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: hypotension, bacteremia major surgical or invasive procedure: endotracheal intubation history of present illness: mr. is a 36 yo male with h/o dm, htn, gastroparesis who has been hospitalized numerous times over the past 2 years for n/v/d and hypertensive emergencies. he now presents with typical symptoms of n/v/d and fever. he states he was feeling well up until midnight of last night. at that time he developed fever, nausea, vomting, and diarrhea. states yesterday he was dialyzed without problems. tolerated po's yesterday and then developed these symptoms last night. pt also noted sore throat, occasional cough. he denies any sob, doe, pnd, orthopnea. currently he denies any abdominal pain, nausea has improved. in the ed he was noted to be febrile to 103, tachycardic, hypertensive, and had a lactate of 4.8. therefore code sepsis was initiated. he had a central line placed. given 8 liters of iv fluids. however his bp was 230, so he was also given nifedipine and dilaudid, which got his bp down to 180 then into the 110-120 range. he was also empirically given levofloxacin, flagyl, and vancomycin in the ed. also recieved numerous doses of dilaudid and anzemet. past medical history: 1. dmi for over 10 years 2. severe autonomic dysfunction with recurrent hospitalizations for hypertensive emergencies, gastroparesis, and orthostatic hypotension 3. esrd on hd started 4. history of esophageal erosion, mw tear 5. cad withh 50% first diagonal stenosis, nl stress in -cad 6. recent admit in late for aspiration vs community-acquired pneumonia 7. history of port-a-cath related coag neg staph infection, s/p prolonged course iv vancomycin and replacement of port-a-cath in social history: living situation labile now as he and his girlfriend broke up. he has five children, ranging in age from 11 to 15. has limited finances currently as child support is being taken from his ssdi checks, so he is having difficulty getting his medications. social work is working with him to get him established in pharmacy program. no tob, etoh or illicits. family history: his father recently died of esrd and diabetes. his mother is in her 50s and has hypertension. he has two sisters, one with diabetes, and six brothers, one with diabetes. physical exam: t 103(in ed) bp 230/110->111/60 hr 104 rr 23 o2sats 96% ra cvp 12 gen: lethargic, young male, falling asleep throughout interview heent: dry mm, perrl, eomi, anicteric, clear op no exudate neck: no jvd lungs: ctab heart: tahcy, no m/r/g abd: soft, nt, nd + bs ext: trace edema neuro: a&o times 3, grossly intact pertinent results: labs/imaging cxr- right subclavian port-a-cath, left subclavian central line, no cardiopulmonary process ct abd scattered/patchy opacities, increased septal lines, sm b/l pleural effusions, liver/gb/spleen/kidneys/adrenals all normal, diffuse stranding indicative of anasarca, sm ascites 06:20am blood wbc-6.7 rbc-4.72 hgb-12.2* hct-37.6* mcv-80* mch-25.9* mchc-32.5 rdw-19.7* plt ct-129* 04:15am blood wbc-5.4 rbc-3.89* hgb-9.6* hct-30.8* mcv-79* mch-24.8* mchc-31.3 rdw-19.7* plt ct-221 06:20am blood neuts-92.0* bands-0 lymphs-5.8* monos-0.7* eos-1.2 baso-0.3 11:35am blood neuts-68 bands-31* lymphs-1* monos-0 eos-0 baso-0 atyps-0 metas-0 myelos-0 nrbc-4* 04:30am blood neuts-60 bands-33* lymphs-1* monos-3 eos-0 baso-0 atyps-0 metas-2* myelos-1* 04:36am blood neuts-78* bands-10* lymphs-3* monos-5 eos-0 baso-0 atyps-1* metas-1* myelos-2* 04:06am blood neuts-76* bands-13* lymphs-4* monos-6 eos-0 baso-0 atyps-0 metas-1* myelos-0 04:19am blood neuts-94.0* bands-0 lymphs-4.7* monos-0.9* eos-0.1 baso-0.3 06:00am blood neuts-92* bands-0 lymphs-4* monos-2 eos-0 baso-0 atyps-0 metas-0 myelos-0 nrbc-1* plasma-2* 05:25am blood neuts-82* bands-0 lymphs-7* monos-8 eos-0 baso-0 atyps-1* metas-0 myelos-0 nrbc-1* plasma-2* 03:38am blood neuts-76.9* lymphs-14.5* monos-8.5 eos-0.1 baso-0.1 06:20am blood plt smr-low plt ct-129* 04:30am blood pt-16.7* ptt-57.0* inr(pt)-1.9 08:15am blood plt smr-low plt ct-92* 01:50pm blood plt ct-83* 05:39am blood plt ct-126* 03:38am blood plt ct-202# 06:50am blood pt-13.2 ptt-32.5 inr(pt)-1.2 04:15am blood plt ct-221 08:15am blood fibrino-262 d-dimer->* 08:15am blood fdp-320-640* 01:50pm blood fibrino-320 01:50pm blood fdp-160-320* 04:36am blood fibrino-400 04:06am blood fibrino-514* 06:20am blood glucose-226* urean-19 creat-5.8* na-142 k-3.3 cl-97 hco3-26 angap-22* 04:15am blood glucose-134* urean-28* creat-5.5*# na-136 k-3.6 cl-98 hco3-28 angap-14 06:20am blood alt-5 ast-14 ld(ldh)-230 ck(cpk)-87 alkphos-104 amylase-85 totbili-0.4 08:15am blood ld(ldh)-218 totbili-0.5 10:55am blood alt-11 ast-30 alkphos-89 amylase-43 totbili-0.4 04:19am blood alt-33 ast-20 alkphos-191* totbili-0.7 06:00am blood alt-16 ast-15 ck(cpk)-21* alkphos-145* totbili-0.4 03:50pm blood ck(cpk)-22* 06:20am blood lipase-126* 10:55am blood lipase-13 04:19am blood ggt-56 06:20am blood ck-mb-notdone ctropnt-0.25* 06:00am blood ck-mb-notdone ctropnt-0.23* 03:50pm blood ck-mb-notdone ctropnt-0.21* 05:25am blood ck-mb-2 ctropnt-0.21* 06:20am blood cortsol-41.0* 09:40am blood cortsol-29.0* 12:05pm blood cortsol-46.3* 12:50pm blood cortsol-51.0* 06:20am blood crp-2.6 04:30am blood vanco-29.4* 10:55am blood vanco-26.2* 10:45pm blood vanco-22.6* 04:36am blood vanco-24.0* 05:39am blood vanco-24.2* 03:38am blood vanco-21.1* 08:00am blood vanco-17.4* 06:28am blood lactate-4.8* 07:38am blood lactate-3.9* 08:31am blood lactate-7.0* 05:52pm blood lactate-4.0* 12:31pm blood lactate-1.1 01:11pm blood lactate-1.9 brief hospital course: 1. fever: pt with an elevated temp, tahcycardia, relative hypotension and elevated lactate therefore put into code sepsis protocol. also came back with significant bandemia. possible sources for sepsis include line infection, cdiff, influenza. cxr showed no evidence of pneumonia or opacities. ct abd/pelvis showed no obvious infectious source. blood cultures drawn on admission grew out 4/4 bottles of pan-sensitive klebsiella. he was given aggressive ivf (13 l). he was initially started on meropenem/vancomycin; this was changed to ceftriaxone once sensitivities were performed, and vancomycin was discontinued. he continued to defervesce, and wbc improved. he was initially placed on vasopressors (levophed, vasopressin), but these were weaned off when possible. he failed a cortisol stimulation test and was placed on hydrocortisone/fludricortisone. source of infection was thought to be his port-a-cath, and this was removed. surveillance blood cultures remained negative. sputum was negative for influenza, and stool was negative for c. difficile. lactate levels were followed and improved with treatment. after transfer to the floor, he devoloped hypoxia, hypotension, perhaps worsening pna. antibiotics were changed to vanco/ceftazidime/flagyl to more broadly cover. the flagyl was discontinued and the patient was going to be treated with a 14 day course of vanco and ceftaz. unfortanately, the patient eloped from the hospital on day 12 of his antibiotic course. 2. hypercarbic respiratory failure: pt was initially intubated due to fatigue. he also had signs of pulmonary edema on cxr (likely ivf received as part of sepsis protocol/treatment). fluid status was managed with hemodialysis. after pressors were weaned, he was transitioned to pressure support and ultimately extubated on . he was initially placed on nc o2, and this was weaned as possible. after transfer to the floor, he developed hypoxia with an increasing o2 requirement, cxr showing worsening failure and ?pna. he was transferred back to icu; cta was negative for pe, tte was unchanged. hypoxia improved with dialysis and was most likely secondary to volume overload with superimposed worsening pna (vap, nosocomial, ?aspiration from extubation). hd was continued, and abx coverage was expanded to vanco/ceftazidime/flagyl. he had also been hypotensive in the setting of this hypoxia, started on levophed (which was ultimately weaned); this was perhaps pna/bacteremia, restarting of antihypertensives. the patient improved and was oxygenating well on ra on the medical floor. 3. n/v/d: antiemetics were continued as necessary; he had tube feeds/ngt while intubated. po (diabetic, renal) diet was commenced after extubation. 4. anion gap: pt has had this on past admissions. likely secondary to lactate and uremia. gap corrected after fluids. 5. esrd: sevalemer was initially held secondary to low phosphate but restarted with po diet. renal was consulted, and hemodialysis was continued in-house. he was given epogen/ferrlecit as per renal. us of fistula was performed; fistula was thought to be patent, with a likely benign fluid collection. sevalemer and ampogel were restarted prior to the patient leaving the hospital. 6. dm: while in the unit, he was maintained on a humalog scale and was transitioned to his outpatient regimen ( lantus). his sugars were running high in the 200-300's and consult was called, but unfortunatly, the patient left prior to being seen. 7. htn: patient with hypertensive urgency on admission. bp went from the 230's to 120's after getting nifedipine and dilaudid. blood pressure was low upon initiation of must protocol, and he was placed on pressors as above. antihypertensives were restarted as hemodynamic status improved. 8. thrombocytopenia: patient developed low platelets following initial aggressive fluid resuscitation. this was initially thought to be secondary to dilution. this persisted, however, and other etiologies were considered. hit was sent, and heparin products were held (pt had been on sq heparin). medications were reviewed (he had received vancomycin and meropenem, both of which could cause this). cause was likely multifactorial, secondary to sepsis, s/p pressors, medications effect. 9. gastroparesis: reglan was continued when pt was taking po's. 10. positive ppd: he has history of positive ppd. no lesions on cxr, however since he is on transplant list being treated with isoniazide and pyridoxine. these were held on admission to prevent hepatotoxicity but were restarted later during the admission. 11. disposition: he was transitioned from the micu to the floor and continued to improve. unfortunatly, the patient eloped the hospital prior to being officially discharged. security was called but could not locate the patient. i am attempting to contact the patient with a follow up appointment to have a new port placed by general surgery. medications on admission: clonidine 0.3 mg/24 hr qweek (sun), aspirin 325 mg qday, insulin glargine 6 units , nifedipine 60 mg qday, pantoprazole 40 mg qday, isoniazid 300 mg qday, pyridoxine 50 mg qday, sevelamer 800 mg tid, metoprolol 50 mg , reglan 10 mg qid, clonidine 0.4 mg tid, insulin lispro per scale discharge medications: patient eloped discharge disposition: home with service discharge diagnosis: sepsis discharge condition: patient eloped discharge instructions: patient eloped followup instructions: patient eloped; i will attempt to contact the patient to set up an appointment with his pcp and with general surgery (for a port) md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube hemodialysis transfusion of other serum diagnoses: hypertensive chronic kidney disease, malignant, with chronic kidney disease stage v or end stage renal disease pneumonia, organism unspecified acidosis end stage renal disease coronary atherosclerosis of native coronary artery severe sepsis acute respiratory failure other septicemia due to gram-negative organisms infection and inflammatory reaction due to other vascular device, implant, and graft diabetes with neurological manifestations, type i [juvenile type], not stated as uncontrolled gastroparesis peripheral autonomic neuropathy in disorders classified elsewhere 

Answer: The patient is high likely exposed to