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: no known allergies / adverse drug reactions attending: chief complaint: headache major surgical or invasive procedure: left craniotomy resection of tumor history of present illness: this is a 52 year old female with of history of metastatic melanoma most recently with metastatic disease to the brain requiring left occipital craniotomy for cyst excision/decompression by dr on and stereotactic radiosurgery to 3 lesions completed this past week. she has had ongoing headaches since diagnosis of her brain metastases that have been exacerbated during her radiotherapy courses per radiation oncology notes dated . the patient presented to the ed today with worsening headache as well as forgetfulness/inattentiveness, nausea, and vomiting for the past day. the patients husband also reports possible difficulty with vision. the patient was accompanied by her husband who is also her health care proxy. the patient denied weakness, numbness or tingling sensation. past medical history: metastatic melanoma dxed -s/p excision -adjuvant interferon rx -hd il-2 -s/p ipilimumab social history: she is married with 4 children ages 12, 14, 16,and 18. she does not smoke, and drinks only socially. she worked as a substitute teacher in an elementary school. family history: her father may have had melanoma. her mother recently died of multiple myeloma. she has 4 siblings who are alive and well. physical exam: on admission: physical exam: o: t:98.7 bp: 155/74 hr:16 r:16 o2sats: 100% ra gen: comfortable, nad. heent: pupils: eoms: grossly intact neck: supple. extrem: warm and well-perfused. neuro: mental status:inattentive, unable to participate in detailed instructions or exam, awake and alert, cooperative orientation: oriented to person and place only recall: unable to recall language: speech fluent with difficulty with comprehension and repetition. unable to name pen or watch. receptive aphasia. cranial nerves: i: not tested ii: pupils equally round and reactive to light, 3 to 2 mm bilaterally. visual fields - pt unable to participate iii, iv, vi: extraocular movements intact bilaterally without nystagmus. v, vii: facial strength and sensation intact and symmetric. viii: hearing intact to voice. ix, x: palatal elevation symmetrical. : sternocleidomastoid and trapezius- unable xii: tongue midline without fasciculations. motor: normal bulk and tone bilaterally. no abnormal movements, tremors. strength grossly full power throughout- patient does not participate in detailed motor exam. no pronator drift sensation: intact to light touch bilaterally. toes downgoing bilaterally coordination: pt unable to participate in this aspect of the exam at discharge: aaox3, speach fluent, no vf cut detected at bedside exam, l end gaze nystagmus. no drift. mae well. incision clean and dry with nylon sutures. pertinent results: ct head - 1. increased size and denisty of the left temporooccipital lesion is concerning for new or worsening intralesional hemorrhage. an increase in the amount of hyperdensity anterior to the mass also may represent new blood products. there is increasing surrounding vasogenic edema with effacement of the sulci, continued effacement of the left lateral ventricle, and new shift of the normal midline structures rightward by 2 mm. 2. mild increase in size of the right parietal lesion without evidence of new hemorrhage or significant new mass effect. 3. stable appearance of the smaller right occipital and left occipital lesions. cxr new mild interstitial abnormality in the perihilar lungs is probably mild edema. size of the 18 x 20 mm right lung nodule cannot be compared to because of differences in radiographic positioning, which also limits comparison of right hilar and subcarinal adenopathy. heart size is normal. no appreciable pleural effusion. mri brain 1. multiple enhancing lesions in the brain parenchyma, redemonstrated for surgical planning. no significant change on the limited images compared to the recent study of ct head expected post-surgical changes from left parieto-occipital craniotomy. mri brain read pending at time of discharge 06:05pm urine hours-random 06:05pm urine ucg-negative 06:05pm urine color-straw appear-cloudy sp -1.010 06:00pm pt-10.3 ptt-21.0* inr(pt)-0.9 01:45pm glucose-102* urea n-22* creat-0.6 sodium-135 potassium-4.1 chloride-94* total co2-26 anion gap-19 01:45pm estgfr-using this 01:45pm neuts-91.1* lymphs-4.8* monos-3.9 eos-0.1 basos-0.1 01:45pm plt count-498* brief hospital course: ms. was admitted to neurosurgery on to icu for observation with q 1 hr neuro checks. she was taken to the or on with dr. and received 1 unit prbcs in or for preop hct 26%. she had a left craniotomy for tumor and she was extubated and taken back to the icu. post-op ct head showed no hemorrhage. she had her post-op mri and was transferred to the floor on . on she was tapering her steroid, voiding, and ambulating well. her vision and headaches were improved. she was discharged to home on this day with plans to restart zelboraf and radiation oncology wanted to revisit her case in the btc and call her with radiation plans. medications on admission: 1. levetiracetam 250 mg tablet sig: three (3) tablet po bid (2 times a day). :*180 tablet(s)* refills:*2* 2. levothyroxine 112 mcg tablet sig: one (1) tablet po daily (daily). 3. lorazepam 0.5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for nausea, anxiety, insomnia. :*10 tablet(s)* refills:*0* 4. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for fever/pain. 5. vitamin b-12 50 mcg tablet sig: one (1) tablet po once a day: please f/u with pcp. :*30 tablet(s)* refills:*2* 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). :*60 capsule(s)* refills:*2* 7. dexamethasone 2 mg tablet 4mg qid po 8. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). :*30 tablet, delayed release (e.c.)(s)* refills:*0* 9. hydromorphone 2 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. :*60 tablet(s)* refills:*0 discharge medications: 1. levothyroxine 112 mcg tablet sig: one (1) tablet po daily (daily). 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). :*30 tablet(s)* refills:*2* 3. levetiracetam 500 mg tablet sig: two (2) tablet po bid (2 times a day). 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). :*60 capsule(s)* refills:*2* 5. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for headache: max 4g/24 hrs. 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). :*30 tablet, delayed release (e.c.)(s)* refills:*2* 7. levothyroxine 112 mcg tablet sig: one (1) tablet po daily (daily). 8. oxycodone 5 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. :*60 tablet(s)* refills:*0* 9. dexamethasone 2 mg tablet sig: two (2) tablet po every six (6) hours: on , then taper to 1 tab q 6hrs on and , then 1 tab starting . :*90 tablet(s)* refills:*2* 10. ultram 50 mg tablet sig: one (1) tablet po every six (6) hours as needed for pain: alternate with oxycodone. :*30 tablet(s)* refills:*0* 11. nystatin 100,000 unit/ml suspension sig: six (6) ml po four times a day: swish for 30 sec. as tolerated and swallow. discharge disposition: home discharge diagnosis: multiple metastatic melanoma to the brain confusion brain compression discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dr. said that you could resume you vemurafenib starting . take as he has instructed. ?????? have a friend/family member check your incision daily for signs of infection. keep your sutures clean and dry until they are removed. ?????? take your pain medicine as prescribed. ?????? exercise should be limited to walking; no lifting, straining, or excessive bending. ?????? increase your intake of fluids and fiber, as narcotic pain medicine can cause constipation. we generally recommend taking an over the counter stool softener, such as docusate (colace) & senna while taking narcotic pain medication. ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, and ibuprofen etc. ?????? you have been discharged on keppra (levetiracetam), you will not require blood work monitoring. ?????? clearance to drive and return to work will be addressed at your post-operative office visit. ?????? make sure to continue to use your incentive spirometer while at home. 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: increasing redness, increased swelling, increased tenderness, or drainage. ?????? fever greater than or equal to 101?????? f. followup instructions: follow-up appointment instructions ??????please return to the office in days (from your date of surgery) for removal of your sutures. this appointment can be made with the nurse practitioner. please make this appointment by calling . the radiation oncologists will call you next week after monday's brain tumor clinic to discuss future radiation plans. the following appointments were in the system: provider: . / phone: date/time: 4:00 provider: , : date/time: 4:00 provider: , md phone: date/time: 9:00 procedure: other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain other repair of cerebral meninges diagnoses: secondary malignant neoplasm of brain and spinal cord personal history of malignant melanoma of skin personal history of antineoplastic chemotherapy personal history of irradiation, presenting hazards to health 

Answer: The patient is high likely exposed to