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: tachycardia, tachypnea, hypoxia, rigors, and worsening mental status major surgical or invasive procedure: none history of present illness: 80 year old male with metastatic melanoma to the brain s/p resection and cyberknife complicated by radiation necrosis requiring chronic dexamethasone, h/o dvt and pe with anticoagulation discontinued due to brain mets, recurrent dvt, and ivc filter placement, who developed b le swelling and sob earlier this week. he was seen at an osh where cta was negative for pe. he had an ultrasound performed today which showed bilateral dvts from common femoral vein down. he was admitted to the omed service on and begun on low dose heparin therapy. repeat cta here confirmed no pe at that time. unfortunately his ptt rapidly climbed to 150 within 12 hours of starting heparin and remained at 150 all day of . in the evening of he was noted to have worsening trouble speaking and was sent to urget mri at 9:20. mri revealed 3x4 cm new bleed in the left parietal region around a previous metastasis. neuro-oncology evaluation at that time revealed significant right sided weakness. neurosurgery was called and suggested active reversal of his coagulopathy. he received 10mg iv vitamin k around 1:30 am with plans for protamine sulfate but he had not yet received that. at approximately 2am, he had an acute rise in his heart rate from nsr in 80s to 150s, acute onset of tachypnea and hypoxia with o2 sat 70% on ra, rigors, and worsening mental status (not following commands). his sbp remained stable at the time. . the resident was called to evaluate him and a code blue was called for emergent intubation. he was then transferred to the icu for further care. past medical history: # metastatic melanoma (pls refer to omr for detailed hx) # hypertension # hypercholesterolemia # pvd s/p fem- x2 in and with chronic left lower extremity swelling # hx of dvts on coumadin # glaucoma # benign prostatic hyperplasia . oncologic history: mr. wide local excision and sentinel lymph node biopsy for a primary left calf melanoma in 9/. in , left inguinal node involvement as well as bilateral periaortic involvement were discovered on ct scan. he was scheduled for a vaccine protocol, but we were unable to prepare vaccine from his disease. in , he began on the ilex-651 chemotherapy trial with shrinkage of target lesions, but there was concern for possible residual disease seen on pet scan.an attempt at biopsy of left inguinal lymph nodes showed no evidence of melanoma. he was transferred to the extension arm of the ilex-651 trial in 10/. another attempt at external iliac lymph node biopsy was made in but it was inconclusive. he stopped ilex therapy in 5/. he then developed a soft tissue nodule on the medial edge of his pectoralis muscle that was fdg-avid on pet scan in 3/. this was resected by dr. on . pathology of this lesion showed a dermal/subcuticular malignant epithelioid neoplasm consistent with metastatic melanoma, likely involving a lymph node, but not seen at the examined specimen margins. there was also a lymph node excision from his left anterior thigh that showed fibrotic and necrotic nodule with marked pigment deposition. his pet scan from also showed increased pelvic and abdominal lymphadenopathy. he was found to be hla-a2 negative. he began a phase i clinical trial using raf 265 on . he did well on study but developed symptoms of distorted color vision, flashing lights and difficulty breathing. he went for a regularly scheduled ct torso as part of the study and was found to have pe in the rml and rll. he then a head ct prior to anticoagulation which revealed a metastasis in the right frontal region. he a single treatment with cyberknife, 2200cgy, on . mri on showed an increase in size of the right frontal metastasis which had been treated with ck and a new 8mm metastasis in the parasagittal left frontal lobe. pet thallium scan showed low level uptake in the right frontal lobe lesion but no uptake in the left parietal lesion. he a biopsy/resection of the right frontal lesion on which was consistent with metastatic melanoma. he then ck to the left parasagittal lesion on . he remained off anticoagulation in the post-operative period and developed a dvt. he had an ivc filter placed on . he was on dexamethasone and keppra post-surgery and cyberknife. he weaned off dexamethasone. in early , he developed weakness on his right side and his wife thought he had a stroke. dr. and dr. were notified and he was restarted on dexamethasone. mri showed identical size of the lesion but increased vasogenic edema. he then had fdg-pet and thallium scans of his brain on and respectively which showed low and no uptake of the radionuclide, which per dr. , suggested radiation necrosis. he continues to wean off dexamethasone and is now on 1mg daily. he is weaning down to 0.5mg next week. he has put on weight, has some mood changes, and has swelling around his ankles from being on dexamethasone. he has not had any seizures or any recurrent weakness. he had one fall but says he became off-balance trying to climb over his puppy's fence. he denies any lightheadedness, dizziness, headaches or visual changes. he denies any fevers, chills or night sweats. he had an upper respiratory infection recently with head congestion, sore throat, rhinorrhea, and a cough. he denies chest pain, sob, or palpitations. he denies any abdominal pain, nausea, vomiting, or constipation. he denies any urinary incontinence, dysuria or hematuria, but does have nocturia several times per night. he denies any back pain. he has swelling in his legs,r>l, but no numbness or tingling. he denies any rashes or skin lesions. he continues to feel fatigued, but it is getting better. social history: lives with wife. daughter who lives locally. never smoked, use etoh or drugs. enjoys boating. family history: nc physical exam: on call out from general appearance: well nourished, no acute distress cardiovascular: rrr nl s1/s2 respiratory / chest: cta anteriorly abdominal: soft, bowel sounds present extremities: + le edema skin: warm neurologic: responding to basic commands of squeezing with his left hand and wiggling his left toes. unable to squeeze with right hand today and wiggle right foot. pertinent results: 04:00pm blood wbc-6.5 rbc-3.07* hgb-9.6* hct-28.2* mcv-92 mch-31.3 mchc-34.1 rdw-17.3* plt ct-120* 04:00pm blood glucose-110* urean-28* creat-1.0 na-140 k-4.3 cl-107 hco3-19* angap-18 04:47am blood lactate-2.1* 04:00pm blood pt-14.4* ptt-68.4* inr(pt)-1.3* 06:07am blood pt-22.6* ptt-150* inr(pt)-2.2* . lenis: impression: extensive bilateral iliofemoral and femoral popliteal deep venous thrombosis. . pulm cta: impression: 1. no pulmonary embolism to the subsegmental level. 2. increased bibasilar atelectasis. 3. coronary artery, aortic and aortic annulus calcifications. 4. unchanged liver lesion, reported as a hemangioma, better assessed by recent ct torso. . mri head: impression: 1. bilateral frontal lobe lesions with surrounding edema as detailed above. these lesions show interval bleeding since , , as detailed above. . ct head: impression: 1. hemorrhagic intracranial foci consistent with those seen on mr with surrounding parenchymal edema. brief hospital course: this is an 80 yo male with metastatic melanoma who presented initially with bilateral dvts. hospital course complicated by acute intracranial hemorrhage associated with metastases accompanied by hypoxic respiratory failure and tachycardia. . #. dvt: after discussion with neuro-onc, he was started on heparin gtt for anticoagulation given large clot burden. on his ptt rapidly climbed to 150. that evening he exhibited neurologic changes and had an urgent mri which showed ich around a previous metastasis. heparin was stopped and neurosurgery was consulted. protamine was recommended and he received vitamin k. shortly thereafter he had hypoxic respiratory failure. . #. hypoxic respiratory failure: acute onset with associated tachycardia, clear cxr, and known extensive dvts were highly suspicious for pe even in the setting of known ivc filter. clot may have formed on the filter or bypassed the filter. no signs of aspiration, no wheezes to indicate bronchoconstriction, no obvious murmurs or cause for intracardiac shunt. however, given ich, he could receive no further anticoagulation. pt was successfully extubated on . his o2 sat is currently normal on room air. . #. acute intracerebral hemorrhage: pt had acute ich in the setting of metastatic melanoma and supratherapeutic anticoagulation. pt then with altered mental status, aphasia, and right hemiparesis. neurosurgery was aware and decided against intervention. after extubation on pt??????s mental status improved. he is alert, oriented to self, and following basic commands although mostly only abe to move the left side of his body. because of his neurologic devastation and poor prognosis, the palliative care team spoke with his family and made the decision to be dnr/dni with a focus on comfort measures only. all bp meds, steroids, and antiseizure meds were discontinued. . # glaucoma: he was restarted on his glaucoma drops given concern that pt might not die immediately and that he could become blind in the interterm. . #. acute renal failure: we are no longer following labs given pt . . #: after discussion with his family, the decision was made to pursue comfort measures. most of his medications including antihypertensive, antihyperlipidemic, steroid, and antiepileptic meds were discontinued. he was allowed to take sips of water with monitorring for signs of aspiration. he was given ativan, morphine, and acetaminophen prn comfort. medications on admission: atorvastatin 80 mg daily dexamethasone taper, currently 1 mg daily, plan to taper to 0.5 mg daily keppra 500 mg tamsulosin 0.4 mg daily travoprost 1 drop each eye qday aspirin 325 mg daily discharge disposition: home with service facility: hospice of the discharge diagnosis: primary: deep venous thrombosis, intracerebral hemorrhage, metastatic melanoma secondary: hypertension, peripheral vascular disease discharge condition: minimally responsive, discharged to home with hospice discharge instructions: you came to the hospital because of clots in your legs. after receiving medications to thin your blood, you had bleeding in your brain around your cancer. you are going home with hospice. all of your medications were stopped except things to make you comfortable. followup instructions: please follow up with your hospice providers. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube diagnoses: acidosis pure hypercholesterolemia unspecified essential hypertension acute kidney failure, unspecified unspecified glaucoma hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) intracerebral hemorrhage pulmonary collapse acute respiratory failure secondary malignant neoplasm of brain and spinal cord cerebral edema long-term (current) use of anticoagulants acute venous embolism and thrombosis of deep vessels of proximal lower extremity melanoma of skin, site unspecified 

Answer: The patient is high likely exposed to