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: subacute shortness of breath major surgical or invasive procedure: 1. bronchoscopy history of present illness: the patient is a 67 year old man with history of htn, poliomyelitis, and laryngeal scc in remission presenting with subacute shortness of breath. he states that for the past week he has had shortness of breath upon waking each morning. the shortness of breath has been associated with increased thick yellow sputum production. he has had no fevers/chills/sweats. he has had no chest pain. he has dyspnea on exertion at walking approximately the length of 1 room. he has no orthopnea or increase in leg swelling. he presented to the ed today because the symptoms of shortness of breath were much worse. he states that he shortness of breath is in his neck and not his chest. he states that he saw his ent in early at which time he was told that the vocal cord mass was not present and the previously seen vocal cord paralysis was resolved. . in the ed his initial vital signs were 98.9 94 135/76 24 96%ra. a chest xray was unremarkable. a cta chest was negative for pe. he received an empiric dose of levofloxacin 750 mg x1 while in the ed. while in the ed he developed acute worsening of dyspnea and stidorous breathing. he received 10 mg of iv dexamethasone and racemic epinephrine with relief of exacerbated symptoms. he was evaluated by ent who found no obstruction of his upper airway on fiberoptic exam. . ros: no ha, vison changes. thrush in mouth. no pain in neck. no abd pain. no n/v/d/c. no bloody or tarry stools. no dysuria. no new rashes. he has been eating normal food and wants to get his g-tube removed. past medical history: hypertension poliomyelitis with right leg length discrepancy scc laryngeal cancer (as below) chronic low back pain. . onchx: initially presented after two-year history of sore throat and cough, which worsened in the fall of . he also developed increasing hoarseness at this time. flexible endoscopy on was notable for an immobile left hemilarynx mass invading the left false cord. mri on showed a 1.4 x 2 x 3.8 cm left anterior periglottic and supraglottic mass extending from the level of the anterior commissure to involve the left false cord and aryepiglottic fold. no extralaryngeal involvement was seen. there was also a 2 cm left level iii lymph node. on , biopsy of the laryngeal tumor was notable for invasive squamous cell carcinoma, moderately differentiated. pet-ct on was notable for intensely fdg-avid laryngeal mass with an fdg-avid left-sided level iii lymph node. the mass had an suv of 28.3 and the lymph node's suv was 4.1. he also was found to have a proximal fdg-avid esophageal focus on the pet-ct. he started radiation on . his first cycle of cisplatin was on . his 2nd cycle of cisplatin was on . he finished radiation therapy on . social history: retired gunsmith and electrical engineer. lives with his daughter who is his hcp. former cig smoking. no drugs. rare etoh. normally ambulates with 2 canes due to his leg length discrepancy family history: mother with liver tumor physical exam: vs: f 142/80 100 24 100%ra, ht 67in, wt 186 ambulatory sats: 97-100%ra while walking 20 yards. gen: elderly male with marked tanning of neck with raspy voice. not visably dyspneic heent: eomi. perrla, mmm, oral thrush, marked skin tanning from radiation changes, no cervical lad cv: rrr no m/r/g pulm: expiratory wheeze through lung and central airways. abd: soft, nt, g-tube in place extrem: right leg shorter than left. mild edema to left leg. neuro: ms- a,ox3. coherent response to interview cn ii-xii intact motor upper and lower extremity strength intact light touch intact to face/hands/feet gait wide with assistance of canes pertinent results: 10:30am wbc-7.8 rbc-3.63* hgb-11.8* hct-32.6* mcv-90# mch-32.5* mchc-36.2* rdw-13.7 10:30am neuts-77.2* lymphs-13.8* monos-7.2 eos-1.4 basos-0.4 10:30am glucose-119* urea n-12 creat-0.7 sodium-144 potassium-3.2* chloride-97 total co2-38* anion gap-12 11:46am lactate-1.5 10:30am pt-13.1 ptt-25.4 inr(pt)-1.1 . . studies: - cta chest findings: there is normal opacification of the pulmonary arteries without pulmonary embolism identified. the pulmonary artery is normal in caliber. the aorta opacifies normally, without evidence of dissection. the thoracic aorta is normal in caliber. there are scattered calcifications in the region of the aortic arch. there are coronary artery calcifications. the lungs are clear and well expanded. there is no focal airspace consolidation, pneumothorax, or pleural effusion. no pulmonary nodules identified. there is no pericardial effusion. limited imaging through the upper abdomen demonstrates surgical clips in the region of the gallbladder fossa, consistent with cholecystectomy. there are severe degenerative changes of the thoracic spine. a gastrostomy tube is present within the stomach. . impression: 1. no pulmonary embolism, or aortic dissection. 2. no cause for the patient's chest pain is identified. . . - neck soft tissues plain films findings: frontal and lateral views are presented. on the lateral projection, there is no evidence of airway narrowing, although this area is difficult to evaluate due to overlying soft tissues. on the frontal view, however, the trachea appears to be narrowed at the level of c5, extending for approximately 2 cm. the more proximal portion of the trachea is widely patent. . . - neck soft tissues plain films findings: in comparison with the study of , there is again persistent narrowing of the trachea at approximately c6-7 level. given the history of a laryngeal mass, ct could be obtained for further evaluation. . . - ct of the neck with contrast ct pet from is reviewed. findings: there is a nodular appearance to the supraglottis and glottis which appears slightly progressed compared to the prior study. recurrent neoplasm cannot be excluded. there is sclerosis of left arytenoid cartilage. there is edema of the supraglottis with marked narrowing of the supraglottic lumen which measures approximately 3 mm in greatest transverse diameter. there is questionable destruction of the anterior thyroid lamina bilaterally with possible spread of soft tissue into the strap muscles in the midline. recommend correlation with pre-treatment imaging. no definite abscess is seen. . no significant tracheal stenosis is seen. there is mild subglottic narrowing measuring approximately 1.3 cm in ap dimensions. there is no pathologic adenopathy by imaging criteria. there are scattered bilateral level 2 lymph nodes which are somewhat rounded but do not meet size criteria for pathology. there is extensive djd in the cervical and thoracic spine. . impression: increased nodularity of the supraglottic and glottic soft tissues with possible extension into the strap muscles through the thyroid lamina. there is also sclerosis of the left arytenoid cartilage. i am uncertain as to how much of this represents tumor recurrence versus post-treatment sequela. recommend correlation with the pre-therapy imaging. there is moderate narrowing of the supraglottic airway as described above. mri may be helpful for further evaluation. there is no evidence for abscess in the neck. there are small rounded level 2 lymph nodes which do not meet size criteria for pathology. brief hospital course: the patient presented to the emergency room for increased shortness of breath and dyspnea on exertion. while the patient was begin evaluated in the emergency department the patitent was noted to have stridor, consitent with laryngeal edema. the patient was given epinephrine and high dose steroids and rapidly improved. the patient was admitted to the hospital. he was continued on steroids. he was found to have narrowing of his airway on soft tissue films of the neck as well as ct scan. interventional pulmonology was consulted to evaluate the patient for tracheal stenosis. the patient had a bronchoscopy done which showed a mass at the vicinity of the vocal chords. ent was consulted and they performed a biopsy of the lesion. the patient required a trach for the procedure, in light of his presentation with laryngeal edema. because the mass was found to be suspicious of tumor recurrence ent has already consented the patient for laryngectomy on the . the patient was transferred to the on after tracheostomy was placed. he did well overnight, maintained his oxygen sat >95%. he received a speech evaluation in the morning and continued to remain stable so he was transferred to the floor. the patient has been eating a modified diet (see below) and has not been requiring use of his peg tube during this admission. a speech and swallow consultation recomended a nectar thick liquids, soft diet with pills needing to be crushed. following the biopsy the patient developed urinary retention requiring foley placement. several attempts at removing the catheter were unsucessfull as the patient exhibited high post void residual volumes (as high as one liter). with this in mind the patient was discharged with a foley in place and scheduled for outpatint follow up with urology. the patient's anti-hypertensive medication norvasc was discontinued due to concerns that it was contributing to the patient's airway edema. the patient was continued on his home dose of lasix. his blood pressure was well controlled throughout this admission. medications on admission: amlodipine 5 mg daily magic mouthwash ibuprofen 1600 mg lasix 20mg dose nystatin discharge medications: 1. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q4h (every 4 hours) as needed for wheeze. disp:*1 bottle* refills:*2* 2. lasix 20 mg tablet sig: one (1) tablet po once a day. 3. nystatin oral 4. tracheostomy trach: 7mm gortex with cannula. 5. oxygen 35% mist trach mask 6. foley cath please give leg bag for foley cath. outpatient follow up with urology arranged for mon at 830 am 7. pantoprazole 20 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po once a day. disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 8. senna 8.6 mg tablet sig: one (1) tablet po once a day as needed for constipation. disp:*30 tablet(s)* refills:*2* 9. oxygen o2 35% continuus. 10. suction portable suction. 11. catheter #14 french catherter. 12. compressor compressor. 13. oxycodone 5 mg capsule sig: one (1) capsule po q6hrs prn. discharge disposition: extended care facility: for the aged - macu discharge diagnosis: laryngeal edema discharge condition: stable discharge instructions: you were admitted with worsening shortness of breath. while in the emergency room you had an episode of airway swelling that was treated with epinephrine. with regards to the cause of the swelling you were found to have a mass near your vocal chords in your breathing airway. a tube was placed in your airway to help you breathe better. we have scheduled you for an appointment with your oncologist in order to follow up the biopsy results and further treatment options for your neck cancer. you were also found to have difficulty urinating after the neck biopsy which required that we place a tube to help you urinate. we are discharging you with this tube in order to help you urinate. we have scheduled you for a follow up visit with a urologist in order to evalaute you for this problem. your anti-hypertension medication norvasc was discontiued due to concerns over swelling. your blood pressure was well controlled on lasix. please make sure to return to the ed if you experience any shortness of breath, chest pain, fevers, chills, increased neck swelling, blood in your urine, decreased urine production or any other symptoms that concern you. followup instructions: please keep in mind that you are scheduled to have your surgical procedure to remove the lesion in your laryx on the . please call dr to schedule an appointment two weeks after that procedure. we have also scheduled yuou for an appointment with a urologist (if you cannot make it, please call to cancel): provider: , m.d. phone: date/time: 8:30 procedure: other esophagoscopy fiber-optic bronchoscopy temporary tracheostomy closed [endoscopic] biopsy of larynx diagnoses: unspecified essential hypertension secondary malignant neoplasm of other specified sites candidiasis of mouth other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation retention of urine, unspecified lumbago urinary complications, not elsewhere classified personal history of irradiation, presenting hazards to health gastrostomy status anemia in neoplastic disease late effects of acute poliomyelitis other tracheostomy complications edema of larynx malignant neoplasm of other specified sites of larynx 

Answer: The patient is high likely exposed to