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: fever, tachypnea major surgical or invasive procedure: thoracentesis history of present illness: 73yo m w/ long hx of cll on chronic steroids and c/b aiha, hypogammaglobinemia, recent r hip fx () s/p r hip nail and orif and recurrent pna's, who now presents with fever and pna. since pt has had off and oncough w/ sputum. in tx w/ outpt levaquin. then admitted multiple times: - chest ct neg, afb negc3, pertusis neg, 1 cx g(-)rods - tx w/ cefepime -worsening sob, ct neg, improved w/ lasix - rsv infection (no lower respir infxn) s/p ivig and levaquin x5d - multilobar pna + persistent rsv infxn, blood cx + for strep pneumo, tx w/ cefpodxime - r femur fx, difficulty extubating, tx w/ meropenem + vori and bronc on showed (contaminant), but w/ elev b-glucan tought to be fungal pna (from other than ), and has remained on fluconazole since then. also tx w/ rituxand and it mtx. d/c on to for rehab. at he was initially doing well, and started walking again. he has had persistent intermittent cough that has unchanged in frequency or severity over the last 1.5 wks. it occasionally productive w/ clear sputum. am pt had a fever 100.1 and went away on its own, but dr. from reported the pt was more lethargic and started vanc/ceftaz and wanted to see how he does. the next morning (today) pt had a fever 100.8 and was significantly more weak, and had tachypnea, and was brought in. in ed, 99.8, hr 98, 141/85, rr40, nrb 98% on ?o2. exam demonstrated bil rhonchi. labs notable for hct drop from baseline, no clinical signs of bleed. given vancomycin and zosyn for presumed pna. but due to tachypnea out of proportion to cxr for pna, cta ordered to rule out pe. placed on bipap for tachypnea, with clinical improvement. vital signs in ed prior to transfer: 129/76, hr 87, rr 28, 100%, fio2 100%. access 18, picc, full code. past medical history: -cll/sll, on rituxan/bedamustine -recurrent pleural effusions, status post right pleurodesis on . he has continued with loculated effusion on the right, although currently improved -hypogammaglobulinemia, receiving ivig q. monthly during winter months in particular, most recently -recurrent pneumonias, requiring admissions periodically -peptic ulcer disease -status post right inguinal hernia repair -status post skin biopsies of the left neck, left shoulder, left ear biopsy consistent with hypertrophic actinic keratoses -basal cell carcinoma with mohs procedures of the left chest, left scalp area, area of squamous cell carcinoma noted on the right forehead with mohs procedure -status post left hip femoral head stress fracture . -status post t5 and t12 vertebral fractures on . -rsv -ivc compression by rp lad causing lower extremity edema -autoimmune hemolytic anemia related to cll, on prednisone x10 years social history: mr. lives with his wife in . he is retired and previously worked doing maintenance. prior to this he was a soccer coach in his home country of . he moved from the before chernobyl. he is a prior smoker, previously smoked 10 cigarettes for 10 years but quit approximately 25 years ago. he denies any alcohol or ivdu. family history: notable for his son who has aml in remission. physical exam: on admission: general: pleasant, mild resp distress heent: normocephalic, atraumatic. no conjunctival pallor. no scleral icterus. perrla/eomi. mmm. op clear. neck supple, no lad, no thyromegaly. cardiac: regular rhythm, normal rate. normal s1, s2. no murmurs, rubs or . jvp=9cm lungs: bibasilar rales, and rales throughout r lung abdomen: +bs, soft, luq firm mass (likely stool), no hsm extremities: 2+ le edema r>l, rle improved from previous per wife skin: at abdomen neuro: a&ox3 psych: listens and responds to questions appropriately, pleasant pertinent results: cxr: bilateral pleural effusions, left greater than right cta: impression: 1. no evidence of pe, dissection or pneumothorax. 2. slight increase in large left and moderate right pleural effusion. 3. interval decrease in size of right upper lobe pulmonary nodule, evaluation of lung parenchyma is limited by motion artifact. pleural fluid: many lymphocytes, mesothelial cells and blood. repeat cxr: moderate bilateral pleural effusion, right greater than left, increased bilaterally since . no pneumothorax. lungs grossly clear. heart size normal. ascending thoracic aorta tortuous or dilated but not acutely changed. no pneumothorax. labs: 10:50am blood wbc-5.4 rbc-2.24*# hgb-7.9*# hct-23.0*# mcv-103* mch-35.2* mchc-34.3 rdw-21.5* plt ct-32*# 04:01am blood wbc-6.1 rbc-2.73* hgb-9.6* hct-27.1* mcv-99* mch-35.3* mchc-35.6* rdw-22.2* plt ct-26* 03:42am blood neuts-17* bands-0 lymphs-76* monos-1* eos-0 baso-0 atyps-6* metas-0 myelos-0 03:42am blood pt-16.9* ptt-26.2 inr(pt)-1.5* 10:50am blood glucose-92 urean-15 creat-0.5 na-133 k-4.2 cl-95* hco3-30 angap-12 04:01am blood glucose-71 urean-25* creat-0.7 na-135 k-4.3 cl-102 hco3-23 angap-14 03:42am blood ld(ldh)-348* totbili-2.4* 10:50am blood ck(cpk)-4* 10:50am blood ctropnt-<0.01 04:01am blood calcium-11.1* phos-2.1* mg-2.2 06:21am blood type-art temp-36.7 o2 flow-3 po2-85 pco2-35 ph-7.50* caltco2-28 base xs-3 intubat-not intuba 11:15am blood lactate-2.7* glucan positive, galactomannan negative. brief hospital course: 73yo m w/ long hx of cll on chronic steroids and c/b aiha, hypogammaglobinemia, recent r hip fx () s/p r hip nail and orif and recurrent pna's, returns with presents with pna (cough, tachycardia, hypoxia) and after treatment with antibiotics and therapeutic thoracentesis without improvement, family discussion reached conclusion of making pt . #. pt was brought to the icu w/ his tachypnea, and placed on bipap. once he reached the icu pt was taken off the bipap and was found the was 97-100% on ra. his rr was still in the 40-50s. this was attributed to his pleural effusions. he also has a h/o recurrent pleural effusions, status post right pleurodesis on . a left thoracentesis was performed w/ 1100cc of bloody fluid removed, sent for cytology, cell count and diff, hct, and was c/w malignant effusion. pt had tachypnea that improved post-thoracentesis w/ rr in 20s increasing to 30s the following day. central hyperventilation was considered from a cns infection but thought low likelihood and lp was not pursued after discussion w/ hem/onc. cxr on showed significant reaccumulation of the fluid. pleurodesis was discussed, but w/ such rapid reaccumilation and pt being near end of life, decision was made to focus on comfort and pt was made . he was transferred out of the icu, where he became lethargic and minimally aroused. nasal cannulla supplementary oxygen was continued for comfort breathing, and morphine ordered for liberal use if breathing appeared labored or pt in pain. vital signs checks were discontinued. pt passed away on from cardiopulmonary arrest, with family by the bedside. #. fever - pt has had chronic cough since , and reccurent pna. no focal infiltrate on ct. pt may have pnau pt may be immunocompromised from cll and will tx. pt received vanc/zosn in ed. pt may have developed a pna vs. pneumonitis, but was placed on vanco/zosyn and fluconazole prophylactically. pt's glucan was still elevated at 219 (previous admission - 411, - 330). also pt's picc was removed as from osh, and was d/c'd. pt's fever's resolved after picc was removed. abx were stopped once pt made . #. volume status- initially it was thought pt may be hypervolemic, but no h/o heart failure - previously fluid overloaded on previous admission, currently 2+ le edema, bibasilar rales. pt does have a h/o ivc compression by rp lad causing lower extremity edema no significant cardiomegaly, and very mild blunting of costophrenic angle. lasix 40 iv x1 was given, and pt became tachycardic to 130s. pt's mm dry and pt recieved fluid boluses. all volume status management was stopped once code status was changed to . #. hypogammaglobinemia- ivig was on , planned to get monthly in winter months. gave ivig on night of admission, but pt developed rigors, temp to 100, and hypertension to 180s. ivig was stopped, pt was given iv benadryl and tylenol. restarted next day w/ premedication and pt tolerated well. #. cll - per outpt onc, on rituxan/bedamustine. all bloodwork and transfusion parameters discontinued once made npo. for secondary autoimmune hemolytic anemia, pt was continued on his chronic steroids, also until made npo. #. s/p femur fx - pain was well controlled # fen: swallow study passed, but recommendation remained npo, crush meds, and can give occasional soft diet given pt's poor mental status #ppx: pt was prophylaxed with pentamidine, acycolovir, ivig, and pneumoboots until made . medications on admission: - acyclovir 400mg tid - albuterol neb q6 prn - ipratrop neb - benzonatate 100mg tid - codeine-guaifenisn 100/10 - fentanyl 25mcg/h q72 - fluconazole 400mg qd - advair 250/50 - folic acid 1mg qd - lidocaine patch q12 - protonix 40mg qd - pentamidine 300mg qmo - prednisone 10mg qd - vit b12 1000mcg qd - delsym q12 prn cough - colce - senna - mvi discharge medications: none discharge disposition: expired discharge diagnosis: pneumonia, pleural effusions, cll discharge condition: expired discharge instructions: none followup instructions: none md procedure: thoracentesis diagnoses: pneumonia, organism unspecified coronary atherosclerosis of native coronary artery unspecified pleural effusion long-term (current) use of steroids acute kidney failure, unspecified asthma, unspecified type, unspecified cachexia pressure ulcer, lower back hypoxemia surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation acquired hemolytic anemia, unspecified other and unspecified infection due to central venous catheter chronic lymphoid leukemia, without mention of having achieved remission neutropenia, unspecified peptic ulcer of unspecified site, unspecified as acute or chronic, without mention of hemorrhage or perforation, without mention of obstruction pressure ulcer, stage ii hypogammaglobulinemia, unspecified 

Answer: The patient is high likely exposed to