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: aspirin attending: chief complaint: substernal/epigastric pain major surgical or invasive procedure: pericardiocentesis with drain placement , lumbar puncture, bone marrow biopsy, intrathecal chemotherapy history of present illness: 44 yo f with pmh of obesity, pcos, htn, h/o dvt s/p ivc filter, seizure and encephalitis/meningitis to severe sinus infection () on dilantin, who presented to ed as transfer from ed with 3 days of substernal/epigastric pain. discomfort started on after eating dinner, a/w fullness/bloating, no nausea/vomiting. her meal did not contain fatty foods. she lay down and went to sleep. on , she was anorexic and had early satiety, no frank pain. on , patient noticed more pain, worse with movement, radiation to ruq, no change with position or exertion. she did feel short of breath after climbing stairs in her home, which is not her baseline. she again tried to eat dinner, but was full after a few bites. on , patient presented to her pcp, referred her to . that morning, she also reports having a loose, mustard-colored bm. of note, patient now recalls a prior mild episode of similar pain one month ago, after gardening but while at rest. she reports a sick contact w/ brother-in-law w/ gi bug. there, she had ultrasound consistent with acute cholecystitis with stone impacted in neck, pericholecystic fluid. ct showed massive pericardial effusion, pericholecystic fluid, nonspecific rlq stranding, normal appendix and right pleural effusion. hemodynamically stable, labs significant for alk phos 195, ast 79, alt 51, tbili 0.6, wbc 12.8, lipase 127. ecg showing sinus tachycardia, relatively low voltage not meeting criteria, qt prolongation with qtc of 508. seen by surgery at who suggested conservative management for gallbladder, received cipro/flagyl. transferred to for further management of pericardial effusion. . on arrival here to ed, vitals were t98.2 hr103 bp146/92 97% on ra. found to have pulsus of 30, bedside echo showed large pericardial effusion with some ra/rv compromise and evidence of tamponade. seen by surgery in ed for cholecystitis, who recommended conservative management with iv unasyn and to keep patient npo. received 1 liter of ns, had bcx sent, 1 piv placed in hand. admitted to ccu for further monitoring. on transfer, vitals were hr104, bp116/80, rr16 96% on ra. . on arrival to ccu, patient was hemodynamically stable. she was scheduled for pericardiocentesis in the cath lab. . on review of systems, she has a prior hx of stroke and dvt in the context of her viral meningitis in . she has been coughing while in the ed. she reports an intentional 20 lb weight loss w/ weight watchers. she denies any prior history of pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, hemoptysis, black stools or red stools. s/he denies recent fevers, chills or rigors. s/he denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for absence of paroxysmal nocturnal dyspnea, orthopnea, palpitations, syncope or presyncope. she has mild ankle edema at baseline. . . past medical history: 1. rare migraines 2. htn 3. obesity 4. pcos/infertility 5. viral encephalitis/meningitis-->ich-->seizure/stroke () - from severe sinus infxn, caused mild non-focal residual deficits 6. csf leak w/ meningitis s/p lumbar drain placement 7. r le dvt s/p ivc filter placement 8. knee surgery social history: married, lives with husband in . no past/present tob or etoh. works as nail technician in beauty salon. -tobacco history: smoked socially x 5 yrs in high school/college -etoh: minimal -illicit drugs: none family history: father had mi in 50's and dm2. uncle w/ leukemia, no other cancer hx. physical exam: physical examination: vs: t=97.1 bp= 124/89 (pulsus ~10) hr=99 rr=24 o2 sat= 97%/2l nc general: obese female in nad. oriented x3. mood, affect appropriate. heent: ncat. mmm. no xanthalesma. neck: supple with no jvd or hjr. no kussmaul's. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no pericardial rub. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, tender to palpation in ruq and mild diffuse ttp. no guarding/rebound. no hsm. extremities: 1+ edema r>l to shin skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: 2+ dp 2+ pt 2+ left: 2+ dp 2+ pt 2+ pertinent results: laboratory data: 136 | 99 | 10 / 112 agap=17 3.4 | 23 | 0.6\ . ca: 9.1 mg: 2.0 p: 3.2 alt: 76 ap: 172 tbili: 0.7 alb: 4.0 globulin: 2.6 ast: 56 ldh: dbili: tprot: 6.6 : lip: 27 tsh: pnd phenytoin: 6.4 lactate: 1.6 . 12.3 89 >---< 307 35.4 n:79.0 l:16.2 m:4.0 e:0.6 bas:0.2 . pt: 13.7 ptt: 24.3 inr: 1.2 . paracentesis fluid wbc-* hct-7* polys-6* lymphs-1* monos-1* other-92* paracentesis fluid tot prot-5.6 glucose-6 ld(ldh)- amylase-16 albumin-3.3 . immunohistochemistry report: pericardial fluid involvement by kappa light chain restricted cd10-positive monotypic b-cell lymphoproliferative process. examination of cytospin reveals pleomorphic cells with vacuolated basophilic cytoplasm. the providing physician (dr. was informed of this diagnosis. correlation with cytogenetics and imaging studies recommended. if a lymphadenopathy is seen, a biopsy will be helpful. . micro: blood cx p . ekg ( 4:00): rate 100, nsr, na/ni, low voltages, q waves in iii, no st/t wave abn. borderline qtc prolongation. . imaging: ruq u/s: stone impacted in neck, perichole fluid ct abd: massive pericardial effusion, perichol fluid, nonspecific rlq stranding. normal appendix. right pleural effusion . 2d-echocardiogram: tte (): left ventricular wall thicknesses and cavity size are normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. left ventricular systolic function is hyperdynamic (ef>75%). there is abnormal systolic septal motion/position consistent with right ventricular pressure overload. there is a large circumferential pericardial effusion, ranging 1.5-2.5 cm adjacent the rv to 3.3 cm adjacent to the lv in diastole. there is right ventricular diastolic collapse, consistent with impaired fillling/tamponade physiology. . compared with the prior study (images reviewed, see below) of , there is now a large circumferential pericardial effusion with rv diastolic collapse. the lv appears more hyperdynamic. . tte: overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. there is abnormal septal motion/position. the mitral valve leaflets are structurally normal. there is a small to moderate sized pericardial effusion which is mainly located posteriorly. there is a small echodense effusion (1.1 cm) anterior to the right ventricle. no right atrial diastolic collapse is seen. no right ventricular diastolic collapse is seen. there is significant, accentuated respiratory variation in mitral/tricuspid valve inflows, consistent with impaired ventricular filling . cardiac mri : 1. right atrial mass with heterogeneous late gadolinium hyperenhancement suggesting cardiac lymphoma, although primary cardiac tumor or metastatic disease cannot be fully excluded. 2. normal left ventricular cavity size with normal regional left ventricular systolic function. the lvef was normal at 59%. no cmr evidence of prior myocardial scarring/infarction. 3. normal right ventricular cavity size and systolic function. the rvef was normal at 55%. 4. no significant valvular regurgitation. 5. the indexed diameters of the ascending and descending thoracic aorta were normal. the main pulmonary artery diameter index was normal. 6. mild -atrial enlargement. 7. a note is made of a gallbladder calculus. brief hospital course: this is a 44 year old female with pmh of pcos, gbs meningitis with intracranial hemorrhage and residual seizure activity, and h/o right dvt with ivc filter who presented with symptoms of cholecystitis and was found incidentally to have a large pericardial effusion. a pericardiocentesis was performed and the fluid analysis was consistent with burkitt's lymphoma. . # pericardial effusion: a large pericardial effusion was found incidentally on an abdominal ct and there was evidence of tamponade physiology on echocardiogram and pulsus paradoxus. pericardiocentesis with drain placement was performed on which drained a total of 1200cc. fluid analysis was suggestive of burkitt's lymphoma. . # burkitt's lymphoma: pericardial fluid was kappa light chain restricted cd10 positive monotypic b cells expressing fmc-7, cd19, cd20, and myc rearrangement consistent with burkitt's lymphoma. a subsequent lumbar puncture and bone marrow biopsy were negative for any involvement which made this a primary cardiac lymphoma. a cardiac mri showed a mass that was 3cm x 1cm on the lateral wall of the right atrium adjacent to the av junction. chemotherapy using the regimen for burkitt's lymphoma was started and the patient tolerated it well. tumor lysis/dic labs were drawn every 8 hours and the patient was started on d5w with bicarb and allopurinol for prohylaxis. she will continue acyclovir prophylaxis and will report to the 7 clinical center for an appointment with drs. and on wednesday at 9:00am. she will receive chemotherapy later that morning, to be administered by the 7 nursing staff. after her chemotherapy, she will be discharged home and will be scheduled to return on . at this time she will proceed to 7 for hospital admission for high-dose methotrexate. . # acute cholecystitis: right upper quadrant u/s was consistent with acute cholecystitis on admission. she was started on a cipro/flagyl regimen and her transaminitis quickly improved. she was tolerating fatty foods with no residual pain and her antibiotics were discontinued after 9 days. geberal surgery originally suggested follow-up with dr. for cholecystectomy 2-4 weeks after discharge. her epigastric pain resolved after her pericardiocentesis. . # hx seizure: once chemotherapy was started, neuro was consulted and the patient was switched to keppra from dilantin because of the possibility of drug-drug reactions with dilantin. she tolerated the switch well and will continue this regimen as an outpatient. . # h/o dvt: she received an ivc filter in the past because anticoagulation was contraindicated in the setting of an intracranial hemorrhage and neurosurgical procedure. neuro was confident that she was no longer at an increased risk for intracranial bleeding and anticoagulation was discontinued when chemotherapy was started. prior to discharge on , she was found to have a clot in the right basilic vein associated with her indwelling picc line. as a result, her picc line was removed prior to discharge with the understanding that a new picc line would need to be placed when she returns for her next hospital admission on . medications on admission: hctz 12.5 po daily dilantin er 300mg po bid nasonex folate calcium discharge medications: 1. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. 3. fluticasone 50 mcg/actuation spray, suspension sig: one (1) spray nasal daily (daily). 4. acyclovir 400 mg tablet sig: one (1) tablet po three times a day. disp:*90 tablet(s)* refills:*2* 5. keppra 750 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* 6. zofran 8 mg tablet sig: one (1) tablet po three times a day as needed for nausea. disp:*30 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary cardiac burkitt's lymphoma secondary diagnoses: -pcos -seizure disorder -migraines -history of group b strep meningitis causing intracranial hemorrhage -history of dvt with ivc filter discharge condition: stable, afebrile, ambulatory discharge instructions: you were admitted to hospital for evaluation of a pericardial effusion incidently found on an abdominal ct scan. you underwent a pericardiocentesis to drain this fluid and the analysis showed that it contained tumor cells that were consistent with burkitt's lymphoma. there was no evidence of tumor in your bone marrow or in your spinal fluid. on , you were found to have a clot in the basilic vein of your arm, associated with your indwelling picc line. as a result, your picc line was removed before your discharged. you will need to have a new picc line placed when you return for your next hospital admission on friday . the following changes have been made to your home medication regimen: you will continue taking acyclovir, levetiracetam, and ondansetron as needed for nausea. you will also be getting chemotherapy as an outpatient. you should stop dilantin and hctz. please keep all of your follow-up appointments listed below. please seek medical care if you experience any concerning symptoms such as fevers, chills, abdominal pain, shortness of breath, or palpitations. followup instructions: please keep your follow-up appointments listed below: * please follow up with dr. (general surgery) regarding your gallbladder , 2-4 weeks from discharge. * please report to the 7 clinical center for an appointment with drs. and on wednesday at 9:00am. you will receive chemotherapy later that morning, to be administered by the 7 nursing staff. after your chemotherapy, you will be discharged to home. you will be scheduled to return next friday, , when you will be seen in the clinic and will then proceed to 7 for hospital admission for high-dose methotrexate. as above, you will need a new picc line inserted on that day. * you will also be regarding an appointment for a repeat echocardiogram this week. procedure: venous catheterization, not elsewhere classified spinal tap incision of lung pericardiocentesis biopsy of bone marrow injection or infusion of cancer chemotherapeutic substance injection of other agent into spinal canal diagnoses: bacteremia other complications due to other vascular device, implant, and graft epilepsy, unspecified, without mention of intractable epilepsy personal history of venous thrombosis and embolism migraine, unspecified, without mention of intractable migraine without mention of status migrainosus calculus of gallbladder with acute cholecystitis, without mention of obstruction other specified bacterial infections in conditions classified elsewhere and of unspecified site, other specified bacteria cardiac tamponade burkitt's tumor or lymphoma, unspecified site, extranodal and solid organ sites 

Answer: The patient is high likely exposed to