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: arf/hypocalcemia/abdominal pain major surgical or invasive procedure: : laparoscopic cholecystectomy history of present illness: 61m who is s/p crt in . discharged from two days ago on for hypocalcemia, generalized weakness and epigastric pain. now presents to ed with abdominal pain for 4 hours duration. a transplant surgery consult was called to evaluate the patient in the ed. pt reports that abdominal pain began during his previous hospital admission when he was started on oral calcium. the pain worsened this morning after taking his calcium. his last bowel movement was this morning and was non-bloody, no diarhea. he did have an episode on non-bilious emesis this afternoon with no relief in his pain. past medical history: -diabetes mellitus - diagnosed at age 10 y/o -diabetic nephropathy/end-stage renal disease transplanted in , on hd for 7 years prior to that. -prostate cancer, radical prostatectomy by dr. in without recurrence -htn -gout -hyperparathyroidism, parathyroidectomy ~12 yrs ago. -hypercholesterolemia -obstructive sleep apnea . past surgical history: -s/p cadaveric renal transplant -s/p prostectomy -s/p vitrectomy - left eye social history: married with 2 sons ages 40 and 23 y/o. employed as an "expediter" at . nonsmoker. etoh - 1 glass wine/month, denies drug use. family history: mother - deceased, breast ca. father - deceased, s/p cva. physical exam: vitals: temp 97.2, hr 65, bp 189/56, rr 16, o2 sat 100% ra gen: sitting on edge of stretcher resting on stand, unconfortable but no distress, and oriented, conversive and apporpriate. cv: rrr, no r/g/m resp: lungs ctab abd: distended, diffusely tender throghout with increased epigastric tenderness with no guarding, no peritoneal signs. reducible unbilical hernia pt reports in baseline. well healed surgical incisons. ext: feet wwp, trade pedal edema b/l pertinent results: on admission: wbc-9.6# rbc-2.63* hgb-8.3* hct-25.4* mcv-96 mch-31.5 mchc-32.7 rdw-22.1* plt ct-247 pt-15.2* ptt-26.2 inr(pt)-1.3* glucose-315* urean-70* creat-4.1* na-141 k-5.9* cl-103 hco3-25 angap-19 alt-90* ast-109* alkphos-499* totbili-7.8* calcium-8.2* phos-5.0* mg-2.3 hbsag-negative hbsab-negative hbcab-negative hav ab-negative at discharge: wbc-7.4 rbc-2.31* hgb-7.0* hct-22.0* mcv-95 mch-30.5 mchc-32.0 rdw-22.2* plt ct-333 pt-13.5* ptt-28.8 inr(pt)-1.2* glucose-81 urean-79* creat-4.8* na-145 k-4.9 cl-108 hco3-28 angap-14 alt-10 ast-12 alkphos-192* totbili-0.9 albumin-2.8* calcium-8.6 phos-4.4 mg-2.0 prograf: brief hospital course: 62 y/o male who was recently hospitalized with hypocalcemia, generalized weakness and abdominal pain. he was started on calcium which he claims has increased his abdominal pain. a ruq ultrasound was obtained on admission showing "extensive amount of gallbladder sludge with mild gallbladder wall thickening. no biliary dilatation identified." his labwork on admission showed a mild elevation in lfts, alk phos and a t bili to 8.5. an ercp was performed on which showed normal major papilla and complete opacification with contrast administration. there was a slight smooth extrinsic compression of the mid common bile duct probably from the distended gallbladder. no filling defects or strictures were identified within the biliary tree. a biliary stent was placed. following the ercp the patient appeared septic and was transferred to the sicu and was started on vanco and zosyn. blood cultures obtained that day grew clostridium perfringens. cultures were reviewed by the id service who recommended treatment with iv pen g for a total of 2 weeks from date of cholecystectomy given the patient's immunosuppressed status. a cholecystectomy was performed on by dr . the op note makes mention of significant adhesions and difficulty with removal of the gall bladder, but it was laparoscopically done. dermatology was consulted to evaluate l arm blisters which developed one day after admission and have increased in size and number since then. initially they recommended biopsy but the patient refused, and with dressings and silvadene the appearance of the blisters has improved and dermatology no longer wishes to pursue the biopsy and signed off. dressings were continued and should be so until the appearance of the arm totally improves. the patient often appeared drowsy but would answer questions appropriately. his medications were reviewed and sedating medications were decreased or discontinued. this includes clonidine which was reduced and gabapentin which will be tapered to off. in addition he received two units of rbc's prior to discharge. iron studies were sent prior to the transfusions and the patient may need erythropoiten due to worsening kidney funtion of his transplant. the nephrology team followed the patient while in house, immunosuppression was maintained and prograf levels checked. his creatinine peaked at 5.6 and was 4.8 upon discharge. he was restarted on po lasix once the surgical phase was over. in addition the patient will need ercp follow up for stent removal. upon admission the patient had a difficult foley placement and ended up requiring a coude catheter. due to past history of radical prostatectomy and penile implant, when he failed his first voiding trial and the catheter was replaced, we determined to keep the catheter in place, initiate flomax with inpatient urology consult and the patient is to follow-up with his outpatient urologist dr for another voiding trial. in the meantime he should remain on a coude with leg bag. the abdominal wounds were healing nicely post surgery although the patient still had some complaint of abdominal pain. liver enzymes have trended back to normal and wbc was stable at 9.3 medications on admission: lipitor 20 mg tab daily lantus 100 unit/ml sub-q 30 asa-acetaminophen-caffeine-buffers 227 mg-194 mg-33 mg tab humalog 100 unit/ml sub-q ss allopurinol 300 mg tab daily clonidine 0.2 mg tab clonazepam 1 mg tab daily calcitriol 0.5 mcg cap daily furosemide 20 mg tab calcium 250 mg tab omeprazole 20 mg cap, delayed release daily prednisone 5 mg tab daily metoprolol 50 mg tab-3 tablet(s) by mouth twice a day gabapentin 300 mg cap 600mg am and 300mg pm prograf 1 mg cap azithioprine 50mg daily bactrim tiw discharge medications: 1. allopurinol 100 mg tablet sig: one (1) tablet po every other day (every other day). 2. atorvastatin 20 mg tablet sig: one (1) tablet po once a day. 3. calcitriol 0.5 mcg capsule sig: one (1) capsule po daily (daily). 4. metoprolol tartrate 50 mg tablet sig: three (3) tablet po bid (2 times a day). 5. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 6. prednisone 5 mg tablet sig: one (1) tablet po daily (daily). 7. azathioprine 50 mg tablet sig: one (1) tablet po daily (daily). 8. trimethoprim-sulfamethoxazole 80-400 mg tablet sig: one (1) tablet po 3x/week (mo,we,fr). 9. ergocalciferol (vitamin d2) 50,000 unit capsule sig: one (1) capsule po 1x/week (mo). 10. calcium acetate 667 mg capsule sig: two (2) capsule po tid w/meals (3 times a day with meals). 11. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. 12. heparin (porcine) 5,000 unit/ml solution sig: one (1) ml injection tid (3 times a day): until mobile. 13. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain. 14. silver sulfadiazine 1 % cream sig: one (1) appl topical twice a day. 15. calcium carbonate 500 mg tablet, chewable sig: three (3) tablet, chewable po q 8h (every 8 hours). 16. clonidine 0.1 mg tablet sig: one (1) tablet po tid (3 times a day). 17. insulin glargine 100 unit/ml solution sig: thirty (30) units subcutaneous twice a day. 18. humalog 100 unit/ml solution sig: per sliding scale subcutaneous four times a day. 19. furosemide 20 mg tablet sig: one (1) tablet po bid (2 times a day). 20. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po hs (at bedtime). 21. gabapentin 100 mg capsule sig: one (1) capsule po q24h (every 24 hours) for 3 days: last day . 22. tacrolimus 0.5 mg capsule sig: one (1) capsule po q12h (every 12 hours). 23. penicillin g pot in dextrose 2,000,000 unit/50 ml piggyback sig: fifty (50) ml intravenous q4h (every 4 hours): last day 2 million units per dose via central line. 24. heparin, porcine (pf) 10 unit/ml syringe sig: ten (10) ml intravenous prn (as needed) as needed for line flush: central line flush. discharge disposition: extended care facility: discharge diagnosis: acute cholecystitis s/p lap chole s/p kidney transplant with acute on chronic renal failure left arm contact dermatitis discharge condition: stable/fair 2 person assist for transfers, needs pt but occasionally somnolent, meds adjustment made, oriented discharge instructions: please call the transplant clinic at for fever, chills, nausea, vomiting, diarrhea, constiaption, increased abdominal pain, yellowing of skin or eyes. labwork q monday and thursday with results to transplant clinic dressing changes pen g through via central line followup instructions: id,mitty id west (sb) phone: date/time: 3:10 , md phone: date/time: 10:30 urology follow-up for voiding trial: date/time: , 1:00. please have patient go to ambulatory care unit at , for appointment with dr please arrange for ercp for stent removal procedure: laparoscopic cholecystectomy endoscopic insertion of stent (tube) into bile duct diagnoses: hyperpotassemia hypocalcemia nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere obstructive sleep apnea (adult)(pediatric) pure hypercholesterolemia unspecified essential hypertension long-term (current) use of steroids acute kidney failure, unspecified gout, unspecified personal history of malignant neoplasm of prostate long-term (current) use of insulin dermatitis due to drugs and medicines taken internally diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled kidney replaced by transplant acute and chronic cholecystitis 

Answer: The patient is high likely exposed to