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: penicillins attending: chief complaint: ha/ confusion major surgical or invasive procedure: :right craniotomy with tumor resection history of present illness: 44 yo w with pmh of metastatic melanoma s/p radiation and il-2 tx presented to osh with ha and confusion. pts spouse reporting pt would forget turns in directions while driving, forgets doing the grocery shopping, short term memory loss and personality changes over the past week. ha is frontal, worse in the evening, responds to ibuprofen. no nausea or vomiting. no visual changes. no focal deficits. . in the ed, vs: t 99.1 hr 76 bp 105/49 rr 18 98ra. head ct showed mass lesion in the brain with midline shift and associated edema. patient received 10mg load dexamethasone and cerebyx 1000mg and was transferred to for further management. she was evaluated by neurosurgery who recommended steroids. she also received iv morphine for pain control. she was then transferred to the for further observation. past medical history: metastatic melanoma s/p resection of a right shoulder lesion notable for melanoma in . mets to right frontal bone, ascending colon and right tibia. s/p cyber-knife radiation to the skull on and began hd il-2 therapy on . s/p xrt to the right tibia completed on . plan for orthopedic surgery in of tibial lesion. social history: she lives with her husband and two children. she lives on the . she is a teacher. no tobacco. she rarely drinks alcohol. family history: mother had pancreatic cancer and diabetes at 63. her grandmother's brother died of melanoma and her great grandmother died of colon cancer. physical exam: temp 97.5 hr 72 bp 107/51 rr 12 spo2 98% general appearance: well nourished, no acute distress eyes / conjunctiva: perrl, pupils dilated head, ears, nose, throat: normocephalic cardiovascular: (s1: normal), (s2: normal), (murmur: no(t) systolic) peripheral vascular: (right radial pulse: present), (left radial pulse: present), (right dp pulse: present), (left dp pulse: present) respiratory / chest: (expansion: symmetric), (breath sounds: clear : , no(t) crackles : , no(t) wheezes : ) abdominal: soft, non-tender, bowel sounds present, no(t) distended extremities: right: absent, left: absent skin: warm, no(t) rash: neurologic: attentive, follows simple commands, responds to: verbal stimuli, oriented (to): person, place, time, movement: purposeful, sedated, tone: normal on discharge: aox3, full strength and power throughout upper and lower extremties. pertinent results: 12:15am wbc-9.3 rbc-3.82* hgb-11.2* hct-34.4* mcv-90 mch-29.4 mchc-32.7 rdw-12.4 12:15am neuts-92.4* lymphs-6.6* monos-0.7* eos-0.2 basos-0.1 12:15am plt count-377 12:15am glucose-164* urea n-19 creat-0.7 sodium-139 potassium-4.1 chloride-106 total co2-26 anion gap-11 12:40am pt-13.2 ptt-27.7 inr(pt)-1.1 09:01am plt count-400 09:01am wbc-6.7 rbc-4.21 hgb-12.6 hct-37.2 mcv-89 mch-29.9 mchc-33.8 rdw-12.2 09:01am osmolal-295 09:01am calcium-9.4 phosphate-3.4 magnesium-1.9 09:01am glucose-127* urea n-13 creat-0.7 sodium-138 potassium-4.1 chloride-101 total co2-27 anion gap-14 12:30pm osmolal-293 labs on discharge: 06:00am blood wbc-9.6 rbc-3.43* hgb-10.2* hct-30.5* mcv-89 mch-29.9 mchc-33.6 rdw-12.3 plt ct-512* 06:00am blood plt ct-512* 06:00am blood glucose-108* urean-18 creat-0.7 na-135 k-4.5 cl-98 hco3-31 angap-11 06:00am blood calcium-9.5 phos-3.7 mg-2.1 06:00am blood phenyto-11.5 imaging: head ct :impression: 1. new 4.7 x 5.2 cm mass lesion of the right frontal lobe with surrounding the vasogenic edema and subfalcine herniation considering the rapid development of the mass lesion, the metastatic disease is most likely possibility. 2. stable 19 mm irregular lytic lesion of the right frontal bone, stable since but might still represent a metastatic focus. head ct (): impression: 1. status post resection of the right frontal mass with blood and pneumocephalus formation at the resection site. the vasogenic edema and subfalcine herniation are relatively unchanged. 2. right frontotemporal subdural pneumocephalus, which is an expected finding after the recent surgery. head ct : impression: slight improvement in mass effect. otherwise, no significant change. brief hospital course: 44 yo female with history of melanoma and now with concerning findings of cns metastasis and significant mass effect. she has had stability of neuro exam over the time in the icu. 1)metastatic cns lesion--significant mass effect is noted and rx is started. neurosurgery evaluation is underway. -transfer to the west if surgical intervention is planned -mannitol 50mg q 6 hrs--serum osms to be checked q 6 with goal of >310 until revised with neuro-surgery or neurology -dilantin -dexamethasone 4mg q 6 hours -neurology to evaluate patient for aid in management and rx 2)metastatic melanoma- -will consult oncology (dr. -will have to defer treatment planning for additional metastatic sites. patient was transferred to the under the care of dr. to undergo surgical resection of her right sided mass. post operatively, she did well and was found to be appropriate for home discharge. she was continued on steroids, and given follow up instructions for cyberknife and btc appointment. medications on admission: klonopin discharge medications: 1. clonazepam 0.5 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)) as needed. 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed. 3. acetaminophen 500 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for headache, pain. 4. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 5. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 6. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 7. dexamethasone 4 mg tablet sig: one (1) tablet po q8h (every 8 hours). disp:*60 tablet(s)* refills:*2* 8. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 9. levetiracetam 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: metastatic melanoma discharge condition: neurologically stable discharge instructions: general instructions ?????? have a friend/family member check your incision daily for signs of infection. ?????? take your pain medicine as prescribed. ?????? exercise should be limited to walking; no lifting, straining, or excessive bending. ?????? you may wash your hair only after sutures and/or staples have been removed. ?????? you may shower before this time using a shower cap to cover your head. ?????? 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, take it as prescribed and follow up with laboratory blood drawing drawing in 7 days and fax results to . ?????? 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. followup instructions: follow-up appointment instructions ??????please return to the office in days for removal of your sutures and a wound check. ??????please call ( to schedule an appointment with dr. , to be seen in 4 weeks. ??????you will need a ct scan of the brain without contrast. ??????you will not need an mri of the brain. you have also had cyberknife schedule to occur on @ 11:15am with , md phone:. at this time, a brain tumor clinic appointment will be scheduled procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain arterial catheterization arterial catheterization diagnoses: secondary malignant neoplasm of brain and spinal cord cerebral edema personal history of malignant melanoma of skin secondary malignant neoplasm of bone and bone marrow other alteration of consciousness family history of malignant neoplasm of gastrointestinal tract 

Answer: The patient is high likely exposed to