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: interferons attending: chief complaint: lue burning major surgical or invasive procedure: t1 corpectomy and anterior cervical plating history of present illness: mr. is a 59 yo with a pmhx s/f cirrhosis secondary to hepatitis c and metastatic hcc who presents for evaluation of cord compression with resulting lue "burning". mr. had been undergoing day 9 of xrt to his r shoulder and r hip for pain related to metastatic lesions and complained to his radiation oncologist of new onset burning symptoms in his lue. as a result of these symptoms an mri was performed which demonstrated a t1 lesion with cord compression. mr. also notes decreased strength on the l. he has been noting burning and a relative loss of strength on the lue for approximately 1.5-2weeks which has progressively worsened. he denies neck pain/back pain, incontinence of stool/urine, fevers/chills, or other symptoms of paresthesias/weakness elsewhere. . in the ed, mr. ' vitals were 96.6 66 151/95 18 100% on ra, exam notable for no saddle anesthesia, but decreased rectal tone. there he endoresed lue paresthesias. he was given dexamethasone 10mg and dilaudid 1 mg in the ed. ct of t and c spine was obtained which demonstrated compression fracture at t1 with retropulsoin into the canal. . review of systems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies blurry vision, diplopia, loss of vision, photophobia. denies headache, sinus tenderness, rhinorrhea or congestion. denies chest pain or tightness, palpitations, lower extremity edema. denies cough, shortness of breath, or wheezes. denies nausea, vomiting, diarrhea, constipation, abdominal pain, melena, hematemesis, hematochezia. denies dysuria, stool or urine incontinence. denies rashes or skin breakdown. all other systems negative. past medical history: developed hepatocellular carcinoma in the setting of hepatitis c cirrhosis. screening ultrasound raised concern for a mass in the right liver, and his afp was elevated at 56.9. mri showed a mass in segment v measuring 2.9 x 3.2 x 2.8 cm with arterial enhancement and wash-out, consistent with hepatocellular carcinoma. also seen was a thrombus in the subsegmental branch of the right posterior portal vein. ct torso on identified a 3.2 cm mass with arterial enhancement and wash-out in segment vi/vii. also seen were two 2-mm right lower lobe pulmonary nodules as well as a fracture in the right 10th rib. bone scan was negative for metastases. egd on showed grade ii varices which were banded. mr. was treated with transarterial chemoembolization to the right liver, having received 60 mg doxorubicin without complications. he underwent repeat tace on , again without complication. despite this his afp continued to rise, and bone identified numerous lesions concerning for bone metastases. bone biopsy performed , confirmed the finding of metastatic hepatocellular carcinoma. mr. was prescribed sorafenib 400 mg b.i.d. beginning , but discontinued after one dose due to nausea/vomiting. . . past medical history: mr. lives with his wife and two daughters. previously worked in construction, but has been out of work since /. tobacco: one-half pack per day for more than 40 years, continues to smoke. alcohol: history of abuse, none since . illicits: history of abuse, none since . social history: mr. lives with his wife and two daughters. previously worked in construction, but has been out of work since /. tobacco: one-half pack per day for more than 40 years, continues to smoke. alcohol: history of abuse, none since . illicits: history of abuse, none since . family history: his mother died at age 72 with metastatic breast cancer. his father is alive without health concerns. his sister has diabetes mellitus. physical exam: admission exam: . vitals - t: 96.6 bp: 140/80 hr: 60 rr: 18 02 sat: 98% on ra general: disgruntled gentleman, pacing around the room in c-collar, talkative/conversant skin: warm and well perfused, no excoriations, venous stasis changes in b/l le, no rashes heent: in c collar, at/nc, eomi, perrla, anicteric sclera, pink conjunctiva, patent nares, mmm, good dentition, nontender supple neck, no lad, no jvd cardiac: rrr, s1/s2, no mrg lung: ctab abdomen: nondistended, +bs, nontender in all quadrants, no rebound/guarding, no hepatosplenomegaly m/s: moving all extremities well, strength 5/5 diffusely, no cyanosis, clubbing or edema, no obvious deformities pulses: 2+ dp pulses bilaterally neuro: cn ii-xii intact, sensation intact in b/l ue/le in all major dermatomes. . discharge exam: . vitals - 98.2/98.4 134/82 (120s-150s/50s-80s) 69 (50s-60s) 18 100%r general: nad, in -j, talkative/conversant skin: warm and well perfused, greyish/blue chronic discoloration of the lgs heent: in -j collar, at/nc, eomi, perrla, anicteric sclera, pink conjunctiva, no lad, no jvd cardiac: rrr, s1/s2, no mrg lung: ctab abdomen: nondistended, +bs, nontender in all quadrants, no rebound/guarding, no hepatosplenomegaly ext: 2+ pulses, chronic appearing bluish/grey changes of the le bilaterally. no edema neuro: diffusely, cn 2-12 intact. no sensory deficits pulses: 2+ dp pulses bilaterally pertinent results: admission labs: . 08:25am blood wbc-1.9* rbc-4.36* hgb-13.9* hct-40.4 mcv-93 mch-32.0 mchc-34.5 rdw-13.6 plt ct-43* 08:25am blood neuts-78.9* bands-0 lymphs-9.2* monos-9.3 eos-2.0 baso-0.5 08:25am blood pt-14.2* ptt-30.6 inr(pt)-1.2* 08:25am blood glucose-94 urean-12 creat-0.7 na-136 k-5.2* cl-99 hco3-32 angap-10 08:25am blood alt-237* ast-323* totbili-2.0* 08:25am blood calcium-8.9 phos-3.6 mg-1.9 08:31am blood k-4.0 . discharge labs . 05:45am blood wbc-1.1* rbc-3.18* hgb-10.4* hct-29.7* mcv-93 mch-32.5* mchc-34.9 rdw-13.7 plt ct-53*# 05:45am blood glucose-81 urean-16 creat-0.6 na-136 k-3.8 cl-102 hco3-27 angap-11 05:45am blood calcium-7.8* mg-1.8 . ct spine : impression: 1. cortical irregularity of the inferior endplate of t12, possibly extending into posterior elements, likely representing metastatic disease and better evaluated on recent mri. 2. lucencies within the vertebral bodies of t5, t8 and t11 also corresponding to signal abnormality seen on recent mr and likely representing metastatic disease. no evidence of cord compression in the thoracic spine from t2 through t12. 3. pathologic fracture of t1, as described on the cervical spine ct from the same day. 4. coarse calcifications of the liver, likely from prior tace procedure. 5. incompletely imaged spleen, which appears enlarged. . t-spine xray in the or: limited evaluation of the upper thoracic spine due to overlying soft tissue and bony structures. surgical instrument is seen at the c6-c7 disc space. status post t1 corpectomy and anterior fusion from c7 to t2. the hardware appears intact. please see the operative report for further details. . c/t spine xray: cervical spine, three views: c1 through t1 are demonstrated on the lateral view. no prevertebral swelling is identified. cervical lordosis is preserved. vertebral body heights are intact. there is intervertebral disc space narrowing of c4-5. no cervical body vertebral fracture is identified. grade 1 retrolisthesis of c4 on c5 is present. no focal lytic or sclerotic lesions. thoracic spine, two views: the patient is status post t1 corpectomy with anterior fusion and cage placement from c7-t2. hardware is intact without signs of complication. the alignment is normal. the remainder of the thoracic spine is unremarkable. the visualized lung fields are normal. impression: anterior fusion from c7-t2 and cage placement status post t1 corpectomy without hardware complication. . spine tumor pathology : pending brief hospital course: mr. is a 59 year old with a pmhx s/f cirrhosis secondary to hepatitis c and metastatic hcc who presents for evaluation of cord compression with resulting lue "burning". . # cord compression from metastatic hcc: likely secondary to t11 retropulsion from metastatic hcc. pt with parastesias and pain in his arms. pt was given 10mg iv dexamethasone in the ed and was maintained on dexamethasone 4mg q6h on admission. pain was controlled with mscontin and oxycodone as well as gabapentin for neuropathic pain. on he was brought to the or for a t1 corpectomy with cervical plating. he tolerated the procedure well without complication. he spent 1 night in the sicu and was called back out to the oncology floor on . post-operatively he denied any parastesias or pain. his strength remained throughout during the admission. after surgery he was ambulating well and advanced his diet. he remained in a -j collar and will remain in it for 6 weeks post op. he will follow up in spine clinic in 2 weeks. he was given instructions to follow up with his oncologist. he remained on his ms contin 60mg , prn oxycodone, and gabapentin for pain on discharge. given his baseline thrombocytopenia he received a total of 7 units of platelets throughout admission including in the operative setting. spine surgery recommended keeping his plt>50 for 3 days post operatively. on pod #2 he was at 53, so he received a unit of platelets prior to discharge. he was cleared by neurosurgery and was deemed suitable to discharge. . # cirrhosis with thrombocytopenia: pt was continued on his nadolol. his thrombocytopenia was likely secondary to his cirrhosis, and he received 7u of platelets during admission to maintain plt>50 in the perioperative setting to reduce risk of bleed (see above section). . # hypertension: initially held hctz/lisinopril given that he was heading to the or. these were restarted without complication on discharge. . transitional issues: . # pathology from or tumor specimen still pending # pt given instructions to follow up with spine surgery in 2 weeks after discharge # he was encouraged to make a follow up appointment with his primary oncologist # platelets should be monitored as an outpatient. medications on admission: gabapentin - 300 mg capsule - 1 capsule(s) by mouth three times per day lisinopril-hydrochlorothiazide - (prescribed by other provider) - 20 mg-12.5 mg tablet - 1 tablet(s) by mouth morphine - (dose adjustment - no new rx) - 30 mg tablet extended release - 2 tablet(s) by mouth q 12 hour nadolol - 40 mg tablet - 1 tablet(s) by mouth daily oxycodone - 5 mg tablet - tablet(s) by mouth q4-6hours as needed for shoulder pain prochlorperazine maleate - 10 mg tablet - 1 tablet(s) by mouth q 8 hour as needed for nausea/vomiting (take 1 pill with morphine) medications - otc magnesium oxide - (prescribed by other provider) - dosage uncertain discharge medications: 1. morphine 30 mg tablet extended release sig: two (2) tablet extended release po q12h (every 12 hours). 2. nadolol 20 mg tablet sig: two (2) tablet po daily (daily). 3. oxycodone 5 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 4. prochlorperazine maleate 10 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for nausea. 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 6. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 7. lisinopril-hydrochlorothiazide 20-12.5 mg tablet sig: one (1) tablet po once a day. 8. gabapentin 300 mg capsule sig: one (1) capsule po every eight (8) hours. discharge disposition: home discharge diagnosis: t1 spinal cord compression metastatic hepatocellular carcinoma discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: mr. , you were admitted to the hospital for compression of your spinal cord due to your cancer. you underwent surgery to decompress your spinal cord. you did well with this and are ready for discharge. you received several units of platelets during admission to decrease the risk of post-operative bleeding. immediately after the operation: - activity:you should not lift anything greater than 10 lbs for 2 weeks. you will be more comfortable if you do not sit in a car or chair for more than ~45 minutes without getting up and walking around. - rehabilitation/ physical therapy: o 2-3 times a day you should go for a walk for 15-30 minutes as part of your recovery. you can walk as much as you can tolerate. - swallowing: difficulty swallowing is not uncommon after this type of surgery. this should resolve over time. please take small bites and eat slowly. - cervical collar / neck brace: you need to wear the brace at all times. - wound care:remove the dressing in 2 days. if the incision is draining cover it with a new sterile dressing. if it is dry then you can leave the incision open to the air. once the incision is completely dry (usually 2-3 days after the operation) you may take a shower. do not soak the incision in a bath or pool. if the incision starts draining at anytime after surgery, do not get the incision wet. call the office at that time. if you have an incision on your hip please follow the same instructions in terms of wound care. - you should resume taking your normal home medications. followup instructions: o please call the office and make an appointment for 2 weeks after the day of your operation with dr . ph o at the 2-week visit we will check your incision, take baseline x rays and answer any questions. o we will then see you at 6 weeks from the day of the operation. please call the office if you have a fever>101.5 degrees fahrenheit, drainage from your wound, or have any questions. md procedure: other excision of joint, other specified sites other cervical fusion of the anterior column, anterior technique insertion of interbody spinal fusion device fusion or refusion of 2-3 vertebrae insertion of recombinant bone morphogenetic protein diagnoses: thrombocytopenia, unspecified tobacco use disorder cirrhosis of liver without mention of alcohol other and unspecified alcohol dependence, in remission unspecified viral hepatitis c without hepatic coma disturbance of skin sensation malignant neoplasm of liver, primary secondary malignant neoplasm of bone and bone marrow personal history of irradiation, presenting hazards to health spinal stenosis in cervical region myelopathy in other diseases classified elsewhere pathologic fracture of vertebrae portal vein thrombosis esophageal varices without mention of bleeding closed fracture of t1-t6 level with unspecified spinal cord injury combinations of drug dependence excluding opioid type drug, in remission 

Answer: The patient is high likely exposed to