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: no known allergies / adverse drug reactions attending: chief complaint: left flank pain, chest pain, shortness of breath (ccu admission for ra thrombus) major surgical or invasive procedure: right atrial mass resection history of present illness: mr. is a 21y/o gentleman with aiha s/p splenectomy on steroids and danazol, iga deficency (likely transforming into cvid) with h/o portal vein thrombosis, left renal vein infarct, and pulmonary embolus now on enoxaparin, as well as steroid-induced dm2 who presented to the ed with left flank pain, chest pain, and shortness of breath. his recent baseline is that he is quite sedentary but can normally climb a few flights of stairs with no problems if needed. his hr since has been 100-110. but for the past 2 days he has had chest pain: mild discomfort at his left side and his left frontal chest that becomes moderate and sharp with deep breathing. there are no associated symptoms. the pain does not radiate. in addition, he notes worsened left flank pain "like the pain i had with the kidney blood clot." has noted worsening dyspnea on exertion to the point that he can't walk even a few steps before feeling short of breath. he went to his pcp's office who was concerned by his symptoms so ems was called and he was taken to hospital. ems found his vs to be: bp 152/92, hr 116, rr 18, pox 95%ra. at hospital, his vs were: rectal t 100.1, bp 122/95, hr 104, rr 18, pox 96% 2l nc. his labs were notable for wbc 26 (96% pmn, 1% bands). blood cultures were sent and he received levofloxacin 500mg iv in case of pneumonia (though cxr was clear). received 1l ns. was transferred to due to medical complexity. in the ed, his initial vs were: pain , t 95, hr 106, bp 148/103, rr 22, pox 91%ra-->96% 2l nc. labs were notable for wbc 27.9 (n:94 band:1 l:1), hct 40.6, plt 373. bun 14, cr 1.0, k 5.2. lactate 0.8. serum tox screen was negative. ekg revealed nsr, rate 93, old twi in iii. due to suspicion for pe, cta was performed that revealed bilateral subsegmental pes in the lung bases, but also a large filling defect in the ra that was suggestive of a near occlusive ra thrombus. in addition, he had left renal vein thrombus. cardiac surgery was consulted and recommended anticoagulation and consideration for possible thrombectomy. cardiology fellow performed a limited tte which showed a limited view of the ra, but no evidence of rv strain. he was started on a heparin gtt, as well as receiving dilaudid 1mg iv x3 for chest discomfort. received 1l ns in the ed here. he was never hemodynamically unstable but given his large clot burden he was admitted to the ccu for monitoring. cardiac surgery was consulted for mass/ clot excision. past medical history: past medical history: iga deficiency coombs(+) autoimmune hemolytic anemia s/p splenectomy pulmonary embolism portal vein thrombosis renal vein thrombosis (left) history of pneumonia: in setting of pulmonary embolism diagnosis c.diff mild bilateral sensorineural hearing loss since childhood s/p tonsillectomy s/p b/l tympanostomy tubes as a child detailed hematologic history: -: diagnosed with aiha, iga deficiency -->on high-dose steroids (can't taper anemia) - splenectomy - pe, portal vein thrombosis --> started warfarin - renal vein thrombosis, c.diff --> continued on steroids but also started danazol as a steroid-sparing - bone marrow biopsy negative for underlying malignant process, given his history of iga deficiency (likely in evolution to cvid) -->changed to lovenox 1mg/kg social history: -home: lives in with his paternal grandfather. his mother lives in and father lives in . has 3 brothers and 3 sisters who are all out of state. his hcp is his maternal aunt . -occupation: he is not currently working. -tobacco history: he quit smoking after he was hospitalized here. -etoh: very rare use. -illicit drugs: none. family history: no early cad or sudden cardiac death. immune deficiency on his mother's side. pt's maternal aunt has common variable immune deficiency complicated by burkitt's lymphoma previously treated. mother, maternal cousin also with immunodeficiency. great-grandmother with breast cancer, grandfather with skin cancer. physical exam: admission exam vs: t 98.3, hr 118, bp 154/101, rr 18, spo2 94% ra general: obese young man, no respiratory distress heent: moon facies with acne; perrl, pink conjunctivae, no xanthelasma, mmm without pallor or cyanosis neck: normal carotid upstrokes, no carotid bruits, no jugular; obese with buffalo hump venous distention, no goiter lungs: clear, normal effort (though some breaths are truncated due to chest discomfort) heart: s1 and s2, regular, tachycardic, pmi nondisplaced and no rv heave abd: soft, obese, ntnd, nabs, no organomegaly, normal aorta without bruit ext: no c/c/e, normal femoral and pedal pulses skin: no ulcers, no rash; has scattered pink/purple striae on thighs and abdomen neuro: alert, oriented x3, depressed mood and appropriate affect pertinent results: cta chest and ct abdomen/pelvis 1. bilateral subsegmental pulmonary embolism. no evidence of pulmonary infarct or right heart strain. 2. large right atrial filling defect concerning for near occlusive thrombus. recommend further evaluation with echo. 3. otherwise, stable exam with atrophic left kidney and stable severe hydronephrosis and hydroureter extending to the level of the mid ureter likely due to thrombus. previously noted main portal vein thrombus appears completely resolved. tee pre-bypass: no thrombus is seen in the left atrial appendage or left atrium. there is a large approximately 3 x 5 cm mass in the right atrium that originates on the free wall and partially obstructs right ventricular diastolic inflow. left ventricular wall thicknesses and cavity size are normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is low normal (lvef 50-55%). the right ventricle displays low normal free wall contractility. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion. trace aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no pericardial effusion. dr. was notified in person of the results prior to incision. post-bypass: overall biventricular systolic function is unchanged. the right atrial mass has been excised. mitral and aortic valve function are unchanged. there is some increase in the degree of tricuspid regurgitation and is now bordering on moderate. there is no evidence of aortic dissection in images obtained. brief hospital course: mr. is a 21 year old gentleman with aiha s/p splenectomy, iga deficency (likely transforming into cvid) with h/o portal vein thrombosis, left renal vein infarct, and pulmonary embolus (on enoxaparin, steroids and danazol), as well as steroid-induced dm2 who presented to the ed with left flank pain, chest pain, and shortness of breath in the setting of known left renal vein thrombus, new pe, and incidental finding of large intracardiac thrombus for which he was admitted to the ccu. on tee he was found to have very large mobile ra clot so he went to cardiac surgery. the patient was brought to the operating room on where the patient underwent excision of large right atrial thrombus. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. pod 1 found the patient extubated, alert and oriented and breathing comfortably. the patient was neurologically intact and hemodynamically stable, weaned from inotropic and vasopressor support. beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. the patient was transferred to the telemetry floor for further recovery. chest tubes and pacing wires were discontinued without complication. hematology continued to follow closely. he was initially anti-coagulated with heparin and transitioned to lovenox. he developed sternal drainage and was started on cefazolin in the setting of diabetes and chronic steroid therapy. blood cultures were sent and initially grew gram positive cocci. antibiotics were adjusted to vancomycin and the infectious disease service recommended continuing this medication until . he was evaluated by the physical therapy service for assistance with strength and mobility. by the time of discharge on post-operative day eleven the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. the patient was discharged to home in good condition with appropriate follow up instructions and iv antibiotics. medications on admission: the preadmission medication list is accurate and complete. 1. acyclovir 400 mg po q12h 2. danazol 200 mg po bid ] 3. enoxaparin sodium 120 mg sc q12h 4. glipizide 2.5 mg po daily 5. pantoprazole 40 mg po q24h 6. prednisone 25 mg po daily 7. sulfameth/trimethoprim ss 1 tab po daily 8. folic acid 5 mg po daily discharge medications: 1. acyclovir 400 mg po q12h ppx for hsv while on steroids 2. danazol 200 mg po bid ] 3. enoxaparin sodium 120 mg sc q12h 4. folic acid 5 mg po daily 5. glipizide 2.5 mg po daily 6. pantoprazole 40 mg po q24h 7. prednisone 25 mg po daily 8. sulfameth/trimethoprim ss 1 tab po daily 9. aspirin 81 mg po daily rx *aspirin 81 mg one tablet(s) by mouth daily disp #*30 tablet refills:*0 10. hydromorphone (dilaudid) 4-6 mg po q3h:prn pain rx *hydromorphone 2 mg tablet(s) by mouth every three hours disp #*40 tablet refills:*0 11. metoprolol succinate xl 200 mg po daily rx *metoprolol succinate 200 mg one tablet(s) by mouth daily disp #*30 tablet refills:*2 12. furosemide 40 mg po daily duration: 10 days rx *furosemide 40 mg one tablet(s) by mouth daily disp #*10 tablet refills:*2 13. vancomycin 1500 mg iv q 8h duration: 4 days end date: rx *vancomycin 750 mg two 750mg bags for total 1500mg q8 disp #*24 bag refills:*0 discharge disposition: home with service facility: vna assoc. of discharge diagnosis: right atrial mass pmh: -bilateral hearing loss -iga deficiency -coombs(+) autoimmune hemolytic anemia s/p splenectomy -pulmonary embolism -portal vein thrombosis -history of pneumonia past surgical history:s/p splenectomy discharge condition: alert and oriented x3 nonfocal ambulating, gait steady sternal pain managed with oral analgesics sternal incision - healing well, no erythema or drainage discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions please no lotions, cream, powder, or ointments to incisions each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart no driving for approximately one month and while taking narcotics, will be discussed at follow up with surgeon when you will be able to drive no lifting more than 10 pounds for 10 weeks please call with any questions or concerns **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge followup instructions: you are scheduled for the following appointments: wound check at cardiac surgery office , 10:00 surgeon dr. at 1:15p cardiologist dr. at 10:00a 7 cbc w diff, panel 7, t.bili, retic count, haptoglobin to be checked one week after discharge with results faxed to dr. at oncology ( and phoned to dr. of heme/onc( please call to schedule the following: primary care dr. , r. in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** md procedure: extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart excision or destruction of other lesion or tissue of heart, open approach central venous catheter placement with guidance diagnoses: adrenal cortical steroids causing adverse effects in therapeutic use asthma, unspecified type, unspecified personal history of tobacco use other acquired absence of organ unspecified hearing loss long-term (current) use of anticoagulants personal history of venous thrombosis and embolism diseases of tricuspid valve other pulmonary embolism and infarction autoimmune hemolytic anemias personal history of pulmonary embolism other ill-defined heart diseases selective iga immunodeficiency secondary diabetes mellitus without mention of complication, not stated as uncontrolled, or unspecified 

Answer: The patient is high likely exposed to