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: severe nausea and vomiting. major surgical or invasive procedure: induction of hemodialysis plasmapheresis kidney transplant small bowel obstruction, ex lap with loa history of present illness: a 65 year-old woman with history of end-stage renal disease scheduled for lrrt presenting with uremic symptoms. she was admitted for induction of hemodialysis to prevent dialysis disequilibrium after receiving her transplant. . in the ed, her vital signs were 98.3, 118/62, 90, 13, and 98% ra. she received zofran 4 mg iv x1 and was sent directly to dialysis before arrival to the floor. at dialysis she had 0.5 kg removed via a right tunnelled line that had been placed one week ago for plasmapheresis (she underwent plasmaphereis to remove antibodies against daughter's antigens-- daughter will provide the donor kidney). upon arrival to the floor from hd, she feels much better. she denies nausea or vomiting, and is looking forward to eating dinner. she denies chest pain, shortness of breath, or lightheadedness. ros is positive for vertigo, worse with sitting and standing, that she says has been ongoing for three months. she says she was seen by ent yesterday for evaluation of the vertigo and was prescribed acyclovir for ?zoster infection, which she has not yet started. however, it appears the vertigo developed several weeks before she started immunosuppressants (which she started one week ago). she denies facial rash or burning. ros otherwise unremarkable. past medical history: - end-stage renal disease, likely due to lithium toxicity - questionable history of temporal arteritis versus polymyalgia rheumatica on prednisone - severe bipolar disorder, controlled with lamictal and celexa - hyperparathyroidism with hypercalcemia related to lithium - vertigo, on meclizine - gastroesophageal reflux disease - cholecystectomy in - right knee replacement in - left benign breast tumor resection 20 years ago - status post appendectomy - history of difficult intubation - living related renal transplant - ex lap, loa for sbo social history: she used to work as secretary at the company, and is retired since . she lives with her son and she has four children. the patient denies any history of tobacco smoking, alcohol abuse, or drug use. family history: her grandfather and one of her uncles suffered from bright disease. her mother's sister died of breast cancer. her uncle had a history of melanoma, which was metastatic. her father died at age of 84 from congestive heart failure. her mother died from a severe stroke. physical exam: on admission: vitals: 98.9, 144/78, 83, 18, 100% ra general: a middle-aged woman in no apparent distress, with appropriate affect, calm and cooperative heent: eomi, perrla, cnii-xii grossly intact neck: supple, no lad heart: rrr, normal s1/s2 lungs: cta bilaterally, no crackles at bases abdomen: overweight, non-tender, normal bowel sounds legs: no pitting edema; 2+ dp pulses skin: no rashes neuro: aaox3, moving all extremities pertinent results: 06:00am blood wbc-8.9 rbc-3.47* hgb-10.4* hct-30.1* mcv-87 mch-30.1 mchc-34.7 rdw-18.5* plt ct-546* 06:33am blood pt-12.8 ptt-23.9 inr(pt)-1.1 06:00am blood glucose-73 urean-25* creat-0.7 na-136 k-4.9 cl-104 hco3-23 angap-14 05:27am blood alt-64* ast-38 alkphos-162* totbili-0.4 06:44am blood calcium-9.9 phos-2.4* mg-1.6 05:30am blood tacrofk-6.9 06:44am blood tacrofk-6.7 06:00am blood tacrofk-6.4 brief hospital course: a 65 year-old woman with history of esrd scheduled for lrrt presenting with nausea and vomiting and emergent induction of hemodialysis. she underwent hd without complication and plasmapheresis to prevent transplant rejection. she received rituximab. her transplant was postponed to 4/9/9 because it seemed that she still had positive antibodies against her daughters kidney, this however, turned out to be not significant. she was continued on her immunosuppressant regimen (cellcept/tacrolimus. she had an episode of fevers/chills and was temporarily on vanc/zosyn, however, the sxs resumed and her cultures remained negative. on she underwent living related renal transplant from her daughter. it was noted that she had a very thin posterior fascia and peritoneum. therefore, the kidney was ultimately intraperitoneal in the retroperitoneal space. the iliac vessels were soft without significant plaque. the donor kidney had a single renal artery with an early bifurcation and a single renal vein and a single ureter. the kidney pinked up and produced urine. please refer to operative note. postop, she was sent to the sicu due to volume overload and respiratory difficulty. respiratory function improved. urine output was excellent. she received plasmapheresis postop transplant for hla desensitization related to transplant for 3 more treatments postop for a total of none treatments. a total of 3 doses of atg were given postop op. solumedrol was tapered. prograf was titrated to trough levels. cellcept continued at 1 gram . creatinine dropped to 0.6. luminex was sent on . urine output average 1.5 liters per day. bp was elevated to 180's/120s. lopressor was uptitrated and norvasc was started. bp improved. diet was advanced and tolerated. pt worked with her and recommended a walker. on postop day 4, she developed ecchymosis around incision with extension to right hip and lower abdomen. she also started to drain sero-sanguinous fluid from her incision. on , she fell in the bathroom after standing up from the toilet striking her nose against the wall. she denied passing out. she was alert and oriented. a stat head ct was done showing no acute intracranial process. a sinus//max ct showed questionable nondisplaced fracture of the nasal bone. she developed bruising over her nose with mild-mod swelling. a developed a frontal headache that was treated with tylenol and iv pain medication. she developed dizziness prompting a neurology consult on . it was felt that this was not a vestibular process, but rather findings were suggestive of cervical spondylosis with myelopathy with dorsal column involvement, with impaired functional position sensation given history of reduced range of motion of the neck, upper motor neuron weakness at the deltoids, triceps, and iliopsoas, reduced vibratory sensation, and brisk reflexes throughout. recommendations were for the her to wear a soft cervical collar at all times for two weeks (if tolerated), then at least at nightwhile sleeping thereafter. around postop day 6, her abdomen appeared distended and she complained of nausea. the incision started to oozed at the inferior edge. this was opened at the inferior edge. she continued to have diffuse bruising aroun the rlq. she developed nausea with vomiting that appeared bilious. lfts increased (alt 144, ast 148, alk phos 296, t.bili 6.8). lfts were monitored daily with continued rise. hepatitis screening was done. this was negative for hav, hbsag, hcv. hemolysis workup was negative. liver duplex was done twice noting a small amount of perihepatic fluid, no intra or extra-hepatic bile duct dilatation. ggt was elevated suggestive of liver/biliary source of increased alk phos that rose to 500 with t.bili of 4.9. a kub was done showing distended loops of small bowel. an ng tube was place. abd ct ()revealed distended small bowel with decompressed distal small bowel and relatively decompressed colon consistent with small bowel obstruction. there was a transition point in rlq. there was no evidence of perforation. normal liver without biliary abnormalities. small amount of perihepatic ascites. she was kept npo. lfts fluctuated daily. she received iv hydration. she started to have flatus and bowel movements. bowel movements increased in frequency. on , the ng tube was removed. kub revealed persistenly dilated loops of small bowel and air fluid levels. kubs continued to show distended loops with air fluid levels despite bms. nausea/vomiting and diarrhea continued. the ng was replaced. lfts improved. on , she was taken to the or by dr. for exploratory laparotomy and lysis of adhesions. postop diagnosis was small bowel obstruction. a wound vac was applied to the lower portion of the incision that was opened. despite the vac, the wound continued to drain serous fluid. the wound vac was discontinued and a gauze dressing was applied. drainage stopped and a topical dry gauze dressing was applied as the wound healed. she remained npo with an ng tube in place. given prolonged npo status, tpn was started. she developed watery diarrhea. stool cultures were negative. a cmv viral load was negative. cellept decreased to 500mg 3x/day. imodium was started. diarrhea resolved. ng was removed and diet slowly advanced and tolerated. tpn was discontinued. ensure supplements were tolerated tid. imodium was discontinued. on , hematocrit was 22.6. she was given 2 units of prbc with a hct increase to 28. she stabilized at 30. pt recommended rehab was recommended. she was screened and accepted at ne . prograf was increased to 6mg on for a trough level of 6.4. goal trough prograf level is 10. she was left on prednisone 20mg qd due to high sensitivity to her donor. she will require labs on for chem 7 and a trough prograf with results called to . labs should then be done every monday and thursday. medications on admission: lanthanum 1000 mg po tid w/meals lamotrigine 250 mg po daily calcitriol 0.25 mcg alternating with 0.5 mcg po every other day meclizine 25 mg po bid mycophenolate mofetil 500 mg po bid citalopram hydrobromide 40 mg po daily omeprazole 20 mg po bid colestid 1 gram oral daily prednisone 5 mg po daily ferrous sulfate 325 mg po daily tacrolimus 2 mg po q12h sodium bicarbonate 1 teaspoon po bid discharge medications: 1. lamotrigine 100 mg tablet sig: 2.5 tablets po daily (daily). 2. citalopram 20 mg tablet sig: two (2) tablet po daily (daily). 3. trimethoprim-sulfamethoxazole 80-400 mg tablet sig: one (1) tablet po daily (daily). 4. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day). 5. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). 6. mycophenolate mofetil 500 mg tablet sig: one (1) tablet po tid (3 times a day). 7. valganciclovir 450 mg tablet sig: two (2) tablet po daily (daily). 8. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q4h (every 4 hours) as needed. 9. ipratropium bromide 0.02 % solution sig: one (1) neb neb inhalation q6h (every 6 hours) as needed for sob/cough. 10. prednisone 20 mg tablet sig: one (1) tablet po daily (daily). 11. insulin regular human 100 unit/ml solution sig: follow sliding scale injection four times a day. 12. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 13. hydromorphone 2 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. 14. tacrolimus 5 mg capsule sig: one (1) capsule po q12h (every 12 hours). 15. tacrolimus 1 mg capsule sig: one (1) capsule po twice a day. 16. outpatient lab work stat labs for chem 7 and trough prograf level am call results to discharge disposition: extended care facility: - discharge diagnosis: end-stage kidney disease secondary to lithium toxicity smal bowel obstruction diarrhea incision cellulitis fall . secondary diagnoses temporal arteritis versus polymyalgia rheumatica on prednisone severe bipolar disorder, controlled with lamictal and celexa vertigo gastroesophageal reflux disease discharge condition: stable discharge instructions: please call the transplant office if you experience fever, chills, nausea, vomiting, abdominal pain/distension, worsening diarrhea or decreased urine output labs every monday and thursday no heavy lifting followup instructions: provider: , transplant social work date/time: 10:30 provider: , md phone: date/time: 9:00 provider: , md phone: date/time: 10:00 provider: , . call to schedule appointment provider: , . call to schedule appointment provider: , . call to schedule appointment procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances hemodialysis venous catheterization for renal dialysis other lysis of peritoneal adhesions other kidney transplantation therapeutic plasmapheresis transfusion of packed cells transfusion of other serum injection or infusion of immunoglobulin transfusion of other substance transplant from live related donor diagnoses: other iatrogenic hypotension anemia in chronic kidney disease end stage renal disease polymyalgia rheumatica esophageal reflux other postoperative infection cellulitis and abscess of trunk unspecified essential hypertension other specified intestinal obstruction other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use diarrhea headache surgical operation with transplant of whole organ causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation bipolar disorder, unspecified closed fracture of nasal bones laparoscopic surgical procedure converted to open procedure cervical spondylosis with myelopathy giant cell arteritis other hyperparathyroidism other transfusion reaction fall resulting in striking against other object 

Answer: The patient is high likely exposed to