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: gait distrubance major surgical or invasive procedure: thoracentesis chest tube placement right frontal craniotomy history of present illness: this is a 69 year old male with a histpry of small-cell lung ca in (s/p chemo and xrt), who has been experiencing frequent falls and loss of balance for 1 week. states he easily loses his balance, has fallen almost daily, and has had increased difficulty with walking. he has baseline ataxia, but this has become more pronounced. he has hit his head on 2 fall occasions, but no loc. was seen at his pcp last evening who ordered a head ct - this demonstrated a right frontal rim enhancing lesion with hemorrhagic component and mass effect. he comes from hospital for continued care and further neurosurgical evaluation. he currently has no complaints; specifically, no headache, nauea, double vision, or problems with speech. past medical history: 1. small cell lung ca , s/p chemo and xrt 2. cva and ? with subtle left sided weakness 3. htn social history: divorced. retired engineer. 13 pack year smoking history, quit 7 years ago. no etoh family history: father deceased of prostate ca, mother deceased on liver ca physical exam: on admission: o: t:98.4 bp: 155/81 hr:80 r:18 o2sats:100% gen: wd/wn, comfortable, nad. heent: normocephalic, atraumatic. slight l facial droop. pupils: perrla eoms intact neck: supple. extrem: warm and well-perfused. neuro: mental status: awake and alert, cooperative with exam, normal affect. orientation: oriented to person, place, and date. recall: objects at 5 minutes. language: speech fluent with good comprehension and repetition. naming intact. no dysarthria or paraphasic errors. cranial nerves: i: not tested ii: pupils equally round and reactive to light, 2 to 1 mm bilaterally. visual fields are full to confrontation. iii, iv, vi: extraocular movements intact bilaterally without nystagmus. v, vii: facial strength and sensation intact and symmetric. viii: hearing intact to voice. ix, x: palatal elevation symmetrical. : sternocleidomastoid and trapezius normal bilaterally. xii: tongue midline without fasciculations. motor: normal bulk and tone bilaterally. ataxic movements/tremors to all extremities when extended. hand grasps 5-/5 on the l. full strength right upper and lower extremities. l pronator drift sensation: intact to light touch, propioception, pinprick and vibration bilaterally. toes downgoing bilaterally on discharge: aox3, left tricep otherwise full motor. left tremor. no pronator drift. perrl. left nasolabial flattening. wound is c/d/i, sutures are dissolveable. pertinent results: head ct : 1. a large hemorrhagic mass with vasogenic edema causing 5.4 mm leftward subfalcine herniation in the right frontal lobe measuring up to 3 cm. this finding is concerning for a metastasis. 2. area of hypoattenuation compatible with vasogenic edema likely from a second metastasis in the left parieto-temporal region. this should be further evaluated with gadolinium-enhanced mri. chest x-ray : 1. right-sided hydropneumothorax with a small right apical pneumothorax and a moderate right-sided effusion. 2. severe volume loss in the right lower lobe. 3. enlarged right hilum either representing the known primary tumor and/or hilar lymphadenopathy. mri brain : impression: 1. no definite evidence of persistent nodular enhancement in the resection cavity. 2. focal area of nodular restricted diffusion along the posterior margin of the resection cavity may be related to surgery. however, clinical correlation and continued attention on followup recommended. 2. extra-axial fluid layering along the convexities of both hemispheres. expected postoperative changes in the right frontal region as above. brief hospital course: mr. was admitted to the neurosurgery service under the care of dr. . he was on decadron and keppra. a chest x-ray showed right pleural effusion/low lung volume and hydropneumothorax. he was stable with 02 sat 95% ra. ct/cxr reports from did not reveal history of pneurmothorax. pulmonology was consulted. they recommend that he be on 02. mri brain showed a large right frontal lesion and left temporal parietal edema. ct torso showed adrenal thickening and lung abnormalities. subsequent work up revealed that the patient had developed a right pleural effusion. this effusion was tapped by the interventional radiologist. cytology from the pleural effusion did not reveal evidence of metastasis. the patient was seen by dr. on . he recommended outpatient brain radiation after resection of the tumor. the same recommendation was also made by dr. , the neuro-oncologist. he underwent tumor resection on . there was a cystic portion of the mass that was sent for cytology and the remaining portion was resected without difficulty. the patient was extubated in the or and was in the icu overnight for q 1 hour neuro checks. he remained neurologically stable was transferred back to the neurosurgical floor where he worked with pt. rehab was recommended and he was discharged to rehab on . cytology from thoracentesis showed 2+ polymorphonuclear leukocytes- infectious disease recommended no further intervention as this was seen to be contaminate. medications on admission: lasix 20 mg tab oral 1 tablet(s) once daily diovan -- unknown strength 1 tablet(s) once daily prilosec 20 mg cap oral 1 capsule, delayed release(e.c.)(s) once daily zestril 20 mg tab oral 1 tablet(s) once daily bactrim ds 800 mg-160 mg tab oral 1 tablet(s) twice daily compazine -- unknown strength 1 suppository(s) , as needed percocet -- unknown strength 1 tablet(s) , as needed asa - 325mg tab oral 1 tablet once daily discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain fever. 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 3. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*90 tablet(s)* refills:*0* 4. levetiracetam 500 mg tablet sig: two (2) tablet po bid (2 times a day). disp:*120 tablet(s)* refills:*2* 5. valsartan 40 mg tablet sig: two (2) tablet po daily (daily). 6. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). 7. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). 8. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily): while on dexamethasone. disp:*30 capsule, delayed release(e.c.)(s)* refills:*2* 9. dexamethasone 2 mg tablet sig: one (1) tablet po q12h (every 12 hours). disp:*60 tablet(s)* refills:*2* discharge disposition: extended care facility: rehabilitation & nursing center - discharge diagnosis: right frontal brain tumor right pleural effusion right hydropneumothorax 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: general instructions ?????? take your pain medicine as prescribed. ?????? exercise should be limited to walking; no lifting, straining, or excessive bending. ?????? increase your intake of fluids and fiber, as narcotic pain medicine can cause constipation. we generally recommend taking an over the counter stool softener, such as docusate (colace) while taking narcotic pain medication. ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, and ibuprofen etc. ?????? you have been prescribed an anti-seizure medicine, keppra, take it as prescribed. ?????? clearance to drive and return to work will be addressed at your post-operative office visit. call your surgeon immediately if you experience any of the following ?????? new onset of tremors or seizures. ?????? any confusion or change in mental status. ?????? any numbness, tingling, weakness in your extremities. ?????? pain or headache that is continually increasing, or not relieved by pain medication. ?????? any signs of infection at the wound site: redness, swelling, tenderness, or drainage. ?????? fever greater than or equal to 101?????? f. ** keep your incision clean and dry until . then you may use shampoo/soap. ** you do not need an appointment for suture removal. the stures will dissolve on their own. ** please continue your dexamethasone until your follow-up with dr. . because this is a steroid, we recommend that you take omeprazole while on dexamethasone to protect your stomach. *** you should follow up with your pcp to discuss your tremor. followup instructions: follow-up appointment instructions you have a brain tumor appointment on with dr. . the btc is located on bld. you can call with questions. procedure: insertion of intercostal catheter for drainage other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain thoracentesis diagnoses: unspecified essential hypertension secondary malignant neoplasm of brain and spinal cord other late effects of cerebrovascular disease cerebral edema lack of coordination malignant neoplasm of main bronchus other musculoskeletal symptoms referable to limbs other specified forms of effusion, except tuberculous 

Answer: The patient is high likely exposed to