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: neupogen attending: chief complaint: shortness of breath major surgical or invasive procedure: non-tunneled hemodialysis line placement tunneled hemodialysis line placement history of present illness: 64 year old man with history of cadaveric kidney transplant in after acute tubular necrosis from a viral gastroenteritis whose kidney function has been slowly worsening of the past year who presents with shortness of breath for 1 week. patient reports cough and shortness of breath, mainly with extertion for the past week. the symptoms started with runny noise and the patient thought he had a cold. he notice dyspnea on extertion when he was walking from his car to his house, a distance he is normally able to do without difficulty. he also has noted this dry cough, worse at night that makes him sit up off the side of the bed. he denies any chest pain or history of chest pain with extertion. he also denies recent fevers, chills, nausea, vomiting, abdominal pain, diarrhea, or constipation. he has noticed a progressive decrease in his urine output over the past year but no acute change recently. he does not occasional intermittent dysuria. he denies any recent medication non-compliance or change in his diet. patient does feel like he has been gaining weight over the past few months. . the patient was also recently admitted at for a similar progressive shortness of breath. it was thought due to his worsening renal function. he was diuresed and he improved. . the patient also reports a fall two weeks prior to admission. patient tripped on stairs at his home and fell. he did hit his head but denies any loc. he denies any associated chest pain, weakness, dizziness, or palpitations. past medical history: #atrial fibrillation - s/p cardioversion in . was maintained on coumadin for 6 months. currently not anticoagulated . #pericardial effusion - s/p drainage, unclear etiology . #kidney disease - esrd from atn in setting of acute gastroenteritis, s/p cadaveric kidney transplant in , worsening renal function over the last year. has appointment in . for av fistula placement in anticipation of future dialysis . #abdominal wall hernia - s/p repair after transplant . multiple knee surgeries 20 years ago social history: denies any history of tob use, no etoh use for 15 years, no drug use. lives with his wife, now on disability. used to work as a spray painter family history: history of cad, cancer, ms physical exam: vitals: 96.9, 132/80, 92, 20, 97% on 4l gen: coughing repeatedly during interview with moderate distress, some difficulty completing sentences because of coughing heent: perrl, eomi, clear op with mmm neck: no lad, jvp difficutly to assess because of girth cv: , otherwise heart sounds difficutly to interpret because of loud ronchi lungs: diffuse ronchi throughout lung fields, few crackles apparent at bases abd: +bs nt nd, soft, obese, large irregular ventral hernia appreciated ext: + peripheral edema, r>l, erythema of right leg but without significant warmth or tenderness, some bruising at right ankle. 2+ dp pulses, rom at right ankles seems full neuro: cn 2-12 intact, 5/5 strength upper and lower extremities, sensation grossly intact throughout pertinent results: ============ laboratories ============ laboratories on admission: wbc-3.7 (neuts-78 bands-0 lymphs-9 monos-9 eos-3 basos-1 atyps-0 metas-0 myelos-0) hgb-9.4 hct-29.0 mcv-88 plt count-151 sodium-126 potassium-6.7* (hemolyzed)-->repeat k=4.1 chloride-93 total co2-17 urea n-103 creat-4.8 glucose-69 alt(sgpt)-9 ast(sgot)-46 ck(cpk)-233 alk phos-24 tot bili-0.4 ck-mb-10 mb indx-4.3 ctropnt-0.07 probnp- albumin-3.6 lactate-0.7 . cardiac enzymes: 11:30am blood ck(cpk)-233 ck-mb-10 mb indx-4.3 ctropnt-0.07 07:30pm blood ck(cpk)-187 ck-mb-12 mb indx-6.4 ctropnt-0.09 05:26am blood ck(cpk)-166 ck-mb-9 ctropnt-0.06 . other laboratories caltibc-276 ferritn-114 trf-212 tsh-0.90 pth-106 blood hbsag-negative hbsab-positive hbcab-negative hcv ab-negative cyclspr-69 . laboratories upon discharge: wbc-3.7 hgb=8.7 hct-29.1 mcv-94 plt count-141 sodium-141 potassium-3.5 chloride-104 total co2-17 urea n-26 creat-3.7 glucose-97 . ======= studies ======= unilat lower ext veins right right lower extremity ultrasound: the exam is technically limited, because pain limited the patient's ability to tolerate compression of the superficial femoral vein at its mid and distal portions. grayscale and doppler were obtained of the right common femoral, proximal superficial femoral, and popliteal veins. normal compressibility, color flow and waveforms are seen. color flow and doppler , without compression, were obtained for the mid and distal right superficial femoral vein. normal color flow and waveforms are seen. the left common femoral vein demonstrates normal color flow and waveforms. impression: dvt highly unlikely. however, cannot be completely ruled out due to technical limitations resulting from patient discomfort. if clinical concern persists, followup exam can be performed following appropriate pain control. . ap portable chest the study is limited secondary to ap portable technique and body habitus. the cardiomediastinal configuration remains markedly enlarged but stable. the cardiac silhouette is globular in morphology. there is no superimposed edema or consolidation evident. no effusion or pneumothorax is seen. again noted and slightly exaggerated is a dextroconcave curvature of the thoracic spine likely at least in part positional. impression: low lung volumes; however, no focal consolidation seen. stable marked cardiomegaly. . ecg study date of atrial fibrillation with moderate ventricular response. diffuse low voltage. delayed precordial r wave transition. diffuse non-specific st-t wave changes. compared to the previous tracing of atrial fibrillation has appeared. rate 85, pr 0, qrs 88, qt/qtc 392/435, p 0, qrs 15, t 89 . portable tte (complete) done the left atrium is moderately dilated. the right atrium is moderately dilated. the estimated right atrial pressure is 10-15mmhg. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef 70%) due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. compared with the findings of the prior report (images unavailable for review) of , cardiac rhythm now atrial fibrillation; no pericardial effusion seen; otherwise findings similar. . chest (portable ap) the right supraclavicular catheter remains in place with tip in the right atrium. bibasilar atelectasis are again seen, slightly worsened on today's examination with a lower lung volume than before. small bilateral pleural effusion have not changed. there is cardiomegaly along with minimal vascular congestion. the abdomen is gasless. impression: 1. lower lung volume with more prominent bibasilar atelectasis. 2. right central catheter still terminates in the right atrium, for which repositioning is required. . cta chest w&w/o c&recons, non-; ct abdomen w/o contrast, 1. no pulmonary embolism. there is ct evidence of pulmonary hypertension. 2. the lung parenchyma is not well evaluated given that the amount of respiratory motion present. there appear to be centrilobular nodules, ground- glass opacity and atelectasis. there are small bilateral pleural effusions. 3. cardiomegaly and coronary artery calcifications. 4. rounded hypodense liver lesions are not fully characterized on this study but not appear greatly changed from . 5. the spleen is generous in size. 6. right lower quadrant renal transplant. 7. right flank ecchymosis and focal right abdominal wall muscular enlargement, possibly representing a hematoma. this muscle enlarged should be followed to complete resolution to exclude an underlying mass. consider targeted ultrasound for followup. . venous dup ext uni (map/dvt) left the left basilic vein was not identified, presumably thrombosed. the left cephalic vein is patent and measures 0.23 cm in diameter superiorly and 0.37 cm in diameter in the forearm distally. in between, measurements range from 0.21-0.33, as charted on the vasculat lab diagram. the left brachial artery is patent with triphasic waveforms. there is respiratory phasicity of the left subclavian venous waveform. . ekg atrial fibrillation, average ventricular rate 80-85. generalized low voltage. delayed precordial r wave progression - cannot exclude anterior myocardial infarction. generalized non-specific repolarization changes most marked anteroseptally and laterally consistent with ischemia. compared to the previous tracing of anteroseptal t wave inversions are new. rate 83 pr 0, qrs 76, qt/qtc 386/426, p 0, qrs 18, t 109 . microbiology . blood culture (4 bottles): no growth final. nasopharyngeal aspirate. positive for respiratory syncytial viral antigen. culture confirmation pending. specimen screened for: adeno,parainfluenza 1,2,3 influenza a,b and rsv. viral culture (final ): herpes simplex virus type 1. confirmed by monoclonal fluorescent antibody brief hospital course: #. respiratory distress the patient's respiratory distress was likely multifactorial due to volume overload and rsv infection (by nasopharyngeal aspirate). in the micu, the patient was also determined to have chronic co2 retention likely secondary to obstructive sleep apnea given his habitus. of note, pt did not tolerate bipap trial in unit. pt received 3 days of burst steroids for ? copd exacerbation, was discontinued given lack of improvement and no known copd (not a smoker). in addition, mr. beta blocker was discontinued as uptitration of it was thought to exacerbate his wheezing. ct chest was negative for pulmonary embolism. hemodialysis was initiated. the patient was diuresed to a net negative fluid balance of ~10 l on hd with significant improvement in wheezing/decreased o2 saturations/rhonchi after dialysis. however, wheezing persisted and low o2 saturations (~91% room air) persisted after significant volume removal. nasopharyngeal aspirate showed patient had an rsv infection. pulmonary was consulted and there was no indication for an antiviral medication for rsv. supportive care was provided for viral pulmonary infection. of note, viral cultures of the nasopharyngeal aspirate grew hsv 1, which was felt to be a normal colonizer of the patient's respiratory tract. by the time the hsv culture returned (), the patient's respiratory status was at baseline; no antiviral for hsv was felt to be indicated. upon discharge, the patient had clear lungs to auscultation bilaterally and had an normal o2 saturation on room air. bactrim was continued for prophylaxis. sleep study was recommended as an outpatient to evaluate the need for home bipap. . #. end-stage renal disease on hemodialysis see above. failed cadaveric renal transplant in , initiated on hemodialysis on this admission with successful placement of tunneled line on this admission. for renal transplant, continued low dose prednisone, and cyclosporine was decreased to 25 mg daily. he was maintained on a fluid restricted diet. venogram was performed in anticipation of outpatient fistula placement. he was scheduled for a vascular surgery appointment as an outpatient for fistula placement. . #. atrial fibrillation the patient has a history of atrial fibrillation s/p cardioversion and re-presented in atrial fibrillation in the setting of metabolic derangements and fluid overload. home betablocker was discontined (due to persistent wheezing), and diltiazem was provided for rate control. of note, diltiazem elevates cyclosporin which could be problem in this patient. in the future if respiratory distress deemed not to be related, beta blocker may provide more cardiac benefit and also does not have cross reaction with cyclosporin; defer to outpatient pcp. cards, no cardioversion was indicated during this admission as the patient could not lie flat for procedure, which would require tee. per ther recs: outpatient cardiology f/u in weeks with dr. for outpatient cardioversion once respiratory status improves. coumadin was provided after hd line placed; he was bridged with heparin drip until then. upon discharge, he was off the heparin drip and therapeutic on coumadin. he was in atrial fibrillation through admission with adequate rate control upon discharge. . #. acidemia the patien presented with mixed metabolic and respiratory acidosis. respiratory component possibly due to co2 retention (osa vs obesity hypoventilation syndrome vs copd); ag metabolic acidosis due to his renal failure. his acidemia improved with dialysis and adjustment of diasylate bath. . # f/e/n: replete lytes prn. fluid restricted renal diet. . # ppx: bowel regimen, ppi (on steroids) . # access: piv 22 x 2, temporary hd line. . # dispo: pending further improvement in respiratory status. . # code status: full medications on admission: docusate sodium 100 mg po bid pantoprazole 40 mg po prednisone 5 mg po qpm furosemide 80mg po daily gengraf *nf* 100 mg oral mycophenolate mofetil 250 mg po tid sulfameth/trimethoprim ss 1 tab po mwf amlodipine 10 mg po daily iron tid calcium + vitamin d discharge medications: 1. atorvastatin 40 mg tablet sig: two (2) tablet po daily (daily). 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 4. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po bid (2 times a day). 5. trimethoprim-sulfamethoxazole 160-800 mg tablet sig: one (1) tablet po q mwf (). 6. prednisone 5 mg tablet sig: one (1) tablet po daily (daily). 7. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 8. cyclosporine modified 25 mg capsule sig: one (1) capsule po daily (daily). 9. diltiazem hcl 180 mg capsule, sustained release sig: one (1) capsule, sustained release po daily (daily). discharge disposition: extended care facility: center for rehab discharge diagnosis: primary: end-stage renal disease respiratory syncytial virus . secondary: atrial fibrillation discharge condition: hemodynamically stable, afebrile discharge instructions: you were admitted to the hospital with shortness of breath. hemodialysis was initiated. your shortness of breath improved with excess volume removal with hemodialysis. you were also found to have respiratory syncytial virus, and you were treated with supportive care. . please keep all followup appointments. . please call your doctor or return to the emergency room if you have any of the following: * you experience new chest pain, pressure, squeezing or tightness. * new or worsening cough or wheezing. * if you are vomiting and cannot keep in fluids or your medications. * you are getting dehydrated due to continued vomiting, diarrhea or other reasons. signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * you see blood or dark/black material when you vomit or have a bowel movement. * your pain is not improving within 8-12 hours or not gone within 24 hours. call or return immediately if your pain is getting worse or is changing location or moving to your chest or back. * you have shaking chills, or a fever greater than 101.5 (f) degrees or 38(c) degrees. * any serious change in your symptoms, or any new symptoms that concern you. * please resume all regular home medications and take any new meds as ordered. . medication changes: 1. cyclosporin dosage was decreased to 25 mg daily. 2. toprol xl was discontinued as it was thought to contribute to your shortness of breath. . new medications: 1. warfarin (coumadin) 2.5 mg by mouth daily. the dosage of your coumadin should be adjusted as an outpatient to maintain a therapeutic level. 2. diltiazem 180 mg daily was added to control your heart rate. followup instructions: 1. for fistula placement for dialysis: provider: , md phone: date/time: 2:30 pm. . 2. provider: , md phone: date/time: 1:30 pm. . 3. provider: , md phone: date/time: 11:10 am. . 4. please followup with you pcp: , md within 1 week of discharge from rehabilitation. phone: . md procedure: hemodialysis venous catheterization for renal dialysis diagnoses: acidosis end stage renal disease acute kidney failure, unspecified atrial fibrillation hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease acute respiratory failure complications of transplanted kidney pneumonia due to respiratory syncytial virus 

Answer: The patient is high likely exposed to