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 / vicodin attending: chief complaint: admitted to rule out tuberculosis major surgical or invasive procedure: exploratory laparotmy history of present illness: this is a 50 year old woman with autoimmune hepatitis/pbc overlap syndrome on imuran and prednisone and essential hypertension who was transferred from hospital in new being admitted for history of fevers, chills, nonproductive cough and status treatment for pneumonia with no improvement. chest ct shows miliary lesions in lung, liver and spleen. she will be admitted to rule out tuberculosis. . patient presented to outside hospital on with fever, chills and nonproductive cough. patient reported a one week history of easy fatigability, shorntess of breath on exertion, pleuritic chest pain and nonproductive cough. she also developed chills and subjective fevers. in osh ed, chest x-ray did not show infiltrate and blood culture grew gram positive cocci in clusters in 1 out of 4 bottles. she subsequently went home and returned the following morning on to the osh ed, with recurrence of chills and temp in ed measured as 103.5 rectally. patient was admitted for further workup. she received 2 doses of rocephin and has since been afebrile. patient denies hemoptysis, phlegm production but does have some slight nausea. denies contact with suspected or confirmed casese of tuberculosis. no recent travel or pets at home. infectious disease was consulted and recommended treatment of cap in an immunocompromised host. covered with ceftriaxone and azithromycin that was switched to levaquin on . patient continued to spike at night to temp of 102-103. chest/abdominal ct revealed miliary lesions in lung, liver and spleen. she was subsequently transferred to bimdc to rule out tuberculosis and for further workup. . ros: denied headache, dizziness, chest pain, vomitting, abdominal or urinary complaints. past medical history: 1. autoimmune hepatitis (dx'd 30 yrs ago and has been on imuran and prednisone. 2. essential hypertension 3. s/p tonsillectomy 4. s/p myomectomy for uterine fibroids 5. s/p appendectomy 6. s/p liver biopsy social history: lives with husband of 26 years in . nonsmoker and nondrinker. no illicit drug use. family history: f died at age 69 of heart disease. physical exam: 101.9 98/66 104 18 95% room air gen: in bed under multiple covers and a down jacket skin: no rashes or lesions appreciated, warm to touch heent: perrl, small white plaque on lateral sides of tongue, op nl, no lad appreciated, neck supple cv: rrr, nl s1 s2, no murmurs/rubs/gallops pulm: fine rales r>l, no wheeze abd: soft, nontender, +bs, nondistended ext: nonedematous, good pulses neuro: aox3, nonfocal pertinent results: at oph: lying hr 146 bp 119/71 sitting hr 150 bp 111/80 standing hr 160 bp 94/60 . wbc 2.5 hct 31.8 plat 94 alb 3.0 ca 7.8 bili 2.3 ast 95 alt 75 . wbc 2.6 h and h 12.2 35.1. plat 57 n 44 bands 37 l11 m 5 atyp lymphocytes 2 burr cells 2+ . na 136 k 3.7 cl 103 hco3 25 bun 13 cr 0.8 gluc 84 . tp 6.7 alb 2.7 ca 7.9 tuberculosis 4.0 ast/alt 97/77 (per dr. note, lfts chronically elevated) alk phos 86 . urine uribilinogen 8 urine pneumococcal ag: pnd legionella ag: pnd mycoplasma igm: pnd chlamydia igm: pnd cryptococcal ag: pnd aspergillus ab, ag: pnd histoplasmosis ab: pnd urine histoplasma ag: pnd influenza a/b: negative sputum cx : pnd bld cxs x2 : ngtd afb cx: pnd urine cx : ngtd ua: negative c diff : negative urine cx : 10-50,000 cfu g negative bacillus bld cxs x2 : coag neg staph in 1 out of 4 bottles . imaging: cxr : elevated right hemidiaphragm with atelectasis of the right lung base . cxr : interval presence of an increased density in the right upper lobe which was consistent with pneumonia. . ekg: 135 sinus tachycardia, nl axis, no acute st-t changes unchanged from prior. . labs at : pending studies: liver blood pool study : focal increased tracer uptake in the liver which correlates with the suspicious lesion seen on mri, consistent with hemangioma. . mri/mra abdomen : cirrhotic liver with an atypical 2.1-cm segment lesion. because there has been equivocal enlargement of this lesion when compared to prior examination, additional imaging is recommended. most likely this lesion is an atypical hemangioma. a technetium-m-labeled red blood cell study (nuclear medicine study) is recommended for further evaluation (this nuclear medicine study could potentially confirm that this lesion is in fact a hemangioma). no other significant change from prior examination. . chest, two views : no active lung disease. brief hospital course: briefly, 50w w/autoimmune hepatitis/primary biliary cirrhosis overlap syndrome on chronic immunosuppressants p/w fever, nonproductive cough and miliary lesions in lung, liver and spleen seen on outside chest/abd ct. . *. fever: unclear etiology. differential diagnosis includes tuberculosis, cap, uti or abdominal infection. given chronic immunosuppresion, infectious etiology should be broad to include fungal and parasitic infections. rul infiltrate seen on osh chest x-ray suggestive of pneumonia and miliary lesions in multiple organs suggestive of miliary tuberculosis, mac or fungal infection. --rec'd ceftriaxone and azithromycin at osh, then changed to levaquin on --continue levaquin for now to cover cap and atypical pna --f/u osh test results --repeat bld cxsx2, mycolytic, ua/urine cx --induced sputum x3 to rule out tuberculosis --repeat cxr and chest/abd ct --respiratory precautions for now --consult pulm in am, may need bronchoscopy if unsuccess with induced sputums --cis >100.4, tylenol 325mg prn not to exceed 2g/day --follow fever curve . *. nonproductive cough: unclear etiology. differential diagnosis includes gerd, asthma, post-nasal drip, pneumonia/pneumonitis, bronchitis or upper respiratory infectio. influenza a/b antigen negative at osh. --cont levaquin for now --induced sputum x3 to rule out tuberculosis --ppi --no wheezes on exam, hold off on nebs . *. chronic liver disease: autoimmune hepatitis and pbc. continued prednisone and imuran. --follow lfts --apprec liver recs . *. miliary lesion in multiple organs: lung, liver and spleen involvement. differential diagnosis includes tuberculosis, atypical mycobacteria, histoplasmosis. less likely include other endemic fungi (coccidioidomycosis, blastomycosis, paracoccidioidomycosis), bacterial (legionella, nocardiosis), viral (varicella, cmv), parasitic (toxo), neoplastic (lymphoma, lymphangitic spread of carcinoma), sarcoid, hypersensitivity pneumonitis, pneumoconioses. --rule out tuberculosis --repeat chest/abd ct --pulm consult and consider bronchoscopy/bal/?bx --consider ct guided biopsy of lesion and send for path and microbiology . *. hypertension: continue to monitor. . *. fen: cardiac healthy/diabetic diet and npo after midnight for possible bronch in am, replete lytes as needed, d5w w/3 amps bicarb at 75cc/hr overnight prior to ct scan . *. ppx: sq heparin, ppi, bowel regimen as needed, respiratory droplet precautions. on the evening of , the pt was transferred to the micu for hypotensive episodes and worsening dyspnea. the hypotension responded to fluid challenges. on , the patient was intubated for bronchoscopy. the bronchoalveolar lavage was positive for pneumocystis carinii pneumonia, and the patient remained intubated. on , a ct scan of the torso was performed to rule out other causes of sepsis and respiratory failure. initial read of the ct showed "free air" in the pelvis. exploratory laparotomy performed on which was found to be negative for any intraabdominal pathology. liver biopsies were performed. post-operatively the patients prior acidosis continued and worsened, despite resucitation. lactate climbed to 25. cvvh was initiated and her acidosis improved, however her lactate continued to rise. she developed a fatal arrythmia and was pronounced dead on . the family declined a post-mortem examination. addendum: a few days after the patient expired, the final path report on the liver biopsy showed non-hodgkin b-cell lymphoma, diffuse large b-cell type, high grade. medications on admission: imuran, prednisone, ursodiol discharge disposition: expired facility: discharge diagnosis: liver failure spesis msof discharge condition: cardiac death procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube exploratory laparotomy closed [endoscopic] biopsy of bronchus transfusion of packed cells transfusion of other serum transfusion of platelets open biopsy of liver diagnoses: acidosis unspecified essential hypertension cirrhosis of liver without mention of alcohol acute kidney failure, unspecified unspecified septicemia severe sepsis acute respiratory failure pneumocystosis other chronic hepatitis reticulosarcoma, unspecified site, extranodal and solid organ sites biliary cirrhosis 

Answer: The patient is high likely exposed to