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 diabetic ketoacidosis and non-st elevation mi major surgical or invasive procedure: cardiac catheterization history of present illness: 55m with dm1 presents with dka. . the night prior to admission, pt had decreased appetite, felt somewhat nauseous, and ate only bowl of soup for dinner. he did not finish it nausea, and went to bed. he developed pain from epigastrium up to throat, and felt like a burning. he vomited a few times, nonbloody. wife recommended that he take tums, of which he took about 12. pt notes that his glucose was in the 400's at dinnertime, and he took 10 units of insulin. pt uses an insulin pump. overnight, he bolused himself 10 units of insulin at a time, with multiple boluses overnight and through the next morning. his glucose readings continued to be > 500. he finally went to , where his glucose was 1047. he was started on an insulin drip. he was told he may have had a small heart attack and a pneumonia, so he was transferred to for further management. . pt notes he has no h/o dka, though he has had a few episodes of hypoglycemia. . in the , pt was loaded with plavix and started on a heparin gtt as his ekg showed lateral st depressions and his first set of cardiac enzymes showed troponin 0.15. pt was given 4l ns and insulin gtt. . micu course: for dka, he was placed on insulin gtt and iv fluid with q1h glucose monitoring and q3h electrolyte monitoring. his anion gap acidosis resolved and he was started on subcutaneous nph and humalog sliding scale and he resumed a consistent carbohydrate diet. his blood sugars were erratic, requiring extra sliding scale doses. diabetes consult has followed the patient and recommended that he receive more intensive diabetes education before resuming use of his pump. . for nstemi, he was loaded with plavix and started on a heparing gtt. he underwent cardiac catheterization. past medical history: insulin dependent diabetes diagnosed 10 years ago hypertension hyperlipidemia social history: lives with his wife and 2 children family history: dm in paternal aunt and paternal cousin physical exam: vs: 99.8 114/46 104 23 98% ra gen: talking, alert, nad heent: mmm, op clear neck: no jvd cv: rrr, nl s1/s2, 2/6 systolic murmur loudest at llsb pulm: ctab, no wheezes or crackles abd: insulin pump in lower ant abdominal wall; soft, nt/nd, +bs, no masses ext: no c/c/e, warm, well perfused pertinent results: . cxr: no acute cp process . ekg: 98 bpm, nsr, 1mm st depressions in v4-v6, ? 1mm st elevation in v1 only but could be c/w j point elevation; nl axis and intervals 09:45pm glucose-537* urea n-55* creat-2.0* sodium-133 potassium-4.2 chloride-100 total co2-18* anion gap-19 07:00pm glucose-690* lactate-3.0* 06:50pm glucose-709* urea n-54* creat-2.1* sodium-131* potassium-4.5 chloride-92* total co2-14* anion gap-30* 06:50pm estgfr-using this 06:50pm ck(cpk)-268* 06:50pm ctropnt-0.15* 06:50pm ck-mb-16* mb indx-6.0 06:50pm calcium-10.9* phosphate-4.4 magnesium-2.6 06:50pm osmolal-342* 06:50pm urine hours-random 06:50pm urine gr hold-hold 06:50pm wbc-22.4* rbc-4.16* hgb-12.5* hct-37.2* mcv-89 mch-30.0 mchc-33.6 rdw-13.1 06:50pm neuts-93.3* bands-0 lymphs-5.4* monos-0.5* eos-0.3 basos-0.6 06:50pm hypochrom-normal anisocyt-1+ poikilocy-normal macrocyt-normal microcyt-normal polychrom-normal 06:50pm plt smr-normal plt count-242 06:50pm pt-15.1* ptt-32.1 inr(pt)-1.4* 06:50pm urine color-straw appear-clear sp -1.023 06:50pm urine blood-neg nitrite-neg protein-neg glucose-1000 ketone-50 bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 06:50pm urine rbc-0-2 wbc-0-2 bacteria-few yeast-none epi-0-2 . echo: conclusions: the left atrium is normal in size. there is mild symmetric left ventricular hypertrophy with normal cavity size and systolic function (lvef>55%). regional left ventricular wall motion is normal. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are mildly thickened. very mild (1+) mitral regurgitation is seen. there is borderline pulmonary artery systolic hypertension. there is an anterior space which most likely represents a fat pad. impression: mild symmetric left ventricular hypertrophy with preserved global and regional biventricular systolic function. very mild mitral regurgitation. . cath: comments: 1. selective coronary angiography revealed a right dominant system with patent lmca, lad, lcx and rca vessels. there was no significant obstructive coronary artery disease. lmca had a mild distal 20% taper. lad had plaqueing up to 30% in the mid-vessel involving the d1. lcx had mild plaqueing and supplied the om1 and 2 as well as an atrial branch. rca had mild luminal irregularities and supplied a tortuous r-pda. 2. left ventriculography was deferred given cri. 3. limited hemodynamics showed elevated lvedp. final diagnosis: 1. coronary arteries are normal. . le u/s neg for dvt brief hospital course: a/p: 55m with dm1 here with dka and concern for acs but now s/p clean cath. hospital course complicated by: . # fever: etiology uncertain; however extensive evaluation failed to demonstrate evidence of active bacterial infection. continued to spike to 100.3 even the day of dischage. highest fever 101.3. given his mild sore throat, suspect that viral pharyngitis/uri may be culprit. blood and urine cx ngtd except one urine cx with coag neg staph that appears to be a contaminant. ua neg x 3. cxr neg. le u/s neg for dvt. - will have outpatient f/u and told to return to the ed if he devlops new symptoms. . # thrombocytopenia - his platelets were observed to drop to 129 from 242 on admission but then went back up and were 144 on discharge so no further work-up was pursued. . # dka - now resolved and back on novolog insulin pump. unclear precipitant. possibly acs, as pt had nausea and substernal chest pain which could have been his sx of acs in the setting of dm. however, ce could have bumped in the setting of pre-renal azotemia. cxr here not convincing for pna and pt without any si/sx of pna, so doubt this as etiology. ua without evidence of infection. - insulin drip discontinued . insulin pump was re-started the day before discharge and his settings were increased continued bs in 200w - monitored lytes initially but once anion gap has closed, monitored daily - folllowed and we recommended that he follow up with a diabetic educator at . - sent home with a urine ketone kit . # acs/nstemi - trop bump to 0.14 and ck to 400 but clean cath s/p pericath hydration and mucomyst. also in setting of arf. . # throat and mouth pain: possibly coxsackievirus but pain resolving, tolerating po. . # dm1 - now back on insulin pump. - appreciate recs - pt should have urinary ketone testing at home for the future - re-started lisinopril . # htn - lisinopril was initially held for arf but re-started before discharge. bp relatively well-controlled with sbp in 130s. . # acute renal failure - cr 2.0 at admission, baseline unknown but likely pre-renal azotemia from dka. - cr on discharge 0.8 . # fen/gi - diabetic diet . # ppx - sc heparin, ppi . # code - full . # dispo - to home this evening if no further fevers and u/s without dvt medications on admission: insulin pump lipitor 20mg daily lisinopril 20mg daily aspirin 325 mg po daily discharge medications: 1. aspirin 81 mg tablet sig: one (1) tablet po once a day. 2. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). 3. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 4. insulin aspart 100 unit/ml solution sig: insulin pump u subcutaneous once a day: as directed. currently at 1u/hr with correction factor 45. 5. urine ketone test kit and strips discharge disposition: home discharge diagnosis: dka nstemi dm1 acute renal failure normocytic anemia discharge condition: hemodynamically stable. ambulatory. discharge instructions: please take all medications as instructed. there were no changes made to your current medications regimen. if you experience any uncontrolled high blood sugars, urine ketones, nausea, vomiting, lightheadedness, chest pain, shortness of breath, or any other concerning symptoms please seek medical attention immediately. followup instructions: please make a follow-up appointment with dr. on asap. tel (. . please make an appointment with diabetic educator asap. tel (. md, procedure: left heart cardiac catheterization coronary arteriography using a single catheter angiocardiography of right heart structures diagnoses: subendocardial infarction, initial episode of care unspecified essential hypertension acute kidney failure, unspecified other and unspecified hyperlipidemia diabetes with ketoacidosis, type i [juvenile type], uncontrolled 

Answer: The patient is high likely exposed to