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: no known allergies / adverse drug reactions attending: chief complaint: headaches major surgical or invasive procedure: : left occipital craniotomy for resection of metastatic lesion history of present illness: 62 year old gentleman with past medical history of nhl, renal cancer, and metastatic melanoma with know metastasis to the brain who was admitted to after being seen for increasing bifrontal headaches in the setting of weaning decadron. he had been weaning the decadron with hopes of starting il-2. he was also noted to have some rue and was admitted to the floor on and restarted on decadron with good results in decrease of his headache. he underwent a mri scan of the brain which showed that there was new hemorrhage in the area of the lesion when compared to the previous mri done at the end of . of note he underwent cyberknife treatment to this lesion on , which was initially found on mri in early . the patient requested discharge home for personal reasons at that time and now presents electively for craniotomy and resection. past medical history: nhl, left nephrectomy for stage t1a renal cancer, melanoma resected from back , right upper lung wedge resection revealed metastatic melanoma, braf negative. he is status post cyberknife srs to left occipital met on to 1800 cgy., bipolar disorder, hypothyroid, skin cancer as well as melanoma, gout, hypertension, social history: he is divorced and currently disabled. he denies tobacco use. he occasionally drinks alcohol. he smoked marijuana in the past. family history: non-contributory physical exam: on admission: general:clearly uncomfortable in wheelchair, unable to sit still skin: warm and well perfused, no excoriations or lesions, no rashes heent: at/nc, eomi, anicteric sclera, pink conjunctiva, dry mm, cardiac: distant heart sounds but rrr, s1/s2, no mrg lung: ctab, occasional wheeze on right abdomen: nondistended, +bs, nontender in all quadrants, no rebound/guarding motor: moving all extremities well, no cyanosis, clubbing or edema, no obvious deformities pulses: 2+ dp pulses bilaterally neuro: awake, a&o to self, year and date, hosptial. cn ii-xii intact. strength 5/5 in upper and lower extremities. on discharge: ao fully x3, participates in exam at his own discretion full strength in all motor groups. cnii-xii intact pertinent results: tissue: occipital metastisis. study date of report not finalized. mr head w/ contrast study date of 8:01 am findings: again seen is a heterogeneous left occipital lobe measuring 4.3 cm ap x 3.1 cm tv x 3.3 cm si. there has been evolution of blood products in this region, as well as tumor progression with increased internal solid components and peripheral enhancement. there is mass effect and effacement of the left occipital and regional sulci. linear region of enhancement persists in the left precentral gyrus (3:21). there has been interval evolution of the 6-mm hypointense focus at the medial border (2:75), which now appears more smaller and more well-defined. finding is not completely evaluated on this study, but could represent cavitating infarct or gliomatosis. ventricles and sulci are prominent, consistent with age-related involutional changes. the major intracranial flow voids are preserved. there is mild mucosal thickening in the right maxillary and frontoethmoid air cells. left maxillary sinus is partially opacified. impression: 1. interval progression of left occipital metastasis. 2. nonspecific enhancement and cystic change in the left frontal lobe. 3. paranasal sinus disease. ct head w/o contrast study date of 7:23 am impression: status post excision of left occipital mass with expected post-surgical changes of fluid, white matter edema, and small blood products at the operative site. bifrontal subdural nonhemorrhagic fluid collection and pneumocephalus is also seen. no large infarction is present. followup should be obtained as clinically indicated. mr head w & w/o contrast study date of 8:29 pm impression: 1. post-surgical changes status post left craniotomy with expected blood products and pneumocephalus. no evidence of suspicious enhancement to suggest residual tumor. 2. stable small enhancement in the left frontal lobe. chest (portable ap) study date of 11:50 am findings: the dobbhoff tube extends to the lower portion of the esophagus, then coils on itself so that the tip lies somewhere above the level of the thoracic inlet. cxr: impression: increased consolidation at the left medial lower lung, concerning for aspiration. cxr: as compared to the previous radiograph, a right-sided picc line projects with its tip at the level of the cavoatrial junction. : bilateral lower extremity doppler ultrasounds: negative for dvt brief hospital course: on the patient electively presented and underwent a left occipital craniotomy and resection of hemorrhagic lesion. surgery was without complication and he tolerated it well. he was extubated and transferred to the icu. he became increasingly agitated and did not respond to haldol, ativan or precedex. due to this agitation post op imaging was delayed and the patient required intubation to complete imaging. head ct was delayed until and demonstrated no hemorrhage. mri was performed later in the evening on which showed no residual tumor. on patient was successfuly extubated. psychiatry evaluated the patient and made recommendations for treatment of his acue dellerium. on , the patient continued to be very aggitated. the decadron was weaned to decadron 3mg tid. due to aggitation the patient required icu level care. on , the patient decadron was written to wean to off over the next 24 hours. aggitation continued. a cxr was performed following dophoff placement which was consistent with dobbhoff tube extends to the lower portion of the esophagus, then coils on itself so that the tip lies somewhere above the level of the thoracic inlet. on , the patient exam was slightly improved, still confused and aggitated. the patient was experiencing difficulty with swallowing and a speech and swallow consultation was placed.on exam, the patient opened his eyes spontaneously. he was oriented to self, the month of and for the place states "". the patient continued to be impulsive but was verbal. he exhibited full strength but did not participate in detailed exam.the last dose of steroids were administered. physical therapy worked with the patient. there was a pallative care meeting in which that patient's primary care dr was present and the patient's partner/significant other but no changes in current care were made. on the patient was neurologically stable. he has one episode of agitation mid morning but was otherwise doing quite well. in the am of he had a new occurance of afib with rate of 145. lopressor was given and his sbp dropped to 90. il fluid bolus was given. he was observed in the icu, managed with prn diltiazem for intermittent rate to 160s. after administration of diltiazem he remained hemodynamically stable in atrial flutter. he received a picc line due to his poor vascular access which was confirmed by cxr. on the patient was more lucid and conversant and he along with family, hcp and his primary care physician, . , made the decision to proceed with care plan consistent with comfort only and arrangements were made for disposition home with hospice care. medications were adjusted for more comfort care measures and he was taken off telemetry. lenis were negative for dvts. at the time of discharge he is tolerating a regular diet, ambulating with assistance, afebrile with stable blood pressure and intermittent tachycardia. medications on admission: 1. sodium chloride nasal spry nu qid:prn 2. trazodone 200 mg po/ng hs 3. lorazepam 1 mg po/ng once 4. oxycodone (immediate release) 5 mg po/ng q6h:prn pain 5. ondansetron 4 mg iv q8h:prn 6. acetaminophen 325-650 mg po/ng q6h:prn 7. divalproex (delayed release) 500 mg po bid 8. methylphenidate (ritalin) 20 mg po/ng 9. multivitamins 1 tab po/ng daily 10. ranitidine 150 mg po/ng daily 11. pravastatin 40 mg po daily 12. levothyroxine sodium 100 mcg po/ng daily 13. dexamethasone 4 mg iv q12h 14. clonazepam 1 mg po/ng :prn 15. bupropion (sustained release) 200 mg po bid 16. amoxicillin 500 mg po/ng q8h 17. allopurinol 100 mg po/ng daily 18. docusate sodium 100 mg po bid 19. senna 1 tab po/ng :prn 20. sodium chloride 0.9% flush 3 ml iv q8h:prn discharge medications: 1. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain or fever. 2. docusate sodium 100 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*0* 3. senna 8.6 mg tablet sig: one (1) tablet po daily (daily) as needed for constipation. disp:*30 tablet(s)* refills:*0* 4. bisacodyl 5 mg tablet sig: tablet, delayed release (e.c.)s po daily (daily) as needed for constipation. disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 5. ranitidine hcl 150 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* 6. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. baclofen 10 mg tablet sig: one (1) tablet po tid (3 times a day) as needed for hiccups. disp:*90 tablet(s)* refills:*2* 8. divalproex 125 mg capsule, sprinkle sig: four (4) capsule, sprinkle po tid (3 times a day). disp:*360 capsule, sprinkle(s)* refills:*2* 9. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po tid (3 times a day). disp:*135 tablet(s)* refills:*2* 10. dilantin extended 100 mg capsule sig: one (1) capsule po three times a day. disp:*90 capsule(s)* refills:*2* 11. haloperidol 5 mg tablet sig: one (1) tablet po three times a day. disp:*90 tablet(s)* refills:*0* 12. sodium chloride 0.9 % 0.9 % solution sig: ten (10) ml injection twice a day as needed for line flush. 13. lorazepam 1 mg tablet sig: one (1) tablet po every six (6) hours as needed for anxiety. disp:*16 tablet(s)* refills:*0* 14. atropine 1 % drops sig: two (2) drop ophthalmic every four (4) hours as needed for secretions: 2 drops under the tounge q4 hours as needed for secretions. disp:*15 ml* refills:*0* 15. morphine concentrate 100 mg/5 ml (20 mg/ml) solution sig: five (5) mg po every four (4) hours as needed for pain or breathlessness. disp:*30 ml* refills:*0* discharge disposition: home with service facility: vna of eastern ma discharge diagnosis: left occipital metastatic lesion metastatic melanoma discharge condition: mental status: confused - sometimes. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: general instructions/information ?????? have a friend/family member check your incision daily for signs of infection. ?????? take your pain medicine as prescribed. ?????? exercise should be limited to walking; no lifting, straining, or excessive bending. ?????? dressing may be removed on day 2 after surgery. ?????? if you have dissolvable sutures you may wash your hair and get your incision wet day 3 after surgery. you may shower before this time using a shower cap to cover your head. ?????? if your wound was closed with staples or non-dissolvable sutures then you must wait until after they are removed to wash your hair. you may shower before this time using a shower cap to cover your head. ?????? increase your intake of fluids and fiber, as narcotic pain medicine can cause constipation. we generally recommend taking an over the counter stool softener, such as docusate (colace) & senna while taking narcotic pain medication. ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, and ibuprofen etc. ?????? you have been prescribed dilantin (phenytoin) for anti-seizure medicine, take it as prescribed and follow up with laboratory blood drawing in one week. this can be drawn at your pcp??????s office, but please have the results faxed to . followup instructions: ?????? you have an appointment in the brain clinic on monday, at 11:30 am. the brain clinic is located on the of , in the building, . their phone number is . please call if you need to change your appointment, or require additional directions. you will need a wound check at this time. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain diagnoses: malignant neoplasm of liver, secondary unspecified essential hypertension unspecified acquired hypothyroidism gout, unspecified atrial fibrillation intracerebral hemorrhage personal history of other lymphatic and hematopoietic neoplasms secondary malignant neoplasm of brain and spinal cord other and unspecified special symptoms or syndromes, not elsewhere classified encounter for palliative care secondary malignant neoplasm of lung bipolar disorder, unspecified personal history of malignant neoplasm of kidney personal history of malignant melanoma of skin delirium due to conditions classified elsewhere personal history of antineoplastic chemotherapy personal history of irradiation, presenting hazards to health 

Answer: The patient is high likely exposed to