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: compazine attending: chief complaint: altered mental status major surgical or invasive procedure: intubation/extubation history of present illness: hpi: this is a 53 year-old gentleman with hcv cirrhosis and refractory lymphoblastic lymphoma/all on rituximab and prednisone who presents with altered mental status. his mother found him this morning with increased lethargy and complaining of diffuse back pain. the back pain was unchanged from his usual back pain, secondary to his all, and was not relieved by morphine or methadone. he was recently admitted to the bmt service from until for fevers and progressive all. infectious work-up was unremarkable and his fevers were atrributed to a reaction to platelet transfusion. of note, he had another admission earlier in at which point he developed a strep viridans line infection (from picc line)-- the picc line was removed, he was treated with a course of pcn g which was changed to augmentin at his last admission with the last dose due either yesterday or today. after finding him this morning, his mother brought him back to 7 today for readmission and an ambulance was called from there to bring him to the ed. . in the ed, initial vitals were t 98.3, bp 122/83, hr 100, rr 12, 100% on 4l. he was sleepy but a+o x3. pt was noted to be very uncomfortable, complaining of back pain. while in the ed, he became more delirious, writhing around in bed, refusing pain medications, and perseverating on wanting to get out of bed to urinate. pt was intubated for ct head and abdomen. spiked temp to 101.8 rectally but remained hemodynamically stable. he was given ceftriaxone, vanco, and acyclovir for empiric meningitis coverage. lp was deferred given platelet count of 14. ct head was negative and ct abdomen was notable for slightly worsened ascites, new bibasilar opacities. attempts to place ogt and foley were unsuccessful and patient was noted to only have 40cc of uop while in the ed. . ros: unable to obtain. past medical history: <b>hematologic/oncologic history:</b> mr. was diagnosed with lymphoblastic lymphoma in . he presented to on with complaints of diffuse myalgias and arthralgias. a ct scan demonstrated multiple enlarged portahepatis lymph nodes (largest 1.5 x 2.7 cm)and portacaval lymph nodes (largest 1.9 cm x 3.4 ) as well as multiple mildly enlarged paraaortic lymph nodes, the largest measuring 1.2 x 1.9cm. on , he underwent a ct-guided fine-needle aspiration of a portahepatis lymph node which was nondiagnostic. a bone marrow biopsy was obtained on , demonstrating involvement by high-grade b-cell lymphoproliferative disorder. tumor cells were diffusely positive for pan b cell markers cd20 and pax-5, with co-expression of cd10 and bcl-2. tdt staining was equivocal, with predominantly cytoplasmic staining and a rare cell with dim nuclear staining. mib-1 staining showed an overall proliferation index of 50-60%, with focal areas with a higher fraction. the differential diagnosis was felt to include lymphoblastic lymphoma/leukemia (precursor b-cell lymphoma/leukemia) or a blastic transformation/progression of a mature b cell lymphoma. it was noted that a definitive diagnosis would require flow cytometry and molecular studies, which could not be performed because there were no blasts in the peripheral blood and a marrow aspirate could not be obtained (dry tap). however, the peripheral blood sample was sent for immunophenotyping, which demonstrated a new population of cd34 positive cells and a small population of cd19 positive cells in the "blast" gait, without expression of tdt. it was felt that these findings should be interpreted with caution since no blasts were identified on a corresponding peripheral smear. given his significant liver dysfunction and other medical co-morbidities, the initial treatment regimen chosen for the patient consisted of r-chop, which was initiated on . he received a second cycle of chemotherapy on , consisting of r-chop without vincristine, which was held secondary to neuropathy. modified hyper-cvad course a was given on , with a second course given on and a third course on . course b was not given due to his history of hepatic cirrhosis. of note, the patient has known retinal involvement by his lymphoma, for which he is followed by dr. of ophthalmology. a liver biopsy on and repeat bone marrow biopsies on and have shown no evidence of recurrent lymphoma. the patient presented on with myalgias, headache, mental status changes, and fevers. a cbc showed a wbc of 7.2 with 14% blasts. a bone marrow biopsy demonstrated marked fibrosis and relapsed acute lymphoblastic leukemia/lymphoma. he was treated with rituximab 500mg, given in three doses of 100mg, 200 mg, and 200mg on - . in addition, he was treated with rituximab 375mg/m2, cyclophosphamide 750mg/m2, doxorubicin 20mg/m2, and dexamethasone 20mg from - . the patient was noted to have recurrence of peripheral blasts on , with a bone marrow biopsy on showing residual leukemia in the marrow. after extensive discussion, he opted to continue palliative chemotherapy with rituximab and prednisone. rituximab was started on at 100mg, with plans to continue threrapy with 200mg daily on and . <br> <b>additional medical history:</b> 1. hepatitis c, not treated. 2. hepatic cirrhosis. 3. history of intravenous drug use. 4. history of depression. 5. chronic lower back pain. 6. status post tonsillectomy and adenoidectomy. 7. lipomectomy. 8. steroid-induced diabetes mellitus social history: the patient is currently living with his mother and his brother, . has two children and four grandchildren. he is a recovering heroin addict who used iv drugs for over 30 years before becoming clean, but he admits that he intermittently uses illegal drugs, most recently in early (cocaine) and did heroin ~5 years ago. he currently smoke cigarretes/day and has history of ~20 pack-year. he denies alcohol use. he formerly worked in housing construction as roof constructor. family history: the patient's father died of lung cancer at 78. his maternal grandmother died of colon cancer 78. his sister died of leukemia. he has 2 brothers and 2 sisters who are healthy as well as 2 children. he is separated physical exam: vitals: t: 101.1 bp: 87/50 hr: 71 rr: 23 o2sat: 100% vent settings: ac 600/14 peep 5 fio2 100% gen: intubated heent: perrl (4-->2mm), sclera anicteric, no epistaxis or rhinorrhea, mmm, et tube in place neck: no jvd, no cervical lymphadenopathy, trachea midline cor: rrr, no m/g/r, normal s1 s2, radial pulses +2 pulm: lungs ctab, diminished breath sounds at the left anteriorly, no w/r/r abd: distended, +bs, difficult to assess hsm, +fluid wave ext: no c/c/e, no palpable cords neuro: opens eyes to voice, does not consistently follow commands. moves all 4 extremities spontaneously. plantar reflex downgoing. skin: scattered ecchymoses on lue (by picc line) and abdomen. no jaundice, cyanosis, or gross dermatitis. no ecchymoses. pertinent results: 08:25am hypochrom-normal anisocyt-1+ poikilocy-1+ macrocyt-occasional microcyt-1+ polychrom-occasional ovalocyt-occasional schistocy-occasional stippled-occasional teardrop-1+ 08:25am neuts-25* bands-1 lymphs-21 monos-3 eos-1 basos-0 atyps-0 metas-0 myelos-1* nuc rbcs-15* other-48* 08:25am glucose-211* urea n-26* creat-0.6 sodium-140 potassium-5.1 chloride-106 total co2-24 anion gap-15 08:00pm urine blood-neg nitrite-neg protein-tr glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.0 leuk-neg 09:00pm glucose-133* lactate-2.3* na+-137 k+-5.1 cl--115* 09:00pm type-art peep-5 o2-60 po2-92 pco2-31* ph-7.43 total co2-21 base xs--2 intubated-intubated dic labs + tbili: 5.1 alb: ldh: dbili: 0.8 fibrinogen: 463 plt: 24 cxr (s/p intubation): although on the frontal view, the electronic measurement of the distance from the et tube tip to the carina is less than 6 cm, the tip is above the upper margin of the clavicles, and it is probably 3 cm above optimal placement, with the discrepancy explained by marked patient kyphosis. aside from mild plate-like atelectasis at the base of the left base, lungs are clear. there is no pleural effusion. heart size is normal. . ct abd/pelvis: slightly worsened ascites. no change in splenomegaly, cholelithiasis, portal lymphadenopathy. bibasal opacities new since , could be due to atelectasis, pneumonia, aspiration. . ct head: no evidence of acute intracranial abnormalities. mr with gadolinium would be more sensitive for intracranial infections or masses. . kub: non-specific bowel gas pattern without free intraperitoneal air. . cxr pa and lat: interpretation is limited by patient rotation and kyphotic angulation. however, there is no evidence of pleural effusion or focal consolidation. allowing for change in positioning, the study is overall not significantly changed since . there is a focus of linear atelectasis at the left lung base. wedge compression deformities of two low thoracic vertebral bodies are unchanged. brief hospital course: patient was a 53 year-old male with a history of relapsing refractory all on prednisone and rituximab and hcv cirrhosis who presents with fever, altered mental status, and hypotension. patient was hypotensive, started on pressors, given ivf, worsened in the setting of adrenal insuffiency, and synthetic hepatic dysfunction. patient was intubated. once infectious etiology was eliminated, patient's dim prognosis was discussed with family and a determination was made to make the patient cmo. patient was extubated and started on morphine drip. patient, due to high drug tolerance, continued to have pain and was responsive on morphine drip. patient was transferred from the to bmt floor for cmo continuation. patient continued to show signs of discomfort and sedatation was switched to dilaudid and ativan drip. patient expired at 7:20 pm on secondary to respiratory failure from relapsing refractory all in the presence of the family. the proxy, , the patient's son, consented to a full autopsy. medications on admission: amoxicillin-pot clavulanate 500-125 mg po q8h lantus 50u daily humalog iss gabapentin 300 mg po hs lactulose 30 ml po qid lorazepam 0.5 mg tablet po q4h filgrastim 480 mcg/1.6 ml q24h acyclovir 800 mg po q8h methadone 30mg po qam , 20mg po noon , 30mg po qpm mirtazapine 30 mg po hs morphine 15 mg po q4h prn nystatin suspension 5 ml po qid prn omeprazole 20 mg po daily prednisone 20 mg po daily spironolactone 100 mg po daily allopurinol 300 mg po daily furosemide 40 mg po daily acetaminophen 650 mg po q4h prn discharge medications: expired --- none discharge disposition: expired discharge diagnosis: lymphoblastic lymphoma / all hcv cirrhosis discharge condition: expired discharge instructions: none followup instructions: none procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube diagnoses: hyperpotassemia cirrhosis of liver without mention of alcohol unspecified septicemia severe sepsis acute respiratory failure long-term (current) use of insulin septic shock other ascites glucocorticoid deficiency lumbago delirium due to conditions classified elsewhere other specified retention of urine unspecified drug or medicinal substance causing adverse effects in therapeutic use secondary diabetes mellitus without mention of complication, not stated as uncontrolled, or unspecified lymphosarcoma, lymph nodes of multiple sites 

Answer: The patient is high likely exposed to