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: incidental finding of right upper lobe nodule major surgical or invasive procedure: right upper lobectomy for right upper lobe nodule history of present illness: 62 year oldg entleman who has had a right upper lobe nodule incidentally noted on a chest ct dated . serial follow up of this scan has noted an increase from 9 mm in size to 13 mm. past medical history: recurrent falls executive dysfunction and dementia- s/p extensive neurologic work-up seasonal allergies thyroid carcinoma s/p thyroidectomy. depression/ dementia hypercholesterolemia mediastinoscopy for lymph node dissection recent largngoscopy showing findings consistent with recurrent right laryngeal nerve palsy social history: no history of ethanol, tobacco, drugs. he formerly worked as a customer service representative for a telephone company, but is currently unemployed. he is divorced and has two kids who are very involved in his care. they both live in , but one is planning to move to shortly. he currently lives with his mother. family history: father died of myocardial infarction at the age of 68. mother is alive and is ok. he has no siblings. physical exam: general- older appearing middle/elderly male, nad. poor historian heent- dry mucous membranes, eomi, perrla; lungs-clear to ausculatation bilat cor-rrr abd-soft, nt, nd ext- no edema, 2+ dp, pt , oriented x2, fleeting attention, resting tremor in left thumb and index finger, rhythmic movements in both lower extremities; strength 5/5 throughout; balance-poor, need 2 full assist; gait- limited le movement. pertinent results: 06:48pm plt count-285# 06:48pm wbc-13.7*# rbc-4.10* hgb-13.0* hct-37.5* mcv-91 mch-31.7 mchc-34.7 rdw-13.6 06:48pm calcium-8.4 phosphate-3.9 magnesium-1.8 06:48pm glucose-152* urea n-30* creat-1.4* sodium-140 potassium-4.6 chloride-107 total co2-22 anion gap-16 09:17pm type-art po2-171* pco2-43 ph-7.35 total co2-25 base xs--1 hematology complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 06:25am 11.7* 3.66* 11.8* 33.6* 92 32.1* 35.1* 13.1 239 basic coagulation (pt, ptt, plt, inr) plt ct 06:25am 239 chemistry renal & glucose glucose urean creat na k cl hco3 angap 10:58am 100 25* 1.1 140 4.31 106 20* 18 slight hemolysis 1 hemolysis falsely increases this result enzymes & bilirubin alt ast ld(ldh) ck(cpk) alkphos amylase totbili dirbili 03:31pm 65* 64* 263* 64 0.5 chemistry totprot albumin globuln calcium phos mg uricacd iron 10:58am 8.8 3.2 1.9 slight hemolysis pituitary tsh 03:31pm <0.02* 05:40am <0.02* added tsh 9:35am thyroid t4 free t4 09:45am 7.9 1.5 radiology final report ct head w/o contrast 9:01 am findings: there is no significant interval change in the appearance of the present noncontrast head ct scan compared to the prior study of , as well as the outside study from hospital. there is no sign for the presence of a visible intracranial mass lesion. both studies show slightly asymmetric atrophy of the cerebellum, more evident in the region of the right cerebellar hemisphere. images of the cerebellum, at this time, are moderately degraded by patient motion. in any case, visualization of the mr- described cavernous hemangioma would be extremely difficult, given its reported small size and typically limited visibility on a noncontrast head ct scan. the surrounding osseous and soft tissue structures show no additional abnormalities. conclusion: no interval change from prior study of . in view of the questions you have raised in the history, kindly forward the original report of the hospital ct scan for our independent review. cta chest w&w/o c &recons 8:11 am ct angiogram findings: the main right and left, lobar and proximal segmental pulmonary arteries are widely patent and appear normal, no evidence of acute pulmonary embolus. at the peripheral segmental level the contrast opacification is slightly suboptimal. normal heart size and central pulmonary arterial vasculature. normal caliber thoracic aorta. patient is status post right upper lobectomy. small right posterior basal pleural effusion. partial atelectasis of the medial segment of the right middle lobe. patchy consolidation in the posterior aspect of the right lower lobe also patchy airspace consolidation in the posterior portion of left lower lobe. there is associated increased ground-glass attenuation in these areas more marked on the left lung. differential possibilities include aspirational pneumonia. although the appearances were asymmetric, worse on the left side, asymmetric pulmonary oedema is also a consideration. however, the nondependent interlobular septae in the right lung do not appear thickened at present. minor area of residual localized pneumothorax in the central medial thorax. no bone lesions demonstrated. in the arterial phase scan, there is an ill-defined area of hypodensity in the posteromedial aspect of segment vii (series 4, image 100) which remains unchanged in size compared to prior ct of . conclusion: 1. no acute pulmonary embolus demonstrated. 2. extensive patchy consolidation in the left lung and posterior aspect of the remaining right lower lobe with associated ground-glass attenuation in those areas. differential considerations include aspiration pneumonia possibly with some associated and asymmetric pulmonary edema. small localized right posterior basal pleural effusion. chest (pa & lat) 11:02 am the patient is status post partial resection of the right lung with volume loss and a persistent small right apical pneumothorax. the heart is normal in size. there are bibasilar areas of consolidation, left greater than right, which appear worsened in the interval. small right pleural effusion is without change. impression: 1. evolving bibasilar pneumonia. 2. small right apical pneumothorax. bronchial lavage : atypical. rare isolated atypical cells, can not exclude malignancy. neutrophils, histiocytes and red blood cells. pathology examination name birthdate age sex pathology # , 62 male report to: dr. gross description by: dr. /mtd specimen submitted: parietal pleura (fs), right. upper lobe wedge (fs), bronchial margin, level 10 hilar, and level 11 inter lobar. procedure date tissue received report date diagnosed by dr. . /vf previous biopsies: 4 r/l lower paratracheal,2 r upper paratracheal,7 diagnosis: i. parietal pleura (a): fragments of lung and pleura with focal fibrosis. note: by immunohistochemistry, the aggregates of cells present are negative for cytokeratin cocktail (ae1/ae3, cam5.2), s-100, hmb-45, and mart-1. calretinin is weakly positive in the mesothelial cells present. ii. right upper lobe, wedge resection (b-j): malignant melanoma (1.0 cm), see note. note: sections show a monotypic population of atypical spindled and epithelioid cells with prominent nucleoli, arranged in nodules and small nests. by immunohistochemistry, these cells are positive for s-100 and mart-1; they are negative for cytokeratin cocktail, 34be12, synaptophysin, chromogranin and ttf1. this immunophenotype supports the diagnosis of malignant melanoma. iii. lung, right upper lobectomy (k-r): 1. bronchial and vascular margins with no malignancy. 2. lung parenchyma with emphysematous changes and vascular congestion; no malignancy identified. 3. pleural fibrosis. iv. lymph node, level 9, pulmonary ligament (s): two lymph nodes with no malignancy identified (0/2). v. lymph node, level 10, hilar (t): one lymph node with no malignancy identified (0/1). vi. lymph node, level 11, interlobar (u): one lymph node with no malignancy identified (0/1). vii. lymph node, level 12, lobar (v): one lymph node with no malignancy identified (0/1). clinical: right upper lobe nodule. gross: the specimen is received in seven parts each labeled with the patient's name, ", " and the medical record number. part 1 is received fresh in the or and consists of two fibrofatty fragments measuring 0.7 x 0.4 x 0.3 cm in aggregate. the specimen is inked and submitted entirely for frozen section and carries a frozen section diagnosis by dr. of: "parietal pleura, focal cellular spindle/epithelial proliferation, fdpps". the specimen is submitted entirely in a part 2 is received fresh in the or and consists of an unoriented lung wedge of spongy grey tissue measuring 5.3 x 2.5 x 1.2 cm. the margin is inked in and the rest in black and the specimen is noted to be previously incised by the surgeon for microbiology. the specimen is serially sectioned to show a well-circumscribed nodule measuring 1.0 x 0.9 x 0.9 cm approximately 1.3 cm from the staple line, but does not involve the overlying visceral pleura. a portion of the specimen is frozen and carries a frozen section diagnosis by of: "right upper lobe wedge, spindle/epithelioid tumor, fdpps". the frozen section remnant is submitted entirely in b. the staple line is cut away from the remainder of the specimen. the specimen is serially sectioned and submitted entirely in cassettes c-j with the nodule in e-h. part 3 is additionally labeled "bronchial margin" and is received fresh in the or and consists of a lung lobectomy specimen measuring 16.0 x 8.0 x 2.5 cm. the bronchial margin is identified and submitted en face for frozen section and carries a frozen section diagnosis by dr. of: "bronchial margin, negative for malignancy". the bronchial margin frozen section is submitted entirely in k. on the pleural and inferior surface of the specimen approximately 5.5 cm away from the bronchial resection margin is a pleural nodule that is tan- in color that measures 3.5 x 2.0 cm and is inked entirely in black. the specimen is serially sectioned and represented as follows: l = multiple sections of pleural nodule, m = representation of unremarkable lung adjacent to pleural nodule, n-p = additional sections of bronchus and vascular resection margins, q = multiple areas suggestive of lymph nodes, r = unattached small free floating piece of dark tissue contained with lung specimen. part 4 is additionally labeled "level 9 pulmonary ligament". the specimen consists of two small soft specimens of red and dark tissue measuring 0.6 x 0.4 x 0.4 cm in aggregate. the specimen is submitted entirely in cassette s. part 5 is additionally labeled "level 10 hilar". the specimen consists of multiple pieces of soft pink, red and tissue measuring 1.0 x 0.6 x 0.4 cm in aggregate. the specimen is submitted entirely in t. part 6 is additionally labeled "level 11 interlobar". the specimen consists of multiple fragments of soft dark red and tissue measuring 1.3 x 0.6 x 0.4 cm in aggregate. the specimen is submitted entirely in cassette u. part 7 is additionally labeled "level 12 lobar". the specimen consists of a single piece of dark red and tissue measuring 0.7 x 0.5 x 0.3 cm. the specimen is submitted entirely in v. brief hospital course: 62 m s/p rul lobectomy for rul nodule. patient tolerated procedure fairly well, slow to wake post procedure, pain control w/ dilaudid/bup epidural. on arrival to pacu extubated, pt unarrousable to verbal stimuli; ct x2right to suction. pacu course sig for continued lethergy, epidural decreased with improvement in mental status- awake to verbal and tactile stimuli, speech slurred, vss. transferred to floor after 5 hour pacu course in stable condition per pacu protocol. pod#1-- hliv/reg diet/ct to waterseal, blakes to bulb- not holding suction overnight.neuro- drowsy, arrousable, slurred speech, le tremors( baseline), a&ox2-3, sitter 1:1> hx falls at home; no falls in house. pod#2--: chest tubes x2 bulbs placed to pleuravac to suction b/c of + leak, bulbs not holding suction. bs congested, dim bs bilat, course bilat at bases; 98%=2l pod#3-- brief afib, tsh < 0.02, ct to water seal: neuro status- confusion, worse memory and language per family report; neuro consult obtained.> 62 yo man with a rapidly dementing illness over the past year, previously was working as a phd in chemistry, all thought to be secondary to paraneoplastic process. some tremor episodes somewhat suspicious for seizure. pe:easily distracted, paucity of speech with poor naming, difficult to engage in activities and amotivational. + ataxia on right (may be related to right cbl hemangioma), + cogwheeling on the left. very unsteady gait. +asterixis. dx: beclouded dementia; plan: toxic and metabolic w/u; pna (by cxry)tx w/ levofloxacin x10d; monitor o2 sats- o2, nebs, cpt; t4= baseline-see below; d/c all sedating meds (trazodone) done; eeg done- pending;ct- head (given hx falls- r/o sdh)- negative-no sdh, has right cbl atrophy .staffed with dr. . pod#4-- one chest tube was dc, ct head was neg, cxr: expanded l consolidationeffusion; swallow-thins/pureed w/ supervision only. epid cap&flag -to be d/c, foley out, t4 7.9 free t4 1.5 (in normal range). pod#5--- 2nd chest tube was dc, cxr-sm r apical ptx. physical exam more alert. d/c sedative rx per neuro (trazadone/benedryl);rapid afib- dilt drip started. pod#6-- desaturation episode in a.m, transfer to icu: re-intubated. bronch: diffuse alveolar bleeding, methylprednisolone x 1, wbc 20 pod#7-- wbc 15, extubated, bradycardic episode- cardiology consulted-amio gtt started; no anticoag, no pacer. pod#8-- stable, transferred out of unit. levaquin dc'd pod#9-- card rec to keep amio 400 , no need for iv hep. anca neg. pod#10-- cxr improved, wbc 9.9 pod#11-- no sitter, cxr better pod#12--dispo planing. medications on admission: asa 325', gemfibrozil 600", lisinopril 30', amlodipine 5', trazodone 25 qhs, synthroid 175, caco3 500"', vit d, buspirone 30', trifluoperazine 4 qhs, fluoxetine 160', colace, tylenol discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 2. acetaminophen 325 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. 3. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 4. lisinopril 10 mg tablet sig: three (3) tablet po daily (daily). 5. levothyroxine 175 mcg tablet sig: one (1) tablet po daily (daily). 6. gemfibrozil 600 mg tablet sig: one (1) tablet po bid (2 times a day). 7. fluoxetine 20 mg capsule sig: four (4) capsule po daily (daily). 8. trifluoperazine 2 mg tablet sig: two (2) tablet po qhs (once a day (at bedtime)). 9. buspirone 10 mg tablet sig: 1.5 tablets po bid (2 times a day). 10. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed. 11. albuterol sulfate 0.083 % solution sig: one (1) inhalation q6h (every 6 hours) as needed. 12. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 13. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day). 14. aspirin ec 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. discharge disposition: extended care facility: - discharge diagnosis: syncope, dementia, thyroid cancer s/p thyroidectomy, depression, hyperchol, s/p mediastinoscopy , laryngeal nerve palsy, right upper lobe nodule discharge condition: good discharge instructions: call dr./ thoracic surgery office () for: fever, shortness of breath, chest pain. followup instructions: call dr./ thoracic surgery office () for an appointment in days. the cutaneous or clinic at will contact patient's daughter for a follow up appointment for w/u of melanoma procedure: insertion of intercostal catheter for drainage continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube other bronchoscopy other bronchoscopy other pleural biopsy closed [endoscopic] biopsy of bronchus transpleural thoracoscopy other local excision or destruction of lesion or tissue of lung simple excision of other lymphatic structure diagnoses: pneumonia, organism unspecified atrial fibrillation unspecified transient mental disorder in conditions classified elsewhere depressive disorder, not elsewhere classified other persistent mental disorders due to conditions classified elsewhere paroxysmal ventricular tachycardia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other and unspecified hyperlipidemia other specified cardiac dysrhythmias malignant neoplasm of upper lobe, bronchus or lung syncope and collapse personal history of malignant neoplasm of thyroid history of fall paralysis of vocal cords or larynx, unspecified 

Answer: The patient is high likely exposed to