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: latex attending: chief complaint: fistula clogged major surgical or invasive procedure: chest compression, right ij, left hd line history of present illness: 60 yo male esrd on hd, cad, avr, ischemic cardiomyopathy, htn, hl, pe, dvt, gib bleed, diverticulosis, hyperkalemia, chronic le foot ulcers, and ? h/o acute leukemia who presents to the ed with hypotension, evletated lactate, clogged left fistula, and left wrist pain. of note the patient had yesterday moved from the heritage facility near to radius in . in discussion with teh radius facility they stated the pt was refusing care on arrival the night before (declined ekg, refusing to eat, refusing are). onarrival to the facility his sbp was 78/52 then increased up to 89/56. at radius on the day of admission to , they were unable to access his av fistula. his sbo was in the 70s. he became lethargic and refused iv access. he also complained of nausea and refused antiemetics. 60 yo m transferred from radius rehab due to clotted dialysis catheter, but was hypotensive to 60s here, lactate 13, minimally responsive. chf ef 30% on arrival to the ed sbps were 60s with a lactates of 13.1 and minimally responsive. while in the ed he received a toatl of 1.6 l of ivf including the antibiotics vancomycin and zosyn. his lactate trended down to 11 while in the ed. labs were notable for hyperkalemia to 6.7, elevated calcium to 10.7, and trop 0.34 trending up to 0.85. cxr was done after line was placed with line terminating in the distal svc and a possible left lower lobe opacity on the left may represent infection or contusion. blood cx were obtaines (pt does not make urine). a r ij was placed and the patient was started on levophed. for his hyperkalemia he received 1amp calcium gluconate, 10 units of insulin, amp of d50, and 3 amps off bicarb. the ed was concerned about possible peaked t wave in lateral leads. pt refused kayexelate. he later looked lethargic, cool, pale, and sweaty. his sugar was 108 when checked and he received another amp of d50. he then was more awake and interactive. a discussion occured with his brother over the phone and the patient was made dni but ok to do chest compressions. the brother said mr. in the dni aspect of the conversations. he was signed out to the medicine floor. while awaiting transit up from the ed he developed a wide complex and bradycardia and likely pea. he received between 15 sec and 1 min of chest compressions and regained a pulse and was alert and interactive. repeat labs showed trop of 0.85 and lactate of 11. pt still hyperkalemic and received calcium/insulin/glucose again. he was made dnr/dni in the ed after discussion with the brother and to the micu. vitals prior to transfer were afeb, t 97.1 hr 98 bp 93/50 rr22 100% nrb whole time while in ed. he was on levophed of 0.08. . on the floor, pt vs were t96 97/53 (on 3 of neo) 92% on nrb. he was alert and interactive but not able to engage in very indepth complex conversation. he started passing brb and melena from below. he later developed chest pain with lateral st depression in the setting of hr to 100s. he had episodes of v tach (like lasting 20-30 beats) that broke spontaneously. he agreed to having a dilaysis line placed. we were unable to reach his brother to get full icu consent but i had spoken with the brother earlier in the night to make the patient dnr/dni while the patient was still in the ed. past medical history: esrd on hd cad avr ischemic cardiomyopathy ef 30% dm pvd htn anemia hl pe venous embolism gib hyperkalemia chronic le foot ulcers scrotal hernia r ue skin ca diverticulosis gait instability adjustment d/o depression acute leukemia scrotal hernia social history: unavailable family history: unavailable physical exam: general: alert, oriented heent: sclera anicteric, mildly dry mm neck: supple, no jvd lungs: decreased bs anteriorly cv: tachycardic, rv heave, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: cold and clammy, radial pulses +2, dp pulses +1, ulcer on heel of left foot and belwo third digit, pain to palpation of left wrist, soft tissue mass on right wrist and right shoulder pertinent results: 02:14pm blood lactate-13.1* 04:10pm blood lactate-11.5* 07:34pm blood lactate-11.6* 11:31pm blood glucose-242* lactate-11.0* na-140 k-6.0* cl-98* calhco3-15* 01:06am blood lactate-8.2* 11:31pm blood freeca-1.56* 03:55pm blood calcium-10.7* phos-11.5* mg-2.8* 11:21pm blood calcium-15.8* phos-10.9* mg-2.9* 12:57am blood calcium-11.1* phos-10.3* mg-2.7* 02:25pm blood glucose-74 urean-104* creat-808* na-136 k-6.7* cl-89* hco3-14* angap-40* 03:55pm blood glucose-73 urean-104* creat-8.8*# na-140 k-6.2* cl-92* hco3-16* angap-38* 11:21pm blood glucose-287* urean-107* creat-8.8* na-138 k-6.1* cl-93* hco3-17* angap-34* 12:57am blood glucose-59* urean-105* creat-8.6* na-140 k-5.3* cl-95* hco3-20* angap-30* 02:25pm blood wbc-9.9 rbc-3.93* hgb-11.0* hct-37.9* mcv-96 mch-28.0 mchc-29.1* rdw-18.7* plt ct-284 03:55pm blood wbc-13.3* rbc-3.51* hgb-9.8* hct-33.5* mcv-96 mch-27.9 mchc-29.2* rdw-19.2* plt ct-268 11:21pm blood wbc-12.9* rbc-3.44* hgb-9.9* hct-32.7* mcv-95 mch-28.8 mchc-30.3* rdw-19.0* plt ct-224 12:57am blood wbc-14.7* rbc-3.41* hgb-9.6* hct-32.4* mcv-95 mch-28.1 mchc-29.6* rdw-19.4* plt ct-238 02:25pm blood neuts-88.6* lymphs-7.3* monos-3.6 eos-0.1 baso-0.4 02:25pm blood pt-16.7* ptt-32.8 inr(pt)-1.5* 11:21pm blood pt-19.5* ptt-37.6* inr(pt)-1.8* 02:25pm blood ctropnt-0.34* 03:55pm blood ctropnt-0.36* 11:21pm blood ctropnt-0.85* 12:57am blood ck-mb-30* mb indx-15.4* ctropnt-0.92* 04:10pm blood po2-59* pco2-39 ph-7.21* caltco2-16* base xs--11 04:54pm blood type-art po2-381* pco2-27* ph-7.31* caltco2-14* base xs--11 intubat-not intuba . blood cx - pending . cxr : the lungs are low in volume and show an unchanged left opacity with mild interstitial opacities. the cardiac silhouette is enlarged, unchanged. the mediastinal silhouette is widened, unchanged. the hilar contours and pleural surfaces are normal. again noted is significant calcification in the soft tissues of the right axilla and right upper cervical region, which might represent tumoral calcinosis given patient's renal failure. aortic valve replacement and intact sternal wires are noted. right ij line terminates in the distal svc appropriately. impression: 1. right ij line terminates in the distal svc appropriately. no pneumothorax. 2. calcified mass in the soft tissues of the right axilla and cervical region should be further evaluated with either a shoulder radiograph or ct if clinically necessary. presumed tumoral calcinosis. . cxr : findings: there has been interval placement of the left internal jugular catheter which terminates in the upper svc without evidence of pneumothorax. right ij catheter is unchanged in position. there is a linear lucency along the right tracheal border. there are unchanged calcifications projecting over the shoulders bilaterally that likely represent tumoral calcinosis. persistent enlarged cardiac silhouette with low lung volumes and a stable left opacity. there is slight improvement in the pulmonary edema. impression: 1. linear lucency along the right tracheal border that may represent artifact versus free mediastinal air. recommend short-term followup radiograph for further assessment. 2. interval placement of left internal jugular catheter terminating in the upper svc without evidence of complications including pneumothorax. brief hospital course: patient was dnr/dni and while placing an a line he suddenly developed a wide complex and immediately became bradycardic and then asystolic. shock/hypotension: the etiology of his shock was unclear. was on levophed 0.27 on arrival to the icu which was titrated up within the first hour of being in the icu. his mixed venous sat was 80 suggesting it was not cardiogenic shock. his lactate was 13.1 on arrival to the hospital and improved to 8.2 on arrival to the icu. he was bolused with d5w with 3 amps of bicarb on arrival to the icu. septic shock seemed less likely once a cvp was checked and returned as 20. however, we do not know how his heart functioned at baseline and he could have other cardiac etiologies explaining his elevated cvp and thus sepsis was not ruled out. he was covered with vancomycin and zosyn for possible sepsis. blood cx were done in the ed. he did not make urine to send for culture. we were concerned about pe especially given his history of pe. he was never stable enough to go for cta and we could not start heparin in the setting of his active gi bleed. . s/p pea arrest: in the ed the patient bradied down and his qrs widened and he then was pulseless. we did not have any strips to review of this event. he received between 15 sec and 1 min of chest compressions with return of circulation and mental status. he was given calcium gluconate, insulin, d50, and bicarb. he was in the thiamine versus placebo study. he did have several episodes of v tach but never long enough to administer metoprolol. he later had a similar event in the icu and given that he was dnr/dni he died at that time. . gi bleed: he passed bright red blood from his rectum on arrival to the icu.unclear baseline hct on was 34.8. his hct was 32 on arrival to the icu. he has a history of gi bleed per records but they do not indicate upper or lower bleed. he was tranfused 2 units of rbcs and started on protonix iv and an octreotide gtt. . acidemia with lactic acidosis: his anion gap was 25. his renal failure and sepsis were his most likely etiology. he was given d5w with 3 amps of bicarb. an hd line was placed and cvvh was initiated. . esrd on hd with severe electrolyte imbalance: he arrived with severe hyperkalemia. his fistula was clogged. an emergent hd line was placed for cvvh. . chest pain and concern for acs: he had ekg changes with st depression in lateral leads v4-v6 in the setting of tachycardia. despite calling several previous facilities where he received care, we were unable to obtain a baseline ekg. these are likely rate related changes and he would be too unstable to go for cath if this was acs. asa, morphine, and a statin was given. no plavix or other agents were given in the setting of his bleed. he received 2 units of rbcs. his chest discomfort was most likely secondary to chest compressions. . hypoglycemia: bs was 59 on floor and he was given amp of d50. . hypothermia: he was warmed with a bear huger and his temperature immediately increased so he was no longer hypothermic. he was warmed despite his cardiac arrest given that he was experiencing arrythmias while in the icu. medications on admission: aspirin lisinopril carvedilol simvastatin renagel tramadol hcl nexium neprhocaps fluzone silver sulfa senna miralax mycostatin powder emla pneumovax discharge medications: deceased discharge disposition: expired discharge diagnosis: deceased discharge condition: deceased discharge instructions: deceased followup instructions: deceased procedure: venous catheterization, not elsewhere classified cardiopulmonary resuscitation, not otherwise specified diagnoses: other primary cardiomyopathies acidosis hyperpotassemia end stage renal disease renal dialysis status coronary atherosclerosis of native coronary artery pure hypercholesterolemia unspecified septicemia sepsis paroxysmal ventricular tachycardia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease heart valve replaced by other means other specified cardiac dysrhythmias surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation blood in stool do not resuscitate status accidents occurring in unspecified place chest pain, unspecified other complications due to renal dialysis device, implant, and graft shock, unspecified 

Answer: The patient is high likely exposed to