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: fever major surgical or invasive procedure: red blood cell exchange transfusion history of present illness: mr. is a 58 year old male with a pmh significant for hodgkin's disease treated more than 30 years ago with radiation therapy and splenectomy who presents with fever, arthralgias, myalgias, and headache after a tick bite. patient reports finding two tick bites 3 weeks ago. he believes these tick bites occured at his home residence in , ma, likely brought into the house from the dog or cats. he denies any recent international travel, but has recently visited . both ticks were removed manually with no signs of rash, except a mild erythematous patch at the bite site. patient was in normal state of health until wednesday pm when he began to experience low grade fevers. over the next 48 hours, his symptoms worsened to include high fevers (per patient 104), chills, night-sweats, arthralgias, myalgias, and 'sharp' headaches localized to the right temple. he reports chest congestion and a mild, non-productive cough, but denies sob or chest pain. he denies vomiting and diarrhea, although reports decreased appetite and nausea. he reports decreased urine output and amber-colored urine, but denies dysuria. . patient believed his symptoms were due to a viral infection and initially self-managed with tylenol and fluids. he reported to am complaining of spiking fevers. vitals on arrival were bp 115/64, p 94, t 98.1, rr 18, spo2 97%. blood smear showed parasites consistent with intracellular ring forms, and other laboratory findings were consistent with hemolysis. patient has no international travel history. . notable laboratory values include: wbc 8.0, hgb 14.2, hct 41.9, plts 64, ldh 797, ast 81, alt 65, and bilirubin tot 2.5 (indirect 1.7). ua was positive for rbcs. . patient received 600 mg iv clindamycin, 650 mg po quinine, and 2.5 l ns. he was transferred to pm for possible urgent rbc exchange transfusion. . on arrival to the floor, initial vitals were t= 100.9, bp=128/66, hr=95, rr=18, o2sat= 97% ra. he reports fevers, a 'sharp' headache, myalgias, arthralgias, and fatigue. . review of sytems: (+) per hpi (-) denies recent weight loss or gain. denies sinus tenderness, rhinorrhea or congestion. denied shortness of breath. denied chest pain or tightness, palpitations. denied nausea, vomiting, diarrhea, constipation or abdominal pain. no dysuria. past medical history: -hodgkin's disease, s/p surgery, radiation, splenectomy in -hypothyroidism -essential hypertension -hyperlipidemia -esophageal stricture: s/p dilatation in -basal cell carcinoma -cad s/p pci : 90% prox to mid lad lesion with cypher sent, nl left main and lcx social history: resides in ma with wife, three children, dog and 2 cats. works in finance. patient reports 14 pack year history (quit ), consumes ~6 drinks per week. reports occasional marijuana use in college and denies elicit drug use. family history: no family members have experienced fevers in the past few weeks, although children have had several tick bites. father deceased (48 ) from emphysema and mother deceased from 'old age.' no family history of malignancy. physical exam: vs: t=100.9, bp=128/66, hr=95, rr=18, o2 sat=97% ra general: well-appearing middle aged male in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple with jvp of 8 cm cardiac: rrr, normal s1, s2. no m/r/g. lungs: resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. liver edge palpable with slight ttp. extremities: no c/c/e. skin: no rash appreciated near bite sites (right clavicle and midline abdomen). pertinent results: admission labs: 06:30pm blood wbc-7.9 rbc-4.34* hgb-12.8* hct-39.3* mcv-91 mch-29.5 mchc-32.6 rdw-15.2 plt ct-109* 05:30pm blood neuts-46* bands-0 lymphs-37 monos-12* eos-3 baso-0 atyps-1* metas-1* myelos-0 05:42am blood pt-12.6 ptt-32.8 inr(pt)-1.1 06:30pm blood ret aut-1.9 06:30pm blood glucose-108* urean-13 creat-0.9 na-138 k-3.6 cl-104 hco3-24 angap-14 06:30pm blood alt-66* ast-76* ld(ldh)-734* alkphos-64 totbili-2.0* 06:30pm blood calcium-8.1* phos-2.5* mg-1.9 06:30pm blood hapto-<5* 08:24pm urine color-yellow appear-clear sp -1.007 08:24pm urine blood-tr nitrite-neg protein-25 glucose-neg ketone-tr bilirub-neg urobiln-8* ph-5.0 leuks-neg 08:24pm urine rbc-0-2 wbc-0-2 bacteri-few yeast-none epi-0-2 . discharge labs: 01:30pm blood wbc-16.3* rbc-4.04* hgb-11.8* hct-36.3* mcv-90 mch-29.2 mchc-32.6 rdw-16.1* plt ct-805* 01:30pm blood glucose-80 urean-12 creat-0.9 na-138 k-4.9 cl-103 hco3-26 angap-14 01:30pm blood alt-150* ast-102* alkphos-74 totbili-0.5 06:20am blood alt-139* ast-104* ld(ldh)-291* totbili-0.5 01:30pm blood calcium-9.2 phos-3.7 mg-2.5 06:30pm blood lyme by western blot-pending 04:08pm blood anaplasma phagocytophilum (human granulocytic ehrlichia ) igg/igm-pending . imaging/studies: cxr: normal lung volumes. normal size of the cardiac silhouette. minimal fibrotic changes in the paramediastinal lung areas. otherwise unremarkable lung parenchyma. no pleural effusions. no pneumothorax. . skin biopsy: pathology pending. brief hospital course: mr. is a 58 yo male with past medical history significant for hodgkin's disease s/p splenectomy, cad, and hypothyroidism who presents with babesiosis & lyme disease. #.babesiosis: mr. was referred to from with diagnosis of babesiosis complaining of fevers, rigors, myalgias and headache. he presented with thrombocytopenia to 64, abnormal lfts, and elevated bilirubin. prior to admission, pcp had given patient quinine 650 mg po plus iv clindamycin 600mg, but per id recommendation, antibiotics were changed to atovaquone 750mg and azithromycin 750mg due to side effect profile of quinine/clindamycin combination and equivalent efficacy of atovaquone/azithromycin regimen. . within 12 hours of admission, patient's parasitemia level increased from 4.7% to 8.8%. id recommended rbc exchange transfusion given asplenia and rising parasitemia. after receiving 15.5 units of blood, patient suddenly developed chills, rigors, and a temperature of 99f. a code blue was called and patient was stabilized with benadryl, solumedrol, demerol, and albuterol. his symptoms resolved and he was transferred to the icu for further monitoring; he was transferred back to the medicine floor within 24 hours. pathology investigation was most consistent with a febrile nonhemolytic transfusion reaction. . following rbc exchange, patient's parasitemia percentage remained stable at 0.8% for the remainder of his hospitalization. his fever, headache and myalgias resolved. however, post-trasfusion, the patient had a persistent leukocytosis and rising transaminitis. although leukocytosis persisted until discharge, the level remained stable and was most likely attributed to a reaction to steriods or an inflammatory response to rbc exchange. simultaneously, the patient's liver enzymes continued to trend upwards to a maximum alt 150 and ast 104. id consult suggested elevated lft could be a natural progression of infection (see below for details) or a side effect of antibiotics, since atovaquone has a known risk of hepatotoxicity and azithromycin is hepatically metabolized. azithromycin dosage was consequently lowered to 250mg. the patient remained clinically stable despite these laboratory findings, and was discharged on a planned two week course of azithromycin, atovoquine and doxycycline. he was instructed to follow-up in id urgent care on for a lab check, as well as with his pcp. . #. lyme disease: laboratory results returned with a positive lyme antibody, negative igm, and positive igg. laboratory lyme western blot testing was pending at discharge. patient was started on doxyclycine 100 mg and instructed to continue for a total 14 day course at discharge. . #. skin lesion: patient reported a dark, atypical lesion on left clavicle. dermatology was consulted and no tick was clearly visualized, but given clinical situation, a bunch biopsy was performed. pathology report was pending at discharge. patient will be informed of results by telephone and encouraged to follow-up with dermatology for total body skin examination. . #. possible anaplasmosis: patient was tested for anaplasma phagocytophilum co-infection. igg/igm serum results were pending at discharge. medications on admission: asa 81 mg daily plavix 75 mg daily levothyroxane 100 mcg daily sl nitro prn viagra 25 mg prn rosuvastatin 40 mg qhs atenolol 25 mg daily lorazepam 0.5 mg po bid prn discharge medications: 1. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 2. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 3. atenolol 25 mg tablet sig: one (1) tablet po daily (daily). 4. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 5. lorazepam 0.5 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for anxiety. 6. sub lingual nitro prn 7. atovaquone 750 mg/5 ml suspension sig: five (5) ml po q12h (every 12 hours) for 7 days. disp:*70 ml* refills:*0* 8. azithromycin 250 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 7 days. disp:*7 tablet(s)* refills:*0* 9. doxycycline hyclate 100 mg capsule sig: one (1) capsule po q12h (every 12 hours) for 8 days. disp:*16 capsule(s)* refills:*0* discharge disposition: home discharge diagnosis: primary diagnoses: babesiosis lyme disease transaminitis 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 because of a babesia infection, which is transmitted by the deer tick. you were also found to be positive for lyme disease. you were treated with antibiotics and underwent a red blood cell exchange transfusion, and your symptoms improved. prior to discharge, your liver tests became elevated; this could be a result of your antibiotics, or a progression of your infection. you should go to urgent care clinic to have these labs re-checked on tuesday. you should also follow-up with your pcp on tuesday. we made the following medication changes: - stop rosuvastatin for now - take atovoquone twice daily for a total two weeks (end on ) - take azithromycin once daily for a total two weeks (end on ) - take doxycycline for a total two weeks (end on ) followup instructions: name: , md specialty: internal medicine when: tuesday at 8am. location: address: , , phone: procedure: closed biopsy of skin and subcutaneous tissue exchange transfusion diagnoses: thrombocytopenia, unspecified coronary atherosclerosis of native coronary artery unspecified essential hypertension unspecified acquired hypothyroidism percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other acquired absence of organ hodgkin's disease, unspecified type, unspecified site, extranodal and solid organ sites fever, unspecified acquired hemolytic anemia, unspecified nonspecific elevation of levels of transaminase or lactic acid dehydrogenase [ldh] lyme disease babesiosis nonspecific abnormal results of function study of liver other transfusion reaction 

Answer: The patient is high likely exposed to