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 / keppra attending: chief complaint: lethargy, headache, and emesis. major surgical or invasive procedure: none. history of present illness: this is a 50-year-old woman with known left glioblastoma followed closely by dr. . she is status post left posterior parietal occipital glioblastoma status post left parietal craniotomy then chemoradiation therapy. she woke up morning of admission day with increasing headaches followed by nausea, vomiting and right sided weakness. patient was seen at where a head ct showed gross left cerebral edema with 1.2 cm midline shift. subsequently, patient was intubated for airway protection and given 10 mg of dexamethasone and 50 gram of mannitol and transferred to . on arrival to the ed, patient was lightly sedated and moving all extremities. additionally, patient's mannitol was held given her good examination per ed. neurosurgery consulted for further management. past medical history: oncologic history: she is status post 1. gross total resection on by dr. at . 2. study drug zd6474 started on . 3. radiation plus temodar started on . her neurological history began in of this year with fatigue, malaise, and headache. it progressed to difficulty doing her usual tasks. she was involved in two minor car accidents. she then started having nausea and vomiting. a head ct was done in , she was living and showed a large left occipitoparietal mass with brain edema. she came back to where her parents live for surgery. this was done by dr. and most of her symptoms improved. past medical history: tonsillectomy as a child. social history: she is single. she is a masters' graduate and is a landscape architect. she does not have any children. she has been living out in for several years and was skiing during the . family history: her parents are alive and well with a history of coronary artery disease and melanoma. she has two brothers, one who has diverticulitis that required a colectomy. she has one sister with asthma and skin lupus. physical exam: admission physical examination: vital signs: temperature 97.0 f, blood pressure 114/77, pulse 63, respiration 23, oxygen saturation 100% on 100% fio2 with peep. general: intubated/sedated on propofol, well nourished and well developed. heent: radiation alopecia, eyes are 2mm and reactive to 1mm, ears: hearing intact, nods to question pupils: , eoms restricted neck: supple. lungs: clear to auscultation bilaterally, no wheezes or rales. cardiovascular: regular rate and rhythm. s1/s2. abdomen: soft, non-tender, and with positive bowel sounds. extremities: warm and well-perfused. neurological examination: mental status: intubates/sedated, after propofol stopped pt nods to questions and follows commands orientation: nods to name follows commands in all extremities, noticeable right hemiparesis ue>le, left side full, + gag, + corneals toes are upgoing on the right, left is mute discharge physical examination: vital signs: t 97.1, tmax 97.5, bp 104/62 (90-112/54-76), hr 70 (56-70), rr 13, o2sat 97% ra general: comfortable, not in distress, pleasant heent: perrla, eomi, visual field defect in her temporal half of right visual field. no op lesion. mmm. neck: no jvd, no ln's cardiovascular: rrr, ns1 s2, no added sounds,murmurs,rub or gallop chest: clear air entry bilaterally, no wheezes or rales. right port-a-cath abdomen: soft, nontender,nondistended, +bs, no organomegaly extremities: no edema or cyanosis or clubbing, pulses palpable peripherally bilaterally +2. neurological examination: her karnofsky performance score is 60. she is awake, alert, and able to follow commands. her language is fluent with good comprehension. her recent recall is good. cranial nerve examination: her pupils are equal and reactive to light, 4 mm to 2 mm bilaterally. extraocular movements are full; there is no nystagmus. visual field examination is notable for a right field cut, with od denser than os. her face is symmetric. facial sensation is intact bilaterally. her hearing is intact bilaterally. her tongue is midline. palate goes up in the midline. sternocleidomastoids and upper trapezius are strong. motor examination: she does not have a drift. her muscle strengths are at all muscle groups. her muscle tone is normal. her reflexes are 2- and symmetric bilaterally. her ankle jerks are absent. her right toe is equivocal while her left is down going. sensory examination is intact to touch and proprioception. coordination examination does not reveal dysmetria. her gait is somewhat unsteady but with minimal assist. pertinent results: admission labs: blood wbc-7.0 rbc-3.40* hgb-13.0 hct-34.3* mcv-101* mch-38.2* mchc-37.9* rdw-14.8 plt ct-413 blood glucose-97 urean-13 creat-0.7 na-129* k-4.4 cl-96 hco3-26 angap-11 blood alt-19 ast-18 ld(ldh)-207 alkphos-85 totbili-0.4 blood calcium-8.7 phos-3.1 mg-2.1 blood osmolal-293 blood lactate-1.4 urine analysis wnl discharge labs: 04:19am blood calcium-9.0 phos-3.5 mg-2.1 06:00am blood glucose-85 urean-15 creat-0.7 na-141 k-4.0 cl-105 hco3-28 angap-12 06:00am blood wbc-5.5 rbc-3.29* hgb-11.8* hct-33.4* mcv-101* mch-35.8* mchc-35.3* rdw-13.7 plt ct-343 radiology: chest (portable ap) study date of impression: 1. endotracheal tube ends 2.5 cm above the carina. 2. nasogastric tube side port is at the ge junction and could be advanced. mr head w & w/o contrast study date of impression: 1. enlarging complex enhancing hemorrhagic mass involving the left occipital, posterior temporal and parietal regions with associated vasogenic edema. there is worsening mass effect over the left lateral ventricle and worsening midline shift to the right now measuring 1.3 cm. brief hospital course: is a 50-year-old woman, with glioblastoma, s/p resection, temozolomide chemo-irradiation, who presented to with nausea, vomiting, and headache. she was found to have a hemorrhagic intracerebral mass with associated edema, mass effect, and midline shift. she was admitted from the ed of to sicu for further care. upon improvement, she was transferred to medical oncology floor and received irinotecan on . (1) glioblastoma: she was intubated for airway protection and was admitted to the sicu on . her mri scan showed left occipital lesion compatible with regrowth of her prior known glioblastoma. it was a hemorrhagic intracerebral mass with associated edema, mass effect, and midline shift. she was treated with dexamethasone and mannitol but was deemed to not be a surgical candidate. she remained stable on the ventilator overnight and on the morning of was extubated. she was transferred to medical oncology floor in a stable condition on . on the floor, neurologically she was alert, interactive and oriented to time place and person, with power of in her right upper and lower extremities. she could say the weekdays back and forth. she could not say the months of the year backwards but could easily say them forward. she needed guidance when testing for cerebellar functions as it seems it was difficult for her to comprehend complex tasks. she received chemotherapy (irinotecan) on . she was evaluated by pt/ot and was felt to benefit from rehabilitation. her home dexamethasone dose was increased to 4 mg every 6 hours, and she was started on phenytoin 100 mg three times daily (for seizure prophylaxis) and famotidine 20 mg twice daily. she will continue these medications until instructed otherwise by dr. . she is scheduled for her next administration of chemotherapy on . (2) hyponatremia: she was hyponatremic on admission and received fludrocortisone and hypertonic saline, which led to normalization of her hyponatermia. fludrocortisone was discontinued. medications on admission: dexamethasone - 1 mg tablet - 2 tablet(s) by mouth daily ondansetron hcl - 8 mg tablet - 1 (one) tablet(s) by mouth one hour before chemo and prn, send with temodar temozolomide - 140 mg capsule - 1 capsule(s) by mouth hs for 5 nights total daily dose 390 mgs temozolomide - 250 mg capsule - 1 capsule(s) by mouth hs for 5 nights, dx: 191.8 needs for . discharge medications: 1. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*0* 2. dexamethasone 4 mg tablet sig: one (1) tablet po q6h (every 6 hours). disp:*120 tablet(s)* refills:*0* 3. phenytoin 50 mg tablet, chewable sig: two (2) tablet, chewable po every eight (8) hours. disp:*30 tablet, chewable(s)* refills:*2* discharge disposition: home with service facility: life care center - discharge diagnosis: left occipital glioblastoma. discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear ms. , it was a pleasure caring for you. you were admitted with a headache, nausea, and vomiting, and were found to have a lesion in your brain. this was treated with medications and chemotherapy. we made the following changes to your medications: - increase dexamethasone from 2mg daily to 4mg every 6 hours (four times daily), to be taken until directed otherwise by dr. - start dilantin (phenytoin) 100mg by mouth every 8 hours - start famotidine 20mg twice daily, to be taken while you are taking phenytoin. followup instructions: department: hematology/oncology (chemotherapy) when: thursday at 9:00 am with: , rn building: campus: east best parking: garage department: hematology/oncology when: thursday at 9:00 am with: , md building: sc clinical ctr campus: east best parking: garage department: center when: tuesday at 11:00 am with: , md building: sc clinical ctr campus: east best parking: garage procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours injection or infusion of cancer chemotherapeutic substance diagnoses: hyposmolality and/or hyponatremia intracerebral hemorrhage compression of brain nausea with vomiting cerebral edema headache other malaise and fatigue family history of other specified malignant neoplasm other specified hemiplegia and hemiparesis affecting dominant side malignant neoplasm of occipital lobe 

Answer: The patient is high likely exposed to