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: this is a 23 year old man with long standing type 1 diabetes mellitus, hypertension, end stage renal disease since , congestive heart failure with an ef estimated at 40 percent, who presented with three days of nausea and vomiting and finger stick glucose in the 400s at home. in the emergency room patient was found to have ketones in his urine and metabolic acidosis with an anion gap of 22, consistent with diabetic ketoacidosis. patient was started on an insulin drip and admitted to the medical intensive care unit on . physical examination: on admission, in general, the patient was a well-developed, well-nourished, white male, lying in bed, in no apparent distress. heent oropharynx clear, no fruity breath odor, moist mucous membranes. neck supple with no lymphadenopathy. heart normal s1, s2, regular rate and rhythm, no murmurs, gallops or rubs appreciated. lungs clear to auscultation bilaterally. abdomen soft, nondistended, mildly tender to palpation, normoactive bowel sounds. extremities 1+ pitting edema in the lower extremities. neuro alert and oriented times three. cranial nerves grossly intact. conversant and appropriate. laboratory data: on admission sodium 139, potassium 4.1, chloride 100, bicarb 17, bun 89, creatinine 6.9. cbc white blood count 18.1, hemoglobin 8.8, hematocrit 27.6, platelets 506. ekg normal sinus rhythm at a rate of 130, no st changes, no t wave inversions, normal intervals, normal axis. chest x-ray diffuse increase in interstitial markings that could reflect pulmonary edema versus an infectious/inflammatory process. ck 323. alka phos 167, amylase 983. ckmb 12, troponin i 5.4. hospital course: 1. diabetic ketoacidosis/diabetes mellitus. the patient was admitted to the medical intensive care unit on an insulin drip. patient's serum glucose responded well to intravenous insulin and trended down to within normal limits within the first day of admission. patient's anion gap decreased from 22 to within normal limits. patient was then restarted on his outpatient dose of glargine insulin q.h.s. patient also had regular insulin sliding scale throughout his hospital course. 2. myocardial infarction. the patient's cardiac enzymes were elevated on admission and increased during the first day of his admission. patient's ck peaked at 334, ckmb 12, troponin i 20.4, all on . patient was placed on a heparin drip for one day in the icu. patient was continued on aspirin, atorvastatin, isosorbide dinitrate 20 mg three times a day as well as a beta blocker throughout his hospital stay, initially metoprolol and then switched to labetalol 600 mg twice a day. patient's cardiac enzymes trended down throughout his hospital stay and continued to trend down at discharge. patient was also started on a low dose ace inhibitor, captopril 12.5 mg three times a day. echocardiogram performed during this hospitalization revealed an ejection fraction of 30 percent, down from patient's previous ejection fraction of 40 percent. patient underwent cardiac catheterization during his hospital stay which revealed normal coronaries with no stenosis. 3. congestive heart failure. the patient's left ventricular ejection fraction was noted to be approximately 30 percent, down from his previous ejection fraction estimate of 40 percent. patient was maintained on lasix 80 mg twice a day. 4. increased white blood count. the patient's increased white blood count as well as x-ray suggestive of possible infiltrate diffusely were concerning. patient was started on levofloxacin 250 mg every 48 hours, renally dosed, on admission and continued this for a course of seven days total. 5. end stage renal disease. the patient was continued on peritoneal dialysis throughout his hospital stay. patient used his own cycler and fluids while on the floor. patient's normal routine is nine hours per night on peritoneal dialysis as he sleeps. 6. anemia. the patient was continued on iron supplements and epogen. 7. fluids, electrolytes and nutrition. the patient was continued on a low sodium, low cholesterol diet throughout his hospital stay which he tolerated well. 8. prophylaxis. the patient was administered subcutaneous heparin for dvt prophylaxis throughout his hospital stay until he was ambulating well. patient was also maintained on pantoprazole 40 mg q.d. throughout his hospital stay for gi prophylaxis. condition on discharge: stable. discharge diagnoses: 1. diabetic ketoacidosis. 2. myocardial infarction. 3. congestive heart failure. 4. end stage renal disease. 5. diabetes mellitus. discharge medications: 1. aspirin 81 mg once per day. 2. folic acid. 3. hydralazine 25 mg four times a day. 4. captopril 12.5 mg three times a day. 5. atorvastatin 10 mg once a day. 6. amlodipine 10 mg once a day. 7. labetalol 600 mg twice a day. 8. pantoprazole 40 mg once a day. 9. glargine insulin 20 units q.h.s. 10. calcium acetate. 11. furosemide 80 mg twice a day. 12. isosorbide dinitrate 20 mg three times a day. 13. levofloxacin 250 mg every 48 hours for two additional days. 14. metolazone 2.5 mg once per day. 15. reglan 10 mg four times a day. followup: the patient is to see his primary care physician, . , within two weeks. patient is to call the diabetes center for an appointment within two weeks. , m.d. dictated by: medquist36 procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters peritoneal dialysis diagnoses: pneumonia, organism unspecified other primary cardiomyopathies subendocardial infarction, initial episode of care mitral valve disorders congestive heart failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease diabetes with ketoacidosis, type i [juvenile type], not stated as uncontrolled acute on chronic systolic heart failure diabetes with renal manifestations, type i [juvenile type], not stated as uncontrolled 

Answer: The patient is high likely exposed to