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: ambisome / penicillins / cefepime attending: chief complaint: hypoxemia, tachypnea major surgical or invasive procedure: l ij central line placed history of present illness: ms. is a 41 year-old female with aml status post hidac and mrd allo- with remission but subsequent relapse with cns involvement in treated with xrt and it mec chemo with eventual remission. she presented again in with hc and elevated icp, and vp shunt was placed. she was readmitted on from clinic with altered mental status and low-grade fever. her work-up in the hospital included normal shunt series, normal vp tap (but protein 60) and unremarkable lp. work-up further revealed bilateral hilar infiltrates on cxr, with preserved saturation at presentation. subsequent imaging included ct chest which showed bilateral ground glass opacities with upper lobe predominance. sputum culture was negative. while in hospital, she was persistently febrile to 102 on . pulmonary was consulted, and bronchoscopy performed on showed thin secretions, but was otherwise largely underwhelming. a bal grew no organisms, and rapid viral screen was negative. on the floor, she developed a new oxygen requirement on of 2l via nc. repeat imaging studies also showed progression of infiltrates, and concern was raised over possible pcp (last inhaled pentamidine dose ). she was started on empiric rx for pcp with bactrim and prednisone on , and levofloxacin was added to cover for atypicals. she transiently defervesced on the floor, but developed progressive hypoxemia with increasing oxygen requirement to 6l nc, then shovel mask, and eventually nrb. abg on floor on shovel mask 70% 7.28/31/71. antifungal coverage was added on (caspofungin). she was given lasix 20 mg iv, then 10 mg iv, with u/o 700ml without much improvement in her respiratory status. an icu consult was called. other issues on the floor have included hyponatremia with nadir to 122, with elevated uosm and una suggestive of siadh. renal has been following. on arrival to icu, patient tachypneic, hypoxemic to 70s on ra, 96% on nrb. she denies chest pain, mild non-productive cough. past medical history: 1) aml - : dx with m5 aml. presented c cholecystitis, found to have wbc 56k with 50% blasts and plts 20. marrow biopsy at showed aml. the cholecystitis perforated, resulting in emergent open chole complicated by fistula and bleeding and 2 month stay in micu. daily hydroxyurea was used for maintenence until she recovered. she had initial cytogenetic abnormality of inversion-16 which also had resolved. (7+3) induction was done when she was stable. - repeat marrow showed a markedly hypercellular marrow with no blast clusters and cd34+ blasts comprising less than 3% of the cellularity. - started consolidation with four cycles of hidac - : bone marrow biopsy later shows relapsed acute leukemia. salvage therapy with mitoxantrone/etoposide. course was complicated by very-delayed count recovery. marrow bx after day 30 did show evidence of recovering marrow without a clear increase in blasts although there were some monocyte precursors noted. they were thought to not resemble her underlying leukemia. - d0 mrd allo sct. - : admission for relapsed leukemia in the csf and r bell's palsy. base of skull xrt and intrathecal chemotherapy through an ommaya reservoir () placed during her admission - : continued on q2week depo ara-c, also with withdrawing immunosuppression. there was noted rising lfts, unclear whether gvh vs the underlying hep c. - mec finished on - biweekly intrathecal depocyt started , last dose - dli 2. endocarditis in 3. mi 4. avr 5. mvr 6. stroke with left hemiparesis 7. hepatitis c: hcv ab positive , vl 22,100,000, liver biopsy in with stage 1-2 fibrosis and bile duct damage likely hep c but cannot exclude gvhd 8. asthma: only on prn albuterol mdi 9. gerd 10. h/o coag neg staph, vre social history: she presently is living in home. her sister-in-law prepares her medications for her. she is widowed and her husband died from complications related to pancreatitis. she doesn't have children. she previously worked as a computer programmer with 2 years college training. she has not worked for two years and is assisted through social security disability. she has a previous history of heroin use which she stopped in . family history: no family history of malignancy. her mother has hypertension, her father had type ii diabetes and died from an mi and stroke at the age of 57, and her brother has hiv. physical exam: vitals: afebrile, bp 108/66, hr 100-110s, rr 24, sat 92% on nrb. gen: tachypneic, unable to speak with full sentences in moderate respiratory distress. anxious. heent: slightly dry mm. jvp difficult to assess secondary to respiratory distress. resp: bilateral inspiratory crackles, most prominent at the upper lung zones posteriorly. cvs: rrr. gi: bs present. abdomen soft, non-tender. ext: + bilateral le edema. neuro: oriented to place, year, month. pertinent results: laboratory results: 11:40am urea n-13 creat-0.6 sodium-133 potassium-4.9 chloride-102 total co2-22 anion gap-14 11:40am wbc-6.4# rbc-3.73* hgb-12.7 hct-38.5 mcv-103* mch-34.0* mchc-33.1 rdw-16.7* 11:40am neuts-66.7 lymphs-25.9 monos-4.9 eos-1.9 basos-0.5 11:40am calcium-8.7 phosphate-2.1* magnesium-1.9 uric acid-2.6 11:40am alt(sgpt)-45* ast(sgot)-93* ld(ldh)-236 ck(cpk)-20* alk phos-352* tot bili-3.8* dir bili-2.5* indir bil-1.3 03:36pm lactate-1.3 relevant imaging data: ct chest w/o: multiple focal areas of ground-glass opacity in both lungs and peribronchial infiltration are more prominent in the upper lobes, and confluent in the left apex. there is no pleural or pericardial effusion. ct chest w/o: worsening diffuse bilateral patchy ground glass opacities with an upper lobe predominance. this appearance is most consistent with an atypical infection such as pcp or viral pneumonia, as noted previously. non-infectious etiologies such as drug reaction could also be considered. cxr portable: the previously described extensive bilateral parenchymal densities are again identified. they have progressed to a moderate degree in the left mid lung field and lower lung field whereas on the right base, a certain degree of regression can be identified. on both films, there is no evidence of pleural fluid accumulation in the lateral pleural sinuses. cxr portable: increase bilateral airspace opacities with decreased lung volumes brief hospital course: a/p: 41 year-old female with aml in remission, with progressive hypoxemic respiratory failure. family meeting was held yesterday with heme-onc team. pt will be made cmo this afternoon after her brothers have spoken to her mother. otherwise ct with current treatment. 1) hypoxemic respiratory failure: the cause of her acute respiratory decompensation was unclear to the housestaff team. within the first day or two of her admission to the there was a drastic change in her cxray. she now had multilobular opacities suggestive of an ards like picture. she was placed on broad spectrum antibiotics-aztreonam, vancomycin, flagyl, caspofungin, levoquin along with bactrim and steroids for presumptive pcp . no nidus of infection was found and all culture data was negative. she was also started on steroids. the pt was extremely difficult to ventilation requiring high peep and pressure support. abdominal paracentesis showed blasts in her abdomen suggesting reoccurence of her cancer. this is most likely the cause of her acute failure. pt was then made cmo and she was slowly weaned off the ventilator. 2) hemodynamic instability: patient was persistently hypotensive during her stay. thought to be secondary an underlying infection, but all culture data was negative. she initially required levophed to maintain her urine output and blood pressure but dopamine was added in hope to wean the levophed down. this was unsuccessfull and she required pressors until her family decided to change her code status to cmo. 3) abdominal distention: patient required extremely high amounts of fentanyl and versed to keep her sedated and synchronous with the ventilator. her abdomen continued to increase in size, thought to be an ileus due to failure of passing stool (secondary to pain medications). ct scan of the abdomen was done and did not suggest an obstruction. her belly was then tapped and preliminary cytology suggested reoccurence of her leukemia. no further intervention was indicated at this time, per discussion with . family was informed of this new information and they decided to change code status to cmo. 4) thrombocytopenia: likely secondary to possible underlying malignancy. she required multiple platelet transfusions to keep her platelet level above 30. 5) fen: ct with tpn. 6) ppx: pneumoboots, no heparin sc given thrombocytopenia. ppi. bowel regimen prn. insulin ss while on high dose steroids. 7) access: picc line, femoral a-line, left ij. pt passed away on after her family decided to change her code status to cmo. no autopsy was obtained. medications on admission: caspofungin acyclovir 400 mg iv q 8 hours ketoconazole tp levofloxacin 500 mg po qd lactulose prn methadone 10 mg po bid, 5 mg po prn albuterol neb benzonanate 100 mg po tid dulcolax prn clotrimazole troches benadryl prn anzemet prn folate 1mg po qd guaifenesin q6 prn atrovent neb topical flagyl nystatin oral suspension dilatin 100 mg iv tid prednisone 40 mg po bid bactrim 350 mg iv q8 hours ursodiol 300 mg po tid senna, prochloperazine discharge medications: pt passed away on discharge disposition: home with service facility: critical care systems discharge diagnosis: aml acute respiratory failure discharge condition: pt died on discharge instructions: pt died on followup instructions: pt died on procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances insertion of endotracheal tube enteral infusion of concentrated nutritional substances percutaneous abdominal drainage arterial catheterization insertion of other (naso-)gastric tube closed [endoscopic] biopsy of bronchus transfusion of packed cells transfusion of other serum transfusion of platelets infusion of vasopressor agent diagnoses: thrombocytopenia, unspecified acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified long-term (current) use of steroids unspecified septicemia severe sepsis portal hypertension unspecified viral hepatitis c without hepatic coma acute and chronic respiratory failure pneumocystosis septic shock paralytic ileus complications of transplanted bone marrow bell's palsy metabolic encephalopathy heart valve replaced by transplant other disorders of neurohypophysis other and unspecified coagulation defects personal history of irradiation, presenting hazards to health presence of cerebrospinal fluid drainage device acute myeloid leukemia, without mention of having achieved remission 

Answer: The patient is high likely exposed to