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: patient recorded as having no known allergies to drugs attending: chief complaint: seizure, r parietal hemmorhage with increased respiratory distress major surgical or invasive procedure: patient was intubated and again thoracentesis central line (removed on ) history of present illness: 48 yo female no past medical history was at home with her husband when she suddenly developed slurred speach, left sided weakness and gaze deviation. she was taken to where her bp was found to be 253/123, she had a head ct which showed a 10 cc r parietal intracranial hemmorhage with some underlying vasogenic edema, no midline shift. she was intubated, given dilantin and ativan and transfered to on . . at was admitted to the neurology service icu given dilantin, labetolol for bp control, head mri was performed. mri showed multiple foci concerning for embolic cause vs. vasculitis. lp was performed, csf cytology was negative for malignancy, fluid not infectious with wbc of 1 and no growth on culture. head mri on revealed ~2x2 cm right temporal lobe intraparenchymal hematoma with surrounding fluid collection, which may represent edema and/or serum-like exudate from the adjacent hematoma; in addition multiple lesions in the frontal and parietal lobes, the pons, and the cerebellum were thought to be focal old lacunar infarcts concerning for embolic pathology, but these will be analyzed further with a head mri w/ contrast. . an arteriogram was performed which ruled out vasculitis, vascular malformation, vascular occlusion, stenosis, or aneurysm. . on her cxr was noted to have moderate size effusion on the right. a ct torso was performed to evaluate for possible sources of malignancy, this showed bibasilar consolidations and pleural effusions, lesions within the liver, and an enlarged left adrenal gland. a tte was performed to evaluate for possible endocarditis, no valvular vegetations were visualized. she was extubated on , her rt pleural effusion was tapped yielding bloody fluid exudative by ldh. tiny pneumothorax post tap. . analysis of pleural fluid identified neoplastic cells consistent with mesothelioma. however, chest ct showed no definite nodular areas of pleural thickening that would be indicative of mesothelioma. . she grew enterococci in her urine , was initially treated with vancomycin, and now being treated with levofloxacin beginning . also had mssa positive sputum and possible consolidation on lung treated with levo/flagyl beginning . a repeat ultrasound was performed of the left sided pleural effusion and the acute read was that there was insufficient to tap. . patient was reintubated for respiratory distress likely secondary to pneumonia, and extubated . patient currently alert and speaking, and has tolerated diet recommended by nutrition. she moves out of bed with difficulty, requiring a walker and support. she is currently is on 4lnc oxygen and she will likely require oxygen at home. . past medical history: peri-menopausal bleeding gestational diabetes social history: homemaker, lives with husband in , has 6 children, no smoking or drugs, no etoh. family has experienced financial difficulties in past year that have caused significant stress. family history: father died at 63 pancreatic cancer, mother died at 63 uterine cancer, sister died from mesothelioma at 42 physical exam: : t: 100.1 / 99.8 hr: 96 bp: 170 / 80 (166-180 / 78-90) rr: 26, 96% on 4l (90% sat after few minutes ra) . 88.6 kg . fingersticks: 185 in am . lying in bed, does not appear agitated and no acute distress. alert and oriented but appears somewhat tired and remains sluggish in speech. no changes from last night. heent: eomi, sclerae white and clear, anicteric cv: rrr, grade ii holosystolic murmur, maximally audible at r 2nd intercostal space lungs: good air movement throughout, decreased sounds at bases abd: soft, non-tender, non-distended, normal bs, no palpable masses ext: no edema neuro: alert and oriented x3, cn 2-12 intact, a sustained ankle clonus noted bilaterally, symmetric strength in extremities . pertinent results: 05:05am wbc-12.1* rbc-4.39 hgb-13.3 hct-39.2 mcv-89 mch-30.3 mchc-33.9 rdw-13.2 neuts-92.3* bands-0 lymphs-6.0* monos-1.3* eos-0.1 basos-0.3 05:05am pt-13.9* ptt-20.7* inr(pt)-1.3 05:05am sed rate-0 05:05am glucose-263* urea n-15 creat-0.7 sodium-135 potassium-3.6 chloride-101 total co2-23 anion gap-15 05:24am type-art rates-/14 tidal vol-550 peep-5 o2-50 po2-108* pco2-42 ph-7.34* total co2-24 base xs--2 -assist/con intubated-intubated . 12:30pm urine color-yellow appear-clear sp -1.021 sm nitrite-neg protein-tr glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.5 leuk-tr rbc-* wbc-0-2 bacteria-none yeast-none epi-<1 hyaline-0-2 . 12:30pm fibrinoge-267 d-dimer-712* 12:30pm crp-14.8* 12:30pm calcium-8.5 phosphate-2.9 magnesium-1.9 . 03:00am blood wbc-9.4 rbc-3.10* hgb-9.3* hct-27.6* mcv-89 mch-30.1 mchc-33.8 rdw-13.7 plt ct-253 05:00am blood wbc-7.7 rbc-3.30* hgb-10.0* hct-29.3* mcv-89 mch-30.4 mchc-34.1 rdw-13.5 plt ct-219 03:00am blood wbc-5.3 rbc-3.01* hgb-9.0* hct-26.4* mcv-88 mch-29.9 mchc-34.1 rdw-13.7 plt ct-242 03:15am blood wbc-7.1 rbc-3.57* hgb-10.3* hct-31.8* mcv-89 mch-28.9 mchc-32.4 rdw-13.7 plt ct-278 03:05am blood wbc-7.0 rbc-3.44* hgb-10.1* hct-31.2* mcv-91 mch-29.5 mchc-32.5 rdw-13.9 plt ct-294 03:15am blood wbc-8.9 rbc-3.52* hgb-10.4* hct-32.4* mcv-92 mch-29.6 mchc-32.1 rdw-13.6 plt ct-323 04:25am blood wbc-10.4 rbc-3.54* hgb-10.8* hct-31.9* mcv-90 mch-30.4 mchc-33.8 rdw-13.7 plt ct-357 04:17am blood wbc-10.5 rbc-3.78* hgb-11.5* hct-33.4* mcv-89 mch-30.4 mchc-34.4 rdw-13.7 plt ct-391 . 03:30am blood esr-55* 03:08am blood esr-32* 03:15am blood esr-13 . 03:15am blood glucose-184* urean-7 creat-0.5 na-141 k-3.5 cl-102 hco3-31 angap-12 03:05am blood glucose-154* urean-10 creat-0.6 na-139 k-5.4* cl-100 hco3-31 angap-13 03:15am blood glucose-123* urean-12 creat-0.5 na-142 k-4.8 cl-106 hco3-31 angap-10 04:25am blood glucose-155* urean-15 creat-0.5 na-141 k-4.4 cl-105 hco3-30 angap-10 04:17am blood glucose-94 urean-13 creat-0.5 na-140 k-4.3 cl-105 hco3-26 angap-13 . 03:30am blood ld(ldh)-204 11:47am blood alt-16 ast-19 alkphos-67 totbili-0.4 04:47pm blood mg-1.9 03:05am blood albumin-2.6* calcium-8.1* phos-4.6* mg-2.0 . 10:58am blood cea-1.6 ca125-13 . 03:08am blood crp-293.1* 03:15am blood crp-166.4* 02:56am blood crp-54.2* 12:30pm blood crp-14.8* . 02:38pm blood type-art temp-37.4 rates-/12 tidal v-550 peep-5 fio2-50 po2-107* pco2-55* ph-7.42 calhco3-37* base xs-8 intubat-intubated vent-spontaneou 06:21pm blood type-art temp-36.8 rates-/18 fio2-50 po2-116* pco2-48* ph-7.41 calhco3-31* base xs-5 intubat-not intuba comment-face tent . studies: . ct at osh rt parietal acute hemorrhage 1.9x1.5 cm, surrounding vasogenic edema. . head mri, : 1. approximately 2 x 2 cm right temporal lobe intraparenchymal hematoma with surrounding fluid collection, which may represent edema and/or serum-like exudate from the adjacent hematoma. 2. multiple focal old lacunar infarcts in the frontal and parietal lobes, the pons, and the cerebellum. these findings, along with the intraparenchymal hemorrhage are concerning for an embolic cause or an underlying vasculitis. . head ct, : foci of hemorrhage in right temporal and occipital lobes . arteriogram, : 1. no convincing angiographic features of vasculitis. 2. slight irregularity at the a2 segment of the right anterior cerebral artery, likely to reflect spasm. 3. tiny dural av fistula upon injection of the left external carotid artery, between the middle meningeal artery and the cortical vein - of doubtful significance. 4. no vascular malformation, vascular occlusion, stenosis, or aneurysm is identified. . chest ct, : 1. no focal chest abnormality is identified, although bibasilar consolidation and atelectasis is seen. the et tube should be retracted approximately 2 cm. 2. at least three discrete liver lesions that could represent metastasis are identified. 3. enlarged left adrenal gland. mr could be performed to evaluate liver and adrenal lesions. 4. multiple perihepatic lymph nodes. . tte, : no valve vegetations . ekg: sinus rhythm at 74, j point elevations v2v3, no t, st changes. . pleural fluid cytology, : positive for neoplastic cells consistent with mesothelioma . pleural fluid pathology analysis, : tumor cells are immunoreactive for calretinin with both nuclear and cytoplasmic staining; and focally positive for ck-7. they are negative for cea (absorbed), ttf-1, ck20, er and pr. these findings are most consistent with a mesothelial neoplasm. . chest xray, : marked patchy pulmonary opacities and bilateral pleural effusions are unchanged from the previous chest radiograph. . torso ct, : 1. since the recent ct torso of six days earlier, there has been development of bilateral alveolar opacities, with a central, perihilar predominance. in conjunction with the presence of anasarca and increasing pleural effusions, they are most likely due to pulmonary edema. however, pulmonary infection is not excluded in the appropriate setting. 2. interval increase in pleural effusions, right greater than left. adjacent basilar lung opacities, which most likely reflect atelectasis. 3. enlarged left adrenal gland concerning for neoplastic involvement. . torso ct, : 1. bilateral moderate-sized pleural effusions, with interval decrease in right pleural effusion. no definite nodular areas of pleural thickening are identified. if a pet ct is planned to assess for extent of disease, it may help in guiding biopsy procedure. 2. stable enlargement of left adrenal gland. 3. previously reported liver lesions on ct torso of are less well demonstrated, likely due to differences in the phase of contrast administration. if the patient is scheduled to undergo pet, these can be evaluated at that time. alternatively, mri of the abdomen could be performed to simultaneously assess the left adrenal and hepatic regions. 4. improving bilateral perihilar opacities, most likely due to pulmonary edema. . spine mri, : disc herniation noted at the level of l5-s1 compressing the right s1 nerve root as it exits the thecal sac. otherwise unremarkable, no evidence noted for metastasis to spine. . abdominal mri, : 1. findings consistent with a left adrenal adenoma. 2. no suspicious lesions identified within the liver. 3. bilateral renal cysts. 4. small bilateral pleural effusions. . brief hospital course: (please see hpi for more details on hospital course) . 48 yo f presenting with sudden change in mental status, seizure and transient hemiparesis with rt parietal bleed undergoing work-up. vasculitis ruled-out, no evidence for endocarditis on tee. in work-up, bilateral pleural effusions discovered and concern of mesothelioma on fluid analysis. ct work-up also revealed possible liver mets and enlarged l adrenal gland. intubated for respirtory distress and with recurrent pleural effusions, now extubated. . 1. respiratory failure - patient extubated . was intubated due to pneumonia which appears most likely given consolidation on ct and cxr, increased wbc and fever. pt also found to have fluid overload with large pleural effusions bilaterally. patient currently maintaining > 95% sat on 5lnc. - goal no net fluid change, monitor i/o's - cover for possible aspiration pneumonia with levo/flagyl. - continues nebs prn - ct surgery evaluated for possible mediastinoscopy to assess for any lesion or lymph node that can be biopsied. if so, possible vats. per ct surgery, may not be mesothelioma given no pleural thickenings on ct, would be uncharacteristic. recommend f/u ct in months (if mesothelioma, very slow growing) and appointment with dr. . instructions for f/u given to patient. . 2. heme/onc: lung: pathology reports cells are more likely mesothelioma in light of recently reviewed path staining. will f/u with onc regarding prognosis and further workup treatments. liver: mri showed no lesions, contrary to ct findings. spine: mri showed no evidence of metastasis. - see note in (1). ct believed unlikely mesothelioma given no pleural thickenings on ct. patient will f/u with dr. . . . 3.intracranial hemorrhage: likely either secondary to hypertensive hemorrhage , possibly amyloid angiopathy or cranial mets. neuro also suspected tuberculosis and ppd ordered. - f/u ppd as outpatient, will be read by vna services. - transitioned to keppra as dilantin may have elevated glucose levels. appreciate neuro recs. continue keppra 750 mg po bid. patient to follow-up with neurology as an outpatient. . 4. hypertension - has been having very labile hypertension hard to control with labetolol, was holding bp meds for hypotension around time of intubation. - increased captopril dose to 50 mg po tid, and transitioned to lisinopril 40 on day of discharge - continue labetalol 100 mg po bid . 5. uti - enterococci in urine - pan sensitive, cont levofloxacin 500 mg po qd . 6. dm: fingersticks in past 24 hr ranged 180-260 - d/c patient with metformin to control glucose. patient has glucometer at home and knows how to check her sugars given gestational diabetes in the past. - checked hba1c 6.9 . 7. fen: speech and swallow consult recommended pureed diet, nectar pre-thickened liquids, crushed pills in pureed if large, whole pills in pureed if small. . 8. ppx - pneumoboots, no heparin given intracranial bleed - ppi - bowel regimen given complaints of constipation . 9. access - rt sub clavian, pulled on prior to discharge . 10. full code- will need to discuss with family/pt . 11. communication with patient and husband. . 12. dispo - patient had repeat head mri on day of discharge. she was discharged with vna services for physical therapy and nursing. she has a follow-up appointment scheduled in a few days to check blood pressure and blood sugars on metformin. medications on admission: meds at home benadryl to sleep estrogen supplementation . medications on transfer levofloxacin 750mg q24 hrs lisinopril 10 daily nebulizers metoprolol 10mg iv q6h metoprolol 50mg po bid protonix 40mg iv daily dilantin 130mg iv q8h vancomycin 1gm iv q8h insulin sliding scale discharge medications: 1. metformin 500 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po twice a day. disp:*60 tablet sustained release 24hr(s)* refills:*4* 2. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 2 days. disp:*2 tablet(s)* refills:*0* 3. ipratropium bromide 18 mcg/actuation aerosol sig: two (2) puff inhalation qid (4 times a day). disp:*qs * refills:*2* 4. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h (every 6 hours) as needed. disp:*qs * refills:*0* 5. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 2 days. disp:*6 tablet(s)* refills:*0* 6. levetiracetam 250 mg tablet sig: three (3) tablet po bid (2 times a day). disp:*180 tablet(s)* refills:*4* 7. labetalol 100 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 8. lisinopril 20 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*4* discharge disposition: home with service facility: home care services discharge diagnosis: right parietal hemorrhage. bilateral pleural effusions with possibility of mesothelioma. pneumonia. urinary tract infection. discharge condition: stable, mobile with walker and support, on supplemental oxygen discharge instructions: please call your primary care physician or return to the hospital if you experience slurred speech, problems with vision, chest pain, shortness of breath or other concerning symptoms. followup instructions: 1) have your ppd test for tuberculosis on left forearm checked within 48-72 hrs by the visiting nurses. . 2) neurology f/u with dr. , tuesday , 4pm, at . this will be to followup on brain hemorrhage and mri results. please call before to update your registration information with neurology office. . 3) thoracic f/u with dr. . you will be contact within a week to set up another chest ct and appointment with dr. . if you are not contact within a week, please call and ask to speak with who will set up your appointment. . 3. you have a follow-up appointment with , md phone: date/time: 11:10 of , , building. . 4. you have a new patient physical exam scheduled with , md phone: date/time: 2:30. , building, clinic. procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more spinal tap incision of lung insertion of endotracheal tube enteral infusion of concentrated nutritional substances thoracentesis arteriography of cerebral arteries diagnoses: unspecified pleural effusion urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled other convulsions intracerebral hemorrhage acute respiratory failure pneumonitis due to inhalation of food or vomitus iatrogenic pneumothorax family history of unspecified malignant neoplasm other nonspecific abnormal findings in body substances 

Answer: The patient is high likely exposed to