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: aspirin / penicillins attending: chief complaint: shortness of breath major surgical or invasive procedure: --intubation/mechanical ventilation --tunneled catheter placement by ir history of present illness: this is a 44-year-old woman with a pmhx. significant for dm 2, hypertension, hcv, depression, and esrd on peritoneal dialysis (with history of peritonitis) who is admitted from the ed with hypoxia in the setting of missing peritoneal dialysis for the past 3 days. ms. states that she has had worsening, crampy abdominal pain for the past 2 days, and as such, has not used peritoneal dialysis since the night of . she denies fevers, chills, or dysuria. does endorse a recent cough that is productive of mucous. of note, patient had similar abdominal symptoms in when she developed a coag negative staph infection in her peritoneal cavity. she was treated with a 14-day course of intra-peritoneal vancomycin. patient was also instructed to follow-up with her nephrologist and transplant surgeons in anticipation of starting hemodialysis. . patient states that she was having trouble breathing the night prior to admission, and felt acutely dyspneic on the morning of admission. in the ed, initial vitals were: 130 164/89 and 53% on ra. an abg was significant for: 7.43 pco2 28 po2 37. white count was 19.5 with a leftward shift and lactate was 4.4. a cxr was consistent with volume overload. ms. was given 120mg of iv lasix (she put out 600cc of urine) and nitro. she was started on a bipap mask with improvement in her sats to 99% with and fio2 of 100. renal was consulted and recommended admission to icu with initiation of hemodialysis. on transfer, vitals were: 115, 169/100, 99% on cpap. past medical history: diabetes mellitus type 2, hypertension, hepatitis c -- genotype 1. -- never previously been treated. -- history of intravenous drug use. depression, end-stage renal disease ----18mo ago on peritoneal dialysis x 1 year ----peritonitis in w/ culture + for mycobacterium fortuitum ----h/o hd line infections as well as failed fistula social history: the patient lives with her mother and daughter. she was employed as a medical , positive tobacco use pack per day for 20 years. no alcohol use, prior history of heroin use. family history: mother hypertension and diabetes mellitus and aunt has hypertension physical exam: vs: 98.2, 115, 143/95, 95% on cpap general: slightly labored breathing, nad chest: crackles bilaterally neck: jvp up cardiac: rrr, 3/6 systolic murmur abdomen: peritoneal catheter in place, area looks clean and non-erythematous extremities: 1+ edema bilaterally, warm, dry on discharge, vs were all stable. lung exam was ctab, no wheezes/rhonchi/rales no peripheral edema pertinent results: ==================== laboratory results ==================== on admission: wbc-19.5*# rbc-3.31* hgb-8.7* hct-27.2* mcv-82 rdw-14.8 plt ct-267 --neuts-90.7* lymphs-6.4* monos-2.5 eos-0.4 baso-0.1 pt-15.6* ptt-26.2 inr(pt)-1.5* glucose-96 urean-72* creat-11.3*# na-133 k-7.8* cl-99 hco3-18* alt-12 ast-21 ld(ldh)-377* ck(cpk)-78 alkphos-102 totbili-0.4 albumin-2.3* calcium-8.0* phos-7.4*# mg-1.8 on discharge: wbc-13.2* rbc-3.53* hgb-9.7* hct-29.8* mcv-84 rdw-15.4 plt ct-163 glucose-158* urean-16 creat-4.4*# na-135 k-3.7 cl-96 hco3-29 calcium-8.8 phos-3.6# mg-1.9 other important labs: lipase-365* 04:56pm blood ck-mb-3 ctropnt-0.22* 04:16am blood ck-mb-3 05:59am blood ctropnt-0.24* 07:30am blood ctropnt-0.18* 10:42pm blood hbsag-negative hbsab-positive hbcab-negative 01:57am blood anca-negative b 01:57am blood -negative 07:30am blood hiv ab-negative ================ other studies =============== echo : the left atrium is normal in size. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no pericardial effusion. impression: normal global and regional biventricular systolic function. cxr : a single ap radiograph was obtained. there is diffuse airspace opacity within the lungs, radiating from the hila, most consistent with severe pulmonary edema. the heart size is difficult to assess. the mediastinal contours are normal. no definite pleural effusions. there is no pneumothorax. impression: diffuse pulmonary airspace opacity which may reflect severe pulmonary edema. brief hospital course: this is a 44-year-old woman with a pmhx. significant for htn, dm2, hcv, and esrd on peritoneal dialysis who presents with acute shortness of breath, likely from volume overload. active issues: # acute diastolic heart failure: on admission, pt presented with exam findings and radiographic evidence of volume overload, likely missing pd. in the ed, ms. was started on bipap and her respiratory status improved. she was given 120mg of iv lasix and put out about 700cc. she was then transferred to the micu where she was given 120mg of iv lasix and 500mg of chlorothiazide with little urine output. patient continued to be short of breath, and an urgent hd line was placed. ultra-filtration was started that night. however, respiratory status continued to decline and on second hospital day, patient was intubated and started on ards net protocol. she continued to receive uf and was ultimately extubated on . an echo showed a normal ef. on discharge, her lungs were clear to auscultation and she had no peripheral edema. she will transition to outpatient hd after discharge. # esrd: patient with esrd likely from diabetes and hypertension. nephrology service was consulted and felt that she was not a good candidate to continue pd and felt she should be transitioned to hd. she had a tunneled lij placed for access and avf mapping prior to discharge. she will continue to follow-up with the outpatient nephrology team. she is also scheduled to follow up with the transplant surgery service for removal of her pd catheter. # delirium/encephalopathy: pt had waxing/ mental status following extubation and transfer to the floor, with occasional agitation that responded well to low doses of iv haldol. this was thought most likely due to sedating medications used during her intubation and micu course. her ams resolved by discharge without intervention. # hypotension: pt was hypotensive after hd with bp 80s/50s. she remained asx and her bp improved to low-normal without intervention. her amlodipine was decreased to 5mg daily and her clonidine patch was decreased to 0.1mg/24h to prevent post-hd hypotension, and she should follow up with her pcp and hd nephrologist regarding her antihypertensive regimen. # leukocytosis: on admission pt had elevated wbc at 15. this was initially concerning for infection and she was started on broad spectrum antibiotics in the micu. however she had no focal s/sx of infection and culture data was negative. antibiotics were discontinued and her leukocytosis resolved. # abdominal pain: patient had abdominal pain on presentation that prevented her from adhering to pd. her lipase was elevated, but she had no radiographic signs of pancreatitis (on ct without contrast). patient's abdominal pain eventually resolved and she was able to eat without difficulty. chronic issues: # htn: her amlodipine and clonidine doses were decreased due to post-hd hypotension as above. # dm: patient was briefly hypoglycemic in the micu but this improved once her ams cleared and she was taking normal diet. however she had a low insulin requirement without her basal insulin, and her home lantus dose was decreased to 10units qam. # methadone maintenance: methadone was initially held due to ams. she was restarted on her home methadone dose (70mg daily) after her delirium resolved. # chronic pain: gabapentin and oxycodone were initially held due to ams and then resumed on discharge. # anxiety/depression: stable on home venlaflaxine and hydroxyzine. transitional issues: - medication changes: decreased amlodipine to 5mg daily and clonidine patch to 0.1mg/24hr patch due to hypotension after hd, decreased gabapentin to 300mg qhd for hd dosing, and decreased lantus to 10u every morning due to low insulin requirement during hospitalization. - she is scheduled to follow-up with her pcp and transplant surgeon after discharge. - she will continue hd as an outpatient with dialysis center. medications on admission: 1. venlafaxine 75 mg tablet sig: as directed tablet po once a day: take one half () tablet daily for 7 days, then increase to one (1) tablet daily. disp:*30 tablet(s)* refills:*0* 2. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 3. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain, fever: do not take more than 2 grams per day. disp:*30 tablet(s)* refills:*0* 4. insulin glargine 100 unit/ml solution sig: twenty three (23) units subcutaneous once a day: in the morning. 5. hydroxyzine hcl 25 mg tablet sig: two (2) tablet po daily (daily). 6. clonidine 0.2 mg/24 hr patch weekly sig: one (1) patch weekly transdermal qmon (every monday). 7. sevelamer carbonate 800 mg tablet sig: two (2) tablet po tid w/meals (3 times a day with meals). 8. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). disp:*30 cap(s)* refills:*2* 9. methadone 10 mg tablet sig: seven (7) tablet po daily (daily). 10. trazodone 50 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. 11. oxycodone 5 mg tablet sig: 1-2 tablets po three times a day as needed for pain. disp:*30 tablet(s)* refills:*0* 12. humalog 100 unit/ml solution sig: as directed subcutaneous four times a day: take with meals per previous sliding scale. 13. lactulose 10 gram/15 ml solution sig: thirty (30) ml po every six (6) hours as needed for constipation. 14. loratadine 10 mg tablet sig: one (1) tablet po once a day as needed for allergy symptoms. 15. gabapentin 300 mg capsule sig: one (1) capsule po three times a day. discharge medications: 1. venlafaxine 75 mg capsule, ext release 24 hr sig: one (1) capsule, ext release 24 hr po daily (daily). 2. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 3. acetaminophen 325 mg tablet sig: 1-2 tablets po every six (6) hours as needed for pain: do not exceed 2g in 24 hours. 4. lantus 100 unit/ml solution sig: ten (10) units subcutaneous qam. 5. sevelamer carbonate 800 mg tablet sig: two (2) tablet po tid w/meals (3 times a day with meals). 6. aripiprazole 5 mg tablet sig: one (1) tablet po daily (daily). 7. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 8. methadone 10 mg tablet sig: seven (7) tablet po once a day. 9. trazodone 50 mg tablet sig: one (1) tablet po at bedtime as needed for insomnia. 10. oxycodone 5 mg tablet sig: 1-2 tablets po three times a day as needed for pain. 11. humalog 100 unit/ml solution sig: one (1) injection subcutaneous four times a day: as directed by sliding scale. 12. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po every six (6) hours as needed for constipation. 13. nicotine 14 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily). disp:*10 patch 24 hr(s)* refills:*0* 14. gabapentin 300 mg capsule sig: one (1) capsule po qhd (each hemodialysis): take after hemodialysis. 15. clonidine 0.1 mg/24 hr patch weekly sig: one (1) patch transdermal once a week: start on wednesdays. disp:*4 patches* refills:*0* discharge disposition: home with service facility: homecare discharge diagnosis: acute diastolic heart failure end stage renal failure hypertension discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear ms. , you were admitted to because you were having difficulty breathing. this likely happened because you missed your peritoneal dialysis and fluid accumulated in your lungs. you were admitted to the intensive care unit and were intubated. you had fluid removed by dialysis and your breathing improved, and your breathing tube was removed. you had a tunneled line placed so you can continue to receive dialysis as an outpatient after you leave the hospital. we made the following changes to your medications while you were in the hospital: -stop hydroxyzine, loratidine for now as they may cause sedation and confusion - please talk to your outpatient providers about when it is safe to restart these medications -decrease amlodipine to 5mg daily -decrease gabapentin to 300mg with hemodialysis -decrease insulin glargine (lantus) to 10 units every morning -change your clonidine patch to 0.1mg/24hours patch once a week (you will need to get new patches) we made no other changes to your medications while you were in the hospital. please continue taking the rest of your medications as prescribed by your outpatient providers. please call your primary care physician to schedule an appointment within 1 week of leaving the hospital. please see below for your currently scheduled appointments at . it has been a pleasure taking care of you at and we wish you a speedy recovery. followup instructions: name: , l. when: thursday at 9:45 am location: community health center phone: 1255 you will be followed by your nephrologist, dr during your upcoming dialysis appointment: chronic unit- t# f# nephrologist- , m.d. schedule-t/t/s you have the following appointments currently scheduled at : department: infectious disease when: friday at 10:30 am with: , md building: lm bldg () campus: west best parking: garage department: transplant center when: monday at 9:00 am with: , md building: lm bldg () campus: west best parking: garage procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube hemodialysis injection or infusion of thrombolytic agent venous catheterization for renal dialysis venous catheterization for renal dialysis diagnoses: end stage renal disease other chronic pain tobacco use disorder congestive heart failure, unspecified toxic encephalopathy cirrhosis of liver without mention of alcohol chronic hepatitis c without mention of hepatic coma acute kidney failure, unspecified depressive disorder, not elsewhere classified opioid type dependence, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease anxiety state, unspecified acute respiratory failure long-term (current) use of insulin hypoxemia noncompliance with renal dialysis acute diastolic heart failure examination of participant in clinical trial diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled physical restraints status 

Answer: The patient is high likely exposed to