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: this is a 33 year-old white male with a history of paresthesias of the left neck, shoulders and intermittent shooting pains down the left arm, which occurred more frequently with sneezing and coughs. he also has a past medical history of migraine headaches for several months. he was worked up as an outpatient and found to have a chiari malformation and is admitted now for surgical decompression of this. past medical history: pertinent for psoriasis. he undergoes ultraviolet radiation three times a week. he has no history of arthritis. he has a positive history of migraines and a history of paraspinal cyst from c2 through t2. he denies hypertension, diabetes, renal hepatic disease or asthma. past surgical history: open reduction and internal fixation of the right forearm fracture in and a pilonidal cyst in . allergies: ibuprofen for which he develops rash and gluten products for which he develops dermatitis. medications: he is currently on ultravate cream and tazorac cream and devonex cream for his psoriasis. he also takes amitriptyline 25 mg po q.h.s. and butalbital, acetamin caffeine products for relief of his headaches. physical examination on admission: blood pressure 145/91. pulse 56. afebrile. height was 6'1". weight 235 pounds. in general, the patient was a well developed, well nourished overweight white male in no acute distress. examination of the head, eyes, ears, nose and throat, heart and lungs abdomen were essentially unremarkable. extremities showed no clubbing, cyanosis or edema. peripheral pulses were intact bilaterally. there was no paresthesias or sensory deficit and neurological examination was essentially unremarkable. hospital course: due to the clinical and radiographs findings the patient was taken to the operating room on the morning of admission where under a general endotracheal anesthetic the patient underwent a suboccipital craniectomy and c1 laminectomy with duraplasty for decompression of the chiari malformation. postoperative course was essentially unremarkable and the patient was noted to be awake, alert and moving all extremities with normal neurological examination. postoperatively, he was ambulatory on the first postoperative day and the remainder of his postoperative hospitalization was essentially unremarkable. wounds were clean and dry at the time of discharge. the patient was given an appointment for a follow up appointment in approximately one and a half weeks time for follow up with dr. in clinic for staple removal and further follow up. condition on discharge: stable and improved. , m.d. dictated by: medquist36 procedure: other exploration and decompression of spinal canal other repair and plastic operations on spinal cord structures other craniectomy diagnoses: compression of brain celiac disease other psoriasis 

Answer: The patient is high likely exposed to