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: penicillins attending: chief complaint: generalized body aches major surgical or invasive procedure: central line history of present illness: ms. is a 58 year old female with history of poorly controlled type 1 diabetes, gastroparesis, cva, htn, hep c, and multiple prior admissions for dka presenting with dka. this time she presents with abdominal pain consistent with previous episodes of gastroparesis, as well as just generally feeling poorly. this all happened when she awoke suddenly and began . the larger picture of her health is that over the past several days, she has been feeling " as a dog," with nausea, , diarrhea, eating very little food and taking only some of her . ed course ekg: sinus 104, nonischemic, borderline peaked t's cxr: nonacute urine: ketones, no infx labs with elevated lactate, vbg, lfts, cardiac - ph-7.16 pco2-21 po2-110 hco3-8 - lactate:4.8 <-5.5 - wbcs 14.2 - n:89.4 l:8.6 m:1.8 e:0.1 bas:0.2 r groin line placed for poor access (pt refused ij) k on green top 5.5 (d/w bg tech at 0526) aggressive ivf iv bolus and gtt admit to icu for dka on arrival to the micu, patient's vs. 122/56 hr 105 rr 19 100% on 2l. she is alert and oriented and complaining of diffuse body aches that are not new. she denied recent fevers, diarrhea (endorses constipation), no rashes, no chills, no chest pain, no changes in vision or hearing in last 3 days, no nuchal rigiditi endorsed either. the patient was subsequently stabilized and transitioned to the hospital medicine service for ongoing management of her blood glucose levels and development of a plan for transition to home. past medical history: --type i dm: diagnosed at age 5, multiple hospitalizations for dka and hyperglycemia. complicated by retinopathy, severe peripheral neuropathy, and gastroparesis with marked constipation. --cva --diabetic polyneuropathy --hypertension --grave's disease, on mmi --seronegative arthritis, followed in rheumatology --hepatitis c, genotype 1a, biopsy with grade 1 inflammation, not on antiviral therapy; acquired from a blood transfusion in . had previous liver biopsy without significant fibrosis. never been treated with antivirals. --gerd --status post bilateral knee arthroscopies --migraine headaches --asthma --s/p tah --mouth surgery for removal of tumors --bilateral foot drop requiring wheelchair use social history: patient lives in an apt building, and remains in her wheelchair on the of the house. she has a son, daughter, and another brother who live on another floor in the same building. she has not worked for many years and uses a wheelchair at baseline. - tobacco: never - alcohol: denies - illicits: denies family history: mother died of colon cancer. there are multiple family members with dm. physical exam: admission exam to medical icu: general: alert, oriented, no acute distress : sclera anicteric, dry mm, oropharynx clear, eomi, neck: supple, jvp not elevated, no lad cv: tachycardic, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-distended, bowel sounds present, no organomegaly, minimally tender throughout, no rebound or guarding gu: foley in place ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: a&ox3. cnii-xii intact, 4/5 strength upper extremities, particularly in bilateral hands with changes consistent with arthritis. lower extremities weak and exam limited by patient effort. gait deferred due to report that patient is wheelchair bound. discharge exam: general: alert, no acute distress abdomen: soft, minimal tenderness, no distension, positive bowel sounds, no organomegaly appreciated, no rebound or guarding. pertinent results: 06:06am blood wbc-14.2*# rbc-3.62*# hgb-11.2*# hct-36.7# mcv-101* mch-30.9 mchc-30.5* rdw-13.5 plt ct-412 06:06am blood neuts-89.4* lymphs-8.6* monos-1.8* eos-0.1 baso-0.2 04:30am blood glucose-745* urean-43* creat-2.1* na-129* k-5.6* cl-85* hco3-8* angap-42* 04:30am blood alt-23 ast-31 ck(cpk)-71 alkphos-96 totbili-0.3 04:30am blood lipase-63* 04:30am blood albumin-3.9 calcium-8.6 phos-8.8*# mg-1.9 05:03am blood type- po2-98 pco2-21* ph-7.26* caltco2-10* base xs--15 comment-green top 05:03am blood lactate-5.5* k-5.5* 05:50am blood wbc-5.9 rbc-3.19* hgb-9.7* hct-31.5* mcv-99* mch-30.3 mchc-30.7* rdw-14.5 plt ct-367 05:50am blood glucose-260* urean-23* creat-1.3* na-132* k-5.5* cl-98 hco3-26 angap-14 05:35am blood calcium-8.8 phos-4.0 mg-1.7 pa and lateral chest radiographs: the cardiomediastinal and hilar contours are normal. the lungs are well expanded and clear, without consolidation, pleural effusion or pneumothorax. impression: no acute cardiopulmonary pathology. ekg: sinus tachycardia. diffuse non-specific st segment changes in the setting of j point elevation with early repolarization in the anterior precordial leads. compared to the previous tracing of , the precordial t waves are slightly less peaked and the inferior st-t wave changes are less pronounced. the ventricular rate is slower. brief hospital course: 58-year-old female with poorly controlled type i diabetes, gastroparesis, peripheral neuropathy, cva, htn, hep c, and multiple prior admissions with dka presents with dka in setting of not taking and poor po intake. active problems: # diabetic ketoacidosis, uncontrolled, complicated type i diabetes mellitus, hypoglycemia: she is followed closely by clinic. she was initially started on drip and iv fluids. her anion gap closed and was consulted to help with further titration of sc . there was no exacerbating factor for dka other than likely exacerbation of gastroparesis vs gastroenteritis and missed doses. she was kept in the hospital a number of days for titration of her regimen. despite the close monitoring she still had labile blood sugars. she did have multiple episodes of hypoglycemia as an inpatient. the goal blood sugars for her regimen are 150-250 given her propensity for hypoglycemia. she was discharged with very close follow up with clinic and her primary care physician. was resumed to help her with diabetes management. social work was also closely involved with her management to work on social issues that may be exacerbating her difficult to control blood sugars. below is her discharge regimen: sc fixed dose orders breakfast lunch dinner bedtime glargine 12 units glargine 22 units sc sliding scale breakfast lunch dinner bedtime humalog humalog humalog humalog glucose dose dose dose dose 0-70 mg/dl proceed with hypoglycemia protocol proceed with hypoglycemia protocol proceed with hypoglycemia protocol proceed with hypoglycemia protocol 71-80 mg/dl 8 units 6 units 6 units 0 units 81-130 mg/dl 10 units 8 units 8 units 0 units 131-170 mg/dl 12 units 10 units 10 units 0 units 171-220 mg/dl 14 units 12 units 11 units 0 units 221-270 mg/dl 18 units 14 units 12 units 2 units 271-320 mg/dl 20 units 15 units 13 units 4 units 321-370 mg/dl 22 units 16 units 15 units 6 units 371-418 mg/dl 24 units 18 units 16 units 8 units 419-420 mg/dl 26 units 19 units 18 units 10 units # acute kidney injury: most likely secondary to hypovolemia from her volume-depleted ketoacidotic state. her creatinine improved in the setting of hydration. # leukocytosis: she had leukocytosis which resolved without antibiotic treatment and was likely a stress response. she did have blood cultures that grew out corynebacterium species, which was thought to be a contaminant. repeat blood cultures were negative. ua was negative. # gastroparesis: no changes were made in her outpatient regimen. better glucose control is essential in minimizing symptoms. she is on metoclopramide, hyoscyamine sulfate and antinausea medications. chronic problems # polyneuropathy with foot drop: continued on home medications. # grave's disease: continued methimazole. # depression: continued amitriptyline. patient reports is controlled, although she feels having her own home would 'improve' her depressed mood. # hypercholesterolemia: continued simvastatin. # seronegative arthritis: continued sulfasalazine. # asthma: continue fluticasone-salmeterol 250-50 , with albuterol prn. # code status: dnr/dni transitional issues: -follow up with clinic and pcp medications on admission: per d/c summary on : 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 3. miralax 17 gram/dose powder sig: one (1) po once a day as needed for constipation. 4. metoclopramide 10 mg tablet sig: one (1) tablet po qidachs (4 times a day (before and at bedtime)). 5. montelukast 10 mg tablet sig: one (1) tablet po daily (daily). 6. hyoscyamine sulfate 0.375 mg capsule,extended release 12 hr sig: one (1) capsule,extended release 12 hr po bid (2 times a day). 7. losartan 50 mg tablet sig: two (2) tablet po daily (daily). 8. sulfasalazine 500 mg tablet sig: two (2) tablet po bid (2 times a day). 9. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 10. calcium carbonate 200 mg calcium (500 mg) tablet, chewable sig: one (1) tablet, chewable po daily (daily). 11. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po daily (daily). 12. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po once a day. 13. percocet 5-325 mg tablet sig: one (1) tablet po twice a day as needed for pain. 14. gabapentin 300 mg capsule sig: three (3) capsule po three times a day. 15. amitriptyline 25 mg tablet sig: two (2) tablet po hs (at bedtime). 16. methimazole 10 mg tablet sig: one (1) tablet po bid (2 times a day). 17. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) puff inhalation (2 times a day). 18. cyclobenzaprine 10 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for pain. 19. zolmitriptan 2.5 mg tablet sig: one (1) tablet po once a day as needed for pain. 20. hydroxyzine hcl 25 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for itching. 21. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 22. ondansetron hcl 4 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for nausea. disp:*30 tablet(s)* refills:*0* 23. sliding scale lantus 12 units every morning; 17 units every evening humalog: see attached sliding scale 24. sliding scale humalog qam: 81-120 11 u 121-170 12 u 171-220 13u 221-270 14 u 271-320 15u 321-370 17 u 371-420 19 u 421-440 21 u lunch: 81-120 5 u 121-170 6 u 171-220 7 u 221-270 8 u 271-320 9 u 321-370 10 u 371-420 11 u 421-440 13 u dinner: 81-120 3 u 121-170 4 u 171-220 5 u 221-270 6 u 271-320 7 u 321-370 9 u 371-420 11 u 421-440 13 u 10pm: 221-270 2 u 271-320 6 u 321-370 7 u 371-420 8 u 421-440 10 u 3am: 221-270 2 u 271-320 6 u 321-370 7 u 371-420 8 u 421-440 10 u 25. cipro 500 mg tablet sig: one (1) tablet po twice a day for 7 days. disp:*14 tablet(s)* refills:*0* discharge medications: 1. sulfasalazine 500 mg tablet sig: one (1) tablet po bid (2 times a day). 2. methimazole 10 mg tablet sig: one (1) tablet po bid (2 times a day). 3. gabapentin 300 mg capsule sig: three (3) capsule po three times a day. 4. hydrocortisone 1 % ointment sig: one (1) appl topical daily (daily) as needed for itching. 5. hydroxyzine hcl 25 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for itching. 6. hyoscyamine sulfate 0.375 mg capsule,extended release 12 hr sig: one (1) capsule,extended release 12 hr po bid (2 times a day). 7. colace 100 mg capsule sig: one (1) capsule po twice a day. 8. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 9. miralax 17 gram/dose powder sig: one (1) po once a day as needed for constipation. 10. metoclopramide 10 mg tablet sig: one (1) tablet po qidachs (4 times a day (before and at bedtime)). 11. montelukast 10 mg tablet sig: one (1) tablet po daily (daily). 12. losartan 50 mg tablet sig: one (1) tablet po daily (daily). 13. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 14. calcium carbonate 200 mg calcium (500 mg) tablet, chewable sig: one (1) tablet, chewable po daily (daily). 15. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po once a day. 16. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po twice a day as needed for pain. 17. amitriptyline 25 mg tablet sig: two (2) tablet po hs (at bedtime). 18. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 19. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 20. glucagon emergency 1 mg kit sig: one (1) injection as needed as needed for hypglycemia: if blood sugar < 50 and not responsive to juice, glucose tabs, or if unresponsive, give glucagon injection. disp:*1 kit* refills:*0* 21. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 22. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po once a day. 23. cyclobenzaprine 10 mg tablet sig: one (1) tablet po twice a day. 24. zolmitriptan 2.5 mg tablet sig: one (1) tablet po once a day as needed for pain. 25. zofran odt 4 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po every eight (8) hours as needed for nausea. 26. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) inhalation every 4-6 hours as needed for shortness of breath or wheezing. 27. flovent hfa inhalation 28. diazepam 5 mg tablet sig: one (1) tablet po every six (6) hours as needed for pain. 29. pen needle 31 x needle sig: one y (180) units miscellaneous 6 times per day. disp:*180 units* refills:*0* 30. lispro 100 unit/ml solution sig: as directed subcutaneous four times a day: please see attached sliding scale. disp:*qs qs* refills:*2* 31. glargine 100 unit/ml solution sig: as directed subcutaneous twice a day: 12 units in am, 22 units in pm. disp:*qs qs* refills:*0* discharge disposition: home with service facility: uphams corner home care discharge diagnosis: diabetic ketoacidosis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: it was a pleasure to care for you during your admission. as you know, you were admitted with diabetic ketoacidosis when you were not able to eat due to nausea and , and then did not have your . you required time in the intensive care unit to feel better. the team helped adjust your plan, and encouraged you to eat regular throughout the day. we continued your bowel medicines. it is very important that you continue these medications at home, including your metoclopramide with . you should make the following changes to your medications on discharge: 1: glucagon injection kit: to be used by your nurse or family member if you are unconcious and your sugars are low 2: glargine 3: humalog - please see attached sliding scale you have appointments listed below. please make sure you arrange for ambulance or other transporation. followup instructions: name: , md when: at 10am location: uphams corner health center address: , , phone: *your appointment may be with another physician as you were booked as an urgent appointment. name: , location: diabetes center when: tuesday at 8am address: one place, , phone: you will have your visiting nurse restarted when you leave the hospital. you should proceed with the following previously appointment: department: radiology when: at 12:45 pm with: radiology building: sc clinical ctr campus: east best parking: garage procedure: venous catheterization, not elsewhere classified central venous catheter placement with guidance diagnoses: esophageal reflux unspecified essential hypertension chronic hepatitis c without mention of hepatic coma acute kidney failure, unspecified asthma, unspecified type, unspecified polyneuropathy in diabetes long-term (current) use of insulin rheumatoid arthritis personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits do not resuscitate status toxic diffuse goiter without mention of thyrotoxic crisis or storm migraine, unspecified, without mention of intractable migraine without mention of status migrainosus diabetes with neurological manifestations, type i [juvenile type], uncontrolled diabetes with ophthalmic manifestations, type i [juvenile type], uncontrolled diabetes with ketoacidosis, type i [juvenile type], uncontrolled background diabetic retinopathy gastroparesis other acquired deformities of ankle and foot 

Answer: The patient is high likely exposed to