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 / watermelon / almond oil / hydralazine attending: chief complaint: abdominal pain, hyperglycemia major surgical or invasive procedure: none history of present illness: mr. is a 33y/o gentleman with poorly controlled dm1 complicated by gastroparesis and h/o dka in the past, esrd on hd, htn and nonischemic cardiomyopathy (ef 30-35%) who presented to the ed with abdominal pain, nausea and vomiting in the setting of hyperglycemia. . he reports that his blood sugars have been reasonably controlled this week (<160) but he also admits that he has not checked his fingerstick at home since the day prior to admission. yesterday he tool his standing lantus 18u in the am, and then a total of 20 units of sliding scale humalog. the last fingerstick he took was 160. he awoke this morning feeling "sick to my stomach," with abdominal pain and he vomited a small amount of nonbloody fluid. he continued to have abdominal pain and vomited a few more times so he came to the ed. . the pain is a diffuse, burning epigastric pain that is associated with nausea and vomiting. it is similar to his prior episodes of gastroparesis and dka. no ruq pain. he denies any fevers/chills. no cough/uri symptoms. he still makes a small amount of urine but has had no dysuria and no change in the color of his urine. no flank pain. no erythema or redness from his rue avf. no skin rashes. . in the ed, initial vitals were: t 99.4, hr 101, bp 123/73, rr 18, pox 100% ra. he was vomiting and appeared volume depleted on exam and had diffuse abdominal tenderness but no acute abdomen. labs revealed glucose 673, anion gap 21, ph 7.39. potassium 5.2 so received no potassium. he received regular insulin 10u then was started on regular insulin drip at 7u/hr. received 1l/hr for 3 hours (total 3l before transfer to icu) and still remained tachycardic. for abdomminal pain, received morphine 4mg iv; no imaging was obtained in the ed. was given zofran 8mg iv and compazine 10mg iv. vital signs prior to transfer were t 99.3, hr 104, bp 182/108, rr 18, pox 96% ra. . on the floor, he complains of abdominal pain but says it is a (compared to 17/10 on admission). no nausea right now but starts to feel nauseated if talking for a long time. very thirsty and asking for ice chips. . review of systems: (+) per hpi. also last week he felt short of breath outside which resolved when he sat near an air conditioner. (-) denies fever, chills, night sweats. denies headache, sinus tenderness, rhinorrhea or congestion. denies cough or wheezing. denies chest pain, chest pressure, palpitations, or weakness. denies diarrhea, constipation, or changes in bowel habits. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes or skin changes. past medical history: -dm type i since age 19, followed at . complicated by nephropathy, neuropathy, gastroparesis, retionpathy. prior episodes of dka and hospitalization. -esrd on hd t/th/s: right arm fistula, , dry weight 73kg -hypertension -nonischemic cardiomyopathy with ef 30-35% -anemia: felt to be due to both iron deficiency and advanced ckd -depression -pulmonary hypertension -migraines social history: -home: lives with his gf. mother lives in the area as well. -tobacco: trying to quit; has relapsed and smokes 1 pack per week -etoh: previously drank heavily (30-40 drinks/week) but has not used alcohol since -illicits: denies other drugs. family history: paternal gf had dm2 but nobody with dm1. hypertension in a few family members. physical exam: admission exam vitals: t 98.8, bp 174/111, hr 98, rr 21, sao2 97%ra general: alert, oriented, no acute distress heent: sclera anicteric, dry mucous membranes neck: supple, jvp not elevated lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: tachycardic, s1 and s2, no murmur abdomen: nondistended, (+)bowel sounds; mild tenderness to deep palpation in all quadrants with no rebound and no guarding gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema; no axillary sweat; rue avf with thrill pertinent results: admission labs 02:30pm blood wbc-8.6# rbc-4.45* hgb-14.1# hct-42.0 mcv-94 mch-31.6 mchc-33.5 rdw-14.4 plt ct-234 02:30pm blood neuts-91.5* lymphs-5.4* monos-2.0 eos-0.4 baso-0.7 02:30pm blood glucose-673* urean-43* creat-9.3*# na-135 k-5.2* cl-90* hco3-24 angap-26* 02:30pm blood alt-32 ast-21 alkphos-183* totbili-0.6 02:30pm blood lipase-62* 02:30pm blood albumin-4.6 calcium-9.4 phos-5.8*# mg-1.8 05:19pm blood glucose->500 lactate-2.0 na-137 k-4.6 cl-99* calhco3-20* 05:19pm blood freeca-1.01* brief hospital course: mr. is a 33 y/o gentleman with htn and dm1 presenting with abdominal pain, nausea, vomiting in the setting of hyperglycemia that are consistent with prior episodes of gastroparesis and dka. . #. hyperglycemia/dka: the patient presented in dka with a blood sugar of 673 and an ag of 21. the patient has a h/o questionable med adherance and dka. he was palced on an insulin gtt and electrolytes were followed. the patient improved with good fs and his gap fell to 13. troponin elevated but without ck-mb elevations; findings likely a result of esrd. ekg without evidence of ami. on arrival in the micu, the patient's fs was 215. drip was d/c'ed and started on iss. on am of , the patient was still with fs in the 200s and had reopened a gap to 17. iss was increased without change in the anion gap despite normal blood sugars, this persistant gap was thought likely renal failure and accumulation of organic acids. patient has had multiple admissions in the past year for similar complaints, patient's primary physician is . . patient asked specifically that we not get consult as it costs him $300 each admission and he will follow up as an outpatient. . #. abdominal pain: on arrival the paient complained of burning/fullness likely as a result of dka, gastroparesis and abdominal wall tenderness from vomiting. this is similar to the pain he has had in the past in the setting of poorly controlled blood sugars. associated with nausea. the pain and nausea were controlled with zofran, reglan, apap and dilaudid. reports that abd pain is greatly improved on am of . patinet has a narcotics contract that states he will not recieve more than mg diluadid po twice daily. . #. htn: the patient has a h/o poorly controlled bp. home meds currently include carvedilol, amlodipine and lisinopril. in the micu, the patient's pressures were initially elevated to the 200/110s range. received home meds and labetolol overnight with good improvement. on , bps are controlled with home meds to 130s systolic. . #. esrd: the patient has esrd on hd. last hd was he is a on a tts schedule. transitional issues: - please do not obtain consult while inpatient as patient cannot afford and will follow up as an outpatient - please contact dr. regarding non-compliance - pt has a narcotics consult as described above. - pt receives hd tts medications on admission: aspirin 81 mg daily carvedilol 50 mg lisinopril 40 mg daily amlodipine 10 mg daily lantus 18u sc qam (recently increased form 15u) humalog sliding scale qachs metoclopramide 10 mg daily before biggest meal ondansetron 4 mg q8h prn omeprazole 20 mg renvela 800 mg tid with meals sumatriptan 25 mg prn glucagon emergency 1 mg prn glucose gel 40 % prn docusate 100 mg viagra 50 mg prn hydromorphone 4 mg prn discharge disposition: home discharge diagnosis: (1) diabetic ketoacidosis (2) end stage renal disease (3) gastroparesis discharge condition: sugars resolved, anion gap closed, ambulating, tolerating pos discharge instructions: dear mr , you were admitted for abdominal pain and nausea/vomiting that we felt was secondary to diabetic ketoacidosis (dka). we're unsure why your sugars went so high. to treat this, we started you on insulin and fluids, and your sugars resolved over the course of a couple of days. your nausea, vomiting, and abdominal pain also improved. we did not make any changes to your medications at time of discharge. followup instructions: department: when: monday at 3:00 pm with: , md building: sc ctr campus: east best parking: garage department: transplant social work when: friday at 10:30 am building: lm campus: west best parking: garage department: gastroenterology when: wednesday at 12:30 pm with: , md building: lm campus: west best parking: garage procedure: hemodialysis diagnoses: other primary cardiomyopathies anemia in chronic kidney disease end stage renal disease renal dialysis status tobacco use disorder congestive heart failure, unspecified other chronic pulmonary heart diseases polyneuropathy in diabetes depressive disorder, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease long-term (current) use of insulin iron deficiency anemia, unspecified hypovolemia diabetes with neurological manifestations, type i [juvenile type], uncontrolled diabetes with renal manifestations, type i [juvenile type], uncontrolled diabetes with ophthalmic manifestations, type i [juvenile type], uncontrolled diabetes with ketoacidosis, type i [juvenile type], uncontrolled background diabetic retinopathy gastroparesis 

Answer: The patient is high likely exposed to