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 / prilosec / bactrim attending: chief complaint: sob and brbpr major surgical or invasive procedure: intubation femoral venous line history of present illness: 52 yo m with diffuse large b cell lymphoma s/p allo stem cell transplant , h/o diverticulosis, hemorrhoids, admitted for fever, cough, and brbpr, now being transferred from bmt to icu for hypoxic respiratory distress. . based on the admission note, patient has been having fatigue and productive cough with white sputum x 4 days as well as fever up to 100.8. there has been wheeze and dyspnea on exertion, which are not relieved by flovent or proair. there is also myalgia for 1 day with r> l sinus tenderness. per report, no sore throat, post-nasal drip, pleuritis, orthopnea, or pnd. . of note, on day of admission, patient had brbpr on toilet paper and then frank blood in the toilet bowl. this is associated with mild, crampy abdominal pain. had history of brbpr but none recently. stool had been yellowish-brown. had been having diarrhea since starting antibiotics (7 days) for his left hand cellulitis. he was seen in clinic on day of admission with tachycardia hr 116, t 98.3, bp 129/71 and hct 29.2 (down from 33.8 on ) wbc 11.7 with 67% pmn, creatinine 1.4 (baseline 1.4-1.5). blood cultures, stool cultures were obtained and patient was given 2l ivns. repeat hct was 27.6. . on arrival to the floor, vitals were t:98.9 bp:150/97 p:113 rr:22 sao295% ra. he complained of ongoing cough and wheezing and moderate dyspnea on exertion though breathing was comfortable at rest. he was started on antibiotics- azithromycin and ceftriaxone. . at around 11pm, patient was triggerred for increased sob requiring more oxygen supplement, o2 sat 84% on ra improved to low 90% on 4l which then improved to mid 90% on nrb. he received lasix 40 mg iv, nebs, and solumedrol 40 iv x1. at around midnight, patient got up to the bathroom. he was noted to have borderline temp at 100.3, bp 148/94, hr 120, rr 20. as he was returning from the bathroom, he felt more sob with o2sat down to 70% on ra which improved to 96% on nrb. then 50 % on nrb. code blue was called. patient was intubated given his respiratory distress and underwent femoral vein catheterization. subsequently, he underwent cta to rule out for pe. a couple messages were left for patient's wife for her to call back for updates. . review of sytems: (+) per hpi (per admission note) unable to get ros given patient is intubated past medical history: oncologic history: # hodgkin's disease over 20 years ago, chemotherapy regimen mopp/abvd and mantle radiotherapy # large b-cell lymphoma: - diagnosed in , status post 4 cycles of r- followed by high-dose cyclophosphamide and autologous stem cell transplant in - remained in remission until early when developed lower abdominal tenderness with ct scanning showing abnormalities within the distal ileum and adenopathy. endoscopy and colonoscopy were non-diagnostic. laparoscopic assisted ileocecectomy on showed non-hodgkin's lymphoma with aggressive features. - treated with 2 cycles of ice plus rituximab in and of with excellent response to treatment - matched unrelated allogeneic transplant on the atg/tli/clofarabine study, cohort 4. day 0 on . - cmv positive started on valcyte - changed valcyte to acyclovir due to concern for affects on blood counts - month restaging pet scan showed no evidence for lymphoma. - left hand cellulitis at the site of thorn stick on #4 digit, treated with 7 days of linezolid . past medical history: 1. history of lymphoma and hodgkin's lymphoma as outlined. 2. pancreatitis status post ercp in 6/. 3. diabetes mellitus type 2, 4. coronary artery disease with history of mi in , status post poba 5. status post splenectomy with diagnosis of hodgkin's lymphoma. 6. history of gerd with barrett's esophagus noted on endoscopy. 7. basal cell carcinoma of the face status post mohs' excision followed by dermatology. social history: married; lives in ma with his wife. returned to work at recently as networking tech. recently quit smoking, 25 pack year history, occasional marijuana smoking, drinks 2-3 alcoholic drinks daily, denies withdrawl, seizures, denies drinking first thing in the am. family history: father with a history of esophageal cancer paternal grandfather with a history of lung cancer grandmother died of mi physical exam: physical exam on arrival to the vitals: t: 99.8 bp:78/47 p:54 r:25 o2:100% general: sedated, intubated heent: sclera anicteric, mmm, oropharynx clear neck: supple lungs: right anterior lung field + bronchial sound, clear on the left, no wheeze or rhonchi. cv: rrr, difficult to appreciate m/r/g abd: soft, nt, nd, bs present, no rebound or guarding, no organomegaly gu: foley, clear yellow urine, ~ 1l since transfer to the ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema physical exam on discharge from bmt service vitals: t:97.3 bp:148/88 hr:94 r:18 o2:97% ra general: awake, in no acute distress heent: no scleral icterus, mucous membranes moist, no oral ulcers neck: supple lungs: clear to auscultation bilaterally cv: rrr, no m/r/g abd: soft, nt, nd, bs present, no rebound/guarding extremities: warm, well perfused,no cyanosis or edema, 2+ pulses b/l neuro: alert and oriented x3, moving all 4 extremities pertinent results: labs on admission 09:00am blood wbc-11.7* rbc-2.72* hgb-10.0* hct-29.2* mcv-108* mch-36.7* mchc-34.1 rdw-15.4 plt ct-399 09:00am blood neuts-67.4 lymphs-27.3 monos-3.6 eos-1.4 baso-0.2 09:00am blood urean-22* creat-1.4* na-141 k-4.8 cl-104 hco3-25 angap-17 09:00am blood alt-48* ast-45* ld(ldh)-197 alkphos-143* totbili-0.4 09:00am blood albumin-4.5 calcium-9.1 phos-3.6 mg-1.4* 12:00am blood igg-871 12:00am blood ck-mb-3 ctropnt-<0.01 04:35am blood ck-mb-3 ctropnt-<0.01 probnp-4183* 09:15pm urine color-straw appear-clear sp -1.012 09:15pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-5.0 leuks-neg cta : 1. new widespread confluent consolidations, findings highly concerning for severe multifocal pneumonia. 2. new small-to-moderate bilateral pleural effusions, right greater than left. 3. standard position of the endotracheal tube and patent tracheobronchial tree. 4. no pulmonary embolism. labs on discharge 12:20am blood wbc-13.7* rbc-2.63* hgb-9.5* hct-29.1* mcv-111* mch-36.2* mchc-32.7 rdw-15.5 plt ct-396 12:05am blood pt-13.4 ptt-27.9 inr(pt)-1.1 12:20am blood glucose-292* urean-26* creat-1.1 na-138 k-4.3 cl-99 hco3-29 angap-14 12:20am blood alt-62* ast-46* ld(ldh)-235 alkphos-180* totbili-0.3 12:20am blood calcium-9.1 phos-2.7 mg-1.8 09:00am blood ebv pcr, quantitative, whole blood- brief hospital course: when mr. was admitted to the floor, vitals were t:98.9 bp:150/97 p:113 rr:22 sao295% ra. he complained of ongoing cough and wheezing and moderate dyspnea on exertion though breathing was comfortable at rest. he was started on antibiotics- azithromycin and ceftriaxone. . at around 11pm, patient was triggerred for increased sob requiring more oxygen supplement, o2 sat 84% on ra improved to low 90% on 4l which then improved to mid 90% on nrb. he received lasix 40 mg iv, nebs, and solumedrol 40 iv x1. at around midnight, patient got up to the bathroom. he was noted to have borderline temp at 100.3, bp 148/94, hr 120, rr 20. as he was returning from the bathroom, he felt more sob with o2sat down to 70% on ra which improved to 96% on nrb. then 50 % on nrb. code blue was called. patient was intubated given his respiratory distress on and underwent femoral vein catheterization. subsequently, he underwent cta to rule out for pe. pe was ruled out, but patient was found to have pulmonary edema and multifocal pneumonia. he was started on vancomycin 1000mg iv q12 and cefepime 2g iv q8. of note, a tte was done which revealed ef 40%, approximately his baseline. patient was extubated on and was saturating well on 3l in the mid 90s. he continued to wheeze and was started on advair and ipratropium and albuterol nebulizers. his infectious work up was unrevealing, and came back negative for ebv, aspergillus, influenza, parainfluenza, rsv, adenovirus, legionella, h. flu and c.diff. he was started on azithromycin 500mg po on . he was transferred to the floor on where he was oxygenating well on room air to the high 90s. however, he was still wheezing a lot, so he was started on solumedrol 30mg iv daily. on steroids, the wheezing improved significantly. on , vancomycin and cefepime were discontinued and levofloxacin 750mg po qd was started. the solumedrol was discontinued and prednisone 30mg po qd was started. mr. remained afebrile throughout his admission on the floor. he was no longer wheezing and breathing comfortably without any oxygen requirements. in regards to his bright red blood per rectum, he did not have another such episode. the lower gi bleed was thought to be secondary to hemorrrhoids. medications on admission: per admission note from bmt: acyclovir 400 mg po q 8 hours atovaquone 1500 mg po q 24 hours coreg 25 mg po bid citalopram 30 mg po daily folic acid 1 mg po daily furosemide 20mg daily glyburide 2.5 mg po daily lansoprazole 30 mg po daily metoformin 1000 mg po bid zocor 80 mg po daily trazodone 75mg po qhsprn insomnia prn vardenafil 20 mg daily prn tylenol 325 mg q6h prn asa81 mg vitamin d3 2,000 unit tablet vitamin b12 1,000 mcg tablet magnesium oxide-mg aa chelate - (otc) - 133 mg tablet - 1 (one) tablet(s) by mouth three times a day nicotine (polacrilex) - (discharge med) - 2 mg lozenge - 1 lozenge(s) every four (4) hours as needed for nicotine withdrawal symptoms proair as needed dose unknown flovent as needed dose unknown discharge medications: 1. acyclovir 400 mg tablet : one (1) tablet po q8h (every 8 hours). 2. atovaquone 750 mg/5 ml suspension : two (2) po daily (daily). 3. citalopram 20 mg tablet : 1.5 tablets po daily (daily). 4. folic acid 1 mg tablet : one (1) tablet po daily (daily). 5. furosemide 20 mg tablet : one (1) tablet po daily (daily). 6. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 7. azithromycin 250 mg tablet : two (2) tablet po q24h (every 24 hours). disp:*1 tablet(s)* refills:*0* 8. prednisone 10 mg tablet : three (3) tablet po q24h (every 24 hours): take on and . disp:*6 tablet(s)* refills:*0* 9. levofloxacin 750 mg tablet : one (1) tablet po q24h (every 24 hours). disp:*8 tablet(s)* refills:*0* 10. cyanocobalamin (vitamin b-12) 500 mcg tablet : two (2) tablet po daily (daily). 11. nicotine (polacrilex) 2 mg lozenge : one (1) gum buccal every 4 hours as needed as needed for pt request. 12. carvedilol 12.5 mg tablet : two (2) tablet po bid (2 times a day). 13. metformin 1,000 mg tablet : one (1) tablet po twice a day. 14. glyburide 2.5 mg tablet : one (1) tablet po once a day. 15. trazodone 50 mg tablet : one (1) tablet po at bedtime as needed for insomnia. 16. proair hfa inhalation 17. flovent hfa inhalation 18. aspirin low-strength 81 mg tablet, chewable : one (1) tablet, chewable po once a day. 19. vardenafil 20 mg tablet : one (1) tablet po once a day. 20. tylenol 325 mg tablet : one (1) tablet po every six (6) hours as needed for pain. 21. vitamin d-3 2,000 unit capsule : one (1) capsule po once a day. 22. magnesium oxide-mg aa chelate 133 mg tablet : one (1) tablet po three times a day. 23. prednisone 10 mg tablet : two (2) tablet po once a day for 2 days: take on and . disp:*4 tablet(s)* refills:*0* 24. lisinopril 5 mg tablet : one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: multi-focal pneumonia pulmonary edema hemorrhoidal bleed discharge condition: stable alert and oriented x3 ambulatory discharge instructions: dear mr. , you were admitted to the hospital with bleeding from your rectum. at that time, your blood counts were within normal limits and you were in stable condition. when you were on the floor, you had respiratory distress and stopped breathing on your own. at that time, you were transferred to the intensive care unit and had a tube in your throat to help you breathe for 3 days. during that time, you had a cat scan of your chest which showed pulmonary edema (fluid in your lungs) and a widespread pneumonia in your lungs. you were started on antibiotics intravenously (vancomycin and cefepime) for the pneumonia and lasix (a fluid pill) to remove the water from your lungs. an echocardiogram was taken of your heart which showed that your heart function was stable. your responded very well to the treatment and you the tube was removed from your throat on . you were wheezing a lot and were started on albuterol, ipratropium, and and advair nebulizer treatments to help with your breathing. your were also started on azithromycin, another antibiotic. on , you were transfered from the intensive care unit to to the floor. you were still wheezing a lot, so we started you on intravenous steroids which reduced the wheezing. since on the floor, you have remained afebrile. on , we discontinued your intravenous antibiotics and started you instead on an oral antibiotic, levofloxacin. we also switched you from intravenous steroids to oral steroids (prednisone.) in regards to the bleeding from your rectum, it was most likely from a hemorrhoid and did not recur during your admission. you did not require a blood transfusion while you were in the hospital. on discharge, there are several medications that you need to take: 1.azithromycin: 1 dose of 500mg orally to complete the 5 day course 2.levofloxacin: 750mg daily for 8 days to complete a 10 day course 3.prednisone: please take 30mg on and and 20mg on and as an outpatient, you will need to have a follow up cat scan of your chest to assess the pneumonia. dr. will decide when you should have this imaging. also, your blood pressure was a bit high during the hospitalization so we added a new medication, lisinopril 5mg daily. when you follow up with your primary care physician, let them know about this new medication. your liver enzymes were slightly elevated today so please do not take your simvastatin and come back at 8:00am on to have your blood draw so that we can re-check your liver enzymes. followup instructions: department: hematology/bmt when: friday at 9:00 am with: , rnc building: sc clinical ctr campus: east best parking: garage procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified insertion of endotracheal tube closed [endoscopic] biopsy of bronchus diagnoses: pneumonia, organism unspecified coronary atherosclerosis of native coronary artery diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified chronic kidney disease, unspecified peripheral stem cells replaced by transplant acute respiratory failure diverticulosis of colon (without mention of hemorrhage) acute edema of lung, unspecified unspecified hemorrhoids with other complication respiratory arrest other malignant lymphomas, intra-abdominal lymph nodes 

Answer: The patient is high likely exposed to