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: tramadol / abacavir attending: chief complaint: hypertension major surgical or invasive procedure: hd history of present illness: 58 y/o anuric hd dependent female with hiv on haart (last cd4 94), ckd stage v on hd ( htn, dialyzed mwf via l cvl), rue avg (ligation and subsequent excision (), hcv with liver biopsy (grade ii inflammation) who p/w ruq pain and vomiting starting at 4 pm today after hd. . of note, pt recently admitted from on surgery service for right arm arteriovenous graft infection. she underwent excision right arteriovenous graft. gpc bacteremia on blood cultures . graft cultures speciated as enterobacter. she completed vancomycin for 2 weeks at , and ciprofloxacin po daily for 2 weeks. . pt reports ruq pain, intermittent, +chills. denies fevers. no diarrhea, constipation, cough/cold sx. reports vomiting, non-bloody. no ha, visual changes. reports she missed her bp pills yesterday and today due to nausea/vomiting. of note, pt does not make urine. . in ed, initial vs - initial vs were: 8, 98.6, 53, 226/101, 18, 100%. ekg showing sinus brady 48, na, qtc 461. lactate wnl. alk phos slightly above baseline. ruq us showing stones, no cholycystitis. cxr showing no acute process. transplant surgery notified, and they are aware and recommend micu admission. ct a/p negative for acute process. overall, "no sbo. distal colonic wall thickening is more likely related to underdistension than colitis, but clinical correlation recommended. polycystic kidneys. high density streaks in peritoneum unchanged since , could be related to a barium spill. ct head showed no acute proces. . pt started to develop worsening sob, and there was a ? of mild pulmonary edema. sbp was 240s at this time. nitro gtt started at 0.2 mcg. . vitals on transfer - bp 215/117, hr 72, rr 18, 100% 2l nc. access - 20g, hd line, r ej. . on arrival to the micu, mental status is alert. . review of systems: (+) per hpi. (+) ha (-) denies fever, night sweats, recent weight loss or gain. denies sinus tenderness, rhinorrhea or congestion. denies cough, shortness of breath, or wheezing. denies chest pain, chest pressure, palpitations, or weakness. denies diarrhea, constipation, changes in bowel habits. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes or skin changes. past medical history: hiv on haart ckd stage v on hd ( htn) rue avg, ligated hep c: liver biopsy showed focal mild-to-moderate portal chronic inflammation with focal periportal extension (grade ii). htn diverticulosis high-grade adenomatous polyp social history: no current iv drug use, no current etoh or smoking family history: non-contributory physical exam: vitals: 97.6, 222/120, 72, 18, 100 ra general: alert, but somewhat sleepy, oriented, mild distress heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1, prominent s2, grade iii holodystolic murmur heard best at lsb lungs: mild crackles at bases, no wheezes, rales, ronchi abdomen: soft, minimally tender ruq, non-distended, bowel sounds present, no organomegaly gu: no foley ext: warm, well perfused, 1+ pulses, no clubbing, cyanosis or edema neuro: cnii-xii intact, 5/5 strength upper/lower extremities, grossly normal sensation, 2+ reflexes bilaterally, gait deferred, finger-to-nose intact pertinent results: labs on admission: 12:35am blood wbc-3.5* rbc-3.99* hgb-11.9* hct-39.0 mcv-98 mch-29.9 mchc-30.5* rdw-17.3* plt ct-148* 12:35am blood neuts-66.3 lymphs-26.5 monos-4.9 eos-1.4 baso-0.9 12:35am blood plt ct-148* 01:41pm blood wbc-3.2* lymph-25 abs -800 cd3%-56 abs cd3-449* cd4%-25 abs cd4-200* cd8%-31 abs cd8-246 cd4/cd8-0.8* 12:35am blood glucose-110* urean-27* creat-5.9* na-137 k-4.2 cl-93* hco3-29 angap-19 12:35am blood alt-18 ast-39 ck(cpk)-52 alkphos-490* totbili-0.7 12:35am blood lipase-39 12:35am blood ck-mb-2 ctropnt-0.02* 12:35am blood calcium-10.3 phos-3.9 mg-2.1 01:41pm blood pth-2913* 12:48am blood lactate-1.8 . labs on discharge: 03:29am blood wbc-3.3* rbc-3.63* hgb-10.7* hct-34.7* mcv-96 mch-29.6 mchc-30.9* rdw-17.1* plt ct-137* 03:29am blood neuts-56 bands-0 lymphs-40 monos-4 eos-0 baso-0 atyps-0 metas-0 myelos-0 03:29am blood plt ct-137* 03:29am blood glucose-87 urean-41* creat-8.1*# na-136 k-4.3 cl-94* hco3-30 angap-16 03:29am blood alt-20 ast-34 ld(ldh)-174 alkphos-415* totbili-1.1 01:41pm blood ggt-62* 03:29am blood albumin-4.2 calcium-10.0 phos-4.8* mg-2.0 01:41pm blood pth-2913* . ct head without contrast : impression: 1. no acute intracranial process. 2. opacification of the left mastoid air cells may be due to inflammatory or infectious process. . ct abd/pelvis without contrast: impression: 1. no evidence of bowel obstruction, diverticulitis or renal stones. 2. left and sigmoid colonic wall thickening with mild stranding along the medial wall of the descending colon is most likely undersitension and chronic abnormality rather than mild colitis, though clinical correlation is needed. 3. polycystic kidneys with some new intermediate density lesions and some increased in size and a septated left cystic lesion. outpatient mri is recommended in no more than 6 months to assess further. 4. cholelithiasis without ct evidence of cholecystitis. 5. 4 mm right middle lobe nodule needs no follow- up if patient is low risk for malignancy. 12 month f/u chest ct if patient is high risk for a malignancy. . cxr pa and lateral: impression: vascular engorgement and early pulmonary edema, due to volume overload, and/or cardiac insufficiency. . liver/gallbladder us : impression: cholelithiasis without evidence of cholecystitis. polycystic kidneys are partially imaged and not completely evaluated, though no overtly concerning lesion is seen in their visualized portions. brief hospital course: 58 y/o anuric hd dependent female with hiv on haart, hcv, ckd stage v on hd, rue avg ligation and subsequent excision (), who p/w ruq pain, nausea, and vomiting, and is admitted to micu for hypertensive emergency. . # htn emergency: pt presented with sbp in 230s and evidence of vascular engorgement and early pulmonary edema with volume overload, classifying her htn as htn emergency. head ct was wnl. no ekg evidence of strain or ischemia was seen. etiology of elevated bp was likely related to nausea/vomiting/missing bp pills at home, along with pain. baseline sbp 140-160 per review of clinic notes. of note, mental status was alert. she was started on nitro gtt with goal sbp 180 but was d/ced in the pm after normalization of her pressures. we continued home lisinopril and home metoprolol. pain control was achieved with iv morphine. patient tolerated hd performed in the icu and was discharged after overnight stay. . # ruq pain: ruq us showed cholelithiasis without cholecystitis. ct a/p showed no sbo. distal colonic wall thickening is more likely related to underdistension than colitis. no fever or jaundice, or evidence for cholecystitis. elevated alk phos may suggest infiltrative disease. recommend repeating outpatient lfts and w/u with possible mrcp if alk phos remains elevated. consider outpt cholecystectomy for biliary colic, now resolved. . # ckd stage v on hd ( htn): gets dialyzed on mwf. renal team performed uf on hospital day 1, and hd on friday (hospital day 2). continued sevelamer, nephrocaps. of note, patient's pth returned as 2913. pt will start iv zemplar at hd for ? secondary vs. tertiary hyperparathyroidism. . # hiv: on haart. last cd4 94 (22%) and vl 71 copies/ml. we continued atazanavir, raltegravir, ritonavir, lamivudine. on discharge, cd4 count pending. pt may require bactrim ppx depending on cd4 count. pt was set up with id appt on discharge. . # hcv: liver biopsy showed focal mild-to-moderate portal chronic inflammation with focal periportal extension (grade ii). . # hx of right arm arteriovenous graft infection/excision right arteriovenous graft: gpc bacteremia on blood cultures . graft cultures speciated as enterobacter. she completed vancomycin for 2 weeks at , and ciprofloxacin po daily for 2 weeks. no signs of infection locally or systemically. bcx pending on d/c. . # 4 mm right middle lobe nodule: per radiology, needs no follow-up if patient is low risk for malignancy. 12 month f/u chest ct if patient is high risk for a malignancy. communicated above with oupt pcp. . # transitional issues: - follow up cd4 count, and start bactrim prophylaxis depending on result. - started iv zemplar at hd (dr ) given high pth values (2913). - 4 mm rml nodule, which requires repeat evaluation and possible ct if high risk for malignancy - id appt re: hiv care as outpt medications on admission: 1. sevelamer carbonate 800 mg tablet : one (1) tablet po tid w/meals (3 times a day with meals). 2. b complex-vitamin c-folic acid 1 mg capsule : one (1) cap po daily (daily). 3. atazanavir 150 mg capsule : two (2) capsule po daily (daily). 4. raltegravir 400 mg tablet : one (1) tablet po bid (2 times a day). 5. ritonavir 100 mg capsule : one (1) capsule po daily (daily). 6. lamivudine 10 mg/ml solution : 25 mg po daily (daily). 7. docusate sodium 100 mg capsule : one (1) capsule po bid (2 times a day). 8. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) as needed for constipation. 9. lactulose 10 gram/15 ml syrup : fifteen (15) ml po daily (daily) as needed for constipation. 10. polyethylene glycol 3350 17 gram/dose powder : one (1) po daily (daily). 11. heparin (porcine) 1,000 unit/ml solution : one (1) injection prn (as needed) as needed for line flush. 12. aspirin 81 mg tablet, chewable : one (1) tablet, chewable po daily (daily). 13. acetaminophen 325 mg tablet : two (2) tablet po q4h (every 4 hours) as needed for pain. 14. lisinopril 20 mg tablet : two (2) tablet po daily (daily). 15. metoprolol succinate 100 mg tablet extended release 24 hr : one (1) tablet extended release 24 hr po daily (daily). 16. oxycodone 5 mg tablet : 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* discharge medications: 1. sevelamer carbonate 800 mg tablet : one (1) tablet po tid w/meals (3 times a day with meals). 2. b complex-vitamin c-folic acid 1 mg capsule : one (1) cap po daily (daily). 3. atazanavir 150 mg capsule : two (2) capsule po daily (daily). 4. raltegravir 400 mg tablet : one (1) tablet po bid (2 times a day). 5. ritonavir 100 mg capsule : one (1) capsule po daily (daily). 6. lamivudine 10 mg/ml solution : twenty five (25) mg po daily (daily). 7. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) as needed for constipation. 8. docusate sodium 100 mg capsule : one (1) capsule po bid (2 times a day). 9. lactulose 10 gram/15 ml syrup : fifteen (15) ml po daily (daily) as needed for constipation. 10. polyethylene glycol 3350 17 gram/dose powder : one (1) packet po daily (daily). 11. aspirin 81 mg tablet, delayed release (e.c.) : one (1) tablet, delayed release (e.c.) po daily (daily). 12. lisinopril 20 mg tablet : two (2) tablet po daily (daily). 13. metoprolol succinate 100 mg tablet extended release 24 hr : one (1) tablet extended release 24 hr po daily (daily). 14. oxycodone 5 mg capsule : capsules po every four (4) hours as needed for pain. 15. zemplar qhd discharge disposition: home discharge diagnosis: primary: - hypertensive emergency . secondary: - end stage renal disease, on hd discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear ms. , it was a pleasure taking care of you in the hospital. you were admitted to the intensive care unit due to very high blood pressures, likely a result of nausea/vomiting, inability to take your home pills, and a shortened session the day before. . while you were here, we controlled your blood pressure with iv medications. your blood pressure responded nicely. you are being discharged on your home blood pressure regimen of metoprolol and lisinopril. . while you were here, we also checked some blood tests related to your kidneys. your pth levels were high and the kidney team will add a new iv medication called zemplar with your . . medication changes - addition of iv zemplar with . no other changes were made to your medications. please follow-up with your outpatient appointments below. please seek medical attention for any concerns. followup instructions: appointments: 1) department: when: thursday at 3:50 pm with: , md building: sc linical ctr campus: east best parking: garage . 2) department: infectious disease when: tuesday at 10:30 am with: , md building: lm campus: west best parking: garage md procedure: hemodialysis diagnoses: end stage renal disease renal dialysis status chronic hepatitis c without mention of hepatic coma human immunodeficiency virus [hiv] disease hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease nausea with vomiting calculus of gallbladder without mention of cholecystitis, without mention of obstruction other diseases of lung, not elsewhere classified diverticulosis of colon (without mention of hemorrhage) personal history of colonic polyps 

Answer: The patient is high likely exposed to