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: iv dye, iodine containing attending: chief complaint: hypotension requiring pressor & elevated bg major surgical or invasive procedure: central venous line placement (femoral) history of present illness: 44 y/o male, with type i dm, resident of , transferred from jp va for hypotension, on peripheral dopamine. per patient, he was in his usoh until this am, when he noticed that his insulin pump was not working. he reported emesis x 5 minutes and a bg of 570. he changed his infusion set and gave himself an injection of 35 units of regular insulin. he subsequently travelled to his jp va optho appointment. his bg was 350 at the eye clinic, for which he took 25 units of regular insulin. he then set his basal insulin pump rate at 1.4 units/hour. at 1 pm, he reported stomach cramps, nausea, diaphoresis. his muscle cramps were epigastric, non-radiating, and were intermittent. he did not take any medications for his pain. he drank some ginger-ale and ate a donut which alleviated his abdominal cramps. no modifying factors for his cramps. he was sent from clinic to the jp va ed for dizziness and diaphoresis. he recalls his bg being 170-180 there (not-treated). he was reportedly hypotensive to sbp 60/45, hr of 70, o2 sats 92%. he was given 0.5 liters of ivf, given a 0.5 mg atropine x 1, and transferred to on peripheral dopamine. in the ed, initial vs were: t 97.6, p 100, bp 104/66, r 20, o2 sat 92% ra. he remained afebrile. his insulin pump was turned off and removed. ros only notable for nausea, malaise, and suprapubic discomfort. he reports that he has been eating and drinking well, except for today. he denied cp, sob, urinary symptoms. exam was non-focal with exception of distended abdomen. he was guaiac negative. his testicular exam and prostate exam were felt to be normal. he was felt to be under-resuscitated. a femoral cvl was placed as his right and left ij were felt to be "completely flat" with ultrasound, in addition to the fact that his carotid was felt to be directly posterior to his ij. subclavian cvl was not attempted given altered anatomy with his sternotomy and prior surgery. patient was given 1 gram vancomycin, zosyn, zofran, and 4l ivf in the ed. he was continued on dopamine, as they were unable to wean despite ivf (sbp in the 80s with weaning attempt, baseline bp unknown). labs notable for lactate of 1.5, cr of 1.7 (unknown baseline), bicarb of 18, negative ce's. ekg reported as nsr at 62, nl axis, nl intervals, nl voltage, isolated q wave in iii, no ischemic changes. ct torso performed, which was largely unremarkable. bedside us of pericardium without large effusion. u/a with few bacteria, 0-2 wbc, neg nitrites, neg leuk esterase. blood and urine cultures pending. on transfer, bp 110/80 and hr 60. access - femoral cvl and 22g piv. on the floor, patient denies recent fevers, cough, diarrhea, dysuria, or flu-like illness. past medical history: - type 1 dm (followed by at va white river junction in vt) - mi with cabg x 3v in - infected sternotomy (mrsa), s/p sternum removal (chest wall without cartilage with muscle flap) - "word finding difficulty" (previously on aricept, now off) - appendectomy - arthroscopy - htn - hld - macular edema - non-proliferative retinopathy social history: - lives in - prior veteran - prior 1 ppd x 20 years, quit smoking in - rare etoh - denies illicits family history: htn in mother, otherwise negative for early cad or cancer. physical exam: physical exam on admission: vitals: t: 98.1, hr 85, bp 105-132/64-69, rr 15, 96% on 2l nc general: alert, oriented, no acute distress heent: sclera anicteric, mm dry, oropharynx clear neck: supple, jvp difficult to assess, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, prominent s1 + s2, no murmurs, rubs, gallops, sternotomy with muscle flap c/d/i abdomen: obese, soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema rectal: old, healed pressure ulcer, at coccyx pertinent results: labs: 07:00pm blood wbc-10.8 rbc-4.64 hgb-14.2 hct-40.4 mcv-87 mch-30.7 mchc-35.2* rdw-13.4 plt ct-376 neuts-78.4* lymphs-16.4* monos-3.5 eos-0.7 baso-0.9 03:44am blood wbc-10.9 rbc-3.71* hgb-11.2* hct-32.8* mcv-88 mch-30.1 mchc-34.0 rdw-13.1 plt ct-327 neuts-69.8 lymphs-23.5 monos-5.2 eos-1.1 baso-0.4 07:00pm blood glucose-181* urean-36* creat-1.7* na-135 k-4.8 cl-101 hco3-18* 03:44am blood glucose-195* urean-26* creat-1.2 na-140 k-4.0 cl-107 hco3-23 07:00pm blood alt-31 ast-32 ld(ldh)-383* alkphos-182* amylase-40 totbili-0.2 03:44am blood alt-20 ast-18 ld(ldh)-175 ck(cpk)-75 alkphos-140* totbili-0.2 07:00pm blood lipase-16 ggt-20 07:00pm blood ctropnt-<0.01 03:44am blood ck-mb-3 ctropnt-<0.01 07:00pm blood totprot-8.5* albumin-5.0 globuln-3.5 calcium-10.1 phos-4.0 mg-2.3 07:00pm blood %hba1c-12.4* eag-309* 07:00pm blood tsh-2.6 . labs upon discharge: 06:13am blood wbc-7.3 rbc-3.70* hgb-11.0* hct-33.0* mcv-89 mch-29.8 mchc-33.4 rdw-12.7 plt ct-266 06:13am blood pt-10.9 ptt-21.9* inr(pt)-0.9 06:13am blood glucose-297* urean-14 creat-0.8 na-134 k-4.5 cl-103 hco3-20* angap-16 06:13am blood alt-17 ast-19 ld(ldh)-201 alkphos-141* amylase-28 totbili-0.2 06:13am blood lipase-11 03:44am blood ck-mb-3 ctropnt-<0.01 06:13am blood albumin-3.9 calcium-8.8 phos-3.2 mg-1.9 07:00pm blood cortsol-44.0* 04:10am blood lactate-1.2 . imaging: - ct chest/abdomen/pelvis : bibasilar atelectasis, no nodules, consolidations, or effusions in the lungs. s/p cabg to the left-sided vessels and large sternal defect 35 mm in the transverse dimension which is post-operative. no abdominal free fluid or free air. there is a repaired abdominal wall hernia on the right a minimal fat and bowel containing hernia. small and large bowels are unremarkable. the rectum, sigmoid colon bladder, prostate, ureters, and seminal vesicles are normal. there is a left sided femoral venous catheter. no pelvic free fluid or free air. no acute pathology was seen to account for hypotension. . - cxr : ap chest compared to : interval widening of the upper mediastinum and left hilus suggests interval volume administration. moderate-to-severe cardiomegaly is larger, but there is no pulmonary edema and, as yet, no pleural effusion. . echo : the left atrium is normal in size. left ventricular wall thicknesses and cavity size are normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef>55%). the aortic valve leaflets (?#) appear structurally normal with good leaflet excursion. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. the pulmonary artery systolic pressure could not be determined. the main pulmonary artery is dilated. there is no pericardial effusion. impression: suboptimal image quality. preserved left ventricular function. cannot accurately assess right ventricular size or function. brief hospital course: mr. is a 44 y/o male transferred from jp va for hypotension with evidence of agma, , and elevated bg suggestive of dka. # hypotension: believed to be most likely secondary to hypovolemia due to volume loss secondary to diabetic ketoacidosis. he had an echo completed which did not reveal rv dilitation concerning for a pe and there was no evidence of endocarditis. in the ed he had an extensive workup to rule out infection that might have been predisposing him to hypotension (although wbc was normal and he was afebrile), including a ct chest/abd/pelvis which did not reveal any nidus of infection. antibiotics were stopped the morning after admission given the low suspicion for infection. he was managed with treatment for dka using insulin drip. he was given several liters of ns ivf, his bp improved and he was able to be weaned off of dopamine. blood cultures & urine cultures have been no growth to date. his home metoprolol and lisinopril were held during admission and upon discharge and can be started if needed as as outpatient. # dka: had elevated bg, ag metabolic acidosis and ketonuria on admission. treated with insulin drip with successful closure of the anion gap. tox screen was negative. he received ivf and insulin gtt, restarted a po diet, and was transitioned to sliding scale insulin followed by restarting insulin drip. he was seen by who made recommendations for his insulin pump. he will follow up with his outpt endocrinologist in vt and was educated on warning signs of rising glucose and dka and instructed to seek emergency care if he was unable to manage his glucose goal <200 at home. # : likely pre-renal azotemia secondary to hypovolemia. creatinine normalized with iv hydration. # type 1 dm: followed by at va white river junction in vt. he has associated non-proliferative retinopathy. his hgba1c is 12.4 showing poorly controlled t1dm. he likely needs further education regarding adequeate insulin dosing through his pump and frequent follow up appointments with his physicians in order to maintain better glucose control. # cad. non-active. he continued with home aspirin and statin. bb and ace inhibitors were held given initial hypotension on pressor. his home metoprolol and lisinopril were held secondary to hypotension during admission and upon discharge and can be started if needed as as outpatient. # hld. his was continued on simvastatin during his admission. he was restarted on gemfibrozil upon discharge. we recommend a trial of lowering his simvastatin dose to 40mg due to risk of rhabdomyolysis on 80mg daily, if unsuccessful, atorvastatin should be considered. # elevated alkaline phosphatase: unclear etiology. ggt was normal indicating the source of alkaline phosphatase is likely not the biliary tree, instead may be coming from the bone or other sources. recommend rechecking in 2 weeks at outpatient and continue work up if clinically indicated. the patient was full code for this admission. medications on admission: - insulin pump with ~ 29.9 units of basal insulin/day - lisinopril 5 mg qday - metoprolol 50 mg - simvastatin 80 mg daily - aspirin 81 mg daily - mirtazapine 30 mg qhs - gemfibrozil 300mgbid - omeprazole 20 mg discharge medications: 1. simvastatin 40 mg tablet sig: two (2) tablet po daily (daily). 2. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 3. mirtazapine 15 mg tablet sig: two (2) tablet po hs (at bedtime). 4. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po bid (2 times a day). 5. gemfibrozil 600 mg tablet sig: 0.5 tablet po twice a day. 6. insulin pump please continue your insulin pump per your usual home settings discharge disposition: home discharge diagnosis: primary diagnoses: diabetic ketoacidosis hypotension acute kidney injury secondary diagnoses: type 1 diabetes mellitus coronary artery disease hyperlipidemia hypertension discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to the hospital for diabetic ketoacidosis, a condition with high blood sugars, dehydration, and low blood pressures. you were given insulin and fluids and medication to keep your blood pressure sufficiently high through an iv and eventually all of your labs normalized and these medications were stopped. you were transitioned to subcutaneous insulin and then to your insulin pump. you were seen by one of the diabetes doctors from the clinic to help us with these transitions. the following changes were made to your medications: please stop taking lisinopril and metoprolol until your follow-up with your primary care physician please talk with your physician about taking simvastatin and gemfibrozil together. followup instructions: please follow-up with your primary care physician within the next 1-2 weeks. procedure: venous catheterization, not elsewhere classified diagnoses: unspecified essential hypertension acute kidney failure, unspecified coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status diabetes with ophthalmic manifestations, type i [juvenile type], uncontrolled diabetes with ketoacidosis, type i [juvenile type], uncontrolled nonproliferative diabetic retinopathy nos 

Answer: The patient is high likely exposed to