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: penicillins / percocet / morphine attending: chief complaint: altered mental status, solmolence, and relative hypotension major surgical or invasive procedure: none, hd per schedule on the day of discharge, transfused 1u prbc history of present illness: ms. is a 24 year old woman with esrd on hd, sle, hx of malignant htn admitted with change in mental status. patient missed hd on and was found unresponsive and diaphoretic by mother this morning after she took some dilaudid. ems was called, 1 mg of narcan was administered with slight improvement in mental status. on arrival to the ed her vitals were 112/64 62 16 99ra she was noted to be hyperkalemic in the absence of ekg changes and was given calcium, d5, 10u regular insulin, 30 mg po kayxalate and repeat k was 5.4. abg: 7.29/38/199. repeat glucose was 41 and 1amp d50 was given. she was sent to the icu for monitoring. past medical history: 1. systemic lupus erythematosus: - diagnosed (16 years old) when she had swollen fingers, arm rash and arthralgias - previous treatment with cytoxan, cellcept; currently on prednisone - complicated by uveitis () and esrd () 2. ckd/esrd: - diagosed - initiated but refused it as of , has survived despite this - pd catheter placement 3. malignant hypertension - baseline bps 180's - 120's - history of hypertensive crisis with seizures - history of two intraparenchymal hemorrhages that were thought due to the posterior reversible leukoencephalopathy syndrome, associated with le paresis in that resolved 4. thrombocytopenia: - ttp (got plasmapheresisis) versus malignant htn 5. thrombotic events: - svc thrombosis (); related to a catheter - negative lupus anticoagulant (, , ) - negative anticardiolipin antibodies igg and igm x4 (-) - negative beta-2 glycoprotein antibody (, ) 6. hocm: last noted on echo 7. anemia 8. history of left eye enucleation for fungal infection 9. history of vaginal bleeding lasting 2 months s/p depoprovera injection requiring transfusion 10. history of coag negative staph bacteremia and hd line infection - and 11. thrombotic microangiopathy: may be etiology of episodes of worse hypertension given appears quite labile 12. obstructive sleep apnea, autocpap/ pressure setting , straight cpap/ pressure setting 7 pshx: 1. placement of multiple catheters including . 2. tonsillectomy. 3. left eye enucleation in . 4. pd catheter placement in . 5. s/p ex-lap for free air in abdomen, ex-lap normal social history: single and lives with her mother and a brother. she graduated from high school. the patient is on disability. the patient does not drink alcohol or smoke, and has never used recreational drugs. family history: negative for autoimmune diseases including sle, thrombophilic disorders. maternal grandfather with htn, mi, stroke in 70s. physical exam: hr: 80 (79 - 80) bpm bp: 127/59(76) {127/59(76) - 139/64(82)} mmhg rr: 34 (21 - 34) insp/min spo2: 100% heart rhythm: sr (sinus rhythm) physical examination gen: sleeping comfortably, easily awoken by verbal stimuli heent: l eye prosthetic non-reactive, r pupil reactive, mmm heart: s1s2 rrr, iii/vi sem throughout the precordium pulm: cta b/l abd: nabs, midline scar well-healed, soft, mild l ttp, no rebound/guarding ext: no edema, no clubbing, wwp. r femoral hd in place neuro: following commands, answers appropriately, motor strength, sensation is intact pertinent results: 01:50pm pt-14.9* ptt-36.8* inr(pt)-1.3* 01:50pm hypochrom-2+ anisocyt-1+ poikilocy-1+ macrocyt-1+ microcyt-1+ polychrom-occasional ovalocyt-1+ schistocy-occasional stippled-occasional teardrop-occasional 01:50pm wbc-5.0 rbc-2.21* hgb-6.4* hct-20.7* mcv-94 mch-29.1 mchc-31.1 rdw-19.6* 10:30pm glucose-87 urea n-66* creat-8.4* sodium-142 potassium-5.9* chloride-110* total co2-16* anion gap-22* history: altered mental status. evaluate underlying for pneumonia. upright portable chest: comparison is made to and , exams. study is slightly limited by patient motion. in the interval, the degree of pulmonary edema appears improved with slightly decreased prominence of the pulmonary vascularity. there is unchanged extensive retrocardiac consolidation obscuring the majority of the left hemidiaphragm with persistent blunting of the left cp angle, likely related to small effusion. exam is otherwise unchanged from prior with persistent cardiomegaly. a catheter is seen projecting over the abdomen, partially imaged. impression: slight improvement in pulmonary edema with persistent retrocardiac opacity, which again may represent atelectasis versus underlying pneumonia. brief hospital course: 24 yo woman with hx of sle, ersd on hd, admitted hypotension and decreased mental status. hypotension and altered mental status were in the setting of excessive narcotic use. patient's narcotics were held, pressors returned to and patient was mentating fine. hct was below baseline and patient was transfused 1u prbc and was given hd before discharge. patient is to continue anti-hypertensive medications as previously scheduled. patient was encouraged to take less pain medications and to use morphine (already previously written for) rather than dilaudid for pain control. # change in mental status: resolved, patient took dilaudid this morning and was noticed to be unresponsive shortly thereafter. patient received 1 dose of narcan with slight improvement in bp and mental status. patient without fevers or leuckocytosis which argue against infection. # hypertension ?????? resumed outpatient regimen. patient did not have any hypertensive episodes requiring hydralizine 10mg iv. # hypotension: resolved, patient normotensive on arrival to icu. relative hypotension likely due to dilaudid. other considerations include sepsis, although patient without objective signs of infection. held pain medications and hypotension resolved. resumed hypertensive medications. # abdominal pain ?????? from previous peritoneal hematoma ?????? pain under control patient should use morphine instead of dilaudid # hyperkalemia: likely due to missed hd session. she received calcium, d5, insulin and kayexalate in ed. hd in am esrd: renal following, had hd the day of discharge, transfused while there. will continue normal schedule as an outpatient with hd t/th/f this week. # metabolic acidosis: likely due to renal failure and missed hd. # sle: continued prednisone at 4 mg po daily. # osa: cpap for sleep with 7 pressure, however patient refuses. continued to offer as inpatient. should try to follow up with sleep medicine. medications on admission: prednisone 4mg qd citalopram 20 mg daily gabapentin 300 mg warfarin 4mg daily pantoprazole 40 mg qd clonidine 0.1 mg/24 qwed clonidine 0.3 mg/24 hr qwed labetalol 900 mg tid nifedipine 90 mg qd aliskiren 150 mg hydralazine 100 mg q8h morphine 7.5 mg q8h prn pain discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 2. gabapentin 300 mg capsule sig: one (1) capsule po bid (2 times a day). 3. warfarin 2 mg tablet sig: two (2) tablet po once daily at 4 pm. 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 5. labetalol 100 mg tablet sig: three (3) tablet po tid (3 times a day). 6. nifedipine 90 mg tablet sustained release sig: one (1) tablet sustained release po daily (daily). 7. aliskiren 150 mg tablet sig: one (1) tablet po bid (2 times a day). 8. hydralazine 50 mg tablet sig: two (2) tablet po q8h (every 8 hours). 9. sevelamer hcl 400 mg tablet sig: two (2) tablet po tid w/meals (3 times a day with meals). discharge disposition: home discharge diagnosis: primary: narcotic overdose relative hypotension anemia secondary: esrd on hd sle malignant hypertension discharge condition: stable - received hd prior to discharge discharge instructions: you were admitted for altered mental status after missing hemodialysis. it was likely from the dilaudid you took as well as missing your scheduled . you were also relatively hypotensive in the setting of excessive narcotic medicaiton usage. narcotic medications were held and hypotension and altered mental status resolved. please use narcotic medications with caution. you are recommended to use morphine for pain control rather than dilaudid. no medication changes were made. please return to the ed if you have any altered mental status or miss or have symptoms such as vision changes or headache from your history of malignant hypertension. followup instructions: provider: , md phone: date/time: 3:00 hd as previously scheduled procedure: hemodialysis transfusion of packed cells diagnoses: hypertensive chronic kidney disease, malignant, with chronic kidney disease stage v or end stage renal disease chronic glomerulonephritis in diseases classified elsewhere other primary cardiomyopathies acidosis systemic lupus erythematosus hyperpotassemia other iatrogenic hypotension thrombocytopenia, unspecified anemia in chronic kidney disease end stage renal disease obstructive sleep apnea (adult)(pediatric) accidental poisoning by other opiates and related narcotics dysthymic disorder long-term (current) use of anticoagulants personal history of venous thrombosis and embolism noncompliance with renal dialysis poisoning by other opiates and related narcotics thrombotic microangiopathy altered mental status nontraumatic hematoma of soft tissue 

Answer: The patient is high likely exposed to