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: hypoglycemia, presumably due to an underlying uti. major surgical or invasive procedure: none. history of present illness: 69 yo man with a history of cad s/p ptci () & cabg (), s/p pacer for junctional bradycardia(), afib on coumadin, and esrd on hd (being evaluated for renal tx) presented with hypoglycemia from the rehab. he was just discharged from the after a pacer with icd placement. also was treated for pna for 10 days. at his rehab he was found unresponsive. his fsg at that time was 40. he was given some oral juice. suspected aspiration during that episode. o2 satts of 90%. pt was given 1 amps d50 and the ms improved. in the ed was noted to have blood glucose of 46. was given 1 amp of d50. denies f/c/c, n/v/d/abd pain, cp. c/o some sob. vs in ed were 97.1 58 116/57 18 100/ra past medical history: coronary artery disease - s/p multiple pci/stents. known cath and lad stent in (3 vessel disease, systemic systolic arterial hypertension, moderate lv systolic heart failure, nl lv diastolic function, and successful ptca of the lpl). cabg - cabg x 3 (left internal mammary artery to left anterior descending artery, saphenous vein graft to obtuse marginal branch, saphenous vein graft to right coronary artery.) history of multiple mi's - most recent ischemic cardiomyopathy, ef 30-40% in mild-mod mr (), dddr peripheral vascular disease end-stage renal disease on hemodialysis since right brachicephalic av fistula tunnelled dialysis catheter diabetes mellitus type ii - now insulin dependent hypertension elevated cholesterol neuropathy s/p appendectomy s/p bilateral lower extremity orif social history: no current tobacco use. there is no history of alcohol abuse. separated from wife; has 4 grown kids. close w/ son, . hcp. recently in rehab/nursing home. family history: there is no family history of sudden death. extensive family history of cardiac disease including early mis (50s) and multiple family members with diabetes. mother died at age 58 due to cerebral hemorrhage and also had h/o dm2. father died at age 65 of a cerebral hemorrhage and also had h/o dm2. brother died at age 74 due to complications of dm1. physical exam: vits: t 96.5; hr 78; bp 124/49; o2 96% on ra gen: nad chest: bibasilar crackles heart: rrr, no m/r/g abd: soft, nt, nd, no hsm neuro: cn ii-xii intact, no focal motor or sensory deficit extr: no edema, 2+ radial, pedal pulses pertinent results: labs on admission: 09:45pm glucose-36* urea n-49* creat-5.7* sodium-133 potassium-4.4 chloride-96 total co2-24 anion gap-17 09:45pm ck(cpk)-26* 09:45pm ck-mb-notdone ctropnt-0.15* probnp-* 09:45pm wbc-15.2*# rbc-4.02* hgb-11.0* hct-36.0* mcv-90 mch-27.3 mchc-30.5* rdw-17.6* 09:45pm neuts-88.0* lymphs-5.4* monos-5.6 eos-0.9 basos-0.1 09:45pm pt-14.8* ptt-34.3 inr(pt)-1.3* 08:20pm glucose-24* urea n-47* creat-5.6*# sodium-133 potassium-5.0 chloride-98 total co2-22 anion gap-18 . labs on discharge: 07:25am wbc-9.4 rbc-3.89* hgb-10.5* hct-34.2* mcv-88 mch-27.0 mchc-30.7* rdw-17.2* plt ct-161 07:25am pt-28.5* ptt-48.0* inr(pt)-2.9* 07:25am glucose-113* urean-20 creat-3.5* na-135 k-3.4 cl-101 hco3-23 angap-14 03:55pm alt-12 ast-13 alkphos-116 totbili-0.3 07:25a calcium-8.1* phos-2.1* mg-1.5* . other important lab values: 03:24am %hba1c-5.8 09:45pm ck-mb-notdone ctropnt-0.15* probnp-* 03:24am ck-mb-6 ctropnt-0.14* 04:38pm ck-mb-notdone ctropnt-0.14* . r-upper ext. us : findings: the right internal jugular vein demonstrates appropriate flow and compressibility. the right subclavian vein where visualized demonstrates appropriate flow. right axillary, cephalic, and basilic veins demonstrate appropriate compressibility and flow. one of the two brachial veins, from approximately just below the elbow to the mid upper arm between the elbow and shoulder demonstrates occlusive intraluminal filling thrombus. . impression: deep venous thrombosis seen in the mid to distal right brachial vein. remainder of right upper extremity veins appears patent. . chest x-ray : . comparison: . . findings: as compared to the previous radiograph, the extent of the right-sided pleural effusion has minimally increased. the preexisting parenchymal opacity in the right lower lung is of slightly different distribution but similar extent. subtle increase of the retrocardiac atelectasis. otherwise, there is no relevant change. the monitoring and support devices are in unchanged position. brief hospital course: 69 yo man with a history of cad s/p ptci () & cabg (), s/p pacer for junctional bradycardia(), afib on coumadin, and esrd on hd p/w hypoglycemia and found to have a urinary tract infection. the patient was admitted to micu where hypoglycemia was treated and resolved. the patient found to have urinary retention; foley was placed that drained pus. patient was loaded on gentamicin based on prior urine cultures. he has several sessions of hemodialysis initially complicated by hypotension. during the last session of hemodialysis, the patient maintained his pressures and was felt to be stable for the floor. the patient did have frequent ectopy and pacer spikes for which ep was consulted. ep felt pacer was working appropriately. patient transferred to service for further care. the patient was maintained on his prior medications and monitored on telemetry. from a cardiac standpoint, the remainder of his stay was uneventful. please see uti and abdominal pain below. . # uti: patient c/o abdominal pain and described pain with urge to urinate. bladder scan urinary retention and a foley was placed. pus/ thick grey/white was noted coming from the bladder. the patient's ua was grossly positive. he has a history of non-fermenter, non-pseudomona (ie stenotrophomonas or acinetobacter) that is multi-drug resisitent, but sensitive to gentamicin. he was loaded with gentamicin and dosing continued by renal. on discharge, he will continue to be renally dosed with hemodialysis for a goal gent trough of 6 mcg/ml. . # hypoglycemia: it was felt this may be attributed to new infection see uti above. in the hospital, he was covered on sliding scale insulin. . # loc: loss of consciousness. likely from hypoglycemia, but it was needed to consider function as well. ep came and interrogated the pacer which was ok, but monitor continues to demonstrate ectopy and pace spikes occasionally on the t-waves. cardiac enzymes negative despite slight elevated tropinins, ck-mb negative. patient was continually monitored on telemetry without incident. . # esrd: missed hd due to admission. patient initially with hypotension with hd for the urgent session and hd session in am . however, hd continued thereafter without hypotension. . # afib: we continued coumadin; he was given a dose on to catch up back into the theraputic range. he was later discharged on 1 mg coumadin daily to follow-up for further adjustment. . # abdominal pain/diarrhea - patient was found to be c.diff positive. he was started on a fourteen day course of flagyl which he will continue as an outpatient. . # htn: he was continued on carvedilol and lisinopril. . medications on admission: 1. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). disp:*60 tablet(s)* refills:*0* 2. escitalopram 10 mg tablet sig: one (1) tablet po daily (daily). disp:*qs tablet(s)* refills:*0* 3. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po hs (at bedtime). disp:*qs capsule, sust. release 24 hr(s)* refills:*2* 4. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed. disp:*qs * refills:*0* 5. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*qs tablet(s)* refills:*2* 6. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed. disp:*qs * refills:*0* 7. carvedilol 25 mg tablet sig: one (1) tablet po bid (2 times a day): hold if sbp < 100 or hr < 60. disp:*60 tablet(s)* refills:*0* 8. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 9. simvastatin 80 mg tablet sig: one (1) tablet po once a day. 10. sevelamer hcl 400 mg tablet sig: one (1) tablet po once a day. 11. lactulose 20 gram packet sig: one (1) po once a day. 12. insulin nph & regular human 100 unit/ml (70-30) cartridge sig: one (1) 68 subcutaneous qam. 13. insulin nph & regular human 100 unit/ml (70-30) cartridge sig: one (1) 38 subcutaneous qpm. 14. ascorbic acid 500 mg tablet sig: one (1) tablet po twice a day. 17. keflex 500 mg capsule sig: one (1) capsule po once a day for 5 days: on dialysis days, please take after dialysis. 19. aspirin 81 mg tablet sig: one (1) tablet po once a day. 20. warfarin 2 mg tablet sig: one (1) tablet po at bedtime. 21. oxycodone 5 mg tablet sig: 1-2 tablets po every six (6) hours for 5 days. discharge medications: 1. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 2. escitalopram 10 mg tablet sig: one (1) tablet po daily (daily). 3. gentamicin hemodialysis dosed per hemodialysis team. dose during hemodialysis. goal is for a gentamicin trough of 6 mcg/ml 4. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po at bedtime. 5. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed. 6. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed. 7. carvedilol 3.125 mg tablet sig: two (2) tablet po bid (2 times a day). 8. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 9. insulin lispro 100 unit/ml solution sig: as directed subcutaneous asdir (as directed). 10. simvastatin 40 mg tablet sig: two (2) tablet po daily (daily). 11. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 12. metronidazole 250 mg tablet sig: one (1) tablet po tid (3 times a day). 13. oxycodone 5 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 14. warfarin 1 mg tablet sig: one (1) tablet po daily (daily). 15. ascorbic acid 500 mg tablet sig: one (1) tablet po twice a day. 16. flagyl 250 mg tablet sig: one (1) tablet po three times a day for 12 days. disp:*36 tablet(s)* refills:*0* discharge disposition: extended care facility: senior healthcare - discharge diagnosis: primary: urinary tract infection clostridium difficile infection . secondary: ischemic cardiomyopathy mitral regurgitation atrial fibrillation peripheral vascular disease end-stage renal disease diabetes mellitus type ii hypertension elevated cholesterol discharge condition: stable. afebrile. chest pain free. discharge instructions: you were admitted after having low blood glucose. you were also found to have a urinary tract infection and a clostridium difficile infection in your intestinal tract. . you were treated with gentamicin for the urinary tract infection and metronidazole for the intestinal infection. you should be continued on gentamycin at least for 14 days (but dosed during hemodialysis). please discuss this medication with your hemodialysis team. you are to continue the metronidazole until . your coumadin was adjusted to 1 mg daily. you need to continue to check your blood (pt/ptt/inr) to continue to adjust this medication as necessary. you should continue to take your other medications as instructed. . please make sure you follow up with your doctors . . if you experience any chest pain, chest pressure with jaw or arm pain, difficulty breathing, or any other concerning symptoms, please call 911 or come to the er. . weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet followup instructions: you have a follow up appointment scheduled with dr. on wednesday, at 1:30pm. . please check cbc and pt/ptt/inr on monday for adjustment of your coumadin (blood thinner). please forward those results to dr. office. thank you. . you have an appointment with device clinic. phone: date/time: 3:00 procedure: hemodialysis diagnoses: end stage renal disease pure hypercholesterolemia mitral valve disorders urinary tract infection, site not specified congestive heart failure, unspecified atrial fibrillation aortocoronary bypass status diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other specified forms of chronic ischemic heart disease other specified cardiac dysrhythmias diabetes with other specified manifestations, type ii or unspecified type, not stated as uncontrolled intestinal infection due to clostridium difficile chronic systolic heart failure long-term (current) use of anticoagulants retention of urine, unspecified cardiac pacemaker in situ 

Answer: The patient is high likely exposed to