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: s/p fall major surgical or invasive procedure: : bedside placement of peg history of present illness: this is a 70 y/o man who had a fall from a ladder after presumed syncopal episode. per osh reports, mr. was working on a ladder, complained of light headedness and fell approximately feet. he was alert and oriented initially, but vomited three times en route to osh, where he had a gcs of 10. he was then intubated for airway protection, and prepared for to . upon arrival here, head ct was performed revealing a significant right sdh and basilar skull fracture. past medical history: hypertension, dyslipidemia social history: married, resides at home. family history: non-contributory physical exam: on admission: o: bp:148/108 hr:97 rr:18 o2sats:100%cmv gen: wd/wn, comfortable, nad. heent: periorbital ecchymosis, there are air bubbles appreciated behind the left ear; right tm appears to be intact pupils: perrl eoms: uta motor: minimal spontaneous movement of the upper extremities, withdrawal of the lower extremities to noxious nail bed pressure. cranial nerves: i: not tested ii: pupils equally round and reactive to light, 2mm to 1.5mm bilaterally. iii, iv, vi-xii: uta. reflexes: +gag, +corneals toes upgoing bilaterally exam on discharge: a&ox self, month, and year perrl 4-2mm bilaterally eoms: intact follows commands intermittently face symmetrical tongue midline rue: biceps and triceps, grip lue: biceps and triceps, grip ble: antigravity peg incision: c/d/i pertinent results: ct c-spine 1. no fracture or malalignment involving the cervical spine. 2. multilevel degenerative change most prominent at the level of c6-c7 with loss of intervertebral disc height, posterior disc-osteophyte complex, facet arthrosis and uncovertebral hypertrophy resulting in mild-to-moderate central canal stenosis and neural foraminal narrowing. this predisposes the patient to spinal cord injury with minimal trauma, and mri of the cervical spine should be considered for further evaluation of cord injury if clinically indicated. 3. basilar skull fracture involving the left occipital bone extending to involve the left occipital condyle and the left internal carotid canal within the petrous portion of the left temporal bone. recommend cta for further evaluation. 4. partially imaged is pneumocephalus involving the right temporal region as seen on concurrent ct examination. ct head : 1. extensive intracranial hemorrhage as detailed above with right cerebral convexity subdural hemorrhage measuring up to 11 mm, a small left frontal subdural hemorrhage measuring up to 4 mm, extensive right-sided cerebral subarachnoid hemorrhage, and likely component of intraparenchymal right frontal contusion. 2. multiple scalp hematomas involving the left occipital region, the right frontal region, and likely near the right frontal convexity. 3. left basilar skull fracture involving the left occipital bone with extension into the left occipital condyle and petrous portion of the left temporal bone, with involvement of the left internal carotid canal. recommend cta for further evaluation. 4. sinus opacification likely related to recent intubation ankle x-ray minimally displaced lateral malleolar fracture. small well corticated ossific density inferior to medial malleolus could represent sequelae of old trauma. cta neck : no evidence of vascular injury, thrombosis or aneurysm. the left basilar skull fracture involving the left occipital bone and extending into the left carotid canal is redomenstrated. the left carotid artery is suboptimally opacified in this region, however given symmteric appearance a focal intimal dissection is felt unlikely. ( ) echo the left atrium is normal in size. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thickness, cavity size, and global systolic function are normal (lvef>55%). due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. ct head 1. increase in the right inferior frontal intraparenchymal hemorrhage with mild increase in the leftward shift of the midline structures. 2. increase in the conspicuity of the subarachnoid hemorrhage in the left frontal and parietal lobes. persistent mass effect on the right lateral ventricle with mild increase in the leftward shift of the midline structures. 3. other details as above. please see the prior ct head study for details regarding the osseous structures. 4. unchanged appearance of the scalp soft tissue swelling, on the left side. mri c-spine : impression: 1. multilevel neural foramen narrowing as above. 2. posterior disc bulge at c6-c7 and c7-t1 levels without impingement on the cord or central canal stenosis. 3. incidental note is made of blood within the left cerebellar cistern. ct head : impression: re-demonstration of multifocal intracranial subdural, intraparenchymal, and subarachnoid hemorrhage. there is no new hemorrhage identified. right subarachnoid hemorrhage is somewhat less conspicuous than on prior study. there is continued mass effect upon the right lateral ventricle, and associated rightward shift of midline structures, again measuring approximately 1 cm. small amount of intraventricular blood is again identified in the occipital of the left lateral ventricle. there is no new hemorrhage or increased mass effect identified. lenis : conclusion: no evidence of dvt in the right or left lower extremity. cta chest : impression: 1. right upper lobe pneumonia. 2. no central pulmonary embolism. limited distal branch evaluation due to respiratory motion artifact. in a single posterior segment right upper lobe pulmonary artery, there is suggestion of a filling defect, although this opacity overlaps with adjacent airspace disease, and may be artifactual. brief hospital course: mr. was admitted to on . he was intubated and taken to the icu with q1hr neuro checks. ct imaging showed worsening hemorrhage. platelets were goiven for history of aspirin use. e was on dilantin for seizure prophylaxis. mri c-spine was performed on . he was see by orthopedics who recommended an air cast for his ankle. serial ct's remained stable. dr. cleared his cervical collar on . he was weaned toward extubation. repeat head ct on was stable. his mannitol was held due to na/osm parameters. he failed speech and swallow evaluation at the bedside and a dobhoff was placed. on his mannitol was discontinued. his foley was discontinued. he was transferred to the step down unit. his dilantin dose was increased for a corrected level of 6.1. the patient had tachypnea overnight but his oxygen saturation remained within normal limits. his neuro exam remained stable. during the day on his tachypnea became worse and his abg showed respiratory alkalosis. he continued to oxygenate well. lenis were negative for dvt. his rr went up to the 40s and he became more lethargic and stopped following commands. the repeat head ct was stable. he also spiked a fever of 102. due to suspicion of a pe and the tachypnea, he was transferred to the icu and had a chest cta on the way there. the cta was equivocal. the patient's head of bed was kept elevated and he had nasotracheal suctioning and he several mucus plugs were removed. he also had chest pt and his rr came down to the 20s. by his mental status improved and he was following commands again with the right side. additionally id was consulted to guide antibiotic managment for his pneumonia. a repeat speach and swallow evaluation was performed and unfortunately, he did not pass. therefore a general surgery consult was obtained. he was also transferred to the stepdown unit, where vancomycin increased to q8h. urine culture was negative from . sputum culture found to have normal flora. his dobhoff was replaced to restart tube feeds. peg was performed on to bridge his nutrition during his recovery. post-operatively, he was tachypneic and reintubated for respiratory managment. he was then transferred back to the icu. after being placed on cpap, his respiratory status improved, as it was thought his tachypnea was due to atelactasis and/or mucous plugs. a nchct was again performed; revealing persistant right acute on chronic sdh and evolving right frontal contusion. it was decided to take him to the operating room on to evacuate the right sdh to optimize his recovery. however, it was noted on morning rounds on , that he has much improved clinically(following commands, moving all extremities); so the or case was cancelled. the patient's mental status remained stable and he was successfully extubated on . he continued to do well neurologically and he was breathing on room air with no difficulty. therefore he was transferred back to the neuro step down unit. he continued to work with pt and ot and was screened for rehab. he is stable neurosurgically and respiratory wise and will be discharged to rehab on . medications on admission: lopid magnesium calcium asa discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for fever. 2. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 3. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 4. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 5. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: inhalation q6h (every 6 hours) as needed for wheezing. 6. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed). 7. levetiracetam 500 mg tablet sig: two (2) tablet po bid (2 times a day). 8. famotidine 20 mg tablet sig: one (1) tablet po q12h (every 12 hours). 9. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 10. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po tid (3 times a day). 11. hydralazine 10 mg iv q4h:prn sbp>160 , hr<100 hold for sbp<100 12. metoclopramide 10 mg iv q6h:prn nausea discharge disposition: extended care facility: discharge diagnosis: subdural hematoma subarachnoid hemorrhage skull fracture cerebral contusion minimally displaced lateral malleolar fracture hospital acquired pneumonia respiratory failure dysphagia hyponatremia discharge condition: neurologically stable discharge instructions: general instructions ?????? take your pain medicine as prescribed. ?????? exercise should be limited to walking; no lifting, straining, or excessive bending. ?????? 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, advil, and ibuprofen etc. you have however, already been restarted on your home dose of aspirin. ?????? you have been prescribed an anti-seizure medicine,keppra. you will not require any bloodwork to monitor this. you will continue to take this until you are seen in follow up ?????? call your surgeon immediately if you experience any of the following ?????? new onset of tremors or seizures. ?????? any confusion, lethargy 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. followup instructions: follow-up appointment instructions ??????please call ( to schedule an appointment with dr. , to be seen in 4 weeks. ??????you will need a ct scan of the brain without contrast prior to this appointment. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] closed [endoscopic] biopsy of bronchus diagnoses: acidosis unspecified essential hypertension hyposmolality and/or hyponatremia pulmonary collapse compression of brain other and unspecified hyperlipidemia acute respiratory failure pneumonitis due to inhalation of food or vomitus alkalosis accidental fall from ladder pneumonia due to klebsiella pneumoniae fracture of lateral malleolus, closed foreign body in respiratory tree, unspecified closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, with no loss of consciousness 

Answer: The patient is high likely exposed to