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: iodine; iodine containing / betadine / shellfish attending: chief complaint: altered mental status major surgical or invasive procedure: central line ultrasound-guided biopsy of left lower quadrant abdominal/pelvic mass history of present illness: 60yo m with pmh of esophageal ca, melanoma, htn, cirrhosis, and gout, brought from nursing home with altered mental status x 3d. pt was noted to be confused and agitated, pulling out lines and talking to himself. he stated he was having hallucinations. he was alert and oriented to person and place only. he was also noted to have a rash on his neck and r arm. he was started on dilaudid 3d pta. per nursing home, pt had no nausea, vomiting, fever, chills, or cough. serum calcium was noted to be 15.1 on and patient was brought to ed. he was afebrile and hemodynamically stable at the nursing home. in the ed, he was noted to be awake but confused and disoriented. he received 1l ns, and k repletion. he also had labs, ua, ekg, cxr, and head ct w/o contrast. unable to obtain history from patient due to mental status. head ct showed a 17 mm low density area in the right lentiform nucleus, c/w prior hemorrhage vs old cva. following admission, he received ns @ 200 cc/hr, calcitonin and pamidronate. given leukocytosis (wbc 15), there was concern that infection could be contributing to his delirium. cxr (-), u/a w/ hematuria (foley) but no evidence of infection. given h/o etoh abuse, he had an abd u/s to evaluate for ascites. no ascites was visualized, however a 10 cm llq fluid collection was noted. subsequent abd ct showed that this mass was erroding into bone; also noted was a lle dvt. past medical history: #. amelonotic melanoma of the left shoulder s/p excision . the sentinal lymph node was negative for metastatic disease. #. scc of the left ankle s/p excision. was metastatic for which the pt received radiation. #. esophageal cancer s/p resection at . his oncologist is dr. at . #. htn #. gout #. chronic renal insufficiency, and h/o acute tubular necrosis. baseline cr 1.1-1.3. #. h/o multiple nonmelanoma skin cancers #. multiple gastric ulcers daignosed during admission for brbpr treated with proton pump inhibitor. # relative adrenal insufficiency during recent admission to micu for gib diagnosed by inappropriate reponse to cosyntropin. treated with hydrocort and fludricort x 7 days. # alcoholic cirrhosis # history of etoh dependence # chronic le pain. seen by pain center felt to be neuropathic in origin. they recommended increasing neurontin. social history: from nh since , h/o heavy etoh use before in nh family history: noncontributory physical exam: pe: af 84 142/85 16 99%2lnc elderly man, alert, oriented only with repeated prompting ncat, sclerae anicteric, perrl no jvd or lad ctab rrr, nl s1/s2, no murmur/gallop soft, does not respond to palpation, nd, +bs 1+ lle edema from groin to ankle, not erythematous or tender, no rle edema, 2+dp pulses b/l pertinent results: 15.1>35.4<418 n:86.8 l:7.9 m:3.5 e:1.4 b:0.3 |92|29/117 3.2|31|1.1\ ca:14.6 mg:1.5 p:2.0 alb:3.6 pt:13.6 ptt:29.1 inr:1.2 brief hospital course: 60 year-old male with history of metastatic esophageal cancer, melanoma, and squamous cell skin cancer who was admitted for shock and mental status changes. he was initially admitted to the medicine floor, but was transferred to the micu for declining respiratory status. 1) respiratory failure: on arrival to the micu, he was intubated for airway protection given his tenuous respiratory status. his respiratory status improved and he was weaned from the ventilator. he was extubated on hospital day 15. 2) dic: he had profuse bleeding after subclavian line was placed. laboratory results were consistent with dic. the dic resolved rapidly with aggressive treatment of sepsis with volume resuscitation and replacement of blood products. in total he received 4 units prbcs, 6 units ffp, and 1 unit cryoprecipitate. . 3) altered mental status: the etiology of his mental status change is unclear. the differential included hypercalcemia, other metabolic abnormality (tsh was normal), drug reaction (dilaudid, ms contin), brain metastasis (none visualized on head ct), infection. there was no evidence of urinary infection or pneumonia. there was no ascites so sbp was unlikely. lumbar puncture was attempted twice without success, therefore meningitis could not be ruled out. another source of infection could be infection in his pelvic mass. he received pamidronate and aggressive ivf to normalization of calcium. his mental status improved throughout the admission and was alert and conversant upon extubation. . 4) septic shock: he initially required levophed to maintain his blood pressure and it was weaned off by hospital day 4. he also received aggressive fluid resuscitation given that meningitis could not be ruled out, he was treated empirically with vancomycin/ceftriaxone/flagyl for a 14 day course. his vancomycin was dosed by levels since he cleared the medication very slowly. the pelvic fluid collection was drained and was sterile, so this was not likely the cause of his sepsis. . 5) hypercalcemia: most likely secondary to malignancy, either due to large mass eroding into left pelvic bone or due to pth-rp secretion from scc. he received pamidronate and aggressive ivf to normalization of calcium. 6) lle dvt: he was maintained on a heparin drip for his dvt once his dic had resolved. . 7) left pelvic mass: the mass is most likely metastatic scc given this was the location of prior positive left inguinal node biopsy. the mass was drained under ultrasound and cytology was consistent with squamous cell cancer. surgery was consulted and they felt that surgery was not feasible. oncology was consulted and he was not a candidate for chemotherapy or palliative radiation during this admission. 8) adrenal insufficiency: he was diagnosed with relative adrenal insufficiency in icu and was scheduled to only receive 7 days of stress dose steroids. it is unclear why hydrocortisone was restarted, but, he was on these steroids for several months. given the concern for infection he was given stress dose steroids. . 9) anemia: his hematocrit was low. during the periods of dic, he required prbc transfusion due to excess bleeding. otherwise, his hematocrit remained stable throughout the admission. . 10) seizure activity: during his admission, he had arm movements and eye deviations that were concerning for a seizure. an eeg showed slow wave focus suggesting fixed subcortical abnormality in left hemicortex, possible subclinical seizure activity, and he was loaded with phenytoin. he was maintained on dilantin throughout the rest of his hospital course without further seizure activity. . 10) ?ileus: towards the end of his hospital stay, he was not tolerating tube feeds and was not having bowel movements. abdominal films were negative for obstruction. his lack of bowel movements was attributed to lack of oral intake. . 11) aspiration: in the final days of this hospitalization, he began to aspirate copious amounts of bilious fluid. three times, he aspirated large amounts of bilious fluid that resulted in second periods of asystole. aggressive suctioning reversed the asystole. a nasogastric tube was placed to suction to prevent aspiration. later, he removed the nasogastric tube. within hours, he had vomited/aspiration large amount of bilious fluid and expired shortly thereafter. . 12) pain: during the admission, he was maintained on a fentanyl drip and morphine for breakthrough pain. his pain medications were titrated up throughout his hospital stay. . 13) tuberculosis exposure: he had been exposed to intern. cxr showed no acute pulmonary and a ppd was negative. . 14) chronic renal failure: he developed acute on chronic renal failure likely secondary to sepsis. his creatinine improved upon resolution of the sepsis. . 15) fen: he was initially maintained on tube feeds. on hospital day 13, he was not tolerating po intake. he switched to tpn. 16) prophylaxis. he was maintained on heparin, pneumoboots, and a ppi throughout the admission. . 17) code: he is estranged from family, his daughter was recently in contact over the past few mouths, but she did not know his wishes clearly. his ex-wife also in communication. once he was extubated, he was able to make his wishes know and he was made dnr/dnr. later, upon discussion with his pcp, was made cmo. medications on admission: 1) hctz 50 mg po daily 2) atenolol 25 mg po daily 3) folic acid 1 mg po daily 4) hydrocortisone 20 mg po qam, 10 mg po qpm 5) mv1 6) quinapril 20 mg po daily 7) ultram prn 8) protonix 40 mg po bid 9) mscontin 60 mg po q8h 10) cymbalta 60 mg po daily 11) msir 15 mg po q4h prn discharge medications: none. discharge disposition: expired discharge diagnosis: 1. metastatic sqaumous cell cancer 2. sepsis 3. disseminated intravascular coagulation 4. hypercalcemia 5. acute on chronic renal failure 6. seizure activity discharge condition: expired. discharge instructions: none. followup instructions: none. procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more spinal tap incision of lung insertion of endotracheal tube enteral infusion of concentrated nutritional substances transfusion of packed cells transfusion of other serum closed [percutaneous] [needle] biopsy of intra-abdominal mass transfusion of coagulation factors infusion of vasopressor agent diagnoses: subendocardial infarction, initial episode of care acute kidney failure with lesion of tubular necrosis unspecified septicemia secondary malignant neoplasm of other specified sites other convulsions hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease defibrination syndrome acute and chronic respiratory failure personal history of other malignant neoplasm of skin pneumonitis due to inhalation of food or vomitus cardiac arrest septic shock paralytic ileus acute venous embolism and thrombosis of deep vessels of proximal lower extremity personal history of malignant melanoma of skin secondary malignant neoplasm of bone and bone marrow hypercalcemia personal history of malignant neoplasm of esophagus secondary and unspecified malignant neoplasm of lymph nodes of inguinal region and lower limb 

Answer: The patient is high likely exposed to