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: history of present illness: briefly, the patient is a 43- year-old male, previously diagnosed with metastatic renal cell cancer, status post nephrectomy of his right kidney with recent clinical course significant for t7 spinal cord compression and large right loculated pleural effusion with pigtail catheter drainage who presented from rehab with shortness of breath, lethargy, pleuritic chest pain, and decrease in hematocrit requiring transfusion. prior to transfer, the patient was noted to have systolic blood pressure of approximately 100, to be tachycardiac to 110, and to have continued dyspnea with desaturations to 80 percent on nasal cannula oxygen. past medical history: metastatic renal cell cancer with metastases to right pleura and spinal cord, status post right nephrectomy in . hypertension. hyperlipidemia. allergies: no known drug allergies. medications prior to admission: 1. labetalol. 2. colace. 3. senna. 4. epo. 5. dilaudid. 6. decadron. 7. prevacid. 8. oxycontin. 9. dulcolax. 10. lactulose. 11. home oxygen. physical examination: temperature 98.8 degrees, heart rate 117, blood pressure 134/53, respiratory rate 20, and saturating 98 percent on nasal cannula oxygen. in general, ill-appearing, diaphoretic, and dyspneic male. heent: extraocular movements intact. neck: no jugular venous distention. lungs: decreased breath sounds at the right base with dullness to percussion. cardiovascular: tachycardiac without a murmur. abdomen: obese, soft, and nontender with normoactive bowel sounds. extremities: no edema. neurologic: alert, conversant, nonfocal. diagnostic studies: cbc, white count 4.5, hematocrit 25, and platelets of 85. differential, 67 percent polymorphonuclear leukocytes and 21 percent bands. chemistry significant for phosphorus 5.0 and no anion gap. coags within normal limits. cardiac enzymes negative. lfts significant for isolated alkaline phosphatase elevation of 168. chest x-ray, re-accumulation of previously seen right-sided pleural effusion with a density at the right lung base representing pneumonia. ct of the chest, loculated pleural fluid collections on the right with air-fluid levels consistent with empyemas. multiple pulmonary and liver metastases with lesions eroding into the left fifth and sixth proximal ribs. no evidence of pulmonary embolism. arterial blood gas on 100 percent nonrebreather mask, 7.2/84/66/34/2. lactate 1.3. hospital course: the patient was initially taken to radiology for a cat scan of the chest to rule out pulmonary embolus, at which time the patient became increasingly lethargic with a decrease in respiratory rate and was intubated for respiratory failure. for his respiratory failure, the patient was initially covered with vancomycin, levofloxacin, and clindamycin for a presumed pneumonia/empyema. while at ct scan, the patient became increasingly dyspneic, the patient was then admitted to the medical intensive care unit and his hypotension was managed with aggressive fluid resuscitation. additionally, the patient was given stress-dose steroids given his chronic steroid dependency, and he was transfused two units of packed red blood cells given his new-onset anemia. upon admission to the medical intensive care unit, the oncology consultation service was asked to evaluate the patient to assist in the management. medical resuscitation was continued until a discussion with the family including the healthcare proxy revealed wishes upon their part to provide comfort measures only to the patient. on hospital day two, the patient was made cmo and the cross covering medical intern was asked to evaluate the patient as he had become apneic and unresponsive. time of death documented at 04:25 p.m. on . family was notified and refused autopsy. condition on discharge: deceased. discharge diagnoses: renal cell carcinoma, metastatic. pneumonia. empyema. respiratory failure. septic shock. inflammatory response syndrome. , md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube transfusion of packed cells diagnoses: malignant neoplasm of liver, secondary unspecified essential hypertension secondary malignant neoplasm of pleura acute respiratory failure septic shock paralytic ileus personal history of malignant neoplasm of kidney empyema without mention of fistula secondary malignant neoplasm of bone and bone marrow 

Answer: The patient is high likely exposed to