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: penicillins attending: chief complaint: right hand clumsiness major surgical or invasive procedure: ->left craniotomy for mass resection ->right craniotomy for mass resection history of present illness: 65 y/o male who has had right arm weakness/clumsiness characterized by dropping of objects difficulty with position sensation, went to on when symptoms became worse. ct of the head showed an area of hemorrhage in the left temp/ parietal lobe and an mri revealed two lesions one in the right and one in the left temp. parietal regions. he was then transferred to for definitive neurosurgical care past medical history: melanoma lesion on left posterior neck resected two years ago with clear margins. diverticulosis s/p partial bowel resection social history: married, one glass of wine/day, remote smoking history 30 years ago for 20yrs/pk/day family history: father-leukemia ca physical exam: exam upon admission: t:98.6 bp: 153 /100 hr: 80 r:18 o2sats:98% ra gen: wd/wn, comfortable, nad. heent: pupils: l 7mm flicker, r 6 to 4 brisk eoms: intact neck: supple. abd: soft, nt, bs+ extrem: warm and well-perfused. neuro: mental status: awake and alert, cooperative with exam, normal affect. orientation: oriented to person, place, and date. recall: objects at 5 minutes. language: speech fluent with good comprehension and repetition. naming intact. no dysarthria or paraphasic errors. cranial nerves: i: not tested ii: pupils equally round and reactive to light, as above. visual fields are full to confrontation. iii, iv, vi: extraocular movements intact bilaterally without nystagmus. v, vii: facial strength and sensation intact and symmetric. viii: hearing intact to voice. ix, x: palatal elevation symmetrical. : sternocleidomastoid and trapezius normal bilaterally. xii: tongue midline without fasciculations. motor: normal bulk and tone bilaterally. right hand grip strength 4/5, finger to nose dysmetria and pronator drift. no abnormal movements. left arm strength full. sensation: intact to light touch reflexes: b t br pa ac right 2 2 2 2 2 left 2 2 2 2 2 toes downgoing bilaterally no clonus exam on discharge: the patient is dysarthric. he is oriented x 3. he has a slightly flattened left nasal labial fold. pupils are perrl. he has persistant right upper extremity weakness, and left upper extremity weakness that is steroid dose dependent. his distal(le) strength is full. sensation is intact. both wounds are clean, dry and intact; without erythema or drainage. sutures have been removed. pertinent results: labs on admission: 12:20am blood wbc-10.3 rbc-4.61 hgb-13.9* hct-40.4 mcv-88 mch-30.2 mchc-34.5 rdw-13.2 plt ct-361 12:20am blood neuts-87.4* lymphs-9.2* monos-2.2 eos-0.8 baso-0.4 12:20am blood pt-14.1* ptt-27.5 inr(pt)-1.2* 03:30am blood calcium-9.4 phos-2.4* mg-2.1 labs on discharge: xxxxxxxxxxx imaging: ct torso : ct chest: the left thyroid is enlarged and heterogeneous without focal lesion. a 2.9 x 2.1 cm left lower lobe subpleural lung mass (3:42) and a 5 mm right upper lobe nodule (3:40) are noted. calcified nodule near the right hilum (3:33) likely represents sequela of prior granulomatous disease. there is no mediastinal adenopathy. several enlarged right axillary lymph nodes measure up to 25 x 22 mm (3:22). heart size is normal. there is no pericardial effusion. the pulmonary arteries are patent to the segmental level. ct abdomen: the gallbladder, spleen, adrenals, and pancreas are unremarkable. well-circumscribed hypodense subcentimeter liver lesion in segment iii (3:50) likely represents a cyst but is not fully characterized. the liver is otherwise unremarkable without evidence of intra- or extra-hepatic biliary dilatation or focal lesion. both kidneys demonstrate several subcentimeter well- circumscribed lesions which likely represent cysts but are not fully characterized. there is extensive descending and distal transverse colon diverticulosis without evidence of diverticulitis. the intra-abdominal loops of large and small bowel are otherwise unremarkable without evidence of pneumatosis, free air, or obstruction. there is no mesenteric or retroperitoneal lymphadenopathy. ct pelvis: the bladder, rectum, and prostate are unremarkable. there is extensive sigmoid diverticulosis without evidence of diverticulitis. bone windows demonstrate no lesion that is concerning for metastasis or infection. mild multilevel degenerative changes are noted. impression: 1. left lower lobe lung mass likely represents metastasis, although tissue diagnosis can be obtained if indicated. 2. right axillary lymphadenopathy likely reflects metastatic recurrence. 3. heterogeneous left thyroid should be further evaluated on thyroid ultrasound. 4. extensive diverticulosis without evidence of diverticulitis. head ct : findings: in the right frontotemporal region, there is a 2.5 x 3.3 cm hypodensity with fine hyperdense rim and surrounding vasogenic edema (series 2, image 19). this is essentially identical in size to the lesion defined on the mr (2.6 x 3.3 cm). there is slight effacement of the subjacent body of the right lateral ventricle but no significant shift of the midline structures. at the left frontovertex, there is 2.2 x 3.0 cm hyperdense lesion, with mild surrounding vasogenic edema and overlying subarachnoid hemorrhage, similar in size to the lesion defined on the mr (2.0 x 2.7 cm). at the posterolateral aspect of this process, there is an ovoid isodense focus measuring 1.2 x 0.9 cm (2:24), corresponding to the enhancing peripheral nodule on the mr. other foci of acute hemorrhage are seen. there is no fracture. there is no osteolytic or- blastic lesion. mastoid air cells and paranasal sinuses are clear. no subcutaneous nodules are demonstrated. impression: unchanged appearance of right frontotemporal lesion and left frontovertex hemorrhagic lesion, likely metastases (for further details, please refer to the mr ). mri head (post-rsxn): findings: the patient is status post left parietal craniotomy, in comparison with the prior study, the previously described left frontal lobe mass lesion, has been resected. the t1 sequence without contrast demonstrates a nodular area of hyperintensity signal, likely consistent with blood products and apparently unchanged after the administration of gadolinium contrast. restricted diffusion is noted adjacent in the posterior margin of the surgical area, blooming artifacts and magnetic susceptibility changes are visualized in the surgical bed. the pattern of vasogenic edema is unchanged. the right frontoparietal deep white matter lesion is unchanged and demonstrates again thick rim enhancement as well as mural enhancement as described in the prior examination. normal flow void signal is identified in the major vascular structures, the orbits, the paranasal sinuses and mastoid air cells are unremarkable. impression: 1. status post left parietal craniotomy, there is a nodular area of hyperintensity signal in the surgical bed and posterior surgical margin, likely consistent with blood products, however residual mass lesion is a consideration, follow-up is recommended. 2. similar pattern of vasogenic edema, the right frontoparietal deep white matter lesion is unchanged. head ct (post-rsxn) findings: again noted are left parietal craniotomy changes, with air seen within the surgical bed, similar in appearance to prior study. residual vasogenic edema within the left frontal and parietal lobes are again noted. minimal focus of hemorrhage within the surgical bed is also unchanged. in the interim, there has been interval right frontal craniotomy, with post-surgical changes seen, with pneumocephalus, small foci of hemorrhage. there is residual vasogenic edema. additionally, there is pneumocephalus overlying the right frontal lobe, as well as small subdural collections bilaterally. no new foci of hemorrhage are identified. ventricles and sulci are normal in caliber and configuration. there is no shift of normally midline structures. visualized paranasal sinuses are normally aerated. impression: 1. interval right frontal craniotomy, with expected post-surgical changes within the surgical bed, with pneumocephalus, small amount of hemorrhage. 2. stable post-surgical changes within the left parietal lobe, following surgical resection. head ct : non-contrast head ct: there has been no significant interval change since one day prior. there are bilateral craniotomies with post-surgical changes in the left parietal lobe, including a tiny amount of pneumocephalus, residual postoperative hemorrhage and vasogenic edema. within the right temporal and parietal resection bed, there is pneumocephalus, hemorrhage and edema. postoperative hemorrhage is stable measuring 5.7 x 4.1 cm. there is stable minimal shift of midline structures, of approximately 3 mm leftward shift. no new foci of hemorrhage are identified. the visualized paranasal sinuses and mastoid air cells are clear. impression: no significant change in the right temporoparietal lobe resection bed hemorrhage and additional postoperative edema and pneumocephalus within the left cerebral hemisphere. head ct : findings: patient is status post bilateral craniotomies. within the surgical bed in the right temporal and parietal lobes, there is residual hemorrhage, pneumocephalus, and vasogenic edema. compared to the prior study, there has been no interval change in size of the residual hemorrhage. postoperative changes in the left parietal lobe with tiny residual hemorrhage, pneumocephalus, and vasogenic edema are also stable. there is a minimal leftward shift of normally midline structures of approximately 3 mm, unchanged. there are no new foci of hemorrhage. ventricles and sulci are normal in caliber and configuration without evidence of hydrocephalus. visualized paranasal sinuses and mastoid air cells are normally aerated. impression: 1. no significant interval change from the prior study in the postoperative hemorrhage within the right temporoparietal lobe resection bed. 2. stable post-surgical changes with the left parietal resection bed. lenis : bilateral lower extremity ultrasound: grayscale and color doppler imaging of the right and left common femoral, superficial femoral and popliteal veins demonstrate normal compressibility, augmentation, waveforms and flow. the peroneal veins are unremarkable. impression: no lower extremity dvt. ekg : sinus rhythm modest st junctional depression is nonspecific and may be within normal limits, but clinical correlation is suggested no previous tracing available for comparison intervals axes rate pr qrs qt/qtc p qrs t 89 156 98 366/416 28 -25 5 brief hospital course: the patient was admitted to the neurosurgery service on . on he went to the operating room for a left sided craniotomy to resect the first of two brain lesions. post-operatively he was monitored in the icu for 24hrs without incident. he was then transferred to the neurosurgery floor for continued planning for the resection of the right sided lesion. during his hospital stay, neuro oncology and radiation oncology were consulted for this patient. on 4.20, he underwent right sided craniotomy for debulking of said lesion prior to cyberknife therapy could be started. post operatively, he was again transferred to the icu for continued monitoring. on pod#1 he was found to have new weakness in the left upper extremity, and to be more lethargic. a head ct was immediately done and there was new bleeding identified in the right sided resection cavity, as well as increased vasogenic edema. he did not worsen neurologically that day, so head ct was again repeated on . vasogenic edema was again noted, and lethargy persisted. it was decided to increase the dose of his steroids from 4mg three times daily to 6mg four times daily. the patient was improving neurologically and was transferred to the stepdown unit on . he was evaluated by neuro-oncology and was scheduled for a brain clinic appointment. pt and ot evaluated the patient and recommended rehab placement. his diet was advanced to regular and he tolerated that well. his steroids were initially decreased to 3mg qid, but had recurrance of left upper extremity weakness. the steroids were again increased to 4mg qid; and to remain at this dose until wbr therapy was initiated and could have this re-evaluated. on ,he was transported to the to receive mapping planning for wbr. he tolerated this well, and was returned to the . he was then discharged to an appropriate rehab facility on with follow up scheduled in the brain tumor clinic. medications on admission: benadryl prn discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed. 2. hydromorphone 2 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. senna 8.6 mg tablet sig: one (1) tablet po hs (at bedtime). 5. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 6. levetiracetam 500 mg tablet sig: two (2) tablet po bid (2 times a day). 7. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical tid (3 times a day) as needed. 8. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 9. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 10. dexamethasone 4 mg tablet sig: one (1) tablet po q6h (every 6 hours). 11. regular insulin sliding scale regular insulin sliding scale per nursing flow sheet discharge disposition: extended care facility: & rehab center - discharge diagnosis: right fronto-temporal, and left frontovertex brain lesions discharge condition: neurologically stable discharge instructions: general instructions/information ?????? have a friend/family member check your incision daily for signs of infection. ?????? take your pain medicine as prescribed. ?????? exercise should be limited to walking; no lifting, straining, or excessive bending. ?????? you may shower and wash your head normally, as your sutures have been removed prior to discharge. ?????? increase your intake of fluids and fiber, as narcotic pain medicine can cause constipation. we generally recommend taking an over the counter stool softener, such as docusate (colace) while taking narcotic pain medication. ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, and ibuprofen etc. ?????? you have been discharged on keppra (levetiracetam), you will not require blood work monitoring. ?????? you are being sent home on steroid medication, make sure you are taking a medication to protect your stomach (prilosec, protonix, or pepcid), as these medications can cause stomach irritation. make sure to take your steroid medication with meals, or a glass of milk. ?????? clearance to drive and return to work will be addressed at your post-operative office visit. ?????? make sure to continue to use your incentive spirometer while at home. call your surgeon immediately if you experience any of the following ?????? new onset of tremors or seizures. ?????? any confusion or change in mental status. ?????? any numbness, tingling, weakness in your extremities. ?????? pain or headache that is continually increasing, or not relieved by pain medication. ?????? any signs of infection at the wound site: increasing redness, increased swelling, increased tenderness, or drainage. ?????? fever greater than or equal to 101?????? f. followup instructions: follow-up appointment instructions ??????please return to the office in days (from your 2nd surgery) for a wound check. this appointment can be made with the nurse practitioner. please make this appointment by calling . if you live quite a distance from our office, please make arrangements for the same, with your pcp. ??????you have an appointment in the brain clinic with dr. . it is on at 2:00 pm. the brain clinic is located on the of , on 8. ??????you will not need an mri of the brain as this was done during your acute hospitalization procedure: other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain diagnoses: personal history of tobacco use intracerebral hemorrhage secondary malignant neoplasm of brain and spinal cord other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation cerebral edema secondary malignant neoplasm of lung personal history of malignant melanoma of skin diverticulosis of colon (without mention of hemorrhage) iatrogenic cerebrovascular infarction or hemorrhage lack of coordination other musculoskeletal symptoms referable to limbs secondary and unspecified malignant neoplasm of lymph nodes of axilla and upper limb dysphagia, unspecified 

Answer: The patient is high likely exposed to