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: metastatic melanoma s/p radiation major surgical or invasive procedure: r parietal craniotomy for mass resection history of present illness: 74-year-old right-handed gentleman with a history of metastatic melanoma to the brain. he underwent srs in 9/. he has had a right parietal lesion that has been monitored (question tumor vs radiation necrosis) which was discussed in the btc yesterday. patient presents today to discuss surgical resection past medical history: past oncologic history: - resection of a 1.85mm thick melanoma from his left calf, wide local excision and sentinel lymph node biopsy with no melanoma detected, and he had a wide local excision with 3 sentinel lymph nodes. he subsequently developed a nodule at the scar site on his left calf with biopsy revealing melanoma. he underwent wide local excision with pathology revealing melanoma approximately 1.2 x 2.5 cm in diameter. -, began interferon treatment completing 12 weeks of therapy. -, he was noted to have lymph nodes in the left inguinal area. fna positive for melanoma pet ct scan showed fdg uptake in the left inguinal area only. -- left inguinal node dissection with 4 of the 11 nodes containing melanoma - adjuvant radiation therapy to the left inguinal area -- pt began adjuvant gm csf -, soft tissue recurrence in his neck documented by fna. pet ct scan showed fdg uptake in the neck as well as what appeared to be a 15 mm metastasis in the left parietal lobe near the cortex. head mri confirmed parietal lobe metastasis. - cyberknife treatment with followup mri showing residual abnormality of the radiation site, but no new lesions. - restarted on gm csf repeat pet ct scan shows uptake in the abdomen with a 1.5 cm mass in the mesentery of the small bowel near the jejunum. -, resection of proximal sigmoid colon with pathology showing melanoma in 1 lymph node - pet/ct scan showed fdg uptake in the area of the left kidney with slow growth noted on followup torso ct scan on . ct guided renal biopsy was performed, which showed evidence of melanoma. - ct guided renal biopsy was performed, which showed evidence of melanoma. braf wild-type. - consented for compassionate use ipilimumab (ctla-4 inhibitor) on trial 07-350 - c1w1 07-350, dose #1 ipilimumab - c1w4 07-350, dose #2 ipilimumab - c1w7 07-350 dose #3 ipilimumab . other past medical history: 1. chronic hsv keratoconjunctivitis 2. htn 3. left lower extremity lymphedema 4. s/p appendectomy 5. s/p cataract surgery social history: lives with wife. is retired from invest banking. previous smoker, but quit >30 years ago. reports drinking several glasses of wine per night, and occasional brandy. no recreational drug use. family history: non-contributory. father had lung cancer. physical exam: gen: wd/wn, comfortable, nad. heent: pupils: perrl eoms intact neck: supple. lungs: no adventicious sounds cardiac: rrr abd: soft, nt, bs+ extrem: warm and well-perfused. neuro: mental status: awake and alert, cooperative with exam, normal affect. orientation: oriented to person, place, and date. language: speech fluent with good comprehension cranial nerves: i: not tested ii: pupils equally round and reactive to light, 3 to 2 mm bilaterally. 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 normal bilaterally. xii: tongue midline without fasciculations. motor: normal bulk and tone bilaterally. no abnormal movements, tremors. strength full power throughout. no pronator drift left lower extremity edema (baseline) sensation: intact to light touch coordination: normal on finger-nose-finger handedness right upon discharge: patient is awake, alert, oriented. mae without any motor defecit, no pronator drift, perrl. patient is ambulating and tolerating po intake. pertinent results: mri head increase in size of right parietal enhancing lesion with increased surrounding edema. no other enhancing lesions are identified. mri head unchanged right parietal lesion. mri head (functional) successful functional mri of the brain demonstrates expected activation in motor areas. there are areas of activation in the right parietal cortex during left foot movement which are close to the right parietal lesion as described above. ct head expected postoperative appearance of resection of known right parietal mass with stable vasogenic edema and minimal mass effect on the right lateral ventricle. no postoperative hemorrhage identified. mri head expected post-op changes, possible residual enhancement in the surgical bed vs. post-op changes. brief hospital course: pt was admitted to the neurosurgery service and underwent r parietal craniotomy for mass resection and bx. he tolerated the procedure very well with no complications. post operatively he was transferred to the icu for further care. his exam remained intact. a ct head showed no hemorrhage and good resection of mass. he was transferred to the floor in stable condition on pod#1. a follow-up mri was done which showed expected post-op changes. the patient was discharged home on . medications on admission: cabergoline - 0.5 mg tablet - half tablet by mouth once weekly dorzolamide-timolol - (prescribed by other provider) - 0.5 %-2 % drops - twice a day fluoxetine - (prescribed by other provider) - 20 mg capsule - 1 capsule(s) by mouth daily lotamax - (prescribed by other provider) - - 2 gtts od twice a day olmesartan - (prescribed by other provider; temp hold due to low bp) - 40 mg tablet - 1 tablet(s) by mouth sequential pneumatic device - - as needed diagnosis code 457.1 valacyclovir - (prescribed by other provider) - 1,000 mg tablet - 1 (one) tablet(s) by mouth once a day medications - otc cyanocobalamin (vitamin b-12) - (prescribed by other provider: ) - dosage uncertain mv-min-folic acid-lutein - (otc) - dosage uncertain omega-3 fatty acids-vitamin e - (otc) - dosage uncertain discharge medications: 1. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain fever. 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 3. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 4. cabergoline 0.5 mg tablet sig: 0.25 mg po weekly (). 5. dorzolamide-timolol 2-0.5 % drops sig: one (1) drop ophthalmic (2 times a day). 6. fluoxetine 20 mg capsule sig: one (1) capsule po daily (daily). 7. cyanocobalamin (vitamin b-12) 500 mcg tablet sig: one (1) tablet po daily (daily). 8. multivitamin tablet sig: one (1) tablet po daily (daily). 9. levetiracetam 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 10. losartan 50 mg tablet sig: two (2) tablet po daily (daily). 11. valacyclovir 500 mg tablet sig: one (1) tablet po q24h (every 24 hours). 12. dexamethasone 2 mg tablet sig: one (1) tablet po every six (6) hours: continue for 7 days then taper to 1 tablet twice daily and continue until your follow-up on . disp:*60 tablet(s)* refills:*0* 13. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 14. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*20 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: metastatic melanoma discharge condition: aox3. activity as tolerated. no lifting greater than 10 pounds. discharge instructions: ?????? have a friend/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, or excessive bending. ?????? dressing may be removed on day 2 after surgery. ?????? you have dissolvable sutures, you may wash your hair and get your incision wet day 3 after surgery. you may shower before this time using a shower cap to cover your head. ?????? 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. please continue this medication until follow-up. ?????? if you are being sent home on steroid medication, make sure you are taking a medication to protect your stomach (prilosec, protonix, or pepcid), as these medications can cause stomach irritation. make sure to take your steroid medication with meals, or a glass of milk. ?????? 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. **** we began a taper of your steroids, please follow as prescribed. call us if there is any worsening of symptoms while tapering this medication. **** 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 ** no wound check needed if being seen in btc within 14 days. ??????please return to the office in days (from your date of surgery) for a wound check. this appointment can be made with the nurse practitioner. please make this appointment by calling . ??????you have an appointment in the brain clinic on at 10:30 am. the brain clinic is located on the of , in the building, . their phone number is . please call if you need to change your appointment, or require additional directions. ??????you will not need an mri of the brain with/ or without gadolinium contrast. procedure: other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain diagnoses: unspecified essential hypertension secondary malignant neoplasm of brain and spinal cord cerebral edema personal history of malignant melanoma of skin 

Answer: The patient is high likely exposed to