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: mental status change major surgical or invasive procedure: : left craniotomy for partial mass resection history of present illness: 48m presents with worsening ha over the past 2 days. went to pcp in /08 with increased anxiety and has had memory loss since . he was treated with mulitiple antidepressants which only made him feel sick. he then self titrated off. he then had ct which showed large l temporal mass. past medical history: panic attacks, anxiety social history: lives alone but has many siblings and mother living nearby. family history: non-contributory physical exam: physical exam upon admission: t:97.8 bp:130/92 hr:84 rr:16 o2sats 100 gen: lying on stretcher, appeard lethargic (due to pain meds) heent:normocephalic/atraumatic pupils: l 3mm r 2mm eoms full neck: supple. extrem: warm and well-perfused. neuro: mental status: awake and alert, cooperative with exam, normal affect. orientation: oriented to person and place language: speech fluent with good comprehension and repetition. naming intact. no dysarthria or paraphasic errors. cranial nerves: i: not tested ii: pupils round and reactive to light, r 3 to 2mm l 2 to 1 mm. 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. no abnormal movements, tremors. strength full power throughout. no pronator drift sensation: intact to light touch, propioception, pinprick and vibration bilaterally. toes downgoing bilaterally coordination: normal on finger-nose-finger, rapid alternating movements, heel to shin on discharge: signigicantly improved. he is oriented to person and place. pupils equal and reactive. face symmetric, tongue midline. no drift. full strength and sensation. able to recall 1 out of 3 items. ambulating on his own. incision clean, dry, and intact. pertinent results: labs on admission: 09:15am blood wbc-7.5 rbc-5.03 hgb-15.6 hct-45.6 mcv-91 mch-31.0 mchc-34.2 rdw-12.6 plt ct-193 05:50pm blood neuts-66.8 lymphs-27.5 monos-3.7 eos-1.7 baso-0.3 05:50pm blood pt-12.5 ptt-22.5 inr(pt)-1.1 05:50pm blood glucose-88 urean-20 creat-0.8 na-141 k-4.0 cl-104 hco3-28 angap-13 05:50pm blood ck(cpk)-55 05:50pm blood ctropnt-<0.01 04:00am blood albumin-4.1 calcium-8.6 phos-3.2 mg-1.9 09:15am blood vitb12-359 09:15am blood tsh-2.5 09:15am blood free t4-0.94 04:00am blood phenyto-12.5 labs on discharge: xxxxxxxxxxxxxxxxx mri/mra brain : findings: there are changes from a left temporal craniotomy for resection of left temporal lobe mass. there is hemorrhage in the operative bed, which limits evaluation for residual neoplasm. recommend attention on followup imaging. the more posteriorly placed medial temporal lobe mass with heterogeneous enhancement and either exophytically bulging or extending into the left temporal is unchanged. there appears to be ependymal enhancement within the left occipital temporal horns. again noted is an approximately 8 mm of midline shift to the right as well as mild uncal herniation which is unchanged from the preoperative imaging. there is extensive t2 hyperintensity in the left temporal lobe extending to the inferior frontal lobe, which could represent vasogenic edema or infiltrative neoplasm. there is small amount of restricted diffusion along the posterior margin of the operative cavity, which could represent acute ischemia or cytotoxic edema from retraction. there is a left frontal subgaleal postoperative collection. intracranial flow voids are maintained. mra demonstrates no stenosis or aneurysm, the basilar artery is somewhat dimunitive, which may be related to prominent pcoms. impression: postoperative changes in the left temporal lobe. due to presence of t1 hyperintense material in the operative bed, evaluation for residual neoplasm is limited. recommend correlation with followup study when the acute blood products resolve. unchanged left posterior medial temporal lobe heterogeneous mass. small amount of restricted diffusion along the posterior margin of the operative cavity. please see above. ct head : findings: patient is status post left craniotomy and resection of large left temporal mass. there is expected pneumocephalus within the left hemisphere. extensive areas of new hemorrhage are seen within the left cerebral hemisphere (2, 21). extensive amounts of edema are similar in appearance (2, 18): there is persistent shift of the normally midline structures by approximately 6.5 mm. there is effacement of the left ambient cistern, unchanged. there is no evidence of hydrocephalus. the occipital of the left lateral ventricle also demonstrates mild effacement, similar to slightly worse when compared to prior exam. there is an unchanged left temporal lobe mass causing mass effect on the temporal . impression: status post partial resection of left temporal lobe mass. extensive areas of new hemorrhage, pneumocephalus and persistent shift of the normally midline structures. close followup is recommended. persistent effacement of the left ambient cistern is similar in appearance. mri head : findings: in the region of the left temporal lobe including the hippocampus, there are two heterogeneously enhancing lesions with thick rind of enhancing tissue surroudning necrotic areas in the center corresponding to those described on the ct scan done on the same day. there is intraventricular extension of these lesions. the more anterior lesion (8:10) measures 33 mm transverse x 23 mm ap x 23 mm cc. the second more posterior area measures 21 mm transverse x 28 mm ap x 23 mm cc. the two lesions closely approximate each other and may, in fact, represent lobules of one large conglomerated lesion illdefined lesion. the lesions are notable for moderate- sized surrounding area of edema. the more posterior lesion displays signal characteristics suggestive of retained blood products. both lesions show an irregular thick rim of enhancement on post- contrast images. there is an approximately 8 mm right deviation of normal midline anatomy as well as partial effacement of the left lateral ventricle, associated with these lesions. there is also mild subependymal enhancement and along the margins of the ventricle on the left side. there is partial entrapment of th left temporal . in addition, effacement of the left border of the suprasellar cistern is consistent with associated left uncal herniation. there is no evidence of tonsillar herniation. there is no evidence of acute infarction. on post- contrastimages, there is displacement of the adjacent vessels including the middle cerebral arteries and venous structures. otherwise, the paranasal sinuses and mastoid air cells are clear. impression: 1. two heterogeneously enhancing left temporal lobe lesions involving the hippocampus and intraventricular extension and resultant mass effect as detailed above. diagnostic considerations include primary cns infiltrative malignancy such as glioblastoma multiforme or less likely a lymphoma, though metastatic disease is also in the differential diagnosis. these findings were discussed with dr. at ~5p.m. on , who indicated that the patient was en route to the emergency room with anticipation of admission. 2. in addition to that, recommendations were conveyed for an mra to assess vascular patency of the displaced vessels as well as a neurosurgical consult. brief hospital course: mr. was admitted after ct revealed a new large left temporal brain mass. he became progressively lethargic to the point of obtundation. in this context, the patient was emergently rushed to the or for a left temporal lobectomy on . he was extubated the following day and his neuro exam improved. due to the large size of his mass and the amount of compression on the brain he remained in the icu for several days. he remained neurologically stable and transferred to the neurosurgery floor on for continued treatment of hyponatremia, utilizing sodium chloride tablets, fluid restriction and frequent lab analysis of serum sodium levels. prior to discharge the salt tablets were discontinued but his fluid restriction continued. the patient was evaluated by dr. who will see him again in the brain clinic on . he also had pt and ot evaluations. the patient requires 24 hour supervision for his cognitive deficits. his family will share the responsibility of caring for him. he was discharged on as noted above. at the time of discharge, the patient was oriented x name and hospital. he can recall items at 1 minute. his ltm is intact to birthday and home address. he speaks with hesitatncy and paraphasic errors. his motor neurologic examination was non-focal. medications on admission: none discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 2. albuterol 90 mcg/actuation aerosol sig: two (2) puff inhalation q6h (every 6 hours) as needed. 3. levetiracetam 500 mg tablet sig: three (3) tablet po bid (2 times a day). disp:*180 tablet(s)* refills:*2* 4. hydromorphone 2 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed: no driving while on narcotics. disp:*50 tablet(s)* refills:*0* 5. zolpidem 5 mg tablet sig: one (1) tablet po hs (at bedtime). disp:*20 tablet(s)* refills:*2* 6. butalbital-acetaminophen-caff 50-325-40 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for headache. disp:*10 tablet(s)* refills:*0* 7. dexamethasone 1 mg tablet sig: two (2) tablet po every six (6) hours for 2 days: the take 1mg po q6 hours for 2 days. disp:*22 tablet(s)* refills:*0* 8. outpatient speech/swallowing therapy patient requires speech therapy for cognitive impairment. 9. outpatient occupational therapy patient requires assistance with cognitive deficit. discharge disposition: home discharge diagnosis: left temporal brain mass discharge condition: neurologically stable discharge instructions: general instructions/information ?????? 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. ?????? your wound closure uses dissolvable sutures, you must keep that area dry for 10 days. ?????? 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 discharged on keppra (levetiracetam), you will not require blood work monitoring. ?????? if you are being sent home on steroid medication, make sure you are taking a medication to protect your stomach (prilosec, protonix, or pepcid), as these medications can cause stomach irritation. make sure to take your steroid medication with meals, or a glass of milk. ?????? clearance to drive and return to work will be addressed at your post-operative office visit. ?????? make sure to continue to use your incentive spirometer while at home. 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: increasing redness, increased swelling, increased tenderness, or drainage. ?????? fever greater than or equal to 101?????? f. followup instructions: follow-up appointment instructions ??????please return to the office in days (from your date of surgery) for a wound check. this appointment can be made with the nurse practitioner. please make this appointment by calling . if you live quite a distance from our office, please make arrangements for the same, with your pcp. ??????you have an appointment in the brain clinic on @ 1:00pm. the brain clinic is located on the of , on 8. their phone number is . please call if you need to change your appointment, or require additional directions. ??????you will not need an mri of the brain as this was done during your acute hospitalization procedure: other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain diagnoses: esophageal reflux hyposmolality and/or hyponatremia asthma, unspecified type, unspecified compression of brain aphasia other diuretics causing adverse effects in therapeutic use malignant neoplasm of other parts of brain chronic cluster headache 

Answer: The patient is high likely exposed to