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: no known allergies / adverse drug reactions attending: chief complaint: dyspnea. major surgical or invasive procedure: none. history of present illness: 28 y/o f w/ syndrome (diabetes insipidus, diabetes mellitus, optic atrophy, and deafness) which is a progressive disease thought to be caused by mitochondrial dysfunction with aspects of demyelination, and as a result autonomic dysfunction w/ orthostatic hypotension, recurrent pna and utis, and subacute on chronic worsening of respiratory status with associated fatigue and lethargy as well as osa p/w 1 month of increasing fatigue, lethargy, and hypoxia. she was recently admitted to the from for similar presentation, reportedly discharged for the holidays. in the , she was treated w/ supplemental o2 to 4l nc and bipap was attempted, but pt could not tolerate claustrophobia. she was discharged home on 4l o2 on for the holidays. at that time neurology was consulted to comment on her progressively worsening respiratory status as well as difficulty speaking and swallowing which they did not feel was gbs, mg or ms. this was thought to be 's disorder as pts w/ this often develop severe polyneuropathy, and some may develop a progressive central hypoventilation syndrome. . she presents from home this time for worsening dyspnea w/ exertion and shortness of breath at rest sometimes desatting to the 90s while speaking, while on 4l nc. she reports fatigue w/ minimal exertion such as getting up to go to the bathroom. reports her respiratory status is similar to her presentation in the a few days ago. she denies fevers/chills/ nausea/vomiting or sick contacts. she reports her boyfriend, with whom she lives has been sick but had been on antibiotics. she went to see dr her pulmonologist in clinic today who recommended she come to the ed for evaluation. in the pt was tired but satting 95% on 4 l nc. sleep medicine (dr was consulted and they convinced pt to try bipap. . in the ed vs: t 98.2 hr 103 bp 125/72 rr 18 sao2 95% 4l nc. cxr was done which was unchanged from prior. abg was 7.35/ 68/ 102/ 39/ 8 (on 4l). nif -80, vital capacity 1.15 l. labs were unremarkable. . on presentation to the icu, pt reports fatigue due to poor sleep over the past few nights but her breathing has been the same as the last time she was in the icu. . ros: positve per above. denies cp, painful breathing, bleeding, bowel incotninence. positive chronic bladder difficulty with voiding, requiring intermittent straight caths. past medical history: 1. syndrome (didmoad; neurodegenerative d/o caused by mitochondrial defects and/or defects in myelination, the latter similar in effect to multiple sclerosis) .....a.diabetes mellitus type i (poorly controlled, on insulin) .....b.diabetes insipidus (on ddavp) .....c.optic atrophy .....d.high-frequency hearing loss. .....e.svt, avnrt (s/p ablation x2) .....f.overflow incontinence (h/o self catheterization in past) 2. orthostatic hypotension 3. depression 4. asthma (albuterol 1xyear; typically in setting of infection) 5. obstructive sleep apnea 6. recurrent utis - vre (), cipro/bactrim resistant e.coli () 7. recurrent pneumonias - (, (requiring micu stay, intubation and bronchoscopy x6)). social history: lives w/ her boyfriend and mom. denies tobacco/drugs. etoh drinks ~ 1-2 drinks/week. on disability. able to perform her adl's. pt does not drive. family history: father w/ narcolepsy. mother with breast cancer. mgm w/ breast cancer and pgm w/ bladder cancer. pgf w/ bone cancer. brother w/ syndrome. physical exam: gen: pleasant, nad heent: anicteric sclera. pink conjunctiva. mmm cv: tachycardic. resp: decreased bs at bases. ctabl. abd: protuberant abdomen. nbs. soft, nt. no organomegaly. ext: lle edema 1+ pitting edema >r (chronic) neuro: aox3. mae. pertinent results: labs: 11:38am blood wbc-9.3 rbc-4.34 hgb-11.1* hct-35.1* mcv-81* mch-25.5* mchc-31.5 rdw-13.3 plt ct-311 11:38am blood neuts-82.3* lymphs-13.3* monos-3.3 eos-0.5 baso-0.5 11:38am blood pt-11.4 ptt-25.5 inr(pt)-0.9 11:38am blood glucose-335* urean-18 creat-0.7 na-137 k-4.6 cl-94* hco3-35* angap-13 11:38am blood calcium-9.2 phos-2.5*# mg-1.7 08:47am blood %hba1c-8.5* eag-197* 12:37pm blood type-art po2-102 pco2-68* ph-7.35 caltco2-39* base xs-8 intubat-not intuba 07:27am blood type-art po2-92 pco2-66* ph-7.38 caltco2-41* base xs-10 08:08am blood type-art po2-88 pco2-59* ph-7.42 caltco2-40* base xs-10 11:39am blood lactate-1.5 k-4.4 11:38am blood acetylcholine receptor antibody-pnd 11:38am blood acetylcholine receptor modulating antibody-pnd micro: blood cultures pending urine culture pending imaging: cxr: low lung volumes and bibasilar opacities, not significantly changed from prior exam and likely represent atelectasis. the cardiomediastinal silhouette and hila are normal. there is no pleural effusion and no pneumothorax. low lung volumes. impression: bibasilar opacities, likely atelectasis. brief hospital course: 28 year old female with 's syndrome admitted for bipap initiation given worsening dyspnea and hypercarbia as an outpatient. . #dyspnea and hypercarbia: thought to be a chronic restrictive process from neuromuscular dysfunction secondary to wolframs syndrome. bipap was initiated at 5/5 and then titrated up to . the mask and the bipap was tolerated well. daily abg's showed improvement in her ph and in her co2 levels. bipap settings: nasal cpap w/psv (bipap) inspiratory pressure: 8 cm/h2o expiratory pressure: 5 cm/h2o supp o2: 4 l/min. her daily oxygen requirement was weaned to 1-2 liters. a cxr revealed low lung volumes and bibasilar atelectasis. blood cultures were sent in the ed despite the low suspicion for infection and were pending at the time of discharge. **anticholinergic antibiodies were sent as recommended by neurology during her last admission and should be followed up by her outpatient pulmonologist. . #neurogenic bladder: a foley was placed in the ed lethargy and fatigue. the foley was removed on the next day of admission. on the second day she developed symptoms of urgency and dysuria. according to patient and mother these symptoms are not typical for her. consequently, started on empiric treatment for uti with cipro for 5 days. ua positive but contaminated. urine culture was pending at discharge and will be followed up. . #diabetes mellitus: last hba1c in was 8.0, and was found to be 8.5 this admission. she was continued on her home long acting and short acting insuling for glycemic control. she will follow up with as an outpatient. . #diabetes insipidus: constellation of syndrome. she was maintained on her home nasal ddavp. . #constipation: she was started on colace and senna as she noted that she did not have a bowel movement in one week. she had a bowel movement on the second day of admission. medications on admission: 1. albuterol sulfate 90 mcg inhaler 1-2 puffs q4-6 hours prn 2. desmopressin 10 mcg/spray aerosol, 2 nasal spray 3. levemir 100 unit/ml solution sig: eighteen (18) units subcutaneous twice a day. 4. humalog 100 unit/ml solution sig: as directed units subcutaneous four times a day: please follow your sliding scale with meals and before bed. 5. midodrine 5 mg tablet 1 tablet po twice a day. 6. multivitamin 1 capsule po once a day. 7. drospirenone-ethinyl estradiol 3-0.03 mg 1 tablet po qday discharge medications: 1. bipap machine name: , l dob: address: , ,ma,us medicaid id#: diagnosis: syndrome with increasing hypoxemia and hypercarbia eqiupment: - mask - headgear - tubing - filters - humidifier for chamber - chin strap rx: 1 year provider: . 2. midodrine 2.5 mg tablet sig: two (2) tablet po once a day. 3. desmopressin 10 mcg/spray aerosol, spray sig: two (2) spray nasal (2 times a day). 4. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inh inhalation q6h (every 6 hours) as needed for wheeze,sob. 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day): over the counter. disp:*60 capsule(s)* refills:*0* 6. senna 8.6 mg tablet sig: one (1) tablet po at bedtime as needed for constipation: over the counter. disp:*30 tablet(s)* refills:*0* 7. ciprofloxacin 500 mg tablet sig: one (1) tablet po twice a day for 4 days. disp:*8 tablet(s)* refills:*0* 8. midodrine 2.5 mg tablet sig: one (1) tablet po prn (as needed) as needed for afternoon prn. 9. insulin see atttached for insulin regimen discharge disposition: home discharge diagnosis: primary: hypercarbia secondary: 's syndrome discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: it was a pleasure being involved in your care, ms . you were admitted to the icu for management of your hypercarbia. you were started on bipap with improvement of your hypercarbia. it is hopeful that your daily oxygen requirement may be decreased or not necessary at all. please follow up with your pulmonologist as an outpatient. followup instructions: an appointment has been made for you to follow up with dr. at the clinic on at 12 pm. an appointment has been made for you to follow up with dr. in pulmonary medicine on 1:30 pm buildling . department: pulmonary function lab when: wednesday at 1:10 pm with: pulmonary function lab building: campus: east best parking: garage department: pft when: wednesday at 1:30 pm department: medical specialties when: wednesday at 1:30 pm with: dr & dr building: sc clinical ctr campus: east best parking: garage procedure: non-invasive mechanical ventilation diagnoses: obstructive sleep apnea (adult)(pediatric) urinary tract infection, site not specified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled depressive disorder, not elsewhere classified constipation, unspecified acute and chronic respiratory failure diabetes insipidus body mass index 35.0-35.9, adult neurogenic bladder nos lipidoses 

Answer: The patient is high likely exposed to