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: history of present illness: the patient presented to medical center by the family with concern for three to four days of multiple falls due to worsening balance, gait abnormality, intermittent slurred speech and word finding difficulties and expressive aphasia. the patient stated he "didn't feel right". the patient denied any head trauma, loss of consciousness, dizziness. cardiac and neurologic review of systems are negative, although the family noted a recent change in his personality and increased alcohol consumption. in addition, the patient noted black stool times one week, cough productive of yellow sputum times three days. the patient's vital signs were normal in the emergency department. his laboratories were notable for a hematocrit of 26.0, potassium 5.6, blood urea nitrogen 61, creatinine 1.5. chest x-ray showed a 7.0 centimeter lesion in the posterior right upper lobe, thought to be a rounded mass versus collapsed lung distal to an endobronchial lesion. head ct showed multiple small calcified ring enhancing lesions, with the differential diagnoses of metastases, syssarcosis or abscesses. for the patient's lung and brain masses, the patient was started on intravenous dilantin on the advice of neurology, and a chest ct was ordered. with regards to his upper gastrointestinal bleed, his hematocrit dropped from 26.0 to 22.0 in the first night with occult blood positive stool. gastric lavage was negative. upper endoscopy showed superficial linear erosions in the lower third of the esophagus, mild nonerosive gastritis and duodenitis with no erosions or bleeding. he continued to have orthostatic hypotension. he received a total of three units of packed red blood cells, and then was transferred to the intensive care unit. his hematocrit was stable since the evening of . the plan was to repeat the colonoscopy after his alcohol withdrawal had resolved. for his alcohol withdrawal, he was started on oxazepam protocol and given multivitamin thiamine and folate. he became agitated on , requiring posy and restraints. on , he became hypertensive to 210/130, requiring control with nitroglycerin paste and clonidine. he was transferred to at the request of the family. in order to stabilize for transfer, he required sedation with propofol and consequent endotracheal intubation. past medical history: 1. hypertension. 2. peripheral vascular disease. 3. nephrolithiasis. 4. hiatal hernia. 5. tobacco abuse. 6. alcohol abuse. 7. high cholesterol. 8. seasonal allergies. 9. colonic tubular adenoma, status post colonoscopy in . outpatient medications: 1. lisinopril 40 mg p.o. once daily. 2. simvastatin 40 mg p.o. once daily. 3. fexofenadine. 4. aspirin 325 mg p.o. once daily. 5. potassium chloride 20 meq p.o. once daily. 6. multivitamin. 7. folate. transfer medications: 1. protonix 40 mg intravenous twice a day. 2. gatifloxacin 40 mg intravenous once daily. 3. dilantin 100 mg intravenous three times a day. 4. diltiazem 7.5 mg intravenous four times a day. 5. diazepam 10 mg intravenous q2hours and 10 mg intravenous q2hours p.r.n. 6. clonidine 0.1 mg patch. 7. propofol drip. 8. nitroglycerin paste two inches. 9. haldol 2 to 4 mg intravenous q2-3hours. social history: the patient is a retired rocket scientist, currently a part-time teacher at . on admission to medical center, he admitted to drinking twenty shots of vodka per day, cage questionnaire was positive. the patient has a significant smoking history of three packs per day times twenty to forty years. physical examination: vital signs revealed temperature 98.8, pulse 73, blood pressure 111/palpable. in general, the patient is an intubated elderly male who occasionally struggles against restraints. possible mild palmar erythema but no spider nevi or caput medusa. head, eyes, ears, nose and throat - pink conjunctiva, no icterus, pupils are equal, round, and reactive to light and accommodation. the neck revels seven centimeter jugular venous distention above the right atrium. cor - regular rate and rhythm with physiologic splitting of s2. the lungs are clear to auscultation bilaterally. the abdomen is positive bowel sounds, soft, nondistended, no flank dullness or fluid wave. liver palpable two centimeters below the right costal margin. extremities - good peripheral pulses, no cyanosis, clubbing or edema. laboratory data: white blood cell count 7.6, hematocrit 32.1, platelets 259,000. prothrombin time 13.8, inr 1.3, partial thromboplastin time 30.1. sedimentation rate 55. sodium 140, potassium 3.9, chloride 107, bicarbonate 22, blood urea nitrogen 11, creatinine 0.8, glucose 114, alt 10, ast 18, alkaline phosphatase 78, total bilirubin 0.6, albumin 3.0, calcium 8.0, phosphorus 3.4, magnesium 1.8. ct of the brain with and without contrast revealed hyperdense edema in both temporal lobes. hyperdensity in superior left parietal lobe. small areas of calcification in the right temporal lobe and bilateral frontal and parietal lobes. hospital course: in short, this is a 70 year old male with new brain lesions, apparent lung mass with endobronchial obstruction, etoh withdrawal requiring deep propofol sedation and endotracheal intubation for interhospital transfer. 1. oncology - as already noted, the patient was noted to have right upper lobe endobronchial mass on chest x-ray concerning for carcinoma, especially given the findings of what appeared to be multiple brain metastases no head ct. ct of the chest, abdomen and pelvis revealed a large right upper lobe mass, two liver lesions in the right lobe, pancreatic mass in the body of the pancreas, read as principal lung neoplasm, with metastatic foci. head ct from , showed metastatic lesions in the frontal, parietal and temporal lobes, with moderate edema, minimal mass effect and some calcification. the patient received bronchoscopy. the pathology on the bronchoscopy was consistent with nonsmall cell lung cancer. given these imaging findings and the patient's changed mental status, he was given a very poor prognosis with his stage iv nonsmall cell lung cancer. the patient was seen by oncology. he was also seen by radiation oncology. there was general agreement that head radiation therapy would be the initial starting point for palliative treatment. however, because the family was able to communicate with the patient and actually saw some improvement in his mental status over the past several weeks, especially since extubation, they decided to hold off on head radiation therapy, understanding that radiation therapy while it could provide further improvement in his mental status, it could also have negative effect too. instead, the patient was kept on dexamethasone which was eventually tapered down to 4 mg four times a day. 2. mental status changes - once the patient was extubated, he initially was still quite somnolent, giving only one word answers. over the period of about one week, however, the patient became much more alert. he was always oriented to person, some times to place, but this was variable. he was never oriented to time and his attention was severely impaired. the patient's mental status changes most probably can be attributed to his multiple brain metastases, however, it is odd that the patient did not show any focal signs even with a greatly limited neurologic examination. other sources of mental status change included high ativan load with poor clearing, effect of dilantin, wernicke's syndrome. there is also concern for carcinomatosis meningitis, however, given that the patient was improving, this was not worked up. the patient's dilantin was stopped, but his steroids were continued. head magnetic resonance scan on , showed multiple foci of enhancement, edema in both cerebral hemispheres, posterior fossa consistent with metastatic disease, no hydrocephalus, mass shift, hemorrhage or left meningeal enhancement that might suggest meningitis. once again, the family held off on head radiation therapy given the patient's improving mental status. they were willing to give it a try, however, should his mental status deteriorate. 3. alcohol withdrawal - the patient did not show any sign of withdrawal once he was extubated. he was kept on clonidine at 0.5 mg p.o. twice a day. 4. gastrointestinal bleed - the patient's hematocrit was noted to decrease from 30.7 to 27.5 on . however, the patient did not overtly pass any blood, and his hematocrit remained stable. 5. fen - initially once he was extubated, the patient had a nasogastric tube. he received swallowing evaluation with nasogastric tube in place and was noted to be a silent aspirator. however, once the nasogastric was removed, repeat video swallowing study revealed that he, in fact, was not aspirating. the patient was kept on aspiration precautions given his waxing and mental status. he was kept on pureed solids and thin liquids with one to one supervision. 6. psychiatric - the patient was noted to have reversed sleep/wake cycles. he was asleep most of the day but was up a lot of the night trying to get out of bed. for this reason, he required a sitter which further complicated his disposition planning. the patient was written for low dose ambien at night as needed to help him sleep. condition on discharge: fair. medications on discharge: 1. regular insulin sliding scale. 2. protonix 40 mg p.o. once daily. 3. folate 1 mg p.o. once daily. 4. thiamine 100 mg p.o. once daily. 5. multivitamin one tablet p.o. once daily. 6. lisinopril 40 mg p.o. once daily. 7. clonidine 0.5 mg p.o. twice a day. 8. dexamethasone 4 mg p.o. four times a day. 9. lopressor 25 mg p.o. twice a day. 10. ambien 5 mg p.o. q.h.s. p.r.n. insomnia. discharge instructions: at this point in time, it is unclear which facility the patient will be going to. the family does not feel that they can handle the patient on their own. the patient will likely go to hospice care. discharge diagnoses: 1. metastatic nonsmall cell lung cancer. 2. mental status changes, likely secondary to brain metastases. 3. alcohol withdrawal. 4. gastrointestinal bleed. 5. hypertension. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more diagnoses: alcohol abuse, unspecified acute respiratory failure secondary malignant neoplasm of brain and spinal cord malignant neoplasm of upper lobe, bronchus or lung hemorrhage of gastrointestinal tract, unspecified unspecified gastritis and gastroduodenitis, without mention of hemorrhage secondary malignant neoplasm of other digestive organs and spleen alcohol withdrawal orthostatic hypotension 

Answer: The patient is high likely exposed to