating a regular diet and blood sugars were well controlled. he never needed to go back on the drip. was consulted and was following the patient. **floor course: pt had labile sugars while on the floor, ranging from 60-300s. his insulin regimen was titrated. patient left against medical advice on . # hypertensive urgency- history of labile bp, with multiple admissions for hypertensive urgency/emergency. unclear etiology of labile bp. on home regimen of lisinopril, amlodipine, patch. currently hypertension is under control, will resume home medication regimen. **icu course: the patient received 20mg of iv labetalol in the emergency department which improved his pressures, but subsequently became hypertensive again and a nitroglycerine drip was initiated in the micu- the patient remained on this drip through most of hd2 has he was still nauseous and would not tolerate his po antihypertensives. the drip was discontinued on hd3 and the patient took his home medications. he never had any neuro changes, and his renal function was baseline and he was dialyzed regardless. **floor course: bp remained stable on the floor with home labetalol and regimen. he left ama shortly after arriving on the floor to go to a celtics basetball game. #hyperkalemia - in the setting of esrd, dka, he was treated in the ed, downtrended to 4.8. improved with medical management and hemodialysis. # esrd: on tuthsa hd. he was given hd for hypertensive emergency/pulmonary edema and hyperkalemia. received hd on hospital day 2 and 3. # gastroparesis: patient with history of gastroparesis, receives relief with zofran, dilaudid, morphine **icu course: treated with antiemetics and pain medications. #against medical advice: pt left ama. he was explained the risks and understood them well. he wanted to attend a basketball game. medications on admission: 1. amlodipine 10 mg tablet daily 2. aspirin 81 mg tablet, daily 3. 0.3 mg/24 hr patch weekly qmonday 4. insulin glargine 14 units qam 5. insulin lispro 100 unit/ml solution iss 6. b complex-vitamin c-folic acid 1 mg capsule daily 7. lisinopril 40 mg tablet daily 8. sevelamer carbonate 800 mg tablet two (2) tablet po tid w/meals 9. sertraline 50 mg tablet : two (2) tablet po daily (daily). 10. hydromorphone 2 mg tablet : two (2) tablet po twice a day prn 11. ondansetron hcl 4 mg tabletq8hrs prn nausea 12. labetalol 200 mg tablet : three (3) tablet po bid 13. labetalol 100 mg tablet : three (3) tablet po at bedtime. discharge medications: 1. aspirin 81 mg tablet, chewable : one (1) tablet, chewable po daily (daily). 2. amlodipine 5 mg tablet : two (2) tablet po daily (daily). 3. 0.3 mg/24 hr patch weekly : one (1) patch weekly transdermal qfri (every friday). 4. labetalol 200 mg tablet : three (3) tablet po bid (2 times a day). 5. labetalol 100 mg tablet : three (3) tablet po qhs (once a day (at bedtime)). 6. sevelamer carbonate 800 mg tablet : two (2) tablet po tid w/meals (3 times a day with meals). 7. b complex-vitamin c-folic acid 1 mg capsule : one (1) cap po daily (daily). 8. lisinopril 20 mg tablet : two (2) tablet po daily (daily). 9. sertraline 50 mg tablet : two (2) tablet po daily (daily). 10. lidocaine (pf) 10 mg/ml (1 %) solution : one (1) ml injection daily (daily) as needed for before dialysis. 11. dilaudid 4 mg tablet : one (1) tablet po twice a day as needed for pain. 12. insulin glargine 100 unit/ml solution : twelve (12) units subcutaneous once a day: breakfast. 13. insulin humalog : 0-7 per sliding scale: as directed per sliding scale. discharge disposition: home discharge diagnosis: diabetic ketoacidosis hypertensive urgency acute on chronic renal failure discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you came to the hospital for diabetic ketoacidosis and hypertension. you were admitted to the intensive care unit for close monitoring. your dka improved but your sugars and blood pressure remained labile. you decided to leave against medical advice. the risks were explained to you and you understood them. these risks include recurrent dka, severe hypertension, death, stroke, heartattack, arrythmias. we strongly encourage you to return to the hospital if you feel sick. weigh yourself every morning, md if weight goes up more than 3 lbs. followup instructions: please arrange to followup with your primary care doctor and your diabetes doctors within the next few days. procedure: hemodialysis diagnoses: other primary cardiomyopathies hyperpotassemia anemia in chronic kidney disease end stage renal disease renal dialysis status acute kidney failure, unspecified other chronic pulmonary heart diseases polyneuropathy in diabetes depressive disorder, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease long-term (current) use of insulin iron deficiency anemia, unspecified migraine, unspecified, without mention of intractable migraine without mention of status migrainosus diabetes with neurological manifestations, type i [juvenile type], uncontrolled diabetes with renal manifestations, type i [juvenile type], uncontrolled diabetes with ophthalmic manifestations, type i [juvenile type], uncontrolled diabetes with ketoacidosis, type i [juvenile type], uncontrolled background diabetic retinopathy gastroparesis 

Answer: The patient is high likely exposed to