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: morphine / demerol attending: chief complaint: transferred for osh with hemothorax major surgical or invasive procedure: chest tube placement right chest wall intubation hemodialysis placement and removal of left groin hemodialysis catheter history of present illness: 71 m admitted to thoracic surgery with right hemothorax likely related to supratherapeutic transfered to micu because of respiratory failure, hypotension, and other comorbidities. . the patient was transferred from hospital with spontaneous hemothorax on right with no prior history of trauma. he had intially complained shortness of breath and dyspnea on exertion for the past 2-4 weeks. he also reports intermittent diarrhea w/ small amount of blood, with inr of >4 the week prior to admission, which was been held 4 days prior to admission(was 1.0 on initial presentation). denies chest pain or fever or chills. he had a right sided pleural effusion at by cxr, and had right thoracentesis and was diagnosed with hemothorax and transferred to . . at he was intially scheduled to go to or and have vats vs thoracotomy, but deveoped resp failure and hypoxia and was intubated on /05while on the floor ( 10) with suspected mucous plug. a chest tube was placed instead. he was requiring levophed temporarily while intubated but this was weaned off, and he was extubated . the chest tube is scheduled to be pulled on . . of note, his hospital course include ongoing hd for esrd followed by the nephrology service. the patient had thrombosed rue and lue av fistulas which will require fistulogram. he has been getting hd via groin line. he had a tte to evaluate for chf showing nl ef. he had required 3u of prbc's for bloody drainage of hemothorax, but there is no report of bloody stools or hematuria. on he was noted to spike a temp to 101.0. this temp spike resolved transiently per-hd on . he was transferred from sicu to micu for further medical managmeent past medical history: 1. type ii diabetes mellitus x 25yrs 2. end stage renal disease secondary to dm, s/p rue brachiocephalic v fistula (, revised ), s/p failed renal transplant () -> failed, hemodialysis since 3. cad s/p mi (), s/p 4v-cabg ()->revised; h/o positive stress and stent of om2 4. chf (but w/ nl ef by tte ) 5. sternal dehiscence-> osteomyelitis (coag neg staph), s/p sternal debridement () 6. hypertension 7. elevated cholesterol 8. h/o broken l ankle -> rehab -> rle dvt (), s/p ivc filter 9. s/p r cataract extraction 10. chronic myelogenous leukemia since ' on gleevec 11. osteoporosis 12. dvt , was on coumdin social history: lives with his wife . previous etoh abuse history (quit in ') quit tobacco 30 years ago, no current etoh or tobacco use. family history: mom and sister w/ ca, brother w/ prostate ca, no family h/o cardiac disease physical exam: tc=99.1 tm=101.0, bp=(121/51)90s-150s/40's-50s, hr=100-120(102), rr=20, o2=99% on 4l nc; i/o's=357/0(+357) pe: gen: patient appears comfortable, lethergic, but in nad heent: nonicteric, mucosa slightly dry chest: course exp bs's ant/lat; no wheezes noted cv: rrr, no appreciable abnormal heart sound abd: good bs's, obese, soft, nt, nd ext: 2+ pitting le edema bileraterally neuro: oriented to person; patient is generally weak and not cooperative w/ exam; no frank asterixis noted pertinent results: 03:15am blood wbc-13.7* rbc-2.88* hgb-8.3* hct-25.4* mcv-88 mch-29.0 mchc-32.9 rdw-14.9 plt ct-182 03:33am blood wbc-17.9* rbc-3.15* hgb-9.4* hct-27.1* mcv-86 mch-29.9 mchc-34.8 rdw-14.8 plt ct-238 02:46pm blood wbc-22.8*# rbc-3.35* hgb-9.9* hct-28.9* mcv-86 mch-29.6 mchc-34.3 rdw-14.4 plt ct-239 04:00am blood pt-12.9 ptt-29.8 inr(pt)-1.1 03:15am blood plt ct-182 03:33am blood plt ct-238 03:33am blood pt-12.8 ptt-31.5 inr(pt)-1.0 03:15am blood glucose-137* urean-75* creat-8.2*# na-148* k-5.8* cl-113* hco3-23 angap-18 03:33am blood glucose-84 urean-59* creat-7.1* na-146* k-4.7 cl-110* hco3-24 angap-17 03:15am blood calcium-8.5 phos-4.9* mg-2.2 03:33am blood calcium-8.1* phos-4.4 mg-2.4 06:24am blood type-art po2-126* pco2-35 ph-7.31* calhco3-18* base xs--7 06:24am blood lactate-0.8 06:24am blood freeca-1.02* 10:42pm blood ck(cpk)-65 04:49pm blood ck(cpk)-66 09:28am blood ck(cpk)-84 10:42pm blood ck-mb-notdone ctropnt-0.62* 04:49pm blood ck-mb-5 ctropnt-0.52* 09:28am blood ck-mb-notdone ctropnt-0.43* cxr: : the right-sided pleural densities are similar to what has been noticed on the preceding study and also the chest tube position is unchanged. no pneumothorax has developed after instrument removal. - cta neg for pe, loculated r hydropneumothorax; also w/ large l sided-effusion w/ assoc atelectesis . - tte w/ ef>55%(suboptimal, mod lae, mild , 1+ ar) . ekg's - nsr at 88 bpm, 1 mm std's and twi's v4-v6, twi's i & avl - nsr at 84 bpm, resolved twi's and std's v4-v6; still w/ twi's i & avl (ols changes compared to ) : impression: 1) av fistulogram demonstrated complete thrombosis of the brachiocephalic vein fistula. multiple stenoses are present throughout the outflow cephalic vein. a significant stenosis was identified within the right brachiocephalic vein. 2) successful lysis of the thrombosed fistula using a total of 10 mg of t-pa. 3) venoplasty of the outflow cephalic vein stenoses using an 8-mm balloon and of the severe right brachiocephalic stenosis using a 12-mm balloon, all with good angiographic success and restoration of forward flow. chest, abd, pelvis ct: 1) no evidence of abscess, and no definite evidence of pneumonia. the lung examination is somewhat limited by respiratory motion. there is airspace opacity along the tract of the prior chest tube which may represent contusion vs. consolidation. 2) there are bilateral pleural effusions, loculated, which have increased in the interim since the prior exam. the left effusion is large and the right effusion is moderate, and there is associated atelectasis. head ct: impression: 1. no evidence of acute intracranial hemorrhage or mass effect. 2. scattered areas of hypodensity within both thalami and the basal ganglia having an appearance consistent with chronic lacunar infarction. ruq u/s: impression: tumefactive sludge within the gallbladder. no ultrasonographic evidence of cholecystitis. limited visualization of the pancreas due to overlying bowel gas. cxr: left-sided picc line is in distal svc. there are small bilateral pleural effusions and associated bibasilar atelectases, essentially unchanged since the prior film of . no new lung lesions. brief hospital course: 71 year old man type ii diabetes mellitus, coronary artery disease s/p cabg, congestive heart failure (nml ef), cml, end stage renal disease s/p failed renal transplant on hemodialysis, transferred from outside hospital with hemothorax to transplant surgery sicu team. hospitalization complicated by mutiple issues: 1. hemothorax: the patient was initially transferred for vats and thoracotomy by the thoracic surgery team. he developed respiratory failure requiring intubation on , and transfer to the micu. a chest tube was placed. studies were not done on the initial specimen showing a spun hct >50%. the cause of the hemothorax was unknown. he was ruled out for pe by negative cta. there was no history of trauma or previous history of copd or bled formation. pleural effusions reaccumulated after removal of the chest tube. a thoracentesis was done which showed an exudative effusion on the right, the side of the hemothorax, and a transudative effusion on the left. gram stain and culture were negative; however, the patient was on antibiotics (levofloxacin) at the time of the tap for treatment of post-intubation tracheobronchitis. cytolgy showed no malignant cells. the patient was extubated , and supplemental o2 requirements weaned. by the time of discharge he had stable small bilateral pleural effusions by cxr and was saturating well on room air, not short of breath. the effusions were attributed to chf and chronic renal failure; the right appearing exudative as a complication of the high blood count. 2. hypoxia: postextubation the patient required supplemental o2. he was treated with a 7 days course of levofloxacin 250mg q48hrs for treatment of tracheobronchitis. the initial decompensation requiring intubation was thought to be due to mucus plugging. chf status remained stable. he was continued on aspirin, metoprolol, and a statin for secondary prophylaxis. 3. fevers: postextubation on he was noted to spike a fever to 101.0. cxr, chest ct, abdominal ct, blood cultures, urinalysis, and urine cultures were nondiagnostic. there was no sign of pneumonia or abscess. he was treated for a day with zosyn and vancomycin for concern of hospital acquired or aspiration pneumonia. sputum grew gram negative rods e. coli and enterobacter. as no findings were seen on cxr or chest ct, this was attributed to tracheobronchitis and treated with a 7day course of levofloxacin. 4. delirium: the patient developed a delirium complicated by agitation requiring a 1:1 sitter, zyprex and haldol, soft restraints. the delirium resolved with treatment of his multiple medical issues. he was continued on zyprexa qhs. 5. nutrition: during his delirium he had an ng tube placed, and he was sustained on tubefeeds. a swallow study was done once the patient was more alert and initially showed risk of aspiration. he was started on a nectar-thickened diet. two days prior to discharge a repeat swallow study was done. the patient passed. he was discharged on a diabetic, renal, heart healthy, low sodium diet of thin liquids and regular solids. 6. hypotension: in the icu the patient became hypotensive and required a small dose of levophed. he was also treated with stress dose steroids. this resolved prior to discharge from the icu. 7. pancreatitis: on , after initiating a po diet, the patient developed nausea and epigastric pain. lfts showed mildly elevated transaminases, normal alk phos and total bilirubin, and moderately elevated lipase and amylase. ruq ultrasound showed sludging in the gallbladder. it was felt he developed a pancreatitis secondary to gallbladder sludging while on tubefeeds. he was made npo, treated with gentle ivf's. nausea and abdominal pain resolved. diet was advanced slowly, to clears, then to full diet. he was tolerating a full diet as described above prior to discharge. 8. history of dvt: the patient had a dvt diagnosed in . he completed his course of anticoagulation and has an ivc filter in place. he was treated with dvt prophylaxis with heparin sc. no further anticoagulation was indicated. his dialysis line was noted to have thromboses. this was corrected by interventional radiology procedure. a temporarily groin line was placed for dialysis. this was pulled and the a-v fistula was used 4 times for dialysis prior to discharge. 9. cardiac: he has known cad s/p cabg and stent and chf. echo was done and showed mild , 1+mr, otherwise normal. he was treated with aspirin, metoprolol and statin. he ruled out for acute mi, and no further acute cardiac issues developed. 10. end stage renal disease: he was continued on m,w,f hemodialysis. 11. type ii diabetes mellitus: he was monitored with qid fingersticks and treated with a regular insulin sliding scale. a standing regimen of insulin was not initiated as the patient's diet fluctuated with tubefeeds, then npo, then slowly advancing diet. he was continued on prednisone 5mg daily for his failed renal transplant. 12. chronic myelogenous leukemia: diagnosed in , the patient was previously on gleevec. this was held in the setting of his acute pulmonary issues. his counts remained stable throughout the hospitalization. hematoloyg/oncology was consulted. they recommended holding the patient's gleevec until he follows up with outpatient oncology given his persistant state of fluid overload (he still had small pleural effusions), modestly elevated lfts and recent course of pancreatitis. he will be following up with dr. in heme/onc for further care. he should bring all records regarding his history of cml and iron overload to that appointment. 13. elevated ck: on the patient was noted to have an elevated ck to 1300. there was no ck-mb or trop elevation to suggest a cardiac etiology. it was felt this was likely muscular and resulted from im haldol injection. subsequent im injections were held, and the ck trended down to normal. 14. dispo: the patient was discharged to rehab. he was evaluated by physical therapy and occupational therapy prior to discharge. he will follow up with his primary care physician dr . he should also plan to follow-up with his endocrinologist regarding diabetes care, nephrologist regarding his end stage renal disease, and dr. regarding his chronic myelogenous leukemia. he is a full code. communication is with the patient and his wife . medications on admission: meds at home: vicodin prn, neurontin 100 qd, nephrocaps, metoprolol 25 , gleevec 400 , prednisone 5 qd, tums prn, coumadin 7.5/10 alternating, paxil 10 qd, riss (+/- nph?) . meds on transfer: ipratropium bromide neb q6h, lorazepam 0.5-1 mg iv q4h:prn, albuterol 0.083% neb soln 1 neb ih q4-6h:prn, calcium acetate 667 mg po tid w/meals, famotidine 20 mg iv q24h, paroxetine hcl 20 mg po daily, fentanyl citrate 25-100 mcg iv q4h:prn, phenylephrine hcl 0.5-5 mcg/kg/min iv drip titrate, prednisone 5 mg po daily, insulin sc discharge medications: 1. prednisone 5 mg tablet sig: one (1) tablet po daily (daily). 2. calcium acetate 667 mg tablet sig: one (1) tablet po tid w/meals (3 times a day with meals). 3. paroxetine hcl 20 mg tablet sig: one (1) tablet po daily (daily). 4. albuterol sulfate 0.083 % solution sig: 1-2 puffs inhalation q4-6h (every 4 to 6 hours) as needed for shortness of breath or wheezing. 5. ipratropium bromide 0.02 % solution sig: one (1) puff inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 6. bisacodyl 10 mg suppository sig: one (1) suppository rectal (2 times a day) as needed for constipation. 7. epoetin alfa 20,000 unit/2 ml solution sig: five (5) thousand units injection asdir (as directed): to be dosed at dialysis. 8. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 9. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 10. insulin regular human 100 unit/ml solution sig: one (1) units injection asdir (as directed): regular insulin per sliding scale: see attached scale. 11. zinc sulfate 220 mg capsule sig: one (1) capsule po daily (daily). 12. ascorbic acid 500 mg tablet sig: one (1) tablet po once a day. 13. miconazole nitrate 2 % powder sig: one (1) appl topical (2 times a day) as needed for to groin. 14. olanzapine 5 mg tablet, rapid dissolve sig: 0.5 tablet, rapid dissolve po hs (at bedtime). 15. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). discharge disposition: extended care facility: hospital of & islands - discharge diagnosis: primary: pleural effusions conjestive heart failure end stage renal disease on hemodialysis type ii diabetes mellitus coronary artery disease pressure ulcers pancreatitis chronic myelogenous leukemia respiratory failure secondary: h/o osteomyelitis/ sternal dehiscence osteoporosis h/o dvt , s/p cataract surgery hypercholesterolemia hypertension discharge condition: stable discharge instructions: please take all medications as prescribed. please participate in all rehabilitation activities. if you develop fever >101.3, chest pain, shortness of breath, abdominal pain, or persistant nausea, please call your primary care physician /or return to the emergency department. followup instructions: please follow-up with dr. in hematology/oncology. . please bring all records from your oncologist regarding your cml, history of chronic transfusions, and iron overload. please also plan to follow up with your primary care physician, . . you can call to make an appointment. you should be seen within the next 1-2 weeks to review your hospital course. you will continue on mon, wed, fri hemodialysis the following appointments have been made for you: provider: , md where: hematology/bmt phone: date/time: 1:00 provider: , hematology/oncology-cc9 where: hematology/oncology phone: date/time: 1:00 md procedure: insertion of intercostal catheter for drainage continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube enteral infusion of concentrated nutritional substances hemodialysis angioplasty of other non-coronary vessel(s) injection or infusion of thrombolytic agent venous catheterization for renal dialysis thoracentesis transfusion of packed cells transfusion of packed cells diagnoses: congestive heart failure, unspecified aortocoronary bypass status hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease acute respiratory failure acute bronchitis delirium due to conditions classified elsewhere other complications due to renal dialysis device, implant, and graft diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled acute pancreatitis chronic myeloid leukemia, without mention of having achieved remission 

Answer: The patient is high likely exposed to