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: penicillins / tetracycline / sulfa (sulfonamide antibiotics) / bee pollen / gadolinium-containing agents attending: chief complaint: transferred for evaluation of fevers, chills, and lymphadenopathy, and hepatosplenomegaly major surgical or invasive procedure: cycle 1 -dexamethasone history of present illness: 33 year old man with 3-4 months of chills, fevers, and drenching night sweats. his symptoms started shortly after he quit drinking and abusing narcotics, about 3 months ago, and he initially attributed the chills and fevers to withdrawal. however, the nightsweats have continued. he has also noticed an abdominal mass, more prominent on the left side, which is diffusely painful and which prevents him from taking a deep breath if he lies down. . on arrival to hosp (), he was febrile to 102.3, pancytopenic with wbc 3.2, 17 bands, hgb 7.7, as well as an ldh of 700. he was transfused and a thoracentesis was performed for pleural effusion (500 cc drained) and then spleen biopsy was performed to evaluate his pancytopenia and lymphadenopathy. he was then transferred to for further evaluation and management of suspected lymphoproliferative disorder. . in our ed, vital signs were t103 p103 bp114/71 r20 sat95% ra. . review of systems: (+) 13 lb weight gain in the last 2 months. (-) denied headache, sinus tenderness, rhinorrhea or congestion. denied cough, shortness of breath. denied chest pain or tightness, palpitations. denied nausea, vomiting, diarrhea, constipation or abdominal pain. denied recent change in bowel or bladder habits. denied dysuria. denied arthralgias or myalgias. denied pruritus. past medical history: - h/o mrsa cellulitis of the right lower extremity - eczema - h/o depression - pyloric sphincterotomy as an infant social history: incarcerated from to of this year, previously worked in construction, smoked one pack of cigarettes daily prior to going into prison, endorses h/o marijuana use and also reports that he has had problems with opioid addiction, using over 80mg of oxycontin several times a day, ending 2 years ago. he was treated with suboxone for several months, but prior to this hospitalization, he had not taken any narcotics in the last 2.5 months. denies iv drug use. family history: mother with diabetes. no family history of cancer in first degree relatives. physical exam: t 99.3 bp140/80 hr99 rr22 96% ra general - resting comfortably in bed, no acute distress heent - sclera anicteric, mmm, oropharynx clear neck - supple, jvp not elevated, no lad pulm - cta bilaterally; no wheezes, rales, or rhonchi cv - tachy, normal s1/s2; no murmurs, rubs, or gallops abdomen - well-healed midline epigastric surgical scar. normoactive bowel sounds; firm, mildly tender mass in the luq extending along the left flank and to the pelvis, non-distended. ext - small, appropriately tender incision in the right axilla. warm, well perfused, radial and dp pulses 2+; no clubbing, cyanosis or edema neuro - cn ii-xii intact in detail, full strength throughout. pertinent results: 12:10pm pt-15.1* ptt-30.6 inr(pt)-1.3* plt smr-low plt count-118* hypochrom-2+ anisocyt-3+ poikilocy-2+ macrocyt-1+ microcyt-2+ polychrom-occasional ovalocyt-1+ schistocy-1+ burr-1+ stippled-occasional teardrop-2+ bite-occasional neuts-40* bands-9* lymphs-42 monos-2 eos-0 basos-1 atyps-0 metas-1* myelos-4* plasma-1* wbc-3.7* rbc-3.66* hgb-9.3* hct-29.0* mcv-79* mch-25.5* mchc-32.2 rdw-19.8* 12:10pm lipase-30 alt(sgpt)-118* ast(sgot)-103* ld(ldh)-702* tot bili-0.7 12:10pm glucose-109* urea n-18 creat-0.8 sodium-139 potassium-3.9 chloride-103 total co2-25 anion gap-15 12:36pm lactate-1.3 02:15pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-tr bilirubin-sm urobilngn-1 ph-5.0 leuk-neg color-yellow appear-clear sp -1.029 03:01pm bone marrow ipt-d cd23-d cd45-d hla-dr 7-d kappa-d cd2-d cd7-d cd10-d cd19-d cd20-d lambda-d cd5-d 09:00pm calcium-8.4 phosphate-3.4 magnesium-2.0 uric acid-5.1 ld(ldh)-580* glucose-89 urea n-16 creat-0.7 sodium-136 potassium-4.5 chloride-102 total co2-26 anion gap-13 diagnostics and imaging: bone marrow cytogenetics : non-specific t cell dominant lymphoid profile; diagnostic immunophenotypic features of involvement by a non-hodgkin lymphoma are not seen in specimen. correlation with clinical findings and morphology (s09-) is recommended. flow cytometry immunophenotyping may not detect all lymphomas as due to topography, sampling or artifacts of sample preparation. tte : the left atrium is normal in size. left ventricular wall thickness, cavity size and regional/global systolic function are normal. quantitative (3d) lvef = 63%. transmitral and tissue doppler imaging suggests normal diastolic function, and a normal left ventricular filling pressure (pcwp<12mmhg). right ventricular chamber size and free wall motion are normal. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. there is no pericardial effusion. impression: normal global and regional biventricular systolic function. ct torso : several enlarged lymph nodes within the axilla, mediastinum, and abdomen. the largest of these are located within the axilla. there is massive splenomegaly. additionally, there are numerous small liver lesions as described above. overall, these findings are consistent with lymphoma. bm immunophenotyping : results: three color gating is performed (light scatter vs. cd45) to optimize lymphocyte yield. b cells comprise 9% of lymphoid-gated events, are polyclonal, and do not express aberrant antigens. t cells comprise 68% of lymphoid gated events, express mature lineage antigens. interpretation non-specific t cell dominant lymphoid profile; diagnostic immunophenotypic features of involvement by a non-hodgkin lymphoma are not seen in specimen. correlation with clinical findings and morphology (see s09-; ) is recommended. flow cytometry immunophenotyping may not detect all lymphomas due to topography, sampling or artifacts of sample preparation. pathology: specimen #1: right axillary lymph node, excisional biopsy (slides labeled s09-1787 from , , ma; from procedure date ) diagnosis: hodgkin lymphoma, nodular lymphocyte predominant type, see note. note: h&e sections show nodal tissue with a vaguely nodular infiltrate and abundant sclerosis. the infiltrate consists of a background of small lymphocytes, plasma cells, and histiocytes harboring many large atypical cells with abundant vesicular chromatin, multiple nuclear lobulations, multiple nucleoli, and scant pale cytoplasm (l&h or popcorn cells). by immunohistochemistry performed at , cd45 is panreactive. cd20 stains the expanded follicles and highlights l&h cells, as well as remaining germinal center and interfollicular b cells. cd15 and cd30 are largely negative within the infiltrate, with positive internal controls. both and bob1 are expressed by the l&h cells. cd21 highlights few expanded follicular dendritic cell meshworks. cd3, cd4, cd5, and cd8 all highlight background expanded t lymphocytes. lmp-1 stain highlights rare positive cell. mib-1 highlights germinal centers - where the proliferation fraction is high - as well as scattered large cells within the expanded b cell nodules. specimen #2: spleen, needle biopsy (slides labeled s09-1874 from , , ma) diagnosis: splenic parenchyma with multiple granulomas. definitive morphologic or immunophenotypic evidence of lymphocyte predominant hodgkin lymphoma is not seen. note: h&e sections show several small cores of splenic tissue with multiple lymphohistiocytic aggregates, which in some areas coalesce into well-formed granulomas with occasional giant cells. there are scattered large atypical cells in a background of lymphocytes, plasma cells, and histiocytes. however, l&h cells are not identified. special stains for acid fast bacteria and fungus (afb, pas, gms, giemsa) are all negative for microorganisms with adequate controls. of note, splenic involvement by lymphocyte predominant hodgkin lymphoma is infrequent and when present it is usually not a cause of splenomegaly, let alone massive splenomegaly. rarely, however, lp hl can behave clinically in a more aggressive manner with widespread dissemination to bone marrow and other sites. please correlate with other clinical, laboratory and imaging findings. micro: cryptococcal antigen (final ): cryptococcal antigen not detected. hiv-1 viral load/ultrasensitive (final ): hiv-1 rna is not detected. hcv viral load (final ): hcv-rna not detected. cmv viral load (final ): cmv dna not detected. hbv viral load (final ): hbv dna not detected. brucella igg 0.03 brucella igm 0.06 reference range: <0.80 coccidioides antibody, id negative ebv pcr: na ebv genomes/10(5) lymphocytes remarks: expected results: ----------------- using a modified protocol, the copy number of ebv genomes in latently infected adults has been estimated to be 0.1 copies/10(5) lymphocytes. therefore, latency falls below the sensitivity of this assay. the expected result for a normal healthy adult with latent ebv infection is "not detected" (nd). note: failure to amplify is reported as "not amplifiable" (na) and differs from "not detected". histoplasma quantitative antigen eia result: none detected ng/ml(-) brief hospital course: 33m with a history of narcotic abuse who presented w 3 months of fevers, nightsweats, lad and splenomegaly found to be pancytopenic upon presentation and subsequently diagnosed with hodgkins lymphoma. . # nodular lymphocyte predominant hodgkins lymphoma. review of path from osh axillary ln biopsy was consisitent with nodular lp hl. bone marrow biospy was not consistent with bone marrow involvement. the patient was placed on steroids and then received one cycle of -dexa. he tolerated this regimen without significant complication although he became quite uncomfortable once steroids were stopped. as a result, he was placed on a steroid taper which he was instructed to continue to taper at his time of discharge. his nightsweats had largely resolved and he was afebrile for >48 hours at the time of discharge. . # hepatosplenomegaly. patient had a splenic biospy at the osh which was reviewed by pathology and found to contain granulomas which were concerning for infectious vs lymphoma-related process. infectious disease was consulted and recommended several viral pcrs as well as serologies be sent. these results were all negative for a particular etiology and are contained in the results section of this document. given concern for non-specific infectious process status-post chemotherapy, the patient was started empirically on fluconazole and levofloxacin. he developed worsening lft abnormalities as well as hyperbilirubinemia which improved when fluconazole was stopped. he was discharged on levofloxacin and asked to continue taking it until further discussion with his outpatient oncologist. the patient's lfts remained elevated throughout his hospitalization but were trending toward normal at his time of discharge. this was also thought to be related to infectious vs lymphoma-related process but was not entirely clear at his time of discharge and was to be closely followed up on as an outpatient. . # fevers. the patient had daily fevers until after completion of chemotherapy during which time he defervesced until his time of discharge. he was asked to return should he become febrile again at home. given his defervescence after chemotherapy in the setting of multiple negative cultures, it was felt that his initialy fevers were related to his lymphoma. . # pain. given patient's history of narcotic abuse, care was taken to limit narcotic medications. the patient clearly had significant pain related to his abdominal distention from his spleen which required low dose morphine sr with ir for breakthrough pain. he was discharged with a limited script for these medications with a plan for down-titration with resolution of his hsm in the setting of lymphoma treatment. . on , the patient was afebrile and otherwise hemodynamically stable with a plan for close follow up in place. he was therefore discharged to home. medications on admission: klonipin 1mg tid. discharge medications: 1. clonazepam 1 mg tablet sig: one (1) tablet po tid (3 times a day) for 2 weeks. disp:*42 tablet(s)* refills:*0* 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours). disp:*30 tablet(s)* refills:*0* 5. prednisone 5 mg tablet sig: asdir tablet po once a day for 5 days: take 4 pills (20mg) on . take 2 pills (10mg) on and . take 1 pill (5mg) on and . . disp:*10 tablet(s)* refills:*0* 6. morphine 30 mg tablet sustained release sig: one (1) tablet sustained release po q12h (every 12 hours) for 2 weeks. disp:*28 tablet sustained release(s)* refills:*0* 7. simethicone 80 mg tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day) as needed. 8. morphine 15 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for 3 weeks. disp:*25 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary: lymphocyte predominant hodgkin lymphoma with massive hepatosplenomegaly secondary: history of narcotic abuse discharge condition: hemodynamically stable with normal vitals and plan for follow up in place. discharge instructions: you were admitted to the hospital for diagnosis and further management of your fever, nightsweats, and abdominal swelling. you were found to have lymphocyte-predominant hodgkin lymphoma causing expansion of your liver and spleen. a bone marrow biopsy showed that your bone marrow was not involved. you had 1 cycle of chemotherapy targeted toward your type of lymphoma. you will need to have 5 more cycles of treatment. these treatments last a couple of hours and can be done as an outpatient. each treatment is 3 weeks from the prior. you will however need more frequent monitoring of your blood counts and liver function. medication changes: you should take levofloxacin (an antibiotic) daily to prophylax against infection. you should take morphine sustained release twice per day to prevent pain. you may take morphine immediate release for breakthrough pain not adequately controlled by the sustained release medication. you should complete a steroid taper as outlined in the prescription provided for you. you should take protonix while on steroids to protect your stomach. you should take a stool softener while taking narcotic medications to prevent constipation. please call your primary doctor or dr. or go to the ed should you experience fevers >100.4, cough, nightsweats, chest pain, shortness of breath, worsening abdominal pain, pain with urination, changes to your bowels, or any other concerning symptoms. because your spleen is so enlarged, you are at increased risk for splenic rupture. you should not engage in any heavy labor or sports. followup instructions: please follow up at the following appointments: building 11:30 , rnc building () 1:00pm (this appointment is for blood work) , md building () 1:00 procedure: venous catheterization, not elsewhere classified thoracentesis biopsy of bone marrow biopsy of bone marrow closed [percutaneous] [needle] biopsy of kidney excision or destruction of peritoneal tissue total splenectomy transfusion of packed cells transfusion of packed cells injection or infusion of cancer chemotherapeutic substance transfusion of platelets open biopsy of liver diagnoses: pneumonia, organism unspecified hyperpotassemia hyperpotassemia thrombocytopenia, unspecified other chronic pain abdominal pain, unspecified site acute kidney failure with lesion of tubular necrosis unspecified pleural effusion hyposmolality and/or hyponatremia dysthymic disorder other specified cardiac dysrhythmias paralytic ileus dermatitis due to drugs and medicines taken internally other acute pain migraine, unspecified, without mention of intractable migraine without mention of status migrainosus other nonspecific abnormal serum enzyme levels other chronic nonalcoholic liver disease neutropenia, unspecified cephalosporin group causing adverse effects in therapeutic use other drugs and medicinal substances causing adverse effects in therapeutic use nonspecific elevation of levels of transaminase or lactic acid dehydrogenase [ldh] combinations of opioid type drug with any other drug dependence, unspecified edema contact dermatitis and other eczema, unspecified cause fever presenting with conditions classified elsewhere fever presenting with conditions classified elsewhere hodgkin's disease, lymphocytic-histiocytic predominance, lymph nodes of multiple sites 

Answer: The patient is high likely exposed to