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: ampicillin / levaquin / vicodin / rituximab attending: chief complaint: hypoxia, fatigue major surgical or invasive procedure: hemodialysis history of present illness: mr. is a 79 yo gentleman with a history of esrd on hd, restrictive/interstitial lung disease on home 2lnc, untreated cll, rcc s/p nephrectomy, prostate cancer, bladder cancer who was sent to the ed from outpatient follow up appointment for hypoxia. . of note, he was recently admitted from /08 for hyperkalemia after missing hd due to a clotted av fistula. he was intially treated medically for hyperkalemia and then admitted to the micu. surgery tried to remove clot from fistula unsuccessfully and fistula was converted to graft. tunnelled r ij hd catheter placed intraoperatively and he received hd. o2 requirement was at patient's baseline after hd. while in icu, he was found to have uti with culture showing >100,000 colonies of lactobacillus and alpha hemolytic strep. he completed 5 days of ceftriaxone. . he is typically receiving hd on t/th/sat but due to the holiday this week, received hd mon/wed, and was due to restart regular hd schedule on sat. he presented to an outpt surgery appointment to have sutures removed from his new lue av graft. at that time, he was found to be hypoxic to low 80s on baseline 2lnc. o2 sats improved to low 90s on 3-5l nc by report. patient noted significant fatigue x 3-4 days but otherwise denies any chest pain, sob, n/v, fevers, chills, or any other complaints. he was transferred to the ed for further evaluation. . upon arrival to the ed, afebrile, hemodynamically stable, sbp 110s-120s, hr 70s. rr 26 and patient appeared to have increased wob although he denied any subjective sob. o2 sats on arrival 74% on ra, 87-88% 30-40% ventimask, low 90s on 45% ventimask. rr 24-26. labs significant for wbc 98, hct 30 at recent baseline, bun/cr 32/5.1. cxr showed pulmonary edema. . in the icu, patient appears comfortable. he notes 3-4 days of fatigue, wanting to do nothing besides sleep. he denies any fevers, chills, nightsweats, myalgias, sob, chest pain, nausea, vomiting, diarrhea, or constipation. he does note pain at his avg site but otherwise denies pain. he notes increased urination yesterday with ~ voids. he typically makes minimal urine. he denies dysuria. he notes chronic cough productive of clear phlegm but denies any recent change in this. patient also reports that in surgery clinic today, there was concern that his avg was infected and he was called in a prescription for keflex 250 mg . past medical history: # restrictive/interstitial lung disease on 2l nc at home # esrd on hd, initiated , t/th/sat at hd # hypertension # hypothyroidism # cll -diagnosed , bl wbc 90s-100s in last 2 years - partially treated with rituximab, initiated after admission for chf # hypogammaglobulinemia - likely rituximab # rcc s/p r nephrectomy # bladder ca x 2 - s/p chemo # prostate cancer in situ - s/p xrt - s/p transurethral resection # recurrent diverticulitis # depression # irritable bowel syndrome # s/p ccy # s/p appendectomy social history: lives in , ma alone. divorced. 2 children. has girlfriend. retired buyer at staples office supply. occ etoh. quit smoking cigarettes 30 years ago, but smoked 2 pks/day x 15 years. smokes marijuana, no other illicit drugs. no ivdu family history: grandmother - breast ca age <50, mother - died at 85 from stroke, father - died at 75 from encephalitis, brother - died at 31 from suicide physical exam: initial physical exam af, 135/81, 74, 22, 91% 45% ventimask cannot appreciate jvp r ij tunnelled line cdi rrr. iii/vi sys murmur crackles at bases distended abd. soft, nt lue fistula with palpable thrill, ttp inferior to avg site. no overlying erythema or drainage 1+ le edema b. full distal pulses pertinent results: 01:00pm hypochrom-normal anisocyt-occasional poikilocy-occasional macrocyt-1+ microcyt-occasional polychrom-normal neuts-3* bands-0 lymphs-94* monos-3 eos-0 basos-0 atyps-0 metas-0 myelos-0 wbc-98.5* rbc-3.23* hgb-10.1* hct-30.1* mcv-93 mch-31.3 mchc-33.6 rdw-17.7* plt count-126* tsh-2.8 ck-mb-notdone ctropnt-0.06* ck(cpk)-22* glucose-103 urea n-32* creat-5.1*# sodium-136 potassium-4.7 chloride-102 total co2-28 anion gap-11 lactate-0.7 04:39pm pt-15.1* ptt-32.2 inr(pt)-1.3* igg-298* albumin-4.1 ctropnt-0.06* alt(sgpt)-8 ast(sgot)-21 ld(ldh)-233 ck(cpk)-19* alk phos-134* tot bili-0.6 chest (portable ap) study date of 1:38 pm impression: mild congestive heart failure. chest (portable ap) study date of 6:38 pm impression: previously seen pulmonary edema has improved. unilat up ext veins us left port study date of 9:11 pm impression: son characteristics of the 1.9 cm subcutaneous fluid collection are more consistent with postoperative seroma than abscess, though infection cannot be completely excluded. brief hospital course: 79 yo gentleman with a history of esrd on hd, restrictive/interstitial lung disease on home 2lnc, untreated cll, rcc s/p nephrectomy, prostate cancer, bladder cancer who was sent to the ed from outpatient follow up appointment for hypoxia. . # hypoxia/pulmonary edema: felt to be due to volume overload with change in hd schedule +/- dietary indiscretion. pt had no symptoms of cardiac ischemia and no fever or other symptoms to suggest infectious etiology. no symptoms to suggest flu. he underwent hd with removal of ~4l of fluid with a prompt response in oxygenation and improvement on repeat chest x-ray. . # fatigue: felt to be due to hypoxia on presentation. tsh was normal and blood cultures were without growth at the time of discharge. over his brief hospital course, the patient's fatigue mildly improved and the patient reported being near his baseline. . # esrd: as above, the patient underwent a session of hd during his hospitalization and was scheduled of a repeat session as an outpaient on monday . # av fistula: the patient had a right av graft which was noted to be swollen. an ultrasound was obtained which was suggestive of a seroma but abcess could not be ruled out. the patient was given several doses of vancomycin for concern of infection, but it was learned that he was already prescribed a course of cephalexin for his graft as an outpatient. his home antibiotic regimen was reinitiated and the patient was discharged with instructions to complete his previously intended course. # hypertension: blood pressure medications were initally held on admission but reinitiated prior to discharge. # cll/hypogammaglobulinemia: wbc 96k on admission and igg of 298, both of which were consistant with previously documented results. no interventions were made and the patient should follow-up with his hematologist as previously planned. # hypothyroidism: the patient was continued on his home levothyroxine. . # depression: the patient was continued on citalopram. . # ibs: continued dicyclomine. medications on admission: albuterol 2 puffs every six hours as needed for wheezing allopurinol 100 mg each day amlodipine 5 mg once a day nephrocaps once a day budesonide 2 puffs inhaled citalopram 40 mg daily dicyclomine 10 mg qid epoetin alfa levothyroxine 88 mcg daily omeprazole 20 mg daily terazosin 10 mg qhs tiotropium bromide 18 mcg daily ergocalciferol iron discharge medications: 1. allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). 2. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 3. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 4. dicyclomine 10 mg capsule sig: one (1) capsule po qid (4 times a day). 5. cephalexin 250 mg capsule sig: one (1) capsule po q12h (every 12 hours) for 7 days. 6. terazosin 5 mg capsule sig: two (2) capsule po hs (at bedtime). 7. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po daily (daily). 8. levothyroxine 88 mcg tablet sig: one (1) tablet po daily (daily). 9. citalopram 20 mg tablet sig: two (2) tablet po daily (daily). 10. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 11. albuterol 90 mcg/actuation aerosol sig: two (2) puffs inhalation q6hours:prn. 12. budesonide 180 mcg/inhalation aerosol powdr breath activated sig: two (2) inhalation twice a day. 13. epoetin alfa injection 14. ergocalciferol (vitamin d2) oral discharge disposition: home discharge diagnosis: pulmonary edema hd dependent end stage renal disease discharge condition: the patient was hemodynamically stable, afebrile and without pain at the time of discharge. discharge instructions: you were admitted for evaluation and treatment of shortness of breath. it is felt that your symptoms were due to the recent change in your dialysis schedule. durining this hospitalization, you underwent dialysis and your symptoms improved. you should attend an outpatient dialysis session tomorrow at your normal dialysis center. no changes were made to you medications. please continue to take all previously prescribed medications (including your recent antibiotic) as directed. please call your doctor or seek medical attention if you develop worsening shortness of breath, cough, fevers, chills, nausea, vomiting, pain or redness over your fisula/gaft site or any other symptoms of concern. followup instructions: provider: function lab phone: date/time: 9:40 provider: . phone: date/time: 10:00 procedure: hemodialysis diagnoses: end stage renal disease unspecified acquired hypothyroidism personal history of malignant neoplasm of prostate hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease postinflammatory pulmonary fibrosis personal history of malignant neoplasm of bladder hypoxemia pulmonary congestion and hypostasis personal history of malignant neoplasm of kidney chronic lymphoid leukemia, without mention of having achieved remission 

Answer: The patient is high likely exposed to