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: patient recorded as having no known allergies to drugs attending: chief complaint: aml,shortness of breath, hematuria major surgical or invasive procedure: whole brain radiation therapy placement of a picc line placement of a central venous line history of present illness: 78 year old woman who was in in her usual state of excellent health unti she was admitted to hospital with substernal chest pain, shortness of breath and upper mid back pain on . she was also noted to have gross hematuria. * her wbc was about 18 and rose to 28 over the following two days. on admission: fibrinogen was decreased on admission to 30 and she was maintained >100 with cyroprecipitate transfusions. her fibrin split products was >40. ptt normal at 29.8 and pt was elevated at 18.6. on peripheral smear she was noted to have early forms, including , myelos and myeloblasts. her ldh was 1,500. her creatinine rose from 1.1 to 2.5 during her admission (nephrotoxic drugs included vanco and ct contrast dye. uric acid was normal electrolytes were normal and w/o evidence of tumor lysis. on admission her plts were 87 and her hct=44. today () her hct=24, plts=55 and wbc=21. over her hospital course, she recieved plts x 7, ffp x 4 and cryo x 3 and one unit of prbc. * her temperature was 38.2 max at the osh. on cxr w/ increase vasc congestion and small left effusion and ill-defined desity at right lung base ? rlll infiltrate. she was treated with vancomycin and zosyn (both started ). blood cultures x 4 are negative to date by report. ucrine culture grew several mixed organisms. ct showed diverticulosis and precarinal lad w/ likely rul opacity c/w scar. also showed left adnexal cystic structure. * she was given vitamin k 20mg iv once for pt of 17.8, which responded by declining to 12.4 on . ptt was normal throughout her stay. haptoglobin-127 * total bilirubin elevated up to 2.3, but declined to 1.9 the following day () * bone marrow aspirate by dr. and on her review, she had increased luekemic blasts, without obvious auer rods. she did not note schistocytes. * on er presentation her bp was elevated to 204/92 and she complained of urine discoloration since starting nitrofurantoin for urinary frequency x 1 week. a bone marrow biopsy revealed acute myeloid leukemia best classified as monoblastic m5a (fab classification) with >90% cells in her bone marrow being blasts. . review of systems: no weight loss, fever or lymphadenopathy. no other bleeding other than hematuria. no nausea, vomitting. chest and back pain now resolved. no diarrhea. no shortness of breath past medical history: past medical history: 1) kidney stone 3 years ago 2) gerd 3) mibi/stress test -- reportedly unremarkable w/o reversible ischemic changes. 4) diverticulosis 5) ?tonsillectomy as a child social history: social history: no smoking. 1 cocktail every night. lives in with her sister who is 83. never married. family history: family history: + cad. no cancers or blood disorders. brief hospital course: aml m5a: she was admitted and started on a low dose ara c + hydrea protocol + gm-csf x 14 days for her aml. she had a slow decline in respiratory function in the setting of dic and initiation of chemotherapy, and was transferred to the icu for noninvasive ventilation and diuresis. this resolved and she was transferred back to the floor where her course was complicated by mucositis as she became neutropenic and her counts declined. her hct and platelets were supplemented as needed with transfusions to keep her hct > 25 and platelets > 10. the mucositis was treated with gelclear, viscous lidocaine and eventually liquid roxicet, and she was placed on tpn. she also suffered hearing loss, which was initially thought to be secondary to vancomycin. however, this was followed by delirium and mental status changes. benadryl, oxycodone, ativan and other psychoactive drugs were initially discontinued, but her mental status continued to vacillate. a head ct was negative, but a head mri ordered showed a possible infiltration in the right and left frontal lobes and left cerebellum as well as a small cva in the left frontal lobe. she had small vessel disease. radiation oncology was consulted and she was started on dexamethasone and a 10-course treatment of whole brain radiation. her mental status improved soon after the radiation was started. her counts began to return on and normalized, requiring no further transfusions. her last cbc showed wbc 13.6 (elevation thought to be due to steroids), hct 33.1 and platelets differential showed her mucositis resolved, and her tpn was weaned off and eventually d/c'ed. * respiratory distress: patient was admitted with respiratory distress that was likely multifactorial. the inciting processes likely include pulmonary edema (diastolic dysfunction, as echo with ef 60-70%, + mr) and pneumonia. after starting her chemo, her respiratory status further declined and she was transferred to the micu. there, she was treated for her pneumonia with vancomycin, flagyl and levofloxacin, placed on noninvasive ventilation to decrease her afterload and preload, and she was diuresed gently given her arf with lasix. she was initially tried on a ccb for afterload reduction, but was eventually switched over to atenolol 25 mg po qd. she was ruled out for an mi with cardiac enzymes x 5 with a baseline troponin of 0.05. on transfer to the floor, she finished her course of antibiotics. the vancomycin was d/c'ed early because of concerns that it was worsening her hearing. she was sat'ing 97-98%, but still fluid overloaded with le edema. due to her bad mucositis, she was placed on tpn and her medications were made iv. the increased fluid worsened her volume status and her respiratory status declined with sats at 93%. as her rf resolved, she was aggressively diuresed with 20 mg iv lasix qd. her respiratory status improved with sats at 99% ra with resolution of her le edema at time of discharge. her baseline weight at discharge was 134 lbs. over the course of her admission, she did have a picc line attempt on her left arm which resulted in an ue dvt. this was not treated as her platelets were <50 at the time. she then developed a second ue dvt due to a picc line in her right arm, which was also not treated due to low platelets. as her platelets improved, the decision was made not to treat her dvts given resolution of her erythema, tenderness and edema in her upper extremities and the risk of bleeding from her leukemic infiltrates. she had no evidence of pulmonary embolus secondary to these dvts during her admission. * renal failure: on admission, she was found to be in arf with a cr 2.6 after a contrast-enhanced ct at the osh. she had a low fena, no glomerular hematuria on sediment, just red cells and very rare muddy browns (3 total). etiology of arf was thought to initially be due to contrast-induced nephropathy. her cr eventually came down and stabilized at 0.9-1.0 which was reportedly her baseline. after aggressive diuresis for her chf, her cr increased back up to 1.2, but resolved with some fluids and the discontinuation of her diuretics. * dic: likely aml. she was given cyroprecipitate to increase her fibrinogen to 100 and ffp for procedures. her dic resolved after her treatment with arac and hydrea. . hepatitis with hyperbilirubinemia: her bilirubin was 2 on admission and trended up to a peak of 5.9. fractionation revealed roughly half direct and half indirect. a ruq u/s on was normal. her bilirubin began to elevate again and a follow-up ruq u/s showed sludge in gallbladder with no evidence of acute cholecystitis or gallstones seen or biliary ductal dilatation. she also developed a mild transaminitis at this point. her fluconazole was discontinued and her liver enzymes have continued to normalize. . coagulase negative staph line infection - she developed an infection of her picc line during her hospital course. as she had hearing loss with vancomycin previously, she was treated with daptomycin. the line was d/c'ed and she has finished a 10 day course of daptomycin since rebound of her anc to > 500, as recommended by id. surveillance cultures show ngtd. central line d/c'ed - tip culture showed ngtd at time of discharge. she has remained afebrile. . hypertension - currently on atenolol. her bp has normalized as her dexamethasone has been weaned. hctz d/c'ed today due to overdiuresis and normalized bp. . bowel and bladder incontinence - during her hospital course, she developed bowel and bladder incontinence. the initial concern was that patient may have leukemic infiltration in cauda equina as well. she stated that she could not tell when she needed to have a bm or to urinate. a foley was placed, and later d/c'ed as her strength recovered. at time of discharge, she was able to alert staff when she needed assistance to her bedside commode, with few accidents. she will need assistance to the commode. if she continues to have incontinence, a barrier cream should be applied to her perineal area to avoid infection. . nutrition - due to bad mucositis, she was placed on tpn during her admission. as her mucositis resolved, she was restarted on a regular diet. . dispo - patient will be discharged to rehab in , new . greater than 30 minutes was spent in the coordination of her care. medications on admission: medications at home: fosamax, mvi, zantac, asa daily, nitrofurantoin discharge medications: 1. albuterol sulfate 0.083 % solution sig: one (1) nebulizer treatment inhalation q6h (every 6 hours) as needed. 2. trazodone 50 mg tablet sig: 0.5 tablet po hs (at bedtime) as needed. 3. acyclovir 200 mg capsule sig: two (2) capsule po q12h (every 12 hours). 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 5. atenolol 25 mg tablet sig: one (1) tablet po daily (daily). 6. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) units injection tid (3 times a day): subcutaneous. 7. polyvinyl alcohol 1.4 % drops sig: 1-2 drops ophthalmic qid (4 times a day). 8. miconazole nitrate 2 % powder sig: one (1) appl topical qid (4 times a day). discharge disposition: extended care facility: st. healthcare center discharge diagnosis: acute myelogenous leukemia discharge condition: fair discharge instructions: 1. please take all medications as prescribed. 2. please keep your follow-up appointment with dr. () and dr. . please make a follow-up appointment with dr. () or dr. (whomever you prefer) within the next 2 weeks. 3. please seek medical attention if you develop fevers, chills, nausea, vomiting, shortness of breath, chest pain or any other concerning symptoms. followup instructions: a follow-up appointment has been made for you with dr. () on at 2 pm, and dr. () on at 2 pm. please also make a follow-up appointment with either dr. or dr. () within the next 2 weeks, whomever you prefer. dr. will give dr. and dr. will give dr. a call. . cc: procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances non-invasive mechanical ventilation other cystoscopy transfusion of packed cells transfusion of other serum injection or infusion of cancer chemotherapeutic substance transfusion of platelets other radiotherapeutic procedure transfusion of coagulation factors diagnoses: pneumonia, organism unspecified unspecified essential hypertension acute kidney failure, unspecified acute respiratory failure defibrination syndrome unspecified hearing loss other complications due to other vascular device, implant, and graft infection and inflammatory reaction due to other vascular device, implant, and graft acute diastolic heart failure other specified antibiotics causing adverse effects in therapeutic use cerebral artery occlusion, unspecified with cerebral infarction delirium due to conditions classified elsewhere hepatitis, unspecified diverticulosis of colon (without mention of hemorrhage) acute myeloid leukemia, without mention of having achieved remission 

Answer: The patient is high likely exposed to