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: patient recorded as having no known allergies to drugs attending: chief complaint: sob major surgical or invasive procedure: mechanical ventilation history of present illness: this is a 56 year-old female with a history of metastatic renal cell carcinoma with mets to the lung/cns presents with worsening sob. the family states that over the last 4 weeks she has been more sob, but has acutely worsened over the last 4 days. she went for her outpatient mri today and followed up with dr. in clinic. her mri was noted to have new lesions and suspicious lesions in her spine as well. she was noted to have severe dyspnea and referred to the ed. . in the ed, 98.4 126/66 118 24 98% 2l. cxr showed worsening mets. she was ordered for a cta, but on route she had a simple complex seizure and desated to 88% on 15l nc. her sats recovered after ativan 1mg to 93% on 15l. she was loaded with keppra per dr. . she everntually had her cta that was negative for pe, but showed worsening disease, compression of her right sided airways, pleural effusions. she was given albuterol and ipratropium nebs and given levofloxacin/flagyl for empiric coverage. she was also given 10mg dexamethasone. she was tachypneic on a nrb and uncomfortable so she was intubated. ip was contact with plans for possible procedure tomorrow. vent settings on transfer were ac tv 480, rr: 16, peep 5, fio2 100% and sedated on propofol. . ros: unable to obtain past medical history: oncology history: -- ct-scan a 10 cm left renal mass consistent with renal cell carcinoma. -- needle biopsy was performed on , which was nondiagnostic and a repeat biopsy of the kidney mass was performed on at hospital and upon review at also was not definitive. -- she had left nephrectomy on by dr. at . -- she had ct scan of torso on . -- this revealed worsening disease in the bilateral lungs and mediastinal masses. -- she was screened to start high dose il-2 post surgery. -- she underwent first week of high dose il-2 on the week of . she progressed after hd il-2 -- s/p 1 cycle of sutent-amg protocol. -- , brain ct on wednesday revealed four small lesion in the cns confirmed by mri. . past medical history: hashimoto's thyroiditis hypertension, appendectomy in right ovary surgery in laparoscopy for infertility social history: per three brothers, three sisters, she has no children. she owns contracting company with her husband specializing in concrete foundation for residential and commercial applications. she denies smoking, drinks occasionally, and doe snot use drugs. family history: per kidney disease in her maternal grandmother who had a nephrectomy for unknown cause, great grandmother who also had kidney disease, which she describes as bright's disease. physical exam: vitals: t: bp: hr: rr: o2sat: gen: intubated and sedated heent: perrl, sclera anicteric, no epistaxis or rhinorrhea, neck: no jvd, carotid pulses brisk, no bruits cor: rrr, no m/g/r, normal s1 s2, radial pulses +2 pulm: coarse breath sounds, prolonged exp phase with wheeze abd: soft, nt, nd, +bs, ext: no c/c/e, no palpable cords neuro: cn ii ?????? xii grossly intact. moves all 4 extremities. skin: no jaundice, cyanosis, or gross dermatitis. no ecchymoses. pertinent results: admission labs 11:06pm type-art rates-/16 o2-100 po2-265* pco2-57* ph-7.22* total co2-25 base xs--5 aado2-413 req o2-70 -assist/con intubated-intubated 09:15pm urine hours-random 09:15pm urine hours-random 09:15pm urine ucg-negative 09:15pm urine gr hold-hold 09:15pm urine color-straw appear-clear sp -1.035 09:15pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-15 bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 08:09pm lactate-1.5 03:48pm urea n-13 creat-0.7 sodium-134 potassium-4.9 chloride-98 total co2-27 anion gap-14 03:48pm alt(sgpt)-15 ast(sgot)-13 ld(ldh)-242 alk phos-98 tot bili-0.3 03:48pm albumin-3.0* calcium-9.4 phosphate-4.3 magnesium-1.6 03:48pm tsh-1.9 03:48pm free t4-1.2 03:48pm wbc-5.3 rbc-3.97* hgb-9.9* hct-30.5* mcv-77* mch-25.0* mchc-32.6 rdw-21.3* 03:48pm plt count-475* . discharge labs 08:40am blood wbc-9.2 rbc-3.83* hgb-9.7* hct-30.5* mcv-80* mch-25.4* mchc-31.8 rdw-22.3* plt ct-584* 03:51am blood wbc-8.8# rbc-3.76* hgb-9.8* hct-29.8* mcv-80* mch-26.0* mchc-32.8 rdw-22.2* plt ct-554* 03:36am blood wbc-5.8 rbc-3.42* hgb-8.6* hct-27.0* mcv-79* mch-25.2* mchc-31.9 rdw-22.7* plt ct-447* 03:36am blood neuts-71.7* lymphs-19.7 monos-6.2 eos-1.7 baso-0.6 08:40am blood plt ct-584* 03:51am blood plt ct-554* 03:36am blood plt ct-447* 08:40am blood glucose-82 urean-10 creat-0.9 na-136 k-3.7 cl-100 hco3-21* angap-19 03:51am blood glucose-93 urean-11 creat-0.8 na-135 k-5.4* cl-100 hco3-18* angap-22* 03:36am blood glucose-107* urean-12 creat-0.8 na-136 k-3.6 cl-105 hco3-20* angap-15 03:48pm blood alt-15 ast-13 ld(ldh)-242 alkphos-98 totbili-0.3 08:40am blood calcium-9.0 phos-3.3 mg-1.7 03:36am blood calcium-8.1* phos-3.0 mg-1.7 03:48pm blood tsh-1.9 03:48pm blood free t4-1.2 10:39am blood type-art po2-101 pco2-38 ph-7.38 caltco2-23 base xs--1 04:39am blood type-art po2-91 pco2-34* ph-7.45 caltco2-24 base xs-0 01:56am blood type-art po2-111* pco2-31* ph-7.46* caltco2-23 base xs-0 10:39am blood lactate-0.9 08:09pm blood lactate-1.5 10:39am blood freeca-1.19 . micro data sputum gram stain-final; respiratory culture-final -no growth mrsa screen mrsa screen-final urine legionella urinary antigen -final blood culture blood culture, routine-pending blood culture blood culture, routine-pending . ekg sinus tachycardia. vertical axis. since the previous tracing of the rate is faster. the axis is more vertical. . mr head 1. mild increase in the size of the right frontal and left frontal lesions. new lesions, in the right frontal lobe and in the right occipital lobe, one of which is possibly dural based. no significant change in some of the right occipital and the smaller lesion in the right frontal lobe. other details as above. continued close followup as clinically indicated. . cxr 1. overall progression of pulmonary metastatic disease. more confluent opacity in the lateral right lung base, while may represent worsening of metastatic disease, cannot exclude underlying consolidation/infection. . cta impression: 1. overall increase in size of innumerable bilateral pulmonary metastases as well as extensive mediastinal and hilar lymphadenopathy, consistent with progression of extensive metastatic disease. 2. no evidence of pulmonary embolism; however, there is attenuation of pulmonary artery branches with mass effect on the right pulmonary artery, worse compared to prior. 3. right middle and lower lobe bronchi are more compressed compared to prior from adjacent pulmonary/hilar masses. trachea is patent. 4. increased right pleural effusion. 5. liver appears heterogenous, however, is incompletely evaluated. hypodensity in the left lobe of the liver is unchanged. 6. suggestion of trace perisplenic fluid, not fully imaged. . cxr the current study demonstrates that the patient has been extubated. multiple pulmonary masses are redemonstrated but there is interval improvement of pulmonary edema. no interval increase in right pleural effusion or development of pneumothorax has been demonstrated. brief hospital course: micu course this is a 56 year-old female with a history of metastatic renal cell carcinoma with mets to the lung/cns presented with hypoxic respiratory failure. #. hypoxic respiratory failure: patient was intubated for a few days and was gradually weaned off her sedation,and was successfully extubated. prior to extubation she had cta which showed no clot and bronchoscopy which showed no airway compression amenable to stenting. she was placed on empiric anti biotics but with low suspicion for pneumonia. based on the fact that her respiratory distress was felt to be due to progressive metastatic disease and not reversible causes, we had a family meeting prior to extubation to discuss her wishes. options wre to mainatin intubation and trail chemo on ventilator versus extubate and hope she is stable on high flow and then can attempt chemo versus extubate and if she has progressive respiratory distress mpve to comfort care. teh decsion was extubate and if fails move to cmo. she initially tolerated extubation well however gradually experienced more respiratory distress and started on a morphine drip and scopalamine patch. . #. seizure: pt with simple complex seizure in the ed. mri showed worsening metastatic disease. she was started on keppra in the ed and given dex 10mg iv. . #. metastatic renal cell carcinoma: s/p 1 cycle of sutent. ct scan and mri showed worsening disease. . # expiration: pt passed today at 11:55am, pronounced by dr. . pt had been on morphine 5mg/hr and o2 at 60% high flow neb. family was at the bedside at time of passing. a came to the bedside to say a prayer, prior to the family leaving the hospital. medications on admission: azelaic acid - 15% gel to face benzonatate - 100mg q8 codeine-guaifenesin - 100 mg-10 mg/5 ml lorazepam - 1mg qhs oxycodone - 5 mg tablet q6:prn prochlorperazine maleate - 10 mg q8prn sertraline - 75mg daily sunitinib - 50 mg daily ibuprofen - 400mg tid/qidprn discharge medications: patient passed away discharge disposition: expired discharge diagnosis: patient passed away discharge condition: patient passed away discharge instructions: patient passed away followup instructions: patient passed away procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube fiber-optic bronchoscopy diagnoses: unspecified essential hypertension other convulsions malignant neoplasm of kidney, except pelvis acute respiratory failure encounter for palliative care personal history of malignant neoplasm of kidney personal history of antineoplastic chemotherapy secondary malignant neoplasm of other parts of nervous system 

Answer: The patient is high likely exposed to