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: simvastatin / ciprofloxacin / glumetza / lisinopril / methotrexate attending: chief complaint: headache major surgical or invasive procedure: bilateral bur hole evacuation of subdural hematoma history of present illness: mr. is a 70m w/ history of burkitt's lymphoma with progressive disease, currently receiving ivac chemo c2d12 who presents from clinic with headache, found to have spontaneous sdh. patient was seen for routine heme-onc checkup today complaining of headache. patient received ct head and was found to have bilateral subdural hemorrhage with midline shift. patient's platelets were 7 and he was given one unit of platelets at that time. patient was transferred to the ed for admission and neurosurgery evaluation. he denies blurry vision, numbness (other than chronic chin numbness), tingling, weakness of the extremities (outside of chronic weakness which has been attributed to vincristine toxicity, and compression neuropathy due to weight loss). he states the headache is pretty mild, has been located over occiput, midline but is currently frontal. he denies nausea, vomiting. patient denies any history of trauma - falls or bumping head. but notes a remote fall in of , for which head ct was negative. wife notes that his voice has sounded different but that it typically sounds this way after receiving chemotherapy. . in the ed, vs 97.2 90 127/80 20 98%, ha . neuro exam was nonfocal, patient a&ox3. labs significant for pancytopenia (wbc 0.1, anc 80, hct 21.4, plts 7), electrolytes and coags wnl (inr 0.9). ekg showed sinus @ 90, no acute changes. patient was transfused an additional 1 unit of platelets. neurosurgery was consulted, and recommended no acute intervention at this time, but stated they will follow patient during admission and give further recs. dr. was updated about the patient and plan for admission for q2h neuro checks. vs prior to transfer 98.3 hr 94 bp 118-103/78 rr 18 o2 sat 98-100% ra. . on arrival to the icu, vs 98.6, 120/64, 93, 14, 99% ra. patient was comfortable without complaints aside from mild frontal ha. denies f/c, cough, chest pain, oropharyngeal discomfort, dysuria, abdominal pain, change in bowel movements (notes intermittent diarrhea, recent h/o c.diff). review of systems: (+) per hpi. notes new skin breakdown and scabbing over left 2nd mcp joint and right forearm. (-) denies fever, chills. denies sinus tenderness, rhinorrhea or congestion. denies cough, shortness of breath, or wheezing. denies chest pain, chest pressure, palpitations, or weakness. denies nausea, vomiting, constipation, abdominal pain, or changes in bowel habits. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes or skin changes. past medical history: burkitt's lymphoma dm htn sarcoid ischemic colitis hyperlipidemia . oncological history - : numbness and pain right jaw and chin, night sweats, right neck mass and weight loss. - pet ct with fdg avid r neck mass and numerous liver lesions. biopsy of the neck mass c/w aggressive b cell lymphoma. echo with ef 55%. - bmbx revealed hypercellular marrow with >95% replacement with high grade b cell lymphoma. m:e ratio cannot be assessed. flow cytometry showed monotypic large b cells, kappa light chain restricted, cd10+, cd19+, cd20+ bright, cd22+, cd 38+ bright, fmc7+, cd5-, cd11c-, cd25-, cd103-. cytogenetics with t(8:14) cmyc-igh. consistent with involvement by burkitt's lymphoma. - c1d1 r-chop in outside hospital(rituximab 750 mg, cyclophosphamide 1500 mg, doxorubicin 100 mg, vincristine 2 mg, dexamethasone 8 mg) with neulasta on d2. - it cytarabine - high dose methotrexate (3500 mg/m2), complicated by acute kidney injury - rituximab 100 mg - c1 (etoposide 45 mg/m2 d1-4, doxorubicin 10 mg/m2 d1-4, vincristine 0.4 mg/m2 d1-4, cyclophosphamide 750 mg/m2 d5) - rituximab 375 mg/m2 - c2 (etoposide 60 mg/m2 d1-4, doxorubicin 12 mg/m2 d1-4, vincristine 0.4 mg/m2 d1-4, cyclophosphamide 900 mg/m2 d5) - it cytarabine - c3 (etoposide 70 mg/m2 d1-4, doxorubicin 12 mg/m2 d1-4, vincristine 0.4 mg/m2 d1-4, cyclophosphamide 1050 mg/m2 d1) - it methotrexate - c4 da- (etoposide 60 mg/m2 d1-4, doxorubicin 10 mg/m2 d1-4, vincristine 0.3 mg/m2 d1-4, cyclophosphamide 900 mg/m2 d5) - rituximab - restaging pet showed disease progression with increased size and fdg-avidity of residual right neck mass and new fdg-avidity of mediastinal, hilar, right supraclavicular, epicardial fat pad, right submandibular space, and portacaval lymphadenopathy. there was also new focal fdg uptake in the l4 vertebral body and left humeral head are also consistent with a neoplastic process. cycle 1 of ivac. biopsy of the cervical fdg avid lymph node, shows lymphoma cells. - cycle 2 ivac social history: smoked 1ppd x five years around age 30, does not drink or use drugs, lives with wife and 2 grown children live nearby, worked as a limo driver family history: sister with cancer, sister with bilateral breast cancer, brother with unspecified cancer, heart disease in father. recently diagnosed with lymphoma, over . physical exam: admission physical exam: vitals: vs 98.6, 120/64, 93, 14, 99% ra general: alert, oriented, no acute distress heent: perrl, eomi, sclera anicteric, mmm, oropharynx clear without lesions neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, nonerythematous port in right upper chest, no wheezes, rales, rhonchi cv: mildly tachycardia, regular rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused, 2+ pulses in dp, no clubbing, cyanosis or edema neuro: a&ox3, very sharp, cn ii-xii intact with the exception of diminished sensation in v3 bilaterally and inability to smile numbness of chin. strength 5/5 in all extremities. sensation to light touch and temperature in all extremities. 2+ brachioradialis and patella reflexes bilaterally. cerebellar function intact. discharge pe: he has two scalp incisions with sutures and the right has 2 staples from drain removal. he has chronic peri-oral numbness. he has no motor or cn deficit pertinent results: labs: on admission: 09:55am blood wbc-0.1* rbc-2.49* hgb-7.8* hct-21.4* mcv-86 mch-31.1 mchc-36.3* rdw-13.8 plt ct-7*# 09:55am blood neuts-80* bands-0 lymphs-12* monos-6 eos-0 baso-0 atyps-0 metas-2* myelos-0 01:36pm blood pt-10.2 ptt-28.2 inr(pt)-0.9 10:00am blood urean-18 creat-0.5 na-138 k-4.2 cl-102 hco3-27 angap-13 05:40pm blood alt-17 ast-16 ld(ldh)-102 alkphos-92 totbili-0.7 05:40pm blood albumin-3.6 calcium-9.0 phos-3.6# mg-1.9 imaging: ct head: impression: new bilateral right greater than left frontoparietal, subfalcine, and supratentorial subdural hematomas of mixed chronicity, causing 8 mm of leftward shift of normally midline structures. no intra-axial hemorrhage. underlying neoplastic disease is poorly assessed on current study. . cxr : heterogeneous opacification in the left lower lung could represent early effect of aspiration. right hilar adenopathy has increased. heart size is normal. there is no appreciable pleural effusion or pneumothorax. a bulging mediastinal contour in the region of the ascending aorta could be due to adenopathy or a tortuous or dilated aorta. right subclavian infusion port ends low in the svc. . ct head: 1. status post evacuation of bilateral subdural hematomas, with small residual bilateral hemispheric subdural collections, and interval decrease in mass effect upon the cerebral hemispheres. 2. large amount of pneumocephalus, in the interhemispheric fissure, extending between the frontal lobes, concerning for "tension pneumocephalus," which should be correlated clinically. ct head 1. enlargement of the left subdural collection with mild mass effect, but no evidence of herniation. 2. decreased amount of post-surgical pneumocephalus. 3. stable size of small right subdural hematoma. brief hospital course: this is a 70 year old man with a pmh of htn, dm, burkitt's lymphoma with progressive disease, who was receiving ivac chemo c2d12 (on admission) with pancytopenia who presented with headache. ct head showed bilateral subacute sdh. he was transferred from to bmt service, after worsening headaches, n/v, and depressed level of consciousness, was transferred to sicu after burr holes for evacuation of b/l sub-dural hematomas. . # sdh: monitored in and then bmt service. it was felt that some component of his headache may have been related to post-lp given positional nature (patient had lp 1 week prior to admission), however given his clinical deterioration, it became apparent that this was unlikely. chronic lower lip numbness and b/l ankle weakness (chronic) were his only apparent neurological deficits noted. he had persistent headaches and nausea, patient received multiple head cts, which were stable until when midline shift increased, and patient became more lethargic. he also had persistent emesis. neurosurgery re-evaluated the patient and felt that surgical intervention was indicated, and the patient was subsequently trasferred to the or and he underwent bilateral bur hole evacuation of the sdh's with a subdural drain left on the right. post-op ct showed pneumocephalus as expected. he was recovering well on and ct head showed some more left sdh but less midline shift. he was seen by pt who recommended home with pt services. he was trasnfered to the floor when a bed was available on . he had some dizziness and nausea when elevated with pt. he continued to be observed. he was screened for rehab as it was felt that he was not strong enough to care for himself while alone during the day. he was dc'd to rehab in stable condition and will follow up as directed by discharge paperwork. #leukocytosis: an infectious work-up was initiated given his somnolence and leukocytosis (persistent elevation after neupogen was discontinued on ). he wbc count did trend down to 11 on . he was afebriel and was contniued on bactrim and antivirals. blood culture from showed....c diff was negative x 3 and contact precautions were lifted. cxr from showed a left lung consolidation and cxr was repeated showing.... . # pancytopenia/neutropenia: patient was c2d12 of ivac on admission with an anc of 80, transfused to maintain hemoglobin >8 and platelets >50, by the time of transfer to sicu, his counts had recovered. platelets were 119 at time of the surgery and raised to 159 on . . # burkitts lymphoma: patient initially diagnosed in . recent pet showed disease progression. us guided biopsy of a right cervical lymph node on showed malignant cells. he was continued on acyclovir, bactrim, voriconazole for prophylaxis. outpatient erstaging pet ct was arranged. . # dmii: no hgba1c in omr. metformin was held and patient was managed on iss. kidney function was normal on and metformin was restarted after speaking with the bmt resident. . # hypertension: continued home metoprolol 12.5 , amlodipine 5mg qday, quinapril was decreased to 20mg qday. . # sarcoid: stable, not being actively managed as an outpatient. . # hyperlipidemia: no results on the computer, not being actively managed as an outpatient. ===== transitional issues: -quinapril decreased to 20mg daily - medications on admission: acyclovir 400 mg tablet tid amlodipine 5 mg tablet daily folic acid 1 mg tablet daily metformin 500 mg tablet metoprolol tartrate 12.5 mg oxycodone 5 mg tablet tid prn pain prochlorperazine maleate 10 mg tablet q6h prn nausea quinapril 40 mg tablet daily saliva substitution combo no.2 qid sulfamethoxazole-trimethoprim 400 mg-80 mg tablet daily voriconazole 200 mg tablet calcium carbonate 200 mg calcium (500 mg) tablet chewable tid cyanocobalamin (vitamin b-12) 100 mcg tablet daily neupogen 480mg sc daily discharge medications: 1. acyclovir 400 mg tablet sig: one (1) tablet po q8h (every 8 hours). 2. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 3. folic acid 1 mg tablet sig: one (1) tablet po once a day. 4. metformin 500 mg tablet sig: one (1) tablet po twice a day. 5. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 6. oxycodone 5 mg tablet sig: one (1) tablet po three times a day as needed for pain. 7. prochlorperazine maleate 10 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for nausea. 8. quinapril 20 mg tablet sig: one (1) tablet po daily (daily). 9. sulfamethoxazole-trimethoprim 400-80 mg tablet sig: one (1) tablet po daily (daily). 10. voriconazole 200 mg tablet sig: one (1) tablet po q12h (every 12 hours). 11. calcium carbonate 200 mg calcium (500 mg) tablet, chewable sig: one (1) tablet, chewable po three times a day. 12. cyanocobalamin (vitamin b-12) 100 mcg tablet sig: one (1) tablet po daily (daily). 13. heparin (porcine) 5,000 unit/ml solution sig: one (1) ml injection tid (3 times a day). 14. levetiracetam 500 mg tablet sig: two (2) tablet po bid (2 times a day). 15. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 16. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 17. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). discharge disposition: home with service facility: vna discharge diagnosis: subdural hematomas brain compression neutropenia thrombocytopenia gait disturbance lymphoma discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: instructions for follow up: subdural, epidural hemorrhages surgical dr. you were admitted for subdural hematomas and had a surgical procedure to relieve the pressure on your brain. you are now on an anti-epileptic medication as these blood collections could cause a seizure. please note the following medication changes: -please decrease your quinapril to 20mg daily -please stop taking neupogen unless instructed to start again by your outpatient doctors. ?????? keep your staples clean and dry until they are removed. ?????? have a friend or family member check the wound for signs of infection such as redness or drainage daily. ?????? take your pain medicine as prescribed if needed. you do not need to take it if you do not have pain. ?????? exercise should be limited to walking; no lifting >10lbs, straining, or excessive bending. ?????? increase your intake of fluids and fiber, as narcotic pain medicine can cause constipation. we generally recommend taking an over the counter stool softener, such as docusate (colace) while taking narcotic pain medication. ?????? do not take any anti-inflammatory medicines such as motrin, aspirin, advil, or ibuprofen etc. until follow up. ?????? if you were on a medication such as coumadin (warfarin), or plavix (clopidogrel), or aspirin prior to your injury, you may not safely resume taking this until follow up in one month. ?????? you have been discharged on keppra (levetiracetam) for anti-seizure medicine; you will not require blood work monitoring. ?????? do not drive until your follow up appointment. call your surgeon immediately if you experience any of the following ?????? new onset of tremors or seizures. ?????? any confusion, lethargy or change in mental status. ?????? any numbness, tingling, weakness in your extremities. ?????? pain or headache that is continually increasing, or not relieved by pain medication. ?????? new onset of the loss of function, or decrease of function on one whole side of your body. followup instructions: follow-up appointment instructions ??????please call ( to schedule an appointment with one of the physician assistants on for staple removal. you can come before your pet ct. ??????you need to see dr. in 4 weeks. you will need a ct scan of the brain without contrast prior to your appointment. this can be scheduled when you call to make your office visit appointment. you will have a pet ct on at 2pm, bld, . the prep with info for your diet the night before and morning of the test will be with your discharge papers.division of nuclear medicine( you have an appt with dr. or in oncology on at 1:30 p.m. md procedure: incision of cerebral meninges diagnoses: unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled sarcoidosis abnormality of gait compression of brain nausea with vomiting other and unspecified hyperlipidemia disturbance of skin sensation right bundle branch block antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits subdural hemorrhage burkitt's tumor or lymphoma, lymph nodes of multiple sites other musculoskeletal symptoms referable to limbs antineoplastic chemotherapy induced pancytopenia 

Answer: The patient is high likely exposed to