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 50-year-old male with a history of mantle cell lymphoma, blastic variant, who presented on with fevers and a white blood cell count of 1.2. the patient was status post two cycles of hyper-cvad therapy with a downtrending white blood cell count from this therapy. the patient initially presented in when he noted pallor and fatigue. a laboratory workup at that time showed him to be anemic with mantle cells in his peripheral smear. a computed tomography scan showed diffuse mediastinal, axillary, retroperitoneal, and deep pelvis lymphadenopathy. in addition, the patient's spleen was markedly enlarged. in the patient a cycle of hyper-cvad chemotherapy which was complicated by febrile neutropenia. in , he part b of this first cycle of hyper-cvad chemotherapy. this was complicated by mucositis. in , he a second cycle of hyper-cvad chemotherapy. in this session, the patient was noted to develop atrial fibrillation which spontaneously reverted to a sinus rhythm. the patient also part b of the second cycle of hyper-cvad in . after the second cycle of hyper-cvad therapy the patient developed a cough productive of blood/green sputum. the patient had this cough two days prior to presenting to his oncologist. the patient presented for a computed tomography scan for further workup of a nodule noted on chest x-ray. during this presentation, the patient was found to be febrile. at that time, he denied nausea, vomiting, diarrhea, and abdominal pain. his cardiac review of systems was entirely negative. the patient was admitted to the hospital for workup of his fever. past medical history: 1. atrial fibrillation. 2. coronary artery disease. 3. hypertension. 4. hypercholesterolemia. 5. gastroesophageal reflux disease. 6. attention deficit disorder. 7. tourette's syndrome. 8. history of left ventricular thrombus. 9. history of cerebrovascular accident without residual deficit. social history: the patient is married. he denies tobacco or alcohol use. family history: father had cancer and coronary artery disease. mother had a myocardial infarction at the age of 53. medications at home: 1. acyclovir 400 mg three times per day. 2. allopurinol. 3. bactrim double strength on monday, wednesday, and friday. 4. fluconazole 200 mg once per day. 5. zestril 40 mg once per day. 6. lopressor 50 mg twice per day. 7. imdur 60 mg once per day. 8. lasix 120 mg in the morning and 60 mg in the evening. 9. digoxin 0.125 mg once per day. 10. folic acid. 11. prilosec. allergies: oxacillin. physical examination on presentation: temperature was 100.5, his blood pressure was 140/82, his heart rate was 88, his respiratory rate was 16, and his oxygen saturation was 92% on room air. head, eyes, ears, nose, and throat examination revealed perioral lesions, multiple buccal lesion. the mucous membranes were moist. chest examination revealed crackles at the bases bilaterally. otherwise, clear to auscultation bilaterally. heart was regular in rate and rhythm. there was a very mild 1/6 systolic murmur heard best at the apex. the abdomen revealed a minimally enlarged spleen and nontender. the abdomen was minimally distended. there was no rebound or guarding noted on examination. there were normal active bowel sounds. extremities revealed no clubbing, cyanosis, or edema. there was no lymphadenopathy appreciated; no cervical, inguinal, or axillary. neurologically, the patient was alert and oriented times three. brief summary of hospital course: the patient was admitted to the bone marrow transplant service with a presumed diagnosis of pneumonia. sputum was sent for culture. due to the patient's renal insufficiency, a computed tomography scan was not immediately obtained. the patient was continued on his acyclovir and bactrim prophylaxis. a computed tomography scan without contrast was eventually obtained on . the impression was new development of diffuse patchy and nodular alveolar opacification. these were noted to be confluent in the right middle lobe and left lower lobe. they were indicative of an infectious process. the differential diagnosis included viral, bacterial, fungal, or pneumocystis carinii pneumonia. the patient was also noted to have significantly decreased diffuse mediastinal, axillary, and hilar lymphadenopathy from his prior examination. with these computed tomography findings, the patient was started on ambisome in addition to cefepime and vancomycin. at this time, he was saturating 94% on 2 liters, and his respiratory status continued to decline over the following two days. in addition, the patient's white blood cell count continued to fall; which was expected from his prior chemotherapy. further complicating the hospital course was a persistent nose bleed. the patient's hematocrit dropped from 30 to 18 on . this responded to blood transfusions. an ear/nose/throat consultation was obtained, and the nose bleed was well controlled by keeping the patient's platelets above 50 and his hematocrit above 30. both the infectious disease service and the pulmonary service were closely involved with the patient's care. the patient a bronchoscopy on . during this procedure, they performed a bronchoalveolar lavage of his right upper lobe. specimens from the lavage were negative for acid-fast bacilli. fungal isolates were negative. potassium hydroxide stain was negative. legionella culture was negative. no pneumocystis carinii were noted. in addition, multiple blood cultures obtained from the patient during fever spikes remained negative for bacteria. the sputum culture was negative for respiratory pathogens. however, the patient continued to decline with regard to his pulmonary status. on , he was transferred to the medical intensive care unit for his worsening pulmonary function and for persistent atrial fibrillation (as described below). 2. cardiovascular issues: the patient was admitted to the bone marrow transplant team and continued on his cardiac medications which included digoxin, lasix, imdur, lopressor, and zestril. the patient remained in a normal sinus rhythm and appeared to be in very mild congestive heart failure. his lungs had crackles at the bases, and his jugular venous pressure was minimally elevated. on , in the setting of receiving an albuterol nebulizer, the patient went into an irregular heart rhythm. an electrocardiogram was obtained which showed atrial fibrillation. the patient's cardiologist, who is on staff at the , was notified and a plan was obtained to control the patient's rate with intravenous metoprolol and by doubling the patient's lopressor dose to 100 mg by mouth twice per day. this transiently kept the patient under a heart rate of 100. however, he persistently had episodes of tachycardia to the 150s. his lopressor was then increased further to 100 mg three times per day, and additional intravenous metoprolol was pushed on three occasions. due to the inability of maintaining the patient's heart rate below 100, he was transferred to the medical intensive care unit with a plan to start a diltiazem drip. note: this ends my dictation. the rest of this will be dictated by the next intern. , m.d. dictated by: medquist36 procedure: other bronchoscopy closed [endoscopic] biopsy of bronchus transpleural thoracoscopy transfusion of packed cells other local excision or destruction of lesion or tissue of lung closed biopsy of skin and subcutaneous tissue diagnoses: pneumonia, organism unspecified congestive heart failure, unspecified acute kidney failure, unspecified atrial fibrillation other malignant lymphomas, unspecified site, extranodal and solid organ sites iatrogenic pneumothorax iatrogenic cerebrovascular infarction or hemorrhage benign neoplasm of skin of upper limb, including shoulder 

Answer: The patient is high likely exposed to