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: indocin / fosamax / diltiazem / norvasc / motrin / actonel attending: chief complaint: left sided weakness (face, arm, leg) major surgical or invasive procedure: intubation x2 stereotactic brain biopsy stereotactic brain aspiration ivig x5 days history of present illness: this is a 77 year old woman with hx mg for >7 yrs on mestinon only, post-polio syndrome, who presents with several weeks (and possibly months) of progressive generalized weakness. she reports that she began to feel unwell when her husband died in of a stroke - she felt depressed. in , she developed a gi virus and had profuse vomiting, diarrhea and abdominal pain as well as chills and worsening weakness over several weeks, unable to keep her mestinon down at times. she had a headache with this and was prescribed percocet and told to sleep in a soft collar at night to help with neck muscle contraction. the gi virus cleared three weeks ago, but she still felt weak all over, as if her myasthenia was getting worse. two weeks ago she had fevers and chills at home for about a week, which have since resolved (one week ago). she feels that her speech has become softer and she feels out of breath, particularly when she talks or does any amount of exercise. she doesn't even want to walk, because it makes her feel markedly weak. when she swallows, the liquid comes out her nose. she continues to take pills and has not complained of choking on foods or liquids. her daughter noticed a left facial droop about 4-5 days ago. she c/o no new numbness, tingling, diplopia or new visual changes, trouble with hearing or headaches except as aforementioned. she did fall several weeks ago and struck the right side of her head, but has not had pain at that site since then. she has had no cp, cough, dysuria, or recent gi sx. past medical history: -myasthenia - dx'ed before , followed by dr. , on mestinon only with no hx use of immunomodulatory agents (steroids, cellcept), no hx intubation or hospitalizations for her mg, in general under "very good control." she has baseline fatiguable weakness of delt at times, has not had recent ptosis. -post-polio syndrome, with bulbar features - soft speech, occasional trouble with swallowing -htn -raynaud's phenomenon -s/p tah -mvp social history: lives alone; husband died in of stroke at , daughter involved with care. no tob, etoh, drugs. family history: no strokes, no mg or neurological d/o's in family. physical : nif -12, fvc 1.05 t 98.4 hr 55 bp 142/73 rr 14 100%ra general appearance: fatigued appearance, elderly white female heent: moist mucus membranes, clear oropharynx neck: supple, no bruits heart: regular rate and rhythm lungs: diminished breath sounds at r>l base abdomen: soft, nontender +bs extremities: warm, well-perfused skull & spine: neck movements are full and not painful to palpation in the paraspinal soft tissues mental status: the patient is alert and attentive, +dow backwards, registered three objects at 30 seconds and recalled 3 out of 3 items at 3 minutes. good knowledge for current events. language is with no errors. there is no apraxia or agnosia. cranial nerves: there is mild ptosis after upgaze for 45 seconds. the visual fields are full. the optic discs are normal in appearance. eye movements are normal, with no nystagmus. pupils react equally to light, both directly and consensually - though there is <1mm anisocoria with r eye slightly bigger than l. sensation on the face is to light touch, pin prick. there is a l umn facial droop. hearing is to finger rub. the palate elevates in the midline. the tongue protrudes in the midline and is of normal appearance. motor system: decreased bulk symmetrically throughout, normal tone throughout. there is 4+/5 weakness of neck extensors, and 4+/5 weakness of r deltoid, 4/5 weakness l deltoid. the r deltoid has fatiguable weakness after 30 seconds of abd/adduction exercises is 4-/5. r bicep 4+/5, r tricep 4+/5, full at r wrist ext, full r finger ext/flex. l bicep 4+/5, l tricep , 4+/5 wrist ext, 5-/5 finger ext, finger flex. in lower ext, r ip is 5-/5, r ham is 5-/5, r quad is full, r foot dorsi- and plantarflexion is full. l ip , l ham 4+/5, l quad , l foot dorsiflex 4+/5, l foot plantarflex . there is l pronator drift. reflexes: the tendon reflexes brisk throughout, symmetric r=l. the plantar reflexes are flexor. sensory: sensation is to pin prick, light touch, vibration sense, and position sense in all extremities and trunk, but there is ext to dss over the l trunk, limbs and face. coordination: there is no ataxia. the finger/nose test and finger and foot tapping are performed normally, as are rapid alternating hand movements. gait: pt declines, feels too weak to walk pertinent results: labs on admission: ph 7.47 pco2 37 po2 113 *air bubble in tube hco3 28 lactate:0.9 2:46p 141 103 24 137 -------------< 4.2 29 1.6 card pending ca: 9.6 mg: 2.1 p: 3.4 mcv 91 wbc 6.6 h/h 10.5/30.1 plt 221 imaging: "ct: impression: large mass lesion of low attenuation involving the right temporal lobe surrounded by significant vasogenic edema and resulting in mass effect and 10 mm midline shift to the left with early changes of subfalcine herniation of the brain. the findings were conveyed to dr. to the eemergency room at the time of the examination. neurosurgical consultation is recommended with followup." cxr: no pneumonia video swallow: poor bolus control, including aspiration of thin liquids without spontaneous cough. please see the report of the speech and swallow pathologist for further information. pathology: r temporoparietal mass note: the tumor infiltrates predominately white matter. the neoplastic cells are small and round with a small amount of cytoplasm. scattered tumor cells are elongated with coarse eosinophilic processes. immunohistochemistry is being performed on the formalin-fixed paraffin-embedded tissue and the results will be performed in an addendum. glial tumor subtyping and grading will be included in the addendum. addendum: immunohistochemistry was performed and reveals a high proliferation rate mib-1 (ki67) with nuclear staining in >25% of tumor nuclei (block b,d). hmb45 is negative. the tumor cells infiltrate brain and some areas are seen floating in a loose matrix. these latter regions show strong gfap positive staining of fibrillary processes (blocks b, d). scattered cd68 and lca positive cells are also present blocks (b, d). the results are consistent with the diagnosis of high grade malignant glioma. tumor necrosis and microvascular proliferation are not detected in the small sample. based solely on the biopsy specimen, the diagnosis is anaplastic astrocytoma (who grade iii). radiologic studies indicate a ring-enhancing cystic mass suggesting the possibility of higher grade tumor in unsampled parts of the tumor. mri head : the large heterogeneous lesion with necrotic center and irregularly nodular-enhancing periphery in the left temporal region is again demonstrated. there is no change in the perilesional edema and the mild shift of the midline structures. no new lesions are noted. there is compression of the right lateral ventricle from the mass effect. post-biopsy changes are noted in the right frontal region. impression: large right temporal lobe necrotic gbm demonstrated for cyberknife procedure. brief hospital course: briefly, 77 year old woman with history of post-polio syndrome (bulbar weakness) and overlying myasthenia on mestinon at home with no past complications, who presents with a combination of fatiguable weakness and myasthenic reaction on , poor nif/fvc consistent with myasthenic crisis, as well as overlying cortical sensory signs on the left with motor weakness in umn pattern, suggesting a focal lesion in the brain r hemisphere. she was admitted to the neurology icu with myasthenic crisis and new r temporo-parietal mass on head ct. neuro: she was subsequently begun on decadron to decrease the cerebral edema associated with the mass and continued intubation given possible worsening of myasthenia crisis. no know primary tumor and torso ct was negative. mri brain with gadolinium showed the right temporal lobe mass being solitary suggestive of a primary malignant glioma or an isolated metastatic lesion. neurosurgery was contact and stereotactic brain biopsy was performed on . mestinon was resumed post-procedure. pathology showed infiltrating glioma which was confirmed by immunophenotyping to be anaplastic astrocytoma. post-operative course was complicated by a serratia marcescens pneumonia by bal that was treated with ceftazidine x 14 days. patient was also initiated on 5 day course of ivig to treat her myasthenia. patient was successfully extubated on . after discussion with the patient and her family, patient was again taken to or for palliative aspiration of the brain mass in the attempt to decompress the r temporal region on . patient will follow-up with dr. in clinic as an outpatient. she will continue taking mestinon and decadron at discharge. cv: during pre-operative workup, patient was found to have had a nstemi with peak enzymes of 0.53 and ck 146. echo showed ef 35%. cardiology was consulted and recommended beta blockade peri-operatively. aspirin 325mg was started and held peri-operatively; and patient was started on metoprolol as tolerated. patient tolerated both brain surgeries with flat cardiac enzymes. patient was without chest pain throughout hospital course. id/pulm: patient spiked a temperature and on , patient underwent bronchoscopy which showed thick secretions. lavage culture grew serratia marcescens. patient completed 14 day course of ceftazidime for likely pneumonia. medications on admission: lisinopril 40 mg hctz 12.5 mg qod mestinon 30 mg tid valium 2 mg qhs discharge medications: 1. acetaminophen 650 mg suppository sig: one (1) suppository rectal q4-6h (every 4 to 6 hours) as needed. 2. guaifenesin 100 mg/5 ml syrup sig: 5-10 mls po q6h (every 6 hours) as needed. 3. bisacodyl 10 mg suppository sig: one (1) suppository rectal hs (at bedtime) as needed. 4. docusate sodium 100 mg tablet sig: one (1) tablet po bid (2 times a day). 5. oxycodone-acetaminophen 5-325 mg/5 ml solution sig: 5-10 mls po q4-6h (every 4 to 6 hours) as needed. 6. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). 7. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day). 8. insulin regular human 100 unit/ml solution sig: per sliding scale units injection asdir (as directed). 9. lansoprazole 30 mg susp,delayed release for recon sig: thirty (30) mg po daily (daily). 10. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 11. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) unit injection tid (3 times a day). 12. heparin lock flush (porcine) 100 unit/ml syringe sig: one (1) ml intravenous daily (daily) as needed: 10ml ns followed by 1ml of 100 units/ml heparin (100 units heparin) each lumen qd and prn. inspect site every shift . 13. sodium chloride 0.9 % syringe sig: three (3) ml injection daily (daily) as needed: peripheral iv - inspect site every shift. 14. pyridostigmine bromide 5 mg/ml solution sig: one (1) mg injection q8h (every 8 hours). 15. dexamethasone sodium phosphate 4 mg/ml solution sig: four (4) mg injection q8h (every 8 hours). 16. phenytoin sodium 50 mg/ml solution sig: one hundred (100) mg intravenous q8h (every 8 hours). discharge disposition: extended care facility: for the aged - macu discharge diagnosis: primary diagnosis: anaplastic astrocytoma (right temporo-parietal mass) myasthenia secondary diagnosis: post-polio syndrome - soft speech, occas trouble swallowing hypertension raynaud's phenomenon s/p total abdominal hysterectomy mitral valve prolapse discharge condition: neurologically stable. ms . no ptosis on sustained upgaze. slight left facial droop. left arm and leg weakness 4-/5 and right side 4+/5. 2+ dtrs throughout. discharge instructions: please take medications as prescribed. please keep follow-up appointments. if you have any worsening shortness of breath, weakness in your arms or legs, increased confusion or any other worrying symptoms, please call your outpatient neurologist , md or return to the emergency room. followup instructions: provider: , .d. phone: date/time: 12:30 please follow-up with dr. . pines. phone: . please call on monday and schedule an appointment to be seen within 1-2 weeks of discharge. please follow-up with your cardiologist, dr. . phone: . please call on monday and schedule an appointment to be seen within 1-2 months of discharge. procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified 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 insertion of other (naso-)gastric tube closed [endoscopic] biopsy of bronchus closed [percutaneous] [needle] biopsy of brain ventricular shunt to extracranial site nec injection or infusion of immunoglobulin diagnoses: subendocardial infarction, initial episode of care pneumonia due to other gram-negative bacteria mitral valve disorders unspecified essential hypertension acute respiratory failure raynaud's syndrome anemia in neoplastic disease late effects of acute poliomyelitis malignant neoplasm of temporal lobe hemiplegia, unspecified, affecting nondominant side myasthenia gravis with (acute) exacerbation 

Answer: The patient is high likely exposed to