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: bactrim / dicloxacillin / levofloxacin attending: chief complaint: hypotension major surgical or invasive procedure: subclavian cvl history of present illness: mrs. is a 63-year-old woman with a history of recurrent burkitt's lymphoma d +15 of , who was recently discharged from after her first treatment for recurrence (see pmh). she had been doing well at home until the morning of . she had awoken early to come to her outpatient appointment at 7 clinic, and on standing from bed, felt very lightheaded. she does not recall much after that point. her son found her in the kitchen, lying against the cabinets in a pool of feces. they called 911, and on transport to , her bp was found to be 58/38. she was given ivf on transport and in the ed at . . she was afebrile, and her blood pressure responded to fluid resuscitation to 90s/40s on transfer. she has been mentating the entire time. at the osh a chest x-ray and head ct were done. both of which were negative for any acute process. she was given a dose of vancomycin and cefepime at the outside hospital out of concern for infection given her neutropenia (wbc 0.2 at the osh) and hypotension. . on arrival to the floor, her vitals were t 99.4, bp 105/50, hr 99, rr 18 and o2 sat 100% on ra. she is mentating well and is currently asymptomatic. she denies any fever or chills, cough, chest pain, shortness of breath, dysuria, frequency, urgency, myalgias, or abdominal pain. she admits to diarrhea this am, lightheadedness, feeling "dry," and pain in her mouth. past medical history: interval history: burkitt's lymphoma: she was admitted with 6 weeks of persistent, progressive shoulder pain. on admission, there was a palpable mass on her right chest wall and axilla. a ct scan showed a large axillary mass that was cocerning for recurrence of disease. she had an ir guided biopsy which was inconclusive, and was then taken to the or for surgical excisional biopsy that showed recurrence of disease. on she had an echocardiogram and began treatment with . she had an lp done on , which was positive for disease. at that time she recieved intrathecal methotrexate and hydrocort. on her lp was repeated and she recieved intrathecal cytarabine. she was discharged with neupogen for one week with close follow-up. . 1. burkitt's lymphoma - diagnosed in , s/p multiple chemo regimens. - most recent cycle (ivac) was on with complications of admission for profound neutropenia, fever, parainfluenza infection, and bacteremia. 2. hypothyroidism. 3. hyperlipidemia. 4. hx of pseudomonas bacteremia. 5. hx of coag-neg staph bacteremia. 6. hx of enterobacter bacteremia. 7. hx of parainfluenza and pneumonia social history: (from omr, confirmed with patient) her husband has copd and has required frequent hospitalizations. one of her sons and daughter-in-law live downstairs with their three children. she worked as a system analysis at nhic, but is currently retired. denies tobacco or alcohol use. family history: (from omr, confirmed with patient) there is no family history of lymphoma or other malignancies within the family. her sister has a history of cirrhosis. her brother has diabetes and anterograde amnesia. physical exam: vitals: t: 99.4 bp: 105/50 hr: 99 rr: 18 o2 sat 100% on ra gen: well appearing woman heent: perrl, eomi, dry mm, no jvp, no lad, multiple areas of mucositis in her mouth cv: tahcycardic, regular rhythm, no m/r/g normal s1 and s2 chest: old ecchymosis on right breast lungs: ctab, no wheezes rales or rhonchi back: 3x5 cm contusion on her left midback, inferior to the scapula, no associated tenderness surrounding the lesion, also a 3x1.5 cm contusion along the top of the left scapula abdomen: soft, non-tender, mildly distended, nabs, palpable liver tip ext: no edema, cyanosis, clubbing. 2+ radial and dp pulses bilaterally skin: no abnormalities other than contusions noted above, warm, dry neuro: cnii-xii grossly intact, aaox3, strength 5/5 in upper and lower extremities pertinent results: admission labs: 03:45pm blood wbc-0.3*# rbc-2.20* hgb-7.7* hct-21.3* mcv-97 mch-35.0* mchc-36.2* rdw-14.5 plt ct-14*# 03:45pm blood neuts-11* bands-22* lymphs-7* monos-0* eos-1 baso-1 atyps-0 metas-1* myelos-1* other-56* 03:45pm blood pt-15.3* ptt-28.0 inr(pt)-1.3* 03:45pm blood plt smr-rare plt ct-14*# 03:45pm blood glucose-125* urean-24* creat-0.6 na-136 k-3.5 cl-104 hco3-24 angap-12 03:45pm blood alt-98* ast-39 ld(ldh)-169 alkphos-134* totbili-1.7* 03:45pm blood albumin-3.2* calcium-8.8 phos-3.5 mg-2.0 uricacd-2.9 06:45pm blood lactate-1.0 discharge labs: 12:00am blood wbc-2.1* rbc-2.92* hgb-8.7* hct-24.7* mcv-84 mch-29.9 mchc-35.5* rdw-13.4 plt ct-85* 12:00am blood neuts-67 bands-0 lymphs-14* monos-17* eos-0 baso-0 atyps-0 metas-0 myelos-2* nrbc-1* 12:00am blood gran ct-1449* 12:00am blood glucose-143* urean-15 creat-0.4 na-132* k-3.9 cl-99 hco3-25 angap-12 12:00am blood alt-75* ast-54* ld(ldh)-377* alkphos-135* totbili-0.4 12:00am blood calcium-8.9 phos-2.2* mg-2.0 uricacd-1.7* micro: 4:56 am blood culture source: line-tlcl. **final report ** blood culture, routine (final ): pseudomonas aeruginosa. of two colonial morphologies. final sensitivities. sensitivities: mic expressed in mcg/ml _________________________________________________________ pseudomonas aeruginosa | cefepime-------------- 2 s ceftazidime----------- 4 s ciprofloxacin---------<=0.25 s gentamicin------------ <=1 s meropenem-------------<=0.25 s piperacillin/tazo----- 16 s tobramycin------------ <=1 s aerobic bottle gram stain (final ): gram negative rod(s). lp (#1) - no malignant cells lp (#2) - no malignant cells lp (#3) - no malignant cells lp (#4) - no malignant cells studies: ct abd/pelvis- 1. no infectious source identified in the chest, abdomen or pelvis. 2. interval decrease in size of confluent right axillary adenopathy compared to . 3. single stable left paraaortic lymph node. 4. sigmoid diverticulosis, without diverticulitis. 5. distention of the stomach, without evidence for mechanical obstruction. correlate clinically. ct chest: impression: 1. no acute pulmonary embolism or aortic pathology. 2. similar appearance of 1-cm ground-glass nodular opacity in the right upper lobe. recommend continued followup. 3. sub-4mm pulmonary nodules, with questionable interval increase in size, could be re-evaluated when followup for the ground-glass opacity. 4. slightly interval decrease in size of the right axillary lymph node conglomerate. echo: impression: mild global hypokinesis. mild mitral regurgitation. no evidence of endocarditis seen. if clinically suggested, the absence of a vegetation by 2d echocardiography does not exclude endocarditis. compared with the prior study (images reviewed) of , the findings are similar. abnormal septal motion was seen on the prior study also. mri shoulder: the lymphomatous mass in the right axilla, encasing the right brachial plexus has increased in size compared to prior imaging. u/s: no evidence of dvt in the right upper extremity. ct torso: read pending at time of discharge, will be followed up at outpatient appt on monday brief hospital course: assessment and plan: mrs. is a 63-year-old woman with recurrent burkitt's lymphoma who is d+15 of admitted from an osh with hypotension and neutropenia after a syncopal episode at home. . # hypotension/syncope: she was found to be hypotensive to 58/38 by ems, which responded to fluids. she was fluid resuscitated to sbp of 70s by ems and sbp of 90's by osh ed prior to transfer. blood cultures were drawn and she was given cefepime and vanco and transferred to 7 . on arrival she was given 2l of fluid, 1 unit of blood, and cefepime, vancomycin, and flagyl. her pressures responded. osh cultures came back as vre 1:4 bottles, sensitive to ampicillin, daptomycin, levofloxacin, and linezolid. she was switched to ampicillin on and her picc was pulled. she was switched to daptomycin on monday because she had begun receiving hyper cvad part b and amp interferes with clearance of methotrexate. she had a tte and tee which showed no vegetations. as she was being treated for the bacteremia, ms. again became hypotensive and febrile, requiring transfer to the where she required pressors. blood cultures were sent and ultimately returned positive with pseudomonas, believed to be associated with her central line. her line was pulled and her broad spectrum antibiotic coverage (started given her sepsis in the setting of neutropenia) was narrowed to cefepime, gentamicin, and linezolid. gentamicin was d/c-ed a few days after transfer to the floor and linezolid was transitioned to ampicillin as the patient was believed to have leukosuppression secondary to the linezolid. she completed a 10 day course of antibiotics (amp and cefepime) from the time her anc was greater than 1000 per id recommendations and remained afebrile and hemodynamically stable for the remainder of her hospital course. . # burkitt's lymphoma: she was admitted on day +15 of . an lp with intrathecal chemotherapy was performed on . a subclavian line was placed on and treatment with hyper cvad part b was started on . she tolerated her chemotherapy well, complicated by mild mucositis and the bacteremia discussed above. she had one more round of intrathecal chemotherapy with cytarabine on . lps on , and were negative for malignant cells. patient had significant right shoulder and arm pain as well as right hand weakness, believed secondary to brachial plexus involvement of her lymphoma. she underwent mri of her r shoulder which confirmed this finding and had 4 sessions of xrt as a palliative therapy. she had 4 lp's which were negative for malignant cells. had it cytarabine on prior to discharge which she tolerated well. pt had ct of torso to evaluate for progression of disease, read at the time of discharge was pending but will be followed up at follow-up appointment monday following discharge when pt will return for chemotherapy gemcitabine and vinorelbine. acyclovir and fluconazole were held given elevated lfts, will trend lfts as outpatient and do liver ultrasound if necessary. pt was given pentamidine prior to discharge for pcp . . # cardiomyopathy: patient became tachycardic at the time of her second episode of sepsis. this continued intermittently through her stay and subsequently on the floor. tachycardia was sinus in nature, up into the 140s with movement, and was attributed to an underlying cardiomyopathy (ef 45-50% on echo, last on ). cardiology was consulted for management and she was started on metoprolol 12.5mg which she tolerated well. . # dvt: found to have right upper extremity dvt last admission and was on lovenox for that until she had a drop in platelets (treatment related). she was thrombocytopenic during her admission and her lovenox was held. an ultrasound of the arm was repeated and was negative for clot. . # hypothyroidism: stable. continued levothyroxine 100mcg po daily . # depression: patient was frequently tearful and endorsed saddened mood and symptoms of depression. was started on citalopram 10 mg daily. medications on admission: 1. acyclovir 400 mg po q8 hours 2. clonazepam 0.5 mg po tid prn for anxiety. 3. levothyroxine 100 mcg po daily 4. pyridoxine 50 mg po daily 5. docusate sodium 100 mg po bid 6. nystatin 100,000 unit/ml suspension 5 ml po qid 7. senna 8.6 mg po qhs prn constipation 8. gabapentin 600 mg po tid 9. polyethylene glycol 17 gram/dose powder po daily prn constipation 10. ms contin 60 mg po q8h 11. hydromorphone 2-4 mg po q4h prn pain 12. saliva substitution 30ml qid 13. enoxaparin 60 mg/0.6 ml subcutaneous q12h 14. filgrastim 300 mcg/ml sc inj q24h for 5 days. 15. dexamethasone 2 mg po daily discharge medications: 1. clonazepam 0.5 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)) as needed for insomnia. 2. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 3. pyridoxine 50 mg tablet sig: one (1) tablet po daily (daily). 4. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 5. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day) as needed for thrush. 6. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 7. gabapentin 300 mg capsule sig: two (2) capsule po q8h (every 8 hours). 8. oxycodone 30 mg tablet sustained release 12 hr sig: one (1) tablet sustained release 12 hr po q12h (every 12 hours). disp:*60 tablet sustained release 12 hr(s)* refills:*0* 9. hydromorphone 2 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 10. dexamethasone 4 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 11. citalopram 20 mg tablet sig: 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 12. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: burkitt's lymphoma discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear ms. , you were admitted to the hospital with an infection in your blood. you had a short stay in the icu and were treated with antibiotics and recovered. during your hospitalization you received chemotherapy and radiation therapy for your burkitt's lymphoma. you will be returning on monday for outpatient chemotherapy. please call if you have any symptoms or concerns before then. we have made the following changes to your medications: take metoprolol 12.5mg twice a day for blood pressure take celexa 10mg daily for depression take dexamethasone 4mg daily take oxycontin 30mg twice a day for long-acting pain control you can continue your home dilaudid 2-4mg every 6hrs as needed for breakthrough pain please do not take acyclovir or fluconazole until you follow-up as an outpatient because these medications can elevate liver labs it was a pleasure taking care of you. we wish you a speedy recovery. followup instructions: the following appointment has been scheduled for you: department: /oncology unit when: monday at 9:30 am building: fd building (/ complex) campus: east best parking: main garage procedure: venous catheterization, not elsewhere classified spinal tap incision of lung spinal tap incision of lung diagnostic ultrasound of heart injection or infusion of cancer chemotherapeutic substance injection or infusion of cancer chemotherapeutic substance injection or infusion of cancer chemotherapeutic substance other radiotherapeutic procedure injection or infusion of oxazolidinone class of antibiotics injection of other agent into spinal canal injection of other agent into spinal canal injection of other agent into spinal canal central venous catheter placement with guidance diagnoses: severe sepsis unspecified acquired hypothyroidism sepsis 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 septic shock infection with microorganisms without mention of resistance to multiple drugs antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use diarrhea anticoagulants causing adverse effects in therapeutic use other and unspecified infection due to central venous catheter streptococcal septicemia drug induced neutropenia other specified antibiotics causing adverse effects in therapeutic use syncope and collapse fall from other slipping, tripping, or stumbling precipitous drop in hematocrit other specified hypotension burkitt's tumor or lymphoma, lymph nodes of multiple sites nonspecific elevation of levels of transaminase or lactic acid dehydrogenase [ldh] septicemia due to pseudomonas neutropenia due to infection other stomatitis and mucositis (ulcerative) other secondary thrombocytopenia secondary cardiomyopathy, unspecified chronic venous embolism and thrombosis of unspecified deep vessels of lower extremity 

Answer: The patient is high likely exposed to