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: etoposide attending: chief complaint: seizure. major surgical or invasive procedure: none. history of present illness: mr. is a 47 y/o man with a pmh of gbm s/p resection, radiation, ongoing chemo (with avastin and carboplatin; last cycle this past tuesday), and seizures who presents after a prolonged seizure this morning. according to his wife, he had a 2 minute seizure last night that involved right facial twitching and inability to talk. afterwards, he returned to his baseline and was able to walk and talk. this morning, a few minutes before 6, his wife felt him kick her on the couch. he was unable to talk, his right face was twitching, his tongue was going up and down and his right arm was rhythmically going up and down. he couldn't open his eyes and was not alert. this was noted to be different than his previous seizures as he is usually alert. his wife proceeded to stand him up and walked him by supporting his weight, she says this usually helps break his seizures, but he wouldn't come out of his unresponsive state. she then noted that the seizure (including the right face twitching, right arm jerking and tongue movements) lasted about 3 hours. he was taken to an osh where he was intubated for airway protection as well as given ativan, dilantin and dexamethasone. he was then transferred to for further care. past medical history: past oncologic history: (1) a stereotaxic brain biopsy by , m.d. on , (2) s/p gross total surgical resection by , m.d. on , (3) received involved-field cranial irradiation with temozolomide to to , (4) started nuvigil on and stopped on , (5) s/p 2 cycles of adjuvant temozolomide at 200 mg/m2/day x 5 days since , (6) s/p 2 cycle of xl-184, which was started on , (7) s/p hospitalization from to after a seizure causing non-fluent aphasia, (8) had 3 cycles of bevacizumab (5 mg/kg on and 10 mg/kg on in cycle 1, 10 mg/kg in cycle 2, 15 mg/kg in cycle 3, and 12.5 mg/kg in cycle 4), (9) had adverse abdominal reaction (pain and inability to tolerate food) with etoposide which he last received approximately 10 days ago (), (10) but after stopping etoposide on , his cramping and nausea improved by . he was admitted to the hospitalist service on for preparation for a colonoscopy. he was found to be neutropenic on with wbc at 1.2 and anc at 467. his colonoscopy had to be with held. he was started on filgastrim 480 mcg subcutaneous daily on . on , his wbc was 1.7 and his anc was 969. he had his colonoscopy on without problem. (11) currently on bevacizumab and carboplatin. past medical history: arthritis gerd hashimoto's thyroiditis glaucoma raynaud's syndrome s/p shoulder surgery seizures sigmoid diverticulosis rectal bleed from hemorrhoids social history: he lives at home with wife and denied tobacco, drugs, or alcohol abuse. family history: his father has hypertension. his mother died of a left frontal lobe astrocytic tumor. he has 2 sisters and a brother; one sister has hypertension. he has 3 children and they are all healthy. physical exam: physical examination at the time of admission: general: awake, alert, nad : sclerae anicteric, no conjunctival injection, oropharynx clear cardiovascular: regular rate, nl s1, s2, no murmurs, rubs, or gallops pulmonary: cta bilaterally, no wheezes, rhonchi, rales abdomen: positive bs, soft, ntnd abdomen extremities: no lower extremity edema bilaterally neurological examination: mental status: awake and alert, flattened affect. he was oriented to person, place, and date. he had decreased attention, perseverates with saying days of week backwards. there was no dysarthria, but stuttering speech, plus mild anomia cranial nerves: right pupil: 7mm-->5mm, left pupil fixed at 6mm and non-reactive. right homonymous hemianopsia. extraocular movements intact bilaterally. mild ptosis of left eyelid with right esotropia. mild flattening of right nasolabial fold. hearing intact to finger rub bilaterally. motor: normal bulk and tone bilaterally. right pronator drift. tri we fe ff ip h q df pf te r 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 sensation: intact to light touch throughout. +extinction on double stimulation with touch to left face and right side. reflexes: 2+ and symmetric throughout. gait: deferred. physical examination on discharge: vital signs: temperature 97.7 f, blood pressure 130/80, pulse 73, repsiration 18, and oxygen saturation 96% in room air. general: aaox3, conversant : left pupil enlarged, minimally reactive cardiovascular: rrr, s1+s2, no m/r/g pulmonary: ctab abdomen: soft, non-tender, non-distended, with psotive bowel sounds extremities: no clubbing, cyanosis, or edema neurological examination: his karnofsky performance score is 60. he is awake, alert, and able to follow commands. his language is fluent with good comprehension. his short-term recall is fine. cranial nerve examination: his pupils are equal and reactive to light, 4 mm to 2 mm bilaterally. but the left pupil is sluggish direct light reflex. extraocular movements are full; there is no nystagmus. visual fields are full to confrontation in od but his os has no light perception. his face is symmetric. facial sensation is intact bilaterally. his hearing is intact bilaterally. his tongue is midline. palate goes up in the midline. sternocleidomastoids and upper trapezius are strong. motor examination: there is slight pronation of his right hand. his muscle strengths are at all muscle groups, except for 4+/5 strength in right handgrip. his muscle tone is normal. his reflexes are 2- and symmetric bilaterally. his knee jerks are 2-. his ankle jerks are absent. his toes are down going. sensory examination is intact to touch and proprioception. coordination examination does not reveal appendicular dysmetria. gait and stance are deferred. pertinent results: adm labs: 08:40am blood wbc-4.0 rbc-3.51* hgb-12.0* hct-35.7* mcv-102* mch-34.2* mchc-33.6 rdw-18.3* plt ct-122* 08:40am blood glucose-80 urean-10 creat-0.6 na-141 k-3.8 cl-103 hco3-27 angap-15 02:54am blood alt-47* ast-34 alkphos-72 totbili-0.3 12:30pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-pos barbitr-neg tricycl-neg discharge labs: 07:05am blood wbc-2.3* rbc-2.53* hgb-9.2* hct-25.5* mcv-101* mch-36.5* mchc-36.2* rdw-17.7* plt ct-147* 07:05am blood glucose-90 urean-11 creat-0.5 na-139 k-3.7 cl-106 hco3-25 angap-12 07:05am blood alt-38 ast-24 ld(ldh)-268* ck(cpk)-18* alkphos-81 totbili-0.2 07:05am blood albumin-3.6 calcium-9.1 phos-2.7 mg-1.9 cxr: impression: bibasilar atelectasis. support lines in satisfactory position. eeg: impression: very abnormal eeg due to overall voltage reduction with marked interhemispheric asymmetry and exaggerated slowing over the left hemisphere compared to the right with periodic lateralized epileptiform discharging activity from the left posterior quadrant. while some of the voltage asymmetry may represent a breach rhythm there was, in addition, some excess of slowing and periodic lateralized epileptiform discharges from the left hemisphere indicative of more disruptive rhythms and destructive processes involving l>r hemisphere. in addition, the overall slowing and voltage reduction would suggest a diffuse encephalopathy more accentuated over the left than the right. mri brain: impression: the multifocal foci of lesional enhancement as well as diffuse flair hyperintensity bilaterally has slightly progressed compared with the prior study. similar to that described on the prior study, in the setting of avastin treatment, this is again concerning for continued tumor progression. neck soft tissue: the current study demonstrates, on the ap view, preserved airway column, but there is slight deviation of the air column to the right with some narrowing and impinging over the left wall. this might be attributed to slight asymmetric position of the neck, but mass effect cannot be excluded, thus repeated radiograph, or if clinically justified, ct of the neck might be considered. lateral view demonstrates no evidence of soft tissue swelling. extensive degenerative changes are demonstrated within the cervical spine. ct neck: impression: no evidence of compression of the airway. note added in attending review: there is a congenital fusion anomaly with c5- c7 "block" vertebral body with rudimentary intervening disc spaces, as well as ankylosis of the posterior elements, particularly at c5-c6 on the right (as on mr examination of . there is associated abnormal rotation of these vertebrae, with focal levoscoliosis, and displacement of the laryngeal skeleton and the proximal cervical trachea to the right. it is this displacement, rather than true compression with effacement, that likely accounts for the appearance on the prompting radiographs. ct head: impression: 1. no acute intracranial hemorrhage. 2. multifocal lesions consistent with tumor in a patient with known glioblastoma multiforme appear overall stable since the prior. 3. hypodensity in the right frontoparietal lobe is more apparent than on reference ct head of and may represent subacute infarct. comment: dr. notified of results by dr. , at 6:15 a.m. on . note added in attending review: the hypodense region in right parietovertex subcortical white matter likely corresponds to the vasogenic edema associated with numerous enhancing lesions at this site, well-demonstrated on the interval mr study of , which had progressed since the prior study of . there is no additional finding to suggest interval infarction. brief hospital course: is a 47-year-old man with a past medical history of glioblastoma of left frontal lobe, s/p resection, radiation, ongoing chemotherapy (bevacizumab and irinotecan since , alternating with 1 cycle of bevacizumab and carboplatin since , and in combination with cis-retinoic acid 3 weeks on and 1 week off) and seizures, who presents after a prolonged seizure, s/p intubation at outside hospital with admission to neurosurgery icu and transferred to omed following extubation . (1) neurological issues: upon admission, mr. was responding to commands although intubated. once extubated, he had significant confusion on exam, with difficulty following complex commands and perseveration that has resolved back to baseline. he continued to have occasional seizures with right sided hand an facical twitching which were responsive to ativan. we opted not to continue the dilantin while in house, instead preferring to increase his lacosamide to 100mg tid. he continues on his home keppra of 1375mg and lamotrigine of 225mg tid. phenobarbitol was added at 15 mg which was uptitrated to 30mg . he also had a nchct that was concerning for some worsening of his edema. in response, we increased the dose of his decadron to 4mg tid, which he has tolerated well. he had an mri that showed slight progression of his lesions from the previous study. his motor seizures were well controlled under above regimen. prior to his discharge had episode of significant fatigue and drowsiness preceeded by some vertigo-like complaints, later developed some lip numbness which resolved with po liquid ativan. labs were unremarkable. ct of his head showed hypodensity in the right frontoparietal lobe which is more apparent than on reference ct head of and may represent subacute infarct. he was feeling was that his complaints of vertigo, lip numbness, drowsiness are all manifestations of continuing seizure activity. he continued seizure prophylaxis as above and prn ativan are recommended. (2) neck swelling: patient developed left sided soft tissue swelling in the neck overnight . this was not associated with any pain or symptoms. neck x-ray showed possible left sided impingement and deviation to the right, which could not differentiate between mass effect versus rotation of the film. he remained clinically stable and swelling resolved by the next morning. a ct neck was pursued which showed no evidence of compression of the airway, just a benign congenital anomaly. (3) leukopenia: likely seocndary to chemotherapy. wbc stable at 2-4 range. (4) thrombocytopenia: he remained stable in the 100a-130s. he was kept off heparin on his home lovenox. (5) anemia: hct on admission 32.1, and remained stable in the high 20s-30s. (6) history of dvt: he continued lovenox. (7) constipation: patient with signficant constipation without a bm for sevaral days on admission. he was put on colace, senna, miralax, bisacodyl, and responded well to this with several bowel movements. (8) anxiety: he has intermittently become agitated and confused at night, requiring prn ativan. he ultimately did not calm down until his wife came in. she stayed with him around the clock and since then, he has been calm. he has repeatedly expressed concerns that he may die. however throughout admission he did quite well on standing and prn xanax especially in the presence of his family (9) hypertension: he has had some high bps with diastolics in the 100s, but has otherwise been stable from a cardiovascular standpoint. we have not made any adjustment in his blood pressure medications. medications on admission: accutane 20mg po bid alprazolam 0.5mg po bid brimonidine 0.15% drops 1 gtt ou dexamethasone 4mg po bid dorzolamide-timolol (cosopt) 2%-0.5% drops 1 drop ou enoxaparin 60mg sc bid lacosamide 50mg po bid lamotrigine 225mg po tid latanoprost (xalatan) 0.005% 1 drop ou daily levetiracetam 1375mg po tid omeprazole e.c. 20mg po daily ondansetron 8mg po q8h prn sulfamethoxazole-trimethoprim 800-160mg 1 tab po m-w-f armour thyroid 45mg po daily tropicamide 1% 1 gtt os daily docusate 100mg po daily prn constipation ergocalciferol (vitamin d2) dose unknown lratadine 10mg po daily simethicone 80mg po tid prn gas discharge medications: 1. alprazolam 0.25 mg tablet sig: one (1) tablet po bid (2 times a day). 2. brimonidine 0.15 % drops sig: one (1) drop ophthalmic (2 times a day). 3. dorzolamide-timolol 2-0.5 % drops sig: one (1) ophthalmic (2 times a day). 4. enoxaparin 60 mg/0.6 ml syringe sig: one (1) subcutaneous q12h (every 12 hours). 5. lamotrigine 200 mg tablet sig: one (1) tablet po tid (3 times a day): total of 225mg . 6. lamotrigine 25 mg tablet sig: one (1) tablet po three times a day: total of 225mg . 7. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime). 8. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 9. sulfamethoxazole-trimethoprim 400-80 mg tablet sig: one (1) tablet po 3x/week (mo,we,fr). 10. thyroid (pork) 15 mg tablet sig: three (3) tablet po once a day. 11. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). 12. loratadine 10 mg tablet sig: one (1) tablet po daily (). 13. dexamethasone 2 mg tablet sig: two (2) tablet po q8h (every 8 hours). 14. amnesteem 20 mg capsule sig: five (5) capsule po bid (2 times a day). 15. tropicamide 1 % drops sig: one (1) drop ophthalmic tid (3 times a day). 16. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 17. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 18. polyethylene glycol 3350 17 gram/dose powder sig: one (1) po daily (daily). 19. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily). 20. alprazolam 0.25 mg tablet sig: one (1) tablet po tid (3 times a day) as needed for anxiety. 21. lacosamide 50 mg tablet sig: two (2) tablet po tid (3 times a day). 22. lorazepam 0.5 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for seizures. 23. menthol-cetylpyridinium 3 mg lozenge sig: one (1) lozenge mucous membrane prn (as needed) as needed for sore throat. 24. oxycodone 5 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for pain. 25. phenobarbital 15 mg tablet sig: two (2) tablet po bid (2 times a day). 26. pilocarpine hcl 1 % drops sig: one (1) drop ophthalmic q6h (every 6 hours) as needed for glaucoma. 27. simethicone 80 mg tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day) as needed for gas. 28. keppra 500 mg tablet sig: 2.75 tablets po three times a day. 29. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for ha. discharge disposition: extended care facility: - discharge diagnosis: primary: glioblastoma multiforme seizures discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: mr. , you were admitted to the hospital because of seizures. you required a breathing tube which we subsequently removed after you improved. you still have occasional seizures but have overall improved from your initial seizure. we have made the following changes to your medications: started: pilocarpine eye drops as needed started: oxycodone as needed for pain started: cephacol lozenge as needed started: lacosamide 100mg by mouth three times daily started: alprazolam 0.5mg by mouth thrice daily as needed started: bactrim 1 ss tab 3x/week started: insulin sliding scale started: phenobarbitol 30 mg po bid started: colace started: senna started: miralax started: bisacodyl started: isotretinoin 100mg by mouth twice daily started: ondansetron 4mg iv every 8 hours as needed for nasuea changed: dexamethasone to 4mg by mouth 3 times daily changed: lorazepam iv to lorazepam by mouth as needed for seizures started: simethicone as needed for gas started: tylenol as needed for pain you should continue all other medications. followup instructions: please make an appointment to follow up with your outpatient neuro-oncologist. also, please keep the following appointment with ophtho: name: dr , md specialty: ophthalmology when: thursday at 1pm location: , , ma phone: procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours diagnoses: thrombocytopenia, unspecified esophageal reflux unspecified essential hypertension unspecified sleep apnea cerebral edema antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use other constipation personal history of venous thrombosis and embolism swelling, mass, or lump in head and neck raynaud's syndrome personal history of antineoplastic chemotherapy personal history of irradiation, presenting hazards to health diverticulosis of colon (without mention of hemorrhage) leukocytopenia, unspecified malignant neoplasm of other parts of brain epilepsia partialis continua, with intractable epilepsy profound impairment, one eye, impairment level not further specified chronic lymphocytic thyroiditis other specified glaucoma 

Answer: The patient is high likely exposed to