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 / ace inhibitors attending: chief complaint: "facial swelling, hoarseness." major surgical or invasive procedure: intubation and successful extubation history of present illness: mr is a 59 year old male with htn and restarted lisinopril presenting with angioedema. . patient recently restarted lisinopril on the day prior to admission after stopping secondary to sexual dysfunction. he presented to the clinic with upper lip swelling, hoarse voice and subjective sob when lying flat. he also felt throat constriction, "like i had strep throat." no swelling elsewhere. no family history of swelling. no accompanying hives or itchiness. epi pen was administered in clinic and patient was referred to the ed. . patient has taken lisinopril for 8-9 years. he noted an episode similar to this one 3 months ago, when his bottom and his upper lip swelled up for two days. no other swelling elsewhere and no sob. he and his family believed that this was secondary to pickled beets, which he had for the first time that day. he stopped taking the medication shortly after because he believed that it contributed to sexual dysfunction. . in the ed, vs 99.3 80 149/94 16 100% ra. pphysical exam concerning with vocal hoarseness and uvula swelling. patient received diphenhydramine 50mg, methylprednisolone sodium succ 125mg, ondansetron 2mg. decision made to electively intubate with anesthesia. patient bolused with propofol and fentanyl with resulting hypotension. the nadir was sbp 88. patient continued on midazolam and fentanyl for sedation while intubated. . vs prior to transfer to the micu, sbps in 90, hrs 60-70s oxygenating well. on arrival to the floor, patient intubated and sedated. he was given 3l ivf for low sbp which recovered to previous baseline of 150s. . on day of transfer to the medical floor, the patient's vital signs were 98.0 160/90 68 20 100%ra. past medical history: # microcytic anemia. presumed to be from lower gi bleeding secondary to severe diverticulosis, identified on colonoscopy on , which also revealed hyperplastic polyp in sigmoid colon. previous reports of hematemesis. egd on also revealed chronic inactive gastritis in stomach. he was treated for h. pylori in 11/. # dm2- diabetes, diagnosed in when mr. 270 pounds. he was treated for nine years with insulin. in , he lost weight to 210 pounds and sugar tests returned to . he stopped taking insulin. currently takes no medication for diabetes. last hba1c was 5.7% in . # htn - controlled with amlodipine and lisinopril (previous to admission). # hypercholesterolemia. t. cholesterol of 225 (hdl 64 ldl 139) on 06/. on simvastatin. # osteoarthritis. end-stage degenerative joint disease in both hips. hip replacement scheduled for the future. he used to take tylenol for pain control but has recently switched to ibuprofen. patient also reports intermittent pain in both knees and left shoulder. he uses a cane to walk. #gout. his last gout attack was a few months ago. he has used colchicine during previous flares. his right mtp is the most commonly involved joint. #previous hep b infection. recovery from hep b per labs in with anti-hbs and anti-hbc present. viral load negative in . no serology for hep c. social history: had been on disability secondary to hip pain since . he worked for 20 years as an autoglazer. he does not smoke. he has drinks/week. he has been encouraged to cut back on his alcohol intake in the past. he smokes marijuana 1x/day. he denies any illicit drug use (cocaine, amphetamines, ecstasy). family history: anemia in his daughter. failure in his mother. has a cousin with cell anemia (and carries the trait himself). physical exam: admission physical exam: . vitals: t: 97.4 bp: 104/74 p: 62reg r:16 o2: 100% on cmv general: intubated, sedated, no acute distress heent: sclera anicteric, pinpoint pupils, mmm, considerable lower lip and tongue swelling neck: supple, jvp not elevated, no palpable lad lungs: anterior fields clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis . discharge physical exam: vitals: 98.2 150/86 72 18 98%ra general: comfortable, appropriate, in nad heent: b/l facial swelling still present but reduced. sclera anicteric, perrla, mmm, oropharynx shows significantly reduced adenoid and uvular swelling. neck: supple, jvp estimated 5-6 cm, no palpable lad lungs: cta b/l. no w/rh/r. cv: rrr, nl s1. s2 loud. no murmurs, rubs or gallops. abdomen: soft, non-tender, non-distended. no hsm. no masses palpated. ext: wwp 2+ pulses. no signs of swelling in mtps or knees. skin: no rashes or other lesions. pertinent results: admission labs 05:30pm pt-11.8 ptt-25.2 inr(pt)-1.0 05:30pm plt count-184 05:30pm neuts-82.1* lymphs-15.0* monos-1.3* eos-1.4 basos-0.3 05:30pm wbc-6.0 rbc-4.58* hgb-13.9* hct-39.0* mcv-85 mch-30.4 mchc-35.7* rdw-17.1* 05:30pm c3-127 c4-34 05:30pm calcium-9.1 phosphate-3.0 magnesium-1.8 05:30pm alt(sgpt)-32 ast(sgot)-24 ld(ldh)-141 alk phos-37* tot bili-0.7 05:30pm estgfr-using this 05:30pm glucose-106* urea n-12 creat-0.8 sodium-141 potassium-3.7 chloride-106 total co2-25 anion gap-14 . discharge labs . 06:41am blood wbc-10.5 rbc-4.59* hgb-14.2 hct-39.5* mcv-86 mch-30.9 mchc-36.0* rdw-17.2* plt ct-191 06:41am blood plt ct-191 06:41am blood glucose-108* urean-15 creat-0.9 na-142 k-3.8 cl-106 hco3-26 angap-14 02:33am blood calcium-9.3 phos-3.8 mg-1.9 05:30pm blood c1 inhibitor- 15 mg/dl (normal mg/dl) . cxr: findings: single supine ap portable view of the chest was obtained. there has been interval placement of an endotracheal tube, terminating approximately 5.4 cm above the level of the carina. a nasogastric tube is seen, coursing below the level of the diaphragm, terminating in the gastric fundus. lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. cardiac and mediastinal silhouettes are unremarkable given supine, ap technique. impression: 1. endotracheal tube in appropriate position. 2. nasogastric tube is seen coursing below the level of the diaphragm, extending into the gastric fundus, although the side port is not well seen. clear lungs. . c3 and c4 within normal limits . c1 inhibitor, protein 15 within normal limits brief hospital course: mr is a 59 year old male with htn, restarted lisinopril on presenting with angioedema, intubated for airway protection; ultimately extubated and transitioned to general medicine floor. . # angioedema. initial differential included allergic mast-cell mediated vs. direct bradykinin mediated effect vs. acquired or inherited c1 inhibitor deficiency. most likely bradykinin-mediated effect, as effect of drug was not immediate and was not accompanied by uriticaria or pruritus. normal c3 and c4 levels and c1 inhibitor levels make inherited or acquired angioedema less likely. in the ed patient received h1 antihistamine: diphenhydramine 50 mg iv, methylprednisolone 125 mg iv. per the literature, treatment of ace-induced angioedema primarily involves discontinuation of drug. in the icu patient continued on iv solumedrol as well as benadryl. swelling drastically improved and patient was extubated on hospital day 2 and steroids and h2 blockers were minimized. he was transferred to medicine floor, where swelling continued to decrease. on discharge, his facial and oropharyngeal edema were minimal. he was advised to never take lisinopril again (as well as other ace inhibitors or arbs) and to return to hospital immediately if he noted any signs of shortness of breath or throat constriction. . # hypotension. patient initially hypotensive to 80s prior to arrival in the icu. low sbps likely secondary to sedative agents administered for intubation. patient received ~3l of iv fluid with improvement and stabilization of pressures. on medicine floor, patient had returned to hypertensive baseline and fluids were not continued. . # history of hypertension. initially home regimen of acei and ccb held. home amlodipine restarted on hospital day 2. acei now listed as an allergy. on hospital day 3, his amlodipine dosage was increased from 5mg qd to 10 mg qd as patient continued to be hypertensive and had lost the antihypertensive effect of acei. . #abdominal ache. "dull ache" with band-like distribution across lower abdomen first noted on night of hospital day 2. likely secondary to constipation as patient had not had bowel movement since admission. patient given bowel regimen prior to discharge. . # normocytic anemia. borderline low hemoglobin and close to baseline. hemoglobin recovered to normal levels upon transfer to medicine floor. patient has history of microcytic (mcv 75-80) anemia for several years that was presumed to be from gi bleeding secondary to severe diverticulosis and gastritis documented on colonscopy in . patient re-started on fe supplementation when extubated and he will continue on discharge . #joint pain. no joint pain during admission but chronic problem for patient. patient scheduled for right then left total hip replacement in the future. patient also has gout in right mtp. consider starting allopurinol for gout prophylaxis on an outpatient basis. he has never been on prophylaxis for gout and used to take colchicine for acute attacks. patient was also advised to curb alcohol intake, as he reports drinks a week and alcohol can precipitate gout attack. . # gerd. continued on home home proton pump inhibitor with daily dosing. . # viral hepatitis. evidence of previous acute hep b infection with recovery per hep b serologies in 07/. hep c negative per test in 07/. liver function tests within normal limits on admission. . # diabetes. blood sugars were consistently within normal limits in icu and on floor. patient maintained on insulin sliding scale but did not require insulin. . # hyperlipidemia. patient admitted on simvastatin. this was discontinued on the last hospital day given the interaction between simvastatin and amlopidine. instead, he was discharged home on atorvastatin with instructions to follow-up with his primary care doctor about continuation of atorvastatin. . # transition of care. - patient will need follow-up regarding hypertension and anti-hypertensive medications. - follow-up regarding continuation of atorvastatin in the setting of continuing amlodipine for control of hypertension. - patient should never take ace inhibitors or angiotensin receptor blockers given angioedema reaction to ace inhibitors. - consider starting the patient on allopurinol for gout prophylaxis. - instructed the patient to take acetaminophen for joint pain instead of ibuprofen given his known history of gi bleed secondary to diverticulosis and gastritis. medications on admission: lisinopril - 30 mg tablet - 1 tablet(s) by mouth qd simvastatin 20mg qpm viagra 50mg prn motrin 800mg prn amlodipine 5mg tab daily prilosec 20mg 1 ferrous sulfate 325mg 1 tab discharge medications: 1. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po daily (daily). 2. amlodipine 10 mg tablet sig: one (1) tablet po once a day. disp:*15 tablet(s)* refills:*0* 3. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 4. viagra 50 mg tablet sig: one (1) tablet po as needed as needed for erectile dysfunction. 5. acetaminophen 650 mg tablet sig: one (1) tablet po every six (6) hours as needed for pain. 6. epinephrine 0.15 mg/0.15 ml pen injector sig: one (1) pen injector intramuscular as needed as needed for throat swelling. disp:*3 pen injectors* refills:*0* 7. atorvastatin 10 mg tablet sig: one (1) tablet po at bedtime. disp:*15 tablet(s)* refills:*0* 8. polyethylene glycol 3350 17 gram powder in packet sig: one (1) packet po once a day as needed for constipation. disp:*30 * refills:*0* discharge disposition: home discharge diagnosis: primary diagnosis: angioedema secondary to lisinopril secondary diagnosis: hypertension gout history of type 2 diabetes mellitus osteoarthritis hypercholesterolemia 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 taking care of your during your hospitalization at . you were hospitalized for angioedema (face and throat swelling) caused by lisinopril, a medication you were taking for control of your blood pressure. you were intubated briefly in the micu and suscessfuly extubated. your lisinopril has been stopped, and your swelling has improved. please take all medications as prescribed. please note the following medication changes: *new: -epinephrine injection pen to be used for symptoms of throat swelling. -atorvastatin 10mg daily. simvastatin interacts with your blood pressure medication amlodipine. -polyethlyene glycol powder 17g packet as needed for constipation. -acetaminophen 650mg every 6 hours as needed for pain. do not exceed 3000mg daily when taking acetaminophen *changed: increased amlopidine to 10mg daily for control of hypertension *stopped: -lisinopril. when you get home from the hospital please throw away any remaining pills of lisinopril that you have. do not take any more lisinopril or medications known as ace inhibitors or angiotensin receptor blockers (arbs) for treatment of your hypertension as you have a known reaction to these classes of medications. -simvastatin- this medication interacts with amlodipine (your blood pressure medication) -ibuprofen. this was stopped given your history of anemia. non-steroidal anti-inflammatory drugs such as ibuprofen increase your risk of bleeding from the gastroentestinal tract. try acetaminophen instead, do not exceed 3000mg daily when taking acetaminophen. please make a follow-up appointment with your primary care doctor for within 2 weeks of hospital discharge. at this appointment, you and your primary care doctor should discuss your blood pressure medication regimen. followup instructions: name: , m. location: community health center address: , , phone: appt: saturday, at 10:45am procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube diagnoses: esophageal reflux pure hypercholesterolemia unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled gout, unspecified angioneurotic edema, not elsewhere classified osteoarthrosis, unspecified whether generalized or localized, pelvic region and thigh other and unspecified agents primarily affecting the cardiovascular system causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to