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: gantrisin attending: chief complaint: found unresponsive at home major surgical or invasive procedure: endotracheal intubation central venous line placement history of present illness: ms. is a 63 yo female with a history of dm type 1 x 35 years complicated by neuropathy, nephropathy and retinopathy with prior admissions for dka and hypoglycemia, who was found unresponsive at home. the patient's son (mentally retarded) called ems. she was down for an unknown period of time. per the patient's sister, she was last seen well on saturday. per ems, ms. was unresponsive, sugar 500, bp 90/50, hr 110, regular and rr 24, sat 100% on nrb. on arrival to ed, she was responsive to pain, saying "no". she was intubated for airway protection (abg 7.02/23/69), sugar >1000, sbp 100/83, hr 87. post-intubation, her bp dropped to 72/33. a femoral line was attempted but resulted in a femoral stick. a right ij was placed, and levophed was started. in the ed, she was also given calcium gluconate, levofloxacin, flagyl, vancomycin, ceftriaxone. past medical history: 1. dm type 1 x 35 years. previous admissions for dka and hypoglycemic episodes. her dm is complicated by peripheral neuropathy, proliferative retinopathy (left eye blindness), and nephropathy. followed at . 2. hypertension 3. history of osteomyelitis, status post left transmetatarsal amputation. 4. history of herpes zoster of left chest in . 5. bezoar, disclosed on ugi series . 6. no documented cad. nuclear stress test : p-mibi, without fixed or reversible defects, normal wall motion. ef 61%. social history: she lives at home with her son, who is mentally retarded. past history of etoh use. ex-smoker, quit in . no history of illicit drug use. family history: per omr records, mother with dm. father with ad. sister with dm and breast cancer. physical exam: physical examination per admission note: vitals: t 97.3, bp 75/33 --> 118/60. hr 80-100. gen: sedated, intubated, on levophed. heent: mm dry, et in place. neck: supple, right ij in place. chest: ctab anteriorly cvs: tachy, regular. no murmur, or rub. gi: soft, no grimacing. ext: no edema. left stump, well-healed. neuro: sedated, arousable to pain. right pupil reactive. surgical eye. physical examination on transfer to floor: vitals: tm 99.1, hr 70-90, bp 100-149/60/100 off levophed, rr 20s, sat 98-100% on room air. gen: in nad. conversant. heent: right pupil reactive, left surgical eye. neck: supple, right ij still in place. resp: early fine bibasilar crackles, no bronchial breathing. cvs: rrr. normal s1, s2. no s3, s4. no murmur or rub. gi: bs na. abdomen soft and non-tender. ext: without edema. no ulcer. let foot stump well-healed. neuro: oriented to time, place and name. moves all 4 extremities. pertinent results: relevant laboratory data on arrival: cbc: wbc-12.9* rbc-4.16* hgb-10.8* hct-39.9 mcv-96# mch-26.0* mchc-27.1*# rdw-14.2 plt count-324 neuts-89.1* bands-0 lymphs-8.9* monos-1.4* eos-0.4 basos-0.1 chemistry: glucose-1240* urea n-70* creat-4.5*# sodium-134 potassium-8.7* (repeat 4.5) chloride-85* total co2-<5.0* phosphate-9.2*# magnesium-3.1* alt(sgpt)-8 ast(sgot)-11 alk phos-126* amylase-1730* lipase-93* lactate-4.9* tot bili-0.1 cardiac enzymes: 11:30am blood ck(cpk)-191* 06:18pm blood ck(cpk)-156* 02:14pm blood ck(cpk)-426* 11:30am blood ck-mb-3 ctropnt-0.03* 12:28pm blood ctropnt-0.03* 06:18pm blood ck-mb-7 ctropnt-0.15* 02:14pm blood ck-mb-10 mb indx-2.3 ctropnt-0.19* urinalysis: color-straw appear-clear sp -1.019 blood-neg nitrite-neg protein-30 glucose-1000 ketone-50 bilirubin-neg urobilngn-neg ph-5.0 leuk-neg urine and serum tox negative relevant imaging data: cxr: an endotracheal tube is seen, a few centimeters above the carina, which should be repositioned. a /orogastric tube is seen coursing below the diaphragm. cardiac, mediastinal, and hilar contours are unremarkable. the lungs themselves are clear; a nodular density over the right mid/lower lung field is probably a nipple shadow. osseous structures are unremarkable. impression: successful placement of endotracheal tube, which should be retracted a few centimeters. ct head: there is no intracranial hemorrhage, mass lesion, hydrocephalus, shift of normally midline structures, minor or major vascular territorial infarct. the density values of the brain parenchyma are within normal limits. note is made of dystrophic calcifications in the lentiform nuclei. there are extensive atherosclerotic calcifications of the carotid arteries. note is made of a left phthsis bulbi. surrounding osseous and soft tissue structures are otherwise unremarkable. impression: no acute intracranial pathology, including no sign of intracranial hemorrhage. see above report. v/q scan: low likelihood ratio for recent pulmonary embolism. matched asymmetry as described likely due to differences in airflow with decrease on the right relative to the left. it may be secondary to mucous plugging versus effects from mechanical ventilation. /nkg ******** micro: blood cultures x 4 ngtd urine cultures x 2 negative brief hospital course: 63 yo female with long-standing dm type 1 with triopathy, admitted with dka of unclear precipitant and profound metabolic dissaray. 1) dka: as noted above, her initial gap on admission was 44 with profound metabolic dissaray. she was started on a regular insulin drip (required as much as 20 units per hour), and aggressively hydrated with close monitoring of her electrolytes, with eventual closure of the gap. she was transitionned to subcutaneous insulin on with nph, then lantus at out-patient dose with novolog sliding scale. of note, lantus was recently decreased to 12 units qhs on , resumed at 14 units qhs in hospital with novolog sliding scale as above, with good glycemic control. lantus decreased to 12 units qhs on . the precipitant remains unclear. she has little recollection of the events that pre-dated her admission, but remembers feeling slightly unwell 3 days pta with some dizziness. no clear dietary indiscretions or medication non-compliance. she did have an elevated wbc on admission without left shift, and an infectious work-up was negative, including u/a, urine culture, blood cultures, and cxr. she was given levo/vanco and flagyl in the ed, not continued in the micu. a ct head was negative. she did have a mild troponin leak, but with flat mb, and this was not felt to be an acute coronary syndrome. it was ultimately felt that a viral syndrome may have been the precipitant. 2) hypotension: as noted above, her blood pressure dropped in the ed following intubation, and she was started on levophed for hemodynamic support. she was weaned off on the day of admission, and remained hemodynamically stable. her hypotension was most likely hypovolemia, exacerbated by sedative medications peri-intubation. as noted, she had a mild troponin leak on admission, not felt to be an acute coronary syndrome. pe was ruled out. infectious work-up on admission negative. 3) cad: ekg on admission showed lateral st depressions in the setting of tachycardia. cardiac enzymes also revealed a mild troponin leak with peak troponin 0.19 but flat mb, in the setting of acute renal failure and tachycardia. review of her records indicated that she had a p-mibi in without reversible defects, normal ef. a repeat ekg on hospital day #2 showed resolution of the changes. she remained asymptomatic throughout her course. she was restarted on asa, metoprolol and statin, then nifedipine. diovan was reintroduced last given her renal insufficiency. no other acute issues in the hospital. 4) respiratory: she was intubated in the ed for airway protection. abg was initially concerning for an a-a gradient, and a v/q scan was obtained and returned as low probability for pe. she was succesfully extubated on hospital day #2, and remained stable on room air. 5) arf on cri: baseline creatinine in 2s. her creatinine peaked at 4.5 on admission, and came down with hydration. sediment was unremarkable on u/a. urine lytes were sent on , and were suggestive of superimposed atn with fena 5.2%. her creatinine continued to improve with hydration, down to baseline at the time of discharge. 6) anemia: her hematocrit dropped to 28 while in the micu, felt aggressive fluid rescuscitation. she was transfused 1 unit of prbcs, with appropriate response, and was placed on protonix . review of her records indicated a baseline hematocrit in the high 20s. her hematocrit subsequently remained stable, and further work-up was deferred. she was changed back to daily protonix. 7) elevated amylase: her amylase peaked at 1730, with only mildly elevated lipase with peak at 92. her abdominal examination was benign throughout, and amylase trended down with hydration. amylasemia is not infrequent in the setting of dka. 8) hypernatremia: patient with corrected sodium >150 in the setting of dka and volume depletion. she was aggressively hydrated, with normalization of her sodium. 9) id: as noted above, an initial infectious work-up was unremarkable. however, she developed a new fever in the hospital on hospital day #3 to 101.2. a repeat infectious work-up was performed, with negative cxr, u/a with few wbc but + epithelial cells (foley removed), and cultures all negative to date. her central line was kept in place given inability to obtain alternative peripheral access, finally removed on . she did have diarrhea on after drinking a coffee with cream despite her known lactose intolerance. nonetheless, c. difficile sent, and result pending at the time of discharge. dr. and to follow-up on result. she had no recurrence of fever in the hospital without antibiotics. medications on admission: atenolol 12.5 mg po qd asa 325 mg po qd nifedipine 60 mg po qd protonix 40 mg po qd diovan 80 mg po bid lumigan 0.03% 1 drop od qd timolol 0.5% 1 drop od qd lantus 12 units qhs with novolog sliding scale. discharge medications: 1. atenolol 25 mg tablet sig: 0.5 tablet po daily (daily). 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 3. nifedipine 60 mg tablet sustained release sig: one (1) tablet sustained release po daily (daily). 4. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 5. valsartan 80 mg tablet sig: one (1) tablet po bid (2 times a day). 6. atorvastatin calcium 20 mg tablet sig: one (1) tablet po daily (daily). 7. timolol maleate 0.5 % drops sig: one (1) drop ophthalmic daily (daily). 8. lumigan 0.03 % drops sig: one (1) drop od ophthalmic once a day. 9. lantus 12 units sc qhs 10. novolog insulin sliding scale please continue your sliding scale as you were prior to admission. please see enclosed sheet. discharge disposition: home with service facility: vna discharge diagnosis: primary diagnosis: diabetic ketoacidosis probable viral syndrome diabetes mellitus type 1 secondary diagnoses: hypertension discharge condition: patient discharged home in stable condition. discharge instructions: please call your pcp or return to the ed if your blood sugars are greater than 400 or less than 50. please take all medications as prescribed. followup instructions: 1) you have a scheduled appointment with your pcp . on friday . see below for time. it is important that you go to this appointment. - provider: , m.d. where: phone: date/time: 11:50 2) you also have a scheduled appointment with dr. at the diabetes center on tuesday at 1500. md procedure: venous catheterization, not elsewhere classified diagnoses: nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere unspecified essential hypertension acute kidney failure, unspecified polyneuropathy in diabetes acute respiratory failure unspecified viral infection diabetes with ketoacidosis, type i [juvenile type], not stated as uncontrolled hyperosmolality and/or hypernatremia acute pancreatitis diabetes with renal manifestations, type i [juvenile type], not stated as uncontrolled background diabetic retinopathy diabetes with neurological manifestations, type i [juvenile type], not stated as uncontrolled diabetes with ophthalmic manifestations, type i [juvenile type], not stated as uncontrolled 

Answer: The patient is high likely exposed to