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: hypoxia major surgical or invasive procedure: central line placement radial arterial line placement mechanical ventilation history of present illness: ms. is a 39 f with widely metastatic melanoma first diagnosed in after undergoing a biopsy of a nevus that had changed in appearance and had become pruritic and prone to bleeding. pathology revealed nodular-type melanoma, invasive to a depth of at least 4.6 mm, level at least 4, extending to the deep and lateral resection margins with ulceration present at 8 mm. there was involvement of a sentinel lymph node with extracapsular extension. on , she underwent pulmonary wedge resection of a metastatic nodule. in , she was started on a clinical trial of sorafenib. her ct scan on revealed enlargement of several pulmonary masses and a right infrahilar azygoesophageal mass. additionally, she was found to have multiple brain metastases measuring up to 2 cm. she underwent whole brain radiation, which she completed on . on , she started on daily temodar but after 6 weeks of therapy she was found to have widely progressive disease. she then elected to undergo il2 for her metastatic disease. her last dose of il2 was yesterday () at 7 am. today is day 5 of cycle 1 of il2. the team elected to discontinue infusion because of hypoxia and acute renal failure. the patient grew progressively more tachypneic and hypoxic, prompting admission to the icu. upon arrival at icu, it was noted that her po2 was 62% and the patient's o2 sats were falling to 80's on nonrebreather. the patient agreed to intubation, which proceded immediately. . ros: denies sick contacts, admits to nonproductive cough x 2 weeks. denies chest pain, shortness of breath, or headache, but admits to nonbloody diarrhea. past medical history: melanoma. social history: she works at pilgrim and lives with her spouse and her son and 2 children. she has about 10-pack-year history of smoking but quit completely. she admits to former etoh use. per notes, denies any recreational drug use. family history: (per notes) mother is alive at 59 with no medical problems. father has hypertension as well as some skin lesions, however, he has never had them biopsied. she has two sisters, 36 and 31 in good health. she has a brother who is 34 in good health. she has one daughter 9 years old who is in good health and a son 12 who is in good health. physical exam: t 96.1 bp 142/75, pulse 126, respirations 30-40, oxygen saturation 71% room air, 91% on nonrebreather general: a 39-year-old female very tachypneic, using accessory muscles to breath, speaking in 1 word answers. heent: sclerae anicteric. extraocular movements are intact. mucous membranes are dry. neck: supple. cardiovascular: tachy, no murmurs, gallops, or rubs. lungs: clear to auscultation but some dullness at bases. abdomen: soft, obese, diffusely tender throughout, nondistended, normoactive bowel sounds present. extremities: no clubbing, cyanosis, but 1+ bilateral edema on hands and feet. skin: well healed scar on left axilla/shoulder. neurologic: alert and oriented x3. cranial nerves ii through xii grossly intact. motor function in all four extremities. pertinent results: ct head w/o contrast 11:13 am findings: there is no intracranial hemorrhage. there is no midline shift, mass effect, or hydrocephalus. there are numerous intracranial metastases which are better demonstrated on the , mri. please refer to that report for description of the metastatic disease. please note that a non-contrast head ct is insensitive to the detection of metastatic disease, abscesses, and vascular anomalies. impression: no intracranial hemorrhage. limited exam due to lack of iv contrast. numerous intracranial metastases as demonstrated on the , mri. there is asymmetry of the nasopharyngeal tissues with prominence on the right. this is a nonspecific finding which could possibly relate to the presence of soft tissue metastases. please correlate with direct visualization. . ct sinus/mandible/maxillofacial w/o contrast 11:14 am comparison is made with prior mri from . there is opacification of left sphenoid and bilateral posterior ethmoid air cells with aerosolized secretions and fluid level. secretions are also seen in the nasal cavity and nasopharynx. the remaining sinuses are clear. there is asymmetric prominence of the right nasopharynx with respect to the left, clinical correlation is advised. bilateral ostiomeatal complexes are patent. no bony dehiscense. impression: mild sinusitis as above. . ct chest w/o contrast; ct abdomen w/o contrast a right axillary node measures 15 mm in short axis diameter and appears new. limited non-contrast evaluation of right hilar lymphadenopathy demonstrates that the node designated as target lesion #1 measures approximately 43 x 26 mm (previously 35 x 24 mm). nodal lesion 6 measures approximately 48 x 32 mm (previously 45 x 35 mm). adjacent target lesions 2 and 3 cannot be adequately measured on this non- contrast study but may have also slightly increased in size compared to . left hilar lymph nodes measuring up to 1.8 cm in short axis diameter are again noted. there is no evidence of pericardial or pleural effusion. there has been progression in size and number of multiple diffuse bilateral pulmonary metastases. a right middle lobe lung nodule in series 2, image 33 measures 4.2 x 3.9 cm compared to previous when it measured 3.7 x 3.5 cm. parenchymal consolidation at the lung bases likely represents atelectasis, however, a superimposed infectious process cannot be completely excluded. endotraheal tube terminates approximately 5cm above the carina. tip of ng tube is present within the stomach. right central venous catheter terminates near the cavoatrial junction. ct abdomen without iv contrast: limited evaluation of the abdomen without contrast does not adequately evaluate the numerous liver and splenic metastatic lesions. the pancreas and right adrenal gland appear unremarkable. a left adrenal lesion designated lesion 5 measures 38 x 26 mm compared to prior when it measured 36 x 28 mm. non-contrast evaluation of the kidneys again reveals a soft tissue mass near the mid pole of the right kidney posteriorly, which does not demonstrate any gross change in size. there is no evidence of free air. multiple mesenteric lymph nodes are again identified, some of which measure up to 15 mm and appear larger compared to . non-contrast evaluation of large and small bowel is unremarkable. note is made of diffuse anasarca. ct pelvis without iv contrast: the rectum and sigmoid are unremarkable. moderate free fluid is present in the pelvis and is new compared to . a left external iliac lymph node measures 1.8 cm in short axis diameter compared to when it measured 15 mm. multiple scattered subcutaneous soft tissue densities have increased in size including a 10- mm one anteriorly (2: 75) and 11-mm periumbilical one (2: 89). a left breast nodule measures 18 x 17 mm, unchanged. osseous structures reveal increased sclerosis around the si joints bilaterally likely representing sacroileitis. a small adjacent right sacral bone island is noted. impression: 1. limited non-contrast evaluation demonstrates progression of metastatic disease with increased pulmonary tumor burden and increase in size of multiple lymph node groups as described. hepatic and splenic tumor burden not adequately evaluated. left adrenal and right renal soft tissue lesions as described. 2. new anasarca and free pelvic fluid. brief hospital course: mrs. is a 39 year old woman with malignant melanoma who received interleukin-2 and developed hypotension, hypoxia and fevers requiring transfer to the icu where she was intubated and placed on pressor agents. she was weaned from the pressors, but required persistent respiratory support. the patient developed oliguric renal failure, renal was consulted, but she did not require dialysis and her kidney function returned to baseline. she had persistently high ventilatory requirements and was difficult to wean from the ventilator, despite treatment for pneumonia. she contined to worsen, so ct torso was performed which revealed worsening metastatic disease. she was made comfort measures only and was terminally extubated on . medications on admission: 1. sertraline 25 mg a day. 2. prilosec 75 mg a day. 3. ativan 0.5 mg prn discharge medications: 1. lasix 20 mg tablet sig: one (1) tablet po once a day for 5 days: or until you reach pretreatment weight. disp:*5 tablet(s)* refills:*0* 2. sertraline 50 mg tablet sig: 0.5 tablet po daily (daily). 3. lorazepam 0.5 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed for n/v. disp:*40 tablet(s)* refills:*1* 4. diphenhydramine hcl 25 mg capsule sig: capsules po q6h (every 6 hours) as needed for pruritis. 5. prochlorperazine 10 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for n/v. disp:*40 tablet(s)* refills:*1* 6. cephalexin 500 mg capsule sig: one (1) capsule po bid (2 times a day) for 5 days. disp:*10 capsule(s)* refills:*0* 7. diphenoxylate-atropine 2.5-0.025 mg tablet sig: 1-2 tablets po prn (as needed) as needed for after each loose stool: max 8 tabs/day. disp:*40 tablet(s)* refills:*1* 8. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day) as needed for thrush. disp:*200 ml(s)* refills:*1* discharge disposition: home discharge diagnosis: metastatic melanoma - s/p c1w1 hd il-2 therapy pneumococcal pneumonia sepsis persistent fevers acute renal failure discharge condition: expired md, procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances other bronchoscopy transfusion of packed cells high-dose infusion interleukin-2 [il-2] diagnoses: acidosis thrombocytopenia, unspecified anemia, unspecified esophageal reflux malignant neoplasm of liver, secondary acute kidney failure, unspecified other pulmonary insufficiency, not elsewhere classified hypopotassemia anxiety state, unspecified secondary malignant neoplasm of brain and spinal cord disorders of phosphorus metabolism antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use paralytic ileus diarrhea encounter for palliative care pneumococcal pneumonia [streptococcus pneumoniae pneumonia] secondary malignant neoplasm of lung personal history of malignant melanoma of skin secondary malignant neoplasm of other digestive organs and spleen mucositis (ulcerative) due to antineoplastic therapy encounter for antineoplastic immunotherapy 

Answer: The patient is high likely exposed to