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: no known allergies / adverse drug reactions attending: chief complaint: altered mental status major surgical or invasive procedure: intubation central line placement history of present illness: history of present illness: 88f w/ h/o grave's disease, ?cri/?htn & recently diagnosed rul lung mass with lad & liver mets who presents from rehab with altered mental. per her rehabilitation facility, the patient is usually responsive to her name and this evening became unresponsive to name. it is unclear her baseline mental status. there is no evidence of fever from rehabilitation records. patient to altered to tell us her symptoms. in the ed, initial vs were: 86 84/40 18 100% 2l nc. cvl was placed in rij. labs were notable for acute kidney injury (cr 4.3 <- 1.2 on ), leukocytosis with wbc 24.1 (up from recent baseline of 17) w/ 91% polys, no bands & hco3 15. transaminases, alk phos and lipase were elevated, however the specimen was hemolyzed which can falsely elevate these values. lactate 2.3. prelim read of ct head & abd/pelvis were negative for acute process. patient received 3l lactated ringers as well as vancomycin 1g iv and zosyn 4.5mg iv empirically. while in the ed, patient's bps were 90s/60s (ems) -> 84/40s (on presentation) -> got 3l fluids with no change in bp -> 90s/40s -> started levophed gtt @ 0.09 & bps increased to 100-107/43-52. vs on transfer were 78, 20, 100%2l, cvp 7->12, 98 rectal. . on arrival to the micu, the patient is non-verbal and unable to partake in a review of systems questions. past medical history: grave's disease htn thoracic spine fx s/p hysterectomy urinary retention constipation osteoarthritis possible chronic kidney disease social history: lives alone, no biologic children, minimal contact with step children no etoh, family history: none relevant to fall physical exam: physical exam on discharge: vitals: 95.3 79/64 83 20 96% on ra general: extubated, still altered, not talking in words. not in any painful distress, but obviously not oriented. heent: sclerae anicteric, very dry mucous membranes, +dry eyes neck: supple, unable to assess jvp, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation anteriorly, no wheezes, rales, rhonchi abdomen: soft, diffusely tender, non-distended, bowel sounds present, no organomegaly gu: foley in place ext: warm, bilateral dp pulses observed by doppler, no clubbing, cyanosis or edema pertinent results: 01:15am blood wbc-24.1* rbc-4.41 hgb-11.1* hct-35.9* mcv-81* mch-25.3* mchc-31.1 rdw-19.6* plt ct-264 03:25am blood wbc-26.1* rbc-3.50* hgb-9.1* hct-26.6* mcv-76* mch-26.1* mchc-34.3 rdw-20.1* plt ct-286 03:25am blood neuts-78* bands-0 lymphs-13* monos-6 eos-3 baso-0 atyps-0 metas-0 myelos-0 03:25am blood pt-22.4* ptt-58.1* inr(pt)-2.1* 03:25am blood glucose-143* urean-84* creat-3.2* na-137 k-3.4 cl-108 hco3-15* angap-17 03:06am blood alt-105* ast-183* alkphos-363* amylase-88 totbili-1.8* 03:25am blood calcium-8.4 phos-3.0# mg-2.7* 03:06am blood cortsol-42.1* 11:48pm blood vanco-19.9 03:45am blood lactate-2.6* ct findings: there is no evidence of hemorrhage, edema, mass effect or infarction. the ventricles and sulci are markedly prominent, likely secondary to age-related global atrophy. there is no shift of normally midline structures. the -white matter differentiation is grossly preserved. there is no evidence of fracture. a large mucous retention cyst is noted in the right maxillary sinus. the remaining visualized paranasal sinuses and mastoid air cells are clear. impression: 1. no acute intracranial process. 2. significant global atrophy, likely age-related. 3. large mucous retention cyst in the right maxillary sinus. ct impression: 1. limited study without iv contrast. 2. similar 1.6 x 1.9 cm spiculated right upper lobe lesion with associated right hilar and mediastinal lymphadenopathy, highly concerning for malignancy. 3. 2-mm left upper lobe nodule, apparently new. bibasilar atelectasis and left lower lobe discoid atelectasis. no definite focal airspace consolidations. 4. multifocal large hypodense lesions in the liver, incompletely assessed without iv contrast but compatible with widespread hepatic metastases. 5. moderate-sized hiatal hernia. 6. evidence of tracheomalacia. 7. large fibroid uterus. 8. similar significant t11 and t12 compression fractures. brief hospital course: assessment and plan: this is a 88 yo female that presented with altered mental status, hypotension, a right upper mass concerning for lung cancer and evidence of metastatic spread. . #. hypotension: the patient presented with hypotension likely due to a combination of hypovolemia (poor po intake for the preceeding days) and distributive/septic shock (given a wbc 24). the infectious source was not found. ct of chest/abdomen/pelvis was not revealing. ua was negative. blood, urine, and sputum cultures were unrevealing for an infectious source. the patient was started on levophed gtt, but was discontinued and made cmo (see below). the patient was initially place on vancomycin and zosyn, which were discontinued after she was made cmo. . #. altered mental status from toxic metabolic encephalopathy in the context of multiple insults including hypotension and infection. a ct of her head was negative for an obvious cause of altered mental status. broad spectrim antibotics were started, but stopped when made cmo. . #. right upper lung mass- the patient presented with a right upper lung mass concerning for malignance with evidence of an 8th rib fracture and hepatic metastases a further work up was deferred after the patient was made cmo. . #. hypercarbic respiratory failure- the patient presented with metabolic acidosis (likely from sepsis) with inappropriate respiratory compensation. she was intubated and placed on mechanical ventilation for hypercarbic respiratory failure. she was extubated and made cmo. . #. comfort measures only- the patient was made cmo after confirming with the patient's next of kind that the patient's wish would be to remain as comfortable as possible until she died. she was extubated. pressors were stopped. the patient was started on artificial tears, morphine prn, and all medication were stopped other than those to maintain comfort. . #. acute kidney injury. the patient presented hypovolemic and labs consistent with pre-renal/atn. all medications were renally dose. nephrotoxic drugs were avoided. the improved after fluid resuscitation. . #. pt home dose of levothyroxine was continued until made cmo . #. microcytic anemia: likely from anemia of chronic inflammation given labs results. medications on admission: 1. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. polyvinyl alcohol-povidone 1.4-0.6 % dropperette sig: drops ophthalmic daily (daily). 4. miconazole nitrate 2 % powder sig: one (1) appl topical (2 times a day) as needed for intertrigo. 5. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed for wheezing. 6. levothyroxine 25 mcg tablet sig: one (1) tablet po daily 7. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po q8h (every 8 hours) as needed for constipation. discharge medications: 1. polyvinyl alcohol-povidone 1.4-0.6 % dropperette sig: drops ophthalmic daily (daily). 2. acetaminophen 650 mg/20.3 ml solution sig: one (1) po q6h (every 6 hours) as needed for pain. 3. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 4. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day) as needed for constipation. 5. pain management please start morphine sulfate 1-5 mg iv q2h:prn sob, pain management. please titrate to comfort. discharge disposition: extended care facility: rehabilitation and nursing of discharge diagnosis: hypoxemia respiratory failure hypotension right upper lobe mass discharge condition: mental status: confused - always. level of consciousness: lethargic and not arousable. activity status: bedbound. discharge instructions: you were admitted to for altered mental status. we found that you had low blood pressure, which we treated by giving you intravenous fluids and medications to raise the blood pressure. we also found that you had difficult breathing, which we treated by intubation you and having a ventilator help you breath. we also found evidence of a likely cancer that has spread around your body. medication: stop taking all medications, except the folllowing: acetaminophen 650 every 6 hours for pain artificial tears 1-2 drops both eyes daily morphine sulfate as needed followup instructions: please see your primary care providor as needed md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube diagnoses: acidosis anemia, unspecified malignant neoplasm of liver, secondary acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified toxic encephalopathy unspecified septicemia severe sepsis hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified chronic kidney disease, unspecified acute respiratory failure malignant neoplasm of upper lobe, bronchus or lung septic shock osteoarthrosis, unspecified whether generalized or localized, site unspecified do not resuscitate status toxic diffuse goiter without mention of thyrotoxic crisis or storm hypovolemia secondary and unspecified malignant neoplasm of intrathoracic lymph nodes acquired absence of both cervix and uterus pathologic fracture of other specified site 

Answer: The patient is high likely exposed to