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: no known allergies / adverse drug reactions attending: chief complaint: back pain major surgical or invasive procedure: picc line placement , removed history of present illness: mr. is a 79 m with a recent diagnosis of acquired hemophilia who presents with back and left thigh pain. patient states that he was in his normal state of health until last night at approx 11:30 pm when he noted upper back pain, the character of which he is unable to describe. this pain was not associated with any extremity weakness, numbess, bowel/bladder incontinence. the pain has improved since it started last night. further, the patient has noticed pain in his left thigh which started just as bruising but today became painful. pt notes no recent trauma or falls. no blood in stool. no hematochezia. no abdominal pain. because of this pain the patient presented to heme/ clinic and immediately was referred to ed for further evaluation with concern for epidural hematoma. . in the ed, initial vitals 97.1 76 139/58 16 100%. exam normal neurologic exam. mri with epidural hematoma c6-7 through t1-2 and ct scan with left gluteal hematoma with active extravasation. three doses of factor rviia given. morphine 2mg iv x one. hct found to be 24.7, which is down 5 points over two days. though difficult to assess baseline. repeat hct was 20 prior to transfure. patient became increasingly tachycardic during ed course, however maintained a normal robust blood pressure with systolics in the 130s. . in the icu patient continues to be tachycardic, though blood pressure stable. states in currently only notes pain in the left hip which is improved. past medical history: 1. prostate cancer (dx. 3 years ago, low-volume, low grade adeno, never treated, follows at ) 2. bph 3. htn 4. hyperlipidemia 5. acquired fviii inhibitor - dx , also found to have positive lupus anticoagulant social history: patient lives alone currently. married; wife was in living with her mother when pt was admitted tobacco: quit in etoh: 4 oz scotch most nights family history: no family history of cancer. physical exam: admission exam: vs: temp:afebrile bp:133/60 hr:109 rr: 13 o2sat: 100% gen: pleasant, comfortable, nad, madarin speaking (translator used) heent: perrl, eomi, anicteric, mmm, op without lesions, no supraclavicular or cervical lymphadenopathy, no jvd, no carotid bruits, no thyromegaly or thyroid nodules resp: cta b/l with good air movement throughout cv: rr, s1 and s2 wnl, no m/r/g abd: nd, +b/s, soft, nt, no masses or hepatosplenomegaly ext: large hematoma over the left thigh and gluteus maximus. margins marked. pain with palpation. warm extremities with normal dp/pt pulses. skin: bruising upper/lower extremity. neuro: aaox3. cn ii-xii intact. 5/5 strength throughout. no sensory deficits to light touch appreciated. no pass-pointing on finger to nose. 2+dtr's-patellar and biceps. discharge exam: vs: 97.9 116/89 16 99ra ext: 2+dp, pt pulses, bruise on left elbow and wrist, nonpainful neuro: aao x3, cn ii-xii intact, 5/5 strength throughout, no sensory deficits skin: improved bruising on left thigh and buttuck, nonpainful. bruises on left wrist and elbow, bilateral lower extremities continue to retreat slowly. no new bleeding sites. he had an elevated non-discolored 7 cm nodule over left shin that has been stable for a week pertinent results: admission labs: 01:05pm pt-12.7 ptt-55.2* inr(pt)-1.1 01:05pm plt count-255 01:05pm neuts-97.2* lymphs-1.6* monos-1.0* eos-0.2 basos-0.1 01:05pm wbc-12.5* rbc-2.51* hgb-8.4* hct-24.7* mcv-99* mch-33.4* mchc-33.9 rdw-20.8* 01:05pm calcium-8.9 phosphate-3.1 magnesium-2.3 01:05pm glucose-208* urea n-38* sodium-132* potassium-4.6 chloride-97 total co2-25 anion gap-15 01:17pm lactate-3.6* 01:17pm comments-green top 04:22pm estgfr-using this 04:22pm creat-0.8 10:46pm hgb-6.7* calchct-20 discharge labs: 05:21am blood wbc-3.1* rbc-2.91* hgb-9.9* hct-27.4* mcv-94 mch-34.2* mchc-36.3* rdw-20.6* plt ct-198 05:21am blood glucose-94 urean-17 creat-0.5 na-136 k-3.2* cl-100 hco3-31 angap-8 factor viii levels: 05:21am blood facviii-2* 05:29am blood facviii-3* 05:34am blood facviii-2* 06:45am blood facviii-2* 10:27am blood facviii-4* 09:15am blood facviii-4* 04:29pm blood facviii-less than 03:55am blood facviii-2* ct ab pel : impression: 1. stable left gluteal hematoma. 2. interval development of some edema within the posterolateral left chest wall without focal fluid, possibly due to chronic positioning. 3. no abdominal or pelvic fluid or hemorrhage to explain this patient's continuing transfusion requirement. 4. some increased stranding and thickening of the subcutaneous tissues and skin adjacent to this patient's left gluteal hematoma. mri c spine impression: compared to the study of the previous day, there has been no significant change in the extent or mass effect of the posterior spinal epidural hematoma, extending from the c4 to the t3 level, with no evidence of new hemorrhage. comment: in the absence of significant change in clinical/neurologic status, the utility of daily follow-up mr examinations in this setting is unclear. mri c spine impression: since the previous mri. the epidural hematoma seen in the lower cervical upper thoracic region has slightly extended inferiorly to t2-t3 level with a small inferior extent now visualized, minimally indenting the thecal sac. overall, the mass effect from the hematoma from c6-t2 level, which was previously noted, has not significantly changed. previously noted degenerative changes are again identified. ct ab pelvis impression: large left buttock hematoma, primarily intramuscular involving the left gluteus maximus muscle with a focal area of active extravasation just posterior to the left superior posterior iliac spine. no evidence of retroperitoneal hematoma. mri t & c spine impression: 1. severe multilevel cervical spine degenerative changes, worst at c4-c5 with severe canal stenosis, cord compression, myelomalacia, and bilateral severe neural foraminal narrowing. 2. epidural hematoma involving c6-7 to t2-t3, as described above. findings were entered in the ed dashboard at 4:20 pm, after initial interpretation pending contrast enhanced studies. additional findings upon availability of contrast enhanced study was entered at 5:27 pm. cxr : the lungs are well expanded and clear without focal consolidation aside from minimal right basilar linear atelectasis. there is no pleural effusion or pneumothorax. the cardiac silhouette and hilar contours are normal. the aorta is slightly tortuous, unchanged. impression: mild linear atelectasis at the right base. no evidence of pneumonia. elbow plain film, left : no previous images. three views show no evidence of acute bone or joint space abnormality. there is, however, some elevation of the anterior fat pad, suggesting some effusion that could represent blood in the joint space. brief hospital course: mr. is a 79 m with a recent diagnosis of acquired hemophilia a (factor viii inhibitor) who presents with back and left thigh pain who was found to have an epidural hematoma and left gluteus maximus hematoma with active extravasation. he was treated with recombinant factor vii infusions and immunosuppression and was discharged after weaning factor replacement. 1. c6-7 to t2-3 epidural hematoma: he presented with back pain and was found to have an epidural hematoma related to his acquired hemophilia. there was no evidence of neurologic compromise on exam. this was his first significant bleed since his diagnosis, and he was subsequently started on recombinant factor vii infusions to prevent cord compression. his hematoma remained stable on serial mris. his neurologic exam was monitored daily throughout his hospitalization and remained normal. 2. left gluteus maximus bleed: his ct scan showed evidence of extravasation into left gluteus maximus muscle. though the patient developed extensive hematoma and edema over lle, the pt never developed compartment syndrome, and the hematoma eventually largely absorbed by the time of discharge. 3. acquired hemophilia: he received a diagnosis of acquired hemophilia a secondary to factor viii inhibitor in of . this was his third hospitalization for this problem. to the seriousness of his epidural bleed, he was started on recombinant factor viia infusions, initially on a q3hr schedule. his factor infusions were incrementally spaced apart, however intermittent findings of peripheral bruising delayed weaning at several points during his month-long hospitalization. we were eventually able to discontinue infusions on without further bruising, or bleeding, and while maintaining a stable hct. with regards to factor suppression, he was continued on high dose prednisone at 60mg daily, and cytoxan, initially 150mg daily which was uptitrated to 200mg daily. he also completed 4 cycles of weekly rituximab in house. his inhibitor levels were originally quite high, at 236.8. by the time of discharge, it had dropped to 56. it will likely take many months to see a full effect of immunosuppressive therapy. he was discharged with close hematology-oncology follow up. the patient was instructed at length about the concerning signs and symptoms of bleeds for which he should call the on-call hematology/oncology fellow. 4. chronic steriod use: the patient was placed on bactrim mwf for pcp . due to the development of leukopenia thought to be secondary to bactrim, he began atovaquone 1500mg daily for pcp prophylaxis prior to discharge. he was also started on daily ppi as well as calcium/vit d supplementation. due to persistent hypokalemia requiring daily repletion, he was started on supplementation on discharge. he was maintained on an insulin sliding scale during his hospitalization, though this was discontinued due to adequate control in the 100s. 5. sinus tachycardia: likely related to significant anemia. ekg with sinus tachycardia. no evidence of ischemia. tachycardia improved with hematocrit stability. 6. leukopenia: he developed leukopenia to 2.5 which was thought to be secondary to bactrim marrow suppression. he was started on atovaquone instead for pcp prophylaxis instead, and his wbc increased to 3.1 at the time of discharge. 7. anemia: he presented with a hct of 24 that dropped to 19 soon after admission. the initial source of bleeding was felt to be from his left gluteus maximus hematoma. he was transfused as needed, and hcts were initially trended tid, and were eventually spaced out to then qd by the time of discharge. his hct remained stable at discharge. 8. hypertension: he was started on lisinopril 5mg daily for hypertension inactive issues: 9. prostate cancer: this was diagnosed 3 years ago and is of low volume and grade. it has not been treated, he follows at . pending labs: none transitional care issues 1. will need close follow up with hematology oncology for further management of his immunosuppression 2. will need continued pcp , ca/vitd supplementation, ppi while on high-dose steroids. medications on admission: 1. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 2. prednisone 20 mg tablet sig: three (3) tablet po daily 3. pantoprazole 40 mg tablet, delayed release (e.c.) 4. cyclophosphamide 50 mg tablet sig: three (3) tablet po for 2 weeks. 5. bactrim ds 800-160 mg tablet sig: one (1) tablet discharge medications: 1. atovaquone 750 mg/5 ml suspension sig: 10 ml po daily (daily). disp:*280 ml* refills:*2* 2. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 3. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 4. calcium carbonate 200 mg (500 mg) tablet, chewable sig: one (1) tablet, chewable po three times a day. disp:*90 tablet, chewable(s)* refills:*5* 5. cholecalciferol (vitamin d3) 1,000 unit tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*5* 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 7. prednisone 20 mg tablet sig: three (3) tablet po daily (daily). 8. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day. disp:*60 tab sust.rel. particle/crystal(s)* refills:*5* 9. cyclophosphamide 50 mg tablet sig: four (4) tablet po once a day. disp:*120 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: primary diagnosis: 1. factor 8 deficiency 2. epidural hematoma 3. gluteus maximus hematoma discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mr. , you were admitted to the hospital with easy bruising and back pain. you were found to have a low level of one of your clotting factors (factor 8). this means your body was making an inhibitor that would attack your normal factor 8. this problem means that you cannot clot like a normal person and have a much higher risk of bleeding. that is what caused the blood collection around your spine. the hematology team helped guide your care. you were treated with blood transfusions, and were given a different clotting factor through (factor 7) an iv to help prevent bleeding. we tried to decrease your inhibitor by using steroids, cyclophosphamide and rituximab while you were here. the following changes were made to your medications: 1. continue cyclophosphamide 200mg daily 2. continue prednisone 60mg daily 3. start atovaquone 1500mg daily to prevent infections while on prednisone 3. start potassium chloride 20meq daily because your steroids are likely causing low potassium 4. start vitamin d 1000units daily to protect your bones while on prednisone 5. start calcium carbonate 500mg three times daily to help protect your bones while on prednisone it was a pleasure taking care of you, mr. followup instructions: you have the following appointments available with your pcp, with a hematology expert. name: , j. location: address: , , phone: when: , , 9:45am name: , md location: address: , 9, , phone: * from dr. office will call you to schedule an appointment. if you dont hear from her by monday, please call the number above. procedure: transfusion of coagulation factors injection or infusion of biological response modifier [brm] as an antineoplastic agent diagnoses: hypocalcemia esophageal reflux adrenal cortical steroids causing adverse effects in therapeutic use acute posthemorrhagic anemia hypopotassemia other and unspecified hyperlipidemia other specified cardiac dysrhythmias disorders of phosphorus metabolism malignant neoplasm of prostate antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use nontraumatic hematoma of soft tissue sulfonamides causing adverse effects in therapeutic use leukocytopenia, unspecified benign essential hypertension edema vascular myelopathies secondary diabetes mellitus without mention of complication, uncontrolled hemarthrosis, upper arm 

Answer: The patient is high likely exposed to