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: codeine / gentamicin attending: chief complaint: chf exacerbation major surgical or invasive procedure: placement of lij tunneled dialysis catheter ultrafiltration history of present illness: 55 year old male with a pmh of dm, pancreas/ transplants, cad s/p multiple stents, chf with ef: 50-55%, hep b/c admitted c/o abdominal pain and increased sob for one week. the pain was described as being sharp and increasing with movement. + chills, +low grad fevers. he stated he was in his usual state of health until 3-4 days prior to admission when he began to get more sob with increasing orthopnea and four pound weight gain. he denies any recent medicine changes, follwed by as outpatient. during hospitalizations here, given lasix iv causing his cr to increase and urine output only -400 net. chf service consulted as only one kidney now and cr was rising with lasix. dr. recommended enrolling in nesiritide/ chf filtration trial. patient's abd pain w/u includd negative kub and thought likely secondary to chf. id/ transplant following during the admission. past medical history: diabetes type 1, coronary artery disease, status post mi, status post ptca, multiple coronary artery stents, congestive heart failure with an ejection fraction of 50 to 55 percent, cardiomyopathy, hepatitis b virus, hepatitis c virus, hypothyroidism, hypercholesterolemia, benign prostatic hypertrophy, peripheral vascular disease, cerebrovascular accident in with residual left-sided weakness. social history: married, no smoking, no alcohol, no drugs family history: nc physical exam: t: 97.5 hr; 56 rr: 20 bp: 127/58 weight- 146.4-- 143 yesterday 98% on ra i/o:/300 since mn gen: aeo x3 heent: perrla, eomi, +jvd to earlobe, jvp approx 16, no carotid bruits cv: nl s1, s2, rrr, no m/r/g lungs: bibasilar crackles with decreased bs abd: midline wound with wet to dry dressing, +pain to palpation in all quadrants, no rebound, voluntary guarding ext: superficial wound on anterior left foot + dryness and erthema, cannot palpate dp and tp pulses, but warm extremities with <2 seconds cap refill, 1+ edema blt lower extremities pertinent results: 10:45pm urine blood-lg nitrite-neg protein-neg glucose-neg ketone-tr bilirubin-sm urobilngn-neg ph-5.0 leuk-sm 10:45pm urine rbc-* wbc-* bacteria-occ yeast-none epi-<1 09:15pm glucose-178* urea n-45* creat-2.8* sodium-137 potassium-5.0 chloride-102 total co2-22 anion gap-18 09:15pm ck(cpk)-32* 09:15pm ck-mb-notdone ctropnt-0.09* 09:15pm calcium-8.3* phosphate-4.1 magnesium-1.9 09:15pm wbc-4.0 rbc-3.67* hgb-10.4* hct-32.5* mcv-89 mch-28.4 mchc-32.1 rdw-18.6* 09:15pm plt count-204 06:10am urine hours-random 06:10am urine gr hold-hold 06:10am urine color-straw appear-clear sp -1.011 06:10am urine blood-sm nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.5 leuk-sm 06:10am urine rbc-0 wbc-0 bacteria-none yeast-none epi-0 11:25pm glucose-91 urea n-44* creat-2.8* sodium-137 potassium-4.4 chloride-103 total co2-25 anion gap-13 11:25pm alt(sgpt)-16 ast(sgot)-35 ck(cpk)-38 alk phos-598* amylase-24 tot bili-0.6 11:25pm lipase-16 ggt-238* 11:25pm ck-mb-3 ctropnt-0.12* 11:25pm tot prot-5.9* albumin-2.9* globulin-3.0 calcium-8.6 phosphate-3.1 magnesium-1.9 11:25pm tsh-6.3* 11:25pm wbc-4.1 rbc-3.92* hgb-10.8* hct-34.6* mcv-88 mch-27.7 mchc-31.4 rdw-18.7* 11:25pm neuts-66.9 lymphs-18.5 monos-12.0* eos-1.4 basos-1.2 11:25pm hypochrom-2+ anisocyt-2+ poikilocy-1+ microcyt-1+ 11:25pm plt count-210 ekg: sinus brady, lad/ lafb, qtc prolonged at 516 echo: the left atrium is markedly dilated. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. lv systolic function appears mildly to moderately depressed. resting regional wall motion abnormalities include inferior/inferolateral akinesis/hypokinesis. the mitral valve leaflets are structurally normal. there is moderate thickening of the mitral valve chordae. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate tricuspid regurgitation is seen. there is at least moderate pulmonary artery systolic hypertension. there is no pericardial effusion. cardiac cath: - s/p lcx stent in , s/p lcx/om3 stent s/p lcx stent in (left dominant, lmca/lad normal, left circumflex stent patent) urine culture from showed pseudomonas aeroginosa 10-100,000 sensitive to zosyn abd x-ray on - no sbo evidence abd us on - nl transplant kidney, nonspecific findings, elevated resistive indices cxr- r basilar infiltrates, bilteral pleaural effusion r>l brief hospital course: a/p: 55 year old male with extensive pmh of dmi, s/p pancreas and transplant (crt x 2), cad s/p multiple percutaneous interventions, chf, and recent takedown of hartmann's pouch admitted with chf exacerbation and abdominal pain. 1. chf- the patient's increasing dyspnea was felt to be due to a chf exacerbation. the patient was originally to undergo ultrafiltration however a tunneled line could not be placed at the bedside. he was admitted to the ccu for niseritide with modest response and then transferred to the floor on a lasix infusion. his weight did not drop on the lasix drip at which and he was felt to be persistently volume overloaded. the patient subsequently underwent a tunneled line placement in the left ij by ir and was started on ultrafiltration. he underent several sessions of uf while in house with removal of liters with each session. the patient tolerated this procedure well although his creatinine did bump from his basline to approximately 3.0. he will be discharged on lasix 50 mg po bid and will receive 3 sessions of uf per week as an outpatient. in addition, he will remain on his beta blocker and low dose hydralazine was added. 2. abdominal pain- the patient initially had abdmominal pain of unclear etiology. significantly, the patient had abdominal cellulitis last month but the incisional area does not appear infected on exam. no fluid collection in that area was seen on ultrasound. lfts were within normal limits except for an elevated alkaline phosphatase and elevated ggt. the patient's abdominal us was nonrevealing except for mildly elevated flow pressures in the transplanted kidney but these were stable compared to a prior exam. plan films of the abdomen were negative for sbo. we discussed ct of the abdomen with the patient however he was unwilling to drink contrast and this was not pursued. the most probable cause of abdominal pain was felt to be hepatic congestion from fluid overload and mesenteric edema. transplant surgery was consulted and did not find the patient to have any acute surgical issues. the patient also complained of diarrhea. c. diff was negative x 3. a cmv viral load was negative. the patient admitted to eating many sugar free, sorbitol containing hard candies. when these were discontinued, his diarrhea resolved. 3. esrd s/p transplant- the patient's creatinine was at baseline on admission and his transplanted kidney was unchanged on us from previous studies. his creatinine did bump with diuresis and initiation of ultrafiltration; however, this did not represent a significant loss of gfr. he was continued on prednisone and imuran for immunosuppression. a pth was also checked and was elevated. he was started on calcitriol for this. 4. type 1 dm- the patient had elevated blood sugars intermittently though this admission. his lantus was increased to 13 units hs and he was maintained on a riss. he will follow up with his diabetologist as an outpatient. 5. cad- ecg unchanged from baseline and patient denied chest pain. he was ruled out for mi on admission and was continued on his home cad meds including beta blocker and statin. pt reports he is not on asa because he has bled on this in the past. 6. proxysmal atrial fib- pt with good rate conrol. he was continued on his beta blocker and amiodarone. there was some concern for amiodarone toxicity given his unusually high dose and his dose was decreased on . the patient is not on anticoagulation due to bleeding on aspirin and coumadin in the past. 7. htn- the patient's blood pressue was well controlled on beta blocker, nitrates and hyralazine. 8. hypothyroidism- the patient has had severe hypothyroidism in the past with tsh in the 70s-100s. this was felt to be a precipitant to chf exacerbations in the past. his dose of levoxyl was maintained at 150 mcg though the majority of his hospital course. a tsh was checked prior to discharge and was elevated at 14. a free t4 returned normal. endocrine was consulted and recommended increasing his levoxyl to 200 mcg and repeating his thyroid function tests in weeks. 9. uti- the patien had a multidrug resistant pseudomonas uti and was trated with 10 days of piperacillin. a follow up ua/ucx was positive for yeast (>100k colonies). he is being discharged on a 7 day course of fluconazole. 10. gerd- he was treated with a ppi with good effect. 11. fen- the paient was given a low sodium, , diet. he was maintained on a 1.5 liter fluid restriction. he was also informed to avoid all sorbitol containing foods. 12. proph- bowel regimen; ppi; sc heparin. 13. dispo- the patient is being discharged to home with pcp, , and follow up. he will initiate oupatient ultrafiltration 3 days after discharge. medications on admission: 1. prednisone 5 mg daily 2. protonix 40 mg daily 3. bactrim ss 1 tab mon, wed, fri 4. lipitor 10 mg daily 5. amiodarone 400 mg 6. lantus insulin 10 units qhs 7. levothyroxine 100 mcg daily 8. hydralazine 10 mg tid 9. imdur 30 mg daily 10. lasix 80 mg daily 11. toprol xl 25 mg daily 12. imuran 50 mg daily 13. colace 100 mg 14. percocet prn 15. rapimine 1 mg daily 16. flagyl 500 mg tid 17. lactulose prn discharge medications: 1. prednisone 5 mg tablet sig: one (1) tablet po qd (once a day). 2. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 3. trimethoprim-sulfamethoxazole 80-400 mg tablet sig: one (1) tablet po 3x/wk (mwf) (). 4. atorvastatin calcium 10 mg tablet sig: one (1) tablet po hs (at bedtime). 5. amiodarone hcl 200 mg tablet sig: one (1) tablet po qd (once a day). 6. metoprolol succinate 25 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po qd (once a day). 7. isosorbide mononitrate 30 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po qd (once a day). 8. becaplermin 0.01 % gel sig: one (1) appl topical qd (once a day). 9. bacitracin-polymyxin b 500-10,000 unit/g ointment sig: one (1) appl topical q6h (every 6 hours) as needed. 10. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed. disp:*20 tablet(s)* refills:*0* 11. calcitriol 0.25 mcg capsule sig: one (1) capsule po qd (once a day). disp:*30 capsule(s)* refills:*2* 12. insulin glargine 100 unit/ml solution sig: thirteen (13) units subcutaneous at bedtime. 13. regranex 0.01 % gel sig: one (1) application topical once a day. disp:*100 grams* refills:*0* 14. azathioprine 50 mg tablet sig: one (1) tablet po once a day for 6 months. disp:*180 tablet(s)* refills:*0* 15. ambien 5 mg tablet sig: one (1) tablet po at bedtime. disp:*30 tablet(s)* refills:*0* 16. lasix 40 mg tablet sig: 1.5 tablets po twice a day. disp:*90 tablet(s)* refills:*2* 17. hydralazine hcl 10 mg tablet sig: two (2) tablet po q6h (every 6 hours). disp:*240 tablet(s)* refills:*2* 18. levothyroxine sodium 100 mcg tablet sig: two (2) tablet po qd (once a day). disp:*60 tablet(s)* refills:*2* 19. fluconazole 100 mg tablet sig: one (1) tablet po twice a day for 7 days. disp:*14 tablet(s)* refills:*0* 20. insulin regular human subcutaneous 21. insulin regular human 300 unit/3 ml syringe sig: per sliding scale units subcutaneous four times a day: bs < 150 : 0 units bs 151-200: 2 units bs 201-220: 4 units bs 221-260: 6 units bs 261-300: 8 units bs >301: 10 units . discharge disposition: home with service facility: discharge diagnosis: primary diagnosis: chf exacerbation secondary diagnosis: abdominal pain type 1 diabetes mellitus cad s/p mi and multiple ptca. pt ruled out for mi on admission. hypothyroidism pvd cva in bph s/p turp hypercholesterolemia gerd discharge condition: weight decreased. abdominal pain improved. diarrhea resolved. discharge instructions: weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet fluid restriction: 1.5 liters 1. please keep all follow up appointments. --call your nephrologist dr. for an appointment --go to dci dialysis center and mon/wed/fri, call with questions . 2. please take all medications as prescribed. 3. seek medical attention for chest pain, shortness of breath, abdominal pain, nausea, vomiting, or other concerning symptoms. 4. you will need to have your thyroid function tests repeated in weeks. followup instructions: 1. call your nephrologist dr. for an appointment . you should also follow up with dr. within 1 week of discharge. 2. call the dci dialysis center if you have questions about your appointment on 3. call the clinic and schedule an appointment with dr. within 1 month of discharge 4. provider: , m.d. where: center phone: date/time: 9:30 provider: , m.d. where: center phone: date/time: 9:30 5. provider: , md where: lm center phone: date/time: 2:40 procedure: venous catheterization, not elsewhere classified hemodialysis venous catheterization for renal dialysis injection or infusion of nesiritide diagnoses: pneumonia, organism unspecified other primary cardiomyopathies coronary atherosclerosis of native coronary artery esophageal reflux pure hypercholesterolemia urinary tract infection, site not specified congestive heart failure, unspecified chronic hepatitis c without mention of hepatic coma unspecified acquired hypothyroidism candidiasis of other urogenital sites atrial fibrillation other chronic pulmonary heart diseases percutaneous transluminal coronary angioplasty status pulmonary collapse hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease pneumonitis due to inhalation of food or vomitus other late effects of cerebrovascular disease old myocardial infarction atherosclerosis of native arteries of the extremities, unspecified chronic viral hepatitis b without mention of hepatic coma without mention of hepatitis delta combined systolic and diastolic heart failure, unspecified diseases of tricuspid valve complications of transplanted kidney other toe(s) amputation status diverticulosis of colon (without mention of hemorrhage) diabetes with renal manifestations, type i [juvenile type], not stated as uncontrolled complications of transplanted pancreas other musculoskeletal symptoms referable to limbs other finger(s) amputation status pneumococcus infection in conditions classified elsewhere and of unspecified site 

Answer: The patient is high likely exposed to