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: betadine / adhesive tape / percocet attending: chief complaint: gi bleeding, vf arrest major surgical or invasive procedure: none history of present illness: 64 yo male with esophageal cancer s/p xrt, on chemo, presented to the ed with complaint of coffee-ground emesis 3x over the past 2 days. he had last chemo dose on monday and had a week of his usual post-chemo fatigue. he had significant epistaxis the night prior to vomiting that required packing. also complained of diarrhea, but denies melena. had complained of some abdominal pain. he did endorse lightheadedness and dizziness. throughtout ed course, compained of abdominal pain, and wife noted he had some ectopy on his tele. he denied any chest pain, shortness of breath, or palpatations. approx 5 hours after arriving in the ed, patient developed v-tach that progressed to v-fib per patient's wife and attending note. vitals had been stable until that time except for a temp of 101.7. patient was shocked at 200 and returned to paced (baseline) rhythm, pulse returned. he was breathing spontaneously, but was intubated for airway protection. og tube placed, no red blood on lavage, no coffee-grounds were noted. patient was fighting the tube, and was sedated. patient was dosed with protonix, cefepime, vancomycin. lidocaine gtt was started. norepinephrine started for bp support. . of note, patient had been using magicmouth for esophageal discomfort. he was more fatigued, but this was normal for his chemo. the epistaxis was also not atypical. recently, his ace and bb were discontinued. . past medical history: copd/ pulmonary fibrosis htn dm2 neuropathy, nephropathy barrett's esophagus and gerd, recently (in ) diagnosed with esophageal ca s/p xrt being treated now with 5-fu and cpt-11; avr in . mechanical valve cad s/p 2v-cabg ppm placed for af (previously treated on amiodarone- discontinued because of concerns pulmonary fibrosis from amiodarone) s/p avj ablation for atrial fibrillation; vvi electronic sigma pacemaker; congestive heart failure diastolic dysfunction (ef 35%); strongyloides resulting in eosinophilia and dyspnea, hypothyroid, left renal artery stenosis, htn, hypercholesterol, cri (baseline cr 2.8-3.4) social history: married. now on diasbility, previous work as a corporate artist, worked in textiles, cloth books. worked with textile manufacturors (inhalation exposure to formaldehyde used in textile processing). no etoh use. smoking history, quit , 25 pack year history. son , wife nurse. family history: nc physical exam: vitals: t 101 70 93/39 sat 100% on ac 550/16/100%/5 gen: sedated, intubated, pale, comfortable, family at bedside, patient can open eyes slightly to his name heent: mmm, og tube and et tube in place, prrl, neck is supple, cv: rrr, s1 loud mechanical s2 2/6 sem pulm: clear bilat abd: thin, soft, non-distended, prior surgical scar noted ext: no edema, warm and well perfused pertinent results: 02:35pm gran ct-1260* 02:35pm pt-31.6* ptt-31.8 inr(pt)-3.4* 02:35pm neuts-79* bands-1 lymphs-7* monos-6 eos-7* basos-0 atyps-0 metas-0 myelos-0 02:35pm wbc-1.7* rbc-3.03* hgb-9.4* hct-28.9* mcv-95 mch-30.9 mchc-32.4 rdw-21.7* 02:35pm glucose-177* urea n-40* creat-1.7* sodium-143 potassium-3.6 chloride-104 total co2-25 anion gap-18 08:10pm gran ct-890* 08:10pm wbc-1.4* rbc-3.10* hgb-9.6* hct-29.7* mcv-96 mch-31.1 mchc-32.5 rdw-21.9* 08:10pm albumin-3.9 calcium-8.6 phosphate-2.3* magnesium-1.7 08:10pm ck-mb-notdone ctropnt-<0.01 08:16pm lactate-3.0* . echo : lv ef 35% mod dilated lv, rv: dilated rv, depressed fxn. tr gradient 50 valves: 2+mr, 2+tr, traace ar cxr: : a left-sided pacemaker is seen with lead in unchanged position. the patient is status post cabg and median sternotomy wires are visualized. a right-sided subclavian catheter terminates in the cavoatrial junction. the cardiomediastinal silhouette is stable with a large left atrial shadow. again noted is left-sided pleural thickening and adjacent parenchymal scarring. there is no evidence of pneumothorax. the right lung is clear. there is a small left pleural effusion. there is no evidence of free air underneath the hemidiaphragms. . kub: air is noted in the rectum and sigmoid colon. there is no evidence of acute obstruction. surgical clips are noted in the left groin. the osseous structures are unremarkable. . brief hospital course: 64 yo male with esophageal cancer, one week after his last chemo, who presented with coffee-grounds emesis after having significant epistaxis requiring packing. while in the ed, patient had a vt/vf arrest that resolved after one shock, and remained hypotensive thereafter. 1. vt/vf arrest: the pt was found in the ed to be unresponsive with a rapid heart rhythm that was assessed by the ed physicians to be v-tach vs vf. there were no ecg rhythm strips recorded for review. the pt was cardioverted, and he rapidly regained awareness. patient is at risk for vt/vf with his hx of chf as well as prior cad. he was started on a lidocaine drip at 30ug/kg per min for suppression of vt, which was continued on arrival to the . the pt was evaluated by cardiology in the ed who agreed that he had a possible episode of vf and that lido vs amio could be continued initially. given that there were no recurrent events, lidocaine was discontinued on the following day. it was likely that sepsis was the precipitating event. ep consulted, and they recommended starting on amiodarone. this was discussed with dr. , the patient's cardiologist. the patient tolerated amiodarone loading, and he had no further events on telemetry. 2. septic shock: patient bordering on neutropenia. pt was febrile to 102 in ed, with increased neutrophil predominance, immunosuppressed, and anc ~600. his lactate level was 3.0 (after vf and shock). he was pan-cultured, started on vanc/cefepime, and arrived to the on levophed in addition to the lidocaine drip. he was weaned off pressors quickly, and all culture data were negative with the exception of sputum gram stain which showed 4+gnr, 4+gpc. his antibiotics were changed to cefpodoxime to complete a 14 day course for a likely respiratory infection. 3. respiratory failure: intubated for airway protection, and weaned from supplemental o2 prior to discharge. 4. gi bleed/hematemesis: likely this was from large epistaxis the night prior to presentation and did not represent gi bleed. however, he is at risk for bleed given esophageal cancer/xrt. og tube had a negative lavage, no sign of melena. vitals were stable on presentation to ed for the first 5 hours. hct trended down from ~30 to 23.3 during his hospital course, and he was guaiac positive, though he had no gross blood loss since icu admission. inr was 5.3, and he was reversed with 3 u ffp and transfused 2u prbc in setting of cad and recent vt event. his hct stabilized, and coumadin was restarted. 5. chf ef 35%: pt was recently taken off ace and bb as outpatient because bp was too tenuous. he was diuresed with transfusions. 6. cad s/p cabg: he had no current evidence of active ischemia, and ruled out by enzymes. aspirin not given due to low platelet counts, and statin started. he will follow up with dr. , who is aware of these issues. 7. esophageal cancer: last cpt dose was one week prior to presentation. follows with dr. . 8. cri: baseline cr 1.7; continued epo. 9. diabetes: nph 9u qam, riss. 10. aortic valve replacement: pt has st. jude's valve with high risk for clot and requiring anti-coagulation. inr elevated, and he was reversed with ffp. restarted coumadin for goal inr >2.5. 11. af: s/p av node ablation, vvi ppm placement. 12. hypothyroid: continued synthroid 13. fen: diabetic, cardiac diet, replete k for goal >4 and mg >2 14. proph: pneumoboots, ppi full code medications on admission: insulin ss fent patch 25 mcg/hr q 72h prednisone 40mg daily pantoprazole 40mg daily metoprolol 12.5mg atorvastatin 40mg daily allopurinol 300 daily tamsulosin 0.4mg qhs levothyroxine 75 mcg daily epo 20,000 units sq qm,w,f colace 100mg bisacodyl prn vancomycin 750mg iv q12h cefepime 2g iv q12h discharge medications: 1. allopurinol 300 mg tablet sig: one (1) tablet po daily (daily). 2. epoetin alfa 20,000 unit/ml solution sig: one (1) injection qmowefr (monday -wednesday-friday). 3. glipizide 10 mg tablet sig: one (1) tablet po once a day. 4. fentanyl 25 mcg/hr patch 72hr sig: one (1) patch 72hr transdermal q72h (every 72 hours). disp:*10 patch 72hr(s)* refills:*0* 5. levothyroxine 75 mcg tablet sig: one (1) tablet po daily (daily). 6. amiodarone 200 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*0* 7. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day) for 2 weeks. disp:*56 tablet(s)* refills:*0* 8. insulin nph human recomb 100 unit/ml suspension sig: eight (8) units subcutaneous qam. 9. morphine 10 mg/5 ml solution sig: 5-10 mg po q4-6h (every 4 to 6 hours) as needed. disp:*100 mg* refills:*0* 10. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day) as needed. disp:*100 ml(s)* refills:*0* 11. prednisone 10 mg tablet sig: one (1) tablet po once a day for 2 days. disp:*2 tablet(s)* refills:*0* 12. prednisone 5 mg tablet sig: one (1) tablet po once a day for 2 days: after you complete 2 days of 10mg doses. disp:*2 tablet(s)* refills:*0* 13. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 14. tamsulosin 0.4 mg capsule, sust. release 24hr sig: one (1) capsule, sust. release 24hr po hs (at bedtime). 15. loperamide 2 mg capsule sig: one (1) capsule po qid (4 times a day) as needed. disp:*30 capsule(s)* refills:*0* 16. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 17. cefpodoxime 200 mg tablet sig: one (1) tablet po twice a day for 10 days. disp:*20 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary: vfib/vt febrile neutropenia cad s/p cabg . secondary: avr s/p st. jude's valve ppm for afib vvi electronic sigma pacemaker copd hypertension dm2 gerd cri hypercholesterolemia discharge condition: stable discharge instructions: please call dr. or if you have fever, chills, increasing esophageal pain, nausea, vomiting, shortness of breath, chest pain, palpitations, diarrhea or any other discomfort. . please keep the appointments that have been scheduled for you - the details are provided below. . note the medications that have been changed during this admission: - amiodarone 400mg twice a day for the next two weeks, then take 400mg once a day thereafter. - please restart the atorvastatin at 40mg per day; he will discuss issues of toprol, lisinopril, and aspirin. you should be on toprol and lisinopril, but your blood pressure will not tolerate this presently. also, aspirin would be beneficial, but platelet count was low (140). dr. aware and agrees with the above. - the prednisone should be tapered in the next several days: take 10mg daily for 2 days, then 5mg for 2 days. - restart coumadin at 5mg daily - you should have your inr and cbc checked on monday at your appointment with dr. . - please continue to take cefpodoxime for the next 10 days for possible lung infection. followup instructions: provider: , md phone: date/time: 10:30 provider: chair 1a date/time: 11:00 provider: , rn phone: date/time: 11:00 dr. : at 2:30pm dr. : at 2:10pm . you will need to follow up with electrophysiology physicians when your chemotherapy is complete. dr. office can assist w/ setting this up for you. md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube other electric countershock of heart transfusion of packed cells transfusion of other serum diagnoses: esophageal reflux pure hypercholesterolemia unspecified essential hypertension chronic airway obstruction, not elsewhere classified atrial fibrillation aortocoronary bypass status diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes chronic kidney disease, unspecified paroxysmal ventricular tachycardia heart valve replaced by other means cardiac arrest long-term (current) use of anticoagulants cardiac pacemaker in situ hemorrhage of gastrointestinal tract, unspecified malignant neoplasm of lower third of esophagus secondary and unspecified malignant neoplasm of lymph nodes of head, face, and neck 

Answer: The patient is high likely exposed to