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: bacitracin / morphine / percocet attending: chief complaint: altered mental status major surgical or invasive procedure: whole brain radiation history of present illness: info taken from micu note and patient interview. in brief,49 yo f with stage iv non-small cell lung cancer who presented to the ed with new onset fevers, worsening respiratory status, + cough, worsening sputum, and fevers. she had recently received her dose of navelbine chemotherapy . also her husband that she had some difficulty thinking specially after last dose of chemotherapy. per micu report, she was also aggitated and there was an intial concern for withdrawing given her history of drinking. . on arrival to micu, she denied cp or sob. she received intiially cefepime and vancomycin on admission. her cheest x ray showed a rll. she was kept on vancomycin and cefepime. she had a head ct done that showed multiple new hypodensities in the right frontal, right temporal, and left centrum semiovale concerning for metastases. dexamethasone was started and patient's mental status improved. blood cx have remained negative. she is going for radiation tomorrow. . currently she feels ok. denied any sob, chest pain. her cough is still there. she has not been febrile over last 24h. past medical history: pancreatitis: chronic from etoh use. c/b pseudocyst, currently managed conservitavly. gerd htn smv thrombosis - not currentyl anticoagulated. was diagnosed in , decided to be followed and not anticoagulated. stage iv non-small cell lung cancer social history: lives with husband. smoked 1ppd x 30 years. reportedly stopped drinking. family history: mother died of colon cancer physical exam: vitals: t: 97.7 p:100 r:16 bp:126/95 sao2:100 ra general: awake, alert, nad. cachectic heent: pupiles equal and reactive to light. eomo preserved. oropharinx is clear. neck: supple, no jvd or carotid bruits appreciated pulmonary: lungs r base crackles. cardiac: rrr, nl. s1s2, no murmurs abdomen: soft, nt/nd, normoactive bowel sounds, no masses or organomegaly noted. extremities: 2+ , no edema. skin: radiation skin changes lower back. neurologic: alert, oriented x3., craneal nerves ii xii preserved, strength 5/5 proximal and distall upper/lower extremity. coocrdination finger to nose preserved. reflex ++/++++ bilaterally. attention intact with serial 7's, months backwards but evidence of subtle cognitive deficits in reasoning. pertinent results: 04:10pm blood wbc-1.2*# rbc-2.73* hgb-10.1* hct-30.4* mcv-111* mch-37.0* mchc-33.2 rdw-20.1* plt ct-39*# 11:16am blood wbc-0.8* rbc-2.12* hgb-8.1* hct-23.3* mcv-110* mch-38.4* mchc-34.9 rdw-17.7* plt ct-31* 05:34pm blood wbc-0.6* rbc-1.37*# hgb-5.3*# hct-15.2*# mcv-111* mch-38.7* mchc-34.9 rdw-18.1* plt ct-21* 05:00am blood wbc-0.6* rbc-2.04*# hgb-7.1*# hct-21.1* mcv-104*# mch-35.1* mchc-33.8 rdw-22.0* plt ct-21* 05:35am blood wbc-1.8*# rbc-3.32* hgb-11.7* hct-33.1* mcv-100* mch-35.1* mchc-35.2* rdw-21.3* plt ct-33* 08:15am blood wbc-1.9* rbc-3.53* hgb-12.1 hct-36.0 mcv-102* mch-34.4* mchc-33.7 rdw-20.7* plt ct-38* 05:50am blood wbc-2.6* rbc-3.30* hgb-11.1* hct-32.9* mcv-100* mch-33.7* mchc-33.8 rdw-20.2* plt ct-40* 05:06am blood wbc-6.1# rbc-3.20* hgb-11.3* hct-32.5* mcv-102* mch-35.3* mchc-34.8 rdw-20.2* plt ct-47* 05:00am blood gran ct-420* 05:00am blood gran ct-690* 05:35am blood gran ct-1140* 05:50am blood gran ct-1720* 05:06am blood gran ct-5210 04:10pm blood glucose-107* urean-6 creat-0.6 na-131* k-3.0* cl-88* hco3-29 angap-17 11:16am blood glucose-86 urean-4* creat-0.4 na-135 k-3.5 cl-104 hco3-20* angap-15 05:00am blood glucose-182* urean-5* creat-0.1* na-133 k-4.2 cl-99 hco3-25 angap-13 05:35am blood glucose-125* urean-7 creat-0.4 na-133 k-3.8 cl-97 hco3-28 angap-12 08:15am blood glucose-119* urean-11 creat-0.5 na-135 k-3.3 cl-100 hco3-22 angap-16 05:50am blood glucose-109* urean-9 creat-0.4 na-137 k-4.3 cl-105 hco3-22 angap-14 05:06am blood glucose-121* urean-13 creat-0.5 na-131* k-4.2 cl-100 hco3-21* angap-14 03:40pm blood glucose-118* urean-15 creat-0.5 na-133 k-4.0 cl-99 hco3-23 angap-15 12:53am blood alt-40 ast-32 ld(ldh)-334* ck(cpk)-33 alkphos-89 totbili-0.9 04:10pm blood ctropnt-<0.01 12:53am blood ck-mb-2 ctropnt-<0.01 11:16am blood calcium-7.7* phos-2.0* mg-1.3* 05:00am blood calcium-8.9 phos-2.5* mg-1.3* 05:35am blood calcium-8.8 phos-3.0 mg-1.8 08:15am blood calcium-9.1 phos-3.5 mg-1.4* 05:50am blood calcium-9.1 phos-2.8 mg-1.5* 05:06am blood calcium-9.1 phos-3.6 mg-1.8 11:16am blood vitb12-1425* 11:16am blood tsh-1.1 12:53am blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg . cxr: lung volumes are mildly diminished with asymmetric density over the right hemidiaphragm. blunting of the right costophrenic angle is again identified anteriorly. there is a rounded mass lesion seen in the mid central right upper lung projecting between the posterior aspects of the right fifth and sixth ribs. mediastinum is unremarkable. the cardiac silhouette is within normal limits for size. no pneumothorax is appreciated. impression: mass lesion recently characterized on pet ct. there is increased density over the right dome of the liver which may represent an early focal infiltrate. pneumonia must be suspected until proven otherwise given neutropenic status. . cxr: part of lung apices obscured by patient's chin. the previously noted right lower lobe opacity appears more prominent today suggesting right lower lobe pneumonia. the right upper lung spiculated mass is less readily evident. there are no other focal consolidations. the cardiomediastinal silhouette is normal. there is no pulmonary edema. there is no pleural effusion or pneumothorax. impression: right lower lobe pneumonia. . ct head: multiple new hypodensities in the right frontal, right temporal, and left centrum semiovale concerning for metastases in this patient with known metastatic lung cancer. an mri before and after iv contrast administration is recommended for further evaluation. these findings were discussed with dr. at the time of this dictation. brief hospital course: # altered mental status: the patient was admitted to the icu for altered mental status. she was found to have new brain metastasis with edema. she was started on dexamthasone 4mg q6hours with marked improvement of her mental status. she then began receiving whole brain radiation. she was continued on the dexamethasone on discharge but at 4mg q8hours to be tapered as necessary as an outpatient. on the day of discharge, she was drowsy in the morning and inattentive. later in the day, she was more alert, able to perform attention testing but cont to have subtle cognitive deficits. the patient demonstrated significant anxiety at the thought of staying. per her outpt fellow, she has baseline moderate anxiety.she was started on zyprexa. given that she will have 24 hour supervision at home, it was decided that she was safe for discharge. # pneumonia: the patient was admitted for altered mental status. cxr noted rll pna. she was started on on cefepime and vancomycin. these abx were continued while she was neutropenic. she received neupogen. when she was no longer neutropenic, she was switched to bactrim and levofloxacin to complete at 10 day course of abx. she was monitored for 48 hours and remained without fever or clinical worsening. . # non-small cell lung ca: started on dexamethasone and whole brain radiation for new brain mets. she also became neutropenic and was started on neupogen. medications on admission: 1. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day) as needed for constipation. disp:*30 tablets* refills:*6* 2. gabapentin 400 mg capsule sig: three (3) capsule po q8h (every 8 hours). 3. lorazepam 1 mg tablet sig: one (1) tablet po tid (3 times a day). 4. fentanyl 75 mcg/hr patch 72 hr sig: one (1) transdermal every seventy-two (72) hours. disp:*30 patches* refills:*2* 5. zofran 4 mg tablet sig: one (1) tablet po every eight (8) hours as needed for nausea. 6. nexium 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 7. ibuprofen 600 mg tablet sig: one (1) tablet po four times a day. 8. atenolol 100 mg tablet sig: one (1) tablet po once a day. 9. fexofenadine 60 mg tablet sig: one (1) tablet po twice a day as needed for sinus congestion. 10. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. disp:*30 tablet(s)* refills:*6* 11. fluoxetine 10 mg capsule sig: one (1) capsule po once a day. 12. flonase 50 mcg/actuation spray, suspension sig: two (2) sprays nasal once a day. 13. folic acid 1 mg tablet sig: one (1) tablet po once a day. 14. amylase-lipase-protease 56,000-20,000- 44,000 unit capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po three times a day: take before meals. 15. pyridoxine 50 mg tablet sig: one (1) tablet po twice a day. 16. cyanocobalamin 100 mcg tablet sig: one (1) tablet po once a day. 17. hydromorphone 2 mg tablet sig: one (1) tablet po every hours as needed for pain. 18. dexamethasone 4 mg tablet sig: two (2) tablet po every eight (8) hours. disp:*120 tablet(s)* refills:*3* discharge medications: 1. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day) as needed for constipation. disp:*30 tablets* refills:*6* 2. gabapentin 400 mg capsule sig: three (3) capsule po q8h (every 8 hours). 3. lorazepam 1 mg tablet sig: one (1) tablet po tid (3 times a day). 4. fentanyl 75 mcg/hr patch 72 hr sig: one (1) transdermal every seventy-two (72) hours. disp:*30 patches* refills:*2* 5. zofran 4 mg tablet sig: one (1) tablet po every eight (8) hours as needed for nausea. 6. nexium 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 7. ibuprofen 600 mg tablet sig: one (1) tablet po four times a day. 8. atenolol 100 mg tablet sig: one (1) tablet po once a day. 9. fexofenadine 60 mg tablet sig: one (1) tablet po twice a day as needed for sinus congestion. 10. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. disp:*30 tablet(s)* refills:*6* 11. fluoxetine 10 mg capsule sig: one (1) capsule po once a day. 12. flonase 50 mcg/actuation spray, suspension sig: two (2) sprays nasal once a day. 13. folic acid 1 mg tablet sig: one (1) tablet po once a day. 14. amylase-lipase-protease 56,000-20,000- 44,000 unit capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po three times a day: take before meals. 15. pyridoxine 50 mg tablet sig: one (1) tablet po twice a day. 16. cyanocobalamin 100 mcg tablet sig: one (1) tablet po once a day. 17. trimethoprim-sulfamethoxazole 160-800 mg tablet sig: one (1) tablet po bid (2 times a day) for 8 days: to end on . disp:*16 tablet(s)* refills:*0* 18. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 8 days: to end on . disp:*8 tablet(s)* refills:*0* 19. hydromorphone 2 mg tablet sig: one (1) tablet po every hours as needed for pain. 20. dexamethasone 4 mg tablet sig: two (2) tablet po every eight (8) hours. disp:*120 tablet(s)* refills:*3* 21. olanzapine 2.5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: home health care discharge diagnosis: non-small cell lung ca brain metastasis altered mental status pneumonia discharge condition: improved- lethargy resolved, pneumonia improved discharge instructions: you were admitted with confusion. you were found to have pneumonia and were started on antibiotics. you were also found to have brain metastasis with edema that caused your altered mental status. your confusion cleared with steroids and radiation. you were also started on zyprexa for anxiety and confusion. . if you have confusion, lethargy, fever, chills or trouble breathing, you should return to the emergency room. followup instructions: you should call radiation oncology to arrange for further radiation. ( . provider: , md, phd: date/time: 9:00 provider: , md phone: date/time: 9:00 provider: , rn phone: date/time: 10:00 md, procedure: teleradiotherapy using photons diagnoses: pneumonia, organism unspecified esophageal reflux unspecified essential hypertension hypopotassemia secondary malignant neoplasm of brain and spinal cord antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use malignant neoplasm of other parts of bronchus or lung dehydration drug induced neutropenia delirium due to conditions classified elsewhere 

Answer: The patient is high likely exposed to