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: penicillins / percocet / morphine attending: chief complaint: acute onset dyspnea major surgical or invasive procedure: dialysis history of present illness: please see micu note for full details. in brief this is a 24 y.o. woman with sle, esrd on hd, hx malignant htn, h/o svc syndrome, h/o posterior reversible encephalopathy syndrome (pres) and prior intracerebral hemorrhage, frequently admitted with hypertensive urgency/emergency who was admitted with acute onset dyspnea after 2 weeks without dialysis given to unable to get transportation ? despite dr. attempting to arrange transport for her (? refused to come). she was admitted therefore on to micu with vs: t 100.4 hr 108 bp 240/180 rr 28 pox100 ra. she was treated with nitro gtt, labetolol gtt and dilaudid-these gtts were stopped at 0700. in the micu she was dialyzed with 1.7l fluid removal (though + 300cc given tranfusion). her sob is improved. her hct was also noted to be low (18->from 22 ) so transfused 2 units prbc's, recent egd with gastric ulcer , guaiac negative in ed, no bm in unit, hemolysis w/u negative. bp in icu 140/106 currently but of note was hypotensive on hd to 86/62. she notes sob improved rapidly on arrival. ros: currently she has no complaints. she notes at home her abdominal pain is at baseline for her, felt mid epigastric, for which she takes dilaudid 4mg up to . she has been getting hd via right femoral catheter which is not painful, no discharge from the sight. she denies ha, visual changes, cough, chest pain or pressure, orthostatic changes, palpitations, nausea, vomiting, constipation, diarrhea, melena, brbpr, dysuria, hematuria, rash, swelling, orthopnea, pnd. past medical history: 1. systemic lupus erythematosus since age 16 complicated by uveitis and end stage renal disease since . -s/p treatment with cyclophosphamide and mycophenolate and now maintained on prednisone 2. ckd/esrd: diagnosed in and has previously been on pd and now hd with intermittent refusal of dialysis, currently only agrees to be dialyzed one time/wk 3. malignant hypertension with baseline sbp's 180's-220's and history of hypertensive crisis with seizures. 4. thrombocytopenia 5. thrombotic events with negative hypercoagulability work-up - svc thrombosis (); related to a catheter - negative lupus anticoagulant (, , ) - negative anticardiolipin antibodies igg and igm x4 (-) - negative beta-2 glycoprotein antibody (, ) 6. hocm: last noted on echo 7. anemia 8. history of left eye enucleation for fungal infection 9. history of vaginal bleeding lasting 2 months s/p depoprovera injection requiring transfusion 10. history of coag negative staph bacteremia and hd line infection - and 11. thrombotic microangiopathy 12. obstructive sleep apnea on cpap 13. left abdominal wall hematoma 14. mssa bacteremia associated with hd line -, . 15. pericardial effusion 16. cin i noted in , not further worked up due to frequent hospitalizations and inability to see in outpatient setting 17. gastric ulcer 18. pres social history: denies tobacco, alcohol or illicit drug use. lives with mother and is on disability for multiple medical problems. family history: no known autoimmune disease. physical exam: vitals - t: 97.7, bp: 140/99 p: 88 r: 19 o2: 98% on ra general: sleeping comfortably but awakens easily, alert, oriented x3 heent: nc/at; perrla on right, enucleated eye on left; op clear, nonerythematous, mmm, moon facies neck: supple, jvp flat, no lad, full rom, left ej in place lungs: coarse bs throughout, no w/r/r, no decreased bs at bases cv: s1, s2 nl, no m/r/g appreciated abdomen: firm, non-tender to palpation, no masses or organomegally ext: warm, well perfused, 1+ dp/pt, no clubbing, cyanosis or edema neuro: a&o x3, motor ue/le bilaterally pertinent results: 05:28pm hct-26.0*# 11:38am hypochrom-2+ anisocyt-1+ poikilocy-1+ macrocyt-normal microcyt-occasional polychrom-normal ovalocyt-1+ schistocy-occasional teardrop-occasional 05:04am glucose-85 urea n-72* creat-10.4* sodium-139 potassium-5.5* chloride-109* total co2-14* anion gap-22* 05:04am ld(ldh)-264* tot bili-0.2 05:04am calcium-6.6* phosphate-6.5* magnesium-1.6 05:04am haptoglob-142 05:04am wbc-3.4* rbc-1.93* hgb-5.8* hct-17.0* mcv-88 mch-30.0 mchc-34.2 rdw-18.4* 05:04am plt count-97* 01:34am glucose-84 urea n-70* creat-10.5*# sodium-136 potassium-5.6* chloride-108 total co2-14* anion gap-20 01:34am estgfr-using this 01:34am alt(sgpt)-10 ast(sgot)-39 alk phos-108 tot bili-0.2 01:34am lipase-115* 01:34am albumin-3.2* calcium-6.6* phosphate-6.8* magnesium-1.7 01:34am wbc-4.5 rbc-2.08* hgb-6.0* hct-18.3* mcv-88 mch-28.6 mchc-32.5 rdw-18.6* 01:34am neuts-78.5* lymphs-16.5* monos-3.0 eos-1.4 basos-0.6 01:34am plt count-104* 01:34am pt-15.0* ptt-33.6 inr(pt)-1.3* brief hospital course: # dyspnea: pt's dypsnea improved on admission to the ed prior to hd. based on her imaging studies her dyspnea was likely related to fluid overload (pt missed 2 weeks of dialysis) and her level of anemia. upon transfer to the floor she was continued on her dialysis regimen and discharged on room air. # anemia: pt's baseline 1 month ago noted to be low 30s, since then her hct has trended down to 22 several week prior to admission. as she missed dialysis she was not able to reserve her eopgen which likely complicated her anemia. pt underwent hemolysis workup in the icu which was ultimately negative. she was given several units of prbc and bumped her hct appropriately. she was noted to be guaiac negative on examination. # hypertension: pt was initially admitted with hypertension. following transition to the floor she was placed on her home regimen. she was noted to be hypotensive in dialysis which is likely due to her being on labetalol, nitro gtt on dialysis. pt was discharged on her home bp regimen with follow up with her nephrologist. # chronic abdominal pain: pt had noted some intermittent abdominal pain which has been chronic. lipases were noted to be mildl elevated however no other concerning physical exam signs of pancreatitis. pt was able to tolerate a po diet prior to her discharge. pt was continued on her outpatient regimen of dilaudid, fentanyl patch, neurontin. # ge junction ulcer: pt was continued on her ppi regimen . # sle: pt was continued on her home regimen of prednisone 4mg daily # history of dvt: pt had a sub-therapeutic inr on admission. she was discharged on warfarin 3mg daily. # esrd on hd: pt was admitted for dyspnea in the setting of missing 2 weeks of hd. the renal team followed ms. during her hospitalization and she was continued on her outpatient regimen of hemodialysis. pt was continued on sevelamer and epogen. # seizure d/o: pt was continued on her home regimen of keppra. # depression: pt was continued on her home regimen of celexa. medications on admission: 1. nifedipine 90 mg tablet sustained release po qam 2. nifedipine 60 mg tablet sustained release po qhs 3. lidocaine 5 % transdermal one daily 4. aliskiren 150 mg po bid 5. citalopram 20 mg po daily (daily). 6. fentanyl 25 mcg/hr patch q72h (every 72 hours). 7. prednisone 4mg po daily (daily). 8. clonidine 0.1 mg/24 hr patch weekly transdermal qsat 9. clonidine 0.3 mg/24 hr patch weekly transdermal qsat 10. sevelamer hcl 400 mg four (4) tablet po tid w/meals 11. gabapentin 100 mg capsule sig: one (1) capsule po bid 12. labetalol 200 mg tablet sig: five (5) tablet po tid 13. hydralazine 100 mg po q8h 14. hydromorphone 2 mg 1-2 tablets po q6h as needed for pain. 15. pantoprazole 40 mg po q12h 16. levetiracetam 1,000 mg po 3x/week (tu,th,sa). discharge medications: 1. nifedipine 90 mg tablet sustained release sig: one (1) tablet sustained release po daily (daily). 2. nifedipine 60 mg tablet sustained release sig: one (1) tablet sustained release po hs (at bedtime). 3. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical q24 h (). 4. aliskiren 150 mg tablet sig: one (1) tablet po bid (2 times a day). 5. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 6. fentanyl 25 mcg/hr patch 72 hr sig: one (1) patch 72 hr transdermal q72h (every 72 hours). 7. prednisone 1 mg tablet sig: four (4) tablet po daily (daily). 8. clonidine 0.1 mg/24 hr patch weekly sig: one (1) patch weekly transdermal qsat (every saturday). 9. clonidine 0.3 mg/24 hr patch weekly sig: one (1) patch weekly transdermal qsat (every saturday). 10. sevelamer hcl 400 mg tablet sig: four (4) tablet po tid w/meals (3 times a day with meals). 11. gabapentin 100 mg capsule sig: one (1) capsule po qhd (each hemodialysis). 12. labetalol 200 mg tablet sig: five (5) tablet po tid (3 times a day). 13. hydralazine 50 mg tablet sig: two (2) tablet po q8h (every 8 hours). 14. warfarin 1 mg tablet sig: three (3) tablet po once daily at 4 pm. 15. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 16. levetiracetam 500 mg tablet sig: two (2) tablet po 3x/week (tu,th,sa). discharge disposition: home with service facility: vna discharge diagnosis: primary: malignant htn, esrd on hd, shortness of breath secondary: lupus discharge condition: stable, afebrile discharge instructions: you were admitted to the hospital after you noticed some shortness of breath. whilst in the hospital you were noted to have a low blood level (anemia) and you some fluid in your lungs. we think your blood level was low because you were not receiving your epo shots, we think the fluid is from not receiving dialysis. before you were discharged from the hospital your breathing was better. we recommend that you continue going to dialysis. we made no changes to your medications. if you notice any fevers, chills, nausea, vomiting, shortness of breath, lightheadedness please return to the ed. followup instructions: provider: clinic phone: date/time: 3:15 provider: , md phone: date/time: 2:00 md procedure: venous catheterization, not elsewhere classified hemodialysis transfusion of packed cells diagnoses: hypertensive chronic kidney disease, malignant, with chronic kidney disease stage v or end stage renal disease other primary cardiomyopathies systemic lupus erythematosus hyperpotassemia anemia of other chronic disease end stage renal disease other chronic pain depressive disorder, not elsewhere classified unspecified disease of pericardium hypotension, unspecified epilepsy, unspecified, without mention of intractable epilepsy personal history of venous thrombosis and embolism gastric ulcer, unspecified as acute or chronic, without mention of hemorrhage or perforation, without mention of obstruction abdominal pain, other specified site noncompliance with renal dialysis 

Answer: The patient is high likely exposed to