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: left facial droop and some mild slurring of speech from glioblastoma multiforme. major surgical or invasive procedure: right frontal parietal craniotomy on . peg placed on . history of present illness: history obtained from sister who accompanied patient and translated. patient is portuguese speaking. this is a 70-year-old man who has had uri for one week slowly resolving. yesterday noticed some left drooling but speech was fine. today, family noticed left facial droop and some mild slurring of speech with some left hand weakness. he complained of ha one week ago, but resolved with tylenol. he denies ha, visual changes, pain, numbness, or weakness. past medical history: tonsilectomy. social history: originally from . he is a retired factory worker, lives with sister. non-, and drinks occasional wine. family history: cousins with stomach cancer. physical exam: vital signs: blood pressure 140/70, heart rate 80, respiratory rate 16. general: wd/wn, comfortable, nad. heent: nc/at. anicteric. extremities: warm and well-perfused. no c/c/e. neurological: mental status: awake and alert, cooperative with exam, normal affect. he did appear to have some confusion with following some commands even considering language barrier. orientation: oriented to person, place, and date. attention: attended examiner language: speech fluent. cranial nerves: i: not tested ii: pupils equally round and reactive to light,4 to 2 mm bilaterally. visual fields are full to confrontation. iii, iv, vi: extraocular movements intact bilaterally without nystagmus. v, vii: facial drrop present on left nasiolabial fold. viii: hearing intact to finger rub bilaterally. 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. strength full power throughout. no pronator drift sensation: intact to light touch bilaterally. reflexes: b t br pa ac right 2 2 2 2 2 left 2 2 2 2 2 toes downgoing right and upgoing left. coordination: normal on finger-nose-finger gait: wide-based pertinent results: admission labs: 07:36pm pt-13.0 ptt-26.1 inr(pt)-1.1 07:36pm plt count-358 07:36pm wbc-7.0 rbc-5.01 hgb-14.7 hct-40.8 mcv-81* mch-29.3 mchc-36.0* rdw-14.0 07:36pm osmolal-291 07:36pm glucose-110* urea n-15 creat-0.9 sodium-136 potassium-4.0 chloride-101 total co2-25 anion gap-14 03:11pm urine color-yellow appear-clear sp -1.017 03:11pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-tr bilirubin-neg urobilngn-neg ph-7.0 leuk-neg 08:40pm phenytoin-9.8* 08:40pm glucose-122* urea n-17 creat-0.9 sodium-141 potassium-3.7 chloride-106 total co2-22 anion gap-17 mri of the brain: (preop) there is an approximately 4.5 x 3.5 cm mass in the right frontal lobe with irregular shape and thick rim enhancement. the central portion of the mass is hypointense on t1-weighted images, without enhancement and demonstrate no evidence of slow diffusion. there is mild mass effect on the right lateral ventricle without midline shift. there is no evidence of acute or chronic blood products seen within the mass. there is surrounding white matter edema noted. there are no other abnormal areas of enhancement seen within the brain. there is no midline shift or hydrocephalus identified. mri of the brain: (postop) extensive postsurgical changes are noted in the right frontal region consistent with recent surgery. enhancement is noted in the postsurgical bed may represent residual tumor versus postsurgical changes. a followup mri is recommended in two to three weeks for further evaluation. moderate brain edema and mild-to-moderate midline shift noted, which appears to be not significantly changed since the prior examination. minimal subdural collections are noted in the postsurgical bed. ct head: essentially stable study compared to the previous examination. slight reduction in subdural gas. kub: prominent small bowel and large bowel gases throughout down to the rectum, probably representing ileus. please correlate clinically, and please perform close followup by abdominal radiograph. kub: nonspecific bowel gas pattern without significant interval change. there is some minimal decrease of the air in the small bowel. most of the gas is within the transverse colon. kub: improvement of the bowel gas pattern since the previous study. no signs of bowel obstruction. kub: nonspecific bowel gas pattern. no evidence of free air or small-bowel obstruction. ct torso: 1. moderate free air within the abdomen. this may be related to recent placement of a percutaneous gastrostomy tube, but correlation with examination and laboratory findings is recommended. bowel loops within the abdomen appear normal. 2. rim-enhancing collection within the left inferior pelvis, at the medial and posterior aspects of the left acetabulum. this collection could represent a small abscess within the obturator internus and gluteus minimus muscles, or may represent an infectious arthritis. correlation with physical exam is requested. an mri may be helpful for further evaluation. 3. mild pulmonary edema, manifested as ground glass opacity. 4. distended bladder, with a tiny air bubble. this may be related to instrumentation, but correlation with urinalysis is requested. 5. a couple of nodular opacities within the lungs. a 3-month ct followup could be considered if clinically indicated. cxr: free air under the diaphragm. cxr: interval decrease in pneumoperitoneum. brief hospital course: is a 70-year-old portugese speaking man admitted with slurred speech and left sided droop noticed by sister. hospital course: patient taken to or on for right craniotomy for resection of fronto-parietal mass under general anesthesia without intraoperative anesthesia. patient stayed in the pacu overnight. he was started on dexamethasone and phenytoin. postoperative day one() patient transferred to neuroicu due to continuing intubation. immediate postoperative neurologic exam was lethargic, speech unintelligible, moves right side spontaneously. patient extubated on . after extubation still somnolent, opens eyes to voice but doesn't follow commands, speech is unintelligible, moves right side vigorously, moving left toes but less vigorously, not moving left arm. transferred to neuro step-down unit on , his decadron was weaned, he followed commands intermittently ans was purposeful on the right and had tone on the left. neurology was following along with the patient recommended starting keppra if he was to start chemotherapy. on , his abdomen was noted to be distended a kub showed an ileus and lfts were slightly elevated. he was made npo started, ng tube was put to low intermittent suction on on his repeat kub showed improvement in the ileus. he was advanced back to tube feeds on the a speech and swallow consult was obtained and a general surgery consult in anticipation of failure of speech and swallow to place a g-tube. he was started on cipro for a uti for 10 days course (to end after last dose on ). postoperative ileus resolved. peg was placed, tf at goal tolerating well. patient being seen bu pt/ot. a foley catheter was placed back again for urinary retention. urine cultures taken on showed e. coli resistant to cipro, switched to augmentin. examination at the time of transfer to oncology: eyes open spont. perrl. speech dysarthric, speaking in portuguese. moves right side spontaneously, follows commands in portuguese on right side. lue w/ no spont movement. lle can move toes minimally. receiving pt/ot. multi-podis boots on for heel protection. hospital course: 1. glioblastoma: the patient was treated as above on the neurosurgery service, and was then transferred to oncology to receive radiation therapy. he received 15 treatments of whole brain radiation. dilantin was continued, with monitoring of levels, and decadron taper was also continued. 2. confusion: throughout the hospital course the patient was at times confused, although he remained alert and interactive. this was likely multifactorial, with his neoplasm and recent surgery, along with related brain edema, as well as medications, constipation, and urinary retention and uti all contributing. each of these conditions was managed as best as possible, and the patient was oriented frequently. 3. constipation/abdominal distention: this was likely related to lying in bed, opiates, and illness in general. the patient had serial abdominal films with no evidence of obstruction. he was given an aggressive bowel regimen, resulting in resolution of constipation. the patient was also started on reglan and simethicone and encouraged to get out of bed and work with physical therapy frequently to prevent recurrence of his constipation and distention. 4. urinary retention: when the patient's foley catheter was removed, he was unable to void spontaneously. initially he was catheterized every 8 hours, in the hopes that his urinary retention would resolve, but after several days he no longer tolerated catheterization (and refused further straight cath) and the foley catheter was replaced. doxazosin was started as well, but at the time of discharge the patient still required an indwelling catheter. 5. uti: the patient was patient was initially started on ciprofloxacin on for a uti. the urine culture grew e. coli resistant to tmp/smx and ciprofloxacin, so the patient was switched to augmentin to complete the course of treatment. on on , the patient was noted to have an elevated wbc count, and ua was found to be positive. culture again grew e. coli with similar sensitivities, so he was treated with ceftriaxone for 1 week. a follow up urine culture grew 10,000-100,000 colonies of vancomycin resistant enterococcus, but the ua at that time was negative and the patient was afebrile and had a normal wbc count so this was considered likely to be a colonizer. 6. thrush: the patient was initially unable to effectively swish and swallow with nystatin, so he was treated with a course of fluconazole. this did not result in a significant improvement in his thrush. nystatin swish and swallow was then initiated, and thrush was stable. 7. fen: a peg tube was placed on and tube feeds were started. a repeat swallow evaluation prior to discharge was done, and the patient was then allowed to take small amounts of pureed food and nectar prethickened liquids with supervision for comfort. the patient was also kept on sliding scale insulin coverage while he was on steroids. 8. code: it was decided during this hospitalization that the patient's code status was dnr/dni, and this was confirmed with his family. medications on admission: none. discharge medications: 1. docusate sodium 150 mg/15 ml liquid sig: one (1) po every eight (8) hours. 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 3. oxycodone-acetaminophen 5-325 mg/5 ml solution sig: 5-10 mls po q4-6h (every 4 to 6 hours) as needed for pain. 4. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 5. lansoprazole 30 mg susp,delayed release for recon sig: thirty (30) mg po daily (daily). 6. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day). 7. phenytoin 100 mg/4 ml suspension sig: two hundred (200) mg po bid (2 times a day). 8. trimethoprim-sulfamethoxazole 160-800 mg tablet sig: one (1) tablet po qmowefr (monday -wednesday-friday). 9. doxazosin 4 mg tablet sig: two (2) tablet po hs (at bedtime). 10. metoclopramide 10 mg tablet sig: one (1) tablet po qidachs (4 times a day (before meals and at bedtime)). 11. dexamethasone 0.5 mg tablet sig: two (2) tablet po daily (daily). discharge disposition: extended care facility: hospital discharge diagnosis: right frontal parietal glioblastoma s/p craniotomy. discharge condition: stable. discharge instructions: if you experience fever, chills, nausea, vomiting, abdominal pain, or any other new or concerning symptoms, please call your doctor or return to the emergency room for evaluation. please take all medications as prescribed. keep incision clean and dry; watch for redness, swelling, or bleeding. followup instructions: as scheduled by your doctor . procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] insertion of (naso-)intestinal tube other radiotherapeutic procedure other radiotherapeutic procedure diagnoses: urinary tract infection, site not specified candidiasis of mouth constipation, unspecified cerebral edema paralytic ileus retention of urine, unspecified pressure ulcer, heel malignant neoplasm of other parts of brain 

Answer: The patient is high likely exposed to