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: sulfamethoxazole / dapsone / nevirapine attending: chief complaint: respiratory distress, abdominal distention, facial swelling major surgical or invasive procedure: thrombolysis history of present illness: hpi: 42 year old woman with aids (by cd4 criteria, cd4 of 42), and a high-grade aids-related lymphoma (plasmablastic lymphoma with the initial site of disease in the left maxillary sinus). she was recently hospitalized here for progressive odynophagia and possible "pill esophagitis" and/or acid reflux. by egd (biopsy results pending), and comes back to the ed with dyspnea, pain in the extremities (legs > arms), swelling of the right jaw, and abdominal distension. per pcp note patient describes symptoms prior to arriving to ed and after recent discharge as: "she started to notice swelling of the right lower jaw that, after being recumbent for a while (such as over night) extends up the right side of her face to close the right eye. the swelling tends to go down if she is upright for a while, but she still has painful swelling over the right side of the mandible. about 48 hours ago, she started to have swelling of the abdomen, with a feeling of being "bloated" and this is making it difficult to eat much. she has had increasing dyspnea over the past 24 hours, and she is not sure if this is because of the abdominal distension making it difficult to expand her lungs. however, with short walks, even across a room, she feels very dyspneic and "weak" and has to sit down to rest." she also reports having increasing pain in the extremities, more the legs (thighs and knees) and the upper extremities. this discomfort is "achy" and does not seem to worsen or get better with movement or rest. . when patient arrived to the ed was found to have temp of 101.2, have a distended abdomen that was diffusely tender. she also was hypotensive with sbp 80-90s and tachycardic with hr 120s. she then went into svt that terminated with vagal maneuvers. she got a dose of dilaudid and her sbp dropped to 70s however patient mentating normally. she was given vanc/levo/flagyl in the ed for concern of infection although no clear source identified. patient then underwent ct torso which revealed multiple pulmonary emboli including left main artery, right atrium extending into svc, cannot exclude extension into ivc, focal clot within pulmonary veins as well; abdominal and pelvic ascites, moderate large right pleural effusion. she was then started on heparin gtt in the ed. radiology felt that patient may benefit from cardiac mri to differentiate between mass vs clot. cardiac surgery evaluated patient who recommended patient get echo to assess for rv collapse, which will be done in am. vascular also consulted in ed and recommend leni to rule out dvt and possible ivc filter placement. patient hypoxic with o2sat 90% on ra, put on nrb with o2sat 97%. abg on nrb was 7.48/29/81; in the ed also tachycardic to 120-140s, appears to be sinus tachy. patient also getting boluses of ivf in the ed. . past medical history: 1. aids (cd4 63 and vl 7,290 in )- multiple antiretroviral meds. adherance has never been an issue. hx of highly resistant viral strains. thought to have gotten hiv from blood transfusion in the 's. 2. high-grade aids-related lymphoma diagnosed in (plasmablastic lymphoma with the initial site of disease in the left maxillary sinus s/p chemotherapy in infusional with a regimen of , complicated by a severe pneumonia in the left lung requiring intubation, and then a left-sided empyema requiring several weeks of a chest tube. she had a recurrence of the lymphoma in the sinus, and has had radiation therapy to the tumor. she has areas in several bones that are hypermetabolic on pet scan 3. thrombocytopenia- responded - (antid-globulin) 4. lung nodules - 1.5 cm cavitary nodule in the left upper lung in 9/. she had a ct scan of the chest in that revealed a 13-mm cavitary lesion in the left upper lobe that had remained stable, and stable nodule in the other lung fields: 3-4 mm noncalcified nodules in the right upper lobe, lingula and right middle lobe remain stable. social history: shx: notable for having been born in and she came to the us at the age of 17. she had the surgery of her mandible the following year and received blood transfusion. she lives in on a farm with her husband and 2 sons (8 and 6 years old), and they own a restaurant. family history: fmhx: notable for her mother who is in her 70's and has hypertension. her father died 2 years ago, at the age of 69 of lymphoma. she has 3 sisters, one of whom had problems with ethanol abuse. no other disorders that she is aware of run in her family. physical exam: pe: t 97.9 hr 107 bp 98/59, 76-99/50-62 rr 26 o2sat 94-98 on 100% nrb gen: comfortable, + resp effort, tachypneic heent: perrl, eomi, op clear, mmm; palpable mass on right mandible neck: no lad chest: decreased bs on r side, + exp wheezes cardiac: tachy, no murmurs appreciated abd: soft, distended, + shifting dullness; no hepatomagaly appreciated, + bs ext: no edema, skin abrasion on l knee neuro: aaox3 pertinent results: 01:07pm k+-3.8 01:00pm glucose-121* urea n-14 creat-0.8 sodium-137 potassium-6.7* chloride-102 total co2-20* anion gap-22* 01:00pm alt(sgpt)-52* ast(sgot)-143* ck(cpk)-112 alk phos-69 tot bili-1.1 01:00pm ck-mb-2 ctropnt-0.03* 01:00pm albumin-3.4 01:00pm wbc-12.5*# rbc-4.39# hgb-12.4# hct-38.8# mcv-88 mch-28.3 mchc-32.0 rdw-19.1* 01:00pm neuts-81.7* lymphs-12.6* monos-5.4 eos-0.1 basos-0.1 01:00pm hypochrom-3+ anisocyt-2+ poikilocy-1+ macrocyt-1+ microcyt-1+ 01:00pm plt count-369 01:00pm pt-14.1* ptt-24.7 inr(pt)-1.3* . ct abdomen: impression: 1. multiple filling defects that could be consistent with either primary cardiac tumor versus tumor thrombus versus de bland embolus located within the left pulmonary artery, the right atrium extending into the superior vena cava, possibly within the inferior vena cava, and within the left atrium. the differential includes a possible primary cardiac tumor centered in the left atrium and further assessment could be performed by cardiac mri. no pulmonary emboli is present within the right lung. . 2. moderate-to-large right pleural effusion. smaller left pleural effusion. 3. incompletely imaged left groin hematoma versus enhancing mass measuring 5.4 x 2.5 cm. recommend ct of the left lower extremity for further assessment. 4. left upper lobe lesion as described above. 5. abdominal and pelvic ascites. 6. thickening of the bladder wall which could be consistent with cystitis. clinical correlation is recommended. . lenis: impression: non-occlusive thrombus within the proximal right superficial femoral vein that does not extend either superiorly or inferiorly. . echo : conclusions: the left atrium is normal in size. a large (at least 2 cm x 2 cm) mass is seen in the right atrium, prolapsing into the right ventricle during diastole. its attachment is not well-defined, but it appears to originate in the inferior vena cava, or near its insertion into the right atrium. the mass is partially obstructing the rv inflow, creating severe functional tricuspid stenosis. there is mild symmetric left ventricular hypertrophy with normal cavity size and systolic function (lvef>55%). regional left ventricular wall motion is normal. the right ventricular cavity is mildly dilated. right ventricular systolic function is normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. the estimated pulmonary artery systolic pressure is normal. there is a small pericardial effusion. there are no echocardiographic signs of tamponade. impression: large right atrial mass with partial right ventricular inflow obstruction. severe functional tricuspid stenosis. preserved global and regional biventricular systolic function. small pericardial effusion without tamponade. brief hospital course: 1) r heart/pulm lymphoma vs clot: chest ct in ed showed extensive obstruction of ivc/svc, ra/rv by tumor or clot. on admission to micu, she was started on heparin iv, and thrombolytics were not immediately given until her respiratory distress increased. tee revealed 2x2 cm mass in ra prolapsing into the rv during diastole, creating severe functional ts. lvef>55%. lenis showed non-occlusive clot/mass in r superior femoral vein. ivc filter not placed given the respiratory distress and unstable hemodynamics. twelve hours after admission to the icu, she received thrombolytics (alteplase 100 mg) but dyspnea did not improve and sbp continued to hover in the 90s, which supports the malignant nature of the mass rather than thrombosis. pet at center showed light up in long bones, r heart area, and l groin area. flow cytometry on this admission was nondiagnostic. she received decadron 10mg q6h for the likely lymphoma. . after a family discussion that no other medical/surgical interventions would be effective, comfort measures only were deployed starting on . she received a morphine drip, titrated to minimize her pain and discomfort. . deceased: patient expired from heart failure in the early morning hours of . . 2) respiratory distress: given the r heart outflow obstruction, she had poor pulmonary perfusion. she was tachypneic throughout her admission, but oxygen sats remained above 90% on 100% nrb. . 3)tachycardia - patient appears to be sinus tachy from r heart outflow obstruction (tumor vs clot). she was not rate controlled since this is normal compensation and she did not experience chest pain or palpitations. . 4) oliguria: she received continuous iv fluids (3amps hco3 in d5w) to maintain max effective arterial volume in setting of preload dependence and organ hypoperfusion, . she had received 8 liters by the time she left the icu, but her urine output remained low, 0-30 cc/hr. her cr rose to 1.6 from a baseline of 0.9, likely prerenal with iscehmic atn. . 5)anion gap acidosis: due to hypoperfusion, her lactate increased from 3.4 on admission to 4.9 on hd 2, and she had an ag of 18. she received more than 8l of 3amps hco3 in d5w. . 6) le mass/hematoma - patient found to have hematoma/? mass of left groin on ct torso. this was felt to be either tumor or clot and further eval was not undertaken on this admission. 7) fever/leukocytosis - low grade temp on arrival with mild leukocytosis, but shortly defervesed. question of dental abscess from dental work that had been drained once by her dentist. no other obvious source of infection based on history/phys, and exam. leukocytosis most likely from stress and recent steroid taper. she did not receive antibiotics. . 8) hiv - patient was on salvage therapy, has been off haart for weeks now given trouble taking po meds (recent esophagitis). per patient was to restart haart as outpatient. her last cd4 count was 47 on , and viral load 7290 (. she did not start haart during admission, but did receive mepron for pcp/tox prophylaxis and azithromycin for mac prophylaxis given her low cd4 count. . 9) abdominal discomfort: abdomen did not show any acute process, but diffuse abd discomfort, likely from ascites. she was not tapped given low suspicion for sbp and high risk of bleeding on heparin. medications on admission: 1. atovaquone suspension 750 mg po bid 2. hydromorphone 2 mg q3-4h as needed 3. nystatin 100,000 units 4x/day 4. pantoprazole 40 mg daily 5. sucralfate 1 gram 4x/day discharge disposition: home with service discharge diagnosis: deceased from heart failure induced by r heart/pulmonary tumor from aids related lymphoma. discharge condition: expired discharge instructions: expired followup instructions: expired procedure: injection or infusion of thrombolytic agent diagnoses: acidosis acute kidney failure with lesion of tubular necrosis unspecified pleural effusion congestive heart failure, unspecified human immunodeficiency virus [hiv] disease other malignant lymphomas, unspecified site, extranodal and solid organ sites compression of vein other pulmonary embolism and infarction other esophagitis 

Answer: The patient is high likely exposed to