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: penicillins attending: chief complaint: fever major surgical or invasive procedure: port-a-cath placement history of present illness: 79 y.o. male patient of dr. with a h/o cll/aml diagnosed in and treated w/palliative allopurinol and hydroxyurea w/ transfusion dependent pancytopenia (wbcc 3.4, 0 neutrophils on differential) who presents with a fever to 100.5. for the past several days the patient has been feeling weak, w/ appetite. he was seen in oncology clinic one day prior to admission and received transfusion of one unit of platelets and one unit of prbc. yesterday evening the pt noted that he had a temperature to 100.5 at which point he contact the on call oncologist who told him to go to the ed. states he has not had prior f/c/n/v/abd pain/changes in bowel or bladder habits. no new rashes. states he has had dry non-productive cough. in the ed, his bp was 92/39. he was given cefepime and 1l ns with subsequent bp 78/32, hr 60, 96% 2l. after 2l ns bolus 89/33, hr 59 t98.4. started on must protocol. rij placed, blood (after abx?)and urine cultures obtained. received total of 4l ns. he was transferred to the . a cxr revealed a new rul infiltrate, and he was treated with vancomycin and cefipime, and blood and urine cultures were done. he was stabilized for 1 day and was transferred to the bmt floor. . currently he is without complaints of pain, shortness of breath, fevers, chills, nausea, diarrhea, urinary problems, cough, mouth sores, or other problems. his last bowel movement was two days ago. past medical history: cml/all dx , palliative care, last peripheral flow showed aml mixed with some cll, consistent with bm biopsy on . hypertension basal cell carcinoma hand cellulitis hx gbs and citerobacter bacteremia - recently finished 2 week course of levofloxacin for citerobacter social history: lives w/ supportive wife; previously worked as a mechanical engineer denies etoh, tobacco use. family history: n/c physical exam: v: t 98.3, bp 102/31 (55), p 56, r26, 98% 6l nc, cvo2 77%, cvp 13 gen: well appearing, pale elderly gentleman, in nad. heent: perrl. pale sclera. mmm. 7 cm jvp. cv: regular s1, s2. no m/r/g. resp: decreased breath sounds at right base, otherwise clear abd: +bs. soft. nt. nd. ext: multiple red petechial lesions on legs; trace edema. neuro: alert and oriented x 3, cn 2-12 intact, strenth ue/le pertinent results: 03:00a 129 99 21 / ------------- 120 4.2 22 0.9 \ ca: 7.3 mg: 1.9 p: 2.6 alt: 16 ap: 46 tbili: 0.8 alb: ast: 10 ldh: 83 dbili: tprot: : 50 lip: 17 other blood chemistry: hapto: 212 cortsol: 19.8 crp: 12.80 82 4.7 \ 9.0 / 22 / 24.8\ n:0 band:0 l:52 m:0 e:0 bas:0 atyps: 2 blasts: 46 lactate:1.0 cxr: rul infiltrate echo : conclusions: the left atrium is mildly dilated. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are mildly thickened. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. compared with the report of the prior study (tape unavailable for review) of , tricuspid regurgitation is now more prominent and estimated pulmonary artery systolic pressure is now higher. cxr : impression: resolution of left lower lobe consolidation. partial resolution of right lower lobe consolidation. persistent small bilateral pleural effusions. possible focal ill-defined density in the right apical region. cxr findings: cardiac and mediastinal contours are unchanged. the lung volumes remain low. compared to the prior study, the region of consolidation in the right mid-lung zone, which appears to cross both the major and minor fissures, appears more confluent. there are also bibasilar regions of consolidation, particularly on the left, with small bilateral pleural effusions. there is no pneumothorax. the prominence of the pulmonary vessels in the upper zones is less pronounced on this study. impression: persistent multilobar pneumonic consolidations, with a more confluent and intense appearance in the right mid-lung zone. brief hospital course: 1) pneumonia - the patient was hypotensive and febrile at admission and therefore admitted to the icu and put on the must protocol but was never placed on pressors. although no initial response. he soon had a stable blood pressure s/p 4l ns. he had no evidence of end organ hypoperfusion with a normal creatinine, cv02, and normal cvp. he had a rml infiltrate and basal infiltrates consistent with bacterial pneumonia. blood cultures were positive once for lactobacillus and sputum gram stain showed 4+ gram negative rods, but no clear pathogen was identified. he was put on vancomycin and cefepime, then agents were added and subtracted over time to a maximal coverage of vancomycin, cepepime, voriconazole for empiric fungal coverage and flagyl for empiric anaerobe coverage. he continued to have temperatures over 100.4 degrees and was functionally neutropenic, but stopped being febrile on . his coverage was gradually reduced to levofloxacin alone and he was afebrile during the remainder of the hospital course. a cxr showed interval resolution in the pneumonia on . he was discharged on levofloxacin x 14 days. 2) cll/aml/heme - the patient's peripheral blood had a mixed appearance consistent with approximately half cll and half aml blasts. his overall wbc stayed under 4 during admission despite holding his hydrea and allopurinol. he was neutropenic during admission. he was known to be transfusion dependent and required approximately 6 blood transfusions during admission and was maintained on epogen. he required approximately 10 units of platelets to keep his platelets above 20-30. 3) petechial rash/le edema - the patient had very low platelet counts and was maintained above platalet count of 10. however, he developed a petechial rash over his lower extermities, on the anterior aspects of his tibias. this was thought to be due to thrombocytopenia in the setting of severe edema. the edema was thought secondary to low albumin of 2.1 as his echo was normal. his tranfusion threshold was increased to 20-30 and he was given some lasix to help diurese the extra fluid, which helped somewhat but increased his creatinine slightly so was discontinued at discharge. he was given aquaphor ointment for his legs to prevent dryness and bleeding. 4) siadh - the patient had a sodium level of 129 at admission and a low of 126. this did not respond to fluids and the patient was euvolemic with a decreased uric acid level, so he likely has siadh of unclear etiology. he was fluid restricted and given some lasix with improvement in his sodium level to 135 at discharge. 5) the patient was dnr/dni during admission per previous outpatient status. medications on admission: hydroxyurea 500mg po qd allopurinol 300mg po qd aranesp qwk mvi discharge medications: 1. danazol 200 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 2. levofloxacin 250 mg tablet sig: one (1) tablet po q24h (every 24 hours). disp:*14 tablet(s)* refills:*0* 3. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed: for pain from line site. 4. aranesp injection 5. multivitamin tablet sig: one (1) tablet po once a day. 6. aquaphor ointment sig: to dry legs topical twice a day. disp:*3 tubes* refills:*10* discharge disposition: home with service facility: homecare discharge diagnosis: community acquired pneumonia chronic lymphocytic leukemia acute myelogenous leukemia syndrome of inappropriate antidiuretic hormone secretion thrombocytopenia anemia petechial/purpuric rash on legs discharge condition: the patient was ambulating and could walk up 4 stairs, was eating, drinking, afebrile and felt ready to go home after port-a-cath placement discharge instructions: please follow up as indicated below. please maintain your previous neutropenic diet (cooked foods only) and try to minimize contact with anyone who is ill. if you have fevers, chills, bleeding, shortness of breath, or other concerns, please return to the ed or call dr. . followup instructions: dr. - ( on monday at 12:30 pm. you will get your potassium checked, cbc checked, and get transfusions if necessary. further follow up will be scheduled at that time. provider: , md where: hematology/bmt phone: date/time: 12:30 procedure: venous catheterization, not elsewhere classified transfusion of packed cells insertion of totally implantable vascular access device [vad] transfusion of platelets diagnoses: pneumonia due to other gram-negative bacteria unspecified essential hypertension personal history of other malignant neoplasm of skin other disorders of neurohypophysis chronic lymphoid leukemia, without mention of having achieved remission acute myeloid leukemia, without mention of having achieved remission 

Answer: The patient is high likely exposed to