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: transferred from outside hospital for management of post-obstructive acute renal failure, urosepsis, pancreatitis, and hyperkalemia. major surgical or invasive procedure: right ureteral stent, left ureteral calculus removal. history of present illness: mr. is a 70 year-old white male with an unknown past medical history who was transferred to the emergency room on from an outside hospital for acute renal failure. the patient was reportedly found at home unconscious in bed, obtunded and lying in his own excrement by emt personnel. his brother, , said he had spoken with mr. a few days ago, who complained of not feeling well and of frequent urination. over the next few days, his brother tried to contact him but was unsuccessful. he went to check on mr. at his house and found the door locked with no answer and several days?????? mail on the doorstep, leading him to alert authorities. emt personnel were able to rouse mr. , but he was unable to stand or speak clearly. after being transferred to the outside hospital, the patient was conscious and able to answer questions, but was very difficult to understand. he complained of abdominal pain and inability to urinate despite urge. the patient was found to have a foreskin stricture, which was cut open by urology via a longitudinal incision. a three-way foley catheter was subsequently placed, which initially drained a purulent discharge followed by several hundred milliliters of bloody urine. the patient reportedly never goes to the doctor, is not aware of any medical problems, and takes no medications. he was seen once before at the outside hospital earlier this year. past medical history: alcohol abuse hypertension ?????? patient states that he had high blood pressure 20 years ago, but that it ??????never bothered him??????. social history: mr. is a former construction foreman who retired 15 years ago. he is single, lives alone, and has no children. his only family is a younger brother named . etoh: drinks 10-12+ shots of whiskey with his buddies 2 - 3 times per week. tobacco: smokes cigars, approximately 20 per month. drugs: denies use. family history: mother ?????? died of cancer father ?????? died of mi physical exam: bp: 146/82 hr: 76 and regular rr:16 o2: 98% on ra. temp: 97.1 general: the patient is an older male who appears his stated age and appears to be very sleepy, but arousable. he appears ill and is oriented to person and place, but not time. he states his age as 59. heent: perrla, 2mm. sclerae clear and not injected. no exudates. eom full. visual fields intact. no nystagmus. oropharynx clear -- no exudate, erythema, inflammation. mucous membranes appeared dry. no rhinorrhea or inflammation noted. poor dentition. neck/thyroid: neck supple. no nodules, enlargement, or tenderness noted. no thyromegaly or tenderness noted. lymphatic: no tenderness, swelling, or pain noted in cervical, supraclavicular, and axillary lymph nodes. bilateral inguinal lymphadenopathy. heart: regular rate and rhythm. s1 and s2 normal, with no s3 or s4 noted. no murmurs, rubs, gallops, or clicks noted. jvp was flat. carotids normal, no bruits. lungs: clear to auscultation bilaterally. normal to percussion. no adventitious lung sounds. no cva tenderness. abdominal: abdomen was soft, non-tender, and obese. normal bowel sounds present. liver and spleen not palpable due to habitus. tenderness bilaterally in the suprapubic region. neuro: cn: ii - acuity, fields, see eye exam. iii, iv, vi - eom intact. v - facial sensation intact. vii ?????? symmetrical expression. viii - hearing normal bilaterally. ix, x - uvula midline; gag, phonation normal. - shrug normal. xii - tongue midline. strength: bilateraly sensation: sharp-dull normal. mental status: oriented to person and place, but not time. when asked, he states that he is 59 years old. findings: no asterixis or ataxia noted. extremities: no cyanosis, clubbing, or edema. gu: bilateral inguinal lymphadenopathy. testicles tender. incision on foreskin appears to be healing well. pertinent results: 12:35am eos ct-110 12:35am wbc-20.7* rbc-4.99 hgb-16.0 hct-44.3 mcv-89 mch-32.2* mchc-36.2* rdw-13.6 12:35am hypochrom-normal anisocyt-1+ poikilocy-1+ macrocyt-normal microcyt-normal polychrom-normal spherocyt-1+ ovalocyt-1+ 12:35am neuts-90.3* bands-0 lymphs-4.4* monos-4.9 eos-0.1 basos-0.2 12:35am asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 12:35am glucose-128* urea n-274* creat-11.5* sodium-140 potassium-7.4* chloride-104 total co2-6* anion gap-37* 12:35am calcium-8.4 phosphate-13.7* magnesium-3.6* 12:35am osmolal-408* 12:35am lipase-183* 12:35am ck-mb-5 12:49am urine rbc->50 wbc->50 bacteria-occ yeast-none epi-0-2 12:49am urine blood-lg nitrite-neg protein-tr glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-mod 12:49am urine color-straw appear-hazy sp -1.007 12:49am urine bnzodzpn-neg barbitrt-neg opiates-pos cocaine-neg amphetmn-neg mthdone-neg 04:30pm blood wbc-10.7# rbc-3.24* hgb-10.0* hct-28.8* mcv-89 mch-30.8 mchc-34.7 rdw-13.4 plt ct-177 04:30pm blood plt ct-177 04:30pm blood glucose-130* urean-35* creat-2.2* na-139 k-4.5 cl-106 hco3-24 angap-14 04:30pm blood calcium-7.7* phos-2.2* mg-1.3* iron-pnd 12:35am blood alt-15 ast-12 ck(cpk)-120 alkphos-105 amylase-126* 09:35am blood amylase-100 01:05am blood psa-51.3* 07:31am blood freeca-1.00* renal ultrasound: the right kidney measures 10.5 cm. the left kidney measures 10.2 cm. there is no hydronephrosis. the kidneys demonstrate normal echogenicity. there is a 6 mm stone in the mid pole of the right kidney and a 5 mm stone in the upper pole of the left kidney. a foley is present within the bladder. impression: 1. no hydronephrosis. 2. stones of the upper pole of the left kidney and mid pole of the right kidney. pelvic ct: impression: 1. thickened bladder wall reflecting chronic bladder outflow obstruction that is likely due to an enlarged prostate gland. left uvj stones ranging in size up to 6 mm. the exact position of 1.1 cm stone in the region of the right uvj is difficult to determine given the bladder wall thickening. there is also mild dilatation of the proximal ureters bilaterally. 2. unremarkable appearance of the pancreas on the study limited by lack of iv contrast. no retroperitoneal mass is identified scrotal ultrasound: impression: no evidence of epididymitis, orchitis or torsion. brief hospital course: 1. post-obstructive acute renal failure ?????? the patient was transferred to the from an outside hospital for management of acute renal failure. the patient was found to be in acute renal failure with an a bun of 274 and a creatinine of 11.5. with the obstruction having been removed by clipping the foreskin and placing a foley catheter into the bladder, the patient was again able to drain urine. the renal team decided against hemodialysis to lower his bun in fear of cerebral edema caused by rapid removal of the bun osmole. instead, they decided to replete the patient with constant d5 ?????? normal saline and allow the patient??????s kidneys to regain function on their own. as time passed, the patient??????s bun and creatinine dropped steadily each day toward a normal baseline level. due to the dilutional effect of the hypotonic iv solution, several electrolytes, such as phosphorous, magnesium, potassium, and calcium had to be repleted. however, as the patient??????s kidney function returned to baseline and the hypo-osmotic solution removed, the electrolyte levels returned toward normal. 2. bilateral ureter obstructions ?????? after performing a pelvic ultrasound, the patient was found to have bilateral calculi at both ureterovesicular junctions. the left calculus measured 6mm and the right calculus measured 11mm. urology, who had already been consulted, decided to operate to remove the calculi and to place stents in both ureters in order to ensure they remained patent. this was performed on . however, due to the severe tortuosity of the left ureter, the calculus was removed but the stent could not be placed. the right ureter was stented but the calculus was not removed. bilateral retrograde pyelograms were performed. bilateral renal pelvis urinary cultures were taken. 3. prostate hypertrophy ?????? both the pelvic ultrasound and the surgery confirmed that the patient??????s prostate was enlarged and heavily vascular. the size was estimated at approximately 100grams. the psa was measured and found to be 51.3. a prostate biopsy was not obtained during the surgery but will be necessary in order to rule out malignancy. given the size, the urology team feels it is unlikely a turp procedure can be performed. the patient was advised to follow-up with the urology on an outpatient basis for management and evaluation of his prostatic hypertrophy. and elevated psa levels. the patient was begun on proscar (finasteride) in the meanwhile in hopes of medically reducing the size of the prostate. 4. mental status ?????? upon presentation the patient presented an altered mental status. however, as time progressed and he regained bilateral kidney function, the patient??????s mental status returned to , eventually returning to baseline functionality. 5. alcoholism ?????? the patient??????s brother initially reported a past history of alcohol abuse. although the patient did not exhibit any signs of withdrawal, he admitted to drinking 2 to 3 times per week with 8-12 shots per session. social work and were consulted to help the patient manage his alcohol abuse. 6. hyperglycemia ?????? the patient??????s blood glucose was noted to be elevated during the course of his hospitalization. however, because he was given d5 saline, an accurate representation of the patient??????s glycemic state could not be obtained. the patient is advised to follow-up with his primary care physician to obtain fasting glucose test and an oral glucose challenge test to determine if he suffers from non-insulin dependent diabetes mellitus. 7. anemia ?????? the patient??????s hematocrit was observed to drop throughout the course of his admission from a peak of 44.3 to a current nadir of 27.0. this is believed to be a dilutional effect from constant administration of hypotonic d5 ?????? normal saline, but the possibility of liver dysfunction or other causes cannot be ruled out. the patient??????s blood levels of b12, folate, iron, ferretin, transferretin, and tibc were measured to help determine the cause and are currently pending. the patient will be informed of the results once available. the patient is strongly advised to follow-up with his primary care physician to further elucidate the cause of his anemia as well as to manage his multiple other medical issues. medications on admission: acetaminophen 325-650 mg po q4-6h:prn aluminum-magnesium hydrox.-simethicone 15-30 ml po qid:prn bacitracin ointment 1 appl tp qid bisacodyl 10 mg po/pr qd:prn docusate sodium 100 mg po bid:prn finasteride 5 mg po qd folic acid 1 mg po qd insulin sc levofloxacin 250 mg po q24h lidocaine jelly 2% (urojet) 1 appl tp prn neutra-phos 1 pkt po tid senna 1 tab po bid:prn simethicone 40-80 mg po qid:prn thiamine hcl 100 mg po qd trazodone hcl 25 mg po hs:prn discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 2. folic acid 1 mg tablet sig: one (1) tablet po qd (once a day). 3. thiamine hcl 100 mg tablet sig: one (1) tablet po qd (once a day). 4. bacitracin zinc 500 unit/g ointment sig: one (1) appl topical qid (4 times a day). 5. lidocaine hcl 2 % gel sig: one (1) appl mucous membrane prn (as needed). 6. finasteride 5 mg tablet sig: one (1) tablet po qd (once a day). 7. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po qd (once a day) as needed. 8. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed. 9. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 10. aluminum-magnesium hydroxide 225-200 mg/5 ml suspension sig: 15-30 mls po qid (4 times a day) as needed. 11. simethicone 80 mg tablet, chewable sig: 0.5-1 tablet, chewable po qid (4 times a day) as needed. 12. trazodone hcl 50 mg tablet sig: 0.5 tablet po hs (at bedtime) as needed. discharge disposition: extended care facility: highlands - discharge diagnosis: post-obstructive uropathy. bilateral ureteral calculi. s/p r ureter stent, l ureteral calculus removal. discharge condition: stable to go to rehab facility. at baseline mental status, urinating freely, acute renal failure resolving. discharge instructions: please take all medications regularly as prescribed. leave your foley catheter in place until your doctor removes it for you. present to the ed for evaluation if you have confusion, sever abd pain, difficulty urinating, fever, or other concerning symptoms. followup instructions: please follow-up with urologist in 1 week. follow-up with primary care physician (, or a local physician of your choice) in 2 weeks. procedure: venous catheterization, not elsewhere classified ureteral catheterization retrograde pyelogram transurethral removal of obstruction from ureter and renal pelvis diagnoses: hyperpotassemia acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified alcohol abuse, unspecified calculus of ureter other abnormal glucose other specified retention of urine hyperplasia of prostate, unspecified, with urinary obstruction and other lower urinary symptoms (luts) 

Answer: The patient is high likely exposed to