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: fever, respiratory failure, aids. major surgical or invasive procedure: endotracheal intubation (at osh) central line placement bronchoscopy x 2 history of present illness: 34 y/o male with a h/o hiv, visceral kaposi's sarcoma, castleman's disease, and pancytopenia who presented to an osh with weakness, anemia, and ftt. he was hydrated with ivf and closely monitored for any signs or symptoms of infection. he was recently admitted to hospital (nh) from for fuo workup, diffuse adenopathy and splenomegaly. a left cervical lnb revealed metastatic kaposi's sarcoma and castleman's disease. he had a follow up appointment made with dr. () for further management of his metastatic kaposi's sarcoma/castleman's disease but he did not keep that appointment. he again presented to hospital on with anemia, weakness, and ftt. he was ordered for a blood transfusion. there was concern that the pt sustained a transfusion reaction because shortly after receiving his first unit of blood. he spiked a temp to 103, and became tachypnic, hypotensive, hr 140. . the decision was made to transfer him to for further management. . ros: unobtainable, pt arrived intubated and sedated at osh. past medical history: 1. hiv, recent cd4 104, undetectable viral load, on haart since , developed resistance to efavirenz 2. castleman's disease 3. metastatic kaposi's sarcoma, no skin lesions, stage iiib, plan to proceed with cytoxan, vincristine, doxil, and prednisone along with rituximab 4. massive splenomegaly 5. pancytopenia 6. recurrent hyponatremia (? to siadh) 7. n/v 8. intractable hiccups 9. recent egd showed afb microorganisms 10. g6pd deficiency 11. chronic interstitial infiltrates on cxr social history: no tobacco or alcohol. originally he is from the . family history: n/c. physical exam: vitals: t 103.4 hr 131 bp 106/59 rr 30 100% ac tv 500 fio2 1.00 peep 5 general: 34m intubated and sedated. heent: nc/at. mmm. et tube in place. neck: no jvd. cv: st, s1, s2 without any m/r/g. pulm: coarse bs b/l. no wheezes. abd: soft, nt/nd with normoactive bs. ext: no c/c/e. neuro: sedated. skin: no rash. pertinent results: ct abdomen: massive splenomegaly with adenopathy . bmb: hypercellular marrow . left cervical lnb: castleman's disease, metastatic kaposi's sarcoma, positive hhv-8 titers . head ct: negative . ekg: st at 131, no axis deviation, no acute st changes . cxr: b/l interstitial infiltrates. final read pending. . pet scan (performed at ) "increased metabolic activity seen within the lymph nodes of the right and left anterior and posterior cervical chain extending into the supraclavicular regions. increased activity noted in both axillary regions where lymphadenopathy is present exceeding 1 cm in size. increased metabolic activity is seen in the lymph nodes of the right paratracheal region. mild increased metabolic activity seen in the lymph nodes of the paraaortic, left and right hilar, and subcarinal lymph nodes. lung parenchyma is unremarkable, as is the spine. . abdomen shows a normal-appearing liver, shows and enlarged spleen which has increased metabolic activity. spleen length approximately 20 cm. . increased metabolic activity seen in lymph nodes which begins at the crural level and are to the right and left and in front of the lumbar vertebrae. the increased metabolic activity within the lymph nodes is seen within the paraaortic, the common iliac, and the inguinal on the right and left. the scan extends to the proximal thigh; no abnormal increased metabolic activity is seen in the muscle or bone." . cxr findings most consistent with diffuse pulmonary edema likely due to fluid overload in the setting of apparent anasarca and ascites. underlying infectious process such as pcp is not excluded and correlation with initial outside hospital radiographs as well as follow up after diuresis may be helpful in this regard. . tte the left atrium is mildly dilated. the estimated right atrial pressure is 11-15mmhg. left ventricular wall thicknesses and cavity size are normal. there is mild regional left ventricular systolic dysfunction with focal hypokinesis of the basal half of the inferolateral wall. the remaining segments contract normally (lvef = 50%). right ventricular chamber size is normal with mild global free wall hypokinesis. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are structurally normal. an eccentric, anteriorly directed jet of mild (1+) mitral regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. impression: mild regional left ventricular systolic dysfunction. mild mitral regurgitation. mild pulmonary artery systolic hypertension. . bronchial washings were negative for malignant cells. . abdominal u/s 1. massive splenomegaly with infiltrative intrasplenic lesion concerning for lymphoma. ks would be less likely but should also be considered. 2) 1.4 cm echogenic lesion in segment ii of the liver may represent a hemangioma. though rare, hepatic kaposi's sarcoma cannot be excluded. 3) sludge in the gallbladder. 4) echogenic kidneys suggesting interstitial renal disease. 5) ascites and bilateral pleural effusions. 6) normal doppler examination. . bone marrow biopsy results pending. . bone marrow from the osh revealed a hypercellular marrow. brief hospital course: 34 y/o male with a h/o hiv, metastatic kaposi's sarcoma, castleman's disease, and g6pd who presented to an osh with weakness, anemia, and ftt. he was later transferred to for further management of fever and respiratory failure along with metastatic kaposi's sarcoma and castleman's disease. # respiratory failure the patient was intubated to respiratory distress at the osh prior to transfer. per osh records, he has had b/l pulmonary infiltrates for several weeks. however, given his fever, tachycardia, and respiratory distress along with his cxr finding of b/l pulmonary infiltrates, there was an initial concern for ards/sepsis. he was hypotensive as well and there was concern for progression to septic shock. in addition, there was an outside hospital report of afb organisms cultured on recent egd as part of his fuo workup. he was moved to respiratory isolation given concern for possible pulmonary tuberculosis. after further information was obtained regarding the above pathology, it was found to be an acid-fast organism. however, he did complete a r/o for tuberculosis. he was initially started on broad spectrum abx given concern for an infectious etiology for his respiratory failure and clinical decompensation. after all cultures returned negative, his abx were gradually d/c. on his second bronchoscopy, there was evidence of kaposi's sarcoma. his malignancy is the most likely etiology for his respiratory failure and b/l infiltrates on cxr. the patient was eventually weaned off of the ventilator and was transferred to the omed service. here, he was followed by pt, and was off of o2 with normal oxygen saturations. the patient continued on his haart therapy and continued to improve until dishcage. # metastatic kaposi' sarcoma/castleman's disease the patient was diagnosed with metastatic kaposi's sarcoma and castleman's disease during recent admission at the osh when he was evaluated for fuo. a left cervical lymph node biopsy was consistent with kaposi's sarcoma and castleman's disease. after infection as an etiology for his clinical deterioration and respiratory failure was unrevealing, the most likely etiology for his fever and respiratory failure was his malignancy. on the second bronchoscopy that was performed, there was evidence of kaposi's sarcoma in his bronchial tree. on , he underwent chemotherapy with dr. he did not receive vincristine to his liver failure. thus far, he has tolerated the chemotherapy well. he no longer required pressor support for his hemodynamic. heme/onc was following from admission for further recommendations. he also underwent a repeat bmb on . he completed a course of neupogen, and was discharged with an anc>1000. the patient will continue his current haart therapy and will follow up with dr. as an outpatient. social services followed the patient and set him up with transportation to assist the patient so he can make his appointments. # fever initially, there was a concern for an infectious etiology causing his fever, respiratory failure, and clinical decompensation. he was started on broad spectrum abx (vanc, zosyn, azithromycin x 1, and levofloxacin). as his cultures became negative and it was clear that his metastatic kaposi's sarcoma was the reason for his respiratory failure and b/l infiltrates on cxr, abx were gradually d/c. he was started on a brief course of doxycycline for concern for tick borne illness but this was also d/c. his fever curve trended down. he was ruled out for tuberculosis. all cultures to date have been negative, including his bals. at discharge, he was afebrile and his anc>1000. # hiv the patient was continued on his haart regimen at the osh and during this admission. his haart regimen dose was adjusted for his renal function. last cd4 count was 104 so there was no need for mac px with azithromycin (did receive a couple doses). he was started on mepron for pcp px as he has a h/o g6pd deficiency and bactrim would not be the best choice. he continued his haart therapy, and at discharge was given prescriptions for all of his medications. he will follow up with dr. for further management. # anemia/thrombocytopenia the above are most likely to his hiv and metastatic kaposi's sarcoma/castleman's disease. there was a question of troli at the osh after receiving blood; however this is unclear and a full panel of tranfusion reactions labs were ordered at the osh. he was given 2 units of prbcs thus far during this admission for anemia. he has also received 3 plt transfusions thus far. plt goal after chemotherapy is > 20 given concern for pulmonary hemorrhage. as his bone marrow recovered, the patient's counts improved and he was no longer required transfusions at discharge. # acute renal failure the patient's acute renal failure is thought to be to atn/intrinsic renal disease. his renal function was monitored and it has not improved or worsened as yet. he was given aggressive ivf along with diuresis to maintain adequate renal perfusion in light of his recent chemotherapy treatment. at discharge, his renal function had markedly improved. he will continue to followup as an outpatient for any changed that may be necessary in the future regarding his management. # dic the patient had evidence of dic on his labs. he was supported hemodynamically and was weaned off pressors. dic was secondary to his metastatic kaposi's sarcoma/castleman's disease/systemic inflammatory process. at discharge, his counts had stabilized. # the patient has a girlfriend in the us as well as a daughter. they visited the patient prior to discharge. social services contact the patient's case manager to discuss future options for the patient so that he can make appointments and get his medications. the patient's case manager is very involved with his case. at discharge, the patient's mental status was at baseline and he was completely congnizant of his surroundings. medications on admission: medications (outpatient): erythropoietin 40,000 units sq qweek fentanyl patch 50 mcg q72h folic acid 2 mg po daily kaletra 2 tab po bid combivir viread 300 mg po daily kcl 20 meq po bid metoclopramide qid . medications upon transfer: tylenol prn benadryl prn fentanyl folic acid lasix hydrocortisone riss combivir 1 tab kaletra 2 tab po bid reglan 10 mg po qachs versed protonix 40 mg iv bid potassium sliding scale sodium chloride tablets tenofovir 300 mg po daily discharge medications: 1. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. disp:*60 tablet(s)* refills:*0* 2. colace 100 mg capsule sig: one (1) capsule po twice a day as needed for constipation. disp:*60 capsule(s)* refills:*0* 3. atovaquone 750 mg/5 ml suspension sig: 1500 (1500) mg po daily (daily). disp:*qs mg* refills:*2* 4. lopinavir-ritonavir 400-100 mg/5 ml solution sig: five (5) ml po bid (2 times a day). disp:*300 ml(s)* refills:*2* 5. tenofovir disoproxil fumarate 300 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. lamivudine-zidovudine 150-300 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 7. azithromycin 600 mg tablet sig: two (2) tablet po qthur (every thursday). disp:*8 tablet(s)* refills:*2* 8. 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:*2* discharge disposition: home with service facility: home health discharge diagnosis: primary diagnosis: castleman's disease kaposi's sarcoma hiv/aids secondary diagnosis: g6pd deficiency pancytopenia discharge condition: good, stable, afebrile discharge instructions: you were admitted from an outside hospital with respiratory distress, low blood pressure requiring intubation and icu stay. you were given antiobiotics and chemotherapy for your castleman's syndrome and kaposi's sarcoma. you were then admitted to the inpatient oncology service where you continued to improve. you were seen by physical therapy who felt you were safe to go home at discharge. please take all medications as prescribed. you will need to followup and keep all future appointments with your physician as it is important for the management of your disease. if you develop any of the following concerning symptoms, please call your pcp, . , or go to the ed: fevers, chills, shortness of breath, chest pain, abdominal pain, nausea, vomiting, weakness, or inability to walk. followup instructions: provider: , m.d. phone: date/time: 2:00 please call your pcp . for followup appointment within the next 2-4 weeks. procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more fiber-optic bronchoscopy fiber-optic bronchoscopy enteral infusion of concentrated nutritional substances other lavage of bronchus and trachea biopsy of bone marrow transfusion of packed cells injection or infusion of cancer chemotherapeutic substance transfusion of platelets diagnoses: acute kidney failure, unspecified human immunodeficiency virus [hiv] disease acute respiratory failure defibrination syndrome other sequelae of chronic liver disease hyperosmolality and/or hypernatremia enlargement of lymph nodes other specified hypotension anemias due to disorders of glutathione metabolism kaposi's sarcoma, lung 

Answer: The patient is high likely exposed to