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 / iodine / glucocorticoids,systemic classifier / dilaudid attending: chief complaint: intractable low back pain and r hip pain major surgical or invasive procedure: partial sacrectomy instrumented sacral reconstruction history of present illness: mr. is a 43 year old man with renal cell carcinoma metastatic to the r sacral ala s/p il2 and cyberknife therapy on the sacrum. since he developed numbness to the r toes, which progressed to numbness up to the calf and some dysesthesia. he was started on neurontin without significant benefit. finally on he underwent pelvic mri which showed progression of the sacral lesion. he had developed intractable low back pain that seemed to be positional as well as right lower extremity radiculopathy in an s1 distribution. past medical history: 1. history of recurrent kidney stones dating as far back as . 2. history of asymptomatic bradycardia which was thoroughly evaluated by cardiology and no therapy was indicated. of note, during anesthesia for his nephrectomy, he required atropine treatment for bradycardia. 3. gerd. 4. degenerative disc disease in the c-spine region. social history: never smoked, beer/month married,kids family history: nc physical exam: aox3. follows commands. speech intact. face symetric. no drift. perrla. eomi. sensation intact in all four extremities. moving all extremities with full strength. pertinent results: mri lumbar spine 1. large right sacroiliac lytic lesion expanding the right sacral ala, with narrowing abutting the right neural foramen at l5-s1. questionable expansion into the right neural foramen, and if is present, probably minimal. 2. multilevel degenerative changes in the lumbar spine, worst at level l4-l5. 3. cystic lesions in the right kidney, incompletely characterized. brief hospital course: pt was admitted and brought to or for partial sacrectomy under general anesthesia. he had ebl of 14liters and received replacement. he remained intubated and was brought to ticu postop and kept at flat bedrest until return to or for fusion. he was extubated the next morning. pain medication was titrated. initially post op he had weakness of his right plantar and dorsiflexors but was full strength by pod#2. his hematocrit was followed and he received transfusions with goal of >25 by return to or for fusion. he was transferred to the floor in stable condition on . on the evening of he was kept npo and started on ivf in preparation for the or on . on he returned to the or for l4-s1 fusion with placement of ileal screws and sacral reconstruction. he tolerated this procedure well with no complication. post operatively he was transferred to the icu for continued monitoring. on post op exam he was doing well. his strength was full and his incisions were clean and dry. he was started on a morphine pca for pain control with relief. on he was transferred to the floor in stable condition. his pca was discontinued and he was started on oxycontin 30mg q12 and the pain managment team was consulted for help in controlling his pain. recommendations per the pain team were to titrate the long acting oxycontin based on his prn pain medication needs. he was transfused 2 units of prbcs on for a hct of 24. post transfusion hct was 27.8. when his pain was adequately controlled he began working with physical therapy and workup was started on his right shoulder pain that included an x ray. r shoulder x ray showed no fracture and was consistent with arthritic changes. his shoulder pain did improve over his stay and will follow up with his pcp for further workup as needed. on his oxycontin was increased to 40mg per pain team recomendations. he was able to get oob and obtain his upright l spine x rays on and these showed good placement of surgical hardware. he was discharged home on with a pt order. medications on admission: tylenol, prevacid, oxycodone, neurontin,zoloft discharge medications: 1. oxycodone 10 mg tablet sustained release 12 hr : four (4) tablet sustained release 12 hr po twice a day. disp:*240 tablet sustained release 12 hr(s)* refills:*0* 2. acetaminophen 325 mg tablet : two (2) tablet po q6h (every 6 hours) as needed for pain or fever. 3. gabapentin 300 mg capsule : two (2) capsule po bid (2 times a day). 4. docusate sodium 100 mg capsule : one (1) capsule po bid (2 times a day). 5. sertraline 50 mg tablet : one (1) tablet po daily (daily). 6. senna 8.6 mg tablet : 1-2 tablets po bid (2 times a day). 7. bisacodyl 5 mg tablet, delayed release (e.c.) : two (2) tablet, delayed release (e.c.) po daily (daily). 8. valium 5 mg tablet : one (1) tablet po every eight (8) hours as needed for spasm. disp:*90 tablet(s)* refills:*0* 9. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 10. oxycodone 10 mg tablet : 1-2 tablets po every four (4) hours as needed for pain. disp:*120 tablet(s)* refills:*0* discharge disposition: home with service facility: me home health discharge diagnosis: metastatic renal cell carcinoma discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: ?????? do not smoke ?????? keep wound clean / no tub baths or pools until seen in follow up/ remove dressing pod#2 / begin daily showers pod#4 ?????? if you have steri-strips in place ?????? keep dry x 72 hours. do not pull them off. they will fall off on their own or be taken off in the office ?????? no pulling up, lifting> 10 lbs., excessive bending or twisting for two weeks then increase as tolerated. ?????? limit your use of stairs to 2-3 times per day ?????? have a family member check your incision daily for signs of infection ?????? take pain medication as instructed; you may find it best if taken in the a.m. when you wake for morning stiffness and before bed for sleeping discomfort ?????? do not take any anti-inflammatory medications such as motrin, advil, aspirin, ibuprofen etc. for 3 months to promote fusion. ?????? increase your intake of fluids and fiber as pain medicine (narcotics) can cause constipation followup instructions: please return to the office 10 days for removal of your staples/sutures. please call to make this appointment. please call to schedule an appointment with dr. to be seen in 6 weeks. you will need xrays prior to your appointment procedure: lumbar and lumbosacral fusion of the posterior column, posterior technique excision of bone for graft, tibia and fibula other partial ostectomy, other bones fusion or refusion of 2-3 vertebrae bone graft, other bones other therapeutic apheresis diagnoses: esophageal reflux acute posthemorrhagic anemia secondary malignant neoplasm of other specified sites personal history of malignant neoplasm of kidney secondary malignant neoplasm of bone and bone marrow neoplasm related pain (acute) (chronic) arthropathy, unspecified, shoulder region degeneration of cervical intervertebral disc 

Answer: The patient is high likely exposed to