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: metastatic melanoma requiring il-2 therapy persistent acidemia, ag acidosis & arf major surgical or invasive procedure: - central line placement - central line placement - cvvh dialysis beginning history of present illness: pt is a 60 yo man with history of metastatic melanoma (primary in foot, known mets in pelvis, liver, lungs who initially presented on to biologics service for il-2 therapy. since admission, pt has been stable, receiving il-2 therapy. of note, hospital course to this point has been complicated by diarrhea, developement of acute renal failure with cr increased to 2.8 from baseline of 0.9, felt secondary to il-2 therapy. today, pt received his 13th out of 14 doses of il-2 therapy at 5pm. during the day, he had been noted to have persistent acidemia (low hco3) and had been treated with total of 5 amps bicarb throughout the day without much improvement of his hco3. this evening, pt was noted to be tachypnic in respiratory distress, as well as tachycardic to 200's. at this time, pt c/o sob, no other complaints. labs at this time demonstrated persistent acidemia, with abg: 7.19/32/158/13. other labs drawn at this time as below - notable for worsening arf (cr 5.1), ag acidosis. the patient was transferred to the icu for closer monitering. on arrival in the icu, pt was noted to be tachypnic to 30-40's, o2 sats 90-100% on nrb, hypotensive with sbp 60's, tachycardic 180-210, and again, complained only of sob. he was intubated for airway protection, initially started on levophed gtt for pressure support. cardioversion was attempted but was unsuccessful. he was therefore switched from levophed to neosynephrine and was bolused amiodarone and started on amio gtt. currently pt remains intubated/sedated. past medical history: metastatic melanoma s/p appy migraine social history: - married with 3 children - he is a retired truck driver and lives in . - he hasn't smoked for ten years and drinks approximately one beer per day family history: - there is no family history of melanoma. - he has an uncle with cancer and a brother with prostate cancer. physical exam: vitals - t , hr 190, bp 73/37, rr 36, o2 99% on nrb -> ac/fio2 1.0/tv 500/rr30/peep 5 gen - awake, alert, able to answer questions, visibly tachypnic with use of abdominal muscles heent - scleral icterus lungs - slight wheezing at bases, otherwise cta b/l cvs - tachycardic, irregular abd - soft, use of abdominal muscles with breathing, no noted tenderness to palpation; tympanic in upper region ext - + le edema b/l neuro - a+o initially, became more lethargic skin - cool extremities, flushed appearance to limbs pertinent results: cxr - prelim read low lung volumes, ? mild chf rpt cxr - prelim worsening chf brief hospital course: this patient is a 60 yo male with h/o metastatic melanoma, who was undergoing il-2 therapy (s/p 13 out of 14 doses), now with severe multi-organ failure; ?r/t to il-2 toxicity. . # respiratory failure: patient was initially intubated for work of breathing/tachypnea, resp distress. there was a significant acidemia as well as cxr which indicated pulm edema. etiology was unlikely to be chf as the patient had no history of cad. presentation was more consistent with an ards picture, given bilateral pulm infiltrates as well as pao2/fio2 < 200, or il-2 therapy adverse event as this can cause a capillary leak syndrome. other possibilities of pulm edema include volume overload renal failure, less likely chf related to heart disease/mi. hypoxia may be secondary to shunt ( likely atelectasis) as well as likely increased intrathoracic pressures secondary to ascites. the patient was continued on ac ventilation following ardsnet protocol--> increase peep 12 to 15, decrease vt 600 to 550, wean oxygen as able. an esophageal balloon was used to measure pleural pressures to aid in target cvp assessment. the patient was maintained on cvvh to help with acid/base disorder with pt. il-2 therapy was held. . # atrial fibrillation: no known history of cad; the patient had afib on admission to icu but converted to nsr after shocks x2 & amiodarone ivp x1; o/n, converted back to afib, requiring cardioversion as well as amiodarone without success. hypotensive, thus requiring levophed, neosynephrine & vasopressin. amiodarone infusion was not used because of hypotension as well as liver failure. . # sepsis/shock: the patient met criteria for sirs, however there was no clear source of infection. the patient was pancultured, the r subclavian cvl was d/c'ed & tip cultured. the patient was hypothermic and hypotensive, requiring 3 vasopressors with sbp still 90's; hypotension was thought to be a side effect of il-2 therapy, unsure if it was related to il-2 toxicity. ct abd unremarkable for lactic acidosis or any ischemic process, however, clinical picture was consistent with shock liver. it was attempted to wean vasopressors to keep map>60, especially levophed given dusky distal extremities. support was given with fluids, both colloid and crystalloid. the patient was started on iv solumedrol, which was changed to standing hydrocortisone for treatment of il-2 related adverse effects. antibiotic therapy for broad spectrum coverage was continued throughout admission. . # acute renal failure: the patient had rising cr during hospital course, intially attributed to il-2 therapy on the floor. il-2 known to cause renal failure, perhaps indirectly due to vasodilation/capillary leak and hypotension. creatinine had elevated to ~5, also with multiple electrolyte abnormalities & in the setting of not wean vasopressors to keep map > 60. medications were renally dosed and nephrotoxins were avoided. . # severe acidemia/ag-acidosis: the patient had severe lactic acidosis in the setting of hypotension sbp 60's on arrival to icu & occasionally overnights, also with triple vasopressor use-vasoconstriction, ?abd compartment syndrome (however ct scan does not support this), shock or ischemic liver were also included in the differential. acidemia is a known effect of il-2 therapy/?toxicity, however unsure if it can account for the extent of acidosis in this patient. the patient was taken off il-2 and was receiving thiamine and steroids. also the patient had evidence of renal failure. as mentioned above, the patient was started on cvvh to correct acid/base abnormality. acid/base status and lactate levels were monitored. . # fulminant liver failure: the patient presented with severely elevated transaminases, also with coagulopathy (see below). initially, mild transaminatis due to il-2 therapy ?toxicity of il-2. also receiving 4gm acetaminophen while on the floor, however standard during il-2 therapy & unlikely to cause such fulminant failure; it was felt that the etiology was most likely shock liver. coagulopathy and lfts were monitored, and a hepatology consult was obtained for further management. . # coagulopathy: the patient appeared to be dic based on labs, however difficult to differentiate in the setting of severe liver failure. also be r/t il-2 toxicity. received 4u ffp & vit k x 1 dose. on inr values returned at 22.8 (from baseline 7) with fibrinogen < 35 and ptt > 150. 3units ffp were transfused with plan to transfuse if platelets < 20 without bleeding or platelets < 50 with bleeding. hit ab was checked, and the patient was monitored for bleeding. . # metastatic melanoma:mets to multiple sites; s/p il-2 therapy. oncology was following along. initiated steroids to reverse effects of il-2 currently. no melanoma treatment for now. oncology recommendations were followed. . the patient was maintained on ppi and pneumoboots for prophylaxis (no sc hep b/c plt low). during the admission a high-dose insulin drip was started up to 23 units/hr for fs up to 600s; however, the patient became hypoglycemic with fs (60s). there was a concern for hypoglycemia in the setting of liver failure and possibly retained insulin given renal failure. . on the team was called to the bedside for an acute change in vs: pt became tachycardic briefly before becoming bradycardic and hypotensive and ultimately going into asystole. cpr was attempted with chest compressions for approximately 25 minutes without a return of pulse; the code was terminated because of persistent asystole with the time of death at 9:25pm on . the family was notified at this time. they elected not to proceed with an autopsy or liver biopsy. . discharge disposition: expired discharge diagnosis: metastatic melanoma - s/p il-2 therapy sirs respiratory failure liver failure renal failure dic acidemia discharge condition: expired procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube hemodialysis transfusion of other serum high-dose infusion interleukin-2 [il-2] diagnoses: acidosis other iatrogenic hypotension malignant neoplasm of liver, secondary acute and subacute necrosis of liver acute kidney failure, unspecified other pulmonary insufficiency, not elsewhere classified secondary malignant neoplasm of other specified sites hypopotassemia nausea with vomiting defibrination syndrome disorders of phosphorus metabolism antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use diarrhea secondary malignant neoplasm of lung personal history of malignant melanoma of skin other nonspecific abnormal serum enzyme levels anemia in neoplastic disease jaundice, unspecified, not of newborn family history of malignant neoplasm of gastrointestinal tract systemic inflammatory response syndrome, unspecified unspecified pruritic disorder family history of malignant neoplasm of prostate encounter for antineoplastic immunotherapy 

Answer: The patient is high likely exposed to