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: iodine; iodine containing / bactrim attending: chief complaint: weakness major surgical or invasive procedure: acdf history of present illness: 49 year-old man with pmh dm type i, htn, esrd on hd for 4 years now s/p kidney transplantation complicated by delayed graft function who p/w pain in both hands, radicular type pain in his right leg, diffuse weakness, mostly proximal; r>l. patient had a renal transplant in complicated by delayed graft function. he also developed 3 weeks after transplant pain in both his hands, he described as a "pricky" sensation in all fingers and palm of his hands. he denied numbness. at that time he had an elevated level of prograf; (; 47.8); reduction of medication dosing correlated with improvement in his hand pain. he reports that he has had for several years decreased sensation in both feet. he has lost a significant amount of weight since his transplant (around 30 pounds); he feels weaker throughout. he has had more difficulty to walk; he has had more frequent falls (last one today, he thought he tripped over on the floor). he also has complaints of worsening pain irradiating through the right leg, posteriorly, down to r foot. he also thinks that his hands and arms are weaker bilaterally; he has had trouble to open the bottles of his medications, to comb his hair along the past few months. he underwent an today performed by dr. which revealed progression of his polyneuropathy, but also denervation in an l5 distribution and proximal myopathic changes and was referred to ed for admission for further work-up. past medical history: 1. cad s/p to om1 in and to rca in 2. end-stage renal disease, on hd since (mwf) 3. diabetes mellitus, type i: diagnosed at age 20, on insulin, c/b nephropathy, neuropathy, and retinopathy status post multiple laser surgeries. right upper extremity fistula. chronic ulcers on left foot. 4. hypertension 5. hyperlipidemia 6. obstructive sleep apnea 7. g6pd deficiency 8. right fifth toe amputation, . 9. history of hepatitis b infection 10. sexual dysfunction s/p penile prosthesis implantation 11. kidney transplant, right iliac fossa . 12. celiac disease social history: the patient lives with his wife and 2 sons in . previously worked at nstar as a janitor, and is currently on diability. no tobacco or etoh use. family history: there is no family history of premature coronary artery disease or sudden death. mother has diabetes mellitus. father is healthy and multiple half brothers and sisters. two children, both boys, are healthy. multiple aunts and uncles decreased from complications of diabetes. no family hx of wegener's or - disease. physical exam: t98.6 hr 73 bp 129/63 rr16 o2 100% ra gen: awake, alert, lying in bed; looks cachetic skin: no rashes. abrasions on r knee (reportedly from fall) heent: ncat, no conjunctival injection, mucous membranes moist, oropharynx clear. neck: supple, no meningismus. extrem: no edema neuro: ms - awake, alert, interactive. oriented to person, place, and date. speech is fluent, with intact registration/recall, repetition, naming, comprehension. could say backwards.. no left-right confusion. cranial nerves ?????? perrl 3-->2, eom smooth and full, no diplopia; no nystagmus; visual field mild/mod restricted in all directions, intact facial sensation, face symmetric with full strength of facial muscles, hearing intact to finger rub bilaterally, palate elevation is symmetric, and tongue protrusion is symmetric and full movement. trazpezius full bilat. motor: diffuse atrophy; r pronator drift delt tri wrex fex fflx io / ip quad ham gastr ta r 4- 5 4- 5- 4+ 5- 5- 5- 4- 5 5- 5- 5- 5- l 4 5 4+ 5- 4+ 5- 5- 5- 4+ 5 5- 5- 5- 5- reflexes - biceps triceps brachioradialis patellar ankle r 3+ 3+ 3+ trace 0 l 3- 3+ 3+ trace 0 plantar responses mute sensation - decreased sensation to pinprick and jps distally in hands (fingers), cold sensation intact in ues but slightly less at distal hands. decreased sensation to cold, pinprick and vibration below the knees in les, jps absent at the toes. coordination - no dysmetria and smooth finger to nose. rams normal and symmetric. gait - wide based; very unsteady, falls to both sides pertinent results: admission labs: 140 112 31 185 agap=13 -----------< 4.7 20 1.8 wbc5.0 hv 11.6 plat235 ht36.9 n:81.4 l:13.9 m:3.0 e:0.9 bas:0.8 imaging: mri cervical spine: bone marrow signal is abnormally hypointense on all sequences, similar to that seen on the prior examination and may relate to the patient's underlying hemosiderosis. there is 2 mm of retrolisthesis of c3 on 4. there is extensive -type 2 and 3 endplate changes and to a lesser extent type 1 endplate change centered at c3-c4. no additional marrow signal abnormalities are appreciated. at c2-3, there is no canal or foraminal narrowing. at c3-4, there is a progressive spondylosis with a central disc herniation resulting in severe canal narrowing with cord deformity and abnormally increased t2 signal. there is severe bilateral foraminal narrowing. at c4-5, there is a spondylotic ridge with a broad central disc herniation resulting in moderate canal narrowing as well as mild bilateral foraminal narrowing. there is flattening of the ventral cord surface without abnormal cord signal. at c5-6, there is a broad spondylotic ridge with a central disc protrusion resulting in mild canal narrowing with slight flattening of the ventral cord surface. there is mild bilateral foraminal narrowing, left greater than right. at c6-7, there is mild spondylosis and facet arthropathy without significant canal or foraminal narrowing. at c7-t1, there is no significant canal or foraminal narrowing. impression: 1. severe canal and bilateral foraminal narrowing at c3-4 with cord deformity and abnormally increased t2 signal. 2. moderate canal narrowing at c4-5. 3. additional degenerative changes as detailed. lumbar spine: bone marrow signal is abnormally hypointense on all sequences, similar to that seen on the prior examination and may relate to the patient's underlying hemosiderosis. sagittal alignment is satisfactory. the conus terminates at t12-l1. again noted is extensive multilevel type 2 endplate change with type 1 endplate change at l4-5 and to a lesser extent l5-s1. there is a rudimentary disc space at s1-2. at l3-4, there is mild disc desiccation without significant canal or foraminal narrowing. at l4-5, again noted is a disc bulge with central annular tear and a small inferiorly migrated disc fragment creating moderate bilateral subarticular zone narrowing. when combined with the facet arthropathy and endplate spur, there is severe right foraminal narrowing and mild left foraminal narrowing. at l5-s1, there is a disc bulge and facet arthropathy with a central/left paracentral inferiorly migrated fragment resulting in severe narrowing of the left subarticular zone and lateral recess with potential for compression of the traversing left s1 root. additionally, there is severe narrowing of the left neural foramen and moderate right foraminal narrowing. there is a right pelvic kidney. impression: 1. diffusely abnormal hypointense bone marrow signal is unchanged from the prior study and likely relates to hemosiderosis. there are superimposed type 1 and 2 endplate changes. 2. moderate bilateral subarticular zone narrowing at l4-5 with severe right foraminal narrowing, similar to that seen on the prior study. 3. severe narrowing of the left subarticular zone and lateral recess as well as the left neural foramen at l5-s1 with potential for compression of the left l5 and/or s1 roots. the appearance is similar to that seen on the prior study. bone scan: interpretation: whole body images of the skeleton were obtained in anterior and posterior projections. there is focused increased radio-isotope uptake probably in the 6th rib in the rib-end. no other increased radio-isotope uptake is seen, in particular, there is no abnormal uptake in c3. the above described findings are consistent with non-specific likely inflammatory changes or post traumatic changes of the right 6th rib. the renal transplant is visualized in the right iliac fossa, and urinary bladder is also visualized, due to the normal excretion of the radio-isotope. discharge labs: 139 | 108 | 26 --------------< 103 4.8 | 26 | 1.2 ca: 9.6 mg: 1.9 po4: 2.3 9.5 2.7 >-----< 159 32.5 tacro level: 4.1 brief hospital course: 49 year old man with pmh dm, htn, esrd on hd for 4 years now s/p kidney transplantation complicated by delayed graft function who p/w bl hand pain, diffuse weakness, mostly proximal r>l. mr. had an mri which showed severe stenosis with cord deformity at c3/c4. he had a bone scan which showed no signs of metastasis or infection. on he underwent an acdf. per orthopedics, he will need to undergo a posterior fusion in the future, but it is not required during this admission. post-operatively he was noted to have an extremely swollen left arm. this was thought to be due to an infiltrated iv. additional iv access was unable to be obtained, so a picc was placed. his arm was elevated and warm compresses were applied, with significant improvement. picc should be discontinued as soon as iv access is no longer needed. post-operatively the patient complained occasionally of the sensation of food sticking in his throat. a swallowing evaluation showed normal swallowing ability, but given post-operative pain it was recommended that his diet consist of ground solids and thin liquids. this should be reassessed as his post-operative pain improves. overnight on mr. did have a temperature of 101.3. he had urine and blood cultures that have been negative to date, and a chest x-ray with no signs of infection. his wound was assessed by ortho, and showed no signs of infection. it was thought this may be due to post-operative atelectasis, and he has been afebrile since. for his dm, the patient was followed by during his hospitalization, and his current regimen consists of 46u nph in am and 34u nph . he also has a lispro sliding scale detailed in the discharge paperwork. the renal transplant team also followed mr. while he was hospitalized. his tacrolimus levels were followed. his level on admission was 11, so his dose was initially decreased to 2.5mg , however his level decreased to 4, so he was increased back to his admission dose of 3mg , with the level at discharge being 4.1. please check tacrolimus level in 1 week, with a goal of . he was also given a dose of pentamidine for pcp . valgancyclovir was discontinued on given his report of significant weight loss, calorie counts were obtained, which showed initial poor po intake, which was primarily attributed to post-operative pain, and improved exam at discharge was notable for mild proximal weakness in his upper extremities, and significant bilateral foot drop ( bilateral at ta). he has a significant peripheral neuropathy, with decreased proprioception to the level of his knees. medications on admission: -albuterol -ergocalciferol 50,000 q weekly -insulin lispro 10uam; 12u pm -insulin nph ss -isosorbide mononitrate 60mg daily -lipitor 80mg daily -lyrica 50mg -loperamide 2mg prn -metoprolol succinate 200mg -cellcept 500mg qid -nitroquick 0.4mg sl prn -pentamidine 300mf -ranitidine 150mg daily -tacrolimus 3mg -trazodone 50mg hs -valgancyclovir 900 mg qday discharge medications: 1. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 2. metoprolol succinate 100 mg tablet sustained release 24 hr sig: two (2) tablet sustained release 24 hr po bid (2 times a day). 3. mycophenolate mofetil 500 mg tablet sig: one (1) tablet po qid (4 times a day). 4. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 5. trazodone 50 mg tablet sig: one (1) tablet po hs (at bedtime). 6. isosorbide mononitrate 30 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po bid (2 times a day). 7. oxycodone 5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. 8. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for fever/pain. 9. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. 10. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 11. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection injection tid (3 times a day). 12. lidocaine hcl 2 % solution sig: one (1) ml mucous membrane tid (3 times a day) as needed for meals. 13. codeine-guaifenesin 10-100 mg/5 ml syrup sig: 5-10 mls po q6h (every 6 hours) as needed for cough. 14. tacrolimus 1 mg capsule sig: three (3) capsule po q12h (every 12 hours). 15. pregabalin 75 mg capsule sig: one (1) capsule po bid (2 times a day). 16. heparin, porcine (pf) 10 unit/ml syringe sig: two (2) ml intravenous prn (as needed) as needed for line flush. 17. humalog 100 unit/ml solution sig: sliding scale subcutaneous ac and hs: 71-150 6u 151-200 8u 201-250 10u 251-300 12u 301-350 14u 351-400 16u. 18. nph insulin human recomb 100 unit/ml suspension sig: forty six (46) units subcutaneous qam. 19. nph insulin human recomb 100 unit/ml suspension sig: thirty four (34) units subcutaneous at bedtime. discharge disposition: extended care facility: center discharge diagnosis: primary: severe c3 stenosis with cord compression secondary: diabetes. esrd s/p kidney transplant. celiac disease. peripheral neuropathy. discharge condition: mild proximal upper extremity weakness (5- in triceps bilaterally, 4+ in l deltoid). right ip 4+, left full strength. bilateral foot drop ( in both ta). significant decrease in proprioception to the knees bilaterally. discharge instructions: you were admitted with increasing weakness and loss of stool. this was found to be secondary to severe cervical stenosis with compression of the spinal cord, for which you underwent surgery. medication changes: pregabalin increased to 75mg weigh yourself every morning, md if weight goes up more than 3 lbs. if you notice any of the concerning symptoms listed below, please call your doctor or come to the emergency department for further evaluation. followup instructions: neurology: dr. on . please call with questions. ortho: dr. on at 7:40 on the of the building pcp: . on 9:40am md, procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified laparoscopic cholecystectomy esophagogastroduodenoscopy [egd] with closed biopsy other excision of joint, other specified sites other cervical fusion of the anterior column, anterior technique closed [endoscopic] biopsy of large intestine biopsy of bone, other bones insertion of interbody spinal fusion device fusion or refusion of 2-3 vertebrae biopsy of gum diagnoses: pneumonia, organism unspecified acidosis anemia in chronic kidney disease obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified unspecified essential hypertension polyneuropathy in diabetes percutaneous transluminal coronary angioplasty status candidiasis of mouth pulmonary collapse other and unspecified hyperlipidemia bacteremia calculus of gallbladder with other cholecystitis, without mention of obstruction intestinal infection due to clostridium difficile chronic systolic heart failure celiac disease duodenitis, without mention of hemorrhage acute osteomyelitis, other specified sites complications of transplanted kidney unspecified gastritis and gastroduodenitis, without mention of hemorrhage diabetes with neurological manifestations, type i [juvenile type], uncontrolled diabetes with renal manifestations, type i [juvenile type], uncontrolled diabetes with ophthalmic manifestations, type i [juvenile type], uncontrolled calculus of gallbladder with acute cholecystitis, without mention of obstruction other specified bacterial infections in conditions classified elsewhere and of unspecified site, other specified bacteria streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, unspecified background diabetic retinopathy other acquired deformities of ankle and foot cervical spondylosis with myelopathy diabetes with other specified manifestations, type i [juvenile type], uncontrolled herpetic gingivostomatitis glycogenosis renal osteodystrophy idiopathic pulmonary hemosiderosis 

Answer: The patient is high likely exposed to