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: patient recorded as having no known allergies to drugs attending: chief complaint: shortness of breath major surgical or invasive procedure: picc line placement (right) history of present illness: 61 yo male with hx aml, s/p 7+3 induction chemo with idarubicin and cytarabine (day 1=), complicated aspergillus pneumonia tx with voriconazole. also, pt found to have a newly depressed ef to 30-40% with focal hypokinesis. he had a left heart cath that found 3vd and had 3 bms placed to lad, 1 proximal and 2 to the mid lad on . the pt was discharged on on aspirin and plavix. he now presents with a chief complaint of chest pain starting this morning. . this morning he felt "cold and clammy" and he had suddent onset of chest pain. he describes the pain as dull/pressure, focused in the center of his chest, . it was non-radiating and associated with diaphoresis and shortness of breath, but no dizziness, palpitations, nausea or vomiting. of note, he had similar chest pain several months ago while raking leaves (pain resolved on its own at that time). he called 911 and was taken by the ambulance to the . cp resolved at osh with nitro and morphine. trop t was elevated to 0.12 and ekg showed no ischemic changes. he had a cta showing no pe. he was transferred to for further management. in our ed, initial vitals were t 96.2 hr 99 bp 105/73 rr14 sao2 97%. he was given vancomycin and zosyn, and blood cultures were sent. also given tylenol 650mg x 1. ces were trending up. . per nursing report prior to transfer the patient became hypotensive and tachycardic when standing up. he was bolused 500cc and placed in a supine position. on arrival to the floor his vitals were t 100.7, hr 114, bp 108/65, sao2 99% on 2l. he denied any chest pain or pressure but did report feeling unable to take a deep breath and feeling intermittent chills/rigors throughout the afternoon. additionally, he reported dysuria starting this morning. he denied gi sx or productive cough. he was given 1 liter ns, then given demerol for the rigors and his bp dropped to 90s. he was started on a 3rd liter and his bp improved. his temp increased to 102. his ekg showed some mild ste vs j point elevation changes in the anterior leads, cardiology felt it was not consistent with a instent thormbosis. he was transfered to the unit for sepsis. . review of systems: he denies gi sx, no hematuria or prior dsyuria other than today, no cough, no vision changes, no neck stiffness. had a mild ha today. has a tender right wrist (where cath was done). past medical history: -3vd (see hpi), bms x 3 to lad -aml s/p induction chemo starting social history: married here with wife. daughter & son. both married & live an hour away. -tobacco history: denies -etoh: denies -illicit drugs: denies family history: brother with aml s/p transplant here at in . father with a history of "multiple small heart attacks," but died in his 80s. physical exam: on admission: vs: temp- t- 101.4 hr- 130 bp 106/60 rr-15 sat- 99% 2 liters general: nad. oriented x3. mood, affect appropriate. eyes closed during most of the exam heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple with no lad cardiac: rr, normal s1, s2. no m/r/g. no s3 or s4. 2+ pulses lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. +bs extremities: no c/c/e. skin: no rashs, skin warm and moist neuro: altert, cn 2-12 grossly intact, gait not assessed, moving all limbs appropriately pertinent results: ekg: sinus tach at 135, ste vs j point elevations in v2-v4, qwave in iii (st changes are new from er ekg) . tte : the left atrium is normal in size. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is moderately depressed (lvef= 30-40 %) secondary to hypokinesis of the anterior septum, inferior septum, anterior free wall, lateral wall, and apex. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. there are focal calcifications in the aortic arch. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. compared with the findings of the prior study (images reviewed) of , the left ventricular ejection fraction is further reduced. . cardiac cath : 1. selective coronary angiography of this right dominant system demonstrated three vessel coronary artery disease. the lmca was not present. there were separate ostia for the lad and lcx. the lad had a 60-70% proximal eccentric lesion, a total occlusion of the mid-lad and a 50-60% lesion of the diagonal branch. the lcs had a 40% stenosis in a large om and a 60-70% stenosis in the smaller distal lcx into the om2. there was a large patent ramus. the rca was 100% occluded proximally. the pda and pl filled by left to left collaterals. 2. limited resting hemodynamics revealed normal systemic arterial pressure of 96/73 mmhg. 3. successful ptca and placement of a 3.0x12mm vision bare-metal stent in the proximal lad and overlapping 2.5x23mm and 2.5x12mm mini vision bare-metal stents in the mid lad were performed. final angiography showed normal flow, no apparent dissection, and no residual stenoses. ivus showed good stent apposition. (see ptca comments.) final diagnosis: 1. three vessel coronary artery disease. 2. placement of bare-metal stents in the lad. . ck: 175 mb: 21 mbi: 12.0 trop-t: 0.61 (9pm) ck: 95 mb: 12 mbi: 12.6 trop-t: 0.20 (2pm) ua: yellow, clear, specgr 1.023, ph 5.0, urobil neg, bili neg, leuk neg, bld sm , nitr neg, prot tr, glu neg, ket neg, rbc 0-2, wbc , bact few, yeast none, epi 0-2 lactate:1.1 . 139 106 13 agap=14 ------------<113 4.6 24 0.7 . wbc 11.6, plt 680, hct 31.3 n:69.3 l:16.6 m:13.0 e:0.1 bas:1.1 pt: 12.7 ptt: 27.0 inr: 1.1 . osh labs: trop t: 0.12, ck 47 wbc 11.1, hct 32, plt 584 . ct abd/pelvis w/ and w/o contrast: 1. no evidence of retroperitoneal hematoma. no focal abscess or overt infection in the abdomen or pelvis. 2. interval development of bilateral moderate pleural effusions with compressive atelectasis, left greater than right. area of focal consolidation vs mass in the left upper lobe as previously identified is not encompassed by today's study, however, is evident on scout radiograph. 3. multiple bilateral sub-4 mm pulmonary nodules are better demonstrated on prior ct from . 4. 9-mm hypodense liver lesion is too small to fully characterize but likely represents a cyst. focal fatty infiltration in anterior left lobe of liver. 5. trace pelvic fluid, a non-specific finding. brief hospital course: 61 yo m with hx of aml, s/p 7+3 induction chemo c/b presumed fungal pneumonia treated with voriconazole, and reduced ef (30-40%), cad s/p pci with bms x3 in lad() who now presents with chest pain and fevers/tachycardia. . # fever/leukocytosis/tachycardia: pt had sirs criteria, new leukocytosis and rigors on admission. pt has known lingular opacity seen on prior imaging last week, as well as osh imaging that confirmed this finding that in the past was thought to be a aspergillus infection, since the ag was positive and b-glucan was present. he denies gi sx, however, did have c. diff infection on , and just completed flagyl 2 days prior to infection. also had mild hypotension concerning for sepsis at the time of admission. osh cta was negative for pe. he initially required an icu stay for management of his hypotension and sepsis, he was treated with vancomycin and cefepime for a hospital acquired pneumonia and also continued on prior voriconazole. he was also continued on treatment for c.diff with po vancomycin. infectious disease was consulted and felt that he should complete a 14 day course of vancomycin/cefepime for a hospital acquired pneumonia, a picc was placed for him to complete his antibiotic course as an outpatient. . # cad, chest pain: as above, patient s/p pci with bms to lad several days prior to admission, now with chest pain and elevated troponin. patient was seen by cardiology who felt that the bump in enzymes was related to demand ischemia in the setting of hypotension, and as a result did not feel that he needed to have a repeat catheterization. given his three vessel disease he was evaluated by ct surgery, who felt that he was not a candidate for a cabg, so he was continued with medical management. he was continued on his aspirin, plavix and statin. . # atrial fibrillation: during this hospitalization patient was found to be in atrial fibrillation with rapid ventricular response. he was started on amiodarone and converted back to normal sinus rhythm. he was continued on metoprolol for rate control, and at the time of discharge was sent home on an amiodarone taper, with ep follow up to determine the duration of amiodarone therapy. . # heart failure: pt with chronic systolic heart failure with recent tte showing ef worsened to 30-40%. he did not have any signs of decompensated heart failure during his admission. he was continued on his beta blocker and ace inhibitor during his admission. . # acute aml s/p induction chemotherapy: patient had a bone marrow biopsy during his stay that was to be followed up with dr. as an outpatient. he was continued on voriconazole during his stay and at the time of discharge had outpatient follow up to determine the next step in his treatment plan. medications on admission: medications at home: 1. clopidogrel 75 mg daily 2. aspirin 325 mg daily 3. voriconazole 200 mg q12h 4. lisinopril 5 mg daily 5. toprol 37.5 mg daily 6. atorvastatin 40 mg daily . transfer medications: - meperidine 12.5 mg iv once - metoprolol succinate xl 37.5 mg po daily - oseltamivir 75 mg po daily - acetaminophen mg po/ng q6h:prn pain or fever - piperacillin-tazobactam 4.5 g iv q8h - aspirin 325 mg po/ng daily - atorvastatin 80 mg po/ng daily - clopidogrel 75 mg po/ng daily - vancomycin 1000 mg iv q 12h - heparin iv sliding scale - voriconazole 200 mg po q12h - lisinopril 5 mg po/ng daily discharge disposition: home with service facility: home therapies discharge diagnosis: primary: pneumonia nstemi atrial fibrillation aml s/p induction chemotherapy secondary: aml discharge condition: vitals stable ambulating alert and oriented to person, place, time and purpose discharge instructions: you were admitted to the hospital with chest pain and came to the icu for low blood blood pressure and concern for infection. you are being treated with iv antibiotics for pneumonia and you had a picc line placed. you will received the iv antibiotics at home for an additional 3 days. you should continue taking the plavix 75 mg once a day (a medication for the stents placed in the blood vessels in your heart). you will need to take this for at least one month. dr. will determine if you need to take this longer. additionally, you must continue to take a full strength aspirin indefinitely. the following medications were added: - cefepime 2g iv twice a day through - vancomycin 1g iv twice a day through - oral vancomycin 250mg four times a day, you will continue taking this through - amiodarone 400mg twice a day for one week, then 200mg once a day for another 3 weeks. this is for your abnormal heart rhythm (atrial fibrillation). dr. will determine if you need to take this for a longer period of time. appointments have been made for you for cardiology (dr. and dr. , infectious disease (dr. , oncology (dr. . if you need to change them, please call the numbers listed below. it was a pleasure meeting you and participating in your care. followup instructions: picc line removal: 7 outpatient clinic at 1pm (you can come over after your cardiology appointment) hematology/oncology: dr. at 1pm 7 outpatient clinic cardiology: dr. : phone: 4:00pm dr. : phone: 11:00am please follow up with your primary care doctor within one month of discharge. procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified biopsy of bone marrow arterial catheterization diagnoses: pneumonia, organism unspecified subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery congestive heart failure, unspecified unspecified septicemia atrial fibrillation percutaneous transluminal coronary angioplasty status sepsis intestinal infection due to clostridium difficile chronic systolic heart failure acute myeloid leukemia, without mention of having achieved remission 

Answer: The patient is high likely exposed to