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: tonic-clonic seizures and left sided weakness major surgical or invasive procedure: endoscopic placement of jejunostomy tube history of present illness: 60 yo m w/ h/o cll and cns lymphoma admitted on s/p seizure x 3 at rehab. he is a patient of dr. . the patient initially presented in with an increased wbc found during a pre-op workup for a hernia repair. further workup found this to be cll and the patient was treated with a cycle of chlorambucil and prednisone finished in . the patient was doing well until when he presented with mild ataxia and memory problems. biospy of his right parietal lesion revealed a b-cell lymphoproliferative disorder with evidence of demylination though was not diagnostic of lymphoma. he underwent 2 cycles of chop/rituxan but progressed. he was thus tried on high dose mtx x 2 to 3 cycles. this was c/b arf and the onset of seizures. he continued to progress on this course of treatment and was thus tried on a course of total brain irradiation from to for a total of 6,000 cgy. an attempt was made to wean his decadron post-tx but was c/b l focal motor seizure. further imaging revealed possibly progressive dz. stereotactic brain bx c/b postop sz confirmed his dx of high-grade b cell lymphoma (cd20+ lymphoma, labs to determine if ebv-related are pending). he was d/c to , unfortunately off his lamictal. the morning of , he suffered 3 generalized tonic-clonic seizures and was brought to the er. there his medication error was recognized and his lamictal was restarted. he was admitted on for re-imaging and treatment. during this admission, the patient continued to have seizures involving his left side. however, and , he became more confused and lethargic, and have myoclonic movements of his right arm. he was then transferred to the icu for close monitoring. an eeg in the icu showed no evidence of seizure acitivity and then he was transferred back to the floor. regarding his lymphoma, a repeat head mri on has shown interval worseining of his mass. he has completed his 3rd cycle of rituxan and ara-c on . past medical history: 1. cll: dx ' when he was noted to have an elevated wbc on preop labs for a hernia repair, 1st tx in w/ chlorambucil and prednisone for ns, lymphadenopathy, and splenomegaly 2. hypercholesterolemia 3. cns lymphoma - see hx above 4. gerd pshx: 1. s/p stereotactic brain biopsy and 2. s/p ear surgery 3. s/p hernia repair in . social history: no etoh, tob, drugs. up until 1 week ago he was living alone, completely independent in a apartment. he was spending a lot of time at his home in with his girlfriend. since his sz following the brain bx (), he has been at . he worked in a brokerage firm in the past. he is divorced w/ 3 children (2 daughters in , 1 son in , co) family history: f w/ cancer (unknown primary), m w/ lung cancer (h/o tobacco) physical exam: vs t98.5 p82 bp119/68 rr20 o2sat93% heent: some crusting inside mouth, but no lesions suggestive of thrush or mucositis. neck: no cervical lymphadenopathy. cardiovascular: normal s1, s2, regular, rate, and rhythm, no murmurs, rubs or gallops. lungs: clear to auscultation (anterior exam) abdomen: hypoactive bowel sounds, soft, nontender, nondistended, no rebound, no guarding. extremities: warm, no clubbing cyanosis, or edema. erythema resolving. neuro: no longer rousable to voice or responding to commands. pertinent results: 10:00am glucose-105 urea n-15 creat-0.8 sodium-141 potassium-3.3 chloride-103 total co2-27 anion gap-14 10:00am lipase-22 10:00am calcium-9.4 phosphate-3.1 magnesium-2.0 10:00am phenytoin-16.8 10:00am wbc-16.3* rbc-4.94 hgb-14.3 hct-40.7 mcv-82 mch-28.9 mchc-35.1* rdw-14.3 10:00am neuts-25* bands-1 lymphs-35 monos-6 eos-0 basos-0 atyps-32* metas-0 myelos-1* 10:00am hypochrom-normal anisocyt-normal poikilocy-normal macrocyt-normal microcyt-normal polychrom-normal 10:00am plt count-147* 10:00am pt-13.1 ptt-21.7* inr(pt)-1.1 ------------ mr contrast gadolin 7:55 pm status post biopsy. increasing extent of enhancement of the mass lesions present at the posterior horns of the lateral ventricles and splenium of the corpus callosum, with mass effect producing a mild right to left shift. ------------ ct head w/o contrast 11:02 am again identified are numerous periventricular masses. these are slightly hyperdense on this non-contrast study. this appearance has not changed since the examination of . there is massive surrounding edema with mass effect on the ventricles and right to left mid-line shift. this has increased slightly since the prior study. there is no evidence of hemorrhage in the interval. there is a small amount of air at the biopsy site. this now demonstrates an air fluid level, which is new since the prior study. conclusion: s/p biopsy of multiple bilateral deep white matter masses. there is no evidence of hemorrhage. again identified are numerous masses with massive edema and right to left mid-line shift. there has been a slight increase in right hemispheric edema since the prior study. ------------- eeg study date of this is an abnormal portable eeg due to the presence of a slow and disorganized background rhythm in the delta frequency range with generalized bursts of delta and theta frequency slowing. these findings suggest an encephalopathy. mixed theta and delta frequency slowing was also noted to be more prominant at times over the right peri-central region. this finding suggests subcortical dysfunction in the right posterior frontal and parietal regions. no epileptiform activity was seen during the recording. note was made of ectopy on the cardiac monitor. ------------- eeg study date of this is an abnormal discontinuous 24-hour bedside telemetry. at the beginning of the record, the background rhythm appeared slow and disorganized in the 3 hz delta frequency range. there were generalized bursts of delta frequency slowing and at times the slowing appeared more prominent in the right parietal region. the findings are suggestive of encephalopathy and there may also be a subcortical region of dysfunction in the right parietal region. as the record progressed, the background rhythm did increase in frequency at times reaching the upper theta frequency range. there was a brief period of delta frequency slowing in the right parietal region that did have some sharp features. no clear epileptiform activity was seen. also, at times during the record, some higher frequency activity and slightly higher amplitude was noted over the right pareital temporal region. this suggests a subcortical dysfunction in this region and could reflect a breach rhythm. it was made on the cardiac monitor and occasional ectopy. no clear seizure activity was seen during this recording. ------------- ct head w/o contrast 4:57 pm 1. numerous masses with massive edema, minimally increased from the prior study, and consistent with a known history of cns lymphoma. 2. persistent right-to-left midline shift, not significantly changed. 3. no new intracranial hemorrhage. ------------- mr contrast gadolin 7:09 pm no significant interval change in extent and appearances of the enhancing component of the lesion involving the splenium and periatrial region of both lateral ventricles compared with the prior study of . no new lesions are identified. the examination is slightly limited by motion. brief hospital course: 60m cll, cns lymphoma diagnosed in status post multiple treatments now with progressive disease and increasing seizure frequency. 1. seizures: patient was initially admitted for seizure management and was given lorazepam as needed to terminate seizures. following rituxan and high-dose arac therapy, patient began to experience twitching of his left lower extremity, which he and his family thought were the prodromal effects of seizures. therefore, although patient was initially managed on the floor, he was then transferred to the unit for concern of status epilepticus and frequent neurological exams. following two eegs, it was determined that patient was not in fact in status, and that sedative medications should be minimized. dilantin was titrated to a serum level of 19-20, and lamictal was continued and no further seizures were noted. 2. cns lymphoma: patient was initially treated with rituxan and high-dose arac for the synergy. cerebral edema was managed with standing dexamethasone with intermittent increases as needed. however, despite treatment and lack of change on repeat mri, patient's mental status began to worsen. although patient was initially able to respond verbally with full-length sentences, at the time of discharge, patient was completely unable to respond to verbal stimuli and was only able to respond to noxious stimuli. since there was no gross change on repeat mri, it was thought that patient's disease continued to progress on a microscopic level that was not visualized by mri. further chemotherapy was felt to be futile. therefore, near the end of the hospital course, a family meeting was held and it was decided that patient would be taken to his home in for hospice care. in preparation, patient underwent endoscopic placement of a jejunostomy tube for continued po medications (especially anti-epileptics). at the time of discharge, patient's prognosis was poor given the progression of his disease despite chemo/biological therapy, and it was felt that patient would benefit from hospice care. patient was taken home to with hospice nursing care. patient's family was instructed to contact the hospital if they needed further assistance with management of palliative medications. medications on admission: protonix 40 p qd colace 100 mg po bid zoloft 25mg po qd dexamethasome 4mg iv q6h lamictal 150mg po bid dilantin 200mg po bid tylenol prn clotrimazole troche folate 1mg po qd nystatin discharge medications: 1. lamictal 150 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* 2. phenytoin 100 mg/4 ml suspension sig: twelve (12) ml po twice a day. disp:*400 ml* refills:*2* 3. bisacodyl 10 mg suppository sig: one (1) tab rectal once a day as needed for constipation. disp:*30 tablets* refills:*2* 4. colace 150 mg/15 ml liquid sig: ten (10) ml po twice a day as needed for constipation. disp:*600 ml* refills:*2* 5. ativan 0.5 mg tablet sig: 1-2 tablets po at bedtime as needed for insomnia: and as needed for agitation. disp:*90 tablet(s)* refills:*2* 6. azithromycin 100 mg/5 ml suspension for reconstitution sig: fifteen (15) ml po once a day for 4 days. disp:*60 ml* refills:*0* 7. zyprexa zydis 20 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po at bedtime as needed for insomnia. disp:*30 tablet, rapid dissolve(s)* refills:*2* 8. dexamethasone 1 mg/ml drops sig: six (6) ml po 9am, 11am, 1pm: and four (4) ml at 3pm. disp:*700 ml* refills:*2* 9. lansoprazole 30 mg susp,delayed release for recon sig: thirty (30) mg po once a day. disp:*1000 mg* refills:*2* 10. acetaminophen 325 mg suppository sig: 1-2 tabs rectal every 4-6 hours as needed for fever or pain. disp:*300 tabs* refills:*2* 11. morphine sulfate 10 mg/5 ml solution sig: ml po every 4-6 hours as needed for pain. disp:*500 ml* refills:*2* 12. metoprolol tartrate 25 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* 13. lactulose 10 g/15 ml syrup sig: thirty (30) ml po three times a day as needed for constipation. disp:*1000 ml* refills:*2* 14. bactrim 400-80 mg tablet sig: one (1) tablet po every monday wednesday friday. disp:*60 tablet(s)* refills:*2* discharge disposition: home with service facility: androscoggin home care discharge diagnosis: central nervous system lymphoma seizure disorder chronic lymphocytic leukemia cellulitis urinary tract infection discharge condition: fair discharge instructions: 1) continue taking the following medications: - dilantin (phenytoin) oral suspension 300mg twice a day - lamictal 150mg twice a day - azithromycin 250mg once a day for four days - bactrim ss 1 tab monday, wednesday, friday - metoprolol 25mg twice a day - ativan 1mg at bedtime, and 0.5mg as needed for agitation - zyprexa zydis 20mg at bedtime - prevacid (lansoprazole) 30mg once a day - morphine oral suspension as needed for pain - dexamethasone 6ml at 9am, 11am, 1pm, then 4ml at 3pm. - bisacodyl suppository for constipation - docusate twice a day for constipation - lactulose 30ml as needed for constipation - acetaminophen 1-2 tablets every 4-6 hours for fever or pain 2) call your doctor if you need help with any of these medications. 3) no invasive procedures, do not resuscitate, do not intubate. followup instructions: none procedure: percutaneous [endoscopic] gastrostomy [peg] injection or infusion of cancer chemotherapeutic substance injection or infusion of biological response modifier [brm] as an antineoplastic agent diagnoses: thrombocytopenia, unspecified other convulsions candidiasis of mouth other malignant lymphomas, unspecified site, extranodal and solid organ sites other encephalopathy other specified hemiplegia and hemiparesis affecting unspecified side chronic lymphoid leukemia, without mention of having achieved remission cellulitis and abscess of hand, except fingers and thumb cheyne-stokes respiration 

Answer: The patient is high likely exposed to