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: codeine / hydrocerin attending: chief complaint: episode of left arm shaking and weakness major surgical or invasive procedure: craniotomy for resection of metastasis. history of present illness: this is a 31 year old female with history of melanoma who presented with an episode of left arm shaking and weakness. she states this episode lasted a minute or so and was self limiting. she does complain of some inability to pick up things with her left hand or perform activites that require dexterity with the same hand and states that she is left handed. subsequently she had an mri of the head today and it showed 2 seperate lesions, one in the right frontal lobe and the other in the left parieto-occipital area with surrounding edema but no midline shift or hydrocephalus. she was started on decadron and keppra and states she has had no further episode. past medical history: metastatic melanoma social history: she is married for 11 years. she has a 11- year-old son. she does not smoke or drink. she works as a clinical nursing assistant and lives in , mass. family history: no family history of melanoma physical exam: on admission: bp: 115/77 hr: 81 r 15 gen: wd/wn, comfortable, nad. heent: pupils: perrla eoms full 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 and repetition. naming intact. no dysarthria or paraphasic errors. cranial nerves: i: not tested ii: pupils equally round and reactive to light, to mm bilaterally. visual fields are full to confrontation. 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 sensation: intact to light touch, propioception, coordination: normal on finger-nose-finger, rapid alternating movements on discharge: her lue is 4+/5 in all muscle groups. her incision is c/d/i. pertinent results: ct torso followup metastatic melanoma with slight increase to right axillary lymphadenopathy and right lower lobe pulmonary nodule. mr head w & w/o contrast interval development of two enhancing lesions in the right frontal and left parieto-occipital lobes respectively, findings concerning for metastatic disease in the setting of malignant melanoma. no ocular lesions. no evidence of other enhancing foci. ct head w/o contrast status post right frontal and left parietal craniotomy and tumor resections with expected postoperative change as described above. residual vasogenic edema noted within the right frontal and left parietal lobes. mri brain ww and w/o gad status post resection of right frontoparietal and left parietal lobe lesions with expected post-surgical changes at the surgical site. mild residual enhancement at both surgical sites as described above. no evidence of acute infarct, hydrocephalus or mass effect or increase in brain edema. brief hospital course: this is a 31 year o f with phmx significant for metastatic melanoma presents after an episode of focal lue seizure and weakness. ct head showed 2 new lesions. patient was admitted and neurosurgery was consulted for 2 lesions. on , patient was transferred to the neurosurgical service for further work up and or planning. she was taken to the or on for a r craniotomy for mass resection. post operatively, patient was transferred to the tsicu and post op ct showed post surgical changes as well as vasogenic edema. upon examination, patient is intact. she was transferred to the floor, mri showed expected post-surgical changes. she was tolerating po intake. she was urinating well. she was encouraged to ambulate. she was cleared by pt and discharged to home on . medications on admission: albuterol sulfate - (prescribed by other provider) - dosage uncertain necon - (prescribed by other provider) - dosage uncertain discharge medications: 1. levetiracetam 500 mg tablet sig: two (2) tablet po bid (2 times a day). disp:*120 tablet(s)* refills:*2* 2. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) puff inhalation q6h (every 6 hours) as needed for wheezing. 3. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 5. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain/fever: max 4g/24hrs. 6. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain: max acetominophen/apap/tylenol 4 g/24hrs. disp:*90 tablet(s)* refills:*0* 7. dexamethasone 1 mg tablet sig: taper tablet po taper: 3mg po q6hrs x6 doses then, 2mg po q6hrs x8 doses then, 2mg po q12hrs & cont at this dose. disp:*100 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: multiple brain tumors discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: general instructions wound care ?????? you or a family member should inspect your wound every day and report any of the following problems to your physician. ?????? keep your incision clean and dry. ?????? you may wash your hair with a mild shampoo 24 hours after your are removed. ?????? do not apply any lotions, ointments or other products to your incision. ?????? do not drive until you are seen at the first follow up appointment. ?????? do not lift objects over 10 pounds until approved by your physician. diet usually no special diet is prescribed after a craniotomy. a normal well balanced diet is recommended for recovery, and you should resume any specially prescribed diet you were eating before your surgery. medications ?????? take all of your medications as ordered. you do not have to take pain medication unless it is needed. it is important that you are able to cough, breathe deeply, and is comfortable enough to walk. ?????? do not use alcohol while taking pain medication. ?????? medications that may be prescribed include: o narcotic pain medication such as dilaudid (hydromorphone). o an over the counter stool softener for constipation (colace or docusate). if you become constipated, try products such as dulcolax, milk of magnesia, first, and then magnesium citrate or fleets enema if needed). often times, pain medication and anesthesia can cause constipation. ?????? you have been discharged on keppra (levetiracetam), you will not require blood work monitoring. ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, and ibuprofen etc, as this can increase your chances of bleeding. activity the first few weeks after you are discharged you may feel tired or fatigued. this is normal. you should become a little stronger every day. activity is the most important measure you can take to prevent complications and to begin to feel like yourself again. in general: ?????? follow the activity instructions given to you by your doctor and therapist. ?????? increase your activity slowly; do not do too much because you are feeling good. ?????? you may resume sexual activity as your tolerance allows. ?????? if you feel light headed or fatigued after increasing activity, rest, decrease the amount of activity that you do, and begin building your tolerance to activity more slowly. ?????? do not drive until you speak with your physician. ?????? do not lift objects over 10 pounds until approved by your physician. ?????? avoid any activity that causes you to hold your breath and push, for example weight lifting, lifting or moving heavy objects, or straining at stool. ?????? do your breathing exercises every two hours. ?????? use your incentive spirometer 10 times every hour, that you are awake. when to call your surgeon: with any surgery there are risks of complications. although your surgery is over, there is the possibility of some of these complications developing. these complications include: infection, blood clots, or neurological changes. call your physician immediately if you experience: ?????? confusion, fainting, blacking out, extreme fatigue, memory loss, or difficulty speaking. ?????? double, or blurred vision. loss of vision, either partial or total. ?????? hallucinations ?????? numbness, tingling, or weakness in your extremities or face. ?????? stiff neck, and/or a fever of 101.5f or more. ?????? severe sensitivity to light. (photophobia) ?????? severe headache or change in headache. ?????? seizure ?????? problems controlling your bowels or bladder. ?????? productive cough with yellow or green sputum. ?????? swelling, redness, or tenderness in your calf or thigh. call 911 or go to the nearest emergency room if you experience: ?????? sudden difficulty in breathing. ?????? new onset of seizure or change in seizure, or seizure from which you wake up confused. ?????? a seizure that lasts more than 5 minutes. important instructions regarding emergencies and after-hour calls ?????? if you have what you feel is a true emergency at any time, please present immediately to your local emergency room, where a doctor there will evaluate you and contact us if needed. due to the complexity of neurosurgical procedures and treatment of neurosurgical problems, effective advice regarding emergency situations cannot be given over the telephone. ?????? should you have a situation which is not life-threatening, but you feel needs addressing before normal office hours or on the weekend, please present to the local emergency room, where the physician there will evaluate you and contact us if needed. followup instructions: follow-up appointment instructions ??????please return to the office in days (from your date of surgery) for removal of your and a wound check. although we try to be thorough, we may miss or staples. be sure to point out any incisions, which may be covered by clothing at the time of suture/staple removal. this appointment can be made with the nurse practitioner. please make this appointment by calling . if you live quite a distance from our office, please make arrangements for the same, with your pcp. ??????please call ( to schedule an appointment with dr. , to be seen in weeks. ??????you will need a ct scan of the brain without contrast. ??????you will not need an mri of the brain. procedure: venous catheterization, not elsewhere classified other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain other repair of cerebral meninges diagnoses: asthma, unspecified type, unspecified other convulsions 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