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: penicillins attending: chief complaint: bradyarrhythmia, transfer for evaluation of ppm major surgical or invasive procedure: pacemaker placement on : sensia history of present illness: mr. is a 89 year old male with pmh significant for chronic lymphocytic leukemia, iddm, cad s/p cabg () who is transferred from hospital for bradycardia. . patient experienced fatigue and weakness for the past few days. on he fell out of a chair onto the floor when adjusting himself. he states that his head got stuck in the legs of the desk. he denies losing consciousness but he states that he "fell asleep." his he denies cp, nausea, diaphoresis, shortness of breath. his daughter found him on the groud ~4hours later. in the ed at , his vs t 98.3, hr 73, rr 20, bp 141/60, o2 96% ra. labs were notable for trop 8.58, ck 618, ck-mb 28.3, hct 24.8, plt 80, cr 1.6. the patient was given aspirin, but not started on heparin gtt. . ecg showed wenckebach block with bradycardia. per osh records, he had multiple runs of nsvt, the longest 10-15sec and was given lidocaine iv. per nursing report, however, patient was stated to have 15-20 sec pause. he had persistent bradycardia with hr of 30s and a temporary pace wire was placed. he was also transfused 2 prbc while there (hct improved to 29). an echocardiogram was done that showed mild mr/tr, biatrial enlargement, ef 50%, dyssynergic septum with rv temp pacing. his trop per nursing report peaked to 10.3. . on review of systems,he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. he denies recent fevers, chills or rigors. s/he denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. past medical history: 1. cardiac risk factors: +diabetes, -dyslipidemia, -hypertension 2. cardiac history: -cabg: s/p cabg -percutaneous coronary interventions: -pacing/icd: none 3. other past medical history: - chronic lymphocytic leukemia, on procrit - dmii, insulin dependent - cad, s/p cabg - bph - bl cataract surgery - scc of the scalp - h/o bradycardia, ppm not recommended social history: lives independently. retired broadcast engineer. has eight children. -tobacco history: none -etoh: none -illicit drugs: none family history: mother w/ cancer. physical exam: general: elderly male, thin, in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. dry mmm. no xanthalesma. neck: supple with flat jvp. guaze covering area of excised scc c/d/i. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ pertinent results: pt with thyroid nodule this admission which needs f/u 09:42pm pt-12.0 ptt-25.2 inr(pt)-1.0 09:42pm plt smr-low plt count-96* 09:42pm hypochrom-normal anisocyt-occasional poikilocy-1+ macrocyt-2+ microcyt-normal polychrom-normal ovalocyt-1+ 09:42pm neuts-25* bands-2 lymphs-73* monos-0 eos-0 basos-0 atyps-0 metas-0 myelos-0 09:42pm wbc-8.6 rbc-3.28* hgb-11.1* hct-33.2* mcv-101* mch-33.7* mchc-33.3 rdw-17.3* 09:42pm tsh-1.4 09:42pm calcium-8.1* phosphate-2.9 magnesium-2.1 09:42pm ck-mb-4 ctropnt-0.34* 09:42pm alt(sgpt)-19 ast(sgot)-30 ld(ldh)-241 ck(cpk)-288 alk phos-83 tot bili-0.6 dir bili-0.2 indir bil-0.4 09:42pm estgfr-using this 09:42pm glucose-311* urea n-29* creat-1.3* sodium-138 potassium-4.1 chloride-108 total co2-24 anion gap-10 brief hospital course: 89 year old male with pmh significant for chronic lymphocytic leukemia, iddm, cad s/p cabg () who is transferred from hospital for ppm for symptomatic bradycardia. # symptomatic bradycardia: patient's fall was suspected to be secondary to symptomatic bradyarrhythmia. his ecg from the osh showed wenckebach and chb. per report, as an outpatient patient had sinus pauses on holter monitor. patient underwent placement of ppm and tolerated this procedure well. he was treated with antibiotics for 48hours. his pacemaker was interrogated and working well. patient will follow up in device clinic next week. please see page 1 for pacer site care and activity restrictions. . # non st elevation myocardial infarction: patient has a history of cabg (anatomy unknown). his cardiac markers were elevated at osh and at . while here he denied any chest pain. patient was limited to receiving anti-aggregation therapy (see below). he was started on lisinopril, metoprolol after ppm was placed, asa 325. lipitor was started at discharge. his lipid panel is pending at this time. there was a discussion at discharge about persuing stress testing but given his cll, it was thought that medical management was most appropriate at this time. . # acute on chronic kidney disease: patient's cr was 1.6 at osh. his urine was notable for large blood and there was a concern for rhabdo. on arrival to patient's cr was 1.4, which remained stable. he also had protein in his urine which suggested likely underlying renal insufficiency likely secondary to diabetes. his metformin and glipizide were held, but restarted on discharge. . # cll: with likely bone marrow involvement: thrombocytopenia and anemia. anc 2150. his counts were monitored and procrit was held. platelets decreased to 64 on day of discharge, hct stable at 30. no signs of overt bleeding. given the patient will not be able to f/u with his home hematologist (dr. in vt) an appt was made wth dr. at for further monitoring. dr. will decide when to restart procrit and arrange for monitoring of labs. feso4 was continued. please check labs on monday . . # iddm: held metformin and glipizide, but restarted on discharge. patient continued on home lantus. . # bph: continued terazosin . # thyroid nodule: an incidental thyroid nodule was seen on ct scan, which needs to be followed as an outpatient. . # s/p mohs surgery for squamous cell ca on scalp on . his daughter has been changing the dressing daily. sutures can be removed on , then a non-occlusive dressing to the site until there is only pink skin visible. medications on admission: medications: folic acid 1mg daily metformin 500mg ; 250mg at noon ecotrin 81mg daily glipizide 10mg terazosin 10mg daily mvi iron tab daily lantus 10u daily procrit . medications on transfer: aspirin 325 daily lipitor 80mg daily metoprolol 25mg mvi terazosin 10mg qhs tylenol 650mg q4prn sln prn iss hsc discharge medications: 1. metoprolol succinate 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 3. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily): hold sbp < 100. 4. lantus 100 unit/ml solution sig: ten (10) units subcutaneous at bedtime. 5. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain. 6. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). 7. metformin 500 mg tablet sig: 0.5 tablet po noon (at noon). 8. glipizide 5 mg tablet sig: two (2) tablet po bid (2 times a day). 9. clindamycin hcl 150 mg capsule sig: two (2) capsule po q6h (every 6 hours) for 1 days. 10. terazosin 5 mg capsule sig: two (2) capsule po hs (at bedtime). 11. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 12. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po daily (daily). 13. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 14. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day): hold for diarrhea. 15. outpatient lab work please check cbc and chem-7 on monday . folic acid 1 mg tablet sig: one (1) tablet po once a day. 17. multiple vitamin tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: newbridge on the discharge diagnosis: primary diagnosis: acute systolic dysfunction: ef 30% non st elevation myocardial infarction complete heart block acute on chronic kidney disease . secondary diagnosis: chronic lymphocytic leukemia diabetes mellitus on insulin coronary artery disease s/p cabg benign prostatic hypertrophy discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you had a fall at home and was brought to hospital with a heart attack. you were then transferred here to for treatment. you were also very anemic and had some dangerous heart rhythms. we placed a pacemaker to fix your heart rhythms and gave you some blood. you blood count and platelet counts are still quite low, you should consider seeing a hematologist/oncologist for this within the next month. you can return to your doctor or you can go to a doctor close to newbridge: , md hospital - , phone: fax: date/time: wednesday at 1:30pm . medication changes: 1. increase aspirin to 325 mg to prevent another heart attack 2. start lisinopril to help your heart pump better 3. start tylenol for pain at the pacer site as needed 4. start clindamycin to prevent an infection at the pacer site, you have one more day left 5. start atorvastatin to lower your cholesterol 6. start colace and senna to prevent constipation. . weigh yourself every morning, call dr. if weight goes up more than 3 lbs. followup instructions: provider: clinic phone: date/time: 4:00pm clinical center, . , . . primary care: provider: , phone:( date/time: 8:30am this appt needs to be cancelled if pt is still in ma . cardiology: at 11:20am with dr. . clinical center, . , . hematology/oncology: , h., md hospital - , across from medical day care. please stop at registration first. , phone: fax: date/time: wednesday at 1:30pm procedure: initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle diagnoses: subendocardial infarction, initial episode of care congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) chronic kidney disease, unspecified other specified cardiac dysrhythmias atrioventricular block, complete long-term (current) use of insulin long-term (current) use of anticoagulants acute diastolic heart failure chronic lymphoid leukemia, without mention of having achieved remission other second degree atrioventricular block 

Answer: The patient is high likely exposed to