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: no allergies/adrs on file attending: chief complaint: hypoxic respiratory failure major surgical or invasive procedure: intubated prior to transfer history of present illness: the patient is an 85 y/o m with h/o t cell leukemia, cad s/p cabg, ckd, hx of tumor lysis syndrome, copd, osa on home bipap who presents from osh intubated for hypoxic respiratory failure. the patient was admitted at earlier in the month for a cap. he was treated initially with ceftriaxone and azithromycin, then transitioned to cefuroxime prior to d/c to ltac. this hospitalization was complicated by and hyperk as well which were treated with ivf and kayexalate. he was discharged on 5l nc - at baseline he uses no supplemental o2. it seems he had a few days of worsening respiratory distress with mild cough and was sent to . he was trialed on bipap but he failed and was intubated, sedated with propofol. labs showed trop of 0.18, ckmb 4.1, wbc 377, k>12. he had a temporary right femoral line placed for dialysis for 2 hours and then decision was made to transfer to for further care. prior to transfer, he was given vanc/zosyn, lasix, solumedrol 125mg iv x1, and started on heparin for presumed pe. was hypotensive en route to the 80s and started on norepinephrine, also satting in the 80s on the vent. when he arrived 94% on vent and normotensive. in the ed, initial vs were not recorded. he had repeat labs sent and a cxr/ekg done. renal and heme/onc were consulted but had not provided full recommendations at the time of signout. the patient was given 2grams calcium iv. on transfer, vitals were: hr: 93, bp 126/71 - on norepi 0.3, satting 97% on cmv 550/18 100% peep 15. on arrival to the micu, the patient is intubated and sedated. he moves all 4 extremities equally. review of systems: unable to be obtained past medical history: 1. ckd w/ baseline creatinine 2.5 2. tumor lysis syndrome 3. hypertension 4. copd 5. osa on bipap 6. t-cell lymphocytic leukemia s/p recent chemotherapy 7. hypertension 8. cad s/p mi and 4 vessel cabg in 9. bph s/p turp 10. cholecystectomy social history: lives with wife in at daughter's house. independent with adl. does not drink alcohol/smoke. family history: nc physical exam: general: intubated and sedated heent: sclera anicteric, perrl, ruddy skin of forehead and cheeks neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation on anterior exam, no wheezes, rales, ronchi abdomen: soft, non-tender, non-distended, bowel sounds present, palpable abdominal pulsation gu: foley in place ext: warm, well perfused, 2+ pulses, + lower extremity edema neuro: moves all 4 extremities spontaneously, did not follow commands when sedation lightened. pertinent results: cxr: 1. endotracheal tube in standard position. 2. congestive heart failure. 04:18am blood wbc-336.7* rbc-3.10* hgb-10.6* hct-33.7* mcv-109* mch-34.2* mchc-31.5 rdw-20.1* plt ct-103* 09:51am blood wbc-471.7* rbc-2.81* hgb-9.8* hct-30.6* mcv-109* mch-34.8* mchc-31.9 rdw-18.6* plt ct-107* 09:51am blood neuts-5* bands-0 lymphs-90* monos-4 eos-0 baso-0 atyps-0 metas-0 myelos-1* 09:51am blood hypochr-2+ anisocy-2+ poiklo-normal macrocy-2+ microcy-normal polychr-occasional stipple-occasional 04:18am blood pt-12.4 ptt-150* inr(pt)-1.1 04:18am blood fibrino-144* 09:51am blood fibrino-151* 04:18am blood glucose-203* urean-49* creat-2.2* na-141 k-3.7 cl-106 hco3-26 angap-13 09:51am blood creat-2.6* na-141 k-3.6 cl-104 hco3-27 angap-14 04:18am blood alt-4 ast-12 ld(ldh)-242 ck(cpk)-73 alkphos-20* totbili-0.1 09:51am blood ld(ldh)-955* ck(cpk)-217 04:18am blood lipase-45 04:18am blood ck-mb-7 probnp-1452* 04:18am blood ctropnt-0.30* 09:51am blood ck-mb-8 ctropnt-0.48* 04:18am blood albumin-2.8* calcium-9.3 phos-3.5 mg-2.5 uricacd-5.6 09:51am blood calcium-9.2 phos-5.1*# mg-2.2 uricacd-6.4 04:18am blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 09:56am blood type-art temp-37.3 rates-28/ tidal v-420 peep-15 fio2-100 po2-46* pco2-52* ph-7.34* caltco2-29 base xs-0 aado2-615 req o2-100 -assist/con intubat-intubated 04:16am blood type-art po2-51* pco2-57* ph-7.31* caltco2-30 base xs-0 intubat-intubated 04:16am blood glucose-214* lactate-1.3 na-141 k-3.5 cl-103 calhco3-28 04:16am blood hgb-9.8* calchct-29 o2 sat-79 cohgb-1.4 methgb-0.5 04:16am blood freeca-1.22 brief hospital course: hospital course: this is an 85 y/o m with h/o t cell leukemia, cad s/p cabg, ckd, hx of tumor lysis syndrome, copd, osa on home bipap who presents from osh with hypoxic respiratory failure and shock of unclear etiology. due to the patients rapid decline and multi-system organ dysfunction, he was made comfort measures only and expired shortly after extubation and cessation of pressor support. his family was at his bedside. . # acute hypoxic respiratory failure with ards - unclear etiology. cxr revealed hyperinflated lungs with evidence of pulmonary edema and central venous congestion. he had a history of copd and osa and a copd flare may have contributed given the history of a few days of shortness of breath. he was recently hospitalized as well so hcap considered althought no evidence on cxr. acs is possible given the elevated troponin and and mb although cardiogenic shock less likely given warm extrmities, low jvp and nor obvious pulmonary edema. on arrival to the micu, he was on 100% fio2 and peep of 15 with pao2 of 51 showing significant a-a gradient concerning for shunt. he was continued on a heparin gtt for treatment of acs and possible pe given a-a gradient. a tte-bubble study was ordered. diuresis with torsemide was started for possible pulmonary edema. he was started on vancomycin, cefepime and levofloxacin to cover hcap. . # shock - likely vasodilatory given presentation - not consistent with cardiogenic at this time given warm extremities and low jvp. he was continued on peripheral levophed with goal map > 65. an hd line with vip port were planned for hd and pressor support. . # troponin leak - concern for ischemia vs demand process given respiratory failure. in setting of , elevated troponin not unexpected, however his mb was elevated as well which is more concerning for cardiac ischemia. a tte-bubble study was ordered and cardiac enzymes were planned to be cycled. a cardiac consult was placed. coreg was held and a full dose aspirine was continued. . # t cell leukemia/leukocytosis - wbc of 336.7k. it appeared that he had a history of a t cell lymphocytic leukemia but his definitive diagnosis was not clear. a hematology oncology consult was urgently placed for possible leukopheresis. examination of his blood smear revealed few, if any, blasts were identified. in the setting of what apepared to be baseline renal function, normal electrolytes, uric acid and coags with the exception of elevated ptt on iv heparin, he had no evidence of tumor lysis or dic although fibrinogen was slightly low at 144. given that his smear showed mature lymphocytes, it was felt unlikely that leukostasis would have occured until the wbc > 400k and therefore not the cause of his acute respiratory failure. his tymor lysis labs were planned to be trended. of note, later on repeat cbc, his wbc was 471.7k. . # comfort measures: on arrival to the micu, the patients clinical course rapidly declined, his a-a gradient widened, shock worsened despite initial rescussitation efforts outlined above. after discussion with the patient's family regarding his clinical status, including his wife, multiple children and grandchildren at the bed-side, the decision was made to transition him to comfort measures. he was extubated, antibiotics, diuresis and pressor support were discontinued. he passed shortly thereafter in the presence of multiple family members. an autopsy was declined. given death within 24 hours of admission the medical examiner was notified who also declined autopsy. medications on admission: vytorin 10/40 1 tab daily lasix 40mg daily bactrim ds 1 tab daily coreg 6.25mg aspirin 81mg daily allopurinol 75mg daily acyclovir 400mg daily calcium carbonate 500mg daily fish oil simvastatin 40mg daily mvi cefuroxime (for recent pneumonia) discharge medications: none discharge disposition: expired discharge diagnosis: hypoxic respiratory failure discharge condition: the patient expired discharge instructions: the patient expired followup instructions: the patient expired md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours arterial catheterization diagnoses: pneumonia, organism unspecified obstructive sleep apnea (adult)(pediatric) acute kidney failure, unspecified chronic airway obstruction, not elsewhere classified chronic kidney disease, stage iv (severe) hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) acute respiratory failure other shock without mention of trauma old myocardial infarction encounter for palliative care do not resuscitate status other pulmonary embolism and infarction personal history of antineoplastic chemotherapy other nonspecific abnormal serum enzyme levels chronic lymphoid leukemia, without mention of having achieved remission tumor lysis syndrome 

Answer: The patient is high likely exposed to