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: history of present illness: the patient is a 55-year-old male status post living-unrelated kidney transplant for end-stage renal disease secondary to type 1 diabetes. he had a baseline creatinine of 1.5. he experienced increase in creatinine in . needle biopsy positive for acr with foci of mild endotheliitis. he was treated with okt3. creatinine decreased to 1.1. he was placed on prograf and rapamune without steroids. on , he called to report mouth sores. rapamune dose was lowered to 1 mg for a level of 9.3. his mouth sores improved. last creatinine and bun on were 1.4/29. stress test performed for complaints of fatigue and chest pain. fair functional exercise capacity. borderline ischemic ekg. bp responds to exercise. stress echo - no 2-d echocardiogenic evidence of ischemia. ejection fraction greater than 55%. the patient has been doing very well, and no chest pain, not actively taking blood pressure medications. no lower extremity edema. no abdominal pain, no fevers, no chills, no nausea, vomiting, no change in urine or bowel movements, eating well without problems. past medical history: end-stage renal disease secondary to type 1 diabetes, living-unrelated kidney transplant , acr treated with okt3 x5 days, history of anemia, history of syncope, history of asthma, celiac sprue, tia in , history of hypotension, history of atrial fibrillation, h. pylori, history of psoriasis, history of osteoarthritis, cardiac catheterization, history of murmur. allergies: captopril and iron. meds on admission: 1. aspirin 325 mg once daily. 2. lantus 12 units once daily. 3. sertraline 100 mg once daily. 4. bactrim ss 1 once daily. 5. asacol 500 mg once daily. 6. alendronate 30 mg q week. 7. plavix 75 once daily. 8. humalog ss. 9. prograf 1.5 b.i.d. 10. rapamune 1 mg once daily. past surgical history: left av wrist fistula , status post cardiac catheterization with right coronary stent , left cataract removed from eye , right cataract removed , living-unrelated kidney transplant, status post t and a, status post deviated septum surgery, status post cholecystectomy, status post bladder tumor excision. social history: married with 1 child, electrical engineer. no alcohol. no tobacco. family history: noncontributory. physical exam: patient, awake, alert, sitting up in bed in no acute distress. temperature 98.8, heart rate 79, bp 140/68, respirations 20 on 98% room air, weight 61.36 kg. heent: atraumatic, normocephalic. eyes: pupils equal, round, react to light. eoms are full. mouth: tongue midline, no exudates. neck: supple, no palpable nodes, no thyromegaly, no carotid bruits bilaterally. full range of motion. lungs: clear to a and p bilaterally. cv: regular rate and rhythm, a systolic ejection murmur of ii/vi. abdomen: positive bowel sounds, well-healed left lower quadrant incision, soft, nontender, no organomegaly. extremities: no c/c/e, +1 pulses at and dp, +2 groin pulses bilaterally. neurologic: cranial nerves ii through xii intact. motor bilaterally. labs on admission: 3.7, hematocrit 33.3, platelets 236, pt 13.3, inr 1.2, ptt 32.4, ast 39, alt 52, alkaline phosphatase 214, amylase 103, total bilirubin 0.4. ekg shows normal sinus rhythm, no st changes. chest x-ray compared to continued to be clear, no acute pulmonary process. hospital course: on , the patient was waiting for the donor, but the donor's organ was not acceptable for this patient. the patient was discharged on . the patient did return on for potential transplant. compared to , there was no change in his physical exam, no fevers, no chills, no abdominal pain, no swelling to lower extremities, no cough, no chest pain. the patient went to surgery on for pancreas transplant, y-graft to left lower quadrant, and bowel anastomosis performed by dr. and . there were no complications. the patient was stable and went to recovery room. please see detailed documentation of the operative note in the computer. the patient went to the regular floor postoperatively. the patient was placed on thymo, mmf and fk. was consulted on for blood sugar control and had continued to follow him while he was a patient in the hospital. the patient continued on fk, atg, mmf, simulect. blood sugars have decreased significantly. the patient had an ng tube placed. the patient was n.p.o., taking meds p.o., and clamping ng tube. the patient had a jp drain in place which was draining sanguineous fluids. labs have been stable. the patient was placed on a pca postoperatively for pain control. foley was removed on . on , the patient had an acute hematocrit drop. on , hematocrit was 31 and this slowly decreased to 29, to 28, to 26 that day. so, it was decided to get a ct abdomen with iv contrast, as well as a ct pelvis. the findings demonstrated that there was nothing to explain the significant hematocrit drop. postoperative changes around the new pancreas and bowel anastomosis. findings were discussed with dr. . the patient continued to do well with this blood sugars. pca was discontinued. postoperatively, the patient had atelectasis bilaterally, but no signs of acute infiltrate from a chest x-ray that was done on . the patient's hematocrit continued to drop requiring packed red blood cell transfusions and ffp for an inr of 4.9 on . the patient continued to have jp intact, but has had bloody output from drain. pt and ot were consulted. he continued to be afebrile. vital signs stable. on , the patient was brought to the or for abdominal washout with removal of pancreatic hematoma. the old incision was opened, and a significant amount of old blood and hematoma were present. please see or note for detailed information about the procedure that was done on . on , labs were the following: wbc 13.8, hematocrit 32.3, platelets 353, pt 13.8, ptt 33.8, inr 1.3. the patient continued to be on tacrolimus and rapamycin during this hospitalization. on , the patient had a ct abdomen status post washout and complained of abdominal pain, diarrhea and elevated white blood cell count. ct abdomen and pelvis demonstrated no evidence of small bowel obstruction, or drainable fluid collection abdomen; interval slight increase in amount of free fluid in the abdomen and pleural effusions after abdominal irrigation. the patient had 2 jp drains, as well as 2 jp drains after the washout surgery. the patient continued to need intermittent transfusions for a low hematocrit. the patient was restarted on aspirin and plavix. the patient continued to see physical therapy and occupational therapy. on , the patient had picc line placement for parenteral nutrition. on , the patient had a lower extremity ultrasound, for right lower extremity edema, demonstrating no evidence of deep venous thrombosis. throughout his hospitalization, the patient has been making good urine output. the patient had a low-grade temperature on with diarrhea and was cultured for that temperature. a swab culture that was finalized demonstrated that there was staph coag-negative. all of his multiple stool cultures have been sent-off which have been unremarkable, no growth, no fungus, no microbacteria. on , the patient had a dobbhoff tube placed under fluoroscopy. tpn was switched to tube feeds, and the reason behind that was that the diarrhea may be due to the actual tpn. on around 5 o'clock in the evening, the patient had dyspnea without any reason. an abg was obtained demonstrating a ph 7.42, po2 82, pco2 33, bicarbonate 22. the patient was transferred to sicu just for close monitoring. ct obtained. cta was obtained to rule out pe. ct chest with cta was performed, demonstrating bibasilar atelectasis, or consolidations with effusions. no evidence of a pulmonary embolism. the renal team continued to see patient, while patient was hospitalized, making excellent recommendations. on , the patient was transferred from the icu to the regular floor since he was stable. the patient had repeat gases on , and his ph was 7.44, po2 190, co2 30, bicarbonate 21. he did have cardiac enzymes obtained which were all unremarkable, and so the patient was transferred to far-10, very somnolent, very low-energy. psychiatry came to see patient and felt that he should continue on his antidepressant medication, which was zoloft at the present dose, and had recommended giving him a trial of ritalin, which they recommended starting at 5 mg in the morning. they felt that while he is at rehab, he should be followed by psychiatrist there. the patient continues to do well, although very somnolent, but awake and ambulating with physical and occupational therapy. he has been afebrile. vital signs stable. his labs have been stable too. he continues on tube feeds, and he is on rapamycin and tacrolimus for immune suppression medications. he has no swelling. no lower extremity edema. his wounds continues to be clean, dry and intact. he has good bowel sounds. he has mild atelectasis at both bases. so, the patient is going to go to rehab, continue on antibiotics for 2 weeks, and continue fluconazole for 2 weeks. discharge medications: 1. tylenol 650 q. h p.r.n. 2. albuterol nebs q. h. p.r.n. 3. anzemet 12.5 iv q 8 h. p.r.n. 4. fludrocortisone acetate 0.1 b.i.d. 5. heparin 5,000 units subcutaneous t.i.d. 6. insulin sliding scale. 7. loperamide hcl 2 mg b.i.d. 8. lopressor 25 b.i.d. 9. flagyl 500 mg t.i.d. 10. miconazole powder 2% 1 application tp t.i.d. 11. nystatin oral suspension 5 ml p.o. q.i.d. 12. percocet p.o. q. h. p.r.n. 13. protonix 40 q. 12. 14. zosyn 4.5 iv q. 8 for 2 weeks. it will be discontinued on . 15. zoloft 150 mg p.o. once daily. 16. sirolimus 1 mg once daily. 17. bactrim ss 1 tab once daily. 18. tacrolimus possibly will leave on 2 mg b.i.d. 19. valganciclovir hcl 450 once daily. 20. ritalin 5 mg q a.m. follow up: the patient is going to be following up with dr. on at 9:10 a.m. at the bldg., transplant office, on the 7th fl., telephone# (, and also mr. is going to follow-up with dr. on at 9:10 a.m. she is also in the bldg, transplant office, on the 7th fl., telephone# (, and also patient is going to follow-up with dr. on at 11:40 a.m. in bldg, 7th fl. the patient should follow-up with psychiatrist while patient is at rehab. the patient or staff at the rehab facility should call transplant surgery immediately if there are any fevers, chills, nausea, vomiting, inability to take medications, decreased urine output, increased glucose, redness, bleeding from incision, or any questions. he should have labs q. monday and thursday for cbc, chem-7, calcium, phosphorus, ast, total bilirubin, lipase, amylase, urinalysis, and a prograf, and a rapamycin level. results should be faxed to transplant office, (. no driving while taking medications. take showers, but no heavy lifting. for the past 7 days, the patient's tacrolimus level has been ranging from 9 to 19. the last one was on which was 19. rapamycin levels: the last one was on , and it was 4.5. they have been ranging from 5 to 8. the patient is currently on rapamycin 1 mg once daily. so, levels are pending for today, and the discharge medications may change according to the levels. final diagnoses: 1. type 1 insulin dependent diabetes mellitus. 2. status post pancreas transplant . 3. second surgery was washout of the abdomen on . , procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances enteral infusion of concentrated nutritional substances insertion of other (naso-)gastric tube reopening of recent laparotomy site transfusion of packed cells transfusion of other serum pancreatic transplant, not otherwise specified peritoneal lavage other operations on lacrimal gland transplant from cadaver diagnoses: nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere coronary atherosclerosis of native coronary artery unspecified essential hypertension acute posthemorrhagic anemia hematoma complicating a procedure asthma, unspecified type, unspecified polyneuropathy in diabetes depressive disorder, not elsewhere classified percutaneous transluminal coronary angioplasty status hypopotassemia pulmonary collapse personal history of other diseases of circulatory system osteoarthrosis, unspecified whether generalized or localized, site unspecified paralytic ileus celiac disease diarrhea other psoriasis diabetes with renal manifestations, type i [juvenile type], not stated as uncontrolled diabetes with neurological manifestations, type i [juvenile type], not stated as uncontrolled kidney replaced by transplant 

Answer: The patient is high likely exposed to