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: fondaparinux attending: chief complaint: fever and neutropenia major surgical or invasive procedure: cardiac cardioversion intubation transjugular liver biopsy extubation history of present illness: patient is a 51yo m with history of all dx'd in , treated and went into remission (onc history below), but then relapsed. he was recently admitted on for the first part of hypercvad. treatment was delayed a few days secondary to elevated bili, but started on . he was discharged on . he received vincristine on days 4 () and 11 (). he returned to clinic today for follow up and was found to have fever to 100.6 and anc of 60. he was reports fever or chills, no sick contacts, no nsaid or tylenol use, but is on steroids. picc removed on sunday. at clinic patient had a negativ cxr, blood culture drawn, received 2g iv cefepime, and was transfused 1u prbcs. ros: negative for fevers, chills, sore throat, nasal congestion, pain, abdominal pain, n/v/d/constipation, change in urinary habits. past medical history: pertinent onc history: (per omr notes) he presented in spring of with chromosome negative all and was enrolled in the ecog e2993 protocol. his course was complicated by arachnoiditis and spinal headache after intrathecal methotrexate and he developed a large saddle pulmonary embolus potentially related to his l-asparaginase. he also developed pulmonary infarct with bloody pleural effusion and has had several episodes of febrile neutropenia. he was treated with heparin for the pulmonary embolus and an ivc filter was placed. he had a trial of fondaparinux but had an allergic reaction. in light of having a filter in place and cyclic thrombocytopenia while on treatment, he has not had further anticoagulation. he has received the remainder of his protocol treatment with l-asparaginase omitted due to the pulmonary embolism. . he entered a complete remission on , and was randomized to a standard intensification consolidation arm. he completed his intensification with high-dose methotrexate and underwent stem cell mobilization in the summer of and then completed his radiation therapy in early and underwent consolidation with intrathecal ara-c. he began cycle 1 of consolidation on . he began cycle 2 of consolidation on , where he received 5 days of cytarabine and etoposide last given on . shortly before , he began to experience an ascending weakness. he was admitted to the neurology service where nerve conduction studies revealed a guillain- like syndrome as well as a polyneuropathy presumed to be from diabetes mellitus and vincristine. he was treated with ivig and had improvement in symptoms. he completed cycles 3 and 4 without further complication. began maintenance on . complicated by transaminitis requiring dose reduction of 6mp and then a change to thioguannine and chemotherapy break in . . ros: denies fevers, weight loss, weight gain, chest pain, shortness of breath, abdominal pain, nausea, vomiting, constipation, brbpr, change in bowel or bladder habits, hematuria, lower extremity edema . past medical hx: - all (as per above onc history) - stable peripheral neuropathies in right hand and lower legs/feet - pulmonary embolism - ivc filter placement - guillain- syndrome vs. cidp - diabetes type 2, on insulin - concern for nash social history: he is married and works at . he is a lifelong nonsmoker. he does not drink alcohol. family history: - mom: coronary artery disease. - father: colon cancer. - no family history of neurologic disorders. physical exam: vs: 99.4 83 104/83 20 100ra heent: eomi, perrl, thrush in mouth neck: no lad cv: rrr 1/6 systolic murmur at lusb lungs: ctab abd: +bs, obese, nt, nd, soft ext: trace edema skin: echymosis on abd, no rashes neuro: aaox3, cn2-12 intact, 5/5 strength, sensation decreased in right hand and feet bilaterally. pertinent results: t bili trend: 4/3/07-10.1 4/4/07-11.6 4/5/07-14 liver, needle core biopsy: central venular hemorrhage with focal drop out. lobular regeneration with scattered rare neutrophils. trichrome stain shows no advanced fibrosis or cirrhosis. focal sinusoidal fibrosis is seen. reticulin stain shows features consistent with nodular regenerative hyperplasia. severe iron deposition in kupffer cells and hepatocytes on special stain. brief hospital course: icu course: patient was transferred to icu. he was intubated, successfully cardioverted. he went for transjugular biopsy of his liver by ir. he was successfully extubated. he continued to be slightly encephalopathic. he was seen by respiratory and nifs initially ~12 returned to baseline of ~40cm. . assessment: patient is a 51yo man with all with like weakness and liver failure after the first part of hypercvad. . plan: # fever/neutropenia: patient presented with anc of 60. monitored with serial cultures which were negative or no growth to date. cxr clear. he was covered with cefepime, vanc, flagyl, micafungin. . # weakness/gbs: on hospital day # patient started having progressive muscular weakness throughout body. neuro was involved. thought that presentation was most consistent with like illness. patient completed 2g (500mg x4 doses) of ivig and had some slow improvement, but difficult to assess in setting of hepatic encephalopathy. . # liver disease: patient presented with an elevated tbili which continued to rise and today is 16.1. his inr began to rise as well. liver biopsy excluded cirrhosis/end stage liver and nash as causes. the histology showed some vascular congestion. based on clinical presentation and histology not to the contrary patient was diagnosed with probable vod. there are case reports of vod after chemotherapy with vincristine and other agents. we received approval from fda for compassionate use of defibrutide for a non-post transplant patient with vod. began treatment with defibrutide on . care transitioned to comfort. . # cardiac: patient had new onset afib with rvr on . he was evaluated by cardiology (ep). he was electrically cardioverted to nsr under anesthesia. he was started on digoxin, sotalol and diltiazem to maintain sinus rhythm. . # all: patient completed 1st part of hypercvad (on day +14--vincristine on day +11, dexamethasone on +11, 12, 13, 14). . # heme: transfuse rbcs to goal hct of 25. transfusion parameters for defibrutide for inr is <2-2.5 and platelets of >50. . # history of pe. stable, no signs of active clot. - ivc filter in place. - no systemic anticoagulation in the setting of thrombocytopenia. . # diabetes. difficult to control glucose while taking steroids. was very involved on last admission and patient was discharged with a detailed insulin regimen based on his changes in decadron. . # goals of care: on night of -7 patient expressed wishes to die and wanted to be made comfortable. after discussion with wife by primary oncologist, the collective decision was to transistion to comfort care. medications on admission: medications: (meds per omr, ) - ativan 1mg po q6 prn - bactrim ds 800-160mg po qmwf - dexamethasone 24mg po daily days of chemo - fluconazole 200mg po daily - humalog sliding scale and lantus 25units in the morning. - lactulose 15ml tid/qid prn constipation - levofloxacin 500mg po daily - methotrexate 45mg po as directed - nasonex 2 sprays each nostril daily - prednisone 6.5mg po daily x 5 days - protonix 40mg po daily - thioguanine 40mg po daily as directed - zofran 8mg po q8 prn nausea discharge medications: none discharge disposition: expired discharge diagnosis: all liver failure diabetes discharge condition: expired. discharge instructions: expired. followup instructions: none procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances other electric countershock of heart closed (percutaneous) [needle] biopsy of liver transfusion of packed cells transfusion of other serum transfusion of platelets injection or infusion of immunoglobulin diagnoses: diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute and subacute necrosis of liver acquired coagulation factor deficiency atrial fibrillation candidiasis of mouth long-term (current) use of insulin personal history of venous thrombosis and embolism hepatic encephalopathy acute lymphoid leukemia, without mention of having achieved remission acute infective polyneuritis other venous embolism and thrombosis of unspecified site 

Answer: The patient is high likely exposed to