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 / cymbalta attending: chief complaint: s/p fall major surgical or invasive procedure: none. history of present illness: mr. is a 67 year old man with a history of esrd on hd (t/th/s), schf, dm2, afib (not on ) presents after a fall with report of weakness. he describes trying to stand with the help of his walker and falling back on his back side. he denies any head trauma or injury. he denies any dizziness, change in vision, loss of consciousness, chest pain, or shortness of breath. he reports calling ems because he knew that his weakness was likely due to missing his hd session today and his symptoms were consistent with prior episodes of hyperkalemia. . in ed vs were t 98.4 hr 90 bp 84/41 rr 12 spo2 96. ekg was consistent with priors showing lbbb and slow afib. labs were notable for potassium of 7.6. he was given insulin 10 u iv, 1 amp d50, kayexalate 30 g po, calcium gluconate 1 amp iv with repeat potassium of 4.3. renal team was notified and planned for hd. due to persistently low blood pressures he was given 2 l ivf, pancultured and started on empiric vancomycin 1 g iv and zosyn 4.5 mg iv. on review of systems he noted intermittent blood tinged sputum over the last week. he denies any recent infections, chest pain, or shortness of breath. a cta was performed revealing right subsegmental pulonary embolisms. he was transferred to the icu for hd and further monitoring. . . review of systems: (+) per hpi, occasional constipation, bilateral leg cramping (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denied shortness of breath. denied chest pain or tightness, palpitations. denied nausea, vomiting, diarrhea or abdominal pain. no recent change in bowel or bladder habits. no dysuria. . past medical history: -ckd on hd , tuesday/thursday/saturday -chronic systolic chf with ef 20% in -dm ii -atrial fibrillation not on -gout -bph -mrsa bacteremia -fungemia secondary to hd line infection social history: (per omr) patient is retired from a career in selling/buying college text books. patient smokes 1 pack cigarettes a day x 3 years, drinks alcohol occasionally. no recent drug use but has hx of marijuana and lsd. he uses multiple herbal medications. he lives alone in an apartment complex. does not have vna. family history: noncontributory physical exam: admission physical exam v/s 98.6 79 82/49 16 94%ra gen: aox3, nad heent: perrla, eomi mmm, poor dentition, no cervical lad, no jvd. neck supple. cards: rrr pulm: ctab no crackles or wheezes abd: soft, nt, +bs, no rebound/guarding, + bs skin: bilateral significant icthyosis and venous stasis changes of bilateral lower extremities, scattered telangectasias of bilateral forearms extremities: no edema, dry skin, 1 + distal pulses, open 1 cm ulcer of left lateral metatarsal with yellow base, no surrounding induration, edema, fluctuance, erythema, or warmth. neuro/psych: cns ii-xii intact. moving all 4 extremities. peripheral nephropathy drains/tubes: r ij tunnelled line without evidence of infection, foley catheter, r piv x 1 pertinent results: cta - 1. filling defects within segmental and subsegmental branches of the pulmonary vessels in the right lower lobe concerning for pulmonary embolism. 2. wedge shaped opacification within the right basal segment is concerning for pulmonary infarction. 3. retained secretions noted within the trachea. 4. opacification with calcified rim in the periphery of the liver (3, 60) is concerning for old torsed epiploic appendage or pseudolipoma of glisson's capsule. . cxr findings: a right-sided hemodialysis catheter tip ends at the cavoatrial junction, unchanged from prior study. the heart size is mildly enlarged, likely exaggerated by technique. the mediastinal contours are normal appearing and unchanged. the hila are normal bilaterally. the lungs are clear of masses or consolidations. there is no large pleural effusion or pneumothorax. there is likely an old left clavicle fracture. impression: no acute cardiopulmonary process. 02:40pm blood wbc-19.1*# rbc-3.23* hgb-10.8* hct-32.4* mcv-100* mch-33.5* mchc-33.5 rdw-16.3* plt ct-208 02:40pm blood neuts-91.6* lymphs-4.1* monos-3.5 eos-0.7 baso-0.2 04:20am blood wbc-13.0* rbc-3.44* hgb-11.3* hct-35.5* mcv-103* mch-32.9* mchc-31.8 rdw-16.5* plt ct-193 04:20am blood pt-15.3* ptt-27.5 inr(pt)-1.3* 02:40pm blood glucose-133* urean-61* creat-7.5*# na-127* k-8.3* cl-88* hco3-24 angap-23* 06:25pm blood glucose-75 urean-58* creat-7.1* na-135 k-4.8 cl-96 hco3-25 angap-19 04:20am blood glucose-79 urean-40* creat-5.2*# na-137 k-3.8 cl-96 hco3-26 angap-19 02:40pm blood ck(cpk)-293 04:20am blood ck(cpk)-118 06:25pm blood digoxin-1.0 02:52pm blood glucose-130* lactate-2.0 na-129* k-7.6* cl-88* calhco3-24 . 05:45pm urine color-yellow appear-clear sp -1.017 05:45pm urine blood-neg nitrite-neg protein-75 glucose-neg ketone-tr bilirub-sm urobiln-neg ph-6.5 leuks-sm 05:45pm urine rbc-* wbc-21-50* bacteri-occ yeast-none epi-0 . 5:45 pm urine site: catheter urine culture (pending): brief hospital course: pulmonary embolus with pulmonary infarct - cta chest showed rll segmental and subsegmental pe with a wedge shaped opacification within the right basal segment concerning for pulmonary infarction. treated with heparin and . left ama prior to achieving a therapeutic inr. referred to the anticoagulation management clinic, who will coordinate inr monitoring with . . hyperkalemia - treated with hemodialysis. plans to resume usual hd schedule, tues/thurs/sat. . acute complicated cystitis - treated with vanc/cipro empirically for 7 days (end ) pending results of urine culture which are pending at the time of discharge. . nonischemic cardiomyopathy - continued digoxin, metoprolol, and enalapril after k returned to range. . type 2 diabetes mellitus - continued basal and sliding scale insulin. . atrial fibrillation - continued metoprolol and started . . end stage renal disease on hemodialysis - received hd on . medications on admission: allopurinol - 300 mg tablet - 0.5 tablet(s) by mouth daily b complex-vitamin c-folic acid - (not taking) - 1 mg capsule - 1 capsule(s) by mouth daily bumetanide - 2 mg tablet - 3 tablet(s) by mouth twice a day carvedilol - 3.125 mg tablet - 1 tablet(s) by mouth twice a day digoxin - 125 mcg tablet - one tablet(s) by mouth every other day enalapril maleate - 5 mg tablet - one tablet(s) by mouth daily fluticasone - (prescribed by other provider) - 50 mcg spray, suspension - 1 spray(s) intranasally twice a day folic acid-vit b6-vit b12 - (not taking) - 1 mg-2.5 mg-25 mg tablet - 1 tablet(s) by mouth daily gabapentin - 400 mg capsule - 1 capsule(s) by mouth three times a day lanthanum - 1,000 mg tablet, chewable - one tablet(s) by mouth three times a day with meals - no substitution oxycodone - 5 mg tablet - one tablet(s) by mouth tid prn oxycodone - 20 mg tablet sustained release 12 hr - 1 tablet(s) by mouth twice a day topiramate - 50 mg tablet - one tablet(s) by mouth twice a day take one extra dose on all days herbal medications: 3 tablets of mixed herbal supplements provided to him by his herbalist/accupunturist ginger for anticoagulation rubarb for constipation discharge medications: 1. allopurinol 300 mg tablet sig: 0.5 tablet po once a day. 2. bumetanide 2 mg tablet sig: three (3) tablet po twice a day. 3. carvedilol 3.125 mg tablet sig: one (1) tablet po bid (2 times a day). 4. digoxin 125 mcg tablet sig: one (1) tablet po every other day (every other day). 5. enalapril maleate 5 mg tablet sig: one (1) tablet po once a day. 6. fluticasone 50 mcg/actuation spray, suspension sig: one (1) spray nasal twice a day. 7. gabapentin 400 mg capsule sig: one (1) capsule po tid (3 times a day). 8. lanthanum 1,000 mg tablet, chewable sig: one (1) tablet, chewable po three times a day: with meals. 9. oxycodone 5 mg tablet sig: one (1) tablet po three times a day as needed for pain. 10. oxycontin 20 mg tablet sustained release 12 hr sig: one (1) tablet sustained release 12 hr po twice a day. 11. topamax 50 mg tablet sig: one (1) tablet po twice a day: take one extra dose on all days. 12. vancomycin 1,000 mg recon soln sig: one (1) grams intravenous qhd for 7 days: on days through . 13. warfarin 2 mg tablet sig: 2.5 tablets po once a day. disp:*75 tablet(s)* refills:*2* 14. cipro 250 mg tablet sig: one (1) tablet po once a day for 7 days: take after on hd days. disp:*7 tablet(s)* refills:*0* 15. novolin n 100 unit/ml suspension sig: eighteen (18) units subcutaneous qam. 16. novolin n 100 unit/ml suspension sig: fourteen (14) units subcutaneous at bedtime. 17. novolin r 100 unit/ml solution sig: as directed units injection four times a day: per sliding scale . discharge disposition: home discharge diagnosis: pulmonary embolus with pulmonary infarct hyperkalemia acute complicated cystitis nonischemic cardiomyopathy type 2 diabetes mellitus atrial fibrillation end stage renal disease on hemodialysis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). against medical advice discharge instructions: you were admitted to the hospital with an elevated potassium level (hyperkalemia) and found to have a blood clot in the lung (pulmonary embolus, or pe) and a urinary tract infection (uti). you were started on blood thinners and antibiotics, both of which we recommend that you continue for the specified duration. it was recommended that you remain in the hospital for further evaluation and treatment but you have elected to leave against medical advice having acknowledged the risks inherent in doing so, including another blood clot, stroke, worsening heart function, worsening of infection, or death. the following medication changes were recommended: 1) vancomycin infusion at each session (through ) 2) ciprofloxacin 250 mg daily after (through ). 3) take 5 mg until instructed by your doctors the clinic to change your dose. please ensure that your level (inr) is checked tomorrow, at , with the results faxed to the number below. please also have your level checked on monday . please notify your healthcare providers about any herbal supplements or nonprescription medications that you may be taking, as these can interact with . the contact information for the (dr. office) clinic is (phone) and . please weigh yourself daily and call your doctor if your weight goes up more than 3 lbs. you were admitted to the hospital with an elevated potassium level (hyperkalemia) and found to have a blood clot in the lung (pulmonary embolus, or pe) and a urinary tract infection (uti). you were started on blood thinners and antibiotics, both of which we recommend that you continue for the specified duration. it was recommended that you remain in the hospital for further evaluation and treatment but you have elected to leave against medical advice having acknowledged the risks inherent in doing so, including another blood clot, stroke, worsening heart function, worsening of infection, or death. the following medication changes were recommended: 1) vancomycin infusion at each session (through ) 2) ciprofloxacin 250 mg daily after (through ). 3) take 5 mg until instructed by your doctors the clinic to change your dose. please ensure that your level (inr) is checked tomorrow, at , with the results faxed to the number below. please also have your level checked on monday . please notify your healthcare providers about any herbal supplements or nonprescription medications that you may be taking, as these can interact with . the contact information for the (dr. office) clinic is (phone) and . please weigh yourself daily and call your doctor if your weight goes up more than 3 lbs. followup instructions: provider: , md phone: date/time: 1:00 provider: , md phone: date/time: 6:40 provider: , md phone: date/time: 11:50 procedure: hemodialysis diagnoses: other primary cardiomyopathies hyperpotassemia end stage renal disease renal dialysis status tobacco use disorder congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled gout, unspecified atrial fibrillation hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) long-term (current) use of insulin chronic systolic heart failure noncompliance with renal dialysis surgical or other procedure not carried out because of patient's decision fall from other slipping, tripping, or stumbling other pulmonary embolism and infarction other specified hypotension ulcer of heel and midfoot venous (peripheral) insufficiency, unspecified acute cystitis combinations of drug dependence excluding opioid type drug, in remission 

Answer: The patient is high likely exposed to