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 / sulfa (sulfonamides) attending: chief complaint: right frontal brain mass major surgical or invasive procedure: : right frontal craniotomy for mass history of present illness: this is a 75 year old woman with a known history of metastatic carcinoma and a right frontal brain mass identified in , consistant with metastasis. she underwent cyberknife treatment. the patient had done well initially, but had developed steroid dependece to remain symptom free from the lesion; the steroids now cuase signifincat side effects such as myopathy, sweats, hunger, acne, lipodystrophy and vasculopathy. past medical history: oncologic history: ms. is a 74-year-old female with hypertension, one-vessel coronary artery disease status post drug-eluting stent in , history of breast cancer 23 years ago status post bilateral mastectomy who was recently found in to have brain and pulmonary metastases. full body imaging revealed a large rul nodule with many satellite nodules, as well as possible t11 bony involvement. fna of the dominant lung nodule was ttf-1 positive, mammoglobin and gcdfp-15 negative, most consistent with a lung adenocarcinoma. : received cyberknife x 1 to right frontal lobe lesion. : c1d1 of carboplatin auc 5 + pemetrexed 500 mg/m2 d1 q21d. completed two cycles with disease progression noted. : c1d1 of gemcitabine 1000 mg/m2 d1,15 q28d. osseous progression noted after two cycles. : admitted with seizures, likely arising from right frontal lobe lesion, imaging c/w radiation necrosis. : repeat ct of the torso showed increased size in the lytic metastasis at t6 and t11 current plans: 1. re: t11 vertebra, this must be addressed locally before any further systemic therapy can be undertaken. the tentative plan is to radiate the lesion and follow this up with kyphoplasty (got treatment xrt on ). 2. re: systemic disease, she has considered her options and currently favors a clinical trial of a novel hsp90 inhibitor. she appears to be eligible for this trial and we would plan to enroll her once the above issue has been resolved. . other past medical history: 1. hypertension. 2. one vessel coronary artery disease with cardiac catheterization in showing om 3/lpl 90% stenosis status post drug-eluting stent with mild coronary disease and the other epicardial coronary tree. 3. hypothyroidism 4. left-sided breast cancer (er/pr status unknown) status post bilateral mastectomy in (pt states she had b/l mastectomies at age 29yo??) with no evidence of recurrence and no adjuvant therapy social history: she lives by herself and has a son who lives in ma. she has a long-term boyfriend. she has no history of smoking or alcohol. family history: per omr: maternal aunt had "eye cancer", father had type ii diabetes and prostate ca at older age. mother who had a myocardial infarction in her 50s physical exam: on pre-op eval: gen: well developed, well nourished, comfortable, no apparent distress. heent: normocephalic, atraumatic, anicteric sclerae,. neurological examination: mental status: awake and alert, cooperative with exam, normal affect. orientation: oriented to person, place, and date. language: speech fluent with good comprehension. no dysarthria or paraphasic errors. cranial nerves: i: not tested ii: pupils equally round and reactive to light,3.5mm to 2mm bilaterally. visual fields are full to confrontation. iii, iv, vi: extraocular movements intact bilaterally without nystagmus. v, vii: facial strength and sensation intact and symmetric. viii: hearing intact to voice. ix, x: palatal elevation symmetrical. : sternocleidomastoid and trapezius normal bilaterally. xii: tongue midline without fasciculations. motor: normal bulk and tone bilaterally. no abnormal movements, tremors. grip tri delt we wf ip quad ham at sensation: intact to light touch. on discharge: oriented x 3. it takes her some time to remember the date but she was correct. perrl, eoms intact. face symmetric, tongue midline. no drift. full strength and sensation throughout. in place - incision clean, dry, and intact. pertinent results: ct head : expected postoperative changes noted in the right frontal region including right frontal pneumocephalus and a small amount of fluid in the right frontal subdural space. head : 1. expected postoperative change following resection of an enhancing mass in the right frontal lobe. 2. persistent enhancement at the superior aspect of the resection bed; attention to this area is necessary on further followup imaging to exclude the possibility of residual tumor. brief hospital course: ms. was admitted to on and underwent a right frontal craniotomy for excision of tumor. post-operatively she was transfered to the icu for q1 hour neuro checks. the patient remained neurologically stable and was then transferred to the neurosurgical floor on pod#1. she worked with pt and ot several times. they felt that she was not ready to be home without 24-hour supervision. therefore she was discharged to a rehab facility on . medications on admission: amlodipine - 5 mg tablet - 5mg tablet(s) by mouth once a day dexamethasone - 4 mg tablet - 1 tablet(s) by mouth once a day donepezil - 5 mg tablet - 1 tablet(s) by mouth daily hydrocodone-acetaminophen - 5 mg-500 mg tablet - tablet(s) by mouth every eight (8) hours as needed for pain levetiracetam - 750 mg tablet - 1 tablet(s) by mouth twice a day levothyroxine - 75 mcg tablet - 1 tablet(s) by mouth once a day omeprazole - 20 mg capsule, delayed release(e.c.) - 1 capsule(s)by mouth daily discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 2. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). disp:*30 capsule, delayed release(e.c.)(s)* refills:*2* 3. levetiracetam 250 mg tablet sig: three (3) tablet po bid (2 times a day). disp:*180 tablet(s)* refills:*2* 4. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 5. donepezil 5 mg tablet sig: one (1) tablet po hs (at bedtime). 6. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 7. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. 8. levothyroxine 75 mcg tablet sig: one (1) tablet po daily (daily). 9. hydromorphone 2 mg tablet sig: 1-2 tablets po every four (4) hours as needed for pain: no driving while on this medication. disp:*50 tablet(s)* refills:*0* 10. dexamethasone 4 mg tablet sig: one (1) tablet po q12 () for 2 days. 11. dexamethasone 2 mg tablet sig: 1.5 tablets po q12 () for 2 days: start after 4 mg tapered dose. 12. dexamethasone 2 mg tablet sig: one (1) tablet po q12 () for 1 days: start after 3 mg tapered dose. . 13. dexamethasone 2 mg tablet sig: one (1) tablet po q24 () for 1 days: start after 2mg tapered dose. discharge disposition: extended care facility: for the aged - discharge diagnosis: right frontal mass discharge condition: neurologically stable mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: general instructions wound care: ?????? you or a family member should inspect your wound every day and report any of the following problems to your physician. ?????? keep your incision clean and dry. ?????? you may wash your hair with a mild shampoo 24 hours after your are removed. ?????? do not apply any lotions, ointments or other products to your incision. ?????? do not drive until you are seen at the first follow up appointment. ?????? do not lift objects over 10 pounds until approved by your physician. diet usually no special diet is prescribed after a craniotomy. a normal well balanced diet is recommended for recovery, and you should resume any specially prescribed diet you were eating before your surgery. be sure however, to remain well hydrated, and increase your consumption of fiber, as pain medications may cause constipation. medications: ?????? take all of your medications as ordered. you do not have to take pain medication unless it is needed. it is important that you are able to cough, breathe deeply, and is comfortable enough to walk. ?????? do not use alcohol while taking pain medication. ?????? medications that may be prescribed include: -narcotic pain medication such as dilaudid (hydromorphone). -an over the counter stool softener for constipation (colace or docusate). if you become constipated, try products such as dulcolax, milk of magnesia, first, and then magnesium citrate or fleets enema if needed). often times, pain medication and anesthesia can cause constipation. ?????? if you have been prescribed dilantin (phenytoin) for anti-seizure medicine, take it as prescribed and follow up with laboratory blood drawing in one week. this can be drawn at your pcp??????s office, but please have the results faxed to . if you have been discharged on keppra (levetiracetam), you will not require blood work monitoring. ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, and ibuprofen etc, as this can increase your chances of bleeding. ?????? if you are being sent home on steroid medication, make sure you are taking a medication to protect your stomach (prilosec, protonix, or pepcid), as these medications can cause stomach irritation. make sure to take your steroid medication with meals, or a glass of milk. activity: the first few weeks after you are discharged you may feel tired or fatigued. this is normal. you should become a little stronger every day. activity is the most important measure you can take to prevent complications and to begin to feel like yourself again. in general: ?????? follow the activity instructions given to you by your doctor and therapist. ?????? increase your activity slowly; do not do too much because you are feeling good. ?????? you may resume sexual activity as your tolerance allows. ?????? if you feel light headed or fatigued after increasing activity, rest, decrease the amount of activity that you do, and begin building your tolerance to activity more slowly. ?????? do not drive until you speak with your physician. ?????? do not lift objects over 10 pounds until approved by your physician. ?????? avoid any activity that causes you to hold your breath and push, for example weight lifting, lifting or moving heavy objects, or straining at stool. ?????? do your breathing exercises every two hours. ?????? use your incentive spirometer 10 times every hour, that you are awake. when to call your surgeon: with any surgery there are risks of complications. although your surgery is over, there is the possibility of some of these complications developing. these complications include: infection, blood clots, or neurological changes. call your physician immediately if you experience: ?????? confusion, fainting, blacking out, extreme fatigue, memory loss, or difficulty speaking. ?????? double, or blurred vision. loss of vision, either partial or total. ?????? hallucinations ?????? numbness, tingling, or weakness in your extremities or face. ?????? stiff neck, and/or a fever of 101.5f or more. ?????? severe sensitivity to light. (photophobia) ?????? severe headache or change in headache. ?????? seizure ?????? problems controlling your bowels or bladder. ?????? productive cough with yellow or green sputum. ?????? swelling, redness, or tenderness in your calf or thigh. call 911 or go to the nearest emergency room if you experience: ?????? sudden difficulty in breathing. ?????? new onset of seizure or change in seizure, or seizure from which you wake up confused. ?????? a seizure that lasts more than 5 minutes. important instructions regarding emergencies and after-hour calls ?????? if you have what you feel is a true emergency at any time, please present immediately to your local emergency room, where a doctor there will evaluate you and contact us if needed. due to the complexity of neurosurgical procedures and treatment of neurosurgical problems, effective advice regarding emergency situations cannot be given over the telephone. ?????? should you have a situation which is not life-threatening, but you feel needs addressing before normal office hours or on the weekend, please present to the local emergency room, where the physician there will evaluate you and contact us if needed. followup instructions: ??????please return to the office in days (from your date of surgery) for removal of your staples/ and a wound check. although we try to be thorough, we may miss or staples. be sure to point out any incisions, which may be covered by clothing at the time of suture/staple removal. this appointment can be made with the nurse practitioner. please make this appointment by calling . you have your removed at rehab. this must be done by . ??????you have an appointment with dr. on at 2:45 pm. procedure: other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain other repair of cerebral meninges diagnoses: urinary tract infection, site not specified unspecified acquired hypothyroidism personal history of malignant neoplasm of breast other specified forms of chronic ischemic heart disease secondary malignant neoplasm of brain and spinal cord malignant neoplasm of other parts of bronchus or lung accidents occurring in other specified places secondary malignant neoplasm of bone and bone marrow radiological procedure and radiotherapy as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other specified bacterial infections in conditions classified elsewhere and of unspecified site, other anaerobes other conditions of brain other ill-defined cerebrovascular disease 

Answer: The patient is high likely exposed to