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: no known allergies / adverse drug reactions attending: chief complaint: nausea and vomitting major surgical or invasive procedure: femoral line placement history of present illness: mr. is a 37 m with a medical history notable for type i diabetes and gastroparesis. he is frequently admitted to for evaluation and management of nausea and vomitting. he was last admitted from . he was also seen in the ed on and discharged to home. after leaving the ed, he reports not feeling better at discharge and re-represented to the ed this evening. he was concerned because his emesis appeared to have coffee-ground like material. vital signs on arrival to ed: t 96.7, p 112, bp 174/103, 99% on ra. in the ed his evaluation was notable for a hct of 33 down from 38. he intially recieved oral zofran and im dilaudid. then, a femoral central venous catheter was steriley placed and he received iv fluids, iv reglan, and iv zofran. review of systems: pain assessment on arrival to the floor: 0/10 (no pain). no recent illnesses. no fevers, chills, or night sweats. appetite is good and weight is stable. no sob, cough, or chest pain. no pnd or orthopnea. no urinary symptoms. no abdominal pain, nausea, or change in bowel habits. no le edema. no skin changes. no arthralgias or joint swelling. other systems reviewed in detail and all otherwise negative. past medical history: - diabetes mellitus, type i - hgba1c 7.7 - gastroparesis confirmed on gastric emptying study at - hypertension social history: patient is currently living with a friend. is unemployed.denies tobacco, alcohol, and illicit drugs. family history: denies family history of cad or diabetes mellitus. ge thinks his father died of hiv or cancer. physical exam: vital signs: physical examination: - gen: well-appearing in nad. - heent: conj/sclera/lids normal, perrl, eom full, and no nystagmus. hearing grossly normal bilaterally. sinuses non-tender. nasal mucosa and turbinates normal. oropharynx clear w/out lesions. - neck: supple with no thyromegaly or lymphadenopathy. - chest: normal respirations and breathing comfortably on room air. lungs clear to auscultation bilaterally. - cv: pmi normal size and not displaced. regular rhythm. normal s1, s2. no murmurs or gallops. jvp <5 cm. 2+ carotids. no carotid bruits. - abdomen: normal bowel sounds. soft, nontender, nondistended. liver/spleen not enlarged. - rectal: no external lesions. normal tone, stool guaiac negative. - extremities: no ankle edema. - msk: joints with no redness, swelling, warmth, tenderness. normal rom in all major joints. - skin: no lesions, bruises, rashes. - neuro: alert, oriented x3. good fund of knowledge. able to discuss current events and memory is intact. cn 2-12 intact. speech and language are normal. no involuntary movements or muscle atrophy. normal tone in all extremities. motor in upper and lower extremities bilaterally. gait normal. dtrs 2+ at brachioradialis and patella bilaterally. plantar reflex down (neg babinski). finger-to-nose and heel-to-shin normal. romberg and pronator drift negative. sensation to light touch intact in upper and lower extremities bilaterally. - psych: appearance, behavior, and affect all normal. no suicidal or homicidal ideations. pertinent results: 08:08am blood wbc-5.2 rbc-4.54* hgb-12.9* hct-38.8* mcv-85 mch-28.3 mchc-33.2 rdw-14.4 plt ct-275 11:00pm blood wbc-13.4*# rbc-4.02* hgb-11.6* hct-33.7* mcv-84 mch-28.8 mchc-34.4 rdw-14.1 plt ct-247 12:00pm blood wbc-20.5* rbc-3.97* hgb-11.4* hct-33.9* mcv-85 mch-28.6 mchc-33.6 rdw-14.3 plt ct-265 04:54am blood wbc-13.0* rbc-4.03* hgb-11.4* hct-34.2* mcv-85 mch-28.3 mchc-33.3 rdw-14.2 plt ct-261 08:08am blood glucose-243* urean-9 creat-0.9 na-138 k-4.5 cl-102 hco3-23 angap-18 11:00pm blood glucose-308* urean-7 creat-0.8 na-135 k-3.0* cl-102 hco3-16* angap-20 04:54am blood glucose-153* urean-3* creat-0.9 na-134 k-4.4 cl-97 hco3-28 angap-13 03:21am blood alt-19 ast-13 ld(ldh)-187 alkphos-87 totbili-0.5 04:54am blood calcium-8.9 phos-4.5 mg-2.2 03:21am blood albumin-3.9 calcium-8.5 phos-1.4*# mg-1.5* 11:00pm blood acetone-negative 11:22pm blood type- po2-72* pco2-21* ph-7.47* caltco2-16* base xs--5 12:13pm blood lactate-2.8* 03:21am urine color-straw appear-clear sp -1.012 03:21am urine blood-neg nitrite-neg protein-neg glucose->1000 ketone-40 bilirub-neg urobiln-neg ph-6.5 leuks-neg . urine urine culture-final inpatient blood culture blood culture, routine-pending inpatient portable abdomen study date of impression: 1. no evidence of bowel obstruction or ileus. 2. no free intra-abdominal air. brief hospital course: mr. is a 37yo m w/hx of dm1 and gastroparesis who presents with n/v abdominal pain, reported ugib and elevated blood sugars. course patient was monitored overnight. he c/o abd pain similar to prior gastroparesis episodes (luq pain), and his hct remained stable at 33.9. he continued to have episodes of emesis, producing yellow/clear vomitus. he was evaluated by gi, who felt that there were no acute interventions necessary. his cbc was noteable for a leukocytosis to 20. this value was consistent w his prior gastroparesis presentations. he remained afebrile and hemodynamically stable, so the suspicion for an infectious process remained low. the patients fs on admission were 300s, w ag of 17. insulin drip was started, followed by d51/2ns maintenance fluids. once ag closed, patient was started on sq insulin and he was transferred to the floor for ongoing care. iv access was difficult, but a peripheral iv was obtained with effort. his femoral line was rapidly discontinued due to infection risk and his history of elopement. his glucose remained under reasonable control on the floor. his nausea and vomiting were treated with antiemetics and ativan. records were reviewed, and pt has had multiple gi consults in the past. records from hospital paraphrased notes from his motility specialist (gi) at , strongly recommend against narcotic use; this has been echoed by multiple previous gastroenterology consultations here. his abdominal pain was treated with iv dilaudid in the icu, but this was subsequently discontinued on the floor; he was prescribed low dose oral dilaudid, which he infrequently took. the focus of his care on the floor was on treating his cyclic vomiting syndrome with ativan and zofran. his nausea improved and he was able to tolerate increasing oral intake. i will note that he was very upset about not being provided iv dilaudid through the rest of his hospitalization. the importance of compliance with his insulin regimen was emphasized, and social work consulted to assist in this effort. he was discharged to home on his home regimen with the exception of his amlodipine, which i have asked him to hold until he follows up with his pcp, he remained normotensive off of antihypertensives. medications on admission: nortriptyline 100 mg at bedtime gabapentin 300 mg twice daily lisinopril 20 mg daily amlodipine 5 mg daily mirtazapine 15 mg at bedtime zofran odt 4 mg tablet three times a day as needed for nausea metoclopramide 10 mg three times daily before meals lantus thirty six (36) units daily novolog with each meal per sliding scale aspirin 81 mg daily protonix 40 mg twice daily simvastatin 20 mg daily miralax as needed for constipation colace 100 mg twice a day as needed for constipation. discharge medications: 1. nortriptyline 50 mg capsule sig: two (2) capsule po at bedtime. 2. gabapentin 300 mg capsule sig: one (1) capsule po twice a day. 3. lisinopril 20 mg tablet sig: one (1) tablet po once a day. 4. amlodipine 5 mg tablet sig: one (1) tablet po once a day: please hold until instructed to resume by your pcp. 5. mirtazapine 15 mg tablet sig: one (1) tablet po at bedtime. 6. zofran odt 4 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po every eight (8) hours as needed for nausea. 7. metoclopramide 10 mg tablet sig: one (1) tablet po qid (4 times a day): take 30 minutes before meals. 8. novolog 100 unit/ml solution sig: 1-15 units subcutaneous qachs: per your sliding scale. 9. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 10. protonix 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po twice a day. 11. simvastatin 20 mg tablet sig: one (1) tablet po once a day. 12. miralax 17 gram powder in packet sig: one (1) packet po once a day as needed for constipation. 13. colace 100 mg capsule sig: one (1) capsule po twice a day as needed for constipation. 14. lantus 100 unit/ml solution sig: thirty three (33) units subcutaneous at bedtime. discharge disposition: home discharge diagnosis: # t1dm uncontrolled with complications # dka # gastroparesis with flare # cyclic vomiting syndrome # possible upper gi bleed/hematemesis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted with abdominal pain, nausea, vomiting, and dka in the setting of stopping your insulin. it is very important that you continue to take your insulin; as a type 1 diabetic you can not stop taking your insulin. you were also treated for your gastroparesis and your cyclic vomiting syndrome. it is important that you minimize your narcotics use, as this will make your gastroparesis and vomiting syndrome worse. followup instructions: please follow up with your pcp early next week. procedure: central venous catheter placement with guidance diagnoses: long-term (current) use of insulin personal history of noncompliance with medical treatment, presenting hazards to health hematemesis diabetes with neurological manifestations, type i [juvenile type], uncontrolled diabetes with ketoacidosis, type i [juvenile type], uncontrolled gastroparesis benign essential hypertension persistent vomiting 

Answer: The patient is high likely exposed to