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: gluten / betalactams / vancomycin hcl attending: chief complaint: 54 year-old male with an enteropathy associated t-cell lymphoma, status post hyper cvad therapy and 5 cycles of chop, and recently ice chemotherapy and collection, being admitted for auto-bmt. major surgical or invasive procedure: esophagogastroduodenoscopy () history of present illness: 54 year-old male with an enteropathy associated t-cell lymphoma diagnosed in , with known gastric and jejunal ulcers and history of small bowel resection for microperforation, admitted for auto-bmt on . he was previously treated with hyper-cvad (did not tolerate) and 5 cycles of chop. his course was complicated by a bout of hepatitis in which was felt to be chemical in etiology and led to weight loss, sprue exacerbation and relapse. following his bout of hepatitis, mr. was started back on tpn and has been doing well on it. he was recently teated with a cycle of ice chemotherapy and collected in preparation for auto-bmt. his bone marrow performed at the beginning of revealed some minimal involvement with his t-cell lymphoma. his liver biopsy performed on revealed numerous apoptotic hepatocytes, multiple small foci of sinusoidal mononuclear inflammation and enlarged kupffer cells consistent with acute hepatitis. no neoplastic cells. tissue egd performed on showed some involvement by enteropathy associated t-cell lymphoma in one biopsy section. past medical history: 1. sprue: diagnosis , which was refractory to gluten-free diet at which point prednisone therapy was initiated. further investigation led to biopsy of small bowel and the diagnosis of t cell lymphoma was made. 2. t cell lymphoma: as per hpi. 3. transaminitis: from (peak ast 198, alt 247, alk phos 1062, negative hav, hbv, hcv, hiv, cmv, toxo, vzv, hsv1, hsv2). thought to be secondary to chemo and/or tpn. liver bx revealed non-specific inflammation consistent with acute hepatitis. social history: mr. lives with his wife, a nurse. 1 pack of cigarettes per day, denies alcohol or illicit drug use. family history: mother with breast cancer. his father died of an unknown cardiac event at the age 34. mother, sister and grandmother have diabetes mellitus. physical exam: on admission: temperature 97.9, hr 80, rr 20, bp 86-98/50-64. general: cachectic man in nad. heent: perrla. clear oropharynx. neck: jvp not elevated. cvs: rrr. normal s1, s2. no murmur, rub or gallop. resp: cta bilaterally. abd: soft and non-tender. no hepatosplenomegaly. ext: no cyanosis, clubbing or edema. 1+ dorsalis pedis pulses bilaterally, 2+ peripheral pulses otherwise. neuro: cn ii-xii intact. strenght . reflexes 2+ throughout. sensation intact. pertinent results: pertinent laboratory results on admssion include wbc-9.3 (differential neuts-87, bands-0, lymphs-6*, monos-6, eos-0, basos-0, atyps-0, metas-0, myelos-1*), hgb-11.1, hct-33.7, plt count-521. chemistry reveals glucose-104 urea n-14 creat-0.4* sodium-140 potassium-4.6 chloride-107 total co2-23. mildly elevated alkaline phosphatase on admission at 124, transaminases within normal limits (alt-9, ast-15, tot bili-0.1). normal coagulation profile. urinalysis negative cmv igg and igm negative brief hospital course: his hospital course will be reviewed by problems: 1) enteropathy-associated t-cell lymphoma: he received ara-c and etoposide (day -6 to -3) and melphalan (day -2) as part of the beam protocol, followed by a rest day. reinfusion was done on , which was well tolerated. his period of neutropenia extended from to , at which time his anc was back up to 2230. he had evidence of only mild oropharyngeal mucositis which was treated with peridex and nystatin. on , mr. had an acute transfusion reaction to platelets, with hypotension, diffuse dermal edema and periorbital edema, currently under investigation. he received solumedrol iv and pepcid iv with symptomatic relief. premedication changed to hydrocortisone 100 mg iv, benadryl 50 mg iv, pecid 20 mg iv, tylenol 500-650 mg po. 2) id: mr had an isolated temperature spike on (day -3), at which time he was started on vancomycin and levoquin (latter to be started as part of the protocol on ). he quickly defervesced, but developed a diffuse maculopapular rash on , at which time vanco was d/c'd as it was felt to be a possible culprit. cultures from that time were negative. he became febrile again on , at which time vanco and cefepime were started, and levoquin was discontinued. he remained persistently febrile and an antifungal was added, along with flagyl for a history of diarrhea (eventually c. difficile negative). his rash persisted, and decision was taken to d/c cefepime (query contribution to persistent rash) and start aztreonam. given worsening of the rash with periorbital edema and query contribution to the fever, along with possibility of drug fever, all antibiotics were stopped on and he received 1 dose of solumedrol. he defervesced for 24 hours, then his temperature rose again. he was restarted on flagyl and levo on . ambisome was added on secondary to a finding of pulmonary nodules on ct scan, however pulmonary did not feel these were significant, and ambisome was d/c'ed on since the patient was not neutopenic. his temperature reached a peak to 104.6 on . ct chest on revealed multiple small non-specific nodules, felt by pulmonary to be non-significant. ct abdomen and pelvis negative on . aztreonam was added to the regimen on . id was consulted, and antibiotics were changed to meropenem and flagyl, and continue acyclovir. daptomycin was added on given persistent fever and desire to broaden gram positive coverage (vancomycin was felt to be a potential culprit in the rash). all cultures negative thus far except for a single bottle positive for corynebacterium on felt to be a contaminant. an mri of the liver done on was negative for hepatic candidiasis. stool cultures were negative. repeat cmv negative. he defervesced on the above regimen. his last temperature spike was on . on meropenem and flagyl were discontinued, with no further fever spikes. he will be discharged on acyclovir, and nystatin swish and swallow. 3) gi: on , mr. had a hct drop from 27 to 21 with frankly guaiac positive stools. the source was felt most likely to be upper gi. he was seen by gi, who was reluctant to perform a scope given the patient's low platelets and leukopenia, although anc > 500. decision was taken to treat conservatively, with blood product support. on , his hct dropped again from 29 to 21.8 with persistent melanotic stools and he was transferred to the icu. an egd was performed on , which revealed ulceration in d3 consistent with an area of ulcerative duodenitis without active bleeding. the egd was otherwise normal to d2. pill endoscopy was considered but cancelled given a prior history of small bowel stricture. the bleeding was also not significant enought for a tagged rbc scan. he received a total of 6 units prbcs in the icu, and 4 units of platelets. he was transferred back to the floor on . his hct has remained stable since transfer, without further melena. protonix iv changed to po bid on , which he will be discharged on. 4) rash: history as above in id section. he developed a diffuse maculopapular rash on , which changed to a diffuse blanching erythematous rash on and persisted. he also developped some periorbital edema on and received a dose of solumedrol. dermatology was consulted, with an impression of erythroderma. levoquin, cefepime and vancomycin considered potential culprits and to be avoided. he was treated symptomatically with triamcinolone, and the rash resolved. 5) fen: mr. was given tpn while he was here, in addition to being encouraged to eat. he will go home with tpn cycled over 10 hours at night, and encouraged to eat a gluten free diet. discharge medications: 1. protonix 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po twice a day. 2. nystatin mucous membrane 3. acyclovir 400 mg tablet sig: one (1) tablet po three times a day. discharge disposition: home with service facility: discharge diagnosis: malt s/p auto-sct . ugi bleed discharge condition: good, stable. discharge instructions: return to the hospital to have your blood drawn tomorrow. take all meds as directed. return if you experience any rectal bleeding or black stools, shortness of breath, chest pain. take your temperature everyday and call dr. if it's greater than 100.4. continue your tpn for 10 hours every night. followup instructions: return to the unit tomorrow for repeat blood work and to be seen by dr. . procedure: parenteral infusion of concentrated nutritional substances other endoscopy of small intestine transfusion of packed cells injection or infusion of cancer chemotherapeutic substance transfusion of platelets autologous hematopoietic stem cell transplant without purging diagnoses: thrombocytopenia, unspecified acute posthemorrhagic anemia unspecified protein-calorie malnutrition other malignant lymphomas, unspecified site, extranodal and solid organ sites blood in stool celiac disease dermatitis due to drugs and medicines taken internally 

Answer: The patient is high likely exposed to