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: morphine attending: chief complaint: shortness of breath major surgical or invasive procedure: none history of present illness: this is a 62yo m pmhx htn, esrd on hd, chf (ef 28%), afib, non-compliance with hd, crack cocaine, recent admission to (most recent ) for volume overload and sob in setting of missing hd session, now p/w 1 day sob. patient reports that 1 day prior to admission, he had an episode of nb diarrhea, causing him to miss hd (normally scheduled for tues/thurs/saturday). he subsequently noted development of shortness of breath and l-sided pleuritic cp. he describes pain as fleeting, lasting seconds at a time, non-exertional non-radiating, not related to eating, and without associated palpitations or diaphoresis. he also reported chills and subjective fevers. of note, patient also reports using crack cocaine on the morning prior to his admission. . patient was bibems for further evaluation. in ed initial vital signs were 100.8 130 152/88 28 100%nrb. exam was notable for tachypnea, dyspnea, desatting to 88% during transfer. patient immediately initiated on bipap. cxr demonstrated bilateral opacities c/w moderate to severe pulm edema. labs were significant for wbc 7.8(n81), hct 32.6, bnp48k, trop 0.37. ekg was not sent with patient. patient was given , tylenol, levofloxacin, vancomycin, 1mg iv dilaudid. was able to be weaned off bipap, and patient was admitted to micu for further management. vital signs prior to transfer were 104 133/79 24 96% 6lnc. . on arrival to the micu patient was coughing, producing thick yellow mucus, but sitting up and talkative. vital signs were 99.0 92 134/72 22 90%6lnc past medical history: 1. esrd on hd t/th/sa at , , 2. type 2 diabetes mellitus c/b peripheral neuropathy 3. chronic systolic chf with ef 30% ( tte) 4. atrial fibrillation/aflutter - s/p ablation ; s/p ablation x 2 in - not on coumadin due to history of gibs. 5. hypertension 6. dyslipidemia 7. history of gi bleeds: duodenal, jejunal, and gastric avms s/p thermal therapy; diverticulosis throughout colon 8. chronic pancreatitis 9. ? hcv: hcv ab + , but neg 10. gerd 11. gout: s/p arthroscopy with medial meniscectomy 12. depression with multiple hospitalizations due to si 13. polysubstance abuse: crack cocaine, etoh, tobacco 14. recurrent chest pain following crack/cocaine use - no evidence cad on cath 15. erectile dysfunction s/p inflatable penile prosthesis 16. h/o c diff in 17.thyrotoxicosis social history: he lives with his . he is on diability, but had worked previously for . he smokes cig/day. denies recent alcohol use. using cocaine, lasted used last week. family history: mother died of mi; per omr multiple sibs with t2dm physical exam: vitals: 99.0 92 134/72 22 90%6lnc admission exam: general: alert, oriented, no acute distress heent: sclera anicteric, mm dry, perrl neck: supple, 8cm jvd, l-sided hd line in place c/d/i cv: irreg irreg, no murmurs, rubs, gallops lungs: diffuse crackles throughout w scattered ronchi bilaterally abdomen: soft, mildly distended, nontender, nabs gu: no foley ext: wwp, 1+ radial equal bilaterlly, dp dopplerable bilaterally, 1+ edema to mid-shin, no cyanosis neuro: aox3, moving all extremities discharge exam: afebrile, sbp 130s, hr 80-90s, 95% ra general: alert, oriented, no acute distress heent: sclera anicteric, mmm, perrl chest: hd line removed, no erythema, pus or induration at site cv: irreg irreg, no murmurs, rubs, gallops lungs: ctab abdomen: soft, mildly distended, nontender, nabs ext: no edema pertinent results: admission labs 08:10pm wbc-7.8 rbc-3.66* hgb-10.1* hct-32.6* mcv-89 mch-27.7 mchc-31.0 rdw-15.7* 08:10pm neuts-81.7* lymphs-10.6* monos-5.1 eos-1.7 basos-0.9 08:10pm plt count-247 07:28pm glucose-243* urea n-71* creat-11.5*# sodium-135 potassium-8.3* chloride-93* total co2-23 anion gap-27* 07:28pm estgfr-using this 07:28pm alt(sgpt)-38 ast(sgot)-60* ck(cpk)-163 alk phos-201* tot bili-0.6 07:28pm lipase-23 07:28pm ck-mb-8 ctropnt-0.37* probnp-* 07:28pm albumin-3.7 calcium-10.1 phosphate-4.5 magnesium-2.8* 07:28pm digoxin-0.9 07:28pm -neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 07:28pm type- po2-91 pco2-37 ph-7.50* total co2-30 base xs-4 comments-green-top 07:28pm lactate-2.0 k+-6.9* 07:28pm pt-12.6* ptt-33.1 inr(pt)-1.2* . ekg atrial flutter with a rapid ventricular response. indeterminate axis with low qrs voltages in the limb leads. non-specific st-t wave changes. compared to the previous tracing of there is no significant change. . imaging cxr ap portable upright chest radiograph: the hilar and mediastinal contours are stable, with a mildly tortuous thoracic aorta. again, seen is a moderate-sized right pleural effusion with mild right basal atelectasis. bilateral perihilar and pulmonary alveolar opacities are most suggestive of moderate-to-severe pulmonary edema. left ij approach central venous catheter ends in the right atrium. there is no pneumothorax. impression: moderate-sized right pleural effusion with moderate pulmonary edema. . echo the left atrium is mildly dilated. the right atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is mild to moderate global left ventricular hypokinesis (lvef = 35-40%). the right ventricular cavity is moderately dilated with mild global free wall hypokinesis. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. there is mild mitral regurgitation. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. impression: mild lvh with mild to moderate global systolic dysfunction. mild right ventricular systolic function. mild mitral regurgitation. moderate pulmonary hypertension. . cxr findings: dual-lumen left central line catheter tip lies at right upper atrium. the severe pulmonary edema is unchanged in severity but has redistributed, with interval improvement in the left lung and worsening on the right side. normal heart size, mediastinal and hilar contours are stable. no pneumothorax. small right pleural effusion is unchanged. impression: since severe pulmonary edema is unchanged in severity but has distribution with interval worsening in the right lung and improved on the left side. cxr : in comparison with study of , there are lower lung volumes, which may account for some of the increased prominence of the transverse diameter of the heart. again, there is moderately severe pulmonary edema. discharge labs: 07:02am blood wbc-7.1 rbc-3.70* hgb-10.3* hct-34.0* mcv-92 mch-27.9 mchc-30.3* rdw-15.7* plt ct-313 07:02am blood glucose-170* urean-50* creat-7.3*# na-136 k-4.9 cl-94* hco3-29 angap-18 07:02am blood calcium-10.5* phos-6.7* mg-2.7* brief hospital course: 62yo m pmhx dm, htn, esrd on hd tu/th/sat, chf (ef 28%), afib, h/o crack cocaine use, non-compliance with hd p/w hypoxia in setting of missed hd appointment, crack cocaine use # hypoxia: he presented with hypoxia in the setting of missed session and active crack cocaine smoking. his cxr showed pulmonary edema but pna could not be ruled out so he was treated for possible co-existing health-care associated pneumonia with broad spectrum antibiotics. echo showed stable to mildy depressed ef though unlikley to be cause of his pulmonary edema. he underwent multiple sessions of and his respiratory status significantly improved. his antibiotics were stopped and he was transferred to the floor where he remained afebrile and was weaned off room air. he was satting 95% on ra at the time of discharge and denied sob. # left-sided chest pain: the patient has been admitted multiple times for chest pain thought to be musckuloskeletal chest pain. he again had chest pain here without associated ekg abonormalities that was not relieved with nitroglycerin. he did have elevated troponins though he has elevated troponins at baseline. the pain was easily reproducible on palpation and improved with removal of his tunneled catheter. he was treated with percocet with good response. on the floor, he had recurrence of chest pain. on review of records, it was noted that his chest pain tended to occur in conjunction with rvr during previous admissions. this was found to be the case here as well, as cp occurred when rate began to run over 120-130s. rvr was managed as below and symptomatic relief for cp was otherwise provided with small doses of iv dilaudid to good effect (0.25mg iv q6h prn). pt denied cp at the time of discharge and rate was well-controlled as below. # atrial fibrillation/flutter: he is chronically in afib/flutter. he has been well rate controlled here on diltiazem and digoxin. of note he is not on metoprolol because of his active cocaine use. during his admission his digoxin level was high on his home dose so his schedule was changed so that he would received digoxin after hd with trough levels drawn pre-. he is on full dose aspirin but not warfarin because of history of gi bleeding. he had two episodes of rvr on the floor with rates into the 160-170s. this was managed with diltiazem iv push 10mg on both occasions and his daily diltiazem dose was increased to 420mg from 360mg daily. it was noted that holding his diltiazem until after hd led to rvr so plan was made to take diltiazem every day at 12pm instead of in the morning. rate well-controlled in 80-90s on this dose. # esrd: he receives hd t/th/s as an oupatient. he has had multiple admission in the setting of missed . he underwent multiple sessions with improvement in his symptoms as above. he was transitioned back to his three times weekly schedule. his tunneled catheter was removed because he has a functional fistula. we continued nephrocaps, cinacalcet, sevelamer carbonate. # dmii. lantus and sliding scale insulin were continued. he did have mild hypoglycemia so his sliding scale was adjusted. # diabetic neuropathy: continued gabapentin 100mg tid transitional issues -should check digoxin troughs pre- -take digoxin post - follow up rate control on 420mg po diltiazem daily taken at noon - encourage cocaine cessation medications on admission: - albuterol sulfate prn - nephrocaps 1mg daily - cinacalcet 90mg daily - digoxin 125mcg daily - diltiazem hcl 360mg extended release daily - gabapentin 100mg tid - hydroxyzine hcl 25mg prn - glargine 14 units - humalog sliding scale - percocet 5-325mg before/after hd prn pain - sevelamer carbonate 3200mg tid w meals - ambien 5mg - docusate sodium 100mg - 325mg daily discharge medications: 1. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) puffs inhalation every four (4) hours as needed for shortness of breath or wheezing. 2. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 3. cinacalcet 30 mg tablet sig: three (3) tablet po daily (daily). 4. diltiazem hcl 420 mg capsule, extended release sig: one (1) capsule, extended release po at lunch, or 2 pm. disp:*30 capsule, extended release(s)* refills:*0* 5. gabapentin 100 mg capsule sig: one (1) capsule po tid (3 times a day). 6. hydroxyzine hcl 25 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pruritis. 7. sevelamer carbonate 800 mg tablet sig: four (4) tablet po tid w/meals (3 times a day with meals). 8. ambien 5 mg tablet sig: one (1) tablet po at bedtime. 9. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 10. aspirin 325 mg tablet sig: one (1) tablet po once a day. 11. digoxin 125 mcg tablet sig: one (1) tablet po every other day (every other day). 12. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po twice a day as needed for pain: you should take this medication before and after session as needed for pain. please do not drive, drink alcohol or operate heavy machinery while on this medication. . 13. lantus 100 unit/ml solution sig: fourteen (14) units subcutaneous at bedtime. 14. humalog 100 unit/ml solution sig: one (1) injection subcutaneous as directed: please follow usual sliding scale as outlined by your outpatient doctors with regards to this medication. discharge disposition: home discharge diagnosis: primary diagnosis: fluid overload atypical chest pain atrial fibrillation with rapid ventricular response secondary diagnosis: end-stage renal disease diabetes mellitus type 2 insomnia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: dear mr. , it was a pleasure caring for you at . you came for further evaluation of chest pain. further evaluation showed that you had fluid on your lungs likely due to missing your session. your heart rate was also fast, from your atrial fibrillation, at numerous times during this admission, and we adjusted your medications to deal with this. it is very important that you take this medication, diltiazem, on a daily basis. it is also very important that you stop using cocaine, as it is likely the reason for most of your hospitalizations, and is extremely bad for your health. it is important that you go to your sessions, as scheduled, and don't miss sessions, and follow up with the appointments listed below. your weight goes up by more than 3 lbs. the following changes have been made to your medications: we increased your dose of diltiazem, which you should take on a daily basis. please do not miss doses of these medications. we changed the dose of your digoxin, in that you will now take this medication every other day instead of every day followup instructions: department: when: wednesday at 3:00 pm with: , md building: sc clinical ctr campus: east best parking: garage department: podiatry when: monday at 8:30 am with: , dpm building: ba ( complex) campus: west best parking: garage department: when: monday at 10:30 am with: , md building: sc clinical ctr campus: east best parking: garage department: hemodialysis when: saturday at 7:30 am procedure: hemodialysis removal of other device from thorax diagnoses: hyperpotassemia end stage renal disease renal dialysis status esophageal reflux congestive heart failure, unspecified atrial fibrillation diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes depressive disorder, not elsewhere classified atrial flutter alcohol abuse, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other and unspecified hyperlipidemia long-term (current) use of insulin noncompliance with renal dialysis personal history of noncompliance with medical treatment, presenting hazards to health acute on chronic systolic heart failure combinations of opioid type drug with any other drug dependence, continuous 

Answer: The patient is high likely exposed to