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: no known allergies / adverse drug reactions attending: chief complaint: fatigue major surgical or invasive procedure: pericardiocenthesis skin biopsy bronchoscopy history of present illness: 74 yo man with a recent diagnosis of mds, now presenting with sob and found to have aml and cardiac tamponade. fatigue and shortness of breath have been progressive over the last week of . initially thought to be due to anemia so he was offered transfusion and refused this. his sob continued to worsen so he presented to clinic on . his sx were so severe that even mild activity, such as changing clothes, was exhausting. he also admitted to chest pain which he described as a racing heartbeat without pressure or sharp pain. there were no associated sx of n/v, diaphoresis, or radiating pain but he did have le edema x past few weeks. in clinic, vitals were notable for an oxygen saturation 97%-100%, hr 109, t 99 and he appeared distressed. labs significant for new wbc of 17, up from 1k one week prior, with 80% other cells, concerning for leukemic transformation of mds. he was admitted to the bmt service. a tte was obtained which showed cardiac tamponade so he was taken for drainage. 250cc bloody fluid was removed. there was a piece of tissue-like material within the pericardial fluid as well which was sent for pathology. opening pressure was 10, after drainage was negative. post-drain echo did not show fluid but showed hyperdynamic septum. no right heart cath was done. pt was transferred to the ccu for monitoring s/p drainage and felt well. . ros: positive per hpi and for 6 lb weight loss over 3 weeks, urinary frequency. also for r sided neck strain. negative for fevers, chills, ns, abdominal pain, n/v, diarrhea, black or bloody stools, myalgias, arthralgias, dysurea, hematuria, dizziness or syncope. past medical history: 1. cardiac risk factors: - diabetes, + dyslipidemia, + hypertension 2. cardiac history: none 3. other past medical history: - mds diagnosed - hypertension - hyperlipidemia social history: he works as a case worker in a chinese senior center next door his lives. he currently lives with his wife who is a homeopathic practitioner. he has two adult children. has 50 pack year smoking history. denies use of alcohol or illicit drugs. family history: no early cad, cardiomyopathy, sudden death. unremarkable for any hematologic or malignant disorders. physical exam: admission pe: vs: t=97.4, bp=113/55, hr=97, rr=23, sat= 97% ra general: lying in bed, appears uncomfortable but not acutely so, responding to questions. states he has "been fighting for my life all day." heent: ncat. sclera anicteric. neck: no kussmaul sign cardiac: pmi located in 5th intercostal space, midclavicular line. rrr, + friction rub louder with inspiration and heard best at 4-5th intercostal spaces in midclavicular line lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. cta in right lung and at bases bilaterally, mild wheezing with expiration over left anterior chest wall abdomen: soft, distended, nt. no hsm or tenderness. extremities: no c/c/e. 2+ pulses in radial and dp bilat. skin: no stasis dermatitis, ulcers, scars, or xanthomas. discharge pe: expired pertinent results: pertinent labs: 09:50am blood wbc-17.1*# rbc-2.30* hgb-7.8* hct-23.1* mcv-100* mch-34.1* mchc-33.9 rdw-15.2 plt ct-105* 09:50am blood neuts-2* bands-0 lymphs-16* monos-1* eos-0 baso-0 atyps-0 metas-1* myelos-1* blasts-0 other-79* 01:20am blood wbc-15.0* rbc-2.05* hgb-6.7* hct-20.7* mcv-101* mch-32.9* mchc-32.5 rdw-15.1 plt ct-78* 12:51pm blood wbc-31.6*# rbc-2.94*# hgb-9.9*# hct-29.4*# mcv-100* mch-33.7* mchc-33.6 rdw-16.6* plt ct-91* 10:30pm blood wbc-14.8*# rbc-2.65* hgb-9.0* hct-26.5* mcv-100* mch-34.2* mchc-34.1 rdw-16.8* plt ct-81* 05:56am blood wbc-18.7* rbc-2.59* hgb-8.7* hct-26.1* mcv-101* mch-33.4* mchc-33.2 rdw-17.1* plt ct-67* 05:05pm blood pt-17.1* ptt-31.8 inr(pt)-1.6* 01:20am blood pt-17.8* ptt-30.5 inr(pt)-1.7* 12:51pm blood pt-17.1* ptt-27.6 inr(pt)-1.6* 10:30pm blood pt-17.6* ptt-30.5 inr(pt)-1.7* 05:56am blood pt-16.6* ptt-28.5 inr(pt)-1.6* 05:56am blood gran ct-370* 05:05pm blood glucose-184* urean-31* creat-1.3* na-135 k-3.5 cl-104 hco3-21* angap-14 01:20am blood glucose-133* urean-32* creat-1.3* na-139 k-3.5 cl-106 hco3-22 angap-15 12:51pm blood glucose-130* urean-36* creat-1.4* na-134 k-4.2 cl-103 hco3-20* angap-15 05:56am blood glucose-118* urean-50* creat-1.8* na-136 k-4.0 cl-105 hco3-20* angap-15 05:05pm blood alt-18 ast-18 ld(ldh)-978* ck(cpk)-208 alkphos-47 totbili-0.4 06:11pm blood ck(cpk)-196 12:51pm blood alt-17 ast-29 ld(ldh)-1695* alkphos-62 totbili-0.7 10:30pm blood ld(ldh)-1540* 05:56am blood alt-14 ast-15 ld(ldh)-1221* alkphos-49 totbili-0.5 05:05pm blood ck-mb-3 ctropnt-0.45* 06:11pm blood ck-mb-3 ctropnt-0.44* 05:05pm blood albumin-3.4* calcium-8.1* phos-2.5* mg-2.0 01:20am blood calcium-7.9* phos-3.2 mg-2.1 12:51pm blood albumin-3.4* calcium-8.2* phos-3.0 mg-2.1 uricacd-7.1* iron-108 10:30pm blood calcium-7.7* phos-4.7*# uricacd-7.8* 05:56am blood calcium-8.1* phos-4.8* mg-2.3 uricacd-8.5* urine: 12:52pm urine color-yellow appear-hazy sp -1.019 12:52pm urine blood-sm nitrite-neg protein-100 glucose-neg ketone-neg bilirub-neg urobiln-2* ph-5.5 leuks-neg 12:52pm urine rbc-1 wbc-3 bacteri-few yeast-none epi-1 transe-<1 12:52pm urine castgr-8* casthy-3* 12:52pm urine hours-random urean-1274 creat-204 na-11 k-59 cl-18 12:52pm urine osmolal-677 marrow: 08:33am other body fluid wbc-1333* hct,fl-5* polys-1* lymphs-8* monos-0 mesothe-3* other-88* studies: echo (): the left atrium is normal in size. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). there is considerable beat-to-beat variability of the left ventricular ejection fraction due to an irregular rhythm/premature beats. right ventricular chamber size and free wall motion are normal. there is abnormal septal motion/position. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are structurally normal. no mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is a moderate sized pericardial effusion. the effusion appears circumferential. there is brief right atrial diastolic collapse. there is significant, accentuated respiratory variation in mitral/tricuspid valve inflows, consistent with impaired ventricular filling. impression: moderate pericardial effusion with evidence of elevated intrapericardial pressures. normal biventricular systolic function. cardiac cath (): comments: 1. pericardiocentesis performed via subxyphoid approach using blunt tipped needle. pericardial location confirmed using by echo using agitated saline. initial pericardial pressure of 8 mmhg. we removed 250cc of serosanguinous fluid and left drain in place. post pericardial pressure of 0 mmhg. the patient tolerated the procedure well and was transferred to ccu in stable condition. 2. successful pericardiocentesis. final diagnosis: 1. moderate pericardial effusion with tamponade physiology by echo. 2. successful pericardiocentesis with removal of 250cc of fluid, sent for routine labs and cytology. echo (): pre-tap: pericardicentesis catheter was confirmed to be in the pericardial space with injection of agitated saline (clip ). post tap: overall left ventricular systolic function is normal (lvef>55%). there is abnormal septal motion and residual variation in mitral valve inflow suggestive of effusive-contrictive physiology. there is no residual pericardial effusion. impression: sucessful pericardiocentesis with no residual pericardial effusion. cxr (): impression: no evidence of acute infiltrates on single portable chest view. recommend completion to pa and lateral chest view whenever situation permits. echo (): the left ventricular cavity is small. left ventricular systolic function is hyperdynamic (ef>75%). there is mild pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. impression: trivial residual pericardial effusion. small, "underfilled" left ventricle with hyperdynamic systolic function. compared with the prior study (images reviewed) of , the patient is more tachycardic, with smaller ventricular cavity. consider interim intravascular volume depletion. cxr (): impression: enlargement of the cardiac silhouette possibly related to pericardial effusion in the absence of significant pulmonary congestion. confirmation echocardiogram is recommended. sinus rhythm. diffuse non-specific st-t wave abnormalities most notable in the inferior leads. compared to tracing #2 t wave changes are slightly more marked, suggest clinical correlation. ct chest 1. no pneumonia or other indication of intrathoracic infection. 2. small posteriorly layering nonhemorrhagic left pleural effusion and associated relaxation atelectasis. 3. severe multi-chamber cardiomegaly. small pericardial effusion. no indication of tamponade. 4. probable anemia. 5. mild atherosclerotic coronary calcification. 6. splenomegaly. echo left ventricular wall thickness, cavity size, and global systolic function are normal (lvef>55%). the right ventricular cavity is dilated with depressed free wall contractility. there is abnormal septal motion/position. the tricuspid valve leaflets are mildly thickened. tricuspid regurgitation is present but cannot be quantified. the pulmonary artery systolic pressure could not be determined. there is a very small pericardial effusion. there are no echocardiographic signs of tamponade. leni no evidence for deep vein thrombosis in bilateral lower extremities. renal us 1. no evidence of obstruction. 2. left and right renal cysts. 3. mildly echogenic kidneys indicating parenchymal disease. 3. prostate is enlarged. immunophenotyping on pericardial fluid cell marker analysis demonstrates that the majority of the cells isolated from this pericardial fluid express immature antigens cd34, myeloid associated antigens cd13. they are negative for cd10, (calla) and cd20. blast cells comprise 69% of total gated events. immunophenotypic findings consistent with involvement by: acute myelogenous leukemia (similar to that seen in bone marrow/peripheral blood). immunophenotyping on bone marrow b cells comprise 33% of lymphoid-gated events, are polyclonal, and do not express aberrant antigens. t cells express mature lineage antigens, and have a normal helper-cytotoxic ratio of 1.1. cell marker analysis demonstrates that the majority of the cells isolated from this peripheral blood/bone marrow express immature antigens cd34, hla-dr, cd117, myeloid associated antigens cd33, cd13, cd15, cd11c (dim), cd71. there are negative for lymphoid associated antigens cd19 (dim) tdt, cd10 (calla) negative, cd14, cd41, cd56 and cd64. blast cells comprise 84% of total gated events. immunophenotypic findings consistent with involvement by: acute myelogenous leukemia; correlate with concurrent bone marrow biopsy (s12-20349l). bone marrow karotyping 44,,(2)(p21p23),(5)(q13q33),?add(16)(p13.1),-17,-18 /46,xy bone marrow aspirate and core biopsy cellular erythroid dominant bone marrow (based on aspirate smear) with trilineage dyspoiesis, consistent with myelodysplastic syndrome, best classified as refractory cytopenia with multilineage dysplasia. please correlate with clinical, cytogenetic and molecular findings. us of left ue occlusive thrombus in the mid to distal brachial vein near the picc line insertion site. chest ct without contrast: 1. multifocal pneumonia, most severe in the right perihilar region. bilateral pleural effusions. in this immunocompromised patient, the etiology may be bacterial or fungal. 2. scattered pulmonary cysts and right apical scarring. 3. cardiomegaly and anemia. 4. splenomegaly; leukemic infiltration cannot be excluded. ct sinus/mandible mild mucosal thickening involving the ethmoidal sinuses as well as the left maxillary sinus with no evidence of an infectious process. tte the estimated right atrial pressure is 0-5 mmhg. left ventricular wall thicknesses and cavity size are normal. left ventricular systolic function is hyperdynamic (ef>75%). the right ventricular cavity is mildly dilated with moderate global free wall hypokinesis. tricuspid regurgitation is present but cannot be quantified. there is a trivial to very small pericardial effusion. the effusion is echo dense, consistent with blood, inflammation or other cellular elements. there are no echocardiographic signs of tamponade. impression: trivial to very small echodense pericardial effusion without echocardiographic signs of tamponade. mildly dilated right ventricle with depressed systolic function. hyperdynamic left ventricular function. compared with the prior study (images reviewed) of and , the effusion appears echodense and decreased in size. the right ventricle appears mildly decreased in size and function appears mildly improved. left upper extremity derm biopsy leukemia cutis, see note. note: the section shows papillary dermal edema, marked extravasated red blood cells, and exuberant perivascular and dermal mononuclear infiltrate. the perivascular cells are atypical and contain large nuclei, conspicuous nucleoli, irregular nuclear membranes, dark chromatin and have eosinophilic cytoplasm. occasional eosinophils are also noted. the atypical perivascular cells are highlighted by cd34 and cd117 (c-kit) immunostains. cd68 highlights occasional admixed histiocytes. given the above histomorphology and immunophenotype, the findings are compatible with leukemia cutis. pas, tissue gram, and afb stains are negative for microorganisms. multiple levels have been examined. cxr there is again seen consolidation in the right upper lobe consistent with pneumonia. this has improved slightly since the prior study. however, there is a new left retrocardiac opacity that has developed and a small left-sided pleural effusion. resolution of these opacities is recommended. there is a right-sided picc line whose distal tip is not optimally seen; however, it is at least to the level of the upper svc. 8:44 pm stool consistency: soft source: stool. microsporidia stain (pending): cyclospora stain (pending): c. difficile dna amplification assay (final ): negative for toxigenic c. difficile by the illumigene dna amplification assay. (reference range-negative). fecal culture (pending): campylobacter culture (pending): cryptosporidium/giardia (dfa) (pending): __________________________________________________________ 2:21 pm sputum source: expectorated. gram stain (final ): <10 pmns and >10 epithelial cells/100x field. gram stain indicates extensive contamination with upper respiratory secretions. bacterial culture results are invalid. please submit another specimen. respiratory culture (final ): test cancelled, patient credited. fungal culture (preliminary): gram stain of this specimen indicates contamination with oropharyngeal secretions and invalidates results. specimen is only screened for cryptococcus species. new specimen is recommended. acid fast smear (preliminary): no acid fast bacilli seen on direct smear. this is only a preliminary result. if ruling out tuberculosis, you must wait for confirmation by concentrated smear. acid fast culture (preliminary): __________________________________________________________ 12:45 am blood culture blood culture, routine (pending): __________________________________________________________ 12:34 am blood culture source: line-picc. blood culture, routine (pending): __________________________________________________________ 8:00 pm blood culture **final report ** blood culture, routine (final ): no growth. __________________________________________________________ 4:59 pm blood culture source: line-picc 1 of 2. **final report ** blood culture, routine (final ): no growth. __________________________________________________________ 7:00 pm tissue site: skin source: skin biopsy. gram stain (final ): no polymorphonuclear leukocytes seen. no microorganisms seen. tissue (final ): no growth. anaerobic culture (final ): no growth. potassium hydroxide preparation (final ): no fungal elements seen. fungal culture (preliminary): no fungus isolated. acid fast smear (final ): no acid fast bacilli seen on direct smear. acid fast culture (preliminary): __________________________________________________________ 5:00 pm urine source: catheter. **final report ** urine culture (final ): no growth. __________________________________________________________ 9:30 am rapid respiratory viral screen & culture source: nasopharyngeal swab. **final report ** respiratory viral culture (final ): no respiratory viruses isolated. culture screened for adenovirus, influenza a & b, parainfluenza type 1,2 & 3, and respiratory syncytial virus.. detection of viruses other than those listed above will only be performed on specific request. please call virology at within 1 week if additional testing is needed. respiratory viral antigen screen (final ): negative for respiratory viral antigen. specimen screened for: adeno, parainfluenza 1, 2, 3, influenza a, b, and rsv by immunofluorescence. refer to respiratory viral culture for further information. __________________________________________________________ 10:35 am rapid respiratory viral screen & culture **final report ** respiratory viral culture (final ): no respiratory viruses isolated. culture screened for adenovirus, influenza a & b, parainfluenza type 1,2 & 3, and respiratory syncytial virus.. detection of viruses other than those listed above will only be performed on specific request. please call virology at within 1 week if additional testing is needed. respiratory viral antigen screen (final ): less than 60 columnar epithelial cells;. specimen inadequate for detecting respiratory viral infection by dfa testing. interpret all negative results from this specimen with caution. negative results should not be used to discontinue precautions. refer to respiratory viral culture results. recommend new sample be submitted for confirmation. reported to and read back by dr at 15:11. __________________________________________________________ 10:35 am bronchoalveolar lavage gram stain (final ): no polymorphonuclear leukocytes seen. 1+ (<1 per 1000x field): gram positive cocci. in pairs and clusters. 1+ (<1 per 1000x field): gram negative rod(s). respiratory culture (final ): 10,000-100,000 organisms/ml. commensal respiratory flora. legionella culture (final ): no legionella isolated. potassium hydroxide preparation (final ): test cancelled by laboratory. patient credited. this is a low yield procedure based on our in-house studies. if pulmonary histoplasmosis, coccidioidomycosis, blastomycosis, aspergillosis or mucormycosis is strongly suspected, contact the microbiology laboratory (7-2306). immunoflourescent test for pneumocystis jirovecii (carinii) (final ): negative for pneumocystis jirovecii (carinii).. fungal culture (preliminary): no fungus isolated. acid fast smear (final ): no acid fast bacilli seen on concentrated smear. acid fast culture (preliminary): viral culture: r/o cytomegalovirus (preliminary): no cytomegalovirus (cmv) isolated. cytomegalovirus early antigen test (shell vial method) (final ): negative for cytomegalovirus early antigen by immunofluorescence. refer to culture results for further information. __________________________________________________________ 10:36 am bronchial washings gram stain (final ): no polymorphonuclear leukocytes seen. 1+ (<1 per 1000x field): gram positive cocci. in pairs and clusters. 1+ (<1 per 1000x field): gram negative rod(s). respiratory culture (final ): >100,000 organisms/ml. commensal respiratory flora. legionella culture (final ): no legionella isolated. potassium hydroxide preparation (final ): test cancelled by laboratory. patient credited. this is a low yield procedure based on our in-house studies. if pulmonary histoplasmosis, coccidioidomycosis, blastomycosis, aspergillosis or mucormycosis is strongly suspected, contact the microbiology laboratory (7-2306). immunoflourescent test for pneumocystis jirovecii (carinii) (final ): negative for pneumocystis jirovecii (carinii).. fungal culture (preliminary): no fungus isolated. acid fast smear (final ): no acid fast bacilli seen on concentrated smear. acid fast culture (preliminary): __________________________________________________________ 8:30 pm blood culture source: line-picc. **final report ** blood culture, routine (final ): no growth. __________________________________________________________ 9:18 pm blood culture **final report ** blood culture, routine (final ): no growth. __________________________________________________________ 12:43 pm sputum site: expectorated source: expectorated. acid fast smear (final ): no acid fast bacilli seen on concentrated smear. acid fast culture (preliminary): __________________________________________________________ 2:42 pm sputum site: induced source: induced. gram stain (final ): <10 pmns and >10 epithelial cells/100x field. gram stain indicates extensive contamination with upper respiratory secretions. bacterial culture results are invalid. please submit another specimen. respiratory culture (final ): test cancelled, patient credited. acid fast smear (final ): no acid fast bacilli seen on direct smear. no acid fast bacilli seen on concentrated smear. acid fast culture (preliminary): __________________________________________________________ 8:59 am sputum site: induced source: induced. gram stain (final ): <10 pmns and >10 epithelial cells/100x field. gram stain indicates extensive contamination with upper respiratory secretions. bacterial culture results are invalid. please submit another specimen. respiratory culture (final ): test cancelled, patient credited. acid fast smear (final ): no acid fast bacilli seen on direct smear. no acid fast bacilli seen on concentrated smear. acid fast culture (pending): __________________________________________________________ 4:15 pm blood culture **final report ** blood culture, routine (final ): no growth. __________________________________________________________ 1:18 pm blood culture source: line-picc. **final report ** blood culture, routine (final ): no growth. __________________________________________________________ 5:40 pm blood culture **final report ** blood culture, routine (final ): no growth. __________________________________________________________ 3:41 pm blood culture source: line-picc. **final report ** blood culture, routine (final ): no growth. brief hospital course: 74m with mds transformed to aml, complicated clinical course including multifocal pneumonia in the setting of neutropenia. # acute myelogenous leukemia: mds transformed to aml. patient started on hydroxyurea. he was then initiated on daunorubicin and ara-c, he had an anaphylactic reaction about 15 minutes into the ara-c therapy, and a code blue was called, although no compressions or intubation were performed. he was transferred to the and stabilized with supportive care, including steroids, nebulizers, benadryl. the patient was then transferred back to the floor and had decitabine therapy for 5 days, without significant decrease in blast count. allergy was consulted and recommended a protocol for desensitization to ara-c, but it was felt that the risks of this protocol outweighed the limited benefit. he developed leukemia cutis. he was then started on mitoxantrone and etoposide for one night. during this night, the patient was significantly more tachypneic and appeared more sick. a discussion with the family regarding the very limited expected benefit and likely harm of ongoing chemotherapy resulted in the decision to transfer to a more comfort-based approach, in which no more chemotherapy, the patient was made dnr/dni but antibiotics were continued. several days later, the patient expressed a desire to be made cmo. family was present and agreed. he was placed on a morphine gtt and expired shortly thereafter. . # multifocal pneumonia: the patient has multifocal pneumonia seen on ct chest and subsequent cxrs are consistent with progression of disease. he was broadened with worsening clinical symptoms and chest x-rays to vancomycin, meropenem, levofloxacin and ambisome, but his clinical status continued to worsen despite these broad-spectrum antibiotics. he was evaluated for tuberculosis with induced sputums, which were negative. bal and bronchial washings negative. he was made cmo and antibiotics were d/c'ed. . # neutropenic fever: mr continued to spike fevers despite broad-spectrum antibiotics, as discussed above in multifocal pna. . # acute kidney failure: fena was consistent with intrinsic renal failure. a possible etiology of his renal failure was his leukemia. . # early tamponade / pericardial effusion: the patient presented to the ccu with fatigue, doe. a tte was obtained which showed cardiac tamponade so he was taken for drainage. 250cc bloody fluid was removed. opening pressure was 10, after drainage was negative. post-drain echo did not show fluid but showed hyperdynamic septum. the pericardial drain was left in for less than a day then removed. interval (post-drain) echocardiograms showed no reaccumulation of fluid in the pericardial space. the patient remained hemodynamically stable, and was transferred to the bmt service for further therapy of his aml. on hd5, his pericardial fluid culture was positive for p.acnes. he was already being covered with vancomycin at this time for neutropenic fever, as discussed elsewhere. . # lower extremity edema: pt also appears to have mild diastolic dysfunction. . # pancytopenia: secondary to aml and cytoreductive therapy. the patient received multiple platelet and prbc transfusions. . # anaphylaxis to cytarabine: resolved. he had acute worsening of his baseline shortness of breath likely secondary to bronchospasm after he received danorubicin and cytarabine (likely cytarabine as the causative ). allergy recommended a desensititization protocol, which was not used. . # leukemia cutis: confirmed on biopsy. . # rue dvt: picc associated and thrombocytopenia precludes treatment, but high risk for infection so was monitored closely. . chronic care # hld: restarted home atorvastatin 80 mg daily . transitions of care: expired medications on admission: atorvastatin 80 mg daily vitamin d2 lisinopril 10 mg daily aspirin 81 mg daily discharge medications: expired discharge disposition: expired discharge diagnosis: expired discharge condition: expired discharge instructions: expired followup instructions: expired md procedure: pericardiocentesis biopsy of bone marrow closed [endoscopic] biopsy of bronchus closed biopsy of skin and subcutaneous tissue injection or infusion of cancer chemotherapeutic substance central venous catheter placement with guidance diagnoses: pneumonia, organism unspecified acidosis unspecified essential hypertension acute kidney failure, unspecified other chronic pulmonary heart diseases personal history of tobacco use other and unspecified hyperlipidemia other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure urinary frequency other complications due to other vascular device, implant, and graft antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use unspecified accident do not resuscitate status gross hematuria injury to bladder and urethra, without mention of open wound into cavity accidents occurring in residential institution other and unspecified coagulation defects knee joint replacement other specified diseases of pericardium neutropenia, unspecified other specified retention of urine other specified disorders of skin cardiac tamponade acute myeloid leukemia, without mention of having achieved remission edema other anaphylactic reaction fever presenting with conditions classified elsewhere acute venous embolism and thrombosis of deep veins of upper extremity tumor lysis syndrome other pancytopenia acute bronchospasm 

Answer: The patient is high likely exposed to