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: hypotension, hypoxia (transfer from urology) major surgical or invasive procedure: nephrectomy central venous catheter placement arterial line placed femoral dialysis catheter placed history of present illness: 56 yo f w pmh of lithium toxicity induced cri (baseline crt 5), htn, asthma, gerd, bipolar d/o, transferred to the for hypotension, hypoxia. she is s/p a laproscopic right nephrectomy on due to a right renal mass noted on mri. following surgery her creatinine began to rise (7.0). nephrology was consulted, and hemodialysis initiation was planned. on , she became acutely hypotensive, vitals at the time were: t 99.4, bp 72/48, hr 95, 02sat 90 on 2l with low uop 5-10cc/hr. she had some response to a fluid bolus with sbp to the 90's. she then became hypoxic with escalating 02 req (95% on 5l). her initial abg was 7.21/48/73. she was given lasix 80mg iv, po mucomyst, placed on a non-rebreather and had a pe protocol ct. she was then transferred to the . . in the , she was managed temporarily on bipap, but never required intubation, and was started empirically on vancomycin and zosyn for likely aspiration pneumonia. her o2 requirements were weaned, and she remained afebrile with stable blood pressures. she required 4u prbc for post-op hct drop, which urology has been following. a temporary femoral hd catheter was placed, and hd has been done over the last two days. surgical pathology from nephrectomy consistent with oncocytoma with atypical features (extensive invasion into fat). past medical history: past medical history: ckd stage vi li toxicity w secondary hyperpth right renal mass x 2 gout htn asthma gerd bipolar d/o . psh: ureteroscopy, removal of tumor on back of knee, ccy, cone bx social history: no smoking, no etoh, no ivdu family history: non-contributory physical exam: vs: temp: 97.1 bp:76 /43 hr:102 rr:18 o2sat 95 on nrb gen: appears tired, mildly confused. breathing comfortably on nrb heent: large neck, could not assess jvd resp: rhonchi in anterior lung fields, distant breath sound posteriorly, bibasilar crackles. cv: tachycardic, reg rhythm, no murmurs abd: 3 post-surgical scars, stapled, dry, intact. obese, tenderness surrounding surgical sites, soft, hypoactive bs ext: warm, non-edematous, 2+ distal pulses neuro: slightly confused,awake and oriented x 3 pertinent results: cta - impression: 1. limited study but no main or lobar pulmonary embolus. 2. partial right lower lobe atelectasis and left basilar atelectasis. 3. 10-mm nodule in the anterior segment of the right upper lobe. given the history of malignancy this is concerning for metastasis and further evaluation with pet-ct can be performed. 4. nodular right apical opacity with surrounding ground-glass halo. in the absence of infectious symptoms, considerations would include bronchoalveolar cell carcinoma and hemorrhagic metastasis. if there is a history of immunocompromised or infectious symptoms fungal infection such as aspergillosis should be considered. . ekg - - sinus rhythm with atrial premature beats. baseline artifact. presence of st-t wave abnormalities cannot be ruled out. since the previous tracing of probably no major change. head mri: mild-to-moderate brain atrophy. no enhancing brain lesions or acute infarcts seen. although no obvious bony or soft parenchymal metastatic disease is identified, direct correlation with pet scan would help for better assessment if clinically indicated. labs on admission: 04:42pm glucose-165* urea n-54* creat-5.1* sodium-148* potassium-3.9 chloride-118* total co2-19* anion gap-15 04:42pm wbc-13.0* rbc-2.83* hgb-8.0* hct-24.5* mcv-87 mch-28.2 mchc-32.5 rdw-15.1 04:42pm plt count-178 labs on discharge: 07:35am blood glucose-83 urean-24* creat-4.0*# na-146* k-3.7 cl-106 hco3-31 angap-13 brief hospital course: a/p: 56 yo f w pmh of ckd to lithium toxicity, htn, asthma, bipolar d/o s/p r nephrectomy found to have an oncocytoma. 1. esrd: the initial impairment was thought to be attriubted to lithium toxicity. the patient was initially admitted to the urology service for the nephrectomy and mass removal but was subsequently transferred to the after her creatinine/ renal failure worsened in the post-operative setting. she was placed on hemodialysis with a temporary groin line until ir placed a tunneled right ij catheter for continued hd. she was followed by the renal consult team during the admission and tolerated hd well. she will continue with hd on a tu,thurs,sat schedule in the future. 2. renal mass: pathology returned as oncocytoma with atypical features. osh pet scan reportedly showed some brain enhancement. also, cta demonstrated r apical nodular apical opacity concerning for metastatic disease. an mri was obtained of the head to eval for previously mentioned pet lesions however no focal lesions were seen on our study here. in regards to the patient's oncocytoma, these lesions are generally considered benign however she will need close follow up in the future with urology. additionally, the nodules seen on ct scan will need to be reevaluated in months. this was conveyed to both her and to her family. 3. pna: the patient developed a likely left retrocardiac pna while in the icu that was initially treated with vanc and zosyn and subsequently switched to levaquin, renally dosed. she was afebrile at the time of discharge and will continue on levaquin for 10 days. 4. htn: the patient's bp was in the 100s-110s during the hospitalization and did not require bp pharmacological management. she will need to follow up with her pcp about restarting regimen. 5. bipolar d/o-patient had no evidence of mania during the hospitalization and was continued on her prior regimen. she was discharged with home pt. discharge medications: 1. levofloxacin 250 mg tablet sig: one (1) tablet po q48h (every 48 hours) for 10 days. disp:*5 tablet(s)* refills:*0* 2. commode please provide one three in one commode 3. divalproex 500 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po hs (at bedtime). 4. rosuvastatin 5 mg tablet sig: two (2) tablet po daily (daily). 5. aripiprazole 10 mg tablet sig: two (2) tablet po hs (at bedtime). disp:*60 tablet(s)* refills:*2* 6. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 7. colace 100 mg capsule sig: one (1) capsule po twice a day. disp:*60 capsule(s)* refills:*2* 8. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). disp:*30 cap(s)* refills:*2* 9. clonazepam 1 mg tablet sig: one (1) tablet po daily (daily) as needed for anxiety. 10. sevelamer 800 mg tablet sig: one (1) tablet po tid w/meals (3 times a day with meals). disp:*90 tablet(s)* refills:*2* 11. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed. disp:*60 tablet(s)* refills:*0* 12. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 13. cinacalcet 30 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 14. na ferric gluc cplx in sucrose 12.5 mg/ml solution sig: one (1) intravenous hd protocol (hd protochol). discharge disposition: home with service facility: vna assoc. of discharge diagnosis: oncocytoma s/p nephrectomy arf on hd pneumonia bipolar disorder discharge condition: stable, no oxygen requirement, afebrile discharge instructions: you were admitted with arf and found to have an oncocytoma which was removed with your right kidney. you are now on hemodialysis and will continue to need dialysis sessions three times a week (tu,th,sat). you are also being treated for a pneumonia. continue to take all of the antibiotics prescribed to you. followup instructions: follow up with dr. in 1 week after discharge from the hospital. call his office at ( to schedule your appointment. you were found to have nodules on your chest ct scan and will require a follow up ct in months. this can be arranged by your pcp. you will have hemodialysis at fmc-, located on , , ma (). you are scheduled to begin this saturday at 6am. moving forward your normal days will be tues./thurs./saturday at 6am. the nephrologist at that facility is dr. . procedure: venous catheterization, not elsewhere classified hemodialysis venous catheterization for renal dialysis venous catheterization for renal dialysis arterial catheterization nephroureterectomy diagnoses: acidosis other iatrogenic hypotension anemia in chronic kidney disease end stage renal disease esophageal reflux acute kidney failure, unspecified hyposmolality and/or hyponatremia gout, unspecified asthma, unspecified type, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease pneumonitis due to inhalation of food or vomitus iron deficiency anemia, unspecified secondary hyperparathyroidism (of renal origin) urinary complications, not elsewhere classified removal of other organ (partial) (total) causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation bipolar disorder, unspecified benign neoplasm of kidney, except pelvis 

Answer: The patient is high likely exposed to