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: ciprofloxacin attending: chief complaint: ha, seizure, hypertension major surgical or invasive procedure: arterial line placement lumbar puncture endotracheal intubation history of present illness: history was derived from the medical chart and the pt's wife. . mr. is a 44 yo man with esrd reflux nephropathy s/p failed lrrt in , htn, pud who awoke on the morning of admission at ~4 a.m. with a severe headache. he had associated nausea and vomiting. he was also mily disoriented, slurring his words and even walked into a wall because he did not see it. the pt's wife then called ems. when ems arrived, he reportedly ahd a gtc seizure that lasted ~2 minutes that resolved without intervention. . at the osh, he underwent head ct, which did not demonstrate any hemorrhage. his intial cbc was wbc 4.4, hgb 10.2, plt 105. his bp was controlled with labetalol 20 mg iv x1 (down to 170/95). . he was transferred to for further care. . in the ed at , his initial vss were 99.9, 87, 233/125, 32, 99%. he underwent lp, which demonstrated no leukocytosis and 42 rbcs in tubes 1 and 4. he received ceftriaxone 2g iv, ampicillin 2g iv, vancomycin 1g iv, acetaminophen, lorazepam 4mg iv total, haloperidol 10mg iv total, hydralazine 20 mg iv, labetalol 20 mg iv and was eventually started on a nitroprusside drip. . no further history was obtained from the pt delirium. past medical history: - esrd secondary to chronic ureterovesical junction obstruction leading to bilateral hydronephrosis, on hemodialysis - s/p renal transplant ( brother) - severe hypertension - gout - peptic ulcer disease - bladder neck stricture - atypical chest pain social history: 40py, quit 2 yrs ago. no etoh or other drugs. lives in apartment building with his wheelchair-bound wife where he works as superintendent. family history: father had mi mid 50s. no dm. brother had cancer of jaw which was resected. physical exam: vitals: t: 100.6 bp: 246/104 p: 85 r: 28 sao2: 100% general: unarousable, jittery, does not follow commands heent: ncat, perrl, no scleral icterus, mmm neck: supple, no significant jvd, no neck stiffness pulmonary: lungs cta bilaterally, no wheezes, ronchi or rales cardiac: rr, nl s1 s2, no murmurs, rubs or gallops appreciated abdomen: soft, nd, normoactive bowel sounds extremities: no edema, 2+ radial, dp pulses b/l skin: no rashes noted. neurologic: unarousable, does not follow commands. perrl. normal bulk. no abnormal movements noted. moves all extremities. 2+ reflexes at the patella and biceps. plantar response was flexor bilaterally. pertinent results: admission labs: 11:50am wbc-5.3 rbc-3.52* hgb-10.0* hct-31.4* mcv-89 mch-28.5 mchc-31.9 rdw-15.7* 11:50am neuts-88.1* lymphs-9.2* monos-2.4 eos-0.2 basos-0.2 11:50am plt count-145* 11:50am pt-13.4 ptt-32.4 inr(pt)-1.1 11:50am glucose-103 urea n-17 creat-6.4* sodium-140 potassium-6.5* chloride-103 total co2-25 anion gap-19 11:50am albumin-4.0 calcium-9.2 phosphate-3.6 magnesium-2.4 11:50am alt(sgpt)-9 ast(sgot)-67* ld(ldh)-885* alk phos-73 tot bili-0.7 11:59am glucose-101 lactate-1.6 na+-140 k+-4.1 cl--100 tco2-30 11:50am ammonia-less than 11:50am tsh-1.0 11:50am t4-7.8 free t4-1.1 11:50am asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 12:30pm urine bnzodzpn-neg barbitrt-neg opiates-neg cocaine-neg amphetmn-neg mthdone-neg 01:00pm cerebrospinal fluid (csf) protein-43 glucose-59 01:00pm cerebrospinal fluid (csf) wbc-1 rbc-42* polys-20 lymphs-60 monos-20 01:00pm cerebrospinal fluid (csf) wbc-0 rbc-42* polys-0 lymphs-0 monos-0 brief hospital course: 44-year-old man with esrd on hd and difficult-to-control hypertension presented with seizures, found to be hypertensive to 233/125. # hypertensive emergency: patient continued on valstartan, carvediol, clonidine, hydralazine, lisinopril, and nifedepine. in the micu his bp was controlled with labetolol and nitro gtts. nicardipine gtt was eventually used. he was converted from nicardipine to nifedipine on . blood pressure were in the 150's with the drips and were slightly higher on the nifedipine but with maintained diastolics in the 80-90's. he was transitioned back to po home meds while in the micu and then transferred to the floor. he was electively intubated for airway protection. he self-extubated and was reintubated, and was eventually extubated without incident. his bp on the floor remained in the 150-160/80-90 range. further workup of the etiology of his refractory chronic htn was deferred for his outpatient care providers given that laboratory test results would have taken a week to return and he did not require inpatient level of care. # neurology: patient's mental status improved gradually. he was initially treated with acyclovir pending csf hsv pcr, but it was discontinued when csf was found to be hsv negative. neurology signed off and indicated no need for further neurologic f/u. # respiratory failure: patient extubated without any respiratory difficulty. # id: patient afebrile off of all antibiotics. an infectious etiology for his presentation was felt to be unlikely. # esrd s/p failed transplant: he had hd every mon, wed, fri. tacrolimus was discontinued due to concern for pres. mycophenolate was increased to 1000 . he was continued on pcp prophylaxis with tmp/smx. his medications were renally dosed. # gerd/pud: continued on outpatient pantoprazole. # code status: full code medications on admission: lisinopril 40 mg carvedilol 12.5 mg valsartan 80 mg daily nifedipine sr 30 mg clonidine 0.3 mg/24 hr patch tacrolimus 2 mg mycophenolate mofetil 1000 mg trimethoprim-sulfamethoxazole 80-400 mg daily pantoprazole 40 mg daily sevelamer hcl 800 mg tid with meals b complex-vitamin c-folic acid 1 mg daily discharge medications: 1. trimethoprim-sulfamethoxazole 80-400 mg tablet sig: one (1) tablet po daily (daily). 2. clonidine 0.3 mg/24 hr patch weekly sig: one (1) patch weekly transdermal qmon (every monday). disp:*4 patch weekly(s)* refills:*2* 3. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 5. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 6. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for fever. 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 8. mycophenolate mofetil 250 mg capsule sig: four (4) capsule po bid (2 times a day). 9. simethicone 80 mg tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day) as needed. 10. hydralazine 50 mg tablet sig: one (1) tablet po q6h (every 6 hours). disp:*120 tablet(s)* refills:*2* 11. valsartan 160 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 12. carvedilol 25 mg tablet sig: two (2) tablet po twice a day. disp:*120 tablet(s)* refills:*2* 13. lisinopril 40 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* 14. renagel 800 mg tablet sig: one (1) tablet po three times a day. 15. nifedipine 30 mg tablet sustained release sig: one (1) tablet sustained release po once a day. disp:*30 tablet sustained release(s)* refills:*2* discharge disposition: home discharge diagnosis: major: hypertensive emergency pres seizure . minor: acute renal failure discharge condition: stable discharge instructions: you were admitted for severely elevated blood pressure. you were found to have a neurologic condition called pres which was thought to be related to your high blood pressure. pres results in your thinking being confused and is life threatening. it is very important to keep your blood pressure under control. your blood pressure is under better control. it is important that you take all of your medications as prescribed. you were also evaluated by neurology. if you develop fevers, chills, confusion, weakness, numbness/tingling in your extremities, or find blood pressures >160 at home you should call your doctor. please take all of your medications as prescribed and follow up with the appointments below. medications: your carvedilol and valsartan has been increased to better control your blood pressure. your nifedipine dose has been decreased to help control your blood pressure. hydralazine has been started to treat your high blood pressure. your tacrolimus has been stopped as you do not need this drug any longer. followup instructions: please call your pcp to set up a follow-up appointment within the next two weeks. dr. telephone number is . please continue to follow-up with your outpatient hemodialysis program and your outpatient nephrologist per your usual schedule. you do not need a follow-up appointment with neurology. however, if you would like to reach the neurology clinic, please call . procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours spinal tap incision of lung insertion of endotracheal tube hemodialysis arterial catheterization diagnoses: end stage renal disease esophageal reflux acute kidney failure, unspecified gout, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease acute respiratory failure other encephalopathy surgical operation with transplant of whole organ causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation complications of transplanted kidney peptic ulcer of unspecified site, unspecified as acute or chronic, without mention of hemorrhage or perforation, without mention of obstruction generalized convulsive epilepsy, without mention of intractable epilepsy 

Answer: The patient is high likely exposed to