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: the patient is a 71-year-old woman with a history of primary central nervous system lymphoma which was diagnosed in (who is status post 3 courses of high-dose methotrexate both intravenously and intrathecally; the last of which was 2 weeks prior to admission), who is here now for her fourth course of high-dose methotrexate. the patient recently had a ommaya shunt placed during an admission from through , but the ventricular reservoir did not work, and she received her scheduled intrathecal methotrexate via a lumbar puncture thereafter. review of systems: review of systems on admission was negative for fevers, chills, nausea, vomiting, diarrhea, constipation, change in mental status, appetite changes, or seizures. positive for mom chest pain, palpitations, orthopnea (3 pillows and stable), and was positive as well for paroxysmal nocturnal dyspnea. past medical history: past medical history is notable for 1. primary central nervous system lymphoma; she was diagnosed on after presenting with tonic-clonic seizure. (a) she was started on high-dose intravenous methotrexate on . (b) she is status post left craniotomy on with a subgaleal hematoma. (c) she has undergone 2 cycles of high-dose methotrexate as well as intrathecal methotrexate. 2. the patient has a history of hypertension as well as atrial fibrillation and was noted to have a troponin leak during her postoperative stay in the neurologic intensive care unit in . 3. asthma. 4. status post left knee surgery. 5. left eye retinal detachment; status post laser surgery. 6. history of zoster with post herpetic neuralgia and a left t4 dermatome. medications on admission: 1. pantoprazole 50 mg by mouth once per day. 2. phenytoin 100 mg by mouth three times per day 3. metoprolol 25 mg by mouth twice per day. 4. colace 100 mg by mouth twice per day. 5. epogen 40,000 units subcutaneously (on sunday). 6. decadron 4 mg by mouth twice per day. 7. serevent inhaler. 8. albuterol inhaler. 9. glucosamine chondroitin by mouth every day. allergies: sulfa (gives her nausea, vomiting, chills, and a flu- like syndrome). social history: the patient lives alone. she has four sons and two daughters. she reports no history of tobacco or alcohol use. physical examination on presentation: physical examination on admission revealed vital signs with a temperature of 97.2 degrees fahrenheit, blood pressure was 156/79, heart rate was 80, respiratory rate was 20, and oxygen saturation was 99% on room air. in general, the patient was found lying in bed in no acute distress. head, eyes, ears, nose, and throat examination revealed a well-healed surgical scar present on her left scapula with some granulation. neck examination revealed no jugular venous distention. no bruits. no lymphadenopathy. chest examination revealed scattered crackles. cardiovascular examination revealed a regular rate and rhythm with some ectopy. normal first heart sounds and second heart sounds. the abdomen was soft, nontender, and non-distended. bowel sounds times 4. extremity examination revealed 1+ pitting edema bilaterally. neurologic examination evaluated the patient was awake and oriented times three. examination was nonfocal. pertinent laboratory values on presentation: laboratories on admission revealed sodium was 139, potassium was 4, chloride was 102, bicarbonate was 27, blood urea nitrogen was 10, creatinine was 0.6, and blood glucose was 82. prothrombin time was 15 and partial thromboplastin time was 33. white blood cell count was 5.8, hematocrit was 30.8, and platelets were 244. hospital course by issue/system: 1. hematology/oncology issues: the patient received high-dose methotrexate per protocol. methotrexate levels were followed. her methotrexate levels were 3.55 on , and 0.27 on , and 0.1 on , and 0.05 on . her urine was alkalized with bicarbonate and urine ph was checked regularly and noted to be 7 and above. a neurosurgery consultation was obtained for correction of her ommaya reservoir as prior imaging demonstrated the catheter tip incorrectly located in the left basal ganglia. the patient underwent correction of her shunt on friday, . her postoperative course was complicated by a retro-orbital hematoma. a computed tomography of the head demonstrated a soft tissue density displacing the superior rectus and optic nerve inferiorly and causing proptosis as well as multisinus disease. a follow-up magnetic resonance imaging study demonstrated the new left-sided extraconal mass at the superior portion of the left orbit; consistent with acute hematoma as well as enhancing meningeal disease in the left frontal lobe with no evidence of hydrocephalus. an ophthalmology consultation was obtained and felt all of the patient's changes in vision and examination were consistent with post surgical hematoma. there was no evidence of compartment syndrome. her vision did not worsen during the remainder of her hospital course. a radiation oncology consultation was obtained and evaluated the patient. they also felt that the patient's proptosis and visual changes were all most likely secondary to a hematoma rather a neoplastic process. 2. infectious disease issues: the patient was noted to have a fever with intermittent spikes in temperature to as high as 101.4 degrees fahrenheit. it lasted only several hours. the fevers began on friday () and continued through sunday (). all cultures remained negative. 3. cardiovascular system: the patient was continued on her regimen of metoprolol and was not given anticoagulation given her neurosurgery during admission. 4. pulmonary issues: the patient was continued on her outpatient regimen of serevent and albuterol inhalers. 5. fluids/electrolytes/nutrition issues: the patient took oral intake as tolerated, and electrolytes were repleted as required. 6. genitourinary system: the patient had new onset of incontinence following her neurosurgical procedure. the cause of this new onset of incontinence was not clear; however, the incontinence was transient and resolved prior to discharge. condition at discharge: the patient was discharged in stable condition. discharge diagnosis: primary central nervous system lymphoma. medications on discharge: 1. pantoprazole 50 mg by mouth once per day. 2. phenytoin 100 mg by mouth three times per day 3. metoprolol 25 mg by mouth twice per day. 4. colace 100 mg by mouth twice per day. 5. epogen 40,000 units subcutaneously (on sunday). 6. decadron 4 mg by mouth twice per day. 7. serevent inhaler. 8. albuterol inhaler. 9. glucosamine chondroitin by mouth every day. discharge instructions/followup: 1. the patient was to meet with dr. . on . 2. the patient was to meet with on . the patient was advised to avoid juices or foods with vitamin c following discharge from the hospital. , m.d. dictated by: medquist36 d: 18:00 t: 08:53 job#: procedure: intravascular imaging of intrathoracic vessels injection or infusion of cancer chemotherapeutic substance diagnoses: congestive heart failure, unspecified unspecified essential hypertension atrial fibrillation asthma, unspecified type, unspecified other convulsions other malignant lymphomas, unspecified site, extranodal and solid organ sites hemorrhage complicating a procedure 

Answer: The patient is high likely exposed to