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: no known allergies / adverse drug reactions attending: chief complaint: pleuritic chest pain major surgical or invasive procedure: none history of present illness: 63 year old man with recent diagnosis of widely metastatic undifferentiated adenocarcinoma, likely of the lung, transferred from for further workup and to consider possible initiation of palliative chemo or radiation. patient presented to osh after worsening substernal chest pain since . he first noted the pain after moving tv's, and he assumed it was musculoskeletal. the pain was continuous, and exacerbated by breathing and laying flat, and began radiating along the right and left thorax. he also developed right shoulder pain and low back pain during this time. additionally, he has noted increasing shortness of breath over the last few months and developed an occasionally productive cough. he denies recent fevers or chills and has not noted any weight loss. denies headache, changes in vision, or focal numbness or weakness. denies pain in hi calves. no nausea or vomiting, although his appetite has been poor as of late. he denies bowel or bladder incontinence. review of systems was otherwise unremarkable. at osh, an abnomral cxr led to cta of the chest which showed likely malignancy and metastatic disease including extensive mediasitnal hilar lad, rt chest wall soft tissue mass with bony destruction of the adjacent right anteriorr second and third rib, left posteriror chest wasll soft tissue mass with bony destruction of the left posterior 8th rib, and mutliple pathologic rib fractures. ct of the abdomen and pelvis showed multiple metastatic lesions within the liver, right adrenal gland, left gluteal muscles, right groin, and a pathologic l1 vertebral body fracture with soft tissue impressing upon the thecal sac. biopsy of the rib lesion was attempted, but failed due to patietn's inability to lie flat. similarly, mri of the head could not be obtained due to inability to lie flat. biopsy of the gluteal lesion was obtained which preliminary report showed undifferentiated adenocarcinoma. of note, patient was also treated empirically for pna with levaquin and steroid taper. past medical history: - chronic back pain - possible copd, no formal diagnosis - alcohol abuse. sober for 4 months - hx of basal cell ca. - cellulitis/mrsa - left hip replacement - metastatic undifferentiated adenocarcinoma, likely of lung social history: smokes 1.5 packs per day for 49 years and has history of abusing alcohol. family history: no family history of lung cancer. physical exam: admission exam: vitals: t:97.6 bp:139/73 p:108 r:23 o2:92% 5lnc general: pleasant, alert, oriented, sitting up in bed in mild distress pain heent: sclera anicteric, mmm, tongue midline, oropharynx clear neck: supple, jvp not elevated, no lad lungs: speaks in short sentences, scattered wheezes with low frequency expiratory ronchi diffusely cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops chest: tender to palpation diffusely over precordium. no rashes, erythema, or swelling noted abdomen: soft, non-tender, non-distended, soft bowel sounds present, no rebound tenderness or guarding, no organomegaly rectal: deferred ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema. rom rt should limited by pain. neuro: alert and oriented x4. good attention. cnii-xii intact. strength 5/5 symmetrically throughout lower extremity. limited by pain in right upper extremity. finger-to-nose intact with good proprioception of feet. gait not assessed. pertinent results: 03:31am blood wbc-17.2*# rbc-4.54*# hgb-15.1# hct-42.3# mcv-93# mch-33.2* mchc-35.7* rdw-12.9 plt ct-330# 03:31am blood glucose-107* urean-25* creat-0.6 na-136 k-4.2 cl-100 hco3-26 angap-14 03:31am blood alt-10 ast-15 ld(ldh)-470* alkphos-84 totbili-0.4 03:31am blood albumin-3.4* calcium-10.9* phos-3.8 mg-2.1 brief hospital course: # metastatic adenocarcinoma of lung: the patient was admitted to the icu and was evaluated by oncology, radiation oncology and palliative care. with his poor performace status and advanced disease, palliative radiation alone was offered to the patient. palliative care made recommendations for pain management with plan to go home with hospice. the patient was agreeable to the plan. he received one dose of radiation on and was discharged home with hospice services. # hypoxia: thought possible pna with underlying copd and splinting from pain of bony lesions. he was treated initially at the osh with steroids and levaquin. the abx completed on and the steroid taper was continued on discharge. he will also go home with supplemental o2 and nebulizer treatments. # hypercalcemia: initial ca was 10.9 on admission. he was hydrated and given one dose of pamidronate. repeat calcium level was 9.0. # goals of care: patient will go home with hospice care. he was dnr/dni. medications on admission: nsaids prn discharge medications: 1. home oxygen home oxygen 5l nc countinuous 99 weeks diagnosis lung cancer 2. hospital bed semi-electric with mattress bed + half rails. please have head of bed elevated to 30 degrees 99 weeks diagnosis lung cancern 3. commode 3 in 1 commode 4. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). disp:*30 capsules* refills:*0* 5. fentanyl 25 mcg/hr patch 72 hr sig: one (1) patch 72 hr transdermal q72h (every 72 hours). disp:*10 patch 72 hr(s)* refills:*0* 6. oxycodone 5 mg tablet sig: 1-2 tablets po as needed for pain, cough, or difficulty with breathing. disp:*60 tablet(s)* refills:*0* 7. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. disp:*60 tablet(s)* refills:*0* 8. prednisone 10 mg tablet sig: taper per instructions po once a day: take 2 tablets daily for 7 days, then reduce to 1 tablet daily for 7 days, then 0.5 tablets daily for 7 days, then stop. disp:*25 tablet(s)* refills:*0* 9. ipratropium bromide 0.02 % solution sig: one (1) dose inhalation q4h (every 4 hours) as needed for wheezing. disp:*50 dose* refills:*0* 10. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) unit dose inhalation q4h (every 4 hours) as needed for sob/wheeze. disp:*50 unit dose* refills:*0* 11. ranitidine hcl 15 mg/ml syrup sig: one y (150) mg po bid (2 times a day) as needed for dyspepsia. disp:*600 ml* refills:*0* 12. dextromethorphan-guaifenesin 10-100 mg/5 ml syrup sig: mls po q6h (every 6 hours). disp:*400 ml(s)* refills:*2* 13. benzonatate 100 mg capsule sig: one (1) capsule po tid (3 times a day). disp:*90 capsule(s)* refills:*0* 14. naproxen 500 mg tablet sig: one (1) tablet po every twelve (12) hours: give with food as this med may irritate stomach. disp:*60 tablet(s)* refills:*0* 15. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 16. lorazepam 0.5 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for anxiety. disp:*50 tablet(s)* refills:*0* 17. nicotine 21 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily). disp:*30 patch 24 hr(s)* refills:*0* discharge disposition: home with service facility: discharge diagnosis: metastatic lung cancer discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you were admitted to evaluate for radiation therapy and or chemotherapy for lung cancer. the oncologists (cancer doctors) did not feel that chemotherapy would give you any benefit, but did want to provide radiation therapy to help with your bone pain. the radiation was given on . pain medication and home hospice services will be provided to you on discharge. medication instructions: 1. prednisone taper, take 20 mg daily for 7 days, then 10 mg daily for 7 days, then 5 mg daily for 7 days, then stop. this is to help with breathing. 2. albuterol and ipratropium nebulizer treatments are also to help with breathing. 3. spiriva is an inhaled medication to help with breathing. 4. naproxen and fentanyl are pain medications that should be used regularly. 5. oxycodone can be used as needed to help with extra pain or symptoms of shortness of breath. 6. lorazepam is for anxiety; take as needed. 7. docusate and senna are for constipation as fentanyl and oxycodone use can cause constipation. 8. ranidine is for heartburn or acid reflux. 9. guaifenesin-dextromethorphan and benzonatate are for symptoms of cough. followup instructions: you may follow-up with your primary care physician as needed: name: , u. location: - address: , wellesly, phone: procedure: other radiotherapeutic procedure diagnoses: pneumonia, organism unspecified malignant neoplasm of liver, secondary long-term (current) use of steroids chronic airway obstruction, not elsewhere classified secondary malignant neoplasm of other specified sites personal history of tobacco use personal history of other malignant neoplasm of skin other constipation malignant neoplasm of other parts of bronchus or lung hypoxemia encounter for palliative care do not resuscitate status secondary and unspecified malignant neoplasm of intrathoracic lymph nodes secondary malignant neoplasm of bone and bone marrow hypercalcemia personal history of alcoholism hip joint replacement neoplasm related pain (acute) (chronic) pathologic fracture of vertebrae other dependence on machines, supplemental oxygen secondary malignant neoplasm of adrenal gland 

Answer: The patient is high likely exposed to