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: patient recorded as having no known allergies to drugs attending: chief complaint: sore throat, coryza symptoms major surgical or invasive procedure: picc placement bone marrow biopsy history of present illness: 51 yo male presents with 1 week history of sore throat and uri type symptoms. he presented to an osh where he was noted to have leukocytosis (wbc >70k) and given concern for hematologic malignancy, he was transferred here for further care. . in the ed, initial vitals were: 98.2, 98, 138/67, 20, 94%. hematology evaluated the patient, and a peripheral smear was consistent with likely aml. bone marrow biopsy was performed, and the patient was then initiated on leukopheresis prior to admission. in the ed, he also received 3 gm hydroxyuria, allopurinol, bicarb, as well as levofloxacin for ? pna on his cxr. . currently, the patient feels better. he reports brownish productive sputum. he saw his pcp on wednesday, and since his lungs were clear, he was told to continue on his otc coricidin. his symptoms continued to worsen which is why he presented to the ed. he states he's also had nightsweats for the last week. . on ros, he denies fevers, chills, weight change, visual changes, headaches, nausea, vomiting, abdominal pain, constipation, brbpr, melena, dysuria, hematuria, frequency, urgency, numbness, weakness, orthopnea, pnd, or lower extremity edema. he does report some increased dyspnea this past week as well as a few episodes of diarrhea. past medical history: hypertension seasonal allergies social history: occasional etoh. previous smoker, none now (25pk/yr) quit 4 yrs ago. no illicit drug use (prior use of marijuana)- no h/o ivdu. family history: first cousin with leukemia physical exam: vitals: 101.0 124/72 85 20 96%1l general: wdwn male, nad, appears comfortable heent: ncat, no cervical adenopathy; mucous membranes slightly dry cv: rrr, no m/r/g lungs: few coarse bs in r base, otherwise clear without wheezes rales or rhonci abdomen: soft, obese, non tender. normal bs. could not appreaciate hsm due to body habitus extremities: no c/c/e skin: no rash; few petecechiae around neck neuro: cn 2-12 grossly intact; prox/distal strength bue/ble extremities. no clonus. psych: a/o x 3; mood and affect appropriate lymph: no cervical, suprclavicular, or axillary lymphadenopathy appreciated at discharge: same as above except: heent: mm moist skin: resolving maculopapular rash w/ excoriations on trunk, single suture at site of skin biopsy on l side of abdomen; minimal petechiae on b/l ankles pertinent results: admission labs: 06:15pm wbc-70.2* rbc-3.90* hgb-13.6* hct-36.5* mcv-94 mch-34.8* mchc-37.2* rdw-15.2 06:15pm neuts-4* bands-0 lymphs-8* monos-5 eos-1 basos-0 atyps-0 metas-1* myelos-1* nuc rbcs-1* other-80* 06:15pm pt-14.4* ptt-24.4 inr(pt)-1.2* 06:15pm glucose-152* lactate-3.1* na+-137 k+-3.1* cl--92* tco2-29 06:15pm glucose-159* urea n-13 creat-1.3* sodium-137 potassium-2.8* chloride-94* total co2-26 anion gap-20 . discharge labs: . imaging: echo the left atrium is elongated. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets (3) are mildly thickened. there is no valvular aortic stenosis. the increased transaortic velocity is likely related to high cardiac output. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. . cytogenetics pml at 15q22 rara at 17q21.1 eto at 8q22 aml1 at 21q22 cbfb 5' at 16q22 cbfb 3' at 16q22 . cxr : impressions: unchanged bibasilar opacities. . ct chest impressions: 1. diffuse right pleural thickening with sparing of the medial pleural surface together with tiny right pleural effusion likely account for the cxr appearance. together with shift of the mediastinum towards the right, fibrothorax is a possibility, especially if the patient has had prior pleural disease. comparison with older imaging may be helpful in establishing chronicity. otherwise, follow up ct in 3 months may be helpful to ensure stability. 2. diffuse ground-glass attenuation of the lungs with smooth septal thickening can be seen in hydrostatic edema, but also in atypical infections such as viral or pneumocystis pneumonia. 3. borderline enlarged mediastinal and hilar lymph nodes may be reactive but attention at follow up ct suggested. 4. splenomegaly with splenic infarct. 5. possible left renal hypodensity, which may represent either renal lesion or renal infarct. this could be evaluated by renal us if warranted clinically. . ct sinus impression: 1. mucosal thickening involving maxillary sinuses and sphenoid sinus, consistent with mucosal sinus disease. 2. no evidence of soft tissue infection or osseous erosion. . cxr cardiac size is normal. bibasilar opacity is new on the left, could be atelectasis but superimposed infection cannot be totally excluded. there is no pneumothorax or pleural effusion. right central catheters remain in place. . cxr cardiomediastinal contours are normal. aside from minimal atelectasis in the right base, the lungs are clear. opacity in the left lower lobe is no longer visualized. there is no evidence of pneumonia, pneumothorax or pleural effusions. moderate degenerative changes are in the thoracic spine. two right central catheters remain in place. . skin biopsy pathology report: superficial dermal hemorrhage associated with small vessel thrombi and superficial to mid dermal perivascular lymphocytic infiltrate (see microscopic description and comment). no herpes virus identified (routine and immunostains). microscopic description. sections show intact epidermis with occasional dyskeratotic cells. no vesiculation is identified in the multiple tissue levels examined. there is an area of red blood cell extravasation in the superficial dermis which is associated with thrombi in small vessels. no vasculitis is seen. in addition, there is relatively superficial to mid dermal perivascular and predominantly lymphocytic infiltrate, with some admixed histiocytes. no herpes virus cytopathic effect is seen on routine stains. no immunoreactivity for herpes simplex or varicella zoster is seen on specific immunostains. no bacterial or fungal organisms are identified on gram or gms stains, respectively. comment. no infectious agents are identified in this sample on routine or infectious stains, and specifically, no herpes viral cytopathic effect is seen. if there is continuing clinical concern for herpes virus, culture may prove more sensitive than tissue based stains. the combined findings of apparently localized superficial dermal hemorrhage, small vessel thrombi and perivascular mononuclear cell infiltration are unusual and are not specifically diagnostic in this biopsy. the histologic differential diagnosis includes trauma, an adjacent lesion or excoriation, a hypersensitivity reaction, and possibly an occlusive vasculopathy. clinical correlation is necessary brief hospital course: the patient is a 51-year-old man with newly diagnosed aml who was hospitalized to undergo 7+3 induction 1. aml patient underwent 7+3 induction and tolerated the chemotherapy well. on , the patient's bone marrow demonstrated "markedly hypocellular marrow with chemoablation effects. no morphological evidence of residual leukemia is seen." pt. underwent repeat bone marrow biopsy on day of discharge () w/ aspirate taken but unable to obtain core sample. acyclovir started for prophylaxis. . 2. febrile neutropenia following a fever on , the patient was started on cefepime on and vancomycin on . micafungin and levofloxacin were added on after ct chest showed ground glass attentuation. he was also ordered for ct sinus (pt uses fluticasone at home). the patient developed a non-pruritic maculopapular rash on his upper right arm. derm was consulted, since rash appeared concomitantly with fever, and were very much convinced that the rash is a drug rash. for pruritus treatment, derm recommended clobetasone. cefepime was changed to meropenem on due to likely drug hypersensitivity. the patient also has an intertriginous rash on his right groin; has miconazole powder to use. on , with the patient having more itching and rash, meropenem was switched to aztreonam and flagyl. on , the patient again began to have fevers. cxr showed perhaps a new opacity at base of left lung. patient was continued on an antibiotic regimen of aztreonam, flagyl, vancomycin, and micafungin. repeat cxr showed no evidence of pna. his fevers resolved on this regimen and flagyl, vancomycin, micafungin d/c'ed on . aztreonam d/c'ed on . anc improved from 0 to 2647 on day of discharge. . 3. rash, likely hypersensitivity reaction to drug patient has maculopapular rash that developed on extremities and torso. cefepime and meropenem were both stopped following outbreak of rashes. patient received sarna and diphenhydramine for pruritus. the rash persisted after discontinuation of antibiotics and derm was consulted for possible viral etiologies. a punch biopsy was obtained and sent for pathology which showed superficial dermal hemorrhage associated with small vessel thrombi and superficial to mid dermal perivascular lymphocytic infiltrate with no evidence of hsv or vzv. the patient had a suture at the site of biopsy in place at time of discharge with instructions to remove around . he was discharged with sarna and clobetasol creams prn. . -f/u w/ dr. in clinic on at 11am -f/u bm aspirate results -skin biopsy suture should be removed around medications on admission: hctz 25 mg daily fluticasone nasal spray discharge medications: 1. sarna anti-itch 0.5-0.5 % lotion sig: one (1) application topical four times a day as needed for itching. disp:*1 bottle* refills:*0* 2. acyclovir 400 mg tablet sig: one (1) tablet po q8h (every 8 hours). disp:*90 tablet(s)* refills:*0* 3. clobetasol 0.05 % ointment sig: one (1) appl topical (2 times a day). disp:*1 tube* refills:*0* 4. fluticasone 50 mcg/actuation spray, suspension sig: one (1) puff each nostril nasal once a day. 5. hydrochlorothiazide 25 mg tablet sig: one (1) tablet po once a day. 6. oxycodone 5 mg tablet sig: one (1) tablet po every 4-6 hours as needed for pain for 20 doses. disp:*20 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary: acute myelogenous leukemia secondary: neutropenic fever rash, likely in reaction to cefepime discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to the hospital with a sore throat and symptoms of an upper respiratory infection. you were found to have a high white blood cell count and were diagnosed with acute myelogenous leukemia. you had multiple bone marrow biopsies. you underwent induction chemotherapy which you tolerated well. your counts went down as expected and you developed a fever which was treated with antibiotics. your fevers resolved and your counts have gone back up. you also developed a rash which may have been related to antibiotics and it was determined that there was no virus causing the rash. the rash improved prior to discharge. . some of your medications were changed during this admission: start acyclovir start oxycodone as needed for pain . you should continue to take your other home medications as prescribed. followup instructions: provider: , md phone: date/time: 11:00 procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified biopsy of bone marrow biopsy of bone marrow biopsy of bone marrow closed biopsy of skin and subcutaneous tissue injection or infusion of cancer chemotherapeutic substance therapeutic leukopheresis diagnoses: pneumonia, organism unspecified unspecified essential hypertension personal history of tobacco use nausea with vomiting antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use dermatitis due to drugs and medicines taken internally diarrhea accidents occurring in residential institution neutropenia, unspecified cephalosporin group causing adverse effects in therapeutic use acute myeloid leukemia, without mention of having achieved remission other specified erythematous conditions fever presenting with conditions classified elsewhere hiccough antineoplastic chemotherapy induced anemia stomatitis and mucositis, unspecified 

Answer: The patient is high likely exposed to