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 allergies/adrs on file attending: chief complaint: altered mental status major surgical or invasive procedure: - intubation - lumbar puncture history of present illness: 68f with recent diagnosis of stage iib melanoma () s/p excision and axillary lymph node dissection (), on interferon x 4 weeks, who presents with acute onset altered mental status. per husband, she had been tolerating interferon until week 3 when she "hit a wall" and began experiencing increased fatigue, forgetfulness and difficulties with concentration and memory. she has been taking celexa prn x 4 weeks to help with medication-related depression/insomnia, last dose 10 mg night prior to admission. patient had been on a 10 day holiday off of interferon after induction phase, about to begin 11 month course of self-administration. on morning of admission, she drove to gynecology office for appointment where she had "confusion" such as not remembering medications or the date. she left the office around 10:30 am and was pulled over by police on highway after merging into a funeral procession on highway. ems found her sitting in her car in the middle of intersection, severely confused, tachypneic, with fsg in 120s after receiving oral glucose. in the ed, her vitals were t 97.7, hr 107, bp 92/52 rr 28 100% ra. she was combative and had a fluent aphasia (word salad). she was not following commands, with no focal motor deficits. code stroke was called. ct and cta show no evidence of ischemia or hemorrhage. she was intubated and sedated on fentanyl and versed in order to obtain mri around noon. her abg was 7.58/26/606. an lp was performed and vdrl and borrelia labs sent. csf was bland (prot 46, glucose 57. wbc 0, rbc 1). her tox screen was negative and urine tox positive for benzodiazepines after versed. ekg showed rbbb twi avl, v1- depressions and no peaking of t waves. troponin t negative. cxr showed no evidence of cardiopulmonary process. u/a negative. her potassium of 3.1 and phosphate of 0.9 were repleted and she wss transferred to micu for further evaluation. on the floor, vital signs were t 97.5, hr 60, bp 108/62, so2 100% on cmv vt450, rr 12 peep 5 40% fio2. she was quickly weaned off of sedation and extubated at 6:30 pm. og tube was removed. abg was 7.38/44/183. patient was leaning forward in bed, not responding to commands, and moving all extremities. she became more alert as effects of sedation wore off and responded to some questions but remained confused. per husband, patient has had no flulike symptoms, no recent travel or sick contacts, and notes she only experienced constipation about 3 days ago for which she took 3 x 250 mg mg pills. past medical history: melanoma s/p resection and left axillary node dissection hyperlipidemia djd hormone replacement therapy menopausal osteopenia insomnia constipation s/p breast biopsy s/p laparoscopic hysterectomy s/p right shoulder surgery s/p cataract extraction social history: active up until a few months before dx of melanoma. she lives in and works as a biochemist with husband who is researcher. 2 sons. etoh: ~1 glass wine/day prior to melanoma dx. no tobacco. family history: there is no family history of melanoma. her father had lung cancer, but he was a smoker. her mother had esophageal cancer. physical exam: admission exam: general: intubated, sedated, thin heent: normocephalic, atraumatic. perrl. heart: normal s1, s2, no murmurs, rubs, or gallops lungs: cta bilaterally abdomen: soft, nontender, nondistended skin: well-healed diagonal scar on left shoulder, no edema ext: moving all extremities, no focal deficits discharge exam: general: frail female resting in bed in nad. heent: eeg electrodes in place. neck: supple. cor: + s1s2 rrr no m/g/r. pulm: ctab, no c/w/ : +nabs in 4q. soft, ntnd. ext: warm, well-perfused. no c/c/e. neuro: maee. strength 5/5 bilaterally throughout. cniii-xii intact. pertinent results: admission labs: 11:32am blood wbc-6.7 rbc-3.82* hgb-12.0 hct-33.0* mcv-86 mch-31.4 mchc-36.4* rdw-13.2 plt ct-230 11:32am blood glucose-115* urean-20 creat-0.8 na-140 k-3.1* cl-102 hco3-21* angap-20 11:32am blood alt-40 ast-33 ld(ldh)-219 alkphos-55 totbili-0.5 11:32am blood lipase-57 11:32am blood ctropnt-<0.01 11:32am blood albumin-4.2 calcium-9.7 phos-0.9* mg-2.1 06:48pm blood triglyc-121 hdl-43 chol/hd-4.1 ldlcalc-111 ldlmeas-119 06:48pm blood tsh-6.4* 06:48pm blood pth-131* 11:32am blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg mri head with & without contrast (): technique: routine enhanced mr examination, comprising t1-weighted axial se and sagittal mp-rage sequences, post-contrast, the latter with coronal and axial reformations. findings: the study is compared with the craniocervical cta, performed roughly two hours earlier. there is no focus of slow diffusion to suggest an acute ischemic event and the principal intracranial vascular flow-voids, including those of the dural venous sinuses, are preserved, and these structures enhance normally. there is no pathologic focus of parenchymal, leptomeningeal, r dural enhancement to suggest intracranial metastatic disease. there is no intra- or extra-axial hemorrhage, the midline structures are in the midline, and the ventricles and cisterns are normal in size and configuration (for age). there is a multifocal round and ovoid, as well as confluent flair-hyperintensity, relatively symmetrically distributed in bihemispheric subcortical and periventricular white matter; this likely represents the sequelae of chronic small vessel ischemic disease. there is no space-occupying lesion, and the sella, parasellar region, and remainder of the skull base are unremarkable. there is evidence of bilateral ocular lens surgery, but the orbits are otherwise unremarkable. there is minimal mucosal thickening involving the anterior ethmoidal air cells, right more than left, with otherwise clear visualized paranasal sinuses and mastoid air cells. the regional bone marrow signal is unremarkable, with no osseous destructive lesion identified. incidentally noted is a small 6.5-mm ill-defined lesion in the left parietovertex scalp subcutaneous soft tissues (10:22, 901:100), which likely represents an incidental sebaceous cyst. impression: 1. no acute intracranial process, including no evidence of acute ischemia. 2. no pathologic focus of enhancement to suggest intracranial metastatic disease. 3. multifocal punctate and confluent flair-hyperintensity in bihemispheric white matter, as detailed, likely the sequelae of chronic small vessel ischemic disease. given the distribution as well as the lack of contrast enhancement, this is unlikely to represent acute demyelination, such as that related to interferon therapy. the confluent involvement of deep, periventricular white matter, as well as the lack of enhancement, would also argue against pres, though this should be correlated with evidence of (even relative) hypertension, particularly during the period of interferon therapy. discharge labs: 03:40am blood wbc-6.3 rbc-3.34* hgb-10.4* hct-29.8* mcv-89 mch-31.2 mchc-34.9 rdw-13.3 plt ct-150 08:45am blood na-140 k-3.6 cl-106 08:45am blood calcium-8.9 phos-2.4* mg-2.2 brief hospital course: primary reason for hospitalization: 69f with hyperlipidemia, osteopenia, menopausal syndrome on hrt, with recent diagnosis of melanoma on interferon alpha presenting with altered mental status acute diagnoses: # altered mental status / encephalopathy: patient was admitted with acute confusion. she underwent ct, cta, mri (which required intubation), that suggested no evidence of ischemic or hemorrhagic stroke, or metastatic disease. she did have posterior white matter changes. csf was bland, and tox screen was negative. cxr showed no cardiopulmonary process. patient was extubated within one hour of arrival to the icu. prolactin on admission was elevated, consistent with a possible seizure as a source of her ams. she was seen by neurology and underwent a 24 hour eeg, which revealed no focus for seizure. she was found to be hypothyroid. lfts, vit b12, and folate wnl. her mental status slowly improved. # hypophosphatemia: patient presented with phosphate of 0.9 and normal calcium. pth found to be elevated at 131. severe hypophosphatemia can lead to metabolic encephalopathy. patient's tachypnea at presentation suggests likely acute respiratory alkalosis in field and worsened by ventilation that can also lead to hypophosphatemia. in addition, magnesium salts can cause net loss of phosphate by binding to both ingested and secreted phosphate. phosphate was repleted and remained stable. chronic diagnoses: #hyperlipidemia: patient was continued on simvastatin 10 mg po qsun, wed, fri. #melanoma: patient has stage iib melanoma s/p resection, 4 weeks ifn-alpha and was about to begin 11 week course of self-administration. no evidence of brain metastasis. interferon and compazine were held on admission. celexa 10 mg was held for medication-related depression. #insomnia: ativan held on admission. #osteopenia: continue esterified estrogen. transitional issues: # follow up: the patient's oncologist, dr. , was contact regarding the patient's admission. she was given a follow-up appointment on at 8:30 am. she was also instructed to follow up with her primary care doctor in weeks. # code status: full code medications on admission: interferon 18mm unit vial sc 3x/week - dose to be 16 million u based on 10mu/m2x 48 wks based on bsa 1.6 (ht 66 in, wt 55 kg) compazine 10 mg q6-8hrs prn nausea/vomiting menest (esterified estrogens) 0.3mg po qmtthsat simvastatin 10 mg po qsun, wed, fri ativan 0.5 mg 1-2 tabs qhs prn insomnia celexa 20 mg 0.5-1 tabs qd ibuprofen prn pain discharge medications: 1. compazine sig: 10 mg q4-6h prn as needed for nausea. 2. menest 0.3 mg tablet sig: one (1) tablet po as directed: , tuesday, thursday, saturday. 3. simvastatin 10 mg tablet sig: one (1) tablet po 3x/week (sun, wed, fri). 4. citalopram 20 mg tablet sig: 0.5-1 tablet po daily (daily). 5. ibuprofen 400 mg tablet sig: 1-2 tablets po q6h prn as needed for pain for 1 doses. 6. ativan 0.5 mg tablet sig: 1-2 tablets po qhs prn as needed for insomnia. discharge disposition: home discharge diagnosis: primary diagnosis: - altered mental status secondary diagnoses: - melanoma discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: ms. , you were admitted to because you were slightly confused while driving and you had an episode of unresponsiveness. while you were here, you underwent a significant work-up, which included a ct scan & mri of your brain as well as a lumbar puncture. the results of these studies did not show anything that explains the event your experienced. your mri did show an abnormality in the grey & white matter at the back of your brain; it is possible that this is due to interferon. as such, we would recommend discontinuing this medication (this has been discussed with your oncology team). while you were here, the neurologists evaluated you and you had an eeg which did not show any seizure activity. as such, you were safe to be discharged home with no new medications. if, however, you feel dizzy or confused, please seek medical attention. medications changes: - medications stopped: interferon. - medications started: none. - medications changed: none. followup instructions: you have an appointment with dr. on , at 8:30 am. please make a follow up appointment with your primary care doctor within 1-2 weeks of discharge. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours spinal tap incision of lung insertion of endotracheal tube diagnoses: unspecified acquired hypothyroidism depressive disorder, not elsewhere classified other and unspecified hyperlipidemia disorders of phosphorus metabolism antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use osteoarthrosis, unspecified whether generalized or localized, site unspecified encephalopathy, unspecified personal history of malignant melanoma of skin delirium due to conditions classified elsewhere personal history of antineoplastic chemotherapy disorder of bone and cartilage, unspecified insomnia, unspecified acquired absence of both cervix and uterus mixed acid-base balance disorder asymptomatic postmenopausal status (age-related) (natural) panic disorder without agoraphobia cataract extraction status hormone replacement therapy (postmenopausal) 

Answer: The patient is high likely exposed to