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 74 year old male with a history of cll diagnosed five years ago, status post fludarabine times one year complicated by aiha, then switched to chlorambucil plus prednisone with the former discontinued secondary to decreasing platelets in . the patient presented to emergency room on wednesday with complaints of nausea and vomiting times one and diarrhea times three. no blood noted in emesis or stool. the patient reported bleeding from pimple on forehead, otherwise not noted to have any overt bleeding sources. at his hematocrit was 24, platelets . coags were normal. d-dimer positive. last cbc taken at that hospital on , revealed hematocrit of 31 and platelets of 101,000. in the emergency room he was given intravenous fluids, solu-medrol 200 mg iv, suspecting itp versus leukemic transformation and levofloxacin. he was transferred to emergency room via ambulance for further management. in e.r. the patient was seen by the bone marrow transplant service. peripheral blood smear revealed a single, normal appearing platelet without clumps or schistocytes. in the emergency room he had bright red blood per rectum times two and significant hematuria complicated by clot retention and difficult foley placement necessitating urology consult. a 14 french coude was placed. repeat labs confirmed hematocrit of 24 and platelets of . he was given one unit of packed red blood cells and a six pack of platelets as well as ivig for presumed itp and transferred to the fennard icu. the patient was hemodynamically stable throughout the e.r. course. past medical history: cll. primary oncologist in is dr. . bph status post turp. hypercholesterolemia. medications on admission: prednisone 4 mg p.o. q.d., acyclovir 400 mg p.o. b.i.d., lipitor, aspirin, hytrin, protonix 40 mg p.o. q.d., folate 3 mg p.o. q.d., bactrim double strength one tab b.i.d. monday, wednesday, friday. allergies: no known drug allergies. social history: lives with wife on . retired college administrator and . no children. prior smoker 20 pack years, quit 20 years ago. rare alcohol use. family history: no oncologic family history. physical examination: on admission temperature 98.6, t-max 99.1, heart rate 104, blood pressure 143/67, 100 percent on 2 liters. in general, he was a very pleasant man in no apparent distress. heent perrl, sclerae anicteric, moist mucous membranes, no mucosal bleeding or petechiae. neck no lad, no jvd, no thyromegaly, no masses. lungs clear to auscultation bilaterally. cv regular rate and rhythm, normal s1, s2, no murmurs, rubs or gallops appreciated. abdomen soft, significantly distended, patient claimed baseline, moderately tympanitic, nontender, no hepatomegaly, hyperactive bowel sounds. extremities trace pitting edema, warm, 1 plus distal pulses. skin petechiae on upper and lower extremities and abdomen. ekg normal sinus rhythm, normal axis, first degree av block, 3 with q wave and inverted t wave. chest x-ray from , ap and lateral, appeared within normal limits, no infiltrates, cardiomegaly or lymphadenopathy. labs on admission white count 10.8, hematocrit 23.7, platelets less than 5, mcv 103. inr 1.2. creatinine 1.4. lfts were within normal limits. amylase and lipase were normal. d-dimer elevated at 10, fibrinogen 280. assessment: the patient is a 74 year old male with a history of cll presenting with severe thrombocytopenia and bleeding. hospital course: thrombocytopenia. initially the patient was transferred to the icu where he remained until when he was transferred to the bone marrow unit. early differential diagnosis for thrombocytopenia included medication or chemo effect, itp, ttp, hus, sequestration or viral infection. the patient was initially given ivig 1 gm per kg and was maintained on solu-medrol 200 mg q.d. he was given a four day course of decadron 40 mg q.d. the patient had a bone marrow biopsy which showed the presence of sparse megakaryocytes which looked normal, but low in number. the patient was treated with rituxan and also with vincristine. ct scan showed a normal sized spleen with a small infarct. the patient was seen in consultation by surgery for the possibility of splenectomy, but at the time of dictation splenectomy is low on the list of possibilities, given the lack of response to ivig, steroids and the surgical risks, given his platelet count. at the time of dictation the patient's platelet count has slightly improved. it is running between 50 and 85 and he requires one to two bags of platelets per day, which is improved compared with the three bags of platelets he was requiring at the beginning of his hospitalization. anemia. the patient was initially transfused with a goal hematocrit of 25. he initially had bright red blood per rectum and maroon stools. the source of the gi bleeding is unknown. at this time he has not had a colonoscopy, but once his platelet count improves and he is discharged, he should be seen by gastroenterology in followup for further workup of his gi bleeding. he also had hematuria associated with low platelet count. he was seen by urology several times in consultation, initially in the e.r. to place a foley after he developed urinary retention. for several days he had hematuria associated with his low platelet count. once the foley was changed and the counts were kept at a level above 50, the hematuria resolved and at the time of dictation he has had clear urine without red blood cells for five days. the plan will be to continue proscar for an additional three days and try to have a voiding trial and remove the foley. cll. the patient was treated with rituxan once and the plan is to continue to treat him weekly during his hospitalization. see subsequent dictation for further information regarding this issue. acute renal failure. the patient initially presented an elevated creatinine, but improved upon hydration. at the time of dictation creatinine is in the normal range between 0.8 and 1. hyperglycemia. the patient was placed on an insulin sliding scale while receiving high dose steroids. hypercholesterolemia. the patient's statin drug has been held while in the hospital. once his platelet count returns to normal, he can be restarted on this medication. further dictation of the hospital course as well as discharge status, discharge condition, discharge medications and followup will be dictated by the next intern taking over the service. dr., 12-699 procedure: biopsy of bone marrow transfusion of packed cells transfusion of platelets insertion of indwelling urinary catheter diagnoses: acute kidney failure, unspecified retention of urine, unspecified diarrhea injury to bladder and urethra, without mention of open wound into cavity hemorrhage of gastrointestinal tract, unspecified chronic lymphoid leukemia, without mention of having achieved remission cough 

Answer: The patient is high likely exposed to