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: history of present illness: the patient is a 30 year old male with a past medical history of pulmonic stenosis (now thought to be secondary to an anterior mediastinal mass), who presented with five weeks of progressive nonproductive cough, fever, and night sweats to an outside hospital on , where a chest x-ray revealed an anterior mediastinal mass and a cat scan showed the mass measuring at 11.3 by 14.4 by 12.0 centimeters, as well as small effusions. the patient was sent home with follow-up but over the weekend, he developed pleuritic left sided chest pain with mild shortness of breath. again, he was evaluated at the outside hospital where the pericardial effusion now appeared large. he was therefore transferred to where an echocardiogram revealed a 3.5 centimeter effusion with inferior vena cava inspiratory collapse and mitral inflow variability without increased jugular venous pressure or a pulsus. the patient was transferred to the ccu for close monitoring. past medical history: 1. hernia repair at eight years old. 2. lyme disease at ten years old. 3. pulmonic stenosis diagnosed in , after a murmur and diagnosed by echocardiogram. 4. shingles. medications on admission: none. allergies: no known drug allergies. social history: the patient lives alone. negative tobacco. three drinks of alcohol per month. the patient works as industrial designer, physically active. family history: mother passed seven years ago from breast cancer. grandfather with prostate carcinoma. physical examination: on admission, temperature 101.8, heart rate 105, blood pressure 130/70, respiratory rate 27 to 32, oxygen saturation 98% in room air. the patient is a well developed male who is thin and diaphoretic, anxious, in mild respiratory distress. the pupils are equal, round, and reactive to light and accommodation. extraocular movements are intact. cranial nerves ii through xii are intact. the oropharynx is clear. negative anterior posterior lymphadenopathy. neck is supple, negative axillary nodes. lungs are clear to auscultation bilaterally. the heart was tachycardia, regular s1 and s2 with ii to iii/vi murmur at the left sternal border. the abdomen was soft, nontender, positive bowel sounds, no hepatosplenomegaly. extremities were no cyanosis, clubbing or edema. no rashes. strength was in all four extremities. laboratory data: on admission, white blood cell count was 10.9, hematocrit 37.2, platelet count 381,000. inr 1.5. chem7 was within normal limits. echocardiogram revealed normal systolic function, 3.5 effusion at the largest diameter, inferior vena cava collapse with inspiration, question of pericardial studding, mild respiratory variation in mitral inflow consistent with some early signs of tamponade. cat scan from , heterogeneous mass in the left midline compressing the left pulmonary artery, right upper lobe pleural nodules, left pleural effusion, pericardial effusion. hospital course: 1. pericardial effusion at admission - the patient had signs for early tamponade physiology but was hemodynamically stable and was admitted to the ccu for close monitoring. repeat echocardiogram showed increasing size of the effusion. the patient therefore underwent pericardial drain and 600cc of grossly hemorrhagic fluid were removed. following the procedure overnight, there was no further drainage from the pericardial drain. repeat echocardiogram showed decreasing pericardial fluid. therefore on , the pericardial drain was pulled. the patient had one further follow-up echocardiogram on . this revealed no effusion and it was felt the patient was stable from a cardiac standpoint. 2. hematology/oncology - the patient underwent a mediastinal biopsy to diagnose the large anterior mediastinal mass. the biopsy revealed nonseminomatous germ cell yoke sac tumor. the patient underwent two treatments of radiation therapy as well as a round of five days of chemotherapy with etoposide and cisplatin. staging workup included a head magnetic resonance scan which revealed no lesions, as well as an ultrasound of the scrotum which was within normal limits. fluid drained from the pericardial and pleural effusions were negative for malignant cells. the patient tolerated chemotherapy well suffering from nausea, relieved by ativan. he was pretreated with allopurinol and intravenous fluids to prevent tumor lysis. the patient completed his five days of chemotherapy. he will follow-up with dr. in one week for continuation of his therapy with the possible addition of bleomycin following pulmonary function tests. 3. infection - during the hospital course, he continued to have shortness of breath as well as a cough with mild hemoptysis. on , the patient spiked a fever. this was thought most likely secondary to the tumor burden, however, the patient was started on vancomycin, levofloxacin and clindamycin as broad spectrum therapy with a question of postobstructive pneumonia. subsequently, the patient did well with no further fevers. vancomycin and clindamycin were stopped and the patient will complete a ten day course of levofloxacin. 4. pleural effusion - the patient had a left sided chest tube placed for drainage of pleural fluid. following the removal of the chest tube, the patient had continued drainage from the site of the tube. after a number of days, this slowly resolved. the patient's site was closed by ct surgery with a suture. the suture is to be removed in seven to ten days at a follow-up appointment with dr. . condition on discharge: stable. discharge status: discharged to home with vna services for dressing changes. follow-up: the patient will follow-up on , with dr. , as well as , with dr. of cardiology. medications on discharge: 1. ativan 0.5 to 1 mg p.o. q3-4hours p.r.n. nausea. 2. levofloxacin 500 mg p.o. once daily times three days. 3. robitussin with codeine p.r.n. final diagnoses: 1, nonseminomatous germ cell anterior mediastinal tumor. 2. pericardial effusion, status post drainage. 3. left pleural effusion, status post drainage. 4. postobstructive pneumonia. , m.d. dictated by: medquist36 procedure: insertion of intercostal catheter for drainage pericardiocentesis pericardiocentesis right heart cardiac catheterization injection or infusion of cancer chemotherapeutic substance other radiotherapeutic procedure closed [percutaneous] [needle] biopsy of mediastinum diagnoses: pneumonia, organism unspecified unspecified pleural effusion malignant neoplasm of anterior mediastinum secondary malignant neoplasm of mediastinum hemopericardium 

Answer: The patient is high likely exposed to