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: no known allergies / adverse drug reactions attending: chief complaint: leg swelling major surgical or invasive procedure: ivc filter placement history of present illness: . history was obtained via interpreter and medical reports. . hpi: this is a 69yo male with a history of itp on prednisone 80mg, htn who presents with left leg swelling and shortness of breath. the patient reports that over the past 1 week he has had worsening left leg pain and swelling. he stated it was associated with some mild shortness of breath, palpitations and fatigue. he denied any chest pain, hemoptysis or trauma to his leg. he presented to his pcp office today and vs were significant for o2 saturation of 94% on room air, heart rate 108 and blood pressure 100/74. he was also noted to have some swelling of his left leg. mr. was sent to the ed for further evaluation. . in the ed, 98.7 109 102/70 16 99%ra. he underwent leni that showed extensive dvt of the left lower extremity that involved the femoral, superficial femoral and popliteal veins. he then underwent cta of his chest that revealed b/l pulmonary embolus including right and left pulmonary arteries and middle & infeior branches. there was also some concern for bowing of the intraventricular septum that could indicate right heart strain. the patient ce negative x1. he was started on a heparin gtt (weight based) with a 5400u bolus and 1200u/hr infusion. he was guaiac negative. the patient's glucose was also noted to be 515 and was given 6u humalog and fs improved to 227. vs upon transfer from the ed to the were 98.1 98 107/82 16 100% ra. he was sent to the icu for closer hemodynamic monitoring given concern for right heart strain on ct-scan. . in the icu he denied sob, pain or other complaints. . of note, the patient was seen in the ed on and found to have platelets of 17k and started on 80mg prednisone daily per hem/onc. he was supposed to follow-up, but did not show for his follow-up appointment. his platelets in the ed were 165. . ros: the patient denies any fevers, chills, weight change, nausea, vomiting, abdominal pain, diarrhea, constipation, melena, hematochezia, chest pain, shortness of breath, orthopnea, pnd, lower extremity oedema, cough, urinary frequency, urgency, dysuria, lightheadedness, gait unsteadiness, focal weakness, vision changes, headache, rash or skin changes. past medical history: hypertension itp anemia h. pylori s/p triple therapy gerd chronic right foot and ankle pain, peroneal tendonitis hearing loss allergic rhinitis erectile dysfunction mild cataracts social history: he is retired and lives with his wife. has two supportive daughters. denies cigarette, etoh, or illicit drug use. family history: there is no family history of bleeding or coagulation disorders. no history of clots physical exam: on admission: gen: well-appearing, well-nourished, no acute distress heent: eomi, perrl, sclera anicteric, no epistaxis or rhinorrhea, mmm, op clear neck: no jvd, carotid pulses brisk, no bruits, no cervical lymphadenopathy, trachea midline cor: rrr, no m/g/r, normal s1 s2, radial pulses +2 pulm: lungs ctab, no w/r/r abd: soft, nt, nd, +bs, no hsm, no masses ext: no c/c/ 1+ edema in the lower ext neuro: alert, oriented to person, place, and time. cn ii ?????? xii grossly intact. moves all 4 extremities. strength 5/5 in upper and lower extremities. patellar dtr +1. plantar reflex downgoing. skin: no jaundice, cyanosis, or gross dermatitis. no ecchymoses. pertinent results: on admission: 11:00am wbc-9.8 rbc-4.14* hgb-13.0* hct-37.5* mcv-91 mch-31.3 mchc-34.6 rdw-13.5 11:00am plt count-165 11:00am neuts-73.7* lymphs-21.8 monos-3.0 eos-0.9 basos-0.5 11:00am glucose-515* urea n-17 creat-1.2 sodium-133 potassium-4.3 chloride-93* total co2-27 anion gap-17 11:00am ctropnt-<0.01 10:56pm ck-mb-2 ctropnt-<0.01 10:56pm ck(cpk)-31* 11:00am pt-13.3 ptt-22.1 inr(pt)-1.1 10:58pm pt-14.9* ptt-100.1* inr(pt)-1.3* . leni: extensive dvt in left lower extremity involving femoral, superficial femoral and popliteal with small amount of residual flow in those veins. calf veins not visualized and may be occluded. . cta chest: impression: 1. bilateral pulmonary emboli involving the right interlobar artery and branches to the right middle and lower lobes as well as the left pulmonary artery with branches to the lingula and lower lobe. 2. right ventricle larger than left ventricle (rv:lv >1), suggestive of right heart strain. 3. ascending aorta measuring up to 4 cm, mildly dilated. . cardiac echo conclusions the left atrium is mildly dilated. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). right ventricular chamber size and free wall motion are normal. the ascending aorta is mildly dilated. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis. trace aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. there is an anterior space which most likely represents a prominent fat pad. impression: normal global rv systolic function. indeterminate pulmonary pressures. limited study. . ct abd & pelvis with contrast ct abdomen with iv contrast: there has been interval development of peripheral ground-glass opacities in the left lower lobe. given the known left lower lobe pulmonary embolus, these likely represent pulmonary infarcts. no pulmonary nodules seen. no pleural effusion seen. no pericardial effusion seen. there is a linear hypoenhancing structure seen superiorly within the right lobe of the liver. this is closely related to the middle hepatic vein which is attenuated, particularly apparent on the coronal reformats. the left hepatic vein is also not seen however. the appearances are concerning for thrombus within a hepatic vein, it is not clear whether this is within the middle hepatic or left hepatic vein. ultrasound or multiphasic ct could clarify the vascular anatomy. no definite extension into the ivc is seen although this is poorly opacified. no other focal liver lesions are seen. no biliary duct dilatation. the gallbladder is distended but otherwise unremarkable in appearance. the portal vein is patent. there is a 1 cm hypoenhancing lesion seen in the lower pole of the right kidney. while this most likely represents simple cyst, the measured hounsfield units are higher than one would expect. this could be further characterized on ultrasound. there are two small cortical lesions in the left kidney, both of which are hypoenhancing but too small to characterize. these may also be visible on ultrasound. the spleen is unremarkable in appearance. the pancreas is somewhat atrophic but otherwise unremarkable, no pancreatic duct dilatation seen. both adrenal glands are unremarkable in appearance. no enlarged mesenteric or retroperitoneal lymph nodes are seen. no free fluid. the small and large bowel is normal in caliber. ct of the pelvis with iv contrast: the urinary bladder, rectum and prostate are unremarkable in appearance. no free fluid seen. no pelvic lymphadenopathy. there are prominent veins seen in the left gluteal region with thrombus expanding the left common femoral vein and visualized superficial femoral vein. the prominent gluteal vessels are likely collaterals draining the lower limb. bony structures: there is a mixed lucent and sclerotic lesion seen in the right ilium with adjacent sclerosis inferiorly. this is a medullary-based lesion without evidence of cortical involvement and is of uncertain significance. no other bony lesion seen. impression: 1. new left lower lobe opacities concerning for pulmonary infarction in a patient with known pe. 2. possible thrombus seen in either the left hepatic or middle hepatic vein, correlation with ultrasound is recommended. in addition, thrombus is seen in the left common femoral and superficial femoral vein with prominent collateral vessels in the left gluteal region. 3. multiple small hypoenhancing lesions in both kidneys likely represent cysts however, this could be confirmed on ultrasound. brief hospital course: mr. is a 68 year old man with a history of itp on 80 mg of prednisone intermittently since this fall, now here with bilateral pes, dvt and possible right heart strain. he was initially admitted to the micu and treated with continuous heparin gtt. he was transferred out of the icu on for ongoing care and management. . he was treated with iv heparin gtt and transitioned to warfarin with a goal inr . the cause of his thrombophilia is unclear. hematology was consulted to help guide treatment for his itp as well as determine the need for an ivc filter, and thrombotic workup. his prednisone was decreased from 80 mg to 40 mg on at their recommendation. his platelet count was monitored closely. as per hematology recommendations, he continued 40mg for three days then started 20mg daily, which he is to continue until his outpatient hematology follow-up. . a ct of the abd/pelvis to look for malignancy and possible compression of the ivc contributing to his distal clot was ordered and showed: new left lower lobe opacities concerning for pulmonary infarction in a patient with known pe, possible thrombus in either the left hepatic or middle hepatic vein, thrombus in the left common femoral and superficial femoral vein with prominent collateral vessels in the left gluteal region, multiple small hypoenhancing lesions in both kidneys which likely represent cysts. tte showed normal global lv and rv systolic function with indeterminate pulmonary pressures. discussion was had with hematology about placing an ivc filter, and he underwent successful placement of an ivc filter via ir guidance on . he remained clinically stable on a heparin gtt until his inr was therapeutic () for 48 hours, then the heparin was discontinued. . the team was consulted to help manage his significant diabetes, likely in large part related to glucocorticoid use. they recommended morning and bedtime nph insulin along with a humalog sliding scale. his last hba1c was >10 so he may have underlying diabetes mellitus type ii in addition to prednisone-induced hyperglycemia. he had nutritional education regarding a diabetic diet as well as teaching regarding self-administration of insulin and checking his blood glucose, etc. vna services were arranged . on , he was hypertensive and his beta blocker was started at a lower dose (after all his antihypertensive meds had been held due to his acute illness). he remained normotensive for the remainder of the hospitalization without the hctz and lisinopril. . # comm: wife (doesn't speak english). daughter , medications on admission: hctz 25mg daily lisinopril 40mg daily metoprolol succinate 100mg daily omeprazole 20mg daily prednisone 80mg daily discharge medications: 1. prednisone 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 2. warfarin 5 mg tablet sig: one (1) tablet po once daily at 4 pm: titrate dose as directed by dr. clinic. disp:*30 tablet(s)* refills:*0* 3. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily): take 30 minutes before breakfast. 4. metoprolol succinate 100 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. 5. calcium carbonate 200 mg (500 mg) tablet, chewable sig: one (1) tablet, chewable po bid (2 times a day). disp:*60 tablet, chewable(s)* refills:*2* 6. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 7. syringe (disposable) 5 ml syringe sig: one (1) miscellaneous twice a day. disp:*qs box* refills:*2* 8. nph insulin human recomb 100 unit/ml suspension sig: one (1) 15 units subcutaneous before breakfast. disp:*qs vial* refills:*2* 9. nph insulin human recomb 100 unit/ml suspension sig: one (1) 5 units subcutaneous at bedtime. disp:*qs vial* refills:*2* 10. glucometer use as directed 11. humalog 100 unit/ml solution sig: one (1) sliding scale subcutaneous four times a day: use as directed; see separate sheet. disp:*qs vial* refills:*2* discharge disposition: home with service facility: uphams corner homehealth discharge diagnosis: # acute pulmonary embolism with right ventricular strain # pulmonary infarction # bilateral lower extremity dvt's # hepatic vein thrombosis # idiopathic thrombocytopenic purpura # steroid-induced diabetes # hypertension discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted with blood clots in your lungs and in your legs. you were treated with heparin and coumadin, and you will need to stay on coumadin at least six months. this medication needs to be monitored closely because too much can cause you to bleed excessively, and too little can predispose you to form more blood clots. a filter was placed through your right leg into the blood vessel returning to your heart, in order to prevent more clots from moving into your lungs. regarding your low platelet condition, the hematology specialists recommended decreasing your prednisone dose, since your platelet count has normalized. you are going home on 20mg, which you should stay on at least until you follow-up with hematology in clinic. in addition, you have diabetes, most likely as a result of being on prednisone. you were evaluated by the specialists, who assisted in treating you with insulin. you will be checking your glucose at home daily and injecting yourself with insulin. we have arranged visiting nurses to assist you with all this, and you should follow-up closely with your primary care doctor, dr. . lastly, regarding your high blood pressure, please note we stopped your hydrochlorothiazide and lisinopril, and your blood pressure has been well-controlled. followup instructions: department: hematology/oncology when: friday at 1:30 pm with: , md building: sc clinical ctr campus: east best parking: garage department: hematology/oncology when: friday at 1:30 pm with: , rn building: campus: east best parking: garage department: internal medicine when: monday at 12:00 pm with: , md building: (, ma) campus: off campus best parking: free parking on site md procedure: interruption of the vena cava diagnoses: esophageal reflux unspecified essential hypertension adrenal cortical steroids causing adverse effects in therapeutic use long-term (current) use of insulin unspecified hearing loss other pulmonary embolism and infarction immune thrombocytopenic purpura heart disease, unspecified acute venous embolism and thrombosis of deep vessels of distal lower extremity secondary diabetes mellitus without mention of complication, uncontrolled 

Answer: The patient is high likely exposed to