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 / tetracycline attending: chief complaint: febrile neutropenia major surgical or invasive procedure: bronchoalveolar lavage history of present illness: 71 y.o.f. with aml who presents with febrile neutropenia. was in usoh until last 3 nights when she developed a fever, the last being to 101.3. she has no localizing signs or symptoms except for a small punctate ulceration on her right butt cheek, a few cm from the anal verge. she states that this appeared about 2 weeks ago and was moderately painful, but has improved. she was started on acyclovir as an outpatient. she denies cough, uri symptoms, headaches, chest pain, sob, abdominal pain, nausea, emesis, diarrhea, or constipation. past medical history: past oncologic history: acute myelogenous leukemia, with background of mds (diagnosed in on decitabine c1d1 on ) - 2nd cycle of decitabine on at - admitted to for febrile neutropenia and was given valtrex for lip lesions, also given decitabine c3d1. bmbx showed slight improvement with 15-20% myeloblasts, no 5q deletion on fish . other past medical history: hypertension hyperlipidemia goiter/thyroid issues (currently not on treatment) vitamin d deficiency gerd social history: lives alone, works for the health commission helping to educate public school students. - tobacco: denies - etoh: denies - illicits: denies family history: one brother exposed to in ; one brother died of lung cancer. physical exam: admission exam: vs: t 98.2, bp 126/60, hr 84, rr 20, sat 100% on ra gen: aox3, nad heent: sclera and conjunctiva clear b/l. mmm. cards: rr s1/s2 normal. no murmurs/gallops/rubs. pulm: ctab no crackles or wheezes abd: soft, nt, no rebound/guarding extremities: wwp, no edema. skin: crusted over lesions at corner of lip on the right. 1 cm right peri-rectal lesion. clean, pink base with central area of scab. neuro: no focal deficit. pertinent results: admission labs: 02:00am blood wbc-0.7* rbc-3.06* hgb-9.5* hct-26.4* mcv-86 mch-31.2 mchc-36.2* rdw-13.8 plt ct-27* 02:00am blood neuts-2* bands-0 lymphs-90* monos-3 eos-0 baso-0 atyps-5* metas-0 myelos-0 nrbc-2* 02:00am blood pt-14.1* ptt-32.0 inr(pt)-1.2* 02:00am blood glucose-229* urean-13 creat-0.6 na-130* k-3.9 cl-100 hco3-24 angap-10 02:20am blood lactate-1.7 . cxr no acute cardiopulmonary process. smaller goiter. . ct torso04/05/11 1. new right-sided opacity in the right upper lobe most likely pneumonia; other etiologies such as hemorrhage could cause a similar appearance; neoplastic infiltrate less likely given rapid development of findings. 2. interval increase in size of mediastinal and right hilar lymph nodes, nonspecific, could be reactive; however, cannot exclude neoplastic involvement. 3. new small right pleural effusion. 4. stable calcified right adnexal mass most likely calcified fibroid, less likely calcified ovarian mass or pedunculated broad ligament fibroid. 5. stable liver hypodensities, some appear as liver cysts, some are too small to be characterized. 6. stable asymmetric enlargement of the thyroid gland. 8:45 am bronchoalveolar lavage add on request for das, acu, lcu, ncu, per fax by on at 08:53 am.. qns for viral cultures reported to and read back by on at 08:54 am.. gram stain (final ): no polymorphonuclear leukocytes seen. 1+ (<1 per 1000x field): squamous epithelial cells. 2+ (1-5 per 1000x field): gram positive rod(s). respiratory culture (final ): >100,000 organisms/ml. commensal respiratory flora. yeast. ~/ml. isolates are considered potential pathogens in amounts >=10,000 cfu/ml. immunoflourescent test for pneumocystis jirovecii (carinii) (final ): negative for pneumocystis jirovecii (carinii).. fungal culture (preliminary): yeast. acid fast smear (final ): no acid fast bacilli seen on concentrated smear. acid fast culture (pending): legionella culture (preliminary): no legionella isolated. culture (pending): brief hospital course: a 71yo f with pmh acute myelogenous leukemia, neutropenic fever, throid goiter, admitted to omed service for neutropenic fever found to have right upper lobe infiltrate, she was treated with broad spectrum antibiotics, her course was complicated by acute renal failure after discussion with patient and family dialysis was declined and the decision was made to provide comfort care was made. she developed uremia and expired with her family at the bedside. . # goals of care: the patient developed acute renal failure and uremia. her oncologist identified her aml course as severely progressive with an expceted life expectancy of days to weeks. given her poor prognosis, a family meeting was held and it was decided that dialysis was not in her goals of care. she developed uremia, hyprekalemia, hyponatraimia and expired on the morning of hospital day 13 with her family at the bedside. . # neutropenic fever: patient was admitted with neutorpenic fever and no clear source of infection she was initially continued on aztreonam/vanc with continuation of home acyclovir and fluconazole. fevers persisted; flagyl was added for anaerobic coverage. given persistant fevers and lack of source, ct torso was performed and showed a right upper lobe pneumonia that was new from her last scan in . her fluconazole was changed to voriconazole, and gentamycin was added to her abx regimen. bronchoscopy was attempted, but could not be done in the procedure suite as there was significant narrowing of the trachea from compression by her goiter. fever curve trended downwards, but serial chest xray showed interval increase in the size of the pna. voriconazole was changed to ambisome, and levofloxacin was added for atypical coverage. she was taken to the icu for repeated bronchoscopy attempt. bronchoscopy performed which showed drainage. it was difficult to advance the scope suggesting post-obstructive pneumonia. gram stain showed gram positive rods which were likely , negative for pcp. culture was added on and results were pending at the time of death. she completed a course of levofloxacin for atypical pneumonia and antibiotics were narrowed to vanco/meropenem. . # hyponatremia: na began to trend downward on . initially thought to be hypovolemia given diaphoresis and poor po intake, but after hydration na continued to fall. renal was consulted who identifed siadh. she was put on a fluid restriction, salt tabs, and furosemide. her sodium improved mildly however she became anuric and free water could not be mobilized. . # acute renal insufficiency: creatinine trended up on believed to be related to a combination of aml and atn from nephrotoxic antibiotics. renal ultrasound was negative. medications were renally dosed and nephrotoxins were avoided. creatinine continued to rise and the patient became anuric. hyponatremia worsened as she became increasingly hypervolemic, she developed uremia and hyperkalemia. dialysis was not in her goals of care. cause of death is attributed to acute renal failure. . # pancytopenia: patient was transfusion dependent related to aml and bone marrow failure. she was ransfused intermittently for platelets < 10 and hct < 25. . # htn, hld, gerd: continued home meds . code status was changed to dnr/dni this admission and then to comfort measures. medications on admission: lisinopril 20mg po daily simvastatin 20mg po daily omeprazole 20 mg daily vitamin d 50,000 units qwednesday per patient was also on acyclovir, cipro, and fluconazole at home discharge medications: deceased discharge disposition: expired discharge diagnosis: primary: neutropenic fever . secondary: acute myelogenous leukemia renal failure uremia discharge condition: deceased discharge instructions: deceased followup instructions: deceased procedure: insertion of endotracheal tube closed [endoscopic] biopsy of bronchus diagnoses: pneumonia, organism unspecified hyperpotassemia esophageal reflux unspecified essential hypertension acute kidney failure, unspecified other and unspecified hyperlipidemia encounter for palliative care do not resuscitate status other disorders of neurohypophysis neutropenia, unspecified unspecified vitamin d deficiency goiter, unspecified acute myeloid leukemia, without mention of having achieved remission fever presenting with conditions classified elsewhere 

Answer: The patient is high likely exposed to