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: adhesive tape / hayfever attending: chief complaint: melanoma resection major surgical or invasive procedure: procedure #1: 1. radical resection of malignant melanoma involving the left temporalis muscle and adjacent soft tissue. 2. left parotidectomy with facial nerve monitoring and dissection. 3. left modified radical neck dissection. 4. zygomatic osteotomy. procedure #2: 1. left radial forearm free flap to left temporal defect. 2. open reduction internal fixation of zygomatic arch defect. 3. autologous fat grafting to the pedicle. 4. split-thickness skin graft of the left upper arm and a 7 x 7 cm 14/1000 of an inch skin graft on the left thigh. history of present illness: pt is a 68 yo f with h/o dmii, htn, paroxysmal afib and now s/p left temporal melanoma resection, parotidectomy, left neck dissection and flap reconstruction on . since then, pt was intermittently in afib rvr (hr iun 130-140s) and had received iv boluses of metoprolol. she was also restarted her sotalol 120 . she has also had brief episodes of asymptomatic sinus bradycardia (slowest rate in 30s, no hemodynamic instability). pt is being transferred to our service today for management of afib rvr and possible cardioversion tomorrow. . upon arrival the floor, pt appears well, denies any pain. denies any palpitations. no nausea/vomiting or abdominal pain. admits to constipation (no bm since admission). denies any cp, doe. . on review of systems, she denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, cough, hemoptysis, black stools. admits to joint pains (from arthritis) and occasional bloody stools (hemorrhoids). she denies recent fevers, chills or rigors. she denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, palpitations, syncope or presyncope. admits to occasional bilat leg swelling. past medical history: 1. cardiac risk factors: diabetes, hypertension 2. cardiac history: atrial fibrillation (dx in on sotalol and coumadin at home) -cabg: none -percutaneous coronary interventions: none -pacing/icd: none 3. other past medical history: arthritis (s/p r total hip replacement in ) dmii (on no meds, recent hba1c 7.1) htn infectious hepatitis () social history: -tobacco history: quit in , 1ppd x 20yrs previously -etoh: occ -illicit drugs: denies family history: mother died of pe at 52yrs of age. physical exam: vs: t= 96.9 bp= 127/78 hr= 99 rr= 18 o2 sat= 96% on 3l general: aoriented x3. mood, affect appropriate. heent: l temporal flap in place, appears well, jp drain in place draining serosangious fluid neck: supple with no jvd cardiac: irregularly irregular rhythm, normal rate, normal s1, s2. no m/r/g. lungs: resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no c/c/e. pneumoboots in place. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ pertinent results: wbc hb hct plts 07:10am 15.2 9.9 29.5 372 01:42am 9.8 9.2 27.7 290 01:48am 12.0 8.6 25.7 240 01:14am 13.1 9.4 26.9 222 01:04am 9.7 9.2 27.0 190 04:20am 7.7 8.5 25.4 179 11:23pm 6.4 8.8 26.3 202 pt ptt inr 07:10am 15.5 85.9 1.4 07:00am 14.0 1.2 01:42am 14.0 25.4 1.2 01:48am 14.0 1.2 11:23pm 15.1 34.0 1.3 gluc bun cr na k cl hco3 07:10am 139 19 0.9 139 4.0 106 26 01:42am 116 13 0.7 142 3.8 112 23 07:42pm 3.6 109 25 01:48am 132 13 0.8 142 3.7 108 27 12:11pm 162 9 0.8 141 3.8 108 27 01:14am 155 7 0.8 140 3.8 110 25 01:04am 167 8 0.8 142 3.4 111 26 04:20am 163 14 0.8 142 3.7 112 25 11:23pm 133 16 0.8 141 4.2 113 22 07:10am ca 8.3 ph 3.4 mg 1.9 cxr : impression: improved aeration of bilateral lower lungs with improved atelectasis and vascular congestion. brief hospital course: 68 yo f with h/o dmii, htn, paroxysmal afib on sotalol and coumadin at home here for left temporal melanoma resection, parotidectomy, left neck dissection and flap reconstruction on and then in afib rvr peri-op. . # afib rvr: pt was in afib rvr, hr in 130-140s, subsequently rate controlled with iv metoprolol doses prn then, switched to 50mg po bid. also, anticoagulation with heparin gtt was started, but given the recent surgery was very cautious (no bolus, ptt goal of 50-70 and q3h checks). pt was started back on coumadin which was held for the surgery. daily inrs were checked and coumadin dose was adjusted accordingly. although tee/cardioversion was initially considered, this pt's current afib is likely to stress from recent surgery and period off her home sotalol. given recent surgery of neck and temporal area, head cannot be extended and a tee may be putting the pt at risk in regards to the surgery. thus, rate-control with sotalol (120mg ) and metoprolol (50mg ) and bridging to coumadin for anticoagulation was pursued. once pt is therapeutic on inr for 3-4 weeks, can consider cardioversion (with no need for tee) at that time if pt is still in afib. meanwhile, pt spontaneously converted to nsr, thus heparin gtt was discontinued. coumadin was continud however and pt was discharged on home dose, to be followed up with inr check soon. . # s/p melanoma excision: left temporal melanoma resection, parotidectomy, left neck dissection and flap reconstruction were performed by plastics on . pt tolerated surgery well. flap checks were performed every 4 hours. pt is to be in soft diet for 2 weeks. left forearm had xeroform/kerlex dressing changed daily. left thig area has xeroform that is left to open air, does not need changing. no head extension or full turning to the left. jp drain remained for a few days, was taken out eventually. ancef was given as long as jp drain was in. . # dmii: pt is diet controlled at home, no meds. pt was maintained on insulin sliding scale. fingersticks were checked 4x/day. . # htn: was well-controlled, not on home hctz currently. can be restarted as outpatient. . # arthritis: was stable, with pain well-controlled on percocet. pt did well with physical therpy, needs more conditioning at a rehab facility. . # anemia: hct was 39 pre-op on , has been in 25-28 range since . pt is asymptomatic, hemodynamically stable. required no tranfusions. . # pt was on a diabetic diet. for dvt ppx, pt was initially on heparin gtt, bridging to coumadin, however once heparin gtt stopped and coumadin was still not therapeutic, started sc heparin. pain management was with percocet and bowel regimen was with docusate, senna, bisacodyl. pt was full code. medications on admission: celebrex hydrochlorothiazide lorazepam sotalol - 120mg warfarin - 2.5mg daily calcium - dosage uncertain multivitamin - discharge medications: 1. sotalol 80 mg tablet sig: 1.5 tablets po bid (2 times a day) as needed for afib. 2. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain for 2 weeks: hold for sedation. disp:*30 tablet(s)* refills:*0* 3. coumadin 2.5 mg tablet sig: one (1) tablet po once a day. 4. famotidine 20 mg tablet sig: one (1) tablet po twice a day. 5. toprol xl 100 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. 6. docusate sodium 100 mg capsule sig: one (1) capsule po twice a day. discharge disposition: extended care facility: health care center - discharge diagnosis: 1) left skull base defect and temple defect, status post resection of melanotic lesion. 2) atrial fibrillation with rapid rate discharge condition: stable discharge instructions: you were admitted to the hospital for melanoma removal and reconstruction. after your surgery you had a rapid irregular heart rhythm called atrial fibrillation. you were given medication to improve you heart and it returned to a normal rhythm. please make the following changes to your medications: 1. continue sotalol 120 mg twice a day 2. start famotidine 20 mg twice a day 3. start oxycodone-acetaminophen 5-325 mg 1-2 tablets every 6 hours as needed for pain for 2 weeks 4. start docusate sodium 100 mg twice a day 5. start toprol xl 100 mg once a day 6. continue coumadin 2.5 mg once a day 7. stop hctz until you follow-up with your pcp 8. stop celebrex until you follow-up with your pcp please seek immediate medical attention if you have chest pain, increased shortness of breath, dizziness, fainting spells, increased leg swelling, confusion or any other concerning symptoms. followup instructions: follow-up with ent: provider: , md phone: date/time: 2:20 pm follow-up with cardiology: provider: browning, md phone: ( date/time: 11:00 am follow-up with plastics: provider: . phone: date/time: 10:00 am follow-up with your pcp . within 1-2 weeks of discharge. please call for appointment time. procedure: other skin graft to other sites attachment of pedicle or flap graft to other sites pressurized treatment of venous bypass graft [conduit] with pharmaceutical substance excision of lesion of skull insertion of skull plate radical neck dissection, unilateral excision of lesion of muscle partial sialoadenectomy diagnoses: anemia, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled cardiac complications, not elsewhere classified atrial fibrillation other specified cardiac dysrhythmias long-term (current) use of anticoagulants obesity, unspecified secondary malignant neoplasm of bone and bone marrow hip joint replacement melanoma of skin, site unspecified malignant neoplasm of connective and other soft tissue of head, face, and neck 

Answer: The patient is high likely exposed to