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: history of present illness: mr. is a 60-year-old male with a past medical history significant for hypertension, times two, who developed a dry cough in late while fly fishing in . the cough persisted and he was given erythromycin times ten days times two courses by his primary care physician, . . the erythromycin did not improve the patient's symptoms. the patient describes the cough as dry, not worse at night, breath. he denied fevers and chills. he states that he lost about six pounds over the past two months intentionally. over the past one to two weeks, however, he has noted increasing dyspnea with stairs, as well as fatigue. on the day prior to admission, he started a z pack. at his primary care physician's office today, he had a chest x-ray which disclosed an enlarged heart and interstitial infiltrates. an esophagogastroduodenoscopy was done, as well as an echocardiogram which disclosed evidence of a pericardial effusion with tamponade. there was diastolic collapse of the right atrium and right ventricle. the patient was sent to the emergency department at for evaluation of the pericardial effusion and drainage. his pulses paradoxes was 18. the echocardiogram performed in the emergency department was consistent with cardiac tamponade. the patient remained hemodynamically stable. past medical history: 1. melanoma. patient is status post removal of melanoma in and in . 2. empyema of the left lung in . 3. labile hypertension. 4. overweight. 5. hypercholesterolemia. 6. myxomatous mitral valve prolapse with mild mitral regurgitation. 7. non-sustained ventricular tachycardia. 8. chronic asymptomatic vea. 9. peripheral vision loss. 10. history of smoking, quit in . medications: 1. tenormin 150 mg q.d. 2. lipitor 80 hs. 3. enteric coated aspirin 325 mg po q.d. 4. accupril 20 mg po q.d. 5. multivitamin. 6. folate 2 tablets b.i.d. 7. vitamin e. 8. vitamin b6. 9. vitamin b12. 10. ativan prn sleep. allergies: penicillin. patient has a rash. social history: patient does office work. he has been a widow for the past nine years. he coaches a girls basketball team. he has two children, ages 30 and 25. he lives with his 30-year-old daughter. has a 2-year-old grandchild. he smoked cigars until . he has not had alcohol for the past nine years. family history: no heart disease and no diabetes mellitus. review of systems: no fevers, chills or night sweats. patient reports a six pound intentional weight loss over the past two months. no history of positive ppd or tuberculosis exposure. no upper respiratory infection symptoms with cough. no nausea, vomiting, diarrhea or abdominal pain, but occasionally "spits up" after his cough. reports dyspnea with stairs and chest tightness occasionally on stairs. no rash, no joint symptoms, no melanoma, no bright red blood per rectum, no dysuria, no edema, no paroxysmal nocturnal dyspnea, no orthopnea, no palpitations, no dizziness. physical examination: temperature 97 degrees. pulse 86. blood pressure 124/63. respiratory rate 23. oxygen saturation 95% on three liters nasal cannula. general: elderly white male in no apparent distress. head, eyes, ears, nose and throat: anicteric, oropharynx clear, pupils equal, round and reactive to light, extraocular movements intact. neck: supple, no carotid bruit, no jugular venous distention. cardiovascular: regular rate and rhythm, soft s1, s2, no murmurs, rubs or gallops, pericardial drain in place. chest clear to auscultation anteriorly, left lateral chest scar. abdomen soft, nontender, nondistended with positive bowel sounds. extremities: no cyanosis, clubbing or edema, 2+ dorsalis pedis pulses bilaterally. neurological: cranial nerves ii through xii are intact. alert and oriented times three. exam otherwise nonfocal. note: this physical examination was done after the patient underwent his cardiac catheterization. laboratory data on admission: white blood cell count 7.3, hematocrit of 41, platelet count of 294,000. pt 13, ptt 23.6, inr 1.1. echocardiogram: normal sinus rhythm, 71 beats per minute, electrical alternans, low voltage precordial leads, prolonged pr. after the procedure, esophagogastroduodenoscopy showed a sinus rhythm at 82 beats per minute, normal axis, prolonged pr, t wave inversions i and avl, biphasic t in v2, qs in v1 to v2, increased voltage. hospital course: the patient was admitted initially to the coronary care unit. he underwent a cardiac catheterization on for pericardiocentesis. hemodynamics showed elevated and equal ra and pericardial pressures, 11-12 mm mercury, slightly lower than pulmonary capillary wedge pressure. there was preserved cardiac index. there is preserved blood pressure with 15-20 mm mercury pulses paradoxes. during the pericardiocentesis, 1116 ml of serosanguinous fluid was easily removed. fluid was sent to the laboratory for analysis. following the pericardiocentesis, the patient was admitted to the coronary care unit for further management. on , the pericardial drain was removed. repeat echocardiogram did not disclose recurrence of the pericardial effusion. patient underwent ct of the chest which disclosed diffuse interstitial infiltrates consistent with lymphangitic spread. there was also a positive mediastinal lymphadenopathy and lytic sclerotic bone lesions. on , the patient was transferred to the service. on the night of the 16th, he was tachycardic to the 160s. echocardiogram disclosed atrial flutter. his blood pressure was stable. he was started on sotalol 120 mg b.i.d. the following day this was decreased to 80 mg b.i.d. while on sotalol, his qtc interval was monitored and his potassium was kept between 4.5 and 5.2. repeat echocardiogram did not disclose re-accumulation of the pericardial effusion. while on the service. a pulmonary consult was obtained for further evaluation of the diffuse infiltrates seen on the ct. pulmonary service recommended awaiting the final pathology from the pericardial fluid. they were willing to perform transbronchial biopsy if necessary. patient was also seen by his oncologist, dr. . patient underwent an mri of his brain on . mri disclosed foci on the surface of the brain that appeared consistent with leptomeningeal spread of cancer. an abdominal ct was done on . ct of the abdomen disclosed one lymphangitic spread of metastatic disease throughout the lungs was stable since the study one week before. there was an increase in the pericardial fluid since the study one week prior. there was interval development of multiple sclerotic and lytic lesions within the osseous structures since . there were stable hepatic lesions that likely represent simple cysts. there was a stable splenic lesion that likely represents a hemangioma. although, colon appeared grossly normal, radiologist's caution that the study was not diagnostic for colon cancer. finally, pathology results from pericardial fluid were obtained. pathologists performed multiple stains to identify the type of cancer, the types of cells in the pericardial fluid. pathologist's concluded that the malignant cells were from adenocarcinoma. the tumor cells are positive for ck7 and ttf1 markers. ttf1 marker is specific for lung and thyroid. the cells were focally positive for ck20. pathologist's concluded that this immunoprofile is consistent with an adenocarcinoma arising in the lung. the patient was discharged on . he will have outpatient work-up of his malignancy. discharge condition: stable. discharge status: patient discharged home on monday, . discharge follow-up: he will follow-up with his oncologist, dr. , at 2 p.m. he will be seen by dr. in the brain clinic at 4 p.m. on . he will follow-up with his cardiologist, dr. , on wednesday, . he was encouraged to call his primary care physician for appointment. patient was given of heart's monitor so that his qtc interval could be monitored for an additional week while on sotalol. discharge diagnoses: 1. pericardial effusion with cardiac tamponade. 2. non-sustained ventricular tachycardia. 3. hypertension. 4. atrial fibrillation. discharge medications: 1. sotalol 80 mg po b.i.d. 2. lipitor 80 hs. 3. enteric coated aspirin 325 mg po q.d. 4. accupril 20 mg po q.d. 5. multivitamin. 6. folate 2 mg po b.i.d. 7. vitamin e. 8. vitamin b6. 9. vitamin b12. 10. ativan prn sleep. 11. potassium chloride 30 meq po q.d. 12. celebrex 100 mg po b.i.d. as needed. , m.d. dictated by: medquist36 d: t: 19:57 job#: procedure: pericardiocentesis right heart cardiac catheterization diagnoses: pure hypercholesterolemia mitral valve disorders unspecified essential hypertension cardiac complications, not elsewhere classified secondary malignant neoplasm of other specified sites atrial flutter paroxysmal ventricular tachycardia unspecified disease of pericardium malignant neoplasm of other parts of bronchus or lung 

Answer: The patient is high likely exposed to