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: patient recorded as having no known allergies to drugs attending: chief complaint: end stage renal failure major surgical or invasive procedure: tunnel hemodialysis line placement on right picc line placement in right arm kidney biopsy history of present illness: briefly, 84 year-old female with suspected cholangiocarcinoma and ckd (baseline creatinine 1.7-1.8) admitted for acute on chronic kidney failure. on day prior to presentation, patient was evaluated by dr. in renal clinic. routine labs drawn and patient was found to have worsening creatinine, metabolic acidosis, and leukocytosis. urine microscopy showed muddy brown casts. patient was requested to go to ed for further managment. at , ua was suspicious for uti. for hyperkalemia, she received kayexylate, calcium gluconate, insulin, bicarbonate, and levofloxacin. she was transferred to for further evaluation. in the ed, 98.1 92 109/58 14 93%ra. physical examination reportedly unremarkable. laboratory data significant for creatinine 9.8 -> 9.3 (baseline 3.8), potassium 6.6 -> 5.0, wbc 21.0 -> 18.3, hematocrit 31.4 -> 25.0, lactate 1.9. ua with blood, proteinuria and no evidence of infection. blood and urine cultures sent. foley placed. ekg reportedly with no acute changes. cxr 2v reportedly with no acute changes. ct abdomen/pelvis without contrast (reportedly performed to rule out urinary obstruction) remarkable for bilateral pleural effusions, small pericardial effusion, and no evidence of obstruction. receiving ns at 150cc/hour; levofloxacin at osh. on transfer to medicine service, afebrile, 87, 120/50, 24, 97% 2l. had bm prior to leaving ed. on medicine service, patient reports fatigue x2 weeks. ros otherwise negative. she denies fever, chills, cough, chest pain, shortness of breath, abdominal pain, nausea, vomiting, diarrhea. also denies decreased urine output, dysuria, or hematuria. denies decreaed urine output. past medical history: - hypertension - hyperlipidemia - ugib () - bell's palsy () - perforated diverticulum, s/p colectomy () - hepatic cholangioadenocarcinoma s/p resection - s/p left thr social history: no tobacco, etoh, drugs. lives with brother and sister, none of whom have ever married and always have lived together. identifies as greek orthodox, but not a regular church attender. family history: noncontributory physical exam: general: laying in bed, comfortable, alert. heent: sclera anicteric, mmm neck: neck supple and nontender lungs: decreased breath sounds at bases. no wheezes, rales, or rhonchi. cv: rrr, normal s1/s2, no mrg abdomen: soft, non-tender, ostomy bag on l side, clean and dry margins. ext: 1+ edema bilaterally in both legs pertinent results: admission labs: 02:00pm blood wbc-21.0*# rbc-3.45* hgb-9.2* hct-31.4* mcv-91# mch-26.6* mchc-29.2* rdw-15.9* plt ct-741*# 02:00pm blood neuts-86.2* lymphs-8.4* monos-4.1 eos-0.7 baso-0.6 04:40am blood pt-14.4* ptt-29.0 inr(pt)-1.2* 02:00pm blood urean-69* creat-9.8*# na-139 k-6.6* cl-102 hco3-11* angap-33* 04:40am blood alt-8 ast-12 ld(ldh)-183 ck(cpk)-34 alkphos-69 totbili-0.3 05:05am blood ck-mb-1 ctropnt-0.04* 02:00pm blood albumin-3.4* calcium-9.8 phos-5.7*# 06:00am blood caltibc-143* ferritn-754* trf-110* 09:45am blood pth-33 05:49am blood cortsol-13.2 workup for renal failure: 02:30pm blood hbsag-negative hbsab-negative hbcab-negative 05:05am blood anca-negative b 05:05am blood -negative 05:05am blood pep-no specifi 05:05am blood c3-128 c4-48* 08:50am blood hcv ab-negative 05:06am blood anti-gbm-negative kidney needle biopsy: pauci-immune crescentic glomerulonephritis light microscopy: the specimen consists of renal cortex and medulla, containing approximately 42 glomeruli, of which 32 are globally sclerotic (some of which show fragmentation of the consistent with a prior crescentic process). of the remainder, about 4 show cellular crescents, and 4 show fibrocellular crescents. there is diffuse interstitial inflammation (mixed cellularity, eosinophils are not prominent), that makes is difficult to judge the extent of interstitial fibrosis and tubular atrophy, but it is at least moderate. arteries show moderate-marked intimal fibroplasia. arterioles show moderate-marked mural thickening, some with hyaline change. no active vasculitis is seen. immunofluorescence: the specimen consists of renal cortex, containing approximately 6 glomeruli, of which 4 are globally sclerotic. there is 0-trace mesangial staining for igg, iga, c3, kappa, and lambda. igm and c1q are negative. 1+c3 is seen along tubular basement membranes and in vessels. albumin is non-contributory. one glomerulus shows fibrin positivity consistent with a crescent. please see omr for chest x-ray reports bilateral lower extremity ultrasounds: deep venous thrombosis in a single peroneal vein bilaterally right upper extremity ultrasound: deep venous thrombosis is incompletely occlusive in the right internal jugular vein, imaged above the level of the patient's right internal jugular dialysis catheter insertion site. brief hospital course: ms. is an 84 yof with history of hepatic adenocarcinoma s/p resection and ckd (baseline creatinine 1.7-1.8) who was admitted for acute on chronic kidney failure. on day prior to presentation, patient was evaluated by dr. in renal clinic. routine labs drawn and patient was found to have worsening creatinine, metabolic acidosis, and leukocytosis. urine microscopy showed muddy brown casts. patient was requested to go to ed for further managment. when ms. was admitted, she had a cr of 9.3. she received a renal biopsy, which showed pauci-immune crescentic glomerulonephritis. treatment with steroids was deferred at the time of diagnosis because of multiple infections (see below) and was ultimately decided to be of little utility due to high risks in the setting of multiple infections, amount of time elapsed from the time of diagnosis, and the advanced stage of scarring seen on biopsy. hd was initiated. complications included removal of 4 hd catheters, the first of which she pulled out while delirius, the second of which was changed for catheter failure, and the third bled from inlet site, and the fourth of which she agian pulled out while delirious. there were multiple failed attempted at hd due to hypotension/bradycardia and line malifunction. cvvh was not considered a treatment option given the her hospital course was also complicated by uti and two pneumonias (community acquired pna treated on admission with levofloxacin, and later hospital-acquired pneumonia treated with flagyl, cefepime, and vancomycin). she developed bilateral lower extremity dvt's and was started on heparin ggt. despite being therapeutic, she subsequently developed dvt in her right arm as well as her right ij extending to the tunneled hd line. there was concern she may have trousseau's given her history of malignancy. given all of the above factors and her inability to tolerate hemodialysis with little chance of recovery of renal function given the degree of her rpgn, the palliative care team was consulted and goals of care were readdressed. she was made "comfort measures only" in the hospital and discharged with home hospice under her family's care. she had mild uremic symptoms on discharge, including nausea and confusion, as well as a 4l oxygen requirement thought to be from volume overload. medications on admission: epo amlodipine metoprolol tartrate pantoprazole multivitamin vitamin d discharge medications: 1. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily) as needed for to back for pain. disp:*15 adhesive patch, medicated(s)* refills:*0* 2. morphine concentrate 20 mg/ml solution sig: 5-10 mg po every 1 to 4 hours as needed for pain, respiratory distress. disp:*30 ml* refills:*0* 3. ativan 2 mg/ml solution sig: one (1) mg injection every six (6) hours as needed for anxiety. disp:*30 ml* refills:*0* 4. atropine 1% drops 2 drops sublingually every 4 hours as needed for secretions. dispense 5 ml. 5. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 1-2 puffs inhalation every 4-6 hours as needed for shortness of breath or wheezing. disp:*1 inhaler* refills:*0* 6. senna 8.6 mg capsule sig: one (1) capsule po twice a day. disp:*60 capsule(s)* refills:*2* 7. colace 100 mg capsule sig: two (2) capsule po twice a day. disp:*120 capsule(s)* refills:*0* discharge disposition: home with service facility: discharge diagnosis: rapidly progressive glomerulonephritis urinary tract infection community acquired pneumonia hospital-acquired pneumonia tachy-brady syndrome bilateral lower extremity dvt's right upper extremity dvt discharge condition: patient was discharged on 4l nasal canula oxygen. she was oriented to person and place as hospital only. she had evidence of mild uremic symptoms with nausea, itching and mild confusion. discharge instructions: you were admitted to the hospital with acute renal failure. the cause of your renal failure is felt to be irreversible and your body did not tolerate hemodialysis because of your heart rate and blood pressure. you were also treated for pneumonia in the hospital, as well as blood clots in your legs, arm and neck. you were followed by the palliative care team in the hospital to help control your symptoms and make you comfortable. home hospice has been arranged and will continue to help you feel more comfortable while you are at home. followup instructions: you will be continued to be followed by hospice while at home. procedure: hemodialysis venous catheterization for renal dialysis venous catheterization for renal dialysis venous catheterization for renal dialysis venous catheterization for renal dialysis thoracentesis closed [percutaneous] [needle] biopsy of kidney removal of other device from thorax diagnoses: pneumonia, organism unspecified acidosis hyperpotassemia anemia in chronic kidney disease end stage renal disease acute kidney failure with lesion of tubular necrosis unspecified pleural effusion urinary tract infection, site not specified acute posthemorrhagic anemia acquired coagulation factor deficiency atrial fibrillation hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease nausea with vomiting constipation, unspecified dysthymic disorder other and unspecified hyperlipidemia disorders of phosphorus metabolism other and unspecified special symptoms or syndromes, not elsewhere classified other postprocedural status diarrhea kidney dialysis as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure methicillin resistant staphylococcus aureus in conditions classified elsewhere and of unspecified site encounter for palliative care acute venous embolism and thrombosis of deep vessels of proximal lower extremity abdominal aneurysm without mention of rupture sinoatrial node dysfunction personal history of malignant neoplasm of liver delirium due to conditions classified elsewhere mechanical complication of other vascular device, implant, and graft hypercalcemia hip joint replacement nutritional marasmus acute pyelonephritis without lesion of renal medullary necrosis other colostomy and enterostomy complication acute venous embolism and thrombosis of internal jugular veins acute glomerulonephritis with lesion of rapidly progressive glomerulonephritis 

Answer: The patient is high likely exposed to