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: morphine attending: chief complaint: dka, nausea/vomiting major surgical or invasive procedure: none history of present illness: 25 yo woman with a h/o dmi (a1c 11.1 since ), hlp, anxiety, presents with increased anxiety, diarrhea/stool incontinence, polydipsia, polyuria, p/w hyperglycemia. patient reports elevated blood sugars this morning to the 200s, then upon recheck were critically elevated. the patient reported very mild abdominal pain, nausea, vomitting (nonbloody, nonbilious), the pt denied diarrhea but admitted to bms that were soft, nonbloody, nonblack. blood sugarts, urinary frequency, bowel incontinence/urgency. fs 200s this am, then critically high. in the ed, initial vs were: 98.9 128 111/62 18 100, fs of 600. pt was rectal heme pos. cxr was negative for any acute cardiopulmonary process. ecg with sinus tach. pt was given dilaudid 0.5mg iv x 2, zofran 4mg iv x 1, and ativan 0.5mg po x 1. has received 4l ns. also received 10 units iv then insulin at 6mg/hr. ecg with sinus tach. ? peaked t's one lead. last fs prior to transfer was 395. . on the floor, the patient was anxious and complaining of thirst. did report mild abdominal pain, urinary urgency, chronic chills, occasional sweats (chronic) . review of sytems: (+) per hpi (-) denies fever, recent weight loss or gain. denies headache, cough. denied chest pain or tightness, palpitations. denied constipation. no dysuria. denied arthralgias or myalgias. past medical history: -diabetes type i: diagnosed age 16 in after her first pregnancy. most recent hgb a1c 10.9 % () - previous admissions for nausea/vomiting with h/o esophagitis and with concern for diabetic gastroparesis - esophagitis / h. pylori and again - stage i diabetic nephropathy - anxiety/panic attacks - depression - hyperlipidemia - s/p mva - lower back pain since then. per patient received oxycodone from her primary provider - g2p1ab1, s/p miscarriage in 06/00 3rd trimester, s/p c-section in , not menstruating secondary to being on depo-provera - genital herpes social history: she was born and raised in but currently lives in her own apartment near . she is currently unemployed and received disability. she has a 6 year old son. cousin recently had fevers, myalgias. her mother and sisters live nearby. she denies tobacco, alcohol or illicit drug use. one current male sexual partner, uses depot shot for birth control. family history: her grandmother had type i diabetes. no hx of cad, htn. physical exam: vitals: t: bp: p: r: 18 o2: general: alert, oriented, no acute distress, anxious : sclera anicteric, mm dry, oropharynx clear neck: supple, jvp not elevated lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema . pertinent results: kub findings: a relative paucity of bowel gas is observed within the abdomen, with a non-obstructive pattern. no free intraperitoneal air is identified. impression: non-obstructive bowel gas pattern. 01:01pm blood glucose-625* urean-22* creat-1.4* na-136 k-6.1* cl-91* hco3-12* angap-39* 03:50pm blood glucose-395* urean-21* creat-1.0 na-145 k-4.0 cl-112* hco3-10* angap-27* 08:35pm blood glucose-103* urean-14 creat-0.9 na-140 k-6.4* cl-110* hco3-16* angap-20 10:16pm blood glucose-99 urean-14 creat-1.0 na-137 k-5.6* cl-109* hco3-16* angap-18 11:39pm blood glucose-91 urean-11 creat-0.8 na-136 k-3.7 cl-109* hco3-15* angap-16 03:38am blood glucose-134* urean-9 creat-0.8 na-137 k-3.6 cl-110* hco3-18* angap-13 01:27pm blood glucose-248* urean-6 creat-0.9 na-127* k-4.1 cl-98 hco3-12* angap-21* 07:44pm blood glucose-113* urean-5* creat-0.8 na-132* k-3.2* cl-97 hco3-16* angap-22* 04:07am blood glucose-162* urean-5* creat-0.7 na-136 k-3.7 cl-103 hco3-21* angap-16 05:15pm blood glucose-235* urean-4* creat-0.9 na-132* k-6.2* cl-103 hco3-19* angap-16 02:06am blood glucose-210* urean-3* creat-0.7 na-135 k-3.2* cl-99 hco3-26 angap-13 03:05pm blood glucose-146* urean-2* creat-0.7 na-135 k-3.2* cl-99 hco3-26 angap-13 10:00pm blood glucose-102* urean-4* creat-0.6 na-135 k-3.6 cl-100 hco3-24 angap-15 06:30am blood glucose-287* urean-4* creat-0.7 na-132* k-4.8 cl-97 hco3-21* angap-19 03:50pm urine color-straw appear-clear sp -1.022 03:50pm urine blood-lg nitrite-neg protein-30 glucose-1000 ketone-150 bilirub-neg urobiln-neg ph-5.0 leuks-neg 03:50pm urine rbc-* wbc-0-2 bacteri-few yeast-none epi- brief hospital course: micu course patient was admitted to the micu with dka. she was treated with insulin gtt and her gap closed. she was transitioned to subcutaneous insulin. she continued to have nausea and vomiting. her gap reopened and she was started again on the insulin gtt with dextrose-containing ivf. she was later transistioned back to insulin subq but ivf with d5 were continued as patient with poor po intake. she was transfered to the floor on but transfered back to the micu on for poor glucose control and widening gap. she was transiently placed back on an insulin gtt. recommened glargine 20units qhs and hiss to started at a blood sugar of 80 and to be given prior to meals. her sliding scale was made more conservative at bedtime. the consulting services continued to follow. . floor course 1.) poorly controlled dm1: the patient was administered ivf and electrolytes were repleted as needed. after some nausea/vomiting the morning of , she was able to increase po intake with a diabetic diet. glargine was changed to qhs. she was placed on a humalog sliding scale after po intake was deemed adequate. overnight on her glucose control was poor and she returned to the micu for insulin drip. the patient returned the the floor on with an aggressive humalog scale. glargine was titrated up from 20 to 25 units. however, the patient developed morning fasting hypoglycemia on this regimen therefore glargine was decreased back to 20units qhs with sliding scale to avoid lows. we strongly encouraged the patient to follow up with as an outpatient in hopes of gaining better control of her dm1 and avoiding subsequent rehospitalizations however she declined. she was given the option to follow up with as an outpatient, but declined. she was instructed to increase her glargine by 2 units every two days if her am fasting finger stick glucose was greater than 140 and to follow up closely with her pcp or . 2.) nausea/vomiting: consistent with dka. po intake was adequate without additional nausea/vomiting after the morning of , after her dka resolved. she was scheduled to see gi as an outpatient on discharge. 3.) anxiety/depression: this seems to have been a contributing factor to the patient's recurrent admissions for dka. psych was consulted and recommended an increased dose of ssri, as well as close outpatient follow up. ativan was continued. they felt the patient was competent to care for her self and to make her own medical decisions. she was scheduled for an appointment with her outpatient psychiatrist on discharge. 4) sinus tachycardia: the patient had sinus tachycardia of 100-140 throughout most of her stay. this resolved with symptom management once her nausea and vomiting abated and was likely reactive in the setting of pain, anxiety, nausea and hypovolemia. thyroid function was normal. 5) chronic low back pain: this was initially treated with diluadid in the icu. however on transfer to the floor, narcotics were discontinued. pain control was achieved with tylenol/toradol/warm compresses and a lidoderm patch. she will follow up with her pcp. 6) thiamine deficiency: the patient was noted to have thiamine deficiency. she was started on thiamine repletion. medications on admission: aspirin 81 mg po daily lorazepam 1 mg po tid metoclopramide 10 mg po tid pantoprazole 40 mg po q24h sertraline 50 mg po daily trazodone 50 mg po hs zetia po daily discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. lorazepam 1 mg tablet sig: one (1) tablet po every eight (8) hours. 3. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 4. sertraline 50 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 5. trazodone 50 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for anxiety/insomnia. 6. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. zetia 10 mg tablet sig: one (1) tablet po once a day. 8. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily) as needed for pain: 12 hours on, 12 hours off . disp:*30 adhesive patch, medicated(s)* refills:*0* 9. ibuprofen 400 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for pain. 10. insulin glargine 100 unit/ml solution sig: twenty (20) units subcutaneous at bedtime: if your blood glucose is over 140 in the morning before you eat, please increase by 2 units every 2 days. 11. insulin aspart 100 unit/ml solution sig: one (1) per sliding scale subcutaneous qachs: please take per sliding scale - see attached. discharge disposition: home discharge diagnosis: primary diagnoses: diabetic ketoacidosis, diabetes mellitus type i discharge condition: mental status:clear and coherent level of consciousness:alert and interactive activity status:ambulatory - independent discharge instructions: you were admitted to for evaluation of elevated blood sugars. you were found to have diabetic ketoacidosis and required an insulin drip, iv fluids and a stay in the icu. during your stay you had much nausea and vomiting. this was determined to be secondary to the diabetic ketoacidosis, and improved with better control of your symptoms. you were seen by the endocrinologists. they have changed your insulin regimen so that you should take only 20 units of lantus (glargine) at night. they would like you to follow up with them as an outpatient. please call to schedule an appointment. medication changes: decrease lantus dose to 20 units at night - if your fasting morning glucose is greater than 140, increase the lantus dose by 2 units every 2 days. continue current humalog sliding scale - see attached stop metoclopramide (or reglan) increase sertraline to 100mg daily (two tablets daily) start thiamine 100mg daily start lidocaine patches - 12 hours on, 12 hours off for back pain start ibuprofen over the counter as needed for pain followup instructions: please keep the following appointments: appointment #1 md: specialty: internal medicine-primary care date/ time: 9:00am location: , ma phone number: appointment #2 md: dr. specialty: pyschiatrist date/ time: 1:00pm location: , ma phone number: provider: , md phone: date/time: 1:50 procedure: venous catheterization, not elsewhere classified diagnoses: nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere other chronic pain hyposmolality and/or hyponatremia dysthymic disorder other and unspecified hyperlipidemia long-term (current) use of insulin personal history of noncompliance with medical treatment, presenting hazards to health esophagitis, unspecified hypovolemia lumbago examination of participant in clinical trial diabetes with neurological manifestations, type i [juvenile type], uncontrolled diabetes with renal manifestations, type i [juvenile type], uncontrolled diabetes with ketoacidosis, type i [juvenile type], uncontrolled gastroparesis goiter, unspecified panic disorder without agoraphobia genital herpes, unspecified other and unspecified manifestations of thiamine deficiency 

Answer: The patient is high likely exposed to