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: insulin pork purified / insulin beef / erythromycin base / codeine / aspirin / compazine / peanut / reglan / phenergan attending: chief complaint: nausea major surgical or invasive procedure: none history of present illness: 35 year old female with multiple medical problems with multiple hospitalization for dka presents with nausea/vomiting of note, just recently admitted from for dka, mrsa bactermeia(?hd line? and heel osteo on 6 weeks of meropenem and linezolid to be completed . during this admission, guardianship was also established. she was then discharged to ne specilaties. patient was sent from ne specialties because she was noncomplaint with medication, treatment and diet. per nh referral sheet, pateint was seen by multiple staff member putting fingers down her throat to induce vomiting. in addition, patient has increased agitation, requiring 2:1 sitter, "out of control", screaming and hollering. paitent reports 5 days history of intermittent nausea/vomiting, but no coffee grounds/hemetemesis/fever/chilss/nause/chest pain/sob/melena. patient has diffuse abdominal pain. in the ed, she was given , morphine, ativan and labetolol past medical history: 1) dm1 - diagnosed initially in . patient has had multiple admissions for dka and hypoglycemia, practically monthly. volatile blood sugars complicated by infections w/ recurrent pyelonephritis, chronic diarrhea, severe gastroparesis, high and low sugars. poor blood sugar control has resulted in severe diabetic neuropathy and diabetic retinopathy. 2) gastroparesis and chronic nausea - as above dm 3) esrd - has been on peritoneal dialysis 5x/week for approximately past year. patient has, in past, refused hemodialysis. has agreed and been started on hd during current admission. baseline cr unknown as patient has had such frequent admissions for dm1 (as above) and acute worsening of failure due to inaccurate pd at home. 4) seizure disorder - worked up in past by neurology. thought to be toxic-metabolic in nature and secondary to patient's endocrine status (brought on by hyper or hypoglycemia) 5) anemia - esrd. now on procrit with hd. 6) htn 7) asthma 8) chronic skin breakdown - secondary to dm1 and poor healing due to poor vascularity. also patient scratching itching from uremia. particularly on lower extremities bilaterally. 9) chronic diarrhea, also with stool incontinence since removal of absces in 10) recurrent pyelonephritis 11) history of peritonitis infection from peritoneal dialysis 12) history of subdural hematoma 13) history of esophagitis/gastritis: admitted for hematemesis in - egd revealed grade iv esophagitis, bleeding in distal esophagus, erythema in stomach body and fundus (consistent with gastritis) 14) cardiac function - last in demonstrated dilated left atrium, moderate symmetric left ventricular hypertrophy, normal ef = 60-70%, no wall motion abnormalities social history: the patient had lived when she was admitted, but was evicted from this residency (court ordered, prior to her hospitalization) and was going to stay with her mother in after the hospitalization. her pcp was who completed his residency and has passed along his patients to dr. , who has yet to meet . per his omr note, her children have recently been taken by dss. she has a long history of medical noncompliance. she previously noted that she smokes 2 packs of cigarettes every 5 days but says that she is smoking less now (approximately 4 pk yr history). she denies use of alcohol or illicit drugs. had been in abusive home relationship but denies current abuse. family history: father with type 2 dm, chf, cva physical exam: t98.2 p88 bp193/86 r18 100% on ra gen- lying in bed, ill appearing but nontoxic heent- perla neck- supple chest- rales at right base, otherwise clear cv- rrr, no r/m/g abd- diffuse tenderness, no rebound/guarding, ulcers at pd site w/ serosanguinous extremity- l?r heel ulcers- well granulated pertinent results: 11:15am glucose-738* urea n-39* creat-6.4* sodium-130* potassium-4.7 chloride-89* total co2-21* anion gap-25 11:15am calcium-8.1* phosphate-6.3*# magnesium-1.9 11:15am acetone-large 09:45pm urine color-yellow appear-clear sp -1.014 09:45pm urine blood-sm nitrite-neg protein-500 glucose-1000 ketone-15 bilirubin-neg urobilngn-neg ph-8.0 leuk-neg 09:45pm urine rbc-* wbc- bacteria-few yeast-none epi-21-50 08:02pm glucose-106* lactate-2.0 na+-146 k+-4.1 cl--98* tco2-28 08:00pm glucose-104 urea n-29* creat-5.5* sodium-142 potassium-4.0 chloride-97 total co2-28 anion gap-21* 08:00pm alt(sgpt)-3 ast(sgot)-18 alk phos-179* amylase-70 tot bili-0.9 08:00pm lipase-20 08:00pm albumin-4.1 calcium-9.7 phosphate-3.7# magnesium-1.8 08:00pm wbc-9.7 rbc-4.41# hgb-11.9*# hct-37.6# mcv-85 mch-27.0 mchc-31.7 rdw-19.7* 08:00pm neuts-68.7 lymphs-22.7 monos-4.8 eos-1.9 basos-1.9 08:00pm hypochrom-1+ anisocyt-2+ poikilocy-1+ microcyt-1+ 08:00pm plt count-380 08:00pm pt-14.3* ptt-33.0 inr(pt)-1.4 . . kub : there is no free air. there is stool and gas in the colon, which is normal in caliber. there are no pathologically dilated small bowel loops to suggest obstruction. . ct head : 1) no evidence of acute intracranial hemorrhage or skull fracture. 2) polypoid mucosal thickening in the left sphenoid sinus unchanged from prior. . blood cx : negative cdiff toxin : negative . blood cx : negative blood cx : negative brief hospital course: 35 year old female with history of type i diabetes w/ multiple dka, esrd on hd, chronic n/v likely from severe gastroparesis, chronic diarrhea and multiple other medical problems presents with nausea/vomiting and abdominal pain for 5 days. . # abdominal pain/nausea: ct abdomen show mild colonic thickening but otherwise unchanged, abdominal labs negative, no fevers/leukocytosis; of note, her nausea often exacerbated post-hd and frequently in association with narcotics in the setting of pain. c diff was positive and she was initially started on flagyll on , she continued to have abdominal pain, and after discussion with id and gi, oral vancomycin (started on ) was also added as the patient has a previous history of c.diff and this would provide better coverage. the patient completed a ..course of antibiotics. her nausea was controlled with antiemetics (), and while initially npo she rapidly was advanced to a full diet. at the time of the patient was not complaining of diarrhea. . # abdominal wound at site of old pd cath: plastics evaluated patient during this admission and no surgical intervention at this time. she was evaluated by a wound care nurse, and wound dressing was continued with xeroform, and vitamin c, zinc. the patient was discharged with wound care instructions. . # heel osteo- completed 6 wk course of linezolid and meropenem finished on . was recently discharged from on a 6-week course of meropenem and linezolid, to complete on . she is now on imipenem on admission, instead. no documentation in her records why this was changed. given her hx of seizure d/o and the fact that imipenem can lower sz threshold, switched back to meropenem/linezolid. finished abx course . consulted for followup evaluation of osteo for further management as necessary. the service continued to see her on a periodic basis during this admission. they were satisfied with the healing of her r heel, felt that the l heel would benefit from an appligraft, however, this can only be obtained as an outpatient. they were investigating for a substitute, no plans for further surgical intervention at this time. . the patient has follow up scheduled with dr. . she will need to have an apligraft placed prior on her first visit. . # hypertension- her blood pressure was controlled with lopressor, and eventually changed to toprol for more convenient dosing. her procardia had recently stopped for hypotension post dialysis. at the time of her toprol 100 daily. . # chronic diarrhea w/ negative w/u. she was ruled out for c-diff on multiple occasions. . # chronic skin breakdown - secondary to dm1 and poor healing, also poor vascularity. patient also constantly scratching/itching from uremia. provided atarax for symptoms control, along with dialysis for uremia. wound care nursing followed her while she was hospitalized. . # type i dm w/ triopathy- poorly controlled the patient was followed by and her insulin regimen was carefully titrated to provide maximum control over her sugars. she was provided with nutrition teaching and a dietician helped to monitor her food choices/limit her carbohydrates. the patient was initially poorly compliant with her diet by buying high sugar foods from the vending machine, hiding snacks in her room, and stacking food from her meal trays. in addition, she would often leave the floor without permission, which would result in her becoming hyperglycemic to the point of critically high sugars. this was addressed and restrictions were placed on the patient's diet; limiting her snacks to only those provided to her on her meal trays. she also required a sitter to ensure that she would not leave the floor. she was somewhat stable initially on a regimen of 18 units lantus at lunch and 32 units of nph at night, with a humalog sliding scale for meal time coverage. her glucose levels improved for a short period of time on this regimen. however this was short-lived. her course became complicated by critically high sugars at night which were often in the range of 400. the patient would be treated per sliding scale. on these occasions her sugars would fall below 60. she was then treated with amps of d50. the patient's sugars would improve to a level above 100. after extensive work with the consultants, the decision was made for them to manage any questions surrounding her insulin regimen in order to avoid these extreme highs and lows. despite this intervention, the patient continued to have labile sugars. at the time of the patient was on glargine 20u at lunch and 38u of nph at night. the patient was provided several copies of a tailored sliding scale. felt that we had achieved optimal insulin regimen give the patient's labile glucose levels. . prior to the patient, personal care attendants and guardian had diabetic teaching by the consultants. . at the time of the patient had prescriptions for her insulin, glucometer, and glucose strips. she also had a copy of her insulin sliding scale. . # vitreous hemorrhage in addition, she experienced a vitreous hemorrhage in her right eye as a complication of her diabetes. she was evaluated at the eye center, and will need to follow-up within 6-8 weeks. . # neuropathy for her neuropathy, she was given gabapentin, amitriptyline, and oxycodone on a prn basis. . # esrd- she was on a 3-4x per week dialysis schedule via tunneled l subclavian hd catheter. the patient was hyperkalemic on multiple occasions with k+ up to 6.5. ekgs were routinely checked, and did not demonstrate change, but did demonstrate peaked t waves. the patient refused kayexalate, lasix, calcium gluconate on multiple occasions despite being told that hyperkalemia could lead to a life threatening arrythmia. there was discussion about placing permanent access via graft, and transplant surgery was consulted. the patient underwent vein mapping, and based on these results, the surgeons felt she would be a poor candidate with no guarantee for success given her vasculopathy and the multiple lines she has had. she would be at high risk for steal and possible limb loss. this was discussed with her nephrologist, dr. and it was thought to defer permanent access for now. she was arranged to have outpatient hd at m,w,f. . # fever- she had persistent fever spikes during the first week of with temp up to 102. she was pan-cultured and ruled out for c-diff. no obvious source of infection was found. given the concern for a line infection from either her l picc or the hd cath site, she was treated with a week course of vancomycin, dosed by level. because she also had an episode of seizure- like activity one day at hemodialysis an lp was attempted on two occasions, but was unsuccessful. she did not exhibit signs of meningitis, and her fever resolved within one week. neuro was consulted for this seizure-like activity and a ct head was done, which was negative. an eeg was consistent with encephalopathy, and the patient was thought to have been exhibiting severe contractions from narcan administration rather than a true seizure. her keppra level was checked, and found to be therapeutic. . at the time of the patient was afebrile. . # dispo- the patient was discharged home with vna and personal care attendants. prior to the personal care attendant had diabetic teaching at . on the day of a meeting was held with the attendants outlining the patient's . medications on admission: imipenem 500 iv qd keppra 500 po bid linezolid 600mg po q12 ca carb 1250mg po tid w/ meals colace protonix lipitor 40 nephrocaps qd heparin sc epogen 20,000 q hd'seroquel 75 qhs, 25 hydroxyzine msir prn zofran prn medications: 1. levetiracetam 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 3. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). disp:*30 cap(s)* refills:*2* 5. hydroxyzine hcl 25 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed for itching. disp:*30 tablet(s)* refills:*2* 6. ascorbic acid 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 7. zinc sulfate 220 mg capsule sig: one (1) capsule po daily (daily). disp:*30 capsule(s)* refills:*2* 8. kayexalate 30ml qd on sat/sunday for doses. 9. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed. disp:*30 capsule(s)* refills:*2* 10. quinine sulfate 325 mg capsule sig: one (1) capsule po hs (at bedtime). disp:*30 capsule(s)* refills:*2* 11. sevelamer 800 mg tablet sig: four (4) tablet po tid (3 times a day). disp:*360 tablet(s)* refills:*2* 12. quetiapine 25 mg tablet sig: one (1) tablet po qam (once a day (in the morning)). disp:*30 tablet(s)* refills:*2* 13. quetiapine 25 mg tablet sig: three (3) tablet po hs (at bedtime). disp:*30 tablet(s)* refills:*2* 14. cinacalcet 30 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 15. amitriptyline 25 mg tablet sig: one (1) tablet po hs (at bedtime). disp:*30 tablet(s)* refills:*2* 16. oxycodone 5 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed. disp:*30 tablet(s)* refills:*1* 17. calcium acetate 667 mg capsule sig: four (4) capsule po tid w/meals (3 times a day with meals). disp:*120 capsule(s)* refills:*2* 18. acetaminophen 325 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. disp:*30 tablet(s)* refills:*2* 19. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h (every 6 hours) as needed. disp:*qs inhalers* refills:*2* 20. hydrocortisone 2.5 % cream sig: one (1) appl rectal /prn (). disp:*qs tubes* refills:*2* 21. calcium carbonate 500 mg tablet, chewable sig: four (4) tablet, chewable po qhs (once a day (at bedtime)). disp:*30 tablet, chewable(s)* refills:*2* 22. metoprolol succinate 100 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po daily (daily). disp:*30 tablet sustained release 24hr(s)* refills:*2* 23. gabapentin 100 mg capsule sig: two (2) capsule po daily (daily). disp:*30 capsule(s)* refills:*2* 24. glucagon emergency 1 mg kit sig: one (1) injection when glucose is critically low. disp:*1 kit* refills:*2* 25. glargine sig: per sliding scale regimen disp: qs refills: 5 26. humalog sig: per sliding scale regimen disp: qs refills: 5 27. nph sig: per insulin sliding scale disp: qs refills: 5 28. glutose 40 % gel sig: one (1) po for critically low sugars. disp:*30 tubes* refills:*2* 29. glucometer please provide patient with a glucometer disp: 1 kit refills: 1 30. glucose test strips sig: use with glucometer disp: qs refills: 2 31. syringes please provide with 50cc syringes for the administration of insulin. disp: qs refills: 5 32. lanthanum 1,000 mg tablet, chewable sig: one (1) tablet, chewable po three times a day. disp:*90 tablet, chewable(s)* refills:*2* lunch (noon) glargine 20 units daily bedtime (10pm) nph 38 units if glucose greater than 300 30 units if glucose less than 300 humalog insulin sc sliding scale breakfast lunch dinner bedtime glucose 0-80 81-100 0 units 0 units 0 units 0 units 101-180 2 units 0 units 5 units 0 units 181-200 3 units 3 units 8 units 0 units 201-250 5 units 5 units 10 units 0 units 251-300 7 units 7 units 12 units 2 units 301-350 9 units 9 units 13 units 4 units 351-400 11units 11units 15 units 6 units > 400 call disposition: home with service facility: family & services diagnosis: primary diagnosis dm1 with labile blood sugars ketoacidosis/hypoglycemia cdiff colitis . secondary diagnosis ) dm1 - diagnosed initially in . patient has had multiple admissions for dka and hypoglycemia. volatile blood sugars complicated by infections w/ recurrent pyelonephritis, chronic diarrhea, severe gastroparesis, severe diabetic neuropathy and diabetic retinopathy. 2) gastroparesis and chronic nausea - as above dm 3) esrd on hd 4) seizure disorder - worked up in past by neurology. toxic-metabolic in nature and secondary to patient's endocrine status (brought on by hyper or hypoglycemia) 5) anemia - esrd. now on procrit with hd. 6) htn 7) asthma 8) chronic skin breakdown - dm1, poor healing from impaired vascularization, patient scratching uremic pruritus. 9) chronic diarrhea, also with stool incontinence since removal of abscess in 10) history of peritonitis infection from peritoneal dialysis 11) history of subdural hematoma 12) history of esophagitis/gastritis: admitted for hematemesis in - egd revealed grade iv esophagitis, bleeding in distal esophagus, gastritis 13) cardiac function - last in demonstrated dilated left atrium, moderate symmetric left ventricular hypertrophy, normal ef = 60-70%, no wall motion abnormalities 14)staph epi bacteremia s/p 1 week vancomycin with resolution condition: stable, still with labile sugars at baseline, normotensive, on room air, alert instructions: weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet fluid restriction: 2 liters per day . please keep a diary of your glucose levels. you must record your before meals before bed time (10pm) and at 3am. also check sugars if you are feeling symptoms of low/high blood sugars. call for any questions regarding insulin dosing. . we are advising you not to drive. followup instructions: . provider: , md phone: 11 am . primary care physician : , md phone: date/time: 3:30 . provider: , dpm phone: date/time: 8:00 . in every monday, wednesday, friday at 4pm . eye appointment on at 1pm with dr . psychiatrist for management of your medications-- on friday at 10:00 in bldg . md procedure: hemodialysis diagnoses: anemia in chronic kidney disease end stage renal disease other convulsions hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease intestinal infection due to clostridium difficile 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 ulcer of heel and midfoot gastroparesis unspecified osteomyelitis, ankle and foot peripheral autonomic neuropathy in disorders classified elsewhere vitreous hemorrhage 

Answer: The patient is high likely exposed to