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: bactrim / lipitor attending: chief complaint: elevated creatinine from 0.9 () to 2.5 ()s/p cadaver kidney transplant major surgical or invasive procedure: kidney biopsy history of present illness: 42 y.o. male with hiv s/p cadaver kidney transplant presents with two day h/o fever of 101.8, nausea, diarrhea and gi discomfort after eating restaurant meal. evaluated in outpatient clinic by dr. . complained of nausea, decreased urine output and orthopnea. denied fever,vomiting and abdominal pain. diarrhea was resolving. past medical history: esrd hiv hiv nephropathy htn hyperlipidemia social history: lives with roommate. works in group home smokes 3 cigarettes per day rarely drinks etoh physical exam: a&o, very pleasant, sitting up in bed, nad vs: t 100.4-78-18, 172/88 o2 93% ra, wt: 84.4 heent: at, nl, proptosis od, perrla, eomi, full, decreased va od, no icterus of sclerae, mouth/tongue midline, moist bm, no exudate neck: supple, no palpable nodes, no tm, no carotid bruits lungs: clear a&p bilaterally, no decreased breath sounds cor: s1s2reg, no murmur/regurgitation abd: full, hyperactive bowel sounds, soft, to palpation, non-tender, well healed rlq scar ext-no cce vasc: lue avf, no sign of infection. 2+ dp/at on l. 1+ dp/at on right pertinent results: 01:15pm urine hours-random 01:15pm urine hours-random creat-215 tot prot-546 prot/crea-2.5* 01:15pm wbc-8.8 rbc-3.46* hgb-10.4* hct-31.7* mcv-92 mch-30.2 mchc-32.9 rdw-15.2 01:15pm plt count-187 01:15pm urine color-ltamb appear-clear sp -1.020 01:15pm urine blood-mod nitrite-neg protein-500 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.0 leuk-neg 01:15pm urine rbc-25* wbc-35* bacteria-few yeast-none epi-<1 01:15pm urine granular-1* 01:15pm blood glucose-137* 01:15pm blood urean-30* creat-2.5*# na-134 k-3.3 cl-103 hco3-16* angap-18 01:15pm blood alt-33 ast-27 totbili-0.9 01:15pm blood albumin-4.1 calcium-9.7 phos-2.1* 01:15pm blood rapamycin-test brief hospital course: admitted on with nausea, vomiting, diarrhea, fever and decreased urine output. noted to have shortness of breath with o2 sat of 88% which responded to o2 2 liters nc with repeat o2 of 94%. foley cath placed to check urine output. urine output 15-30 ml/hr and u/a positive. ultrasound of the transplanted kidney revealed increased resistive indices, and decreased diastolic flow in conjunction with cortical edema and swelling. no hydronephrosis was noted. shortness of breath increased with respiratory rate of 38,decreased breath sounds, bp of 170/88 and temperature of 100.6. 100% non-rebreather was placed on patient with o2 sat increased to 96%. transfered to sicu for worsening abgs. cxr revealed interstitial markings/edema. labs revealed wbc of 8.4, hct 27.4, creatinine of 3.3, bun 51, potassium 3, sodium 133 and bicarb 14. iv bicarb was started. sputum was sent for pcp as well as a cmv viral load and bk pcr. dapsone was changed to bactrim and valcyte was decreased to qod.empiric zosyn and levaquin were started with zosyn later changed to iv vancomycin. nephrology was consulted for increased creatinine and decreased urine output. on a transplant kidney biopsy was performed by nephrology without complications. on a pulmonary consult was obtained. diuresis was recommended for dyspnea/hypoxia consistent with fluid overload given cxr changes and low urine output. pcp was less likely dianosis, but induced sputum was ordered for viral pathogens and pcp. infectious disease consult was also obtained. nasal aspirate for viral cultures, sputum, and cultures were recommended as well as changing stavudine to 20mg q 24 hours for creatinine clearance of 10-25cc/min. on he received 2 units of prbc for a hematocrit of 22.3. on a steroid pulse was given pending renal biopsy results. consequently hyperglycemia occurred necessitating an insulin drip. iv vancomycin was stopped on per id recommendations as urine and blood cultures were negative. on the renal biopsy results were postive for acute cellular rejection (acr)/endothelitis. atg was initiated. on he was transfered out of sicu to the medical-surgical unit with improved respiratory status. pulmonary signed off as patient improved with diuresis and treatment of acr. cmv vl, pcp, cultures, for c. diff and rapid repiratory viral cultures were negative. urine culture from revealed >100k gram + bacteria. a blood culture from revealed coag neg staph felt to be a contaminant. gradually renal function improved with five doses of atg and solumedrol. creatinine improved to 1.5 on hd 6. rapamune was converted to prograf. per id recommendation repeat blood cultures were obtained and subsequently negative. given temperature spike on hd 6, diarrhea and fevers of 101.8 suspicious for c. difficile despite c. diff and e.coli negative cultures, patient was empirically started on po flagyl. flagyl was later switched to po vancomycin qid per dr. , id. fevers were felt to be secondary to atg, but repeat cultures of blood, urine and were sent on . mmf was changed to 500mg qid as mmf can cause gi disturbance, and iv bicarb was given for acidosis secondary to diarrhea. a total of 7 doses of atg were given for acr. diarrhea improved with vancomycin po. valcyte was increased to qd and needs to continue indefinately based upon cd4 count. azithromycin 1200mg po q week was initiated for no cd4 count. patient was discharged to home with vital signs wnl, decreased nausea and diarrhea feeling better. urine output improved and creatinine decreaed to 1.5. he was tolerating a regular diet. patient will monitor his glucose qid as he had steroid induced hyperglycemia and was instructed to call transplant office if glucoses were greater then 200mg/dl. labs on discharge were as follows: creatinine 1.4, plt 214, hct 28.1, and wbc 5.2. he will complete a three week course of po vancomycin. medications on admission: efavirenz 600mg po qhs ritonavir 100mg po bid norvasc 10mg po qd atenolol 100mg po qd dapsone 100mg po qd cellcept 1000mg po bid protonix 40mg po qd valcyte 450mg po qd ziagen 300mg po bid agenerase 600mg po bid stavudine 40mg po bid clonidine 0.3mg po tid clonidine patch 3mg tp q wk oscal +d 500mg po qd lipitor 40mg po qhs prednisone 7.5mg po qd rapamune 0.5mg po q wk discharge medications: 1. efavirenz 200 mg capsule sig: three (3) capsule po hs (at bedtime). 2. amlodipine besylate 5 mg tablet sig: two (2) tablet po daily (daily). 3. dapsone 100 mg tablet sig: one (1) tablet po daily (daily). 4. mycophenolate mofetil 500 mg tablet sig: two (2) tablet po bid (2 times a day). 5. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 6. abacavir sulfate 300 mg tablet sig: one (1) tablet po bid (2 times a day). 7. atorvastatin calcium 40 mg tablet sig: one (1) tablet po pm (). 8. ritonavir 100 mg capsule sig: one (1) capsule po bid (2 times a day). 9. fosamprenavir calcium 700 mg tablet sig: one (1) tablet po q12h (every 12 hours). 10. clonidine hcl 0.3 mg/24 hr patch weekly sig: one (1) patch weekly transdermal qsat (every saturday). 11. zolpidem tartrate 5 mg tablet sig: one (1) tablet po hs (at bedtime). 12. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed). disp:*1 * refills:*2* 13. sodium citrate-citric acid 500-334 mg/5 ml solution sig: twenty (20) ml po tid (3 times a day). 14. prednisone 2.5 mg tablet sig: three (3) tablet po daily (daily). 15. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day). 16. stavudine 20 mg capsule sig: two (2) capsule po q12h (every 12 hours). 17. vancomycin hcl 10 g recon soln sig: one (1) recon soln intravenous q6h (every 6 hours). disp:*120 recon soln(s)* refills:*2* 18. valganciclovir hcl 450 mg tablet sig: one (1) tablet po daily (daily). 19. azithromycin 600 mg tablet sig: two (2) tablet po once (once) for weekly weeks: take every thursday follow up with dr. from infectious disease. disp:*8 tablet(s)* refills:*2* 20. atenolol 50 mg tablet sig: three (3) tablet po daily (daily). 21. insulin syringes 22. syringes 1 box insulin syringes 23. syringe storage bin misc sig: one (1) miscell. once a day. 24. insulin syringes (disposable) syringe sig: one (1) miscell. four times a day: low dose insulin syringes for sliding scale insulin. disp:*1 box* refills:*0* discharge disposition: home discharge diagnosis: acute cellular rejection s/p cadaver kidney transplant pulmonary edema renal insufficiency hiv diarrhea, c.difficile steroid induced hyperglycemia mac discharge condition: stable/good discharge instructions: call transplant office if fevers, chills, nausea, vomiting, inability to take medications, decreased urine output. lab draw on monday for cbc, chem 7, calcium, phosphorus, ast, t. bili, and tacrolimus trough level. check accuchecks twice a day, record followup instructions: provider: , md where: lm center phone: date/time: 2:20 provider: , md where: lm center phone: date/time: 2:40 provider: , (transplant) transplant center-medicine where: lm center phone: date/time: 1:30 provider: , call to schedule appointment procedure: closed [percutaneous] [needle] biopsy of kidney diagnoses: unspecified essential hypertension acute kidney failure, unspecified human immunodeficiency virus [hiv] disease intestinal infection due to clostridium difficile complications of transplanted kidney 

Answer: The patient is high likely exposed to