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: tetracyclines / lisinopril attending: chief complaint: increasing back pain and failure to thrive major surgical or invasive procedure: none history of present illness: the patient is a 78 yo retired plastic surgeron with a history of metastatic prostate cancer currently on taxotere who presents with worsening back pain. he was initially diagnosed with prostate ca in and has failed hormonal therapy now on cycle 12 of taxotere rec'd on . he presents to the er with worsening back pain. the patient states his back pain is lower back and has been worsening for the past 24 hours. he has also had some subjective lower extremity weakness for the past months without any change. no fecal incontinence or urinary retention or incontinence. no saddle anesthesia. he has known bony mets throughout his spine. over the past 3-4 days he also has noted a decrease in his urine output as well as a darkening of his urine. he has been slightly confused from time to time only over the past few days and much more somnolent and with generalized weakness. no other symptoms. denies fevers. . in the ed, initial vs were: t 97.5 hr 75 bp 121/64 rr 18 o2 sat 100. he was noted to have paroxysmal afib w/ rvr and rec'd 2x 15mg iv boluses of dilt and 30mg po dilt without much effect and then started on a dilt drip. he also was noted to have a retrocardiac opacity so was given 250mg iv levofloxacin (given arf cr 5.6). he was given 250cc of ivf for his arf. he underwent a renal u/s which was negative for stone or hydronephrosis. he was noted to have lower extremity stregnth bilaterally; his mri of his spine was deferred until he arrived on the floor. . vs prior to transfer were: t 97.5 hr 120 bp 139/74 rr 19 98% on 2l past medical history: oncologic history: - diagnosed s/p prostatectomy - multilevel osseous metastatic changes in the cervical and thoracic spine without epidural disease or cord compression. posterior disc protrusion at level c4- c5. - previously received on casodex and finasteride - now on c12 taxotere () . pmh: -metastatic prostate cancer: known metastases s/p 6 cycles of docetaxel last on -paroxysmal atrial fibrillation on coumadin and flecainide s/p cardioversion attempts -hypertension -hyperlipidemia -h/o nephrolithiasis -s/p appendectomy -s/p left inguinal hernia repair -s/p ventral hernia repairs (now recurred) social history: he is the former chief of plastic surgery at but is now retired and lives with his wife. does not smoke, drink alcohol, or use any drugs. family history: noncontributory physical exam: vitals: t: bp: 174/73 p: 143 (afib) r: 12 o2: 98% ra general: alert, oriented, no acute distress heent: sclera anicteric, mm dry, oropharynx clear, conjunctiva pale neck: supple, jvp 8cm, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: tachycardic, irregularly irregular, sem at the lusb abdomen: soft, non-tender, mild to mod distension, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: aox3, no asterixis, able to hold a normal conversation, no saddle anesthesia, 4+/5 stregnth in lower extremities- bilaterally symmetric quad, hamstring, dorsiflex, plantarflex, abduction, adduction. pertinent results: admission: wbc-10.6 rbc-3.43* hgb-9.7* hct-29.6* mcv-86 mch-28.3 mchc-32.8 rdw-18.8* plt ct-56*# neuts-93.4* lymphs-3.6* monos-2.6 eos-0.1 baso-0.4 pt-26.2* ptt-31.5 inr(pt)-2.5* fibrino-411* d ret aut-0.4* glucose-129* urean-100* creat-5.6*# na-139 k-4.7 cl-104 hco3-21* angap-19 alt-18 ast-37 ld(ldh)-554* ck(cpk)-223* alkphos-83 totbili-0.7 dirbili-0.2 indbili-0.5 calcium-8.4 phos-6.2*# mg-2.2 hapto-<20* lactate-0.9 cxr: increased retrocardiac density at the left base, with corresponding basilar opacity on the lateral view, concerning for left lower lobe pneumonia. low lung volumes. renal us: no hydronephrosis. potentially partially septated cyst. recommend attention paid to these cysts on presumed followup imaging. ct abd/pelvis without contrast: 1. no evidence of hydronephrosis or hydroureter. no findings to account for acute renal failure. left non- obstructing renal calculus/calculi. 2. right pelvic wall mass and non-pathlogically enlarged right external iliac node have increased in size compared to 5 months prior. status post prostatectomy. 3. bilateral renal cysts, several of which are hyperdense, and liver cysts; the enhancement pattern of these is not evaluated due to lack of iv contrast. 4. diffuse bony metastases redemonstrated, without acute fracture identified. 5. small left greater than right pleural effusions are new, with associated atelectasis. mri l, t, c spine : 1. progression of osseous metastases in the cervical, thoracic and lumbar spine. no new compression fractures. 2. unchanged small anterior epidural lesion at the level of l5, without evidence of definite nerve root involvement. 3. no evidence of new epidural lesions. no cord compression. 4. unchanged spondylosis as described above. ct head : 1. no intracranial hemorrhage. no mass effect. 2. no non-contrast ct evidence for metastases. mr is more sensitive in the detection of small masses and acute stroke. le u/s no evidence of dvt in the left lower extremity. brief hospital course: 78 yom w/ a h/o metastatic prostate cancer and afib presents with worsening back pain, found to have thrombocytopenia and severe acute renal failure as well as afib with rvr- admitted to the icu as he was requiring a diltiazem drip for rate control. # acute renal failure: patient's arf peaked at creatinine of 6.4, just barely made it without requiring dialysis. etiology remained unclear. thrombocytopenia, low haptoglobin, anemia, ttp/hus and dic remained on the differential, however smear was without evidence of microangiopathic hemolytic anemia making these diagnoses less likely. hypotension leading to ischemic insult secondary to a fib in rvr is another possibility, however patient has had a fib for years making this also less likely. nonetheless, his arf resolved with fluids and time. renal was following. last creatinine at 1.7. renal recommended continuing his iv fluids until his po intake increases. # anemia: hct was slightly lower than baseline, as above labs were consistent with hemolysis but smears failed to show abundant schistocytes. baseline was in the low 30s and based on iron studies from consistent with anemia of chronic disease. vitb 12 low at 147, folate was normal. patient was started on b12 repletion of 1 week of injections, which did not yet resolve his anemia but his b12 levels returned to . # afib with rvr: patient's a fib in rvr was difficult to control with dilt in the icu. metoprolol was used instead with good affect. however, pt developed fatigue, increased depression, and bradycardia with high dose metoprolol concerning for beta blocker toxicity. his metoprolol was titrated down while being uptitrated on diltiazem. his heart rate remained well controlled throughout the admission. # delerium: pt developed delerium secondary to most likely a combination of mirtazapine and reglan use. this cleared after 2 days. infectious w/u remained negative. # abdominal pain/nausea vomitting: kub was negative, these symptoms resolved with bms and were thought to be related to constipation. # back pain: patient's back pain was associated with a few months of lower extremity weakness. last imaging of his spine was with an mri of his c, t and l spine which demonstrated diffuse metastasis to the spine and no cord compression. patient was put on oxycontin 10mg po bid with prn po oxycodone and prn iv morphine prn pain. code: full (discussed with patient). patient's pcp, . , had a long conversation with the patient on his code status, and patient decided to keep the code as full for now. medications on admission: allopurinol 300 mg daily citalopram 10 mg daily dexamethasone 1 mg daily immodium lupron oxycodone 5 mg q4-6 prn oxycontin 10 mg tid pravastatin 20 mg daily prochlorperazone 10 mg q6h prn coumadin 2 mg tablet - tablet(s) by mouth daily takes 4mg mon and fri and 3mg all other days vitamin d lactobacillus mom om3fa ocuvite discharge medications: 1. pravastatin 10 mg tablet sig: one (1) tablet po daily (daily). 2. citalopram 20 mg tablet sig: 0.5 tablet po daily (daily). 3. compazine 10 mg tablet sig: one (1) tablet po every six (6) hours as needed for nausea. 4. cyanocobalamin 1,000 mcg/ml solution sig: one (1) injection daily (daily) for 5 days: last dose . 5. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. 7. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 8. polyethylene glycol 3350 17 gram/dose powder sig: one (1) po daily (daily) as needed for nausea. 9. alum-mag hydroxide-simeth 200-200-20 mg/5 ml suspension sig: 15-30 mls po qid (4 times a day) as needed for gas, bloating. 10. oxycodone 10 mg tablet sustained release 12 hr sig: one (1) tablet sustained release 12 hr po q12h (every 12 hours). 11. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 12. allopurinol 300 mg tablet sig: one (1) tablet po once a day: please only start when creatinine is <1.5. . 13. dexamethasone 1 mg tablet sig: one (1) tablet po once a day. 14. lansoprazole 30 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 15. warfarin 1 mg tablet sig: two (2) tablet po once a day. 16. vitamin a-vitamin c-vitamin e tablet sig: one (1) tablet po once a day. 17. omega-3 fatty acids capsule sig: one (1) capsule po once a day. 18. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po every six (6) hours as needed for constipation. 19. ondansetron 4 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po q8h (every 8 hours) as needed for nausea. 20. metoprolol succinate 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily): hold of sbp<100 or hr<50 . 21. diltiazem hcl 30 mg tablet sig: one (1) tablet po qid (4 times a day): hold of sbp<100 or hr<50 . 22. iv fluid 20 meq potassium chloride / 1000 ml d5 1/2 ns continuous at 50 ml/hr discharge disposition: extended care facility: for the aged - ltc discharge diagnosis: primary: 1) acute renal failure 2) atrial fibrillation with rapid ventricular rate 3) thrombocytopenia secondary: metastatic prostate cancer depression discharge condition: stable vitals, afebrile. discharge instructions: you were admitted to the hospital for lower back pain and you were found to have a very high heart rate, kidney failure, and low platelet count. you were admitted to the icu where they controlled your heart rate with an iv diltiazem drip. we treated your kidney failure by aggressive iv hydration. the cause of your kidney failure was unclear, however, it might have been related to your elevated heart rate leading to low blood flow to the kidneys. fortunately, your kidney function improved with iv hydration. your heart rate also came under control by increasing your metoprolol dosage. we have made the following changes to your medications: start taking diltiazem 30mg by mouth four times a day start taking lansoprazole 30mg by mouth once a day start metoprolol succinate 50 mg by mouth every day start coumadin 2mg by mouth every day you will be transported to your follow up appointments listed below. please seek medical care if you develop chest pain, shortness of breath, palpiations, syncope, fevers. followup instructions: you have an appointment with provider: , md phone: date/time: 12:00 you have an appointment with provider: , rn phone: date/time: 1:00 you have an appointment with provider: , md phone: date/time: 10:20 md procedure: insertion of indwelling urinary catheter diagnoses: thrombocytopenia, unspecified acute kidney failure with lesion of tubular necrosis unspecified essential hypertension atrial fibrillation personal history of malignant neoplasm of prostate depressive disorder, not elsewhere classified atrial flutter nausea with vomiting other and unspecified hyperlipidemia long-term (current) use of anticoagulants other constipation hyperosmolality and/or hypernatremia antidepressants causing adverse effects in therapeutic use drug-induced delirium other and unspecified coagulation defects secondary malignant neoplasm of bone and bone marrow personal history of antineoplastic chemotherapy anemia in neoplastic disease antiallergic and antiemetic drugs causing adverse effects in therapeutic use unspecified psychosis psychotic disorder with delusions in conditions classified elsewhere 

Answer: The patient is high likely exposed to