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: aleve / erythromycin base / simvastatin / boniva / augmentin attending: chief complaint: tachycardia major surgical or invasive procedure: picc placement history of present illness: reason for micu admission: a-flutter w/ rvr . primary care physician: , l. . cc:. hpi: this is a 64 year-old female with a history of diffuse b-cell lymphoma s/p 6 cycles of r- (), stage iii nsclc (dx on apical posterior segment of the left upper lobe mass) s/p chemoradiation with /taxol on , cad s/p 3 stents , pe x2 s/p ivc filter (not on coumadin hemoptysis), htn who presents with pnuemonia. the patient reports coughing and increased sputum over the last week. she was treated with a 5 day course of azithromycin as an outpatient for "bronchitis" that she finished on monday. the patient reports development of fatigue and and pleuritic left sided chest pain that started last night. she denied fevers, chills, or sob. she went to her outpatient transfusion clinic for planned prbc transfusion. at clinic today she was noted to be tachycardic to the 140's and bp was 75/50. she was referred to the ed for further management. . in the ed, 99.2 130 108/85 18 85%ra. she had a cxr that showed a new left upper lobe opacity concerning for pneumonia. she also underwent a cta that was negative for pe, but confirmed the left upper lobe consolidation. the patient's labs were signficant for a leukocytosis of 13.8 and lacate of 0.7. she was empirically covered with levofloxacin/vancomycin. her hct was 25.7 and received 2u prbc. she was also given 1.5l ivf. she continued to be in a-flutter with rvr. her ce were negative x1 and bnp 3351. she was given tylenol and no rate controlling agents were given. on transfer her vitals were 99.8 132 101/70 19 100% ra . in the the patient reported feeling well without chest pain. she did endorse continued cough that had not resolved after antibiotics. . ros: the patient denies any fevers, chills, weight change, nausea, vomiting, abdominal pain, diarrhea, constipation, melena, hematochezia, chest pain, shortness of breath, orthopnea, pnd, lower extremity edema, urinary frequency, urgency, dysuria, lightheadedness, gait unsteadiness, focal weakness, vision changes, headache, rash or skin changes. . past medical history: oncologic history: -presented in spring to cardiologist with dyspnea and lightheadedness. cxr prior to catherization showed a possible pneumonia. ct then showed evidence of mediastinal lymphadenopathy, as well as a splenic abnormality. underwent a ct guided core biopsy of the spleen on consistent with diffuse large b-cell lymphoma. bone marrow biopsy on without disease. 6 cycles of r-. . -stage iii nsclc (dx on apical posterior segment of the left upper lobe mass). treated chemoradiation with /taxol on . - coronary artery disease with history of myocardial infarction in , s/p 3 stents w/ last one in - osteoarthritis. - polymyalgia rheumatica - hypertension. - steroid-induced hyperglycemia. - status post bilateral oophorectomy for ovarian cyst (). - status post bilateral cataract surgeries - status post cholecystectomy. - status post r hip replacement in . post-op, the patient developed bilateral pulmonary emboli, ivc placed - she underwent a left hip replacement in . - gerd. - obesity. - depression. - "clot" involving left kidney. - hypercholesterolemia - pe in , lovenox-->coumadin bridge - copd social history: - married - lives in with her husband, 2 of her daughters and a son who has special needs - 6 children in total and 3 grandchildren - does not work outside the home - former smoker for 40 years, quit 3 years ago - rare alcohol - denies use of illicit drugs. family history: - father died of unknown malignancy - mother died from complications secondary to hip surgery physical exam: on admission: gen: well-appearing, no acute distress heent: eomi, perrl, sclera anicteric, no epistaxis or rhinorrhea, mmm, op clear neck: no jvd, carotid pulses brisk, no bruits, no cervical lymphadenopathy, trachea midline cor: tachy, no m/g/r, normal s1 s2, radial pulses +2 pulm: rhonchi in the left upper lobe, otherwise no w/r/r abd: soft, nt, nd, +bs, no hsm, no masses ext: no c/c/e, no palpable cords neuro: alert, oriented to person, place, and time. cn ii ?????? xii grossly intact. moves all 4 extremities. strength 5/5 in upper and lower extremities. patellar dtr +1. plantar reflex downgoing. . pertinent results: studies: ecg: poor baseline, a-flutter with rapid ventricular rate at 130. imaging: cxr: impression: unchanged left hilar mass. new left upper lobe opacity, concerning for post obstructive pneumonia. followup radiograph is recommended after completion of treatment to ensure resolution. . cta: no evidence for pulmonary embolism. new left upper lobe consolidation, concerning for pneumonia, but new or underlying mass cannot be excluded. if treated for pneumonia, follow-up chest imaging is recommended to ensure resolution and exclude new mass. 01:48pm wbc-14.2*# rbc-2.84* hgb-9.1* hct-26.6* mcv-94 mch-32.1* mchc-34.3 rdw-20.2* 01:48pm plt count-405# 11:13am plt smr-normal plt count-383 11:13am pt-13.2 ptt-24.0 inr(pt)-1.1 01:48pm urea n-12 creat-0.8 sodium-136 potassium-4.1 chloride-92* total co2-34* anion gap-14 11:13am hypochrom-1+ anisocyt-2+ poikilocy-1+ macrocyt-2+ microcyt-normal polychrom-normal ovalocyt-1+ 11:13am wbc-13.8* rbc-2.81* hgb-8.8* hct-25.7* mcv-91 mch-31.3 mchc-34.2 rdw-20.6* 11:13am neuts-80* bands-0 lymphs-10* monos-8 eos-0 basos-1 atyps-0 metas-1* myelos-0 11:13am glucose-144* urea n-10 creat-0.8 sodium-138 potassium-3.3 chloride-95* total co2-33* anion gap-13 11:13am calcium-8.8 phosphate-3.6 magnesium-1.9 11:13am ctropnt-<0.01 11:13am probnp-3351* 07:26pm fibrinoge-694*# 07:26pm pt-15.1* ptt-26.2 inr(pt)-1.3* 07:26pm haptoglob-435* 07:26pm ck-mb-2 ctropnt-<0.01 07:26pm ld(ldh)-153 ck(cpk)-37 tot bili-1.4 11:30am urine rbc-0 wbc-0-2 bacteria-rare yeast-none epi- 11:30am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 11:30am urine color-yellow appear-clear sp -1.003 brief hospital course: 64 year-old female with a history of diffuse b-cell lymphoma s/p 6 cycles of r- (), stage iii nsclc (dx on apical posterior segment of the left upper lobe mass) s/p chemoradiation with /taxol on , a-fib, cad s/p 3 stents , pe x2 s/p ivc filter (not on coumadin hemoptysis), htn who presents with pnuemonia and a-flutter with rvr. . # hcap/post obstructive pneumonia: pt with h/o stage iii nsclc with a left upper lobe mass. she had cxr and cta evidence of a consolidation in the left upper lobe. she has a leukocytosis, but otherwise afebrile and without cough, sputum or sob. represents a post-obstructive pneumonia. she received vanco/levofloxacin in the ed. urine legionella negative. patient initially treated with zosyn and levofloxacin. on patient had temp to 101 - levofloxacin was changed to cipro and vancomycin was added. vanco d/c'ed on . plan for 10 day treatment course for post-obstructive pna with zosyn and cipro. picc placed on and vna arranged. blood cx with ngtd. unable to obtain sputum cultures as patient without productive cough. plan for antibiotics through . she has a persistant leukocytosis (wbc 15 at discharge); blood cultures negative, ua negative and repeat cxr stable. recommend repeat cbc at pcp f/u appointment later this week. will need to consider xrt, bronch/stenting if symptoms return or do not resolve with full course of antibiotics. . # a-flutter w/ rvr: rate control difficult in the icu, likely precipitated by volume depletion and infection. cardiology was consulted. required intermittent dilt gtt; however eventually achieved rate control with dilt 90mg qid, metoprolol 100mg qid and digoxin. blood pressures stable. pt is not on coumadin given history of hemoptysis. asa 81 mg was started. she was discharged on digoxin, metoprolol 100mg qid and diltiazem 360 daily with heartrates of 60-70s x 24 hours. she has close follow up with dr. on monday (the day after discharge). . # cad, native: her chest pain is likely related to her post-obstructive pna. no evidence of ischemia and cp free. cta was negative for pe. restarted bb and ccb. holding at discharge; consider restart as an outpatient. aspirin 81 mg daily started. . # htn, benign: on admission relative hypotension and initially held home medications. as bp permitted and rate necessitated beta-blocker and calcium channel restarted. home lasix restarted on . held held as above. . # copd: patient peristently wheezey on exam; treated with xopenex and ipratropium neb treatments as well as prednisone 40mg pulse x 5 days with improvement of respiratory status. . # diabetes: home oral medication held initially, covered with sliding scale, restarted prior to discharge. # comm: (husband)- . # code: the patient was full code during this admission. medications on admission: albuterol 2 puffs:prn wheeze codeine-guaifenesin 5-10ml advair 250/50 lasix 40-60mg daily glipizide 2,5mg er daily halobetasol propionate 0,05% cream hydrocortisone 1% cream :prn levothyroxine 175mcg daily lorazepam 1mg:prn losartan 50mg daily metoprolol 50mg qam and 25mg qpm zofran prn paroxetine 20mg daily kcl 20meq sr pravastatin 20mg daily prochlorperazine 10 q8:prn tylenol probiotic calcium & vit d folic acid 0.4mg daily mv discharge medications: 1. piperacillin-tazobactam-dextrs 4.5 gram/100 ml piggyback sig: 4.5 grams intravenous q8h (every 8 hours) for 2 days. disp:*6 vials* refills:*0* 2. ciprofloxacin 250 mg tablet sig: three (3) tablet po q12h (every 12 hours) for 2 days. disp:*12 tablet(s)* refills:*0* 3. paroxetine hcl 20 mg tablet sig: one (1) tablet po daily (daily). 4. levothyroxine 175 mcg tablet sig: one (1) tablet po daily (daily). 5. pravastatin 20 mg tablet sig: one (1) tablet po daily (daily). 6. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain/fever. 7. calcium carbonate 200 mg (500 mg) tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day). 8. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 9. lorazepam 0.5 mg tablet sig: 1-2 tablets po twice a day as needed for insomnia/anxiety. 10. furosemide 20 mg tablet sig: three (3) tablet po daily (daily). 11. glipizide 2.5 mg tablet extended rel 24 hr sig: one (1) tablet extended rel 24 hr po once a day. 12. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 13. prednisone 20 mg tablet sig: two (2) tablet po daily (daily) for 1 days. disp:*2 tablet(s)* refills:*0* 14. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). disp:*30 tablet, chewable(s)* refills:*2* 15. digoxin 125 mcg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 16. metoprolol tartrate 100 mg tablet sig: one (1) tablet po q6h (every 6 hours). disp:*120 tablet(s)* refills:*0* 17. outpatient lab work please ask dr to check a chem 10 and cbc at your appointment later this week. 18. diltiazem hcl 360 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). disp:*30 tablet sustained release 24 hr(s)* refills:*0* 19. heparin flush (10 units/ml) 2 ml iv prn line flush picc, heparin dependent: flush with 10ml normal saline followed by heparin as above daily and prn per lumen. 20. advair diskus 250-50 mcg/dose disk with device sig: one (1) inhalation twice a day. 21. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day. 22. folic acid 400 mcg tablet sig: one (1) tablet po once a day. 23. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: inhalation every four (4) hours as needed for shortness of breath or wheezing. disp:*2 inhalers* refills:*2* discharge disposition: home with service facility: home solutions discharge diagnosis: post obstructive pneumonia/healthcare associated pneumonia rapid atrial fibrillation/flutter nsclc coronary artery disease chronic diastolic chf discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted with shortness of breath and high heart rate. you were diagnosed with a post obstructive pneumonia as the cause of your symptoms. with antibiotics your symptoms have improved. you will need to continue these medications to complete a full course. **please have dr check a cbc (blood count) and chem 10 (chemistries) at your visit with her this week.** in addition, you were found to have a very high heart rate called atrial fibrillation/atrial flutter. even with high dose medication your heart rate remained high. cardiology recommended changes to your medications which resulted in improved heart rate. medication changes: continue ciprofloxacin and zosyn to complete a course through start diltiazem and metoprolol for heart rate control. we have also treated you with a medication called digoxin for your heart rate; ask dr at your appointment tomorrow whether you should continue this medication or whether you may discontinue it now. start aspirin 81mg daily your other blood pressure medications (losartan) have been held. weigh yourself every morning, md if weight goes up more than 3 lbs. followup instructions: name: , department: cardiology- address: , ma phone: appointment: monday 2:00pm department: healthcare of when: thursday at 11:40 am with: , md building: (, ma) ground campus: off campus best parking: parking on site procedure: central venous catheter placement with guidance diagnoses: pneumonia, organism unspecified acidosis anemia, unspecified coronary atherosclerosis of native coronary artery polymyalgia rheumatica esophageal reflux congestive heart failure, unspecified adrenal cortical steroids causing adverse effects in therapeutic use chronic airway obstruction, not elsewhere classified atrial fibrillation personal history of tobacco use depressive disorder, not elsewhere classified atrial flutter percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia other malignant lymphomas, unspecified site, extranodal and solid organ sites malignant neoplasm of upper lobe, bronchus or lung old myocardial infarction antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use osteoarthrosis, unspecified whether generalized or localized, site unspecified personal history of venous thrombosis and embolism chronic diastolic heart failure hip joint replacement benign essential hypertension secondary diabetes mellitus without mention of complication, not stated as uncontrolled, or unspecified 

Answer: The patient is high likely exposed to