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: unresponsive. major surgical or invasive procedure: none. history of present illness: 43 year-old male with diabetes mellitus type i complicated by nephropathy s/p renal transplant (), hypertension, hypertensive cardiomyopathy, and dyslipidemia admitted after being found unresponsive. patient reports felling well recently and this morning. presented to work, and was noted to be confused; coworkers found him unresponsive and called ems. at the scene, blood glucose 51. . patient with long-standing diabetes mellitus type i. he uses an insulin pump. insulin pump is managed by himself. he reports blood glucose typically runs 80-140, and rarely down to low 20s or 30s. he is symptomatic during these episodes (cannot describe particular symptoms), and symptoms resolve with po intake. he recalls one instance when ems was called for similar incident; he received dextrose infusion and did not go to the emergency department. . of note, trasplant from living donor complicated by post-transplant lymphoproliferative disease and antibody-mediated rejection. eventually with graft failure, and was placed on hemodialysis. he was converted to peritoneal dialysis approximately 3-4 weeks ago. recently with difficulty with getting fluid off and worsening lower extremity edema. to help with diuresis, dextrose in pd increased to 4.25% from 1.5-2.5%. . in the ed, 63, 121/50, 12, 99% ra. initially unresponsive. fsbg 30. received 1 amp d50 with response within 1 minute; temporarily awake, alert. blood glucose rose to 130, then trickled back down to 60 with associated fatigue received additional 1 amp d50 with response, and currently on d5 continuous infusion. still fatigued. able to eat a . laboratory data remarkable for creatinine 13.5, blood glucose 118, anion gap 18. serum tox negative. ldh 268, lfts unremarkable. mild anemia, cbc otherwise within normal limits. ct head without contrast negative. cxr 2v with bilateral atelectasis. on tranfer to the icu, 94.9, 72, 139/85, 10, 96%ra. blood glucose 200. . on arrival to the icu, patient reports feeling well. reports 15-pound weight gain and lower extremity swelling since starting pd. also reports considerable fatigue since starting starting pd due to being up at night to operate machinery. he denies fever, chills, headache, visual changes. he has a nonproductive cough. denies chest pain, shortness of , palpitations, abdominal pain, nausea/vomiting, diarrhea, constipation, myalgias, arthralgias. he is anuric. past medical history: 1. diabetes metllitus type 1 c/b esrd, retinopathy 2. end-stage renal disease on hd s/p failed lrrt , undergoing repeat evaluation 3. post-transplant lymphproliferative disorder 4. hypertension 5. hypercholesterolemia 6. chronic diastolic heart failure - history of depressed ef, stress mibi shows moderate left ventricular enlargement, calculated lvef 56% social history: lives in with family. works in mantainence, locksmith. used to work in engineering. no smoking, no alcohol, no ivdu family history: no history of hypertension, coronary artery disease, or renal disease. physical exam: 16, 78, 97% ra, 157/94, general: comfortable heent: sclera anicteric, dry mucous membranes, oropharynx clear neck: supple, jvp not elevated, symmetric anterior cervical chain lymphadenopathy lungs: right basilar crackles; otherwise clear to auscultation bilaterally cv: regular rate and rhythm, normal s1 + s2, early systolic murmurs best heard at rusb abdomen: pd catheter in placed, dressed; hypoactive bowel sounds; soft, non-tender, non-distended gu: no foley ext: warm, well perfused; 2+ pulses; 1+ lower extremity edema to knees bilaterally pertinent results: 09:20am blood wbc-5.0 rbc-4.33* hgb-12.2* hct-37.8* mcv-87 mch-28.2 mchc-32.2 rdw-14.6 plt ct-339 09:20am blood neuts-81.2* lymphs-8.1* monos-4.8 eos-5.0* baso-0.9 09:20am blood glucose-118* urean-71* creat-13.5* na-142 k-4.8 cl-98 hco3-26 angap-23* 04:36pm blood ck(cpk)-332* 09:20am blood alt-16 ast-14 ld(ldh)-268* ck(cpk)-328* alkphos-75 totbili-0.1 09:20am blood ck-mb-8 ctropnt-0.06* 04:36pm blood ck-mb-10 mb indx-3.0 ctropnt-0.05* 09:20am blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 09:20am blood albumin-3.8 brief hospital course: 43m with dmi c/b nephropathy s/p failed renal transplant, hypertension, hypertensive cardiomyopathy, and dyslipidemia admitted to the micu after being found unresponsive. now awake and alert. . #. hypoglycemia: differential diagnosis includes increased insulin sensitivity secondary to pd, pump malfunction, decreased po intake, infection. he does not take oral hypoglycemics (type i). patient reports feeling well lately, does not report infectious symptoms. case was discussed with who recommended patient continue with pump as he normally does and will evaluate in morning. the plan was to continue q2h fsgs, complete an infectious workup and cycle cardiac biomarkers (which were 0.6 then 0.5 in the setting of a cr of 13.5). the patient however expressed a desire to leave against medical advice. he acknowledged the risk of a recurrent episode of hypoglycemia overnight, with risks including death, and he demonstrated his own competence in managing his diabetes. he was felt to be competent to make his own medical decisions and was allowed to sign out ama. #. altered mental status: associated with hypogylcemia/hypothermia. differential diagnosis includes hypoglycemia, intoxication, infection, uremia. likely secondary to hypoglycemia given rapid response with dextrose infusion. no evidence of substance abuse on serum tox screen; unable to send urine secondary to anuric. currently aox3, conversant, and at baseline. - infectious/hypoglycemia workup, as above - dialysis, as below . #. esrd: - pd per renal - continue cincacalet - discuss potential for increased insulin sensitivity on pd with - continue prednisone for prior failed renal transplant . #. diabetes mellitus, type i: - will add on a1c - q2 hour blood glucose checks, will space out if stable - insulin dosing per patient/insulin pump - recs - holding gabapentin renal failure - will discuss with renal if safe to use . #. anion gap: at baseline. suspect secondary to uremia. . #. ldh elevation: normal bilirubin. known to have metabolic bone disease. - continue cinacalcet, as above #. hypertension: bp currently elevated. - continue amlodipine, metoprolol, lisinopril, valsartan . #. dyslipidemia: currently not taking statin. medications on admission: amlodipine 10mg po daily cinacalcet 30mg po daily gabapentin 200mg po daily insulin pump, humalog lisinopril 40mg po daily metoprolol tartrate 100mg po bid minoxidil 2.5mg po bid pantoprazole 40mg po daily prednisone 5mg po daily valsartan 320mg po daily discharge medications: 1. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 2. cinacalcet 30 mg tablet sig: one (1) tablet po daily (daily). 3. minoxidil 2.5 mg tablet sig: one (1) tablet po bid (2 times a day). 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 5. prednisone 5 mg tablet sig: one (1) tablet po daily (daily). 6. metoprolol tartrate 50 mg tablet sig: two (2) tablet po bid (2 times a day). 7. lisinopril 20 mg tablet sig: two (2) tablet po daily (daily). 8. valsartan 160 mg tablet sig: two (2) tablet po daily (daily). discharge disposition: home discharge diagnosis: hypoglycemia. discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted after being found down with profound hypoglycemia. your mental status slowly improved with iv glucose administration. you were transferred to the micu for observation overnight, however you expressed a desire to leave against medical advice. you clearly demonstrated that you have the capacity to manage your diabetes on your own. your medications have not changed. please be cautious about your insulin administration, there is a chance that your pump is administering too much insulin. check your fingerstick glucose at least every 2 hours over this first night. we strongly advise you to schedule an appointment with as your insulin needs can also change on peritoneal dialysis. please go to all of your outpatient appointments. please seek urgent medical advice or go to the ed if your experience: palpitations, sweats, shakiness, fainting or passing out, headache, chest pain, shortness of , other new or concerning symptoms. followup instructions: diabetes center please call to make an appointment within the next 7 days. procedure: injection or infusion of other therapeutic or prophylactic substance diagnoses: anemia in chronic kidney disease nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere renal dialysis status congestive heart failure, unspecified chronic kidney disease, unspecified other and unspecified hyperlipidemia long-term (current) use of insulin surgical operation with transplant of whole organ causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation complications of transplanted kidney diabetes with renal manifestations, type i [juvenile type], uncontrolled diabetes with ophthalmic manifestations, type i [juvenile type], uncontrolled chronic diastolic heart failure background diabetic retinopathy edema insulin pump status diabetes with other coma, type i [juvenile type], uncontrolled cardiomyopathy in other diseases classified elsewhere post-transplant lymphoproliferative disorder (ptld) hypertensive heart and chronic kidney disease, unspecified, with heart failure and with chronic kidney disease stage i through stage iv, or unspecified abnormal weight gain 

Answer: The patient is high likely exposed to