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: erythromycin base attending: chief complaint: right leg numbness major surgical or invasive procedure: left craniotomy for resection of left parietal mass history of present illness: ms. is a 55 year-old female with stage iiic melanoma (t4bn3bm0) who has completed surgical management and adjuvant radiation therapy as well as surgical management of a second primary, stage ib melanoma, currently on week 32 of interferon therapy. however, her therapy has been hold due to tachycardia possibly from volume depletion. she has had intermittent right hand tingling and numbness for the past one or two years. however, in the afternoon of , she had a acute onset of numbness of right that only lasted for 15 mins. after she arrived at our ed, a head ct was taken and showed "2.3 x 1.7 x 1.5 cm lesion in the high left frontoparietal region with surrounding vasogenic edema. adjacent small 0.4 cm focus of hyperdensity=hemorrhage. additional 1 cm rounded lesion in the right parietal lobe with mild surrounding edema". the neurology team saw her and recommended an mri of head and starting keppra and steroid. she denied focalized weakness, tingling, fecal and urine incontinence. review of systems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies blurry vision, diplopia, loss of vision, photophobia. denies sinus tenderness, rhinorrhea or congestion. denies chest pain or tightness, palpitations, lower extremity edema. denies cough, shortness of breath, or wheezes. denies nausea, vomiting, diarrhea, constipation, abdominal pain, melena, hematemesis, hematochezia. denies rashes or skin breakdown. no numbness/tingling in extremities. all other systems negative. past medical history: oncology history: ms. noted a "pimple" on her mid back which began to bleed intermittently, and increased in size. on an excisional biopsy was performed with pathology revealing an at least 14.5 mm deep, ulcerated and invasive melanoma, which was classified as type non-specific, but clearly contained a nodular component. there was a small focus of epidermal involvement of mmis and the tumor extended to at least level iv. additionally, a pet/ct scan showed a 3 cm fdg-avid mass in her right axilla without other disease. on , she underwent a wide local excision, sentinel lymph node evaluation with selective left axillary lymphadenectomy, and a right axillary lymph node dissection. there was no residual disease found in the wide excision nor disease in the four left axillary sentinel lymph nodes, however, five of twenty-seven lymph nodes were involved in the right axilla, as well as evidence of extracapsular spread. she completed a course of adjuvant radiation therapy to her right axilla on . on , she was preparing to commence a year of adjuvant interferon when a suspicious lesion was identified on her right leg above the ankle and was biopsied, with pathology showing a 1.2 mm deep, non-ulcerated invasive melanoma with at least two mitoses per square millimeter. on , she underwent a wide local excision with sentinel lymph node sampling with pathology revealing no evidence of disease in the wide excision specimen or any of the three right inguinal sentinel lymph nodes. ms. began adjuvant interferon therapy on . in early , her chest x-ray revealed a new, ill-defined opacity in the right apex projecting over the posterior third rib. on follow up ct performed , an area of most likely scarring was seen in the right apex without features consistent with neoplasm seen. in addition, a suspected stone at the level of papilla of vater with dilatation of common bile duct up to 11 mm. on , i called to inform her of the results of her imaging. at that time, she noted increased abdominal bloating, reduced energy and appetite. she was referred to the ed, underwent an ercp with sphincterotomy on and a laparoscopic cholecystectomy on . she was discharged on , and restarted interferon on . pmh: obesity, hyperlipidemia psh: appendectomy, uterine myomectomy social history: she lives alone and is currently unemployed. she has previously worked doing secretarial work. she is a lifetime nonsmoker and rarely drinks alcohol. she has no children. family history: her father died at age 58 from complications of colon cancer and her mother died at age 88 from complications of an intracranial hemorrhage. she has a 50-year-old sister who suffers from epilepsy and multiple sclerosis. there is no family history of melanoma. physical exam: vitals: t 97.4 bp 160/90 hr 88 rr 18 sao2 96% on ra general: comfortable, nad heent: nc/at, eomi, anicteric, slightly dry mm, chin-to-chest normal motion and not painful cv: rrr, nl s1/s2, no m/r/g lungs: clear to auscultation bilaterally without rales or rhonchi abdomen: + bowel sounds, nondistended, no tenderness to palpation, no organomegaly appreciated extremities: no edema or rash neurologic: a&ox3, cn ii-xii grossly intact psych: appropriate, pleasant, cooperative pertinent results: 06:55pm glucose-115* urea n-7 creat-0.6 sodium-144 potassium-3.3 chloride-108 total co2-25 anion gap-14 06:55pm estgfr-using this 06:55pm calcium-8.9 phosphate-4.0 magnesium-2.0 06:55pm wbc-7.2 rbc-4.22 hgb-11.9* hct-35.3* mcv-84 mch-28.2 mchc-33.8 rdw-17.9* 06:55pm neuts-83.1* lymphs-13.5* monos-3.0 eos-0.3 basos-0.2 06:55pm hypochrom-1+ anisocyt-1+ poikilocy-1+ macrocyt-normal microcyt-1+ polychrom-occasional stippled-occasional 06:55pm plt count-193 ct of the head: 2.3 x 1.7 x 1.5 cm lesion in the high left frontoparietal region with surrounding vasogenic edema. adjacent small 0.4 cm focus of hyperdensity=hemorrhage. additional 1 cm rounded lesion in the right parietal lobe with mild surrounding edema. findings highly suggestive of metastatic dz. no midline shift or herniation. mri head :multiple parenchymal enhancing lesions, consistent with metastases. the largest lesion in the left paracentral lobule is hemorrhagic and demonstrates moderate surrounding edema, but no significant shift of midline structures and no herniation. ct c/a/p : 1. right axillary postoperative seroma and radiation changes. 2. scarring in mid-back at site of primary melanoma lesion. 3. no evidence of additional disease in the torso. eeg this is an abnormal awake and sleep eeg due to the presence of occasional sharp wave discharges and spike and slow wave discharges in the bilateral frontal central regions, phase reversing at f3 and f4, indicative of an area of epileptogenic cortex in these regions. additionally, intermittent bursts of theta frequency slowing was seen in the bilateral frontal central regions indicative of subcortical dysfunction. otherwise, the waking background reached a normal 9 hz alpha frequency rhythm. no clear electrographic seizures were seen. mri brain stable appearance to multifocal peripheral parenchymal enhancing lesions, with a large amount of edema surrounding the left parietal lesion. ct head 1. expected postoperative changes in the left parietal resection bed, including minimal hemorrhage and pneumocephalus. 2. no large quantity of intracranial hemorrhage. 3. no acute large vascular territorial infarction. 4. no shift of normally midline structures or central herniation. brief hospital course: ms. is a 55 year-old female with stage iiic melanoma (t4bn3bm0) who has completed surgical management and adjuvant radiation therapy as well as surgical management of a second primary, stage ib melanoma, currently on week 32 of interferon therapy(however, his therapy has been hold due to tachycardia possibly from volume depletion), presenting with right sided numbness and tingling and weakness. head ct revealed a new mass. # brain mass: neuro was consulted for patient's numbness and brain mass on ct. mri was done which revealed hemorrhagic lesion, likely metastatic melanoma in left parietal lobe which would correspond to symptom distribution. eeg was also done which showed epileptogenic cortex in frontal lobes bilaterally but no seizures, as well as subcortical dysfunction. pt was started on keppra for seizure prophylaxis as well as decadron for management of cerebral edema. pt's symptoms of tingling improved without further intervention but did not completely go away. her primary oncologist recommended surgery to remove largest brain met, followed by xrt. due to hemorrhage associated with lesion, anticoagulation and antiplatalet therapies were avoided (dvt prophylaxis with pneumoboots) and pt was placed on captopril to maintain sbp goal <160. on the patient was transfered to the neurosurgery service for left sided craniotomy for resection of left parietal lesion. postoperatively she was extubated and transfered to the pacu. she remained there overnight without any issues. ct head showed no hemorrhage. she was transfered to the floor. she was transitioned oob and her cathter was removed. her diet was advanced. # anemia: this was likely secondary to underlying cancer and/or medication or iv fluids. hct was followed by remained stable. medications on admission: lorazepam 0.5 mg tab one - two tablet(s) by mouth every 4-6 hours as needed for nausea naproxen 375 mg tab one tablet(s) by mouth two-three times per day. as needed for fever, achiness, pain. simvastatin 20 mg tab 1 tablet(s) by mouth each night prochlorperazine maleate 10 mg tab one tablet(s) by mouth three times per day as needed for nausea intron a 18 million unit (1 ml) solution for injection self inject subcutaneously 18 miu three times a week m-w-f discharge medications: 1. lorazepam 0.5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for nausea. 2. naproxen 375 mg tablet sig: one (1) tablet po every twelve (12) hours as needed for pain. 3. prochlorperazine maleate 10 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for n/v. 4. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 5. keppra 750 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*0* 6. dexamethasone 2 mg tablet sig: taper po taper for 5 days: take 2 tablets by mouth twice a day for 2 days. then take 1 tablet twice a day for 2 days. then take 1 tablet for 1 day. then discontinue. disp:*7 tablet(s)* refills:*0* 7. oxycodone 5 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain. disp:*40 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: metastatic melanoma discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: general instructions/information ?????? have a friend/family member check your incision daily for signs of infection. ?????? take your pain medicine as prescribed. ?????? exercise should be limited to walking; no lifting, straining, or excessive bending. ?????? you may wash your hair only after sutures and/or staples have been removed. if your wound closure uses dissolvable sutures, you must keep that area dry for 10 days. ?????? you may shower before this time using a shower cap to cover your head. ?????? increase your intake of fluids and fiber, as narcotic pain medicine can cause constipation. we generally recommend taking an over the counter stool softener, such as docusate (colace) while taking narcotic pain medication. ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, and ibuprofen etc. ?????? if you have been prescribed dilantin (phenytoin) for anti-seizure medicine, take it as prescribed and follow up with laboratory blood drawing in one week. this can be drawn at your pcp??????s office, but please have the results faxed to . if you have been discharged on keppra (levetiracetam), you will not require blood work monitoring. ?????? if you are being sent home on steroid medication, make sure you are taking a medication to protect your stomach (prilosec, protonix, or pepcid), as these medications can cause stomach irritation. make sure to take your steroid medication with meals, or a glass of milk. ?????? clearance to drive and return to work will be addressed at your post-operative office visit. ?????? make sure to continue to use your incentive spirometer while at home. call your surgeon immediately if you experience any of the following ?????? new onset of tremors or seizures. ?????? any confusion or change in mental status. ?????? any numbness, tingling, weakness in your extremities. ?????? pain or headache that is continually increasing, or not relieved by pain medication. ?????? any signs of infection at the wound site: increasing redness, increased swelling, increased tenderness, or drainage. ?????? fever greater than or equal to 101?????? f. followup instructions: department: hematology/oncology when: wednesday at 9:15 am with: , np building: campus: east best parking: garage department: hematology/oncology when: wednesday at 9:30 am with: , rn building: campus: east best parking: garage department: hematology/oncology when: friday at 9:30 am with: , rn building: campus: east best parking: garage department: neuro-oncology when: monday at 1 pm with: , md building: campus: east best parking: garage please obtain a referral for dr. from your primary care physician. referral can be faxed to . follow-up appointment instructions ??????please return to the office in 10 days (from your date of surgery) for a wound check. this appointment can be made with the nurse practitioner. please make this appointment by calling . ??????you have an appointment in the brain clinic on at 1pm. the brain clinic is located on the of , in the building, . their phone number is . please call if you need to change your appointment, or require additional directions. procedure: other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain diagnoses: anemia, unspecified intracerebral hemorrhage other and unspecified hyperlipidemia disturbance of skin sensation secondary malignant neoplasm of brain and spinal cord cerebral edema obesity, unspecified other musculoskeletal symptoms referable to limbs secondary and unspecified malignant neoplasm of lymph nodes of axilla and upper limb malignant melanoma of skin of lower limb, including hip 

Answer: The patient is high likely exposed to