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: transferred from ; initially presented for urinary retention and back pain major surgical or invasive procedure: none history of present illness: mr. is a 75 yo cantonese-speaking man with h/o afib, htn, copd and metastatic nasopharyngeal ca with known liver mets, who presented to for urinary retention and back pain. he is currently on day 13 of cycle 2 of cisplatin and gencytabine. mri of the spine showed no cord compression but lesions at c7, t10 and t12. he had 1.5l uop with placement of the foley (per discharge summary, retention reportedly started in the evening of ). he did not receive morphine or compazine for pain effects of urinary retention. history on the patient is limited due to language barrier (have not been able to contact interpreter yet). . he was a direct floor transfer. vs on arrival to the floor were 96.5, 112/70, 118 - 140 in afib, 96% on ra. the patient was on his feet wlaking to the bathroom to urinate (though had a foley) when i met him. past medical history: 1. hypertension 2. atrial fibrillation 3. chronic obstructive pulmonary disease 4. stage iv nasopharyngeal carcinoma - - rhinoscopy with tumor extending into the nasal cavity - pet-ct - fdg avid mass in nasopharynx, left palatine tonsils, clivus, floor of the sella turcica, posterior nasal cavity, posterior ethmoid air cells, and the sphenoid sinus; enlarged lymph nodes with associated necrosis; lytic bone lesion in right iliac bone - - biopsy with squamous cell carcinoma 5. poorly characterized hepatic mass - it is unclear if this represents a metastatic lesion or a primary hepatic neoplasm; he is scheduled for a liver biopsy on 6. obstructive sleep apnea 7. hypophosphatemia 8. hearing loss 9. bilateral renal cysts (benign finding on recent ct abdomen) 10. anemia 11. arthritis social history: home: cantonese-speaking; immigrated to the us from southern approximately 12 years ago tobacco: 80 ppy ( 2 ppd x 40 years), quit 10 years ago etoh: denies drugs: denies occupation: previously employed as a bus driver family history: father - died at about age 50 from an unknown cause to the patient. mother - died in her 90s 4 siblings - 1 brother died of a cancer (unknown type) physical exam: vs on arrival to floor: 96.5, 112/70, 118 - 140 in afib (100-120's at per d/c summary), 96% on ra general: was walking to bathroom with nurses when initially seen; pleasant small elderly asian male heent: mmm, op clear lungs: cta thrughout cardio: irregularly irregular, rapid heart rate, could not distinguish any murmurs abd: thin,, + bs, soft, ntnd ms: no spinal tenderness extremities: no edema skin: no rashes neuro: aa, cannot ascertain orientation due to language barrier, was up walking to bathroom without difficulty, gait normal, strength seems to be symmetric and normal (does not cooperate for full neuro exam) pertinent results: 04:59am blood wbc-9.1 rbc-3.23* hgb-10.1* hct-30.4* mcv-94 mch-31.2 mchc-33.2 rdw-16.7* plt ct-184 02:10am blood wbc-11.3*# rbc-2.78* hgb-8.8* hct-26.1* mcv-94 mch-31.5 mchc-33.5 rdw-16.8* plt ct-110* 02:41pm blood hct-25.8* 05:42am blood pt-11.6 ptt-43.4* inr(pt)-1.0 04:59am blood glucose-148* urean-24* creat-0.9 na-134 k-3.5 cl-96 hco3-27 angap-15 05:42am blood glucose-104* urean-28* creat-0.8 na-140 k-3.3 cl-101 hco3-26 angap-16 04:59am blood alt-18 ast-19 ck(cpk)-29* alkphos-152* totbili-1.2 04:59am blood ck-mb-2 ctropnt-<0.01 05:42am blood calcium-8.5 phos-2.3* mg-1.4* 04:59am blood vitb12-566 04:59am blood tsh-1.1 03:21am urine rbc-50* wbc-1 bacteri-none yeast-none epi-0 03:21am urine blood-mod nitrite-neg protein-30 glucose-neg ketone-neg bilirub-neg urobiln-neg ph-6.5 leuks-tr 03:21am urine color-yellow appear-clear sp -1.015 3:21 am urine urine culture (final ): no growth. blood cultures - no growth to date ct head - 1. no intracranial hemorrhage or major vascular territorial infarction identified. 2. large soft tissue mass within the nasopharynx, with associated osseous destruction as detailed, which is incompletely imaged and characterized without iv contrast. if there is concern for intracranial metastases or an acute infarct, an mri with gadolinium is recommended. mr/mra brain - 1. acute/subacute left pontine infarct associated with high-grade stenosis of the basilar artery. 2. large poorly-defined enhancing mass within the nasopharynx with permeation and destruction of the clivus with associated cervical adenopathy, better visualized on the recent neck mri. 3. 3 mm right ophthalmic aneurysm. 4. markedly irregular right posterior cerebral artery with high-grade segmental stenosis. video swallow study - barium passed freely through the oropharynx and esophagus without evidence of obstruction. there was gross aspiration with multiple consistencies of barium including thin, nectar, and pudding. for details, please refer to the speech and swallow division note in the online medical record. brief hospital course: #. urinary retention, new spinal mets: patient was transferred for evaluation of urinary retention because all of his care is at . he was transferred with foley in place with good output and no evidence of acute renal failure. there is concern for metastatic disease to spine given mri findings at osh prior to transfer, however there report with no sign of cord compression. urine output was adequate with the foley and no evidence of renal failure on labwork. urinary retention work-up was deferred pending the development of stroke and afib with rvr. (see below) # acute/subacute left pontine infarct - mr. developed right sided weakness and confusion shortly after arrival to . code stroke was initiated. neurology consult felt that exam was extremely difficult to interpret in setting of no interpreter available, however was notable for confusion, disorientation vs. aphasia and weakness in rue w/o signs of umn disease at time of evaluation. nihss score was 8. ct head was done due to patient's inability to lie flat for a prolonged period and showed no intracranial hemorrhage or major vascular territorial infarct identified. patient underwent romi thich was negative, ua was negative for uti. started aspirin. patient was transferred to micu due afib with rvr. mr. then underwent mri/mra under sedation which showed acute/subacute left pontine infarct. he was started on heparin for anticoagulation. mr. continued to be confused/disoriented after transfer from the unit to the floor. discussion with the family at that time about goals of care resulted in change of code status to dnr/dni due to poor prognosis. video swallow on showed aspiration with all levels of consistency. family refused peg. ultimately, patient clinically deteriorated in setting of no po intake, recent stroke with aspiration on video swallow, and afib with rvr requiring diltiazem infusion. he was likely aspirating his secretions. on a discussion regarding goals of care was again initiated and patient was placed on comfort measures only. mr. passed away the evening of . # atrial fibrillation with rvr - patient was noted to be in atrial fibrillation with rapid ventricular response after arrival from osh. he was given iv diltiazem for rate control without success. he was transferred to the micu where he was placed on a continuous diltiazem infusion with rate control to the 90-100's. he was unable to take po due to his cva event on the night of admisison. he was then transferred to the cardiology floor on the diltiazem infusion for further management. he remained in atrial fibrillation throughout his hospital course. patient's family refused peg so he was continued on diltiazem infusion until goals of care were changed to comfort measures only. #. metastatic nasopharyngeal ca: currently undergoing second round of palliative chemo prior to the admission. ng tube unable to be placed due to large nasopharyngeal mass. patient's clinical course and prognosis was discussed with his primary oncologist. medications on admission: diltiazem er 120 mg qd-- last given on at 11 am advair 250/50 monteleukast 10 qd proair 90 q6 hours lidoderm patch qd senna peg discharge medications: deceased discharge disposition: expired discharge diagnosis: deceased discharge condition: deceased discharge instructions: deceased followup instructions: deceased procedure: insertion of endotracheal tube diagnoses: obstructive sleep apnea (adult)(pediatric) malignant neoplasm of liver, secondary unspecified essential hypertension chronic airway obstruction, not elsewhere classified atrial fibrillation retention of urine, unspecified encounter for palliative care cerebral artery occlusion, unspecified with cerebral infarction delirium due to conditions classified elsewhere secondary malignant neoplasm of bone and bone marrow arthropathy, unspecified, site unspecified malignant neoplasm of nasopharynx, unspecified site 

Answer: The patient is high likely exposed to