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: r sided weakness . icu admission: hypoxia major surgical or invasive procedure: picc history of present illness: mr is an 81 yo male with lung cancer (), throat cancer (approx ), and new diagnosis of mandible cancer who was found down on his kitchen floor by a neighbor after 24+ hours. at this point he reported awakening with new r arm weakness. he states that he was in his usual state of health at this time and thinks he "must have slipped." he denied any preceding weakness or numbness in his extremities. he does have approx 1 month hx of dysarthria and pain from jaw mass. additionally denies fever, chills, cough or respiratory symptoms. during the interview he is coughing, but states that this started once he got to the hospital. no sick contacts. denies headache or neck stiffness. he was taken by ems to the er at which point his o2 sat was 88% and he was placed on a nrb. . upon arrival to the ed his vitals were t 98.9, hr 67, bp 116/62, rr 20, o2 sat 96% on nrb, and while there failed a trial on nasal cannula and placed on 70% cool mist mask. abg revealed:7.40/51/135 on nrb, and cxr showed rll opacity suspicious for pneumonia. he received 3l of ivfs as well as levoflox 750mg iv x 1 and flagyl 500mg iv x 1. stat ct head showed no evidence of bleed. neurology was consulted and recommended mri brain and c-spine +/- gadolinium to eval for mets once respiratory status stabilized (not emergent) as well as eeg. past medical history: lung cancer- s/p radiation neck cancer- newly diagnosed/awaiting biopsy, pt has severe dysarthria x1month as a result. large mandibular mass for which he is followed at institute social history: patient lives alone in , widowed x3 years, no children, quit smoking in 's, drinks on saturdays up to 5 glasses of alchohol - denies any withdrawal symptoms. no no illicit druges. distant cousins check in on him: and , (cell). family history: non-contributory physical exam: admission: vs: temp: 96.2 bp: 126/46 hr: 63 rr: 13 o2sat 86% on ra, 95% on 70% cool mist mask gen: pleasant, comfortable, mild respiratory distress, loose cough heent: l pupil slightly larger than r, both briskly reactive to light, eomi, anicteric, very large mass both in r oral cavity and on jaw - greenish and crusted. neck: supple resp: fine crackles r greater l, rhoncherous bs cv: bradycardic, s1 and s2 wnl, no m/r/g abd: nd, +b/s, soft, nt, no masses or hepatosplenomegaly ext: no c/c/e, warm, good pulses, weak rt ue skin: no rashes/no jaundice neuro: aaox3 but confabulates. horner's syndrome on r. r sided ue weakness. pertinent results: lactate:2.2 . pt: 15.9 ptt: 33.4 inr: 1.4 . abg: ph 7.40 pco2 51 po2 135 hco3 33 basexs 5 . u/a: 1.023, +ket 50, few bacteria, otherwise negative . lactate:2.4 . ck: 1391 mb: 15 mbi: 1.1 trop-t: 0.02 . labs: 05:15pm glucose-91 urea n-19 creat-0.6 sodium-134 potassium-4.3 chloride-94* total co2-28 anion gap-16 05:15pm alt(sgpt)-45* ast(sgot)-98* ld(ldh)-282* ck(cpk)-1391* alk phos-80 tot bili-0.5 05:15pm calcium-9.3 phosphate-3.2 magnesium-2.4 05:15pm wbc-15.9* rbc-3.87* hgb-11.7* hct-35.9* mcv-93 mch-30.3 mchc-32.7 rdw-15.7* 05:15pm neuts-93.3* lymphs-3.7* monos-2.8 eos-0 basos-0.2 : na 143 k3.7 cl 105 bicarb 29 bun 1 cr 0.5 glucose 115 : wbc 9.6 hct 30 plt 302 : pt 17 inr 1.6 . microbiology: blood cx : lactobacillus blood cx and : no growth . le doppler: partially occlusive dvt noted in the left mid sfv to the popliteal vein, with eccentric shape, likely chronic. . non-contrast head ct: multiple prior lacunar infarctions, age related atrophy with widened ventricles, no hemorrhage or mass effect. . cxr: rll infiltrate c/w pneumonia versus large mass . cta prelim read: 1. segmental pulmonary embolism to the right middle lobe. smaller subsegmental filling defect in a left lower lobe branch. 2. pleural-based mass, the right lung base mass and extensive pleural thickening in the setting of pathologically enlarged mediastinal and left axillary lymph nodes appear consistent with the patient's reported history of mesothelioma. 3. centrilobular emphysema and right basilar honeycombing are consistent with advanced chronic interstitial lung disease. 4. air-bronchograms present at the medial aspect of the right lung base could be consistent with pneumonia. clinical correlation recommended. . mri/mra head: impression (prelim):scattered throughout the left cerebral hemisphere, predominantly within the left parietotemporal lobe, but also including the occipital and frontal lobes, there are multiple focal areas of restricted diffusion with accompanying flair hyperintensities likely to represent acute/subacute infarctions, probably secondary to multiple emboli. no areas of restricted diffusion are demonstrated in the right cerebrum. there is no evidence of intracranial hemorrhage, mass effect, or shift of normally midline structures. there is moderate periventricular t2 and flair hyperintensity consistent with chronic microvascular infarction. 1. multifocal left cerebellar areas of restricted diffusion with associated edema, most likely representing acute/subacute infarction. given distribution, this probably represents embolic phenomenon. the distribution of these lesions favors infarction over encephalitis. 2. slightly heterogeneous clivus which although not overtly consistent with metastasis, can be followed up with bone scan if there is further clinical concern. 3.mra circle of : there is no evidence of stenosis, aneurysm, or vascular malformation. . video swallow evaluation: this swallowing pattern correlates to a dysphagia outcome severity scale (doss) rating of 2, moderately-severe dysphagia. recommendations: 1. suggest having a discussion with the pt regarding his options for nutrition (pos alone vs pos with supplemental tube feeds vs tube feeds only). pt will need to understand the risks of continued aspiration prior to making his decision. 2. if he decides to continue with po intake, i would recommend a po diet of nectar thick liquids and pureed solids with the following aspiration precautions: a) alternate between every bite and sip b) small, single sips of liquid only -no straws and no chugging c) pills crushed with purees . brief hospital course: he was briefly admitted to the floor and then transfered to the icu for hypoxia. in the icu, his hypoxia resolved and he was transitioned from nrb to nc. he was transfered back to the hospital wards. during his hospital stay, he was treated for pe and pneumonia. he was followed by neurology for new left hemisphere strokes. he was also seen by the palliative care team given his deteriorating performace status and poor prognosis. the patient decided that he would like further treatment and rehabilitation and would consider hospice in the future. transfer to the va was arranged, but on the day of transfer, the patient became somnolent. after discussion with his brother, the patient was made . after being made , he received morphine for pain and air hunger. on , morphine was discontinued per the brother's request. in discussion with his brother, he was to be given sparing amounts of morphine only if the patient was suffering. overnight on , the patient was agitated, moaning and tachypnic per nursing report and was given 1 dose of morphine 2mg iv at 3:30 am. he passed away at 11:45 am on . . # somnolence: on , the patient became increasingly somnolent and was unarousable. at the time he was not hypoxic and had not received any morphine, or sedating medications. abg's noted hypercarbia which is the most likely cause of his somnolence. the patient had decided to be dnr/dni, but bipap was discussed with his brother. the causes of his hypercarbia were felt to be irreversible - advance lung ca-, and he was changed to comfort measures only. . # found down: the patient can not elucidate further any events surrounding being found on his kitchen floor. the reason for his fall is likely multifactorial with pna, gait instability, vasovagal episode?, arrhythmia?, deconditioning and possible dehydration. he was noted to have a wandering atrial pacemaker on ekg and possible old anterior mi but no av block or arrhythmia that would explain loss of consciousness. he was given ivf to resolve dehydration and antibiotics for likely pna. an echo to evaluated for structural heart abnormalities or vegetations was attempted but the patient was too agitated to tolerate the study. he has been occaisonally delerius during his hospital stay but has normal mental status at the time of discharge. he responded well to zyprexa or risperdal during episodes of agitation. . # hypoxia: on admission the patient was hypoxic with sao2 88%. he was started on oxygen. on chest ct , he was found to have large pelural mass (consistent with known lung ca) and a possible post-obstructive pneumonia. in addition, the ct showed segmental rml pe. le u/s showed left femoral dvt. cta also showed advanced interstitial lung disease on cta - the patient has a known extensive history of asbestos exposure and 100 pack year smoking history. mri of the head showed no metastasis making him lower risk of intracranial hemorrhage. given, the lack of intracranial mets, he was kept on heparin for pe. he was also started on coumadin originally but this was stopped when he had an episode of gib. he may be switched to lovenox when consistently without gib. he was also given albuterol and ipratropium nebs prn, but did not require them. his was treated for pna with unasyn. he was weaned off the oxygen. . # stroke: on admission, the patient was found to have right arm weakness, possible right facial droop and possible right horner's syndrome on exam. neurology was consulted and followed the patient during his hospital stay. head ct noted multiple non-specific lesions. an mri/mra was performed which showed multifocal left cerebral acute infarction. given distribution, it was thought that these lesions probably represent embolic phenomenon although metastatic disease is also possible. given his dvt/pe, thromboembolic disease is likely although it is unkown if patient has a pfo. the patient had no new heart murmur, no physical findings of septic embolic disease and only 1/4 bottles lactobaccillus (an unlikely endocarditis pathogen) making endocartitis unlikely. an echo to evaluate for endocarditis was attempted but the patient was too agitiated to tolerate it. given the low suspicion for endocarditis, echo was not pursued further. as the patient was already on heparin for pe, and this was continued. neurology would recommend asa if heparin is changed to lovenox. the patient also received a speech and swallow evaluation which showed significant dysphagia and aspiration. it was recommended that he avoid oral intake. however, given his prognosis, the patient elected to continue with oral intake (thickened fluids and pureed solids) knowing the risks of aspiration and pneumonia. he was followed by ot and pt. . # gi bleeding: several days after the patient was started on heparin for pe, he had a bowel movement with bright red blood on the exterior, no melena. the patient remained hemodynamically stable with no change in serial hct's. his gi bleed was presumed to be due to hemrrhoids. he was continued on heparin but coumadin was stopped in order be able to stop anticoagulation if gi bleed became more significant. he had no further episodes of bloody stool. one could consider switching to daily therapeutic lovenox if he continues to be stable w/o bloody bowel movements. . # lung cancer/ head & neck cancer: the patient has know extensive disease, confirmed by chest ct and head mri. head mri found multiple areas of infarction but no overt metastasis. per his pcp, was originally scheduled to have his jaw mass biopsied at 2 weeks from the date of admission. however, given his poor prognosis and the patient's prior decision not to have his lung ca worked up or treated, the patient decided not to have any biopsies performed. no evaluation/treatment was performed for his lung/heent ca. . # pna: ct notes a possible post-obtructive pna. in the setting of fever, leukocytosis and left shift, the patient was presumed to have a pna and given antibiotics. in the ed he was given vancomycin, levofloxacin and flagyl for pna but this was changed to unasyn given likelihood of aspiration of gram positive oral anaerobes with his mouth cancer. he became afebrile and his wbc trended down. . # lft elevations: initially, he was found to have mild lft elevations with ast 98 and alt 45 of unclear etiology. lft's promptly trendended down. . # ck elevations: on admission, his ck was elevated (peak 1391), with troponin 0.02 making ami unlikely. given that he was found down over 24h, his ck was elevated due to mild rhabdomyolysis. he never had any electrolyte abnormalities or myoglobin in his urine. he was given fluids and his ck's trended down. . # communication: (brother) medications on admission: clindamycin ativan zolpidem percocet prn discharge medications: n/a discharge disposition: expired discharge diagnosis: primary: pulmonary embolism and left hemisphere stroke secondary: dvt, lung ca, ? mandibular ca vs lung metastasis, pneumonia discharge condition: expired discharge instructions: n/a followup instructions: n/a procedure: venous catheterization, not elsewhere classified diagnoses: pneumonia, organism unspecified postinflammatory pulmonary fibrosis malignant neoplasm of other parts of bronchus or lung hypoxemia acute venous embolism and thrombosis of deep vessels of proximal lower extremity internal hemorrhoids with other complication cerebral artery occlusion, unspecified with cerebral infarction other pulmonary embolism and infarction rhabdomyolysis malignant neoplasm of head, face, and neck 

Answer: The patient is high likely exposed to