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: metastatic renal cell cancer to thoracic spine. major surgical or invasive procedure: 1. transpedicular decompression at t11-t12. 2. fusion t5-l2. 3. segmental multiple thoracic laminotomies. 4. instrumentation t5-l2. 5. autograft. 6. epidural catheter placement. history of present illness: metastatic renal cell cancer to thoracic spine. past medical history: pmhx: 1. renal cell carcinoma- diagnosed ~11 months ago. , pt was admitted to the hospital () with right chest pain and shoulder pain. imaging at that time revealed a large right sided kidney tumor. he underwent angioinfarction in the same admission on . 2 weeks discharge on , mr. presented to the hospital and was found to have a large pe. he was in the icu for several days and was subsequently discharged with anticoagulation. on , pt underwent right nephrectomy and ivc thrombectomy with ivc clip placement. within several months, mri revealed ? of liver metastasis and lung metastases. pt started on avastin chemo and received day 15 of cycle 8 on . 2. ivc clot, on coumadin. 3. hyperlipidemia 4. nephrolithiasis social history: mr. has been married for 15 years. he has two children from his first marriage. no etoh. no alcohol. he lives in , and works as a fireman. family history: cad in multiple family members as well as peripheral vascular disease. one uncle with a cancer, but pt unsure of what type it was. physical exam: a+o x 3 nad. v.s.s afebrile incision pt is moving extremities well. pertinent results: 08:37pm urine hours-random 08:37pm urine gr hold-hold 08:37pm urine color-yellow appear-clear sp -1.010 08:37pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-7.0 leuk-neg 06:00pm glucose-106* urea n-16 creat-1.1 sodium-139 potassium-4.3 chloride-105 total co2-23 anion gap-15 06:00pm albumin-4.2 06:00pm wbc-6.6# rbc-4.55* hgb-13.9* hct-39.7* mcv-87 mch-30.6 mchc-35.1* rdw-13.4 06:00pm plt count-184# brief hospital course: pt admitted pt's coumadin stopped pt started on heparin gtt . ptahad embolization of thoracic tumor and decompression thoracic spine . pt's coumadin restarted . pt dc'd to rehab medications on admission: coumadin 5 mg qd discharge medications: 1. fentanyl 100 mcg/hr patch 72hr sig: one (1) patch 72hr transdermal q72h (every 72 hours) as needed for pain. disp:*10 patch 72hr(s)* refills:*0* 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 3. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 4. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*2* 5. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. disp:*100 tablet(s)* refills:*0* 6. warfarin sodium 5 mg tablet sig: one (1) tablet po daily (daily): hold for inr >3. disp:*30 tablet(s)* refills:*2* 7. heparin sodium (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day) as needed for hx svc thrombus. disp:*90 u/ml* refills:*2* discharge disposition: extended care facility: medical center - discharge diagnosis: metastatic renal cell cancer to thoracic spine discharge condition: stable discharge instructions: keep wound clean and dry. wear tlso brace when out of bed. physical therapy: therapy - wear tlso brace when out of bed. stretching and strengthening. activity as tolerated. no excessive bending, lifting, or twisting. treatments frequency: fentanyl 100mcg apply 1 patch q72h docusate sodium 100mg 1 tab po bid famotadine 20mg 1 tab po bid metoprolol 25mg 0.5 tab po bid oxycodone acetaminophen 5/325 tab po q4-6h prn pain wafarin sodium 5mg 1 tab po daily, hold for inr >3 heparin sodium (porcine) 5,000 units/ml 1 injection tid, hx of svc thrombus thoracic wound. daily wound check. change dressing as needed. steri strips to be removed in dr. office in two weeks. followup instructions: follow up in dr. office in two weeks as scheduled. procedure: other exploration and decompression of spinal canal other endovascular procedures on other vessels arteriography of other specified sites transfusion of packed cells dorsal and dorsolumbar fusion of the posterior column, posterior technique insertion of catheter into spinal canal for infusion of therapeutic or palliative substances systemic to pulmonary artery shunt fusion or refusion of 9 or more vertebrae diagnoses: anemia, unspecified spinal stenosis, thoracic region personal history of venous thrombosis and embolism personal history of malignant neoplasm of kidney secondary malignant neoplasm of bone and bone marrow thoracic or lumbosacral neuritis or radiculitis, unspecified 

Answer: The patient is high likely exposed to