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: pollen/hayfever / bactrim / cipro / levofloxacin / cefepime attending: chief complaint: fever major surgical or invasive procedure: left portacath removal central line placed in right internal jugular vein central line removal history of present illness: 38 y/o male with hiv and burkitt's lymphoma recently currently undergoing treatment for a mrsa neck abcess with vancomycin presented to er on with fevers to 102 and rigors. he had been doing well post recent d/c on without fever, but was noted by his vna nurse changes of his neck to be febrile to 102. he denies any localizing symptoms but feels generalized weakness, myalgias and feeling "warm." he presented to the emergency room on with a fever of 102.3 with a wbc of 2.4 with 58%n/ 33l/o bands. he was given cefepine, vancomycin and tylenol in the emergency room ros: denies headache, photophobia, neck pain, sinus tenderness, sore throat, shortness of breath, cough, chest pain, abdominal pain, diarrhea, dysuria, frequency, cva tenderness, or rash. past medical history: pt had pneumonia as a child and was hospitalized for 6 days. hiv positive diagnosed . burkitt's lymphoma. social history: pt lives in partner in ma. he moved here from 13 years ago. he works for toy importer company and is also a massage therapist. he has no children. he is a social drinker. he quit smoking five months ago, seven years smoking total. no iv drugs use. prior to diagnosis he exercised regularly. family history: brother and sister with hx of hyperchol and htn. pt reports hx of mult cancers on mothers side of family. no first degree relatives with cancer. physical exam: pe 101.7 20 109 102/52 98% ra general nontoxic, nad heent: perrla, no sinus tenderness, op clear, area of abcess without fluctuance lad: no palpable cervical, axillary, supraclavicular, infraclavicular heart: rrr lung: bibasilar crackles abdomen: benign ext no c/c/e no rash pertinent results: 10:55pm wbc-2.4* rbc-3.30* hgb-8.4* hct-25.4* mcv-77* mch-25.6* mchc-33.2 rdw-15.0 10:55pm neuts-24* bands-26* lymphs-37 monos-6 eos-2 basos-0 atyps-3* metas-2* myelos-0 10:55pm hypochrom-2+ anisocyt-2+ poikilocy-2+ macrocyt-2+ microcyt-2+ polychrom-occasional ovalocyt-2+ teardrop-2+ acanthocy-occasional 10:55pm plt smr-normal plt count-157 10:55pm albumin-4.0 10:55pm alt(sgpt)-20 ast(sgot)-12 ld(ldh)-194 alk phos-87 tot bili-0.1 10:55pm glucose-100 urea n-11 creat-1.0 sodium-141 potassium-3.9 chloride-104 total co2-28 anion gap-13 11:16pm lactate-1.2 11:55pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-8.0 leuk-neg 11:55pm urine color-straw appear-clear sp -1.008 . 01:53am blood wbc-18.8* lymph-3* abs -564 cd3%-93 abs cd3-522* cd4%-26 abs cd4-147* cd8%-65 abs cd8-369 cd4/cd8-0.4* 12:00am blood ret aut-0.2* 09:20am blood gran ct-* . 08:15am blood wbc-8.4 rbc-3.73* hgb-10.1* hct-30.4* mcv-82 mch-27.0 mchc-33.0 rdw-16.7* plt ct-263 08:15am blood plt ct-263 08:15am blood glucose-80 urean-9 creat-0.9 na-138 k-4.2 cl-103 hco3-26 angap-13 08:15am blood alt-72* ast-32 alkphos-225* totbili-0.2 08:15am blood calcium-8.5 phos-3.9 mg-1.7 imaging: cxr (): no evidence of pneumonia mri of the soft tissues of the neck (): enhancing irregular masses are identified in the posterior neck, especially on the right, at the level of c2 and extending inferiorly ct torso w/contrast (): stable appearance of multiple sub-cm mediastinal and hilar lymphadenopathy as well as stable appearance of mediastinal soft tissue. stable appearance of numerous tiny bilateral pulmonary nodules. no new pulmonary nodules identified. stable appearance of hepatic hemangioma. 20 x 13 mm subcutaneous lesion of the anterior left shoulder with internal hounsfield density consistent with air. it is unclear what this lesion represents and clinical correlation is suggested. brief hospital course: 1. fever/sepsis/neutropenia: pt admitted to medicine, initially treated with treated with broad spectrum antibiotics, ivf, blood cultures were performed daily. he was initially started on cefepime and vancomycin due to a history of mrsa abscess, as well as flagyl for gram negative coverage). pt was found to be borderline neutropenic with anc of 1200. pt was also transfused 1 unit prbc for anemia (hct24.2, increased to 27.5). two days after admission he remained febrile as high as 104f, became tachycardic and hypotensive with good response to fluid boluses. rash was also noted across face, chest, arms - non pruritic, non painful thought to be secondary to drug rash vs. reaction to blood transfusion. at that time, abx regimen was changed to vancomycin, aztreonam, and levofloxacin (cefepime was discontinued to do ? drug reaction). voriconazole was started for fungal coverage as well as one dose of gentamicin. pt was pan cultured and sent to the or for double lumen porta cath removal (empiric for ?line sepsis) and admitted to the icu for sepsis management, hypoxemia and hypotension. . on admission to , pt had , cough, fatigue/weakness, some diarrhea and unknown source of infection. he was continued with aggressive fluid resuscitation (central line - rij -placed ), vancomycin, flagyl, aztreonam, voriconazole were continued, levofloxacin was d/ced due to ?drug rash and history of cipro allergy. gentamicin was added for double gram neg coverage. pt's blood pressure stabilized with fluid resuscitation and fever defervesced with abx and tylenol/ibuprofen. cxr revealed congestion and pt obtained diuresis with relief of , thought to be due to flash pulmonary edema secondary to chemo induced cardiomyopathy. by patient was improving, improved leukocytosis, but pt remained febrile. voriconazole and flagyl discontinued at that time as fevers were thought to be secondary to drug reaction vs. underlying lymphoma. repeat cd4 count was 184 (previously 800), viral load >10,000. pt was transferred back to medicine floor on . . pt came to the floor feeling much better but still having fevers of unknown etiology. sources included the healing abscess in the neck, chest wound after catheter removal, drug reaction? pt was empirically covered with vancomycin and aztreonam. all cultures still negative but patient became febrile to 102. gentamycin added back, atovaquone added for pcp . mri of the neck did not show persistence/recurrence of abscess or osteomyelitis. hbv, hcv sent due to rising lfts all negative. c. diff, galactomannin and strongyloides sent and were negative due to persistent diarrhea. pt was re-evaluated by the icu due to persistent fevers, diarrhea and tachycardia. pt was deemed fit to be managed on the floor. during his stay on the floor he received his third dose of chemo during which time antibiotics were held. he was later restarted on vanco/aztreonam. pt stabilized but remained with intermittent fevers and tachycardia. neutropenia resolved with stable wbc. ct torso of the abdomen was performed as a last effort to identify a source, which was unrevealing. wound cultures taken from the site of line removal grew resistant coagulase positive staph aureus for which he was empirically covered by vancomycin. . 2. - pt complaining of subjective on presentation to icu. o2 sats good on 3l nc. ?pneumonia as source of infection vs. overlying pcp (hiv status and immunocompromised from chemo, plus continually rising ldh) vs. fluid overload from resuscitative fluids vs. generalized infection. cxr on presentation to demonstrated b/l pulm congestion vs. pneumonia. ef on = 55%, repeat ef on echo () = 40-45% therefore decreased likelihood cardiogenic pulm congestion, although still possibility of chemo-induced cardiac dysfunction given the newer lower ef, but could be pulm congestion early sepsis w/ leaky capillaries or pcp. improved with diuresis with lasix. . 3. tachycardia - related to fever vs. functional heart changes chemo vs. pericardial effusion vs. pe (low on differential). pt remained tachycardic in icu, but per patient and patient's partner, baseline hr = 100. therefore, echo was obtained and r/o for structural heart abnormality as cause of tachycardia - therefore was just monitored during icu stay. patient remained intermittently tachycardic upon return to the floor, thought to be secondary to insensible loses due to continued fever, underlying condition, infection? patient remained stable until discharge with low grade tachycardia. . 4. rash: pt developed a rash across face, trunk, ue>le, developed . appears to be drug rash in nature - cefepime vs. levofloxacin vs. related to blood transfusion (pt transfused while febrile) vs. enteroviral infection. likely drug rxn - per pt, rash same as rash he experienced after cipro. therefore cefepime + levofloxacin d/ced and rash monitored throughout stay with improvement. . 5. diarrhea - pt c/o diarrhea since admission, profuse, yellow in color and watery. pt on broad spectrum abx since admission. initial c diff on presentation neg - repeat also negative. other stool studies and neg. pt with improved (decreased) stool output and . viral stool cxs positive for adenovirus. diarrhea resolved during hospital course, etiology unclear. . 6. burkitt's lymphoma: admitted s/p -r cycle x 2. ldh= 194 ()-> 811() as indication of tumor burden vs. related to transfusion of prbc vs. ?pcp. restarted on chemotherapy s/p third cycle of -r. ldh later normalized to 130. . 7. anemia - pt with history of anemia - s/p transfusion 1 unit prbc on floor. hct monitored and remained stable. . 8. - pt with mildly elevated ast, alt, alk phos likely secondary to medications/illness. liver function remained stable, discharged with mildly elevated enzymes. etiology unclear. . 10. hiv: last cd4=800, viral load > 100,000 in past couple months. haart held for now due to burkitt's lymphoma and therapy. cd4 resent during hospitalization = 147 () ?accurate due to acute infection. patient was later restarted on haart with tenofovir, emtricitabine, nelfinavir. . 11. fen: patient tolerating regular diet throughout stay. neutropenic diet temporarily, discontinued once wbc normalized. electrolytes were repleted as necessary. 12. prophylaxis: heparin, protonix, pneumoboots, oob to chair w/ assistance, patient later became stronger, ambulating without difficulty . 13. access: r ij () . 14. code status: full throughout admission medications on admission: neulasta procrit -r 6d prior vanc stopped doa ativan prn allopurinol undergoing treatment with -r (cycle 2). also undergoing therapy on protocol s/p 4 weekly intrathecal ara-c. discharge medications: 1. atovaquone 750 mg/5 ml suspension sig: ten (10) ml po daily (daily). disp:*300 ml* refills:*2* 2. nelfinavir 625 mg tablet sig: two (2) tablet po bid (2 times a day). disp:*120 tablet(s)* refills:*2* 3. tenofovir disoproxil fumarate 300 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. emtricitabine 200 mg capsule sig: one (1) capsule po q24h (every 24 hours). disp:*30 capsule(s)* refills:*2* 5. ambien 5 mg tablet sig: one (1) tablet po at bedtime as needed for insomnia. disp:*30 tablet(s)* refills:*0* 6. pantoprazole sodium 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* 7. compazine 5 mg tablet sig: 1-2 tablets po every eight (8) hours as needed for nausea. disp:*30 tablet(s)* refills:*0* 8. linezolid 600 mg tablet sig: one (1) tablet po twice a day for 10 days: please start . disp:*20 tablet(s)* refills:*0* 9. zofran 4 mg tablet sig: 1-2 tablets po every eight (8) hours as needed for nausea. disp:*30 tablet(s)* refills:*0* discharge disposition: home with service facility: home health care discharge diagnosis: 1. sepsis primary diagnoses: 1. sepsis 2. burkitts lymphoma 3. hiv/aids 4. febrile neutropenia discharge condition: good; low grade fevers discharge instructions: please take all medications as prescribed. please complete course of antibiotics. please keep all you follow up appointments. please contact physician or come to hospital if increased shortness of breath, fever greater than 100.4, any other signs or symptoms of infection. followup instructions: 1.) follow up with dr. (hematologist/oncologist) as directed for treatment of burkitt's lymphoma. please call to schedule an appointment. 2.) follow up with dr. , infectious diseases, as directed for hiv care. , md where: lm disease phone: date/time: 11:30 3.) follow up with primary care physician as directed procedure: venous catheterization, not elsewhere classified incision with removal of foreign body or device from skin and subcutaneous tissue transfusion of packed cells injection or infusion of cancer chemotherapeutic substance injection or infusion of biological response modifier [brm] as an antineoplastic agent diagnoses: other primary cardiomyopathies congestive heart failure, unspecified long-term (current) use of steroids other pulmonary insufficiency, not elsewhere classified unspecified septicemia severe sepsis human immunodeficiency virus [hiv] disease septic shock other specified disorders of biliary tract iron deficiency anemia, unspecified dermatitis due to drugs and medicines taken internally diarrhea infection and inflammatory reaction due to other vascular device, implant, and graft other specified antibiotics causing adverse effects in therapeutic use burkitt's tumor or lymphoma, unspecified site, extranodal and solid organ sites cellulitis and abscess of neck human t-cell lymphotrophic virus, type i [htlv-i] adenovirus infection in conditions classified elsewhere and of unspecified site pain in joint, site unspecified 

Answer: The patient is high likely exposed to