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: shellfish attending: chief complaint: afib rvr major surgical or invasive procedure: cardioversion history of present illness: 53 with recurrent non-hodgkin's lympoma currently started new round of chemo presents with afib rvr. pt reports that for the past week he has felt weak and unwell, and two days ago he felt pre-syncopal. he denies any chest pain or shortness of . he presented today to clinic today for routine pre-chemotherapy echocardiogram and was found to be in afib rvr with hr 150. he was sent to the ed from clinic. incidentally, per , pt had a fever several days ago, was pan-cultured in and empirically started on levofloxacin. . in the ed, he was placed on a diltiazem drip. per report he was breifly hypotensive to sbp 70 but his pressures then improved. past medical history: onc history: patient of dr. . found to have mesenteric mass during workup after a fall from a tree. biopsy revealed mixed lymphocytes, cd19/20 +, cd5 -, cd10 weakly positive, bcl-2/bcl-6 positive. pet scan demonstrated uptake in the abdomen and rectal area. underwent r-chop * 6 () with complete remission. pet scan in demonstrated recurrent disease (l retrocrural area 2.5 cm c scv 8.8 c/w lymphomatous recurrence). . treated with r-ice and then had a second cycle of r-ice , autologous bmt . pet scan showed resolution of lesion in l retrocrual area, but repeat pet suggested recurrence. . past medical history: -low testosterone - presented with muscle weakness, improved with testosterone injections. injections discontinued secondary to elevated lfts and lymphoma -gerd -paroxysmal atrial fibrillation - was on digoxin. then on metoprolol. one episode in the setting of caffeine intake + adderrall use. now not on any meds -rectal hemorrhoids -sleep apnea on cpap - does not use cpap machine at home -elevated lfts, elevated cpk - had been seen by dr. . he was concerned that chronically elevated cpk may represent muscle etiology im injections of testosterone. however, liver biopsy showed mild steatosis without balloon degeneration / intracellular hyalin, and mild portal/lobular mononuclear cell inflammation. chronically elevated cpk is not currently explained as far as we can find. social history: () resident. married. 2 children (daughter, son) in their early 20s. smoked 8 years, quit 25 years prior. no history of ivdu. distant history of polysubstance abuse. goes to 12-step groups. works as representative of invisible fence, also as bus driver for bus system. family history: mother with ovarian cancer. brother died of esophageal cancer. cad in family physical exam: admission: vitals: 98.3 hr 140 bp 103/65 sao2 94% ra gen: nad, well appearing, aox3 heent: thick neck w/o jvd cv: tachycardic and irregular, no mrg, unable to palpate pmi pulm: ctab abd:obese, soft, nt/nd ext: no edema . discharge pertinent results: echo #1: 2d-echocardiogram: the left atrium is elongated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is moderately dilated. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is difficult to assess given marked resting tachycardia, but may be mildly depressed (lvef= 50 %). the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. impression: suboptimal image quality. marked resting tachycardia renders study difficult to interpret. possibly mildly reduced global left ventricular function. recommend repeat evaluation when heart rate slower. compared with the prior study (images reviewed) of , the heart rate is faster. left ventricular function is less vigorous. . echo #2: results pending brief hospital course: assessment and plan, to be reviewed and discussed in multidisciplinary rounds: 53 with recurrent non-hodgkin's lympoma currently started new round of chemo presents with afib rvr. . # rhythm: aflutter w/ rvr now resolved. in the past the patient has been on digoxin (stopped) then toprol xl 25mg for paf which appears to have been discontinued. pt had also been on coumadin which was recently discontinued when plt began decreasing after chemotherapy. the patient received tee and then successful d/c cardioversion on . it sucessfully converted to normal sinus rhythm. he was continued on heparin gtt for anticoagulation and was converted to lovenox for ease of stopping as his platelets may drop with further treatment. due to his size, his dose was titrated to an appropriate factor xa level. he will continue this anticoagualation for 30 days. he was also started on toprol xl 25mg for better rate control. he will follow up with dr. . . # fever?: pt had fever to 101.8 several days ago with malaise but no focal symptoms was seen in and cultured. was started on levofloxacin epirically at that time. blood cx from mv were negative. ucx negative. an initial cxr was w/o evidence of pna but a repeat cxr showed bibasilar interstitial infiltrates. he was initially broadened to cefepime after he spiked again but was rapidly switched back to high dose levofloxacin. he remained afebrile for >24hrs on po antiobiotics. he will complete 10 day course and follow up with dr. . . # lymphoma: the patient had dropping counts after his navelbine and gemcitabine but his nadir was about 1.6k. he was continued on his allopurinol and his prophylactic bactrim and acyclovir. he will follow up with dr. in days. . # cad/ischemia: none . # pump: possibly mildly reduced ef but no heart failure at this time . # valves: no abnormalities . # dm: n/a . # sleep apnea: cont on cpap at night . # anxiety: - cont venlaflaxine daily - cont xanax tid prn panic attacks . # fen: heart healthy diet . # prophylaxis: heparin gtt, ppi . # code: full . # communication: wife medications on admission: acyclovir 400 tid allopurinol 300 gabapentin 100 larazepam 0.5-1 prn oxycodone prn protonix 40 compazine prn effexor 150 xr bactrim ds qmwf discharge medications: 1. acyclovir 200 mg capsule sig: two (2) capsule po q8h (every 8 hours). 2. allopurinol 100 mg tablet sig: three (3) tablet po daily (daily). 3. alprazolam 1 mg tablet sig: 1-2 tablets po tid (3 times a day) as needed for anxiety. 4. gabapentin 100 mg capsule sig: two (2) capsule po hs (at bedtime). 5. venlafaxine 75 mg capsule, sust. release 24 hr sig: two (2) capsule, sust. release 24 hr po daily (daily). 6. prochlorperazine maleate 5 mg tablet sig: two (2) tablet po q8h (every 8 hours) as needed for nausea. 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 8. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 9. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 10. trimethoprim-sulfamethoxazole 160-800 mg tablet sig: one (1) tablet po mwf (monday-wednesday-friday). 11. oxycodone 5 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. 12. metoprolol succinate 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). disp:*30 tablet sustained release 24 hr(s)* refills:*2* 13. levofloxacin 750 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 10 days. disp:*10 tablet(s)* refills:*0* 14. lovenox 100 mg/ml syringe sig: one (1) subcutaneous twice a day for 30 days. disp:*60 syringes* refills:*0* 15. lovenox 80 mg/0.8 ml syringe sig: one (1) subcutaneous twice a day for 30 days: take one 100mg and one 80mg syringe at the same time. . disp:*60 syringes* refills:*0* 16. lovenox instructions you must take a total of 180mg of lovenox twice a day. this means that you need to take 1 injection of 100mg lovenox and 1 injection of 80mg lovenox in the mornings and repeat the same 2 injections in the evenings. discharge disposition: home discharge diagnosis: atrial fibrillation status post cardioversion bacterial pneumonia lymphoma sleep apnea discharge condition: all vital signs stable, afebrile, ambulatory, in normal sinus rhythm discharge instructions: you were admitted with a rapid heart rate called atrial fibrillation. your heart rate was initially controlled with medications and then it was shocked back into a normal rhythm. you will need to continue to take the blood thinning medication, lovenox, for 1 month after this to prevent blood clots from forming in the heart. you also have a mild pneumonia for which you were treated with antibiotics. you will continue these antibiotics for several days after you are discharged. please take all your medications as prescribed. please make all of your follow up appointments. please call your doctor or return to the emergency room if you have a fever, chills, shortness of , pain, nausea, vomitting, diarrhea, painful urination, numbness, weakness, tingling or any other symptom that concerns you. followup instructions: please call dr. office at on monday morning to set up a follow up appointment for tuesday. provider: , md phone: date/time: 10:00 provider: , m.d. phone: date/time: 3:00 procedure: diagnostic ultrasound of heart other electric countershock of heart non-invasive mechanical ventilation diagnoses: thrombocytopenia, unspecified esophageal reflux atrial fibrillation personal history of tobacco use bone marrow replaced by transplant anxiety state, unspecified hypotension, unspecified unspecified sleep apnea hypoxemia family history of malignant neoplasm of gastrointestinal tract bacterial pneumonia, unspecified hiccough family history of malignant neoplasm of ovary other abnormal clinical findings other malignant lymphomas, intra-abdominal lymph nodes unspecified hemorrhoids without mention of complication 

Answer: The patient is high likely exposed to