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: multitrauma major surgical or invasive procedure: : 1. right forearm and upper arm exploration with debridement of nonviable skin and muscle. 2. exploration of the brachial artery with restoration of blood flow to the radial artery. 3. repair of median nerve x 1 with tagging of the distal median nerve and the ulnar nerve endings. 4. forearm fasciotomy. 5. local advancement flap closure. 6. vacuum-assisted closure dressing. 7. bilateral catheters in aorta 8. bilateral lower extremity angiogram 9. bilateral lower extremity 4-compartment fasciotomies 10. ligation of transected left popliteal artery. 11. left above-knee popliteal to posterior tibial artery bypass graft with reversed right greater saphenous vein 12. bilateral lower extremity spanning external fixator placement from the femur to the tibia . 1. reexploration of right arm with repair of median nerve x1 and ulnar nerve x2, reapproximation of biceps muscle, extensor carpi ulnaris, flexor carpi ulnaris, local advancement flap closure of wound. 2. bilateral lower extremity washout with dressing changes, and partial closure left lower extremity wound . (disruption of left -tib vein graft) 1. ligation of vein graft and below-knee popliteal to proximal posterior tibial bypass with non reversed saphenous vein. 2. bilateral lower extremity removal of external fixator. 3. debridement of bilateral lower extremity fasciotomies 4. orif of left proximal tibia with lateral plating 5. orif proximal tibia rle with transverse 7.3 mm screw. 6. orif right segmental shaft fracture with intramedullary nailing 7. exploration left peroneal nerve . (bleeding in rue) 1. emergent right arm exploration 2. ligation of arterial bleeder. 3. median nerve repair with repair of previous neurorrhaphy . 1. percutaneous tracheostomy tube insertion 2. percutaneous endoscopic gastrostomy 3. placement of right femoral vena caval filter history of present illness: patient is a 43m firefighter directing traffic at mvc scene , hit by high speed passing car. had partial amputation of right arm, and bilateral leg deformity, and bleeding from head. arrived to ed in vfib arrest, and was successfully resuscitated after 28 minutes. intubated, bilateral chest tubes in ed. and taken to the operating room immediately for ex fix of bilateral le, bolt placment, and degloving injury of rue, and revascularization of lle with harvest of saphenous vein from right. past medical history: none social history: firefighter family history: no pertinent history physical exam: t 99.7 hr 96 bp 143/64 rr 14 spo2 100% on ac fio2 40 tv 600 peep 5 gen: unresponsive heent: perrla, eyes opening spontneously resp: tracheostomy, course breath sounds bilaterally. trach site without drainage or erythema cv: rrr, strong pedal pulses ab: soft, mildly distended, + bs. peg tube w/o drainage or erythema gu: foley in place ext: cast on rue, multipodus boots on bilateral le, bilat le wrapped with gauze dressing; pic on left arm, c/d/i skin: pressure sore on coccyx - stage 3, covered wtih tegaderm neuro: no gag response, + corneal response, no motor seizure activity pertinent results: cxr: small bilateral ptx s/p ct removal cxr: no interval change eeg: pending mri brain: findings consistent with hypoxic ischemic injury. no evidence of hemorrhagic diffuse axonal injury ct leg: occlusion of the left popliteal artery at the level of a fractured left tibial plateau. the above the knee left popliteal bypass graft is partially visualized and is patent. ct torso: large right sided pneumothorax. recommend repositioning of the right sided chest tube. tiny residual left sided pneumothorax ct head: grey white matter differentiation has become less distinct. marked increase in subcutaneous swelling likely secondary to volume resuscitation with unchanged right parietal subgaleal hematoma. ct c-spine: negative cxr: little change cxr: decrease size of r ptx ct head: negative cxr and pelvis: left calvicle fx brief hospital course: patient is a 43m firefighter who was directing traffic at the scene of a motor vehicle crash on , and was hit by high speed passing car. he suffered multiple injuries including a near-amputation of right arm, severe bilateral leg fractures, as well as head trauma. he arrived to the ed in vfib arrest, and was successfully resuscitated after 28 minutes. the patient was intubated, and had bilateral chest tubes placed in ed. he was taken to the operating room emergently for exploration of his right upper extremity degloving injury, external fixation of bilateral lower extremity fractures, bolt placment, and revascularization of left lower extremity with harvest of saphenous vein from right as well as bilateral fasciotomies. in the operating room the patient also underwent an exploratory laparotomy for a tense distended abdomen and falling blood pressure. by hospital day 2, when the patient returned from the operating room, he was hemodynamically stable and remained so throughout his hospitalization. however, his traumatic and anoxic brain injury caused profound neurologic injury portending an extremely poor prognosis. during his extended stay, the patient underwent numerous procedures and diagnostic tests. the following summarizes his course by system: . neuro: on the day of admission a cranial bolt was emergently placed with an opening pressure of 21, but without good wave form. ct scan: showed loss of grey white matter differentiation : the bolt was removed. he had an mri that day that showed findings consistent with hypoxic ischemic injury; no evidence of hemorrhagic diffuse axonal injury, however the radiologists also reported a tiny focus of signal abnormality in the left thalamus could potentially relate to a focus of non-hemorrhagic . of note, the patient suffered from convulsive and non-convulsive status epilepticus from approx until . he was placed on continueous eeg monitoring from until . to arrest his seizures, he required a phenobarbitol coma while optimizing anti-seizure mediations. he required an array of anti-seizure medications. numerous attempts were made to withdraw pentabarbitol before he was able to ween without return of seizures. he was weaned off pentobarb completely on . on the day of discharge, he was requiring several anti-seizure medications including dilantin, depakote, topamax, and keppra. . pulmonary: the patient was emergently intubated in ed. : the patient underwent percutaneous tracheostomy tube insertion. : the patient was weened to trach mask on the day of discharge, the was on on mechanical ventilation: assist control (volume targeted(tidal volume 600 cc rr 14, peep 5 fio2 40% ween to psv as tolerated . cardiovascular: in the initial resuscitation, the patient recieved multiple units prbc. : the patient underwent placement of a right femoral vena caval filter after the initial resuscitation, the patient remained hemodynamically stable. . gi: on , the patient underwent percutaneous endoscopic gastrostomy. nutrition: the patient's current tube feeding regimen is as follows - nutren pulmonary full strength with beneprotein 40 gm/day at rate of 65 ml/hr. check residual q4hr, and hold feeding for residual >100 ml. flush with 200 ml water q6hr . skin on , it was noted that the patient was developing a sacral decubitus ulcer (superficial level 2). we treated this with close wound site monitoring, continuous placement on kinair air matress throughout hospital course with meticulously frequent position changes. his nutrition was optimized with tubefeeding as well. . infectious disease: during his hospital course, the patient frequently spiked low grade and high fevers on many occasions. most of these were considered to be centrally mediated febrile responses secondary to his seizure activity and profound cerebral injury. empiric courses of antibiotics were given multiple times and cultures were positive on several occasions as outlined below. overall, it was felt that most of his fevers were central, and not infectious in nature. ancef begun prophylactically 7/5 blood cx - negative, sputum - h. flu start zosyn and vanc, stop ancef wound cx: 2+ pmls, 2+ gram - rods, bacilus sputum 2+ gram + cocci in pairs and clusters. 1+ gram - rods: staph aureus coag +. pending sensitivity and acinetobacter baumannii pansensitive sputum: 2+ pmls, 1+ gram - rods :sputum gram positive cocci and gram - rods. mrsa and e.coli sputum: gram + cocci and gram - rods, yeast. mrsa and gram - rods blood cx negative discontinued vancomysin and zosyn urine/sputum with gnr (klebsiella and e-coli) blood cx negative mrsa start cipro for ecoli sputum coag + staph, gnrs blood cultures negative x 2 urine culture negative sputum coag + staph, gnrs blood cultures negative x 2 urine culture negative stop cipro begin vanco for suspected line infection catheter tip neg blood cx pending begin cipro and cefepime for gnr in sputum sputum ngr and staph aureus, urine - no growth . extremities: the patient sustained a severe degloving/near amputation of his right upper extremity with neurovascular compromise. the patient also suffered a left leg popliteal artery transection and fractures that resulted in distal ischemia and muscle necrosis. his complex right lower extremity fractures also lead to distal ischemia. the treatment for these were extensive. on , the patient underwent: 1. right forearm debridement/fasciotomy with reattachment of radial artery 2. bilateral le 4-compartment fasciotomies 3. ligation of transected left popliteal artery. 4. left above-knee popliteal to posterior tibial artery bypass graft with reversed right greater saphenous vein 5. bilateral lower extremity spanning external fixator placement from the femur to the tibia . on , the patient underwent: 1. reexploration of right arm with repair of median nerve x1 and ulnar nerve x2, reapproximation of biceps muscle, extensor carpi ulnaris, flexor carpi ulnaris, local advancement flap closure of wound. 2. bilateral washout le with dressing changes, and partial closure lle wound . on , the patient's left lower extremity was found to have disruption of left -tib vein graft. he was taken emergently to receive: 1. ligation of vein graft and below-knee popliteal to proximal posterior tibial bypass with non reversed saphenous vein. 2. bilateral lower extremity removal of external fixator. 3. debridement of bilateral lower extremity fasciotomies 4. orif of left proximal tibia with lateral plating 5. orif proximal tibia rle with transverse 7.3 mm screw. 6. orif right segmental shaft fracture with intramedullary nailing 12x345 synthes. on , the patient was found to have acute bleeding in the right upper extremity, with frank blood coming from his incision site. he underwent: 1. right arm emergent exploration with ligation of arterial bleeder. 2. median nerve repair with repair of previous neurorrhaphy . . due to the prognosis that the patient was highly unlikely to have significant neurologic recovery, the fact that he could not acquire nutrition voluntarily, and was ventilator dependent, the following procedures were performed: 1. percutaneous tracheostomy tube insertion. 2. percutaneous endoscopic gastrostomy 3. placement of right femoral vena caval filter . social: numerous and extensive family meetings were held with the staff and the patient's family. the family understands that the patient has profound neurologic injury with extremely poor prognosis for neurologic recovery. nonetheless, the family continued to desire full treatment. on the ethic committee was consulted to offer advice on the patient's dispo and the family's wishes for care. the family's wishes were honored and extensive efforts were made to arrange for the patient to be placed in a rehabilitation facility. all of the family's questions and concerns were addressed. medications on admission: none discharge medications: 1. famotidine 20 mg tablet sig: one (1) tablet po q12h (every 12 hours). 2. artificial tear with lanolin 0.1-0.1 % ointment sig: one (1) appl ophthalmic prn (as needed). 3. levetiracetam 100 mg/ml solution sig: po qhs (once a day (at bedtime)). 4. levetiracetam 100 mg/ml solution sig: po qam (once a day (in the morning)). 5. acetaminophen 160 mg/5 ml solution sig: po q6h (every 6 hours) as needed. 6. ibuprofen 100 mg/5 ml suspension sig: po q8h (every 8 hours) as needed. 7. enoxaparin 30 mg/0.3 ml syringe sig: subcutaneous q12h (every 12 hours). 8. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po hs (at bedtime) as needed. 9. phenobarbital 100 mg tablet sig: three (3) tablet po tid (3 times a day). 10. docusate sodium 50 mg/5 ml liquid sig: po bid (2 times a day). 11. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day) as needed. 12. topiramate 100 mg tablet sig: one (1) tablet po 5x/day (5 times a day). 13. therapeutic multivitamin liquid sig: five (5) ml po daily (daily). 14. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 15. ferrous sulfate 300 mg/5 ml liquid sig: po daily (daily). 16. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). 17. phenytoin 100 mg/4 ml suspension sig: po q6h (every 6 hours). 18. insulin regular human 100 unit/ml solution sig: injection per iss as needed. 19. valproate sodium 250 mg/5 ml syrup sig: po q3h (every 3 hours). 20. papain-urea 830,000-10 unit/g-% ointment sig: appls topical daily (daily). 21. heparin lock flush (porcine) 100 unit/ml syringe sig: mls intravenous daily (daily) as needed. 22. vancomycin in dextrose 1 g/200 ml piggyback sig: intravenous q 12h (every 12 hours). 23. ciprofloxacin 400 mg/40 ml solution sig: intravenous q12h (every 12 hours). 24. cefepime 2 g recon soln sig: recon solns injection q12h (every 12 hours). discharge disposition: extended care facility: northeast - discharge diagnosis: 1)closed head injury 2)bilateral tibia/fibia fracture 3)right upper extremity degloving-closed by plastics and vac drain placed 4)bilateral lower extemity fasciotomy 5)right clavicle fracture 6)left lower extremity arterial injury 7)proximal humerus fracture discharge condition: stable to long-term care rehabilitation facility discharge instructions: continue mechanical ventilation: assist control (volume targeted(tidal volume 600 cc rr 14, peep 5 fio2 40% ween to psv as tolerated continue tube-feeds: nutren pulmonary full strength with beneprotein 40 gm/day at rate of 65 ml/hr. check residual q4hr, and hold feeding for residual >100 ml. flush with 200 ml water q6hr, and follow sodium continue wet to dry dressings on bilateral le, changed on coccyx continue accuzyme, and tegaderm dressing continue standard trach and peg care, as well as decubitus prevention. keep on air mattress. followup instructions: 1. please follow with dr. in trauma surgery. please call to make an appointment: (. 2. please follow-up with dr. and dr. in vascular surgery for your leg wounds. please call to make an appointment: (. 3. please follow-up with dr. in orthopaedic surgery for your leg fractures. please call to make an appointment: ( 4. please follow-up with dr. in plastic surgery for your right arm. please call to make an appointment:( 5. please follow-up with neurology service. please call to make an appointment . md, procedure: insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more diagnostic ultrasound of heart insertion of endotracheal tube interruption of the vena cava enteral infusion of concentrated nutritional substances other (peripheral) vascular shunt or bypass other (peripheral) vascular shunt or bypass exploratory laparotomy percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy fasciotomy fasciotomy fasciotomy other surgical occlusion of vessels, lower limb arteries other surgical occlusion of vessels, lower limb veins attachment of pedicle or flap graft to other sites suture of vein application of external fixator device, tibia and fibula open reduction of fracture with internal fixation, tibia and fibula open reduction of fracture with internal fixation, tibia and fibula transfusion of packed cells suture of artery cardiopulmonary resuscitation, not otherwise specified transfusion of other serum other suture of muscle or fascia other diagnostic procedures on brain and cerebral meninges other myectomy other myectomy other myectomy transfusion of platelets other irrigation of wound other immobilization, pressure, and attention to wound other neuroplasty other neuroplasty other neuroplasty transfusion of other substance other surgical occlusion of vessels, upper limb vessels video and radio-telemetered electroencephalographic monitoring diagnoses: pneumonia, organism unspecified urinary tract infection, site not specified acute posthemorrhagic anemia disruption of internal operation (surgical) wound motor vehicle traffic accident involving collision with pedestrian injuring pedestrian hemorrhage complicating a procedure cardiac arrest anoxic brain damage methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site grand mal status pressure ulcer, lower back closed fracture of one rib traumatic pneumothorax without mention of open wound into thorax injury to popliteal artery traumatic compartment syndrome of lower extremity mechanical complication of other vascular device, implant, and graft closed fracture of upper end of fibula with tibia intracranial injury of other and unspecified nature without mention of open intracranial wound, with prolonged [more than 24 hours] loss of consciousness without return to pre-existing conscious level other tracheostomy complications hemophilus influenzae [h. influenzae] infection in conditions classified elsewhere and of unspecified site injury to peroneal nerve injury to brachial blood vessels closed fracture of shaft of clavicle open wound of upper arm, with tendon involvement traumatic amputation of arm and hand (complete) (partial), unilateral, level not specified, complicated other open fracture of upper end of humerus injury to multiple nerves of shoulder girdle and upper limb 

Answer: The patient is high likely exposed to