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: this is a 46-year-old female with multiple medical problems including poorly controlled hypertension, end stage renal disease on hemodialysis, hepatitis c and a history of chronic abdominal pain who was recently discharged three days prior to admission for hypertensive crisis, and abdominal pain, as well as possible lyme/skin infection. she ems on the morning of admission after waking with severe right-sided chest pain similar to that she has experienced in the past. she had no shortness of breath, nausea, vomiting, or diaphoresis. the chest pain was described as being not pleuritic. in the emergency department, she was found to have a blood pressure of 256/158 and was treated with nitroglycerin intravenously without response. she was started on nipride and labetalol intravenously with some improvement. in addition, she was given labetalol, lopressor and hydralazine, as well as aspirin and morphine. cardiology was consulted and felt that she merely had a left ventricular strain on her electrocardiogram and suggested further management of blood pressure without further more invasive interventions. she was admitted to the medical intensive care unit for hypertensive crisis management and was ruled out for an myocardial infarction with three sets of enzymes. she was treated with enalapril, hydralazine, norvasc and clonidine after response to intravenous medications and was transferred out to the floor after blood pressure was in better control. in the medical intensive care unit, she was also noted to have a vague history of methicillin-sensitive staphylococcus aureus positive blood culture and was started on a course of vancomycin. on transfer to the floor, she complained of right knee pain and right lower extremity numbness and weakness, which had been ongoing for the past few weeks. she also complained of right-sided chest wall tenderness at the hemodialysis catheter site, however, she denied abdominal pain, nausea, vomiting, and stated that her last bowel movement was one day prior to admission. she denied chest pain, shortness of breath, headache, and visual changes. ............ 8. status post resection in . 9. femur and tibial fractures in . 10. chronic abdominal pain of unclear etiology. 11. polysubstance abuse of cocaine and narcotics. 12. catheterization in showing clean coronaries. 13. transthoracic echocardiogram in showing ejection fraction of 55%, left ventricular hypertrophy, 1+ mitral regurgitation and mild pulmonary hypertension. medications on admission: 1. albuterol mdi 2 puffs q. 6 hours prn. 2. colace 100 mg po b.i.d. 3. amlodipine 10 mg po q.d. 4. aspirin 325 mg po q.d. 5. bumetanide 2 mg po b.i.d. 6. ferrous sulfate 325 mg po q.d. 7. b complex/vitamin c/folate acid. 8. aluminum hydroxide gel 1200 mg po t.i.d. with meals. 9. clonidine 0.3 mg patch q. week. 10. atenolol 100 mg po q.d. 11. enalapril 20 mg po b.i.d. 12. minoxidil 10 mg po b.i.d. 13. calcium acetate 1334 mg po t.i.d. with meals. 14. hydralazine 20 mg po q.i.d. 15. protonix 40 mg po q.d. allergies: penicillin, kefzol, codeine. family history: noncontributory. social history: five children, 50 pack year tobacco history, one pack per week currently, no etoh, history of cocaine use which patient states none in the last six months, but positive urine toxicology screen in the last week. physical examination: vital signs on admission: dropping to 197/130 with nipride to 162/97. pulse 84-117. oxygen saturation 99% on room air. in general, patient was in mild discomfort and uncooperative with exam. head, eyes, ears, nose and throat: team was unable to perform funduscopic exam secondary to patient's noncompliance and equipment malfunction. mucous membranes moist, anicteric sclera. neck: jugular venous pressure 10 cm at 30 degrees. thorax: rales at left base, no wheezes, right hemodialysis catheter site clean, dry and intact, but very tender to palpation. cardiovascular: regular rate, very prominent s1, s2, no murmurs, rubs or gallops. abdomen: normal active bowel sounds, soft, minimally tender, no masses. extremities: no lower extremity edema. neurological: alert and oriented times three. pupils equal, round and reactive to light. extraocular movements intact. visual fields intact. 4-/5 motor of the right lower extremity, left lower extremity. sensory deficit in the right lower extremity. laboratory data on admission: significant for a white blood cell count of 8.7 with 63% neutrophils, 15% lymphocytes, 15% eosinophils, baseline 11% eosinophils in . chemistries remarkable for a sodium of 141, potassium 6.0, chloride 101, bicarbonate 29, bun 50, creatinine 8.6, glucose 90. electrocardiogram showing normal sinus rhythm at 83 beats per minute, left ventricular hypertrophy, left axis deviation, t wave inversions in v4 through v6 and left ventricular strain pattern. chest x-ray shows mild volume overload. hospital course: 1. hypertension: the patient's blood pressures on regimen of amlodipine 10 mg once a day, enalapril 40 mg once a day, labetalol 100 mg q.p.m., bumetanide 20 mg po b.i.d., hydralazine 30 mg q. 6 hours, minoxidil 10 mg b.i.d. and clonidine 0.3 mg patch became quite low for her with systolics in the 100 to 120s. but after transfer to the floor, we stopped her labetalol, hydralazine and bumex. the labetalol was stopped secondary to worry that the patient would continue abusing polysubstance as an outpatient including cocaine. hydralazine was stopped as this is a q.i.d. medication in which the patient was not likely to be able to take. although, we attempted to wean off her clonidine patch, per report, she often would self discontinue this with rebound hypertension as a result, we were unable to do so as her blood pressures became from the systolics in the 150s to 170s. her renal team was satisfied with these blood pressures given the fact that fewer medications might led to higher overall ability to comply with taking them. she experienced no further hypertensive urgency or neurological symptoms during her admission. 2. end stage renal disease: she continued with hemodialysis tuesday, thursday, saturday. because she continued to complain of pain at the right-sided hd cath site. this line was pulled by radiology and a new one was inserted into her left subclavian vein during her admission. she experienced minor left-sided cath site though both sides had remained clean, dry and intact with no erythema or edema and no signs of infection. 3. infectious disease: the patient had vague history of methicillin-sensitive staphylococcus aureus passed onto the medical team from the intensive care unit team, however, this was not well documented in ccc and all blood cultures logged in had been negative. we called to the patient's outpatient dialysis site, clinic in , who confirmed that they had taken many blood cultures, all of which were negative. these included cultures from , , and , thus, we did not continue her vancomycin and patient did not have any further signs of bacteremia. 4. submandibular gland swelling: during this hospitalization, she began to develop bilateral submandibular gland swelling with tenderness. a throat gc and swab for strep were negative, as well as a monospot. hiv test was resent and also negative. this was not treated and both sides began to reside by discharge, although, the right side still remained somewhat tender with minor swelling. she had low grade temperatures during this admission but blood cultures were always negative. we elected to have her primary care physician follow the swelling as an outpatient given the fact that it was unclear if it was an infection that we could treat. 5. neurological symptoms: it was extremely difficult to perform a adequate neurological exam given the patient's continual noncompliance with allowing us to exam her. because the symptoms appeared to be somewhat chronic over the last several weeks, and that no new immediate concerns, she will have further work-up as an outpatient. we attempted to do so work-up as an inpatient with an mri of her l spine and emg, but these were not able to be scheduled as an inpatient. she had a repeat anca which was negative. patient stated she was so weak that she had fallen out of bed one night during her stay, and hit her head on the side of her bed. she had a negative head ct for intracranial hemorrhage or edema, but the ct did show chronic microvascular disease. physical therapy evaluated the patient who was initially unable to walk and very weak, however, when told that she would have to enter rehabilitation from the hospital given her weakness, the patient refused and subsequently two days later, stated that she was able to walk and demonstrated a complete normal gait. thus, she was able to be discharged to home. 6. chronic pain: the patient has a history of drug seeking behavior with recent documented cocaine abuse, which she still denies. we had attempted to switch her to methadone during admission, but this also did not control her pain well. six hours which she found satisfactory for her pain relief. the pain service also recommended starting on neurontin 300 mg q.h.s. as well as ibuprofen. it was difficult to assess if it helped. 7. history of substance abuse: had followed the patient somewhat during her admission. at the end, child protective services were and given the patient's polysubstance abuse issues and lack of capability to care for her five young children at home. condition of discharge: stable. discharge status: to home. discharge diagnoses: as per admission past medical history with the addition of change of right-sided hemodialysis catheter to new insertion of left subclavian hemodialysis catheter, and right lower extremity weakness. discharge medications: 1. albuterol mdi 2 puffs q. 6 hours prn. 2. aluminum hydroxide 10 cc po t.i.d. 3. calcium acetate 1334 mg po t.i.d. 4. enteric coated aspirin 325 mg po q.d. 5. amlodipine 10 mg po q.d. 6. enalapril 40 mg po q.d. 7. minoxidil 10 mg po b.i.d. 8. clonidine 0.3 mg patch q. week. 9. percocet 1 tablet q. 4-6 hours prn. 10. neurontin 300 mg po q.h.s. 11. pantoprazole. 12. lactulose/colace/senna. 13. ibuprofen acetaminophen prn. follow-up plans: the patient was scheduled for a follow-up within a week with her primary care physician, . , as well as an outpatient emg in early . , m.d. dictated by: medquist36 procedure: hemodialysis venous catheterization for renal dialysis diagnoses: hypertensive chronic kidney disease, malignant, with chronic kidney disease stage v or end stage renal disease hyperpotassemia chronic hepatitis c without mention of hepatic coma diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled cocaine abuse, unspecified personal history of noncompliance with medical treatment, presenting hazards to health 

Answer: The patient is high likely exposed to