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: history of present illness: the patient is a 58 year-old male with past medical history of prostate cancer, status post radical prostatectomy and hairy-cell leukemia status post treatment with 2 cda last does on who presented on from to the patient had a pic line associated thrombophlebitis with mrsa. the patient was treated with vancomycin which was later switched to linezolid secondary to rash with vancomycin. the patient was discharged home with temperatures of approximately 100 f. the day after admission, the patient had a rise in associated cough, chest tightness and diarrhea. the patient was seen by dr. on where room air 02 saturation was 97%. the patient was febrile and sputum studies were planned. the patient then returned home from clinic. on the patient presented to the ed with fever of 102f, heart rate of 110 and blood pressure of 84/38 with a respiratory rate of 30 and o2 saturation 93% on room air. abg at that time showed po2 of 69. the patient was admitted to the fenard icu service and started on ceftazidine, bactrim and prednisone for presumed pcp which was later changed to clindamycin primaquine due to fear of bone marrow suppression, levaquin and linezolid. the linezolid was continued for completion of previous course. the patient was also given 6 liters of normal saline with increased in blood pressure to 94/58. infectious disease was consulted. ceftazidine was discontinued and induced sputum sent for pcp. because of enlarged heart on chest x-ray an echocardiogram was ordered. ct scan of the chest and abdomen were ordered for better evaluation of the lungs and new onset abdominal pain. the patient reports that since the last admission he has had a nonproductive cough and increasing shortness of breath that is worse when lying down. he also reports some mild diarrhea and "searing calf pain" that was initially bilateral then left greater than right which resolved spontaneously. the patient also reports continued fever and an unusual amount of fatigue. past medical history: 1. hairy-cell leukemia diagnosed in treated with 2 cda. on the patient was referred to dr. for pancytopenia then followed by drs. and until . recurrence was diagnosed in and from to the patient was re-treated with 2 cda. treatment was complicated by pic line associated septic thrombophlebitis treated with vancomycin initially which was then changed to linezolid due to diffuse macular papular rash. 2. history of prostate adenocarcinoma status post radical prostatectomy. 3. nephrolithiasis. 4. status post hernia repair. allergies: 1. vancomycin causes rash. questionable reaction to oxicillin and allopurinol as these were all given at the same time vancomycin was given and is questionable whether these were responsive for the patient's initial rash. 2. intolerance to codeine which causes nausea and vomiting. 3. morphine causes mental status changes. medications in the fenard icu: 1. linezolid 600 . 2. protonix 40 mg q day. 3. aspirin 325 mg po q day. 4. g-csf 300 micrograms subcutaneous q day. 5. prednisone 40 mg po q day. 6. colace. 7. peridex. 8. primaquine 30 mg po q day. 9. levaquin 500 mg po q day. 10. albuterol inhaler prn. 11. clindamycin 900 mg iv q eight hours. medications on admission to the hospital: 1. linezolid. 2. compazine. 3. peridex. physical examination: vital signs blood pressure 94/58, heart rate 94, o2 saturation 98% on room air, respiratory rate approximately 24. in general the patient is chronically ill appearing, slightly shortness of breath and pale. heent - no thrush. op is clear. heart - normal s1, s2. no murmurs, rubs, or gallops. lungs - decreased breath sounds at left base, dullness to percussion at left base, decreased lung volume secondary to the patient's inability to take a deep breath. abdomen - distended, positive bowel sounds. liver margin is palpable 2 cm below costal margin. diffuse tenderness to palpation no guarding or rebound. extremities - left lower extremity slightly larger than right lower extremity. trace edema. laboratory data: white blood cell count 3.4, hematocrit 25.1, anc 3,050, platelet count 220,000. pt 15, ptt 25.5, inr 1.5. chem 7 remarkable for a bun of 33 and creatinine of 1.1. calcium 6.9, magnesium 2.5, phosphate 2.9, free calcium 1.01. alt 439, ast 447, albumin 3.1, haptoglobin 410, alkaline phosphatase 80, t bilirubin 0.6, ldh 964. ck #1 38, troponin 2.3. ck #2 102, troponin 0.9. ck #3 104, troponin 0.8. hospital course: this is a 58 year-old male with hairy-cell leukemia admitted for fever, hypotension and acute onset of shortness of breath. 1. fever and hypotension - infectious disease was consulted during this admission. ceftazidine was discontinued when the patient was no longer neutropenic and the patient was started on levaquin for coverage of community acquired pneumonia. there was low suspicion by the infectious disease team for pcp in this patient. the patient's hypoxia resolved and with ambulation the patient's o2 saturation was 95 to 96%. the patient had two induced sputum sent, one of which was negative and the other of which is pending at the time of this dictation. after the first induced sputum was negative, infectious disease recommended discontinuing prednisone 40 mg po q day and discontinuing the clindamycin primaquine medications. infectious disease at first was concerned over a possible fungal infection. however ct scan of the chest did not reveal any cavitary lesions and the patient did not worsen. no antifungal medications were started during this hospitalization and it was thought there was low probability the patient had a fungal lung infection due to his clinical improvement without any treatment. a chest x-ray revealed a left retrocardiac density which could be either consolidation versus atelectasis. considering that the patient had fevers and a cough it was thought most likely that this consolidation likely represented a pneumonia. the patient was continued on levaquin and continued to defervesce. t max was 100.4 f on day prior to discharge. the patient's overall fever curve continued to decrease. at the time of this dictation the patient was afebrile for 24 hours. the patient will be discharged home on levaquin to complete a 14 day course to cover for community acquire pneumonia and any atypicals. the patient had several blood cultures sent, urine cultures, crypto antigen, micro plasma antigen, cmv antigen, histo antigen and ebv titer sent. all of which have been negative thus far. the patient as mentioned above had induced sputum sent for pcp the first of which had been negative and the second of which is still pending at the time of this dictation. there has been no obvious source for the patient's fevers at this time. 2. cardiac - because of the enlarged cardiac silhouette seen on chest x-ray and hypotension, an echocardiogram was done to evaluate for ejection fraction. the echocardiogram revealed surprisingly global hypokinesis with an ejection fraction of 20 to 25% and 2+ mr. there was relative preservation of the lateral wall and trace tr. in light of these new echo findings cardiology was consulted. the patient had no previous history of any cardiac disease. cardiology reviewed the data and believed the patient's new onset cardiomyopathy may be secondary to 2 cda. there is one reported case of 2 cda induced cardiomyopathy however this is a very rare complication of the medication and only one case report has been published. it was thought unlikely that the patient had myocarditis due to the relative low cardiac enzymes. the patient did have a slight troponin leak with troponin max of 2.3. the patient was started on treatment for congestive heart failure with lasix, captopril, and carvedilol. the patient's blood pressure continued to rise and was at baseline levels of 120 upon discharge. the patient will follow up with dr. as an outpatient. 3. pulmonary - upon admission to the omed service there was concern for pulmonary embolus however a cta was done which did not reveal any pulmonary embolus. there were bilateral pleural effusions seen left greater than right and atelectasis. the patient's hypoxia improved with diuresis and treatment of possible pneumonia with levaquin. 4. gastrointestinal - the patient had acute transaminitis with liver enzymes that rose to an alt of 722 and ast 348. with improvement of the patient's cardiac function these liver enzymes seemed to decrease. it was thought that the patient may have suffered from shock liver secondary to hypotension or liver congestion secondary to new onset chf. upon discharge the patient's transaminitis continues to improve. the patient also did complain of diarrhea about one loose stool a day. this was attributed to antibiotic use. stool studies were sent which have been negative thus far. if diarrhea continues as an outpatient, the patient will seek further evaluation. 5. hematology - oncology - the patient was continued on neupogen and dr. is to decide when to discontinued the neupogen. the patient was anemic with a hematocrit of 25 and had two units of blood transfused. the patient's hematocrit continued to rise during his hospitalization and the patient symptomatically felt better after the transfusions. discharge condition: to home with follow up with dr. on and dr. two weeks after discharge. discharge diagnosis: 1. new onset cardiomyopathy complicated by congestive heart failure, complicated by hypotension. 2. fevers/sepsis of unclear etiology. 3. hairy-cell leukemia status post treatment with 2 cda complicated by neutropenia. discharge medications: 1. aspirin 325 mg po q day. 2. g-csf 300 micrograms subcutaneous q day. 3. levaquin 500 mg po q day to be discontinued on to complete a 14 day course. 4. carvedilol 3.125 po q day. 5. lasix 20 mg po q day. 6. lisinopril 20 mg po q day. , m.d. dictated by: medquist36 d: 13:26 t: 09:39 job#: procedure: transfusion of packed cells diagnoses: pneumonia, organism unspecified pneumonia, organism unspecified unspecified septicemia personal history of malignant neoplasm of prostate leukemic reticuloendotheliosis, unspecified site, extranodal and solid organ sites secondary cardiomyopathy, unspecified 

Answer: The patient is high likely exposed to