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: malaise, fever major surgical or invasive procedure: r inguinal ln biopsy bone marrow biopsy history of present illness: 63 y/o female with asthma presents with 4 days of malaise, weakness, fever, chills, mild headache, sinus congestion, nausea without vomiting, right shoulder soreness, anorexia, and one day of dry cough. she has had some wheezing with mild shortness of breath over the last four days, having to use her inhaler twice daily for the last week. she did not have her flu shot this year. her brother, who lives with her at home, was recently ill with a cold. she denies sore throat, dysuria, diarrhea, myalgias, or severe headache. . ems recorded t to 103.8, hr 112, and bp 104/60. in the ed, tmax of 102.7 hr 120 bp 131/76. she was hypotensive to 92/54, but fluid responsive. a right sc central line was placed with cvp 15 and svo2 93%. she was given 2 l ns and she was treated empirically for a respiratory tract infection with vancomycin, levofloxacin, and ceftazadime. past medical history: asthma gerd s/p cholecystectomy social history: lives with her brother and two sons in . never a smoker. never drank alcohol. no drug use. originally from . husband in (where she used to live). family history: mother with kidney and heart disease. grandmother with tuberculosis (no exposure) and aunt with cancer. physical exam: gen: tired but generally well appearing and pleasant african american female in no distress. vitals: t 98.5 hr 105 bp 112/63 rr 16 sat 100% 2l nc heent: no sinus tenderness, sclera anicteric, dry mucous membranes. neck: supple, no jvp elevation. mild anterior cervical lad. chest: lungs with crackles at the bases bilaterally, but no rhonchi or areas of consolidation. heart: regular, tachy, no murmurs. abd: soft, nt, nd, no masses. ext: no edema. good pulses. neuro: normal cranial nerves and muscle strength. pertinent results: admit labs: ----------- 04:25pm wbc-11.0 rbc-3.17* hgb-10.5* hct-30.6* mcv-97 mch-33.0* mchc-34.2 rdw-16.1* 04:25pm neuts-58 bands-5 lymphs-31 monos-4 eos-2 basos-0 atyps-0 metas-0 myelos-0 04:25pm haptoglob-201* 04:25pm albumin-3.2* calcium-8.7 phosphate-2.3* magnesium-1.7 04:25pm alt(sgpt)-69* ast(sgot)-73* ld(ldh)-189 alk phos-65 tot bili-1.2 04:25pm glucose-143* urea n-15 creat-1.0 sodium-131* potassium-4.2 chloride-99 total co2-24 anion gap-12 05:02pm lactate-1.5 06:15pm urine color-amber appear-clear sp -1.022 06:15pm urine blood-sm nitrite-neg protein-100 glucose-neg ketone-neg bilirubin-sm urobilngn-8* ph-5.0 leuk-neg 10:49pm wbc-8.0 rbc-2.52* hgb-8.4* hct-24.7* mcv-98 mch-33.4* mchc-34.1 rdw-16.4* 08:30pm wbc-8.7 rbc-2.51* hgb-8.5* hct-24.3* mcv-97 mch-33.9* mchc-35.0 rdw-16.1* 08:30pm neuts-62 bands-0 lymphs-23 monos-11 eos-2 basos-2 atyps-0 metas-0 myelos-0 10:49pm glucose-145* urea n-14 creat-0.9 sodium-135 potassium-3.9 chloride-107 total co2-23 anion gap-9 10:49pm alt(sgpt)-52* ast(sgot)-49* ld(ldh)-129 alk phos-50 tot bili-1.2 brief hospital course: 63 y/o female presented with fevers, cough, bandemia, fluid responsive hypotension, hyponatremia, and thrombocytopenia. pt was initially admitted to the micu for management of hypotension. review of osh records shws that pt has had persistent fevers of unknown origin for 8 months, and diffuse lymphadenopathy. . 1. castleman's syndrome: see below. diagnosis by lymph node biopsy. hiv ab negative heme/onc in discussion with patient deferred inpatient treatment given rapid clinical improvement. has follow up with heme/onc for decision on treatement . 2. fever with bandemia/aspiration pneumonia: bandemia resolved after first hospital day. blood cultures ngtd. sputum culture ngtd, with afb negative x3. urine culture ngtd. initially treated empirically for pna with levo/tamiflu. influenza a and b negative so tamiflu d/ced. pt subsequently developed increasing fevers with rul opacity after intubation for inguinal ln biopsy. abx changed to vanc and zosyn and patient defervesced. id has recommended an extensive workup with serum assays, some of which are still pending at discharge. repeat cxr did not show clear evidence of infiltrate. serum ebv showed igg positive and titer of 400. treated with 7 days of vanc/zosyn for aspiration pneumonia, defervesced, clinically much improved by discharge. toxo, ebv, cmv all igg positive, igm negative. - 3. pancytopenia: posible etiologies include lymphoma with marrow suppression, infection with marrow suppression and itp. pt had ln biopsy and bmbx to further evaluate. heme/onc and id are follwed throughout. pt required multiple plt transfusions due to continued oozing from central line site and bmbx site. because of the need for multiple plt transfusions, she had hla typing. results showed: a34, a68, b35, b58, cw4, and cw7. a68 is highly reactive with a2 and in future plt transfusions a2 donor plts should be avoided. no schistocytes on peripheral smear and hemolysis labs negative. stool for occult blood negative. anemia likely secondary to marrow supression. also had continuous oozing form central line site, significant hematuria, and significant blood loss from bmbx site. transfused two units for crit of 20 on . appropriate bump to 28. all cell lines stabilized for rest of hospitalization, trouble with platelet clumping throughout. hematology reviewed smeasrs multiple times. be related to castleman's or have been from critical illness/infection. platelets 180,000 by discharge. . 4 lymphadenopathy: pt has ct thorax with diffuse lad with broad infectious ddx vs. possibility of lymphoma. lymph node biopsy came back positive for multicentric castleman's disease. hiv ab negative, vl pending at time of discahrge. will follow up with heme/onc. . #. hypotension: fluid responsive and resolved since first day of admission. most likely etiology is decreased po intake with an element of sepsis. . #. hyponatremia: resolved with ns, likely hypovolemic hyponatremia. . # hypoxic respiratory failure: the patient required intubation during bone marrow biopsy. was slightly difficult to wean her off the ventilator due to hypoxia. after extubation, patient was quickly weaned off oxygen and had high o2 sats on room air. she did have a persistent cough and sore throat. also continued on ppi for gerd and albuterol for asthma history. medications on admission: albuterol flonase discharge medications: 1. fluticasone 50 mcg/actuation spray, suspension sig: one (1) spray nasal daily (daily). 2. albuterol 90 mcg/actuation aerosol sig: 3-6 puffs inhalation q4h (every 4 hours). 3. loratadine 10 mg tablet sig: one (1) tablet po once a day as needed for allergy symptoms. 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). discharge disposition: home with service facility: vna discharge diagnosis: 1. castleman's disease 2. fever 3. lymphadenopathy 4. aspiration pneumonia 5. pancytopenia secondary: 1. gerd 2. asthma discharge condition: stable, afebrile x days, ambulatory, good po intake. discharge instructions: take all mediations as prescribed. we have made no changes to your medications. follow up as below. you have been diagnosed with a serious hematologic/oncologic disease called "castleman's syndrome" and as we discussed you absolutely need to follow up with the hematology/oncology doctors. you were also treated for a pneumonia. you have completed your course of antibiotics. if you develop fevers, chills, cough, shortness of breath, chest pain or any other new concerning symptoms, contact your doctor or go to the emergency room. followup instructions: follow up with the hematology/oncology team. you will follow up with dr. . his office will call you with your appointment. his number is . follow up with your primary care doctor. call him at to schedule a follow up appointment within the next week or two. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube biopsy of bone marrow biopsy of lymphatic structure diagnoses: thrombocytopenia, unspecified esophageal reflux hyposmolality and/or hyponatremia asthma, unspecified type, unspecified hemorrhage complicating a procedure acute respiratory failure hypotension, unspecified pneumonitis due to inhalation of food or vomitus enlargement of lymph nodes 

Answer: The patient is high likely exposed to