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: generalized weakness major surgical or invasive procedure: none history of present illness: mr. is a 64 year old male with type 2 dm, htn, atrial fibrillation on coumadin, cad s/p cabg (4-vessel at ), chronic surgical wound of left foot complicated by osteomyelitis and status post debridement on intravenous vancomycin, who was sent to the ed after evaluation in the podiatry clinic for htn and feeling unwell. at podiatry clinic he was noted to be pale and weak. . the patient stated he has "not been feeling well" for the last one week. last week, he was trying to get up out of his recliner and noticed that it felt like his legs were giving out underneath him. he hit his hip on the sofa but otherwise had no injuries. he denies any other associated symptoms especially lightheadedness or dizziness. still states that he continued to feel weak in his legs, occasionally he felt jittery. his greatest difficulty comes with attempting to rise from a chair. his knees ache constantly. two nights ago he had some discomfort/weakness while lifting a few folders from his kitchen table. these light objects felt as though they were 12 pounds heavy. . his sleep has also been poor over the last two to three weeks. his wife thinks it is because he is short of breath but no pnd and stable 2 pillow orthopnea. he also noted increase in his abdominal girth over the last one week. . his sob has been ongoing since . he says over all he thinks it is about the same. it s more pronounced with walking; he only walk small distance with a walker in his home. the patient had a cough while on lisinopril. his wife described his breathing as "labored." she also noted more lower extremity edema. this evening he states it is easier for him to sit up to breath. denies cp/pressure, lh/dizziness. . overall he feels unwell and has a difficult time honing in on the exact nature of his symptoms. . in the ed, he was afebrile, hr 80, bp 167/89, rr 18, saturation of 94 % on room air. he was given aspirin and beta blocker, ns and tums in the ed. head ct for history of a recent fall at home was negative. cardiology was consulted in ed. . admitted for workup of muscle weakness, elevated troponin, and sob. . ros: no f/c/+night sweats x a few months, no n/v/d/c/change in stool or blood in stool, no lh/dizziness, no numbness/tingling, no change in vision past medical history: iddm, htn, afib w/ anticoagulation therapy gout, hypercholesterolemia, arthritis cad psh: s/p l 5th ray amputation s/p r inguinal hernia repair s/p cholecystectomy s/p coronary artery by pass surgery x4 s/p l tma social history: retired postal worker, married, 4 children, no tobacco, no drugs use, etoh qweek, wife involved family history: mother died of liver cancer in her 70's physical exam: physical exam - vs: 150/90, hr 77, rr 22, 89% ra, 94% 2l oxygen gen - alert, no acute distress, some sob with talking for several minutes heent - perrl, extraocular motions intact, anicteric, mucous membranes moist neck - jvp difficult to assess, no cervical lymphadenopathy chest - bs in ll, no crackles, no wheezing, some bs on right ll, surgical scar cv - distant hs, nl s1/s2, irrr abd - obese, nontender, +distended, with normoactive bowel sounds, ?+fluid wave back - no costovertebral angle tendernes, no sacral edema extr - no clubbing, cyanosis, 1+ edema to mid shin on r, + in lle. 1+ dp pulses in right left leg: surgical scar on left leg, dressed left foot wound neuro - alert and oriented x 3, cranial nerves intact, ue strength 5/5 except for deltoid (), le except for hip extensors () skin - no rash msk- no thigh, bicep, calf tenderness pertinent results: labs: see below, notable for elevated ck/mb/troponin, transaminitis, elevated bnp . ekg unchanged, low voltage - a fib, no st changes. . ct head (prelim): no acute intracranial hemorrhage. small vessel ischemic changes and evidence of prior left parietal lobe infarction. . cxr: cardiomegaly without pulmonary edema. left lower lobe atelectasis versus consolidation. 04:10pm ck(cpk)-* 04:10pm ck-mb-100* mb indx-0.8 ctropnt-0.27* probnp-1510* 04:10pm vit b12-188* folate-8.2 04:10pm tsh-3.0 01:00pm glucose-69* urea n-22* creat-1.1 sodium-143 potassium-3.7 chloride-107 total co2-28 anion gap-12 01:00pm alt(sgpt)-373* ast(sgot)-433* ck(cpk)-* amylase-41 tot bili-0.5 01:00pm lipase-28 01:00pm ck-mb-96* mb indx-0.8 ctropnt-0.24* 01:00pm albumin-3.7 calcium-8.0* phosphate-3.3 magnesium-1.7 01:00pm wbc-7.1 rbc-4.11* hgb-12.4* hct-36.1* mcv-88 mch-30.2 mchc-34.3 rdw-15.9* 01:00pm neuts-77.4* lymphs-15.4* monos-4.8 eos-2.0 basos-0.3 01:00pm plt count-195 01:00pm pt-26.3* ptt-26.7 inr(pt)-2.7* 06:04am blood wbc-8.6 rbc-4.38* hgb-13.0* hct-38.0* mcv-87 mch-29.6 mchc-34.2 rdw-16.3* plt ct-216 01:00pm blood neuts-77.4* lymphs-15.4* monos-4.8 eos-2.0 baso-0.3 06:04am blood plt ct-216 06:04am blood glucose-119* urean-25* creat-1.2 na-140 k-4.1 cl-100 hco3-30 angap-14 06:04am blood alt-511* ast-525* ck(cpk)-* 05:58am blood alt-474* ast-501* ck(cpk)-9940* alkphos-48 05:23am blood alt-490* ast-535* ck(cpk)-* alkphos-46 04:59pm blood -negative 05:23am blood hcv ab-negative 06:30am blood hcv ab-negative 05:23am blood hbsag-negative hbsab-negative igm hbc-negative brief hospital course: mr. is a 64 year old gentleman with dm2, htn, af, cad s/p cabg, and pvd who is admitted with diastolic chf and elevated ck's. . 1. rhabdomyolysis/proximal muscle weakness- admission creatine kinase enzymes were found to be 11,419, this value peaked 3 days later at 12,300 and reached a nadir of 9,200 during the hospitalization. his admission urinalysis was supportive of rhabdomyolysis with the finding of large heme positivity with only scant rbc's. the patient was immediately taken off his lipid lowering agents ezetimibe and tricor. the patient had only a distant history of treatment with statins. at first the patient was given gentle hydration to prevent renal dysfunction in the setting of elevated ck's. however his kidney function remained relatively stable throughout the hospitalization with creatinine on admission at 1.1 peaking at 1.4 and reaching a nadir of 0.8. in this setting it was decided to institute gentle diuresis with iv lasix to improve the patient's respiratory status. with a net diuresis of .5 liters per day the patient reported improvement in his sensation of shortness of breath. it was later felt that the patient may have had diaphragmatic weakness in the setting of a thus far, occult intraabdominal process. in the two weeks prior to hospitalization the pt and his wife noted nearly a doubling in the size of his abdomen. this in itself may explain a mechanical deficit in the patient's ability to respire. abdominal ultrasound did not reveal any ascites, could not adequately assess the patient's liver, but did note a mildly enlarged spleen to 13.6cm. hepatitis b and c were negative, neurology consultation was obtained at it was felt that the patient's long term use of tricor in combination with the recent addition of ezetemibe were likely at cause for the patient's ck elevation. low vitamin b12 was treated with b12 injection for 7days. as noted above, the patient's ck's fluctuated around 10,000 throughout the hospitalization without any clear alteration in renal function. daily physical therapy also greatly improved the pt's functional status and he was soon ambulating with a walker and able to climb a flight of stairs without difficulty. creatinine values exhibited some fluctation from 1.1-1.4-0.8 at time of discharge it was thought the patient's ck elevation could be due to lingering effects of tricor/zetia combination, however an intrabdominal process that may explain the patient's clinical picture could be be ruled out. mr scan with gadolinium contrast was attempted, but the patient was unable to fit into the mr machine due to his abdominal girth. an outpatient open mri is suggested to further evaluate the abdomen and specifically the liver to assess for possible vascular or intrahepatic process. ct abdomen with contrast was not obtained due to the patient's baseline mild renal insufficiency. . 2. diastolic chf/cad/afib- cardiology consultation was obtained on admission for evaluation of elevated ck-mb and troponin. the patient was not having an acute coronary syndrome, but rather a demand mediated ischemia. ck-mb enzymes trended down moderately, but remained elevated in the setting of his general ck eleavtion. transthoracic echocardiography revealed lvef of 55%, and mildly dilated , no wall motion abnormalities. given the patient's body habitus it was thought diastolic dysfunction may be a component of his symptoms of shortness of breath. he was titrated to 50mg po bid of metoprolol in this setting, and was tolerating the therapy well. he was switched to his home dose of lasix 40mg po daily and continued on avapro, coumadin, aspirin, and fish oil. of note, the patient's chest xray was never fully consistent with a picture of heart failure, but rather demonstrated low lung volumes. pulmonary consultation was obtained to assess for possible obstructive sleep apnea. they suggested an outpatient sleep study with follow up by the sleep clinic at (or other facility of the pcp's choosing). pulmonary consult did concur with the fact that the patient seemed to be exhibiting signs of diaphragmatic weakness. further cause for the need for abdominal evaluation . 4. transaminitis: the patient ast was around 500 and alt mid-high 400's. transaminase enzymes remained stable, but persistently elevated throughout the admission. hep b was negative, hep c was negative. . 5. status post left foot debridement/osteomyelitis: the patient was examined by podiatry for recommendations on optimum care of pt's l tma. the patient should continue to follow up with podiatry as an outpatient. the patient's picc line used for iv vancomycin with his history of osteomyelitis was removed just prior to discharge. . 6. dm2: the patient's blood glucose levels were optimally maintained on nph 18 u in am, 12 u in the evening, in combination with a humalog sliding scale. medications on admission: actos 45 mg qd allopurinol 300 mg qd amytriptilene 1 mg qd avapro 300 mg qd asa 81 mg qd catapress 0.3 qweek, changes on sat. diltizem cr 300 mg qd lasix 40 mg qd neurontin 600 mg tricor 145 mg qd coumadin 5 mg qhs x 6 days zetia 10 mg qd lopressor 25 mg insulin: novolog 24 u qam/18qpm fish oil 2 gm . discontinued: lisinopril 40 mg glucophage 500 mg, pravacol 10 mg, indapamide 2.5 mg qd, norvasc 10 mg qd, zocor? temp meds: rocephine, zyvox, zosyn, flagyl, levoquin, vancomycin (9 weeks) discharge medications: 1. allopurinol 100 mg tablet sig: two (2) tablet po daily (daily). 2. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 3. clonidine 0.3 mg/24 hr patch weekly sig: one (1) patch weekly transdermal qsat (every saturday). 4. irbesartan 300 mg tablet sig: one (1) tablet po qd (). 5. warfarin 5 mg tablet sig: one (1) tablet po 6x/week (mo,tu,we,th,fr,sa). 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 7. omega-3 fatty acids 550 mg capsule sig: one (1) capsule po bid (2 times a day). 8. gabapentin 300 mg capsule sig: one (1) capsule po bid (2 times a day). 9. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 10. cyanocobalamin 1,000 mcg/ml solution sig: one (1) injection daily (daily) for 7 days. 11. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 12. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). 13. insulin nph-regular human rec 100 unit/ml (70-30) suspension sig: follow insulin flow sheet attached subcutaneous twice a day. discharge disposition: home discharge diagnosis: primary: rhabdomyolysis secondary: diabetes mellitis peripheral vascular disease diastolic heart dysfunction discharge condition: good discharge instructions: you have been diagnosed with rhabdomyolysis that may be related to the cholesterol lowering drugs zetia and tricor. there is also a possibility that this could be related to an abnormality with your liver or gastrointestinal tract and it is important you follow up as an outpatient for an abdominal mri. please contact your doctor or call 911 if you should experience shortness of breath, chest pain, severe muscle pain or worsening weakness, dizzyness, uncontrollable bleeding, increasing abdominal girth, or any other concerning symptoms. followup instructions: 1)you should follow up with dr. within the next thursday to follow up on your condition after discharge. it is recommended you have further evaluation of your liver, with an mri scan, as an outpatient. this will need to be scheduled at a facility with an open mri scanner. 2)you have been taken off of zetia and tricor and it is important you follow up with your primary care provider, . to discuss alternative management of your cholesterol. 3)the pulmonary doctors have recommended have schedule a sleep study due to their concern for obstructive sleep apnea and how it may be affecting your heart. you can follow up with the sleep clinic at with the results from your sleep study if you choose. 4)you should see your podiatrist for follow up care of your foot. md procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube fiber-optic bronchoscopy fiber-optic bronchoscopy enteral infusion of concentrated nutritional substances hemodialysis venous catheterization for renal dialysis non-invasive mechanical ventilation percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy open biopsy of soft tissue transfusion of other serum diagnoses: obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery pure hypercholesterolemia acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified gout, unspecified atrial fibrillation aortocoronary bypass status peripheral vascular disease, unspecified chronic kidney disease, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease acute and chronic respiratory failure long-term (current) use of anticoagulants acute diastolic heart failure diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled rhabdomyolysis infection (chronic) of amputation stump nonspecific elevation of levels of transaminase or lactic acid dehydrogenase [ldh] antilipemic and antiarteriosclerotic drugs causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to