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: hydrochlorothiazide / ribavirin attending: chief complaint: arthralgias, failure to thrive major surgical or invasive procedure: arterial line placement rij cvl placement hd catheter placement patient expired. history of present illness: 51 yo m with hcv cirrhosis, copd, eosinophilic pneumonitis, eosinophilia, diffuse lymphadenopathy (? lymphoma), htn, spinal stenosis (wheelchair bound), dvt on warfarin with acute on chronic shoulder pain and arthralgias. he reports that he has had worsening r shoulder pain over the last few months and it reached a point that he "couldn't take it anymore". he reports that it feels "like he has a rotator problem" but notes that he has pain, numbness, swelling in the joints of his upper extremities (wrists, fingers). he has not had any fevers, chills, cough, chest pain, nausea, vomiting, diarrhea. per nursing home report, he c/o more severe shoulder pain, has been very "weepy", lethargic. in ed, triage vitals: 99.4 (rectal) 64 128/88 20 94% ra. given vancomycin and levofloxacin for possible pneumonia. also received iv hydromorphone (1.5mg total) for pain. past medical history: spinal stenosis - wheelchair bound eosinophilic pneumonitis - diagnosed in summer at hypereosinophilia diffuse lymphadenopathy, ? t-cell lymphoma copd lung nodules (2-3 mm) hcv hypertension chronic back pain mva with subsequent shoulder pain, chronic back pain arthritis grand mal seizures - described as "lightning in my shoulders", last seizure in , says controlled on keppra social history: lives at health care center. no other home to go to. sister is hcp. - current 1ppd x 43 yrs; quit for 2 months and restarted etoh - previous use, but denies current use illicits - denies family history: brother - cad s/p pci mother - dm2 daughter- asthma physical exam: physical exam on admission: 98.3 115/81 79 18 95% 2l 90% ra gen: quiet, interactive, uncomfortable eyes: nc/at, perrl, eomi without nystagmus, no scleral icterus noted ears/nose/mouth/throat: dry mm, no lesions noted in op neck: supple, no jvd or carotid bruits appreciated respiratory: lungs cta bilaterally without r/r/w cardiovascular: reg s1s2, no m/r/g noted gastrointestinal: soft, tender in ruq, luq skin: large hyperpigmented area over sacral spine, macular, erythematous rash over back, ? petechial rash on le bilaterally, left heel skin breakdown extremities: no c/c/e bilaterally. tender to palpation over r lateral shoulder, fingers slightly swollen bilaterally, tender over r over wrist neurologic: -mental status: alert, oriented x 3. able to relate history but somewhat tangential -cranial nerves: ii-xii intact -motor: normal bulk, 1/5 strength in le bilaterally (? limited by pain), 2/5 strength in ue psychiatric: very depressed/flat mood patient expired on discharge. pertinent results: 11:35pm wbc-15.8* rbc-4.45* hgb-15.3 hct-45.6 mcv-103* mch-34.5* mchc-33.6 rdw-16.0* 11:35pm neuts-24* bands-1 lymphs-20 monos-2 eos-48* basos-5* atyps-0 metas-0 myelos-0 11:35pm plt smr-low plt count-135* 11:35pm pt-38.7* ptt-43.5* inr(pt)-3.9* 11:35pm glucose-86 urea n-14 creat-0.6 sodium-140 potassium-4.0 chloride-107 total co2-26 anion gap-11 11:35pm alt(sgpt)-183* ast(sgot)-127* ck(cpk)-24* alk phos-78 tot bili-0.6 11:35pm albumin-3.1* calcium-9.4 phosphate-3.6 magnesium-1.9 11:35pm ammonia-65* 11:35pm lipase-18 cxr (personally reviewed): l atelectasis vs. infiltrate, interstitial opacities throughout pet scan: new moderate left pleural effusion. 2. fdg avid lymphadenopathy of the neck, axilla, mediastinum, hila, porta hepatis, iliac and inguinal regions as described above. 3. splenomegaly. ekg: sr@66, nml axis, no ischemic changes blood cultures: pending labs on discharge (death): 08:34pm blood wbc-23.7* rbc-3.08* hgb-11.2* hct-33.9* mcv-110* mch-36.4* mchc-33.1 rdw-16.5* plt ct-135* 03:00am blood neuts-52 bands-8* lymphs-5* monos-2 eos-31* baso-2 atyps-0 metas-0 myelos-0 03:00am blood hypochr-normal anisocy-occasional poiklo-2+ macrocy-1+ microcy-normal polychr-1+ burr-2+ 03:46pm blood pt-32.1* ptt-54.3* inr(pt)-3.2* 10:21am blood pt-70.0* ptt-57.5* inr(pt)-7.9* 03:46pm blood fibrino-243 03:46pm blood esr-21* 02:38am blood glucose-44* urean-37* creat-3.9* na-138 k-5.3* cl-100 hco3-10* angap-33* 03:46pm blood alt-258* ast-335* ld(ldh)-930* ck(cpk)-334* alkphos-100 totbili-5.1* dirbili-3.4* indbili-1.7 03:46pm blood ck-mb-6 ctropnt-0.13* 02:38am blood calcium-8.8 phos-6.4* mg-2.2 03:46pm blood d-dimer-* 03:46pm blood ferritn-1358* 03:46pm blood anca-pnd 03:46pm blood crp-127.9* 07:38pm blood igg-1414 iga-402* igm-67 03:46pm blood c3-82* c4-26 08:44pm blood vanco-15.7 02:48am blood type-art po2-110* pco2-32* ph-7.16* caltco2-12* base xs--16 11:41pm blood type-art po2-113* pco2-33* ph-7.24* caltco2-15* base xs--12 08:52pm blood type-art temp-38.3 tidal v-550 fio2-50 po2-68* pco2-34* ph-7.23* caltco2-15* base xs--12 intubat-intubated 02:48am blood lactate-11.8* 08:52pm blood lactate-9.5* 06:55pm blood lactate-9.7* 08:52pm blood o2 sat-92 06:55pm blood o2 sat-94 02:48am blood freeca-0.94* 11:41pm blood freeca-1.18 07:38pm blood strongyloides antibody,igg-pnd brief hospital course: primary reason for hospitalization: 51m with multiple medical problems including copd, spinal stenosis leading him to be wheelchair bound, eosinophilic pneumonitis, hcv, and diffuse lymphadenopathy and hypereosinophilia leading to concern for t cell lymphoma who p/w progressive arthralgias and transfered to the icu for multisystem organ failure. active diagnoses: #) hypotension: unclear etiology, but was worked up for infectious etiologies with negative blood & urine cultures. ct scan w/ pulmonary nodules and effusion, but no clear infiltrate. has no significant cardiac history to suggest cardiogenic shock or ischemia. adrenal insufficiency was possible, especially in the setting of severe stress from underlying proces whether rheumatologic or oncologic, but am cortisol normal. blood cultures were pending, and he was empirically covered w/ vancomycin and cefepime. he was provided with fluid boluses as was volume responsive and on the morning of his death was 5.5 l positive compared to the day prior. at the time of his death, he was supported by 4 pressors and still hypotensive to the 80s/40s. when pressors were ultimately withdrawn based on family decision to withdraw care, his blood pressure eventually fell to 60s/30s shortly before death. #) fevers: as high as 104 degrees w/ associated rigors since a day prior to icu transfer. ct torso without clear infectious source except for pleural effusion. on transfer, wbc high at 21.7 with 11% bands, eventually trending up to 36. he was put on vancomycin and cefepime. not currently covering for or anaerobes. given abdominal distention, there was a question of sbp, but no clear ascites. patient was also sent for blood cultures, lyme serologies, urine legionella. per id, ordered mycolytic blood cx, repeat strongyloides, and put on meropenem q8h. he was given tylenol (2g max daily), ibuprofen and motrin prn and cooling blanket to bring his temperature down. a source of infection/inflammation was not identified prior to his death. #) hypoxia: new over the past two days. unclear what precipitated the hypoxia; no clear infiltrate on ct, pleural effusion is not so impressive to account for sats on 5l. given question of immunosuppression wth possible underlying process pcp, , , be in differential as well. also has hx of copd, eosinophilic pneumonia. he underwent a bal that showed polys and no growth. has h/o dvt, coumadin has been held given coagulopathy, but lenis were negative for dvt. he was eventually intubated with psv, as he was not able to tolerate a/c. eventually, he was started on a paralytic to reduce autopeep to gain better control of his acid/base status. #) severe eosinophilia: trending down but still abnormally high and a chronic process. differential has included sezary syndrome, t cell lymphoma/leukemia, vasculitis, ige eosinophilia. derm consult was obtained and differential included perivascular granulomas, histiocytes/eos around blood vessels,? churg (want us to consult rheum, they will come by tomorrow), pseudo lymphoma keppra (ask neuro if substitute for keppra). per id recommendations, blood cultures were sent for mycolytic blood cx, repeat strongyloides. a cause of his eosinophilia was not identified prior to his death. #) metabolic acidosis: on the night of icu night 2, he developed worsening metabolic acidosis, non-gap to ph 7.2 and was given d5w, and abx was changed from cefepime to meropenem to provide greater coverage of any infectious causes. the next day, his ph 7.11, bicarb 10, lactate increased to 11. he was started on a paralytic in an effort to reduce autopeep. he was given bicarb, which mom increased his ph, which would then trend down again. at the time of his death, after numerous amps of bicarb, ph remained in the 7.1 range with lactate in the 10s. #) coagulopathy: inr continues to trend up despite holding coumadin. given low albumin as well, likely underlying synthetic problems secondary to liver dysfunction. underlying cause may be related to malignancy, eosinophilic process, or rheumatologic disease infiltrating liver. hcv less likely. he began oozing from his cvl site, inr was 3.7. bleeding was controlled with surgicel and 5mg po vitk. patient was planned for a mixing study for inhibitor and considered for vitamin k to address nutritional component if the coagulopathy progresses. his coagulopathy was noted to have worsened when he clotted off his crrt filter, yet persisted to ooze from line sites. #) acute kidney injury: progressive with rising creatinine from baseline of 0.6 on admission. likely hypovolemic and atn components. ua, renally dose medications, including antibiotics. he was started on crrt, but quickly clotted off his filter, indicating worsening coagulopathy. #) arthralgias: no marked synovitis and imaging has been relatively unremarkable. ck was not elevated on admission. likely due to cytokine storm and inflammatory mileau. esr flat, crp not significantly elevated. #) toxic/metabolic encephalopathy: oriented x2. mentating well consider level of hypotension. disorientation likely related to combination of fever, infectious process and troublesome meds. lactulose unless having bm per day. his home opiates as this could worsen encephalopathy. #) lle dvt: consider lenis to see if dvt still present and warranting anticoagulation. inr was trended, and warfarin was held. #) hcv with transaminitis/cirrhosis: hcv viral load moderate and unlikely to be primary motivator of ongoing eosinophilia (though could be driving transaminitis). ct abdomen. ct abdomen shows mediastinal, axillary, pelvic, and inguinal lymphadenopathy, all unchanged. new left lung pleural effusion. right lung base atelectasis. pulmonary nodules, unchanged from prior examination. #) spinal stenosis: reports lower extremity weakness stable. pain was controlled with home opiates. #) depression: very flattened affect currently though unclear if encephalopathy vs depression. social work was consulted. #) seizure disorder: he was initially continued on levetiracetam, but this was discontinued out of concern for keppra being the underlying cause of his dermatologic disorder. medications on admission: albuterol prn advair 250-50 1 puff spiriva 1 capsule daily cyclobenzaprine 5- 10 mg doxepin 10mg qhs hydromorphone 4mg q3 hours prn levetiracetam 500mg ms 60mg omeprazole 20 mg daily warfarin 3-3.5 mg daily asa 81mg daily colace 100mg ibuprofen 600mg q6 hours senna bisacodyl mylanta milk of magnesia discharge medications: patient expired. discharge disposition: expired discharge diagnosis: patient expired. discharge condition: patient expired. discharge instructions: patient expired. followup instructions: patient expired. md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube enteral infusion of concentrated nutritional substances arterial catheterization closed [endoscopic] biopsy of bronchus closed biopsy of skin and subcutaneous tissue central venous catheter placement with guidance central venous catheter placement with guidance diagnoses: acidosis other chronic pain acute kidney failure with lesion of tubular necrosis unspecified essential hypertension cirrhosis of liver without mention of alcohol chronic hepatitis c with hepatic coma unspecified septicemia severe sepsis depressive disorder, not elsewhere classified candidiasis of mouth acute respiratory failure long-term (current) use of anticoagulants epilepsy, unspecified, without mention of intractable epilepsy other diseases of lung, not elsewhere classified personal history of venous thrombosis and embolism other acute pain hypovolemia enlargement of lymph nodes spinal stenosis, unspecified region other and unspecified coagulation defects pulmonary eosinophilia adult failure to thrive pain in joint, multiple sites pyogenic granuloma of skin and subcutaneous tissue 

Answer: The patient is high likely exposed to