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: codeine attending: chief complaint: ams, hyperglycemia, hypertension major surgical or invasive procedure: intubation, central line placement history of present illness: history of present illness: 24-year-old gentleman with poorly controlled type i diabetes with esrd recently started hd, hypertension, retinopathy, with three separate admissions this past week who was referred to the ed from dialysis for elevated blood sugar and vomiting. per patient's family, patient took am dose of insulin today. he had awoken feeling unwell and had been vomiting prior to going to dialysis. he reportedly was not febrile. he reportedly did not take his am bp meds. . in the ed, initial vs were: t98 hr:88 bp:193/113 rr:16 o2sat:100ra. serum glucose on arrival was 818 with ag of 21. he received 10 units of regular insulin. he received less than 1 liter ns. for bp got total of 30 mg iv labetolol. pt acting confused and agitated requiring total 10mg im haldol, ativan 2mg. given his extreme agitation he was intubated and transferred to micu for further management. . on the floor,patient intubated and sedated. he appeared comfortable on the ventilator. . review of systems: (unable to obtain) past medical history: - diabetes mellitus, type i. diagnosed in . poorly controlled with past dka. complicated with retinopathy, nephropathy - hypertension, poorly controlled - chronic kidney disease - chronic constipation - chronic anemia (baseline hematocrit 30-35) social history: lives with aunt in . smokes 2 packs per week since age 16. denies recent alcohol use. denies illicit drug use, now or in the past. family history: father, grandmother with diabetes mellitus. no relatives currently on dialysis. physical exam: vitals: t:99 bp:184/106 p:104 r:14 cmv tv 500 rr 16 peep 5 fio2 100% general: sedated, intubated heent: sclera anicteric, perrl, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: labs on admission: 05:35am wbc-8.2 rbc-2.98* hgb-8.5* hct-26.6* mcv-89 mch-28.6 mchc-32.0 rdw-15.3 05:35am glucose-151* urea n-27* creat-6.4* sodium-138 potassium-4.8 chloride-100 total co2-31 anion gap-12 04:30pm plt count-329 04:30pm neuts-77.6* lymphs-17.3* monos-3.1 eos-1.5 basos-0.4 09:17pm asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 11:11pm urine rbc-0-2 wbc-* bacteria-occ yeast-none epi-<1 11:11pm urine bnzodzpn-neg barbitrt-neg opiates-pos cocaine-neg amphetmn-neg mthdone-neg micro: blood culture blood culture, routine-pending inpatient urine urine culture-pending inpatient csf;spinal fluid gram stain-negative; fluid culture-preliminary inpatient blood culture blood culture, routine-pending inpatient mrsa screen mrsa screen-final {positive for methicillin resistant staph aureus} inpatient imaging: ct head () impression: no acute intracranial process. sinus disease. cxr () findings: there is a right ij line with tip at the cavoatrial junction. there is volume loss in the left lower lobe. the heart is moderately enlarged, similar to prior. there is no focal infiltrate. mri head stroke protocol (): 1. no acute intracranial abnormality; specifically, there is no evidence of either acute or previous ischemic event. 2. unremarkable cranial mra, with no flow-limiting stenosis. \ eeg (): impression: this is a mild to moderately abnormal routine eeg in the waking and drowsy states secondary to diffuse attenuation of signal over the left hemisphere and overall mildly slow and disorganized background. there were no epileptiform features noted. brief hospital course: this is a 24 yo male with type i dm, esld on hd, resistant htn who presents with hyperglycemia and emesis and found to have significantly elevated blood pressures. # fever/mental status changes/? delirium: when patient arrived to the hospital, he was agitated and required intubation for airway protection. he does have a history of oppositional defiant disorder. was agitated and confused on admission. pt was laughing and crying inappropriately. head ct read neg for any acute ic process. infectious w/u was negative though pt was febrile on admission, and lp and blood cx were negative. pt was covered for bacterial and hsv meningitis until cx results returned. also have had some component of uremic encephalopathy, and pt underwent dialysis in-house. all electrolyte abnormalities have been aggressively corrected. glucose management as (see below). neuro was consulted and recommended mri to r/o pres and/or stroke, particularly given rue weakness, and mri stroke protocol was negative. pt was started on asa 81mg and simvastatin 20mg for preventative measures. psych consulted in light of odd; he was deemed not to have capacity due to lack of insight and lack of cooperation, and pt was restrained from leaving ama by security on two occasions. however, on the mental status improved during hospitalization back to baseline, per family, and pt was re-evaluated by psychiatry and was deemed to have capacity, after which he signed out ama (with close f/u arranged prior to sign out). . # hyperglycemia: on initial presentation, pt in hhs given no ketonemia, though ag present, liekly insulin non-compliance. ag resolved after only 10 units of im regular insulin, but blood glucose remained difficult to control give pt's irregularly timed eating habits, during which he does not receive insulin (as insulin is regularly scheduled with mealtimes, during which times pt does not eat). followed pt and sliding scale and lantus was adjusted, but sugars remained in 200's prior to discharge. infectious workup was all negative. f/u with was scheduled prior to pt's signing out ama. . # anion gap acidosis: resolved after only 10 units of im insulin. tox screen positive only for opiates. lactate 1. most likely renal failure. # hypertension: bp >200's/100's on admission. has run similarly high on previous admissions. was on labetalol drip and home doses of metoprolol, lisinopril, and amlodipine. anti-hypertensive regimen was changed to labetolol , lisinopril, nifedipine and clonodine patch. clonodine patch and labetolol are new on this admission and the lisinopril was doubled on this admission. pt's home amlodipine was switched to nifedipine per renal, and dosed at night as pt typically had high bp's during the night. . # esrd on hd: received hd in-house, but all hd sessions were terminated prematurely due to pt's inability to tolerate due to symptoms. renal followed, started pt on sevelamer. . #anemia: s/p 1 unit prbc. likely chronic renal failure (baseline about 25). patient received epo after dialysis sessions. medications on admission: glargine 10 units qhs humalog ss humalog 2 units after each meal metoprolol succinate 200mg daily metoclopramide 5mg po q6 omeprazole 20 mg capsule po daily ondansetron hcl 4 mg tablet q8prn docusate sodium 100 mg capsule :prn b complex-vitamin c-folic acid 1 mg daily amlodipine 10 mg tablet daily lisinopril 10 mg tablet daily sevelamer hcl 800 mg tablet tid with meals aspirin 81 mg tablet daily discharge medications: 1. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). disp:*30 cap(s)* refills:*2* 2. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 3. sevelamer hcl 800 mg tablet sig: one (1) tablet po three times a day. 4. lisinopril 40 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 5. clonidine 0.2 mg/24 hr patch weekly sig: one (1) patch weekly transdermal qwed (every wednesday). disp:*5 patch weekly(s)* refills:*2* 6. nifedipine 90 mg tablet sustained release sig: one (1) tablet sustained release po at bedtime. disp:*30 tablet sustained release(s)* refills:*2* 7. labetalol 300 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* 8. nephrocaps 1 mg capsule sig: one (1) capsule po once a day. 9. docusate sodium 100 mg capsule sig: one (1) capsule po bid prn as needed for constipation. 10. ondansetron hcl 4 mg tablet sig: one (1) tablet po q8h prn as needed for nausea. 11. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 12. metoclopramide 5 mg tablet sig: one (1) tablet po every six (6) hours. 13. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 14. insulin lispro 100 unit/ml solution sig: as directed subcutaneous as directed: please follow the instruction for insulin doses from your sliding scale. discharge disposition: home discharge diagnosis: type i diabetes mellitus hypertension end stage renal disease discharge condition: inadequate blood pressure and blood glucose control. not medically stable, advised patient not to leave the hospital but patient wished to leave against medical advice. discharge instructions: you were admitted for confusion, high blood pressures, and high blood sugars. you were intubated due to your confusion. an extensive workup failed to find a cause of your confusion, but your mental status improved. your blood pressure medications were changed in order to better control your blood pressure. your insulin regimen was also adjusted to better manage your blood sugars. eating regular meals at intervals at least 4 hours apart and taking your insulin prior to eating will help regulate your blood sugar. . the following changes were made to your medications: - metoprolol was stopped - amlodipine was stopped - lisinopril was increased to 40mg daily - labetalol 300mg twice daily was added - nifedipine 90mg daily at night was added - clonidine patch 0.2mg/24hr 1 patch every wednesday was added - atorvastatin 20mg daily was added - your insulin scales were adjusted (please see attached sheet) . please come to the emergency department or call your primary care physician if you have confusion, severe headaches, change in vision, chest pain, fevers, chills, or any other concerning symptoms. followup instructions: you have scheduled the following appointments: . dr. at diabetes center () tuesday @ 3:00pm . dr. , md phone: date/time: 3:20 . dr. , md phone: date/time: 1:40 . dr. (phone ) on at 8:30 pm. you are also scheduled to see dr. on thursday at 1:30 pm. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified spinal tap incision of lung insertion of endotracheal tube hemodialysis diagnoses: hypertensive chronic kidney disease, malignant, with chronic kidney disease stage v or end stage renal disease acidosis hyperpotassemia anemia in chronic kidney disease end stage renal disease nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere other pulmonary insufficiency, not elsewhere classified hyposmolality and/or hyponatremia alkalosis fever, unspecified other encephalopathy awaiting organ transplant status hematuria, unspecified diabetes with renal manifestations, type i [juvenile type], uncontrolled diabetes with ophthalmic manifestations, type i [juvenile type], uncontrolled legal blindness, as defined in u.s.a. background diabetic retinopathy other musculoskeletal symptoms referable to limbs 

Answer: The patient is high likely exposed to