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: ampicillin / levaquin / vicodin / rituximab attending: chief complaint: hypoxia major surgical or invasive procedure: noninvasive positive pressure ventilation history of present illness: mr. is a 79 yo gentleman with a history of esrd on hd, emphysema and interstitial lung disease on home 2lnc, untreated cll, rcc s/p nephrectomy, prostate cancer, bladder cancer who was sent to the ed from pcp's office for hypoxia. of note, he was most recently discharged from for hypoxia attributed to chf flare that improved with hd. . per pcp, patient complained of shortness of breath for days. no chest pain, nausea, or vomiting. did note dark stools recently and baseline chronic cough. office o2 sat 83% on 4lnc, other vitals bp 118/58, t 97.8. lungs with diffuse rhonchi and wheezes, mild llq pain to deep palpation but no rebound or guarding, and no pedal edema. he was last dialyzed yesterday per his usual schedule. sent to ed for evaluation, and recommended palliative care evaluation given multiple recent hospitalizations and difficulties at home. . ed eval notable for o2sat 79% on ra that improved to 84% on 4l. thought to be volume overloaded / chf based on cxr and given 40iv lasix with some urine output, nitro, started on bipap with improvement o2sat to 96%. labs with wbc 124k without left shift (most recent baseline ~100k), hct 30.2 (at baseline), lactate 1.0, ck 55, tnt 0.05. moderate respiratory distress on exam, guaiac negative. renal and onc notified, plans for hd tomorrow. admit icu. past medical history: # restrictive/interstitial lung disease on 2l nc at home # emphysema # esrd on hd, initiated , t/th/sat at hd # hypertension # hypothyroidism # cll - diagnosed , bl wbc 90s-100s in last 2 years - partially treated with rituximab, initiated after admission for chf # hypogammaglobulinemia - likely rituximab # rcc s/p r nephrectomy # bladder ca x 2 - s/p chemo # prostate cancer in situ - s/p xrt - s/p transurethral resection # recurrent diverticulitis # depression # irritable bowel syndrome # s/p ccy # s/p appendectomy social history: lives in , ma alone. divorced. 2 children. has girlfriend. retired buyer at staples office supply. occ etoh. quit smoking cigarettes 30 years ago, but smoked 2 pks/day x 15 years. smokes marijuana, no other illicit drugs. no ivdu. family history: mother d. 85yrs cva, father d. 75yrs encephalitis, brother d. 31yrs suicide, grandmother had breast cancer <50yrs physical exam: general appearance: well nourished, mild respiratory distress eyes / conjunctiva: perrl head, ears, nose, throat: normocephalic lymphatic: cervical wnl cardiovascular: normal s1, s2 2/6 systolic murmur, av graft on left arm respiratory / chest: crackles up to of bilatera lung fields, no wheezes, rhonchi abdominal: soft, non-tender, bowel sounds present extremities: right: trace, left: 1+, no(t) cyanosis, no(t) clubbing skin: warm, no(t) rash: neurologic: attentive, follows simple commands, responds to: not assessed, oriented (to): x3, movement: not assessed, tone: not assessed pertinent results: on admission: 02:35pm wbc-124.2* rbc-3.26* hgb-10.3* hct-30.2* mcv-93 mch-31.6 mchc-34.0 rdw-17.9* 02:35pm plt smr-normal plt count-152 02:35pm neuts-3* bands-0 lymphs-97* monos-0 eos-0 basos-0 atyps-0 metas-0 myelos-0 02:35pm glucose-96 urea n-17 creat-4.0* sodium-139 potassium-3.7 chloride-97 total co2-32 anion gap-14 02:35pm ck(cpk)-51 02:35pm ctropnt-0.05* 02:35pm ck-mb-notdone 02:41pm lactate-1.0 blood culture: pending sputum cultures: pending cxr : bilateral pulmonary edema has significantly progressed in the interval, currently being at least moderate accompanied by pleural effusions. cardiomediastinal silhouette is unchanged. there is no evidence of pneumothorax. the right internal jugular line tip terminates in the mid-svc. brief hospital course: 79 yo man with a history of esrd on hd, emphysema and interstitial lung disease on home 2lnc, untreated cll, rcc s/p nephrectomy, prostate cancer, bladder cancer who was sent to the ed from pcp's office for hypoxia and admitted to the icu. . # hypoxia: patient with fluid overload in physical exam and on cxr upon presentation in a very labile patient with copd, ild with posibly increased blood viscosity in the setting of leukocytosis. patient was admitted to the icu for close monitorina and nippv support. patient was ruled out for mi with serial ecgs and negative cardiac enzymes. of note, patient had normal echocardiogram 4 months ago without evidence of diastolic dysfunction. patient did not meet criteria for hf. there were no focal signs or symptoms to suggest infection and cxr did not show consolidation, but showed pulmonary edema without any cardiomegaly. bnp was not available on presentation. patient had blood and sputum cultures, which have been negative so far. non-invasive positive pressure support was performed with bipap and attempt of fluid removal with lasix was done. patient did not tolerated bipap, because he was feeling uncomfortable. renal was consulted and patient underwent hd with 3 l of fluid removed the day after admission. extra uf session was performed during hospitalization with 3 l removed. albuterol, fluticasone and ipratropium therapies were continued. target spo2 was 88-92 sp02%. within 30 hours patient was breathing comfortably on 4 l nc and was transfered to the medicine floor. patient was discharged home on 3 l nc. . # dark stools: h/o diverticulosis but guaiac neg in ed and hct at baseline. be due to iron supplementation. active t&s. daily hct. epo supplementation at hd. . # anemia: guaiac negative stools and cbc compatible with renal failure. will continue epo at hd with target hgb . . # esrd on hd: hd t,th,sat , followed by dr. . received 2 hd sessions and one extra uf while inpatient. . # hypertension: well controlled, continued amlodipine. . # cll: diagnosed . wbc slightly above most recent baseline on admission. s/p incomplete treatment with rituximab. contact outpatient oncologist, dr. via email to notify of inpatient/icu stay and she will follow as outpatient for possible treatment of cll. . # hypogammaglobulinemia: igg of 298 (normal= ) on last check . ? whether due to recent rituximab therapy. does place pt at risk for infection. reluctant to use ivig in past given concerns for chf. received flu shot prior to admission. monitored closely for evidence of infection. contact heme-onc to consider trial ivig while inpatient, but it was decided that benefit would be minimal and would be large volume load. . # hypothyroidism: continued levothyroxine. last tsh 2.8. . # depression: distressed by declining health and social problems at home. sw consult placed. continued home citalopram. . # rcc: s/p r nephrectomy . . # bladder ca x 2: s/p chemo . . # prostate cancer in situ: s/p xrt and transurethral resection 5/. continued home terazosin. . # ibs: continued dicyclomine, fiber supplements. . # fen: low na diet. # ppx: heparin sc. ppi. bowel regimen # access: tunneled rij hd line. piv. # code: dnr/dni, palliative care consult # comm: (daughter) hcp. medications on admission: 1. allopurinol 100 mg tablet sig: one (1) tablet po daily. 2. b complex-vitamin c-folic acid 1 mg po daily. 3. amlodipine 5 mg po daily. 4. dicyclomine 10 mg po qid. 5. terazosin 10 mg po hs. 6. ferrous sulfate 325 mg po daily. 7. levothyroxine 88 mcg po daily. 8. citalopram 40 mg po daily. 9. omeprazole 20 mg po daily. 10. albuterol 2 puffs inhalation q6hours:prn. 11. budesonide 180 mcg/inhalation aerosol 2 inhalation twice a day. 12. epoetin alfa injection 13. ergocalciferol (vitamin d2) oral discharge medications: 1. multivitamin tablet sig: one (1) tablet po daily (daily). 2. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 3. dicyclomine 10 mg capsule sig: one (1) capsule po qid (4 times a day). 4. terazosin 5 mg capsule sig: two (2) capsule po hs (at bedtime). 5. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po daily (daily). 6. levothyroxine 88 mcg tablet sig: one (1) tablet po daily (daily). 7. citalopram 20 mg tablet sig: two (2) tablet po daily (daily). 8. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 9. allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). 10. albuterol 90 mcg/actuation aerosol sig: two (2) inhalation every six (6) hours as needed for shortness of breath or wheezing. 11. ergocalciferol (vitamin d2) 400 unit tablet sig: three (3) tablet po once a day. 12. budesonide 180 mcg/inhalation aerosol powdr breath activated sig: two (2) inhalation twice a day. 13. miconazole nitrate 2 % cream sig: one (1) appl topical (2 times a day). disp:*1 tube* refills:*0* 14. vitamin b comp & c no.4 150 mg tablet sig: one (1) tablet po once a day. discharge disposition: home with service facility: vna discharge diagnosis: primary diagnossi: fluid overload with copd and ild exacerbation. . secondary diagnsis: interstitial lund disease chronic obstructive pulmonary disease (emphysema) end-stage renal disease on hemodialysis tts hypertension hypothyroidism depression irritable bowel syndrome discharge condition: stable, breathing comfortably on 2 l o2 nc, tolerating diet. discharge instructions: you were seen at for shortness of breath and were found to have very low oxygen level in your blood. you had a chest x-ray that showed some fluid in your lungs. you were put in bipap and diuresed with some lasix with mild improvement. you had hemodialysis, where they were able to remove some fluid and you improved. we spoke with the renal doctors and they try to remove more fluid in every session. . the icu doctors thought that may benefit of obstructive sleep apnea treatment, but you are not comfortable with the mask. if you think you would like to give it a try, please discuss this with dr. next week. . if you have worsening of your shortness of breath, increased oxygen requirements, fever, chills, rigors, gain more than pounds from your baseline weight, please call your pcp . . all your medications were left unchanged, but you were started on: miconazole nitrate 2 % cream for your skin lession in your leg. followup instructions: please follow up with your pcp 1-2 weeks after discharge. you can make appointment at: , m. . provider: . phone: date/time: 10:00 provider: ,interpret w/lab no check-in intepretation billing date/time: 10:00 provider: function lab phone: date/time: 9:40 md, procedure: hemodialysis diagnoses: anemia in chronic kidney disease end stage renal disease renal dialysis status congestive heart failure, unspecified unspecified acquired hypothyroidism personal history of malignant neoplasm of prostate acute on chronic diastolic heart failure depressive disorder, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease postinflammatory pulmonary fibrosis other emphysema personal history of malignant neoplasm of bladder hypoxemia kidney dialysis as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure personal history of malignant neoplasm of kidney personal history of antineoplastic chemotherapy personal history of irradiation, presenting hazards to health chronic lymphoid leukemia, without mention of having achieved remission irritable bowel syndrome hypogammaglobulinemia, unspecified 

Answer: The patient is high likely exposed to