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: patient recorded as having no known allergies to drugs attending: chief complaint: hypotension major surgical or invasive procedure: r ij central line placement history of present illness: briefly, this is 53 yo m s/p ddrt in who was in his usal state of health until 2 days prior to presentation when he develped non-bloody diarrhea and non bloody, non-bilious emesis. no sick contract, no travel, no abnormal food exposure and no recent antibiotic exposure. he reports lightheadedness and dizziness and 2 syncopal episodes. . in the emergency department he was found to be hypotensive with bp 70/40 (baseline sbp = 90-110) with hr = 60s-80s with a leukocytosis of 16k and acute on chronic renal failure with cr = 4.0 up from his baseline of 1.9-2.3. code sepsis was initiated and he received ivf, stress dose steroids and vancomycin 1 gm, zosyn 2.25 gm. . in the icu, he was hemodynamically stable and his bp normalized to sbp 110s without additional ivf nor need for pressors. . on the floor the pt feels comfortable, he denies any further lh or dizziness lying in bed and with ambulation. he denies abdominal pain, fevers, chills and states that he would like to go home in the morning. past medical history: esrd ? htn s/p deceased donor renal transplant in gout htn impaired glucose tolerance hyperlipidemia social history: born in , moved to us in at about age 23. he had worked in electronics but is now on disability. no tobacco, alcohol or ivdu. . family history: father who died at 78 of kidney disease, mother who is in her 80s and well. there is no history of diabetes or cancer in the family. he has one brother and two sisters who are well. he also has two children, ages 23(a daughter) and 17 (a son) who are well. physical exam: t 98.6 bp 106/77 p 94, o2 sat 97% ra heent: nc/at, perrl, no scleral icterus noted, mmm, neck: supple, no jvd or carotid bruits appreciated pulmonary: lungs cta bilaterally without r/r/w cardiac: rrr, nl. s1s2, no m/r/g noted abdomen: soft, nt/nd, normoactive bowel sounds, no masses or organomegaly noted. ext: no c/c/e bilaterally, 2+ dp b/l skin: no rashes or lesions noted. pertinent results: 05:20am wbc-16.1*# rbc-4.89 hgb-15.2 hct-44.9 mcv-92 mch-31.1 mchc-33.9 rdw-14.5 05:20am neuts-78.4* lymphs-14.3* monos-6.7 eos-0.4 basos-0.2 05:20am plt count-217 05:58am lactate-1.4 07:30am albumin-3.1* calcium-6.7* phosphate-3.0 magnesium-1.9 01:37pm freeca-1.19 03:36pm type-mix po2-41* pco2-30* ph-7.27* total co2-14* base xs--11 comments-central ve 01:37pm type- ph-7.24* . admission cxr: no acute process. right ij line with tip in the svc/ra junction. . ct abd/pelvis: 1. mild fascial thickening posterior to the transplant kidney. no evidence of hydronephrosis or perinephric fluid collection. 2. incompletely visualized coronary artery calcifications. 3. cholelithiasis without evidence of cholecystitis. . renal transplant u/s: a transplant kidney is seen in the right lower quadrant and measures 13.2 cm. there is no hydronephrosis or perinephric fluid collection. resistive indices in the upper, mid, and lower poles are 0.64, 0.72, and 0.69 espectively. the main renal artery and main renal vein are patent with normal waveforms. a foley catheter is in the decompressed bladder. impression: normal renal transplant ultrasound. . ct head: no intracranial hemorrhage or mass effect. . cardiac evaluation: ett - 8.5 mets. no anginal symptoms nor ekg changes. . admission ekg: nsr, lad, poor r wave progression and first degree av block. no acute st changes. brief hospital course: 53 y.o. m with h/o esrd s/p deceased donor kidney transplant in on chronic immunosuppression presents with emesis, diarrhea, hypotension and acute on chronic renal failure. . 1. hypotension: was likely due to volume loss from diarrhea and vomiting. elevated wbc with left shift. etiology most likely viral given lack of fever, abdominal pain. he was continued on ivf with bicarbonate. he received hydrocortisone 50mg q8h for one day, then was placed back on his outpatient dose of oral prednisone. pt initially received antibiotics in the ed, none were necessary anymore after that since his bp remained stable and he also remained afebrile. he was discharged with stable bp but off his antihypertensives. he should schedule a followup appointment with dr. within one week after discharge. at this time, it can be decided if he should continue any of his antihypertensives. . 2. diarrhea: probably infectious, most likely viral, however atypical bacterial presentation was initially considered. also in this immunosuppressed pt need to consider crytpo/micropsiridia and cmv. cmv was negative in the past. no recent antibiotic exposure and presentation not suggestive of c diff. extensive stool studies were sent but pending upon discharge. his diet was advanced and his diarrhea resolved slowly after admission. . 3. non anion gap metabolic acidosis: probably secondary to diarrhea, possible component of rta in the context of worsening rf, however, the patient has had normal bicarbonate in the past. he received ivf with hco3 and his hco3 came back up to normal levels. . 4. syncopal episodes: unlikely to be cardiac/seizure/stroke, probably due to orthostatic hypotension secondary to hypovolemia. ct head was negative. patient was without focal neurological signs. he was monitored on telemetry for 24 h. hypocalcemia was repleted with iv calcium gluconate as needed. . 5. esrd s/p ddrt 10 years ago on neoral and imuran and prednisone. renal us was wnl w/o signs of rejection. he was continued on neoral, imuran and prednisone (except for one day while being on stress dose steroids instead of his po prednisone). . 6. acute on chronic renal insufficiency: likely secondary to hypovolemia, quickly improved with ivf. back to baseline (around 2.0) on . . 7. hypocalcemia: no qt prolongation. probably secondary to diarrhea. repleted with iv calcium gluconate. . 8. hypertension: initially hypotensive. resolved after ivf. then remained normotensive. all antihypertensives were held given hypotension. they should be restarted as an outpatient. . 9. prophylaxis: tolerating pos, pantoprazole while on steroids, issc while on steroids, sq heparin . 10. access: rij was placed on , then pulled the next day. piv. . 11. code: full medications on admission: colchicine 0.6mg po qd prn gout hydralazine hcl 50mg po bid imuran 50mg po q day lopressor 100mg po qday neoral 50mg prednisone 5mg po qday probenecid 500mg--one by mouth twice a day for gout vasotec 10mg--one by mouth every day ranitidine 150mg po bid discharge medications: 1. prednisone 5 mg tablet sig: one (1) tablet po daily (daily). 2. cyclosporine modified 25 mg capsule sig: two (2) capsule po q12h (every 12 hours). 3. azathioprine 50 mg tablet sig: one (1) tablet po daily (daily). 4. probenecid 500 mg tablet sig: one (1) tablet po twice a day. 5. ranitidine hcl 150 mg capsule sig: one (1) capsule po twice a day. discharge disposition: home discharge diagnosis: primary diagnosis: 1. gastroenteritis with hypotension, self-limited, likely viral 2. esrd s/p deceased donor renal transplant 3. hypertension secondary diagnosis: 1. gout 2. hyperlipidemia discharge condition: afebrile. hemodynamically stable. ambulating. tolerating po. discharge instructions: you have suffered from a gastroenteritis which was likely caused by a virus. your blood pressure was low and you received intravenous fluids and briefly antibiotics. . please call your primary doctor or return to the ed with fever, chills, chest pain, shortness of breath, nausea/vomiting, worsening diarrhea, spontaneous bleeding or any other concerning symptoms. . please take all your medications as directed. you should hold your blood pressure medications (lopressor, hydralazine and vasotec) until your next outpatient visit when it will be decided if you should be restarted on them or not. . please keep you follow up appointments as below. followup instructions: we have called to schedule you an appointment with , md phone:. the office will call you with your appointment time. you should have your blood checked (cbc, calcium) and follow up with her on your blood pressure medications and kidney function. . in addition, please keep the following scheduled appointments: . provider: , md phone: date/time: 9:30 . provider: , m.d. date/time: 4:10 md procedure: venous catheterization, not elsewhere classified diagnoses: acidosis hypocalcemia end stage renal disease acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other and unspecified hyperlipidemia hypovolemia surgical operation with transplant of whole organ causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation complications of transplanted kidney intestinal infection due to other organism, not elsewhere classified 

Answer: The patient is high likely exposed to