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: l iph major surgical or invasive procedure: none history of present illness: 66m who is well known to neurosurgery who is s/p left craniotomy for resection of a metastatic cell carcinoma in , with dr. . he is currently receiving whole brain radiation and has received 14 out of 15 fractions. he is currently at center receiving lovenox for a lower extremity dvt which was stopped yesterday when he was noted to have decreased mentation and also bloody diarrhea in the setting on c.diff colitis with ongoing vancomycin therapy. he went was seen by radiation oncology today who sent him to the ed for evaluation for decreased mental status and fevers. past medical history: oncologic history: # neuroendocrine small cell cancer likely cell: - diagnosed in after patient incidentally found a left axillary lymph node. fna was positive for malignant cells, positive for cytokeratin (ae1/3/cam 5.2), ck20, synaptophysin, and chromogranin, negative for cd45, ck7, ttf-1, and s-100. the immunophenotype suggested a neuroendocrine carcinoma. imaging studies showed fdg-avid enlarged left axillary lymph node without other concerning nodes or masses. - : colonoscopy showed an adenomatous ascending colon polyp - : derm exam revealed 3 small lesions on the back consistent with basal cell carcinoma - : axillary lymph node excision - /: 4 cycles of cisplatin and etoposide - /: received radiation - : imaging study showed no evidence of recurrence of cancer . other medical history: 1. neuroendocrine tumor consistent with cell 2. : s/p left parietal-occipital craniotomy for mass resection. preliminary pathology report was consistent with a neuroendocrine tumor. 3. treated for recent uti and epididymitis as an outpatient prior to admission c/ cell cancer 4. basal cell carcinoma 5. left hip pain 6. h/o shooting pain to the left lower extremity after a fall in college social history: he is married, lives with his wife. has two daughters. is a dentist. he never smoked. both his parents died at age 85. family history: his father did have melanoma and developed brain metastases. he mother had thyroid disease and congestive heart failure. he has two sisters, all healthy. history of malignant melanoma in his maternal aunt. physical exam: gen: lethargic heent: pupils:7mm to 4mm eoms: unable to asses secondary to lethargy neck: supple. lungs: cta bilaterally. cardiac: rrr. s1/s2. abd: soft, nt, bs+ extrem: warm and well-perfused. neuro: mental status: 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,7 to 4mm 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: ua : ua xii: ua 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. discharge exam: as above pertinent results: head ct: impression: new 3.8 x 3.1 cm intra-axial hemorrhage within left temporoparietal lobe in the region of prior surgical resection of a metastatic lesion, with slight increase in temporal trapping, but stable mild rightward midline shift as compared to . no evidence of transtentorial or uncal herniation. head ct: impression: little change from at 16:32 hours in the appearance of large left temporoparietal intraparenchymal hematoma, with adjacent edema and associated mass effect. no new hemorrhage is identified. abdominal ct: impression: 1. extensive fecal loading throughout the colon and rectum, which may account for the patient's abdominal pain. there is sigmoid diverticulosis, without evidence for acute diverticulitis or other colonic inflammatory process. 2. normal appendix. 3. bilateral parapelvic cysts, stable. 4. distended gallbladder, without additional findings to suggest acute cholecystitis. radiology report chest port. line placement study date of 1:40 pm findings: the picc line has been re-positioned. the line now projects with its tip over the mid svc, at the level of the azygos vein. no evidence of complications. otherwise unchanged to the previous radiograph from today, 1237. the findings were discussed on the telephone with the responsible iv nurse, at the time of dictation. ct head further organization of a left occipital intraparenchymal hemorrhage with decrease in the size of the acute high attenuating blood products, but unchanged vasogenic edema and left temporal enlargement. brief hospital course: patient was admitted to the icu for close neurological monitoring. a repeat head ct was ordered as well as lower extremity dopplers and pan culture. it was recommended that he start 3% saline for his hyponatremia but due to his poor peripheral access this was not started until after a picc line was placed. repeat head ct revealed slight enlargment in trapped left temporal but the patient's exam remained stable so no intervention was done at this time. keppra dose was increased as well as decadron. early in the morning of the patient developed difficulty speak so a stat head ct was obtained. the ct scan showed interval decrease in the size of the hemorrhage and stable appearance of the left temporal enlargement. on exam the mornign of he was noted to stable as he was oriented to himself and hospital as well as if given choices. other then his confusion he was nonfocal and following simple commands. given his history of recent dvt of the rle he received leni's, which were negative for dvt. he was also seen by speech and swallow who cleared him to have a regular diet and his nasogastric tube was removed. on his na was stable on 3%, therefore salt tabs were added and the 3% was discontinued. na cont to be checked q4hrs. on his na was stable and checks were changed to q8hrs. he was cleared for transfer to the floor. pt and ot were ordered, and they determined that he met criteria for return to . on , his daily na dose was decreased to 3mg tid. his sodium remained in the high 130s for over 48 hours, and his sodium was checked once per day. he was discharged to rehab on . medications on admission: dexamethason 4mg tid flagyl 500 mg tid nystatin swish and spit prilosec 40mg qd oxycodone 5mg q4hrs prn pain ondansetron 4mg prn q6h anusol-hc 2.5 rectal bactrim ds 800mg 160 one tab daily dulcolax 10mg rectal prn floranex one pack keppra 500mg lovenox 80mg/.8ml sub q zofran 4mg colace 100mg discharge medications: 1. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 12 days. 2. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain/fever. 3. oxycodone 5 mg tablet sig: 0.5 tablet po q4h (every 4 hours) as needed for pain. 4. hydrocortisone 2.5 % cream sig: one (1) appl rectal (2 times a day). 5. polyethylene glycol 3350 17 gram/dose powder sig: one (1) po daily (daily). 6. mineral oil oil sig: 15-30 mls po daily (daily) as needed for constipation. 7. miconazole nitrate 2 % powder sig: one (1) appl topical qid (4 times a day). 8. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 9. vancomycin 125 mg capsule sig: one (1) capsule po q6h (every 6 hours) for 12 days. 10. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed). 11. levetiracetam 500 mg tablet sig: two (2) tablet po bid (2 times a day). 12. dexamethasone 4 mg tablet sig: one (1) tablet po q12h (every 12 hours). 13. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 14. sodium chloride 1 gram tablet sig: three (3) tablet po q6h (every 6 hours). 15. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day) as needed for thrush. discharge disposition: extended care facility: - discharge diagnosis: left intraperenchymal hemorrhage hyponatremia - siadh discharge condition: mental status: confused - sometimes. level of consciousness: alert and interactive. activity status: ambulatory - independent. 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. if 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. ?????? if you have been prescribed dilantin (phenytoin) for anti-seizure medicine, take it as prescribed and follow up with laboratory blood drawing in one week. this can be drawn at your pcp??????s office, but please have the results faxed to . if you have been discharged on keppra (levetiracetam), you will not require blood work monitoring. ?????? 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, unless you have been instructed not to. 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: please call ( to make an appointment to see dr. in 4 weeks. you will need a head ct prior to this appointment. procedure: other radiotherapeutic procedure diagnoses: intracerebral hemorrhage personal history of other malignant neoplasm of skin secondary malignant neoplasm of brain and spinal cord intestinal infection due to clostridium difficile cerebral edema long-term (current) use of anticoagulants personal history of venous thrombosis and embolism other disorders of neurohypophysis personal history of irradiation, presenting hazards to health diverticulosis of colon (without mention of hemorrhage) dermatophytosis of groin and perianal area fever presenting with conditions classified elsewhere personal history of malignant neuroendocrine tumor 

Answer: The patient is high likely exposed to