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: sulfa (sulfonamides) attending: chief complaint: wk feeling unsteady major surgical or invasive procedure: brain biopsy left sided craniotomy history of present illness: patient is a 80 yo man with pmh of htn, hyperlipid, h/o afib, osteoporosis, dm2, low testosterone, prostate ca s/p radiation who is transferred from with a necrotic brain lesion in the left parietal/occipital area. reports that he went to his pcp recently with 3-4 weeks of spells of unsteadiness. he describes it as feeling as if he is going to tip over. there is no dizziness or vertigo with this. his pcp ordered the ct and he was admitted for further work up including a non contrast mri. notes mention both primary and secondary as possibilities, but there is no official report. ct torso mentioned as negative but no official repport. ros: denies ha, fever, chills sweats. reports that he has had lb planned wt loss over 6 mo with diet/excercise. he is unsure if his vision has changed, but poor at baseline. no n/v, vertigo or bladder or bowel changes. small cough which is new and dry. past medical history: -htn -hyperlipid -h/o afib -osteoporosis -dm2 -low testosterone -prostate ca s/p radiation -chronic dry eyes. social history: pt is a retired school superintendent. pt quit smoking 40 ago, reports drinking 6 /week. pt lives alone since wife died 2 ago. daughter lives on and son lives in . family history: father died at 78 and mother in 90s both of mi. physical exam: t- 98.0 bp- 176/80 hr- 80 rr- 12 o2sat 97 ra gen: lying in bed, nad heent: nc/at, moist oral mucosa neck: no tenderness to palpation, normal rom, supple, no carotid or vertebral bruit back: no point tenderness or erythema cv: rrr, nl s1 and s2, no murmurs/gallops/rubs lung: clear to auscultation bilaterally abd: +bs soft, nontender ext: no edema neurologic examination: mental status: awake and alert, cooperative with exam, normal affect. oriented to person, place, and date. attentive, says backwards. speech is fluent with normal comprehension and repetition; naming intact. no dysarthria. and writing intact. registers , recalls in 5 minutes. no right left confusion. no evidence of apraxia or neglect. no agraphesthesia in left hand. cranial nerves: pupils equally round and reactive to light, 3 to 2 mm bilaterally. visual fields are full to confrontation. catarcts bilaterally left > right. unable to visualize disc left but intact right. extraocular movements intact bilaterally, no nystagmus. sensation intact v1-v3. facial movement symmetric. hearing intact to finger rub bilaterally. palate elevation symmetrical. sternocleidomastoid and trapezius normal bilaterally. tongue midline, movements intact motor: normal bulk bilaterally. tone normal. no observed myoclonus or tremor tri wf we fe ff ip h q df pf te tf r 5 5 5 5 5 5 5 5 5 5 5 5 5 5 l 5 5 5 5 5 5 5 5 5 5 5 5 5 5 sensation: intact to light touch, cold, vibration throughout. no extinction to dss on hands, but extinguishes right foot consistently. reflexes: +2 and symmetric throughout. toes down right and up left (?) coordination: finger-nose-finger normal, heel to shin normal, rams normal. gait: narrow based, steady. romberg: retropulses pertinent results: radiology final report mr head w & w/o contrast 7:37 pm mr head w & w/o contrast reason: follow up on postop residual tumor. please do before midnigh medical condition: 80 year old man with s/p craniotomy for tumor resection. reason for this examination: follow up on postop residual tumor. please do before midnight . contraindications for iv contrast: none. exam: mri brain. clinical information: patient status post craniotomy for tumor resection for postoperative evaluation. technique: t1 sagittal and axial and flair t2 susceptibility and diffusion axial images of the brain were acquired before gadolinium. t1 sagittal, axial and coronal images were obtained following gadolinium. comparison was made with the previous study of . findings: since the previous study, the patient has undergone resection of enhancing brain lesion in the left parietal convexity region. small amount of blood products is seen in this region with surrounding edema. following gadolinium, enhancement is seen along the medial margin of the resection site as well as inferior margin of the resection site indicating some residual enhancement. there is also evidence of small area of slow diffusion seen adjacent to the surgical site which could be related to surgery. there is pneumocephalus identified. there is no midline shift or hydrocephalus seen. there is moderate brain atrophy. impression: status post resection of the left parietal convexity enhancing intra-axial brain lesion. small amount of residual enhancement is seen immediately and inferior to the resection site. no large hematoma seen, midline shift or hydrocephalus identified. no change in the surrounding edema noted. dr. approved: sat 5:38 pm radiology final report mr head w/ contrast 5:39 am mr head w/ contrast reason: pre-op for tumor resection, please do at 5:00 am on contrast: magnevist medical condition: 80 year old man brain tumor reason for this examination: pre-op for tumor resection, please do at 6:00 am on , prior to or time contraindications for iv contrast: none. indication: brain tumor, preoperative for tumor resection. comparison: mri head dated . technique: multiplanar t1- post-gadolinium images were obtained including axial mp-rage images. mri head with contrast: enhancing peripheral mass in the left posterior parietal lobe is again demonstrated and unchanged compared to . surrounding signal abnormality on t1-weighted images is also again demonstrated and not significantly changed. ventricles are stable in size. no other enhancing lesions within the brain are seen. impression: enhancing left parietal mass without significant change compared . the study and the report were reviewed by the staff radiologist. dr. dr. . approved: sat 9:10 pm radiology final report ct head w/o contrast 6:39 pm ct head w/o contrast reason: rule out postop ich. please do before 7pm . medical condition: 80 year old man with s/p craniotomy for tumor resection. reason for this examination: rule out postop ich. please do before 7pm . contraindications for iv contrast: none. history: status post left parietal lobe tumor resection. evaluate for postoperative hemorrhage. comparison is made to mri and head ct. non-contrast head ct. findings: there is expected air within the left parietal surgical bed and expected postoperative pneumocephalus and adjacent subcutaneous emphysema and swelling adjacent to the high right parietal craniotomy site. no postoperative intraparenchymal or extra-axial hemorrhage is identified. stable-appearing vasogenic edema within the left parietal lobe. the appearance of the head ct is otherwise unchanged with stable mild mucosal thickening within the right maxillary sinus. impression: expected postoperative changes with no evidence of hemorrhage. the study and the report were reviewed by the staff radiologist. dr. dr. approved: fri 5:52 pm cardiology report ecg study date of 1:59:38 am probable idioventricular rhythm with prolonged qtc interval at a rate of 56 beats per minute. compared to tracing #3 idioventricular rhythm is now evident. qtc interval is more polonged. clinical correlation is suggested. tracing #4 read by: , s. intervals axes rate pr qrs qt/qtc p qrs t 56 0 178 514/507 0 -42 114 radiology final report chest (pa & lat) 8:46 am chest (pa & lat) reason: please do in am.man with new brain mass medical condition: 80 year old man with new brain mass reason for this examination: please do in am.man with new brain mass history: an 80-year-old male with new brain mass. chest, pa and lateral: there are no prior studies for comparison. heart size is normal. the hilar and mediastinal contours are normal. lungs are clear. there is a tiny 2-mm rounded opacity projecting over the left second anterior rib, likely represents a vessel. no pleural effusions are seen. fracture deformities of the right fourth, fifth, and sixth posterior ribs are seen. no pneumothorax identified. impression: no evidence of intrathoracic malignancy. jr the study and the report were reviewed by the staff radiologist. dr. dr. dr. approved: fri 4:33 pm test name value units reference range 06:25am complete blood count white blood cells 11.6* k/ul 4.0 - 11.0 performed at west stat lab red blood cells 4.49* m/ul 4.6 - 6.2 performed at west stat lab hemoglobin 14.1 g/dl 14.0 - 18.0 performed at west stat lab hematocrit 42.5 % 40 - 52 performed at west stat lab mcv 95 fl 82 - 98 performed at west stat lab mch 31.5 pg 27 - 32 performed at west stat lab mchc 33.3 % 31 - 35 performed at west stat lab rdw 13.7 % 10.5 - 15.5 basic coagulation (pt, ptt, plt, inr) platelet count 142* k/ul 150 - 440 performed at west stat lab test name value units reference range 06:25am renal & glucose glucose 127* mg/dl 70 - 105 performed at west stat lab urea nitrogen 36* mg/dl 6 - 20 performed at west stat lab creatinine 0.9 mg/dl 0.5 - 1.2 performed at west stat lab sodium 140 meq/l 133 - 145 performed at west stat lab potassium 4.8 meq/l 3.3 - 5.1 performed at west stat lab chloride 101 meq/l 96 - 108 performed at west stat lab bicarbonate 31 meq/l 22 - 32 performed at west stat lab anion gap 13 meq/l 8 - 20 test name value units reference range 06:40am renal & glucose glucose 189* mg/dl 70 - 105 performed at west stat lab urea nitrogen 25* mg/dl 6 - 20 performed at west stat lab creatinine 0.9 mg/dl 0.5 - 1.2 performed at west stat lab sodium 139 meq/l 133 - 145 performed at west stat lab potassium 3.9 meq/l 3.3 - 5.1 performed at west stat lab chloride 102 meq/l 96 - 108 performed at west stat lab bicarbonate 30 meq/l 22 - 32 performed at west stat lab anion gap 11 meq/l 8 - 20 estimated gfr (mdrd calculation) estimated gfr (mdrd equation) using this patient's age, gender, and serum creatinine value of 0.9, estimated gfr = >75 if non african-american (ml/min/1.73 m2) estimated gfr = >75 if african-american (ml/min/1.73 m2) for comparison, mean gfr for age group 70+ is 75 (ml/min/1.73 m2) gfr<60 = chronic kidney disease, gfr<15 = kidney failure enzymes & bilirubin alanine aminotransferase (alt) 28 iu/l 0 - 40 performed at west stat lab asparate aminotransferase (ast) 17 iu/l 0 - 40 performed at west stat lab lactate dehydrogenase (ld) 200 iu/l 94 - 250 performed at west stat lab alkaline phosphatase 109 iu/l 39 - 117 performed at west stat lab amylase 46 iu/l 0 - 100 performed at west stat lab bilirubin, total 0.6 mg/dl 0 - 1.5 performed at west stat lab other enzymes & bilirubins lipase 29 iu/l 0 - 60 performed at west stat lab chemistry albumin 3.9 g/dl 3.4 - 4.8 performed at west stat lab calcium, total 8.9 mg/dl 8.4 - 10.2 performed at west stat lab phosphate 2.7 mg/dl 2.7 - 4.5 performed at west stat lab magnesium 2.5 mg/dl 1.6 - 2.6 performed at west stat lab pituitary thyroid stimulating hormone 0.41 uiu/ml 0.27 - 4.2 hematology general urine information type color appear sp 11:09pm yellow clear 1.027 source: cvs dipstick urinalysis blood nitrite protein glucose ketone bilirub urobiln ph leuks 11:09pm neg neg neg 1000 neg neg 4* 6.5 neg source: cvs 11:09pm source: cvs 06:37a other blood chemistry: %hba1c: 5.8 comments: %hba1c: recommendations:; <7% goal of therapy; >8% warrants therapeutic action other blood chemistry: cryoglb: negative tsh:0.44 other blood chemistry: t4: 4.6 pep: no specific abnormalities seen;interpreted by , md hcv-ab: negative sed-rate: 1 , pathology examination name birthdate age sex pathology # , 80 male report to: dr. gross description by: dr. /dif specimen submitted: brain tumor. procedure date tissue received report date diagnosed by dr. /tcc diagnosis: brain, stereotactic core biopsies, seven: 1. "-3" (a): anaplastic oligoastrocytoma, grade iii (see note). 2. "-2": glial neoplasm. 3. "-1" (b): anaplastic oligoastrocytoma, grade iii (see note). 4. "0": glial neoplasm. 5. "+1" (c): anaplastic oligoastrocytoma, grade iii (see note). 6. "+2": glial neoplasm. 7. "+3" (d): anaplastic oligoastrocytoma, grade iii (see note). note: the tumor shows areas with microgemistocytes and halos suggesting an oligodendroglial differentiation. other areas show clear fibrillary processes positive for gfap (immunohistochemistry) suggesting astroglial differentiation. lca immunohistochemistry identifies macrophages in this tumor. clinical: "brain tumor." gross: the specimen is received in seven containers, labeled with the patient's name " . " and the medical record number. part 1 is received in formalin additionally labeled "-3" and consists of a tan white fragment of tissue measuring 0.1 x 0.1 x 0.1 cm. the specimen is entirely submitted in a. part 2 is received fresh and additionally labeled "-2" and consists of a tan white fragment of tissue measuring 0.1 x 0.1 x 0.1 cm. an intraoperative consultation was performed and the entire specimen was smeared onto a slide. intraoperative smear diagnosis (sm -2) is "glial neoplasm" by dr. . part 3 is received in formalin and additionally labeled "-1" and consists of a tan white fragment of tissue measuring 0.1 x 0.1 x 0.1 cm. the specimen is entirely submitted in b. part 4 is received fresh and additionally labeled "0" and consists of a tan white fragment of tissue measuring 0.1 x 0.1 x 0.1 cm. an intraoperative consultation was performed and the entire specimen is smeared onto a slide. intraoperative smear diagnosis (sm tp) is "glial neoplasm" by dr. . part 5 is additionally labeled "+1" and consists of a fragment of tan white tissue measuring 0.1 x 0.1 x 0.1 cm. the specimen is entirely submitted in c. part 6 is received fresh and is additionally labeled "+2" and consists of a tiny tan white fragment of tissue that measures 0.1 x 0.1 x 0.1 cm. an intraoperative consultation was performed and the entire specimen is smeared onto a slide. smear diagnosis (sm +2) is "glial neoplasm" by dr. . part 7 is received in formalin and is additionally labeled "+3" and consists of a tan white fragment of tissue measuring 0.1 x 0.1 x 0.1 cm. the specimen is entirely submitted in d. brief hospital course: patient is a 80 yo man with pmh of htn, hyperlipid, h/o afib, osteoporosis, dm2, low testosterone, prostate ca s/p radiation who is transferred from with a necrotic brain lesion in the left parietal/occipital area. there is nothing on physical exam to suggest mass effect. in his coumadin was held, and he was started on keppra and decadron which we have continued. he has recent diagnosis and treatment of prostate ca, however this does not metastasize to the brain parenchyma. primary neoplasm such as gbm, less likely cns lymphoma. he had a repeat mri with gad. on he underwent a brain biopsy; pathology report: anaplastic oligoastrocytoma, grade iii on he underwent a craniotomy for removal of the left parietal mass. post operatively he spent the night in the sicu to monitor his bp he required a nitro drip intermittently. neurologically he was intact. he was transferred to the surgical floor on . pt saw the patient and recommended rehab; ot was also consulted and recommended short term rehab. medications on admission: vytorin daily januvia 100 daily miacalcin nasal spral 200 iu alternating each nostril qod androgel 5% 2 pumps daily, shoulders and chest protonix 40mg po bid oscal with vit d 500 diovan 160 daily rythmol sr 225 po bid astelin keppra 500 decadron 4mg iv or po q6hrs riss all: sulfas? redness with hctz. discharge medications: 1. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po bid (2 times a day). 2. calcitonin (salmon) 200 unit/actuation aerosol, spray sig: 200 units nasal daily (daily). 3. testosterone 1 %(50 mg/5 gram) gel in packet sig: 1% /2pumps 50mg/5gm transdermal daily (): apply transdermal to chest and shoulders. 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 5. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). 6. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 7. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 8. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 9. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily). 10. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 11. propafenone 150 mg tablet sig: one (1) tablet po tid (3 times a day). 12. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed. 13. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). 14. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4-6h () as needed. 15. valsartan 160 mg tablet sig: one (1) tablet po daily (daily). 16. levetiracetam 500 mg tablet sig: three (3) tablet po bid (2 times a day). 17. dexamethasone 2 mg tablet sig: one (1) tablet po q12h (every 12 hours). 18. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed). 19. hydralazine 20 mg/ml solution sig: one (1) injection q6h (every 6 hours) as needed for sbp>140. discharge disposition: extended care facility: nursing & rehabilitation center - discharge diagnosis: left temporal parietal mass anaplastic oligoastrocytoma, grade iii discharge condition: neurologically stable discharge instructions: discharge instructions for craniotomy/head injury ?????? have a 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, excessive bending ?????? you may wash your hair only after sutures and/or staples have been removed ?????? you may shower before this time with assistance and use of a shower cap ?????? increase your intake of fluids and fiber as pain medicine (narcotics) can cause constipation ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, ibuprofen etc. ?????? if you have been prescribed an anti-seizure medicine, take it as prescribed and follow up with laboratory blood drawing as ordered 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, drainage ?????? fever greater than or equal to 101?????? f followup instructions: please have your staples/sutures removed between to in rehab facility or dr office (please call ( for appointment) please call to schedule an appointment with dr. to be seen in 4 weeks. you will need a cat scan of the brain without contrast prior to appt. appointment with dr in brain tumor clinic on (friday) at 1pm on the , building, . if you need to cancel or reschedule the appt., please call procedure: other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain closed [percutaneous] [needle] biopsy of brain transfusion of other serum diagnoses: unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hyposmolality and/or hyponatremia atrial fibrillation personal history of malignant neoplasm of prostate personal history of tobacco use other and unspecified hyperlipidemia other specified cardiac dysrhythmias malignant neoplasm of parietal lobe osteoporosis, unspecified other postprocedural status hemiplegia, unspecified, affecting unspecified side tear film insufficiency, unspecified 

Answer: The patient is high likely exposed to