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: dka major surgical or invasive procedure: dialysis history of present illness: 36m with dmi and gastroparesis recently admitted for dka (d/c'd on ) now with nausea/vomiting that started last night. emesis is coffee-ground. pt denies any abd pain, chest pain, dizziness, blood in stool, dark stools, cough, fever or chills. pt last bm last night. esrd on hd (m,w,f), missed appt today d/t symptoms. reports glucose this morning was 211. feels nauseaous in the ed, initial vs were: t-96.0 p 103 bp 224/122 r18 100% ra pt was found to have ag of 29 with an initial glucose of 209. pt was started on insulin drip and 1 l of ns bolus. pt received 2 doses of zofran and ativan for nausea. lfts and lipase were negative in the ed and ekg did not show any signs of ischemia. pt gap started to close on insulin drip. on arrival to the micu, the patient continues to complain of mild nausea. he otherwise feels well. pt denies any chest pain, abdominal pain, fever, chills, or cough. past medical history: - type i diabetes: since age 19, complicated by gastroparesis, retinopathy (laser treatment), dka, chronic kidney disease - esrd, on hd mwf, started ; currently on transplant list - s/p left brachiocephalic av fistula created on s/p angioplasty of the arterial anastomosis, mid cephalic and cephalic arch, complicated by an extravasation and mid-fistula hematoma (still usable) - syndrome - hypertension - asthma - hld - chronic multifactorial anemia, on epo, h/o prbc transfusion x2 social history: lives with his parents. denies tobacco use, alcohol use, or illicit drug use family history: father with cad/mi, hld, type ii dm. mother with thyroid cancer physical exam: admission: vitals: t:afebrile bp:189/110 p:91 r: 18 o2:98 on ra general: alert, oriented, no acute distress; appears mildly uncomfortable heent: sclera anicteric, mm slightly dry, oropharynx clear, eomi, perrl neck: supple, no lad cv: tachycardic s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi abdomen: soft, mildly tender to palpation in epigastrium; no rebound or guarding gu: no foley ext: av fistula in left upper extremity with thrill; warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: cnii-xii intact, 5/5 strength upper/lower extremities, grossly normal sensation discharge: vitals: patient was afebrile, normotensive, non-tachycardic, non-tachypneic, 98% on room air general: alert, oriented, nad heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, no lad cv: rrr, transmitted flow murmur from fistula, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi abdomen: soft, nontender, no rebound or guarding ext: av fistula in left upper extremity with palpable thrill and audible bruit, warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: cnii-xii intact, 5/5 strength upper/lower extremities, grossly normal sensation pertinent results: admission: 06:45pm blood wbc-9.5# rbc-4.02* hgb-11.5* hct-36.4* mcv-90 mch-28.6 mchc-31.6 rdw-15.2 plt ct-218 06:45pm blood glucose-209* urean-88* creat-12.4*# na-138 k-5.0 cl-95* hco3-20* angap-28* 06:45pm blood lipase-58 11:36pm blood ctropnt-0.07* 06:45pm blood alt-18 ast-25 alkphos-116 totbili-0.7 08:43pm blood type- po2-77* pco2-48* ph-7.32* caltco2-26 base xs--1 comment-green top pertinent: 02:30am blood glucose-213* urean-36* creat-7.0* na-133 k-4.3 cl-96 hco3-29 angap-12 05:18pm blood glucose-91 urean-27* creat-6.1*# na-138 k-4.0 cl-97 hco3-33* angap-12 discharge: 06:00am blood wbc-6.3 rbc-3.70* hgb-10.7* hct-33.5* mcv-91 mch-28.9 mchc-31.9 rdw-15.0 plt ct-172 06:00am blood glucose-160* urean-29* creat-5.6*# na-138 k-4.4 cl-97 hco3-30 angap-15 06:00am blood calcium-8.9 phos-5.8* mg-2.1 brief hospital course: brief course: 36m with type i dm and gastroparesis recently admitted for dka (discharged on ) who presented with nausea and coffee ground emesis and dka. he was treated with insulin drip and received dialysis in house. active issues: #dka: likely secondary to witholding his insulin in the setting of not eating due to nausea and vomiting from gastroparesis. anion gap was 29 on presentation with glucose of 209. electrolytes were initially checked q 4 hours and repleted when needed until the gap was closed. patient was started on insulin drip and transitioned to subcutaneous insulin after his gap had closed with 2 hour overlap. patient is tolerating good po and is discharged on his home insulin regimen. #gastroparesis: complication of type i dm. likely the cause of his nausea and vomiting. patient's outpatient gi doctor has seen the patient in the hospital. he was continued on eythromycin and metoclopramide and given zofran and prochlorperazine prn for nausea. #coffee ground emesis: had similar episode in , and egd at that time was largely normal. no more episodes while in hospital and hematocrit was stable. maintained active type and screen. possibly due to tear from vomiting. pud, gastritis also in differential. placed on ppi. tolerating good po. #esrd: chronic secondary to diabetes, on hemodialysis mwf. the patient is currently on the dual pancreatic/kidney transplant list. he missed his monday dialysis session because it was the day he came into the hospital, so he was dialyzed while in the hospital on tuesday and wednesday. he will continue his scheduled dialysis along with nephrocaps and sevelamer. #htn: normalized after dialysis. pt states that bp is usually elevated prior to dialysis. he was continued on his home clonidine patch, labetolol and lisinopril without issues. transitional issues: 1. code status: full 2. communication: patient 3. medication changes: none 4. pending studies: none 5. follow up: pcp, medications on admission: preadmission medications listed are correct and complete. information was obtained from patientwebomr. 1. clonidine patch 0.3 mg/24 hr 1 ptch td qtues 2. metoclopramide 10 mg po qidachs 3. nephrocaps 1 cap po daily 4. omeprazole 20 mg po daily 5. sevelamer carbonate 2400 mg po tid w/meals 6. labetalol 200 mg po tid 7. lisinopril 10 mg po daily 8. erythromycin 250 mg po tid 9. insulin sc sliding scale insulin sc sliding scale using novolog insulin discharge medications: 1. clonidine patch 0.3 mg/24 hr 1 ptch td qtues 2. erythromycin 250 mg po tid 3. labetalol 200 mg po tid 4. lisinopril 10 mg po daily 5. nephrocaps 1 cap po daily 6. sevelamer carbonate 2400 mg po tid w/meals 7. metoclopramide 10 mg po qidachs 8. omeprazole 20 mg po daily 9. glargine 5 units breakfast glargine 4 units bedtime insulin sc sliding scale using hum insulin discharge disposition: home discharge diagnosis: primary: dka esrd on dialysis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mr. , you were admitted for dka. you were treated with iv insulin and transistioned back to your home insulin regimen. your nausea resolved and you were able to tolerate food. we have made no changes to your medications. please follow up with your doctors as described below and continue dialysis at your previous schedule. followup instructions: name: , md specialty: endocrinology when: tuesday at 1pm location: diabetes center address: one place, , phone: name: np specialty: primary care when: tuesday at 2pm location: address: , , phone: procedure: hemodialysis diagnoses: end stage renal disease renal dialysis status asthma, unspecified type, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other and unspecified hyperlipidemia long-term (current) use of insulin awaiting organ transplant status diabetes with neurological manifestations, type i [juvenile type], uncontrolled diabetes with renal manifestations, type i [juvenile type], uncontrolled diabetes with ophthalmic manifestations, type i [juvenile type], uncontrolled diabetes with ketoacidosis, type i [juvenile type], uncontrolled background diabetic retinopathy gastroparesis disorders of bilirubin excretion 

Answer: The patient is high likely exposed to