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: patient recorded as having no known allergies to drugs attending: chief complaint: s/p fall, shortness of breath major surgical or invasive procedure: none history of present illness: mr. is an 82 year old portugese-speaking man admitted on with shortness of breath and abdominal pain. he was transferred here intubated and was found to have a wbc of 194k and have hyperkalemia. he had a fever to 101.4 and was extubated on . cta to assess for pe was negative. . translated by the portugese translator, he says that he feels much better. he says that he originally fell while he was trying to walk, but that he doesn??????t walk very much because he gets ??????lightheaded?????? or ??????dizzy?????? but he could not clarify further. he kept referring to ??????bronchitis?????? and that he worked in a plant with a lot of dust exposure. today he feels that he is not having trouble breathing. his right arm swelling is new for him. he expects his daughter to arrive soon who can explain more. past medical history: copd parkinson's htn r cataract social history: portugese speaking man, had occupational exposure to large amounts of dust- many coworkers have died of lung diseases. he lives at home and is mostly sedentary for the past 3 years. he denies alcohol or drug use. family history: noncontributory physical exam: pe: 66, 122/50, 14, 100% on fio2 1.0 intubated, sedated, anasarca chest: diff bilat crackles, no weezing cv: rrr, distant hs abd: protruding, large r sided round mass mid abdomen, large/diffuse ecchymoses ( abdomen), +bs ext: 2=3+ pitting edema+ woody edema le, no lad ecg: sinus, no ischemic changes pertinent results: admission labs: 02:45pm asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 02:45pm caltibc-303 haptoglob-191 ferritin-119 trf-233 07:30pm urine blood-lg nitrite-neg protein-tr glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.5 leuk-neg 02:45pm wbc-172.6* rbc-2.49* hgb-7.2* hct-21.6* mcv-87 mch-28.7 mchc-33.1 rdw-14.4 02:45pm neuts-10* bands-1 lymphs-86* monos-2 eos-0 basos-0 atyps-1* metas-0 myelos-0 other-0 02:45pm hypochrom-1+ anisocyt-occasional poikilocy-occasional macrocyt-normal microcyt-normal polychrom-occasional spherocyt-occasional ovalocyt-occasional 02:45pm plt smr-normal plt count-171 02:45pm ret aut-4.2* cta of chest: 1) no pulmonary embolism. 2) bilateral pleural effusions with atelectasis of the right upper and both lower lobes. mediastinal and left hilar lymphadenopathy. 3) splenomegaly, with small amount of adjacent free fluid. echo : the left atrium is mildly dilated. left ventricular wall thickness, cavity size, and systolic function are normal (lvef>55%). regional left ventricular wall motion is normal. right ventricular chamber size is mildly dilated with mild free wall hypokinesis. the ascending aorta is mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are structurally normal. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is a small circumferential pericardial effusion without evidence of hemodynamic compromise. impression: preserved global and regional biventricular systolic function. pulmonary artery systolic hypertension. mild right ventricular cavity enlargement with free wall hypokinesis. small circumferential pericardial effusion without hemodynamic compromise. based on aha endocarditis prophylaxis recommendations, the echo findings indicate a low risk (prophylaxis not recommended). clinical decisions regarding the need for prophylaxis should be based on clinical and echocardiographic data. : abdominal/pelvis ct: 1. no evidence of lymphoma recurrence within the abdomen and pelvis. 2. enlarged lymph, in the part of cardiac region, large bilateral pleural effusions, right greater than left with compressive atelectasis again seen. these are unchanged from prior cta obtained . 3. 11.3 x 5.1 cm rectus sheath hematoma. 4. splenomegaly. 5. bilateral inguinal hernias. ecg: atrial fibrillation multifocal atrial rhythm since previous tracing of , irregular supraventricular rhythm seen cytology pleural fluid pending cxr : compared with there is considerable interval clearing of the pulmonary edema and the pulmonary vascular engorgement. residual right pleural effusion is seen causing haziness at the right base. the lungs are better aerated. flow cytometry on peripheral blood: the following tests (antibodies) were performed: hla-dr, fmc-7, kappa, lambda, and cd antigens 3, 5, 10, 19, 20, 23, 45. results: three-color gating is performed (light scatter vs. cd45) to optimize lymphocyte yield. abnormal/lymphoma cells comprise 90% of total gated events. b-cells demonstrate a monoclonal kappa light chain restricted population. they co-express pan-b cell markers cd19, 20 (bright) along with cd 23 and fmc7. they do not express any other characteristic antigens including cd10 or cd5. t-cells express mature lineage antigens. interpretation immunophenotypic findings consistent with involvement by: a kappa-restricted b-cell lymphoproliferative disorder. cytogenetics (pending). brief hospital course: 82 year old man with cll, copd, htn admitted s/p fall 3 days prior to admission 1) pulmonary: pt arrived from osh intubated for tachypnea ?lung collapse and airway protection per ed physician who evaluated pt at . pt has been fluid overloaded with anasarca and right pleural effusion. thoracentesis done around 2pm which showed a transudative process consistent with chf. after diuresis and thoracentesis, patient's respiratory status much improved. 2) id: s/p 10days of ceftriaxone/azithro/clinda for pneumonia. started on keflex for possible right wound infection, although superficial wound culture was negative. pt still occasionally spikes fevers but blood, urine and pleural fluid cultures have been negative. we feel that his intermittent fevers are due to his leukemia. 3) onc: pt has chronic lymphocytic leukemia with extremely elevated white blood count. pt was temporarily started on allopurinol for possible tumor lysis, but this was discontinued. the patient is noted to have an enlarged spleen. heme onc was consulted, but they felt no acute interventions were indicated. abd/pelvis ct was performed for staging. will f/u with dr. as outpt on . 4) cardiovascular: a) rhythm: intermittently tachycardic, ep curbside suggested resolving systemic issues. we considered adding beta-blockade although there is some quetion of whether he also is in wenckebach although official ekg read as afib w/ multifocal atrial rhythm. b) pump: echo shows normal ef, decreased e/a ratio == dialstolic heart failure, pulmonary hypertension. pulm effusions may in part be due to chf. 5) neuro: history of parkinsons disease, continue cinemet. 6) f/e/n: continue cardiac/salt-restricted diet. creatinine is 1-1.1 at baseline. we restarted home dose of lasix 40mg for am but increased it to 60mg qd. this should be decreased as an outpatient. please keep him in/out even, increase lasix as needed. 7) ppx: pneumoboots, heparin sc. medications on admission: laix 40 protonix carbidopa 25' iron 325 naprosyn 375 alprazolam 0.5 tid celexa 20 lisinopril 20 terazosin 5' advair discharge medications: 1. heparin sodium (porcine) 5,000 unit/ml solution sig: 5000 (5000) units injection tid (3 times a day). 2. carbidopa-levodopa 25-100 mg tablet sig: one (1) tablet po tid (3 times a day). 3. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q4h (every 4 hours) as needed. 4. ferrous gluconate 300 mg tablet sig: one (1) tablet po bid (2 times a day). 5. citalopram hydrobromide 20 mg tablet sig: one (1) tablet po daily (daily). 6. alprazolam 0.25 mg tablet sig: two (2) tablet po tid (3 times a day). 7. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours). 8. senna 8.6 mg tablet sig: two (2) tablet po hs (at bedtime). 9. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 10. docusate sodium 100 mg capsule sig: one (1) capsule po twice a day. 11. neomycin-bacitracin-polymyxin ointment sig: one (1) appl topical tid (3 times a day) for 5 days: to right arm abrasion. 12. albuterol sulfate 0.083 % solution sig: one (1) neb inhalation q6h (every 6 hours). 13. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours). 14. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 15. cephalexin 500 mg capsule sig: one (1) capsule po q6h (every 6 hours) for 7 days: day 1=. 16. furosemide 20 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 17. insulin regular human 100 unit/ml solution sig: asdir injection asdir (as directed): sliding scale. discharge disposition: extended care facility: nursing & rehabilitation center - discharge diagnosis: chronic lymphocytic leukemia congestive heart failure pleural effusion discharge condition: stable. discharge instructions: please seek medical attention for fevers>101.4, for chest pain, or for anything else medically concerning. please take your medications as directed. followup instructions: 1) please see your pcp 1-2 weeks following discharge from rehab. (daughter has information on new pcp. 2) provider: , md where: hematology/bmt phone: date/time: 12:00 md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours thoracentesis transfusion of packed cells diagnoses: pneumonia, organism unspecified hyperpotassemia anemia, unspecified unspecified pleural effusion congestive heart failure, unspecified unspecified essential hypertension hyposmolality and/or hyponatremia chronic airway obstruction, not elsewhere classified acute on chronic diastolic heart failure paralysis agitans acute respiratory failure cellulitis and abscess of upper arm and forearm chronic lymphoid leukemia, without mention of having achieved remission 

Answer: The patient is high likely exposed to