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: lethargy/exhaustion major surgical or invasive procedure: none history of present illness: 56 year old male with metastatic renal cell carcinoma on sutent presents with several days of lethargy and exhaustion. pt. had completed his one month of therapy, followed by one week off, and was to start another month of therapy. additionally, patient complains of several days of sore throat and cough -> evaluated by home vna, felt to have thrush, and started on nystatin swish and swallow qid with improvement. pt. called oncologist this am -> referred to the ed for hematocrit check and probable blood transfusion -> as is what usually happens when pt. feeling as he has been. . in ed, initial vs 97.5, 60, 128/56, 16, 100% on ra. labs sent and hct 31.4 -> no need for transfusion. ekg found to have st depressions/twi in inferior & anterolateral leads -> question of nstemi. cards reportedly notified and may see patient in the am. pt. given asa, bb, plavix, and statin. not started on heparin. first set ce negative. cta done to eval for pe -> negative. lij placed for access. pt. having couging fit and given total of 40mg oxycontin for pain (greater that his usual dose). he then had an episode of desaturation to 88% per nursing notes. sat improved to 97% on 4l, but pt drowsy. because of desaturation and drowsiness pt admitted to icu. past medical history: pmhx: - asthma - right femoral clot - left upper extremity clot - s/p ivc filter - s/p bilateral humerus fx - htn - hypercholesterolemia . oncologic history: presented in with lytic lesion in the ischium, found to have renal cell carcinoma, clear cell subtype. underwent right nephrectomy in at . he has pulmonary as well as progressive skeletal metastases involving multiple sites with radiation and various other therapeutics, including hardware implantation. he received il-2 and breviarium protocol with mixed response, followed by sunitinib therapy in . he restarted sunitinib in weeks on, 4 weeks off. he was also started on temsirolimus in early , last dose . he had a left subclavian port-a-cath placed on for easier chemotherapy administration in the face of poor peripheral venous access. social history: he lives with his wife in . he is a retired police officer. he has a 20 pack year history of smoking, however quit in . drinks alcohol occasionally. family history: father passed of heart disease. mother passed of breast ca . physical exam: vitals: 97.0 117/82 (117-157/82-106) 91-99 20 96%ra general: obese male laying in bed. heent: nc/at, no scleral icterus noted, mmm, no lesions noted in op neck: supple pulmonary: bibasilar crackles cardiac: rrr, s1 s2, no m/r/g noted abdomen: soft, nt/nd, normoactive bowel sounds, no masses or organomegaly noted. extremities: 3+ edema b/l l arm in splint. he has marked swelling of the left arm which he states is normal skin: multiple sub-cutaneous tumor collections present on torso. neurologic: alert, oriented x 3. able to relate history without difficulty. very weak-unable to lift himself off of the bed. has chair/ at home. pertinent results: admission labs: 02:15pm wbc-6.0 rbc-3.22* hgb-10.8* hct-31.4* mcv-98# mch-33.6* mchc-34.4 rdw-25.2* 02:15pm neuts-92.8* bands-0 lymphs-4.1* monos-1.2* eos-1.8 basos-0.1 02:15pm hypochrom-normal anisocyt-3+ poikilocy-2+ macrocyt-3+ microcyt-1+ polychrom-1+ ovalocyt-1+ schistocy-1+ stippled-1+ teardrop-1+ 02:15pm plt smr-normal plt count-159# 02:15pm glucose-125* urea n-35* creat-1.1 sodium-126* potassium-4.6 chloride-90* total co2-23 anion gap-18 02:15pm calcium-8.5 phosphate-3.0# magnesium-2.4 02:15pm alt(sgpt)-18 ast(sgot)-19 ck(cpk)-31* alk phos-110 amylase-43 tot bili-1.1 02:15pm lipase-31 . imaging: cxr (): bedside ap examinations labeled "semi-upright at 4:30 p.m. and "5 p.m." are compared with the bedside examination done some two hours earlier; the overall appearance is unchanged. there is a left ij intravenous catheter reaching the distal svc, with no pneumothorax in this position. the vague ground-glass opacity reported earlier is not well-demonstrated on this examination. there is scarring or atelectasis at the left lung base with slight elevation of this hemidiaphragm. the patient's known extensive, expansile lytic osseous metastases are difficult to appreciate on this study. however, there is destruction of the end of the left fourth rib with associated ill- defined and pleural-based soft tissue mass, as well as expansile destruction of the right clavicular head. these findings, as well as the patient's known spinal metastases, are better characterized on the concurrent ctpa. noted is gaseous distension of numerous bowel loops in the upper abdomen, as on the earlier study. . cta (): 1. no evidence of pulmonary embolism or aortic dissection. 2. interval decrease in size and extent of bilateral multifocal ground-glass opacities, likely representing resolving pneumonitis or pneumonia. 3. stable metastatic disease including within the mediastinum and bony thorax. . echo: the left atrium is normal in size. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. brief hospital course: pt is a 56 year old man w/progressive metastatic renal cell ca who was admitted to the intensive care unit with transient hypoxia and ekg changes. while in the unit, he had negative enzymes x 2, suggesting his ekg changes may have been secondary to demand ischemia given his low hematocrit. he was transfused several units with improvement in all of his symptoms. . his hypoxia quickly resolved after he cleared his narcotics. he had a cta which was negative for pulmonary embolus. at discharge, he was saturating >95% on ra. . the patient had transient hyponatremia and acute renal failure, which resolved on the floor. . during this hospitalization, the patient made the decision to go home to bridge to hospice care. per his request, lab draws were kept to a minimum. medications on admission: ambien 10 qhs ativan 0.5 q8 prn dexamethasone 4 qday lasix 40 tid prn oxycodone 5-10mg q4-6 hours prn oxycontin 20mg prn paxil 40 qday discharge medications: 1. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. disp:*30 tablet(s)* refills:*1* 2. acetaminophen 325 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for fever, pain. 3. zolpidem 10 mg tablet sig: one (1) tablet po at bedtime as needed for insomnia. disp:*30 tablet(s)* refills:*0* 4. lorazepam 0.5 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed. disp:*30 tablet(s)* refills:*0* 5. paroxetine hcl 40 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 6. ropinirole 0.5 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*1* 7. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h (every 6 hours) as needed. disp:*1 inhaler* refills:*2* 8. fluticasone 50 mcg/actuation aerosol, spray sig: one (1) spray nasal (2 times a day). disp:*1 aerosol* refills:*2* 9. sodium chloride 0.65 % aerosol, spray sig: sprays nasal (2 times a day) as needed. disp:*1 spray* refills:*2* 10. benzonatate 100 mg capsule sig: one (1) capsule po tid (3 times a day). disp:*90 capsule(s)* refills:*2* 11. dexamethasone 4 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 12. oxycodone 20 mg tablet sustained release 12 hr sig: one (1) tablet sustained release 12 hr po q12h (every 12 hours). disp:*60 tablet sustained release 12 hr(s)* refills:*0* 13. oxycodone 5 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain. disp:*180 tablet(s)* refills:*0* 14. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po every other day as needed for constipation. disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 15. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po tid (3 times a day). disp:* ml(s)* refills:*2* discharge disposition: home with service facility: , discharge diagnosis: metastatic renal cell carcinoma weakness asthma deep venous thrombosis discharge condition: stable discharge instructions: 1)you were admitted to the hospital because you were found to be extremely weak and tired. this improved while you were here. your blood count was stable on discharge. 2)please take all medications as listed in the discharge instructions below. 3)please schedule a follow-up appointment with your primary care physician/oncologist upon being discharged from the hospital for follow-up laboratory work. 4)if you experience any fevers, chills, chest pain, shortness of breath, or any other concerning symptoms please return to the emergency room. followup instructions: please schedule follow-up with your primary care physician and oncologist after being discharged from the hospital. md, procedure: transfusion of packed cells diagnoses: pure hypercholesterolemia unspecified essential hypertension acute kidney failure, unspecified hyposmolality and/or hyponatremia asthma, unspecified type, unspecified malignant neoplasm of kidney, except pelvis candidiasis of mouth hypoxemia secondary malignant neoplasm of bone and bone marrow anemia in neoplastic disease pathologic fracture of humerus 

Answer: The patient is high likely exposed to