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: patient recorded as having no known allergies to drugs attending: chief complaint: ams and generalized weakness major surgical or invasive procedure: none history of present illness: mr. is an 80 yom with esrd on hd and recent e. coli bacteremia, who presented to the ed after dialysis today with delta ms. the patient reportedly had symptoms of confusion and difficulty speaking, as well as generalized weakness, beginning around 11 am. per his daughter, he began to exhibit an expressive aphasia on the way to the car, and they returned to the hd unit where he had an ekg with ? afib/flutter. he was brought to via ems from the hd unit where he had a neg nchct and nml fsg. he was then brought to for further stroke workup and possible cta. neurology felt he was severely inattentive, but had no focal deficits, c/w a toxic-metabolic derrangement rather than a stroke. . in the ed, vs were initially tmax 98.0, sbp 89-132, hr 76-95, rr 18-24, 100% 2lnc. lactate was noted to be 3.4, and ua was wbc, + le, neg nit. he was given 1lns over several hours (fluids given at a gentler rate b/c of his dialysis status), at which point his sbp dropped to the 90's. his sbp then fell to the 80's and he was given another 500 cc bolus, with improvement of his sbp to the 100's. hr remained in the 70's and he was never tachycardic. he was given vanco/ceftriaxone for presumed urosepsis. . he was also c/o abdominal pain (of several weeks duration) and an a/p ct was obtained that showed a large, complex ventral hernia w/o evidence of incarceration, but no other acute pathology. . on arrival to the , he says he is feeling "much better," "much less dizzy." he appears to have no word-finding or speech production difficulties and feels these sx have resolved. he denies ha, change in vision, stiff neck, sob, chest and skeletal pain; he has had no fevers and was feeling well throughout the week prior to hd on . per the patient, he had no episodes of hypotension at hd. . patient was transferred to the floor after he was found to be stable in the . mr. stated that he felt well and no longer had any of the symptoms that had originally brought him to the hospital. past medical history: # esrd on hd-- recently started on hd in # ascending cholangitis with e. coli bacteremia in . had ercp with stone/sludge removal. completed 10 day course of ampicillin. # htn # dementia # s/p b/l hip replacement # abdominal hernia repair # prostate resection # tia-- per records, in had tia with some speech impediment # atrial fibrillation with history of rvr while bacteremic/septic from ascending cholangitis. converted back to nsr prior to discharge. # anemia--iron deficiency and anemia of chronic disease # systolic chf with ef 40% in social history: lines at home alone in his apartment no etoh, smoking, or drug use. has a fiance and 2 daughters who are also his hcp. family history: non-contributory physical exam: admission physical exam: vs in the ed: tmax 98.0, sbp 89-132, hr 76-95, rr 18-24, 100% 2lnc vs on arrival to the floor: 96.2, 72/39 (though as high as 100 sbp on repeat measurements), 77, rr 20, 97% 3l gen: well-appearing, nad heent: sclera anicteric, perrl, eomi, op clear, mmm neck: supple, no lad cv: ii/vi sm at b/l usb, no rubs pulm: pt not cooperative with siting up so unable to obtain full lung exam; crackles at bases anteriorly abd: soft, obese, slight ttp midline/suprapubic, small hernia palpated in region but does not buldge with valsalva ext: no c/c/e neuro: aaox3, language fluent, no word finding difficulties, fully attentive, cn ii-xii intact, 5/5 strength throughout, reflexes 2+ throughout pertinent results: admission labs: 11:20am blood wbc-10.1 rbc-4.23*# hgb-11.6*# hct-37.1*# mcv-88# mch-27.4 mchc-31.2 rdw-18.7* plt ct-129* 11:20am blood neuts-85.1* bands-0 lymphs-8.8* monos-5.3 eos-0.3 baso-0.5 11:20am blood pt-14.0* ptt-24.1 inr(pt)-1.2* 11:20am blood glucose-84 urean-22* creat-4.5*# na-139 k-3.8 cl-99 hco3-21* angap-23* 11:20am blood alt-22 ast-22 ck(cpk)-17* alkphos-115 totbili-0.8 11:20am blood ctropnt-0.05* 11:20am blood lipase-51 11:20am blood calcium-8.9 phos-1.3*# mg-1.7 04:24pm blood lactate-3.4* urinalysis 05:05pm urine color-amber appear-hazy sp -1.018 05:05pm urine blood-mod nitrite-neg protein-30 glucose-neg ketone-tr bilirub-mod urobiln-neg ph-5.0 leuks-mod 05:05pm urine rbc-* wbc-* bacteri-mod yeast-none epi-0 micro: bcx x 3: pending, at least one set drawn off the line ucx: pending --> he has no record of positive ucx in system (only yeast) ekg: regular, at ~90 bpm, nml axis, < dep in v2/v3 imaging: admission cxr: the lungs are clear without focal consolidation. there is no pulmonary edema. there is no pleural effusion or pneumothorax. heart size is normal. left subclavian catheter terminating at the brachiocephalic confluence is noted. the osseous structures are unremarkable. impression: no acute cardiopulmonary process. . cta head/neck: no hemorrhage or mass effect. chronic microvascular ischemia. mri with dwi should be performed if there is concern for acute infarct. complete recons and perfusion images are not available. there is no flow limiting stenosis. there is mild atherosclerotic calcifications at the carotid bifurcations. no flow limiting stenosis. . ct abd/pelvis (prelim read): no acute process. large complex ventral hernia, but no sign of incarceration. brief hospital course: mr. is an 80-year-old man with a history of esrd, recent bacteremia, and possible prior tia who presented with confusion. . #. ams: mr initial neuro exam is non focal, with only global inattention which has resolved by arrival to . ddx included encephalopathy secondary to fluid shifts duing hd, infarction, and infection. imaging was negative, with no evidence of acute infarct or vessel cutoff; there was no report of hypotension during dialysis. there are no gross electrolyte abnormalities aside from his baseline uremia. patient had positive ua at osh for which he was initially treated for w/ cipro, but then stopped once cultures grew diptheroids. patient afebrile and w/o a leukocytosis. no evidence of recurrent cholangitis currently given nml lft's. the etiology was unclear at discharge as mr. was ao x3 and sharp in his judgement. . # h/o tia and chf: patient was started on full dose asa and started on zocor. additionally, patient is on low dose metoprolol. #. esrd on hd: patient on mwf schedule; patient to resume hd on discharge. of note, his dose of renagel has been reduced to 800mg tid. . #. htn: patient's bp initially during course was persistently low, but was likely secondary to hd prior to admission. bp meds were initially held, but bp at discharge was 110/70. given his other comorbidities, mr. was discharged on metoprolol tartrate 12.5mg po qhs. #. indicental findings: during course, patient's latate was found to be elevated and ct abdomen was obtained and a small 3.2 cm right adrenal nodule found that needs to be followed up as outpatient. additionally, on ct head/neck a thyroid nodule was found that will need follow up. unknown clinical significance. medications on admission: renal caps softgel cyp- 1 capsule daily metoprolol 12.5 mg po qhs renagel 2400 mg po tid lactulose 10 g/15 ml - 2 tbls po prn constipation colace 100 mg po bid acid controller 20 mg po bid gas relief 80 mg q6h discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. sevelamer hcl 800 mg tablet sig: one (1) tablet po tid w/meals (3 times a day with meals). disp:*90 tablet(s)* refills:*2* 3. renal caps 1 mg capsule sig: one (1) capsule po once a day. 4. lactulose 10 gram/15 ml solution sig: one (1) po twice a day. 5. colace 100 mg capsule sig: one (1) capsule po twice a day. 6. simvastatin 20 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 7. omeprazole 20 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day: please continue to take the acid med you have at home. 8. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po at bedtime. discharge disposition: home discharge diagnosis: primary: 1) altered mental status, resolved. unknown etiology. 2) hypotension, resolved. secondary: - esrd on hd-- recently started on hd in - ascending cholangitis with e. coli bacteremia in . - htn - dementia - h/o tia -- per records, in had tia with some speech impediment - anemia - systolic chf with ef 40% in discharge condition: afebrile, vitals stable. discharge instructions: you were hospitalized because you had altered mental status and had trouble uttering your words. initally, our concern was that you were having another stroke. after a thorough work up to make sure that you didn't have a stroke or an infection, it is unclear what caused your episode altered mental status. additionally, your blood pressure was a little low when you arrived at the hospital, although that has now resolved. . we will be continuing your home medications on discharge with a few additions and changes. we are starting you on simvastatin (zocor) to control your cholesterol, and aspirin 325mg (full strength) for secondary prevention of stroke. additionally, your dose of renagel has been reduced to 800mg, three times a day. . of note, on your ct scan of the abdomen, we found a small 3.2 cm right adrenal nodule, that we would like your pcp to follow up on in 6 months. you also had a thyroid nodule on your ct head/neck that needs to be followed up by your pcp. . please return to the ed if your symptoms return. followup instructions: please follow up w/ dr. on thurs at 9am. procedure: hemodialysis diagnoses: anemia in chronic kidney disease end stage renal disease congestive heart failure, unspecified atrial fibrillation other persistent mental disorders due to conditions classified elsewhere hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease hypotension, unspecified chronic systolic heart failure iron deficiency anemia, unspecified personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits altered mental status hip joint replacement ventral, unspecified, hernia without mention of obstruction or gangrene nontoxic uninodular goiter other specified disorders of adrenal glands 

Answer: The patient is high likely exposed to