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: unasyn attending: chief complaint: metastatic melanoma major surgical or invasive procedure: radical resection of recurrent metastatic melanoma left neck. pectoralis myofascial transpositional flap. placement of meshed skin graft (1.5:1) measuring 10 cm x 20 cm in area. closure of pharyngeal defect nasogastric tube placement history of present illness: mr. is a 83 year old gentleman who underwent excisional biopsy of a nasal lesion in with pathology revealing a lentigo maligna melanoma. he underwent wide local excision with reconstruction of the nasal dorsum with a transposition flap and sentinel lymph node biopsy on . reexcision pathology revealed a lentigo maligna melanoma, level iv, 1.75 mm thick nonulcerated without perineural invasion. one sentinel lymph node was negative for metastases. in , a nasal recurrence was noted. he underwent surgical resection with reconstruction of the nasal defect with transposition nasolabial fold flap and sentinel lymph node biopsy with melanoma in one of two lymph nodes. he underwent right radical neck dissection on with 33 lymph nodes removed, all negative for melanoma. in , left submandibular mass was noted with fna confirming melanoma. he underwent left radical neck dissection on by dr. with 1 of 12 lymph nodes positive with extracapsular extension. he completed radiation therapy in mid . in the interim, he established oncology follow up in and at his visit in he was found to have a nodule in the left submandibular region. fna of this lesion confirmed melanoma. he has also undergone staging cts with the head ct negative for any intracranial involvement. he had resection of the submandibular mass on and which was found to have inadequate margins on pathology and returns for a more extensive resection. past medical history: metastatic melanoma (see hpi) brachytherapy for prostate ca () htn chronic renal insufficiency vitiligo h/o colonic polyps social history: does not smoke, does not drink. nkda family history: non contributory physical exam: tmax 99.4 tcurrent 98.2 93 128/68 18 95%ra nad rrr ctab soft nt/nd, ngt in place neck: flat, skin graft in place, clean dry and intact l skin flap: mild edema, warm, + capillary refill <2sed, jp drains intact to bulb suction, serosanguinous output l thigh donor site-xeroform in place, c/d/i pertinent results: 07:15am blood wbc-7.1 rbc-4.07* hgb-12.6* hct-35.5* mcv-87 mch-31.0 mchc-35.5* rdw-13.3 plt ct-151 07:00am blood glucose-118* urean-25* creat-1.0 na-142 k-3.8 cl-102 hco3-32 angap-12 07:00am blood calcium-9.0 phos-4.1 mg-2.3 07:15am blood glucose-125* urean-21* creat-0.9 na-139 k-4.0 cl-102 hco3-30 angap-11 07:15am blood calcium-9.2 phos-3.2 mg-2.3 07:30am blood glucose-125* urean-21* creat-1.0 na-137 k-4.2 cl-103 hco3-29 angap-9 07:30am blood calcium-8.8 phos-2.9 mg-2.2 04:45am blood glucose-172* urean-24* creat-1.2 na-141 k-4.0 cl-104 hco3-28 angap-13 04:45am blood calcium-8.5 phos-3.2 mg-1.9 04:53pm blood glucose-144* urean-23* creat-1.4* na-143 k-4.0 cl-105 hco3-29 angap-13 04:53pm blood calcium-9.1 phos-4.2 mg-2.1 brief hospital course: mr. is an 83 year old gentleman who presented for left radical neck dissection and excision of submandibular connective tissue for metastatic melanoma. he was taken to the operating room on with dr. for the left neck procedure with excision of melanoma connective tissue from left neck and dr. then reconstructed the left neck with a left pectoralis myofascial transpositional flap, with placement of meshed skin graft (1.5:1) measuring 10 cm x 20 cm in area, closure of pharyngeal defect and nasogastric tube placement. the patient tolerated the procedure well, was extubated and transferred to the pacu in stable condition. he remained in the pacu overnight for close graft monitoring. he was started on unasyn for post operative antibiotic prophylaxis and was made npo for 2 weeks secondary to the pharyngeal defect repair. he was transferred to the floor on post operative day 1 and continued to do well, with his vital signs remaining stable, his pain well controlled and the flap/graft continued to be stable. he developed a hive-like rash on his arms, which was thought to be secondary to the unasyn. the unasyn was discontinued, the patient was started on clindamycin and the rash resolved within 24 hours. he was started on tube feeds on post op day 2 and tolerated advancing to goal of 75cc/hr. he continued to do well through his hospitalization, he was afebrile, vital signs stable, flap/graft intact and stable, tolerating tube feeds and pain well controlled on oral medications (tylenol). he is being discharged to rehab on post operative day 4 in stable condition and will continue to be npo, all meds per ngt, continue tube feeds, continue drains to bulb suction and antibiotics until futher instructed at plastic surgery follow up appointment in 1 week. he will follow up with dr. in weeks as well. he was instructed to keep his head/neck neutral or facing to the right at all times. medications on admission: diovan/hctz 160/12.5mg daily asa 81mg (stopped ) mvi discharge medications: 1. hydrochlorothiazide 25 mg tablet sig: 0.5 tablet po daily (daily): please administer per ngt only. 2. valsartan 160 mg tablet sig: one (1) tablet po daily (daily): please administer per ngt only. 3. acetaminophen 160 mg/5 ml solution sig: po q6h (every 6 hours) as needed for pain/fever: please administer per ngt only. 4. ascorbic acid 90 mg/ml drops sig: five hundred (500) mg po bid (2 times a day) for 2 weeks: please administer per ngt only. 5. zinc sulfate 220 (50) mg capsule sig: one (1) capsule po daily (daily) for 2 weeks: please administer per ngt only. 6. nystatin 100,000 unit/ml suspension sig: five (5) ml po bid (2 times a day): please apply to tongue with swab and have patient spit out, do not have patient swish and swallow . 7. clindamycin palmitate 75 mg/5 ml recon soln sig: twenty (20) ml po every eight (8) hours: (300mg) please administer through ngt only. continue while drains are in. discharge disposition: extended care facility: for the aged - macu discharge diagnosis: metastatic melanoma discharge condition: stable discharge instructions: seek immediate medical attention for fever >101.5, chills, increased redness, swelling or discharge from incision, chest pain, shortness of breath, or anything else that is troubling you. please keep xeroform dressing on left thigh and left neck at all times, left neck xeroform may be changed prn. jp drains to bulb suction. ambulate as tolerated with assistance please keep head in a neutral position or facing to the right at all times. no pressure or strain on left neck. followup instructions: please follow up with plastic surgery, dr. , in 1 week, call ( to schedule that appointment follow up with otolaryngology, dr. in weeks, call to schedule that appointment. procedure: enteral infusion of concentrated nutritional substances other skin graft to other sites graft of muscle or fascia excision of lesion of muscle diagnoses: hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified personal history of malignant neoplasm of prostate secondary malignant neoplasm of other specified sites chronic kidney disease, unspecified dermatitis due to drugs and medicines taken internally other diseases of lung, not elsewhere classified personal history of malignant melanoma of skin long-term (current) use of aspirin personal history of colonic polyps penicillins causing adverse effects in therapeutic use vitiligo 

Answer: The patient is high likely exposed to