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: history of present illness: mrs. is a 48 year old female who was the unrestrained driver in a motor vehicle accident where the car struck a tractor-trailer which was parked in the break-down . she was "partying" and was intoxicated at the time with ethyl alcohol and opiates on board. she was trapped within the vehicle and it was a difficult extrication. she was first brought to hospital in for stabilization. she underwent a preliminary workup there which included an inadequate cervical spine, chest x-ray which showed multiple left-sided rib fractures and an inadequate pelvis x-ray. no computerized tomography scans were performed. she denied any loss of consciousness and was medflighted to the directly from hospital for evaluation of multiple head and face injuries. she arrived at the with coma scale of 15 out of 15. past medical/surgical history: significant for chronic obstructive pulmonary disease, appendectomy, diverticulosis with diverticulitis, lower back pain, pilonidal cyst. medications on admission: prilosec, prinivil, albuterol and atrovent, serevent, and vicodin allergies: no known drug allergies. physical examination: on physical examination at the time she was afebrile with stable vital signs. in general she was obese, intoxicated with coma scale of 15. her head, eyes, ears, nose and throat examination was significant for a 10 to 15 cm laceration of the posterior scalp over the occiput through the galea down to the skull. she had right raccoon eye, right eyebrow 2 cm laceration, nasal bridge 1 cm laceration. her right pupil was reactive 3 to 2 mm. her left pupil was reactive 4 to 3 mm. her neck was in a cervical spine collar with the trachea midline. her chest was clear to auscultation bilaterally. she had no sternal tenderness. her cardiac examination was regular rate and rhythm. her abdomen was obese, nontender, nondistended. her pelvis was stable. her rectal was normal tone, no stools. her extremities, right shoulder demonstrated 1 to 2 cm laceration over the deltoid. her left and right upper extremities had full range of motion, 5/5 strength. her left and right lower extremity showed full range of motion with 5/5 strength. her left upper elbow had significant ecchymosis and tenderness. laboratory data: her admission hematocrit was 41.6 with white count of 21.7. her coags were within normal limits as were her chem-7 with a bun of 14, creatinine 0.6. her urine toxicology demonstrated opiates and alcohol. hospital course: at this time it was felt that this was a 49 year old female in an unrestrained motor vehicle accident who had sustained multiple soft tissue and likely skeletal injuries who was stable in the trauma bay. she was transferred to the computerized axial tomography scanner for further workup. a trauma series was first performed which was significant for the following: no pleural effusions or pneumothorax with clear lungs, no fractures documented. the patient was taken to the computerized axial tomography scanner where multiple radiographic studies were performed including a computerized tomography scan of the head which demonstrated no masses, midline shift or hemorrhage, normal ventricles, no extra axial fluid collections, significant right orbital soft tissue swelling with fractures of the lamina papyracea, medial orbital wall and opacification of the right-sided ethmoid air cells. there was intracaudal air as well as extracaudal air. a small portion of the medial rectus muscle was immediately adjacent to the lamina fracture and it appeared that it could be partially entrapped. there was opacification with bony fragments in the maxillary sinus, worrisome for an inferior orbital fracture. there was fluid within the sphenoid sinuses suggesting fracture fragments and of the sinus cells as well. bilateral nasal bone fractures were noted with slight medial displacement. there was also a fracture of the nasal septum. the globes were both intact. there was a large scalp laceration with subcutaneous emphysema and skin thickening and also a subgluteal hematoma within the right posterior higher convexities. the cervical spine was notable for no fractures or dislocations from c7 to t1. the prevertebral soft tissues were normal. there were multiple degenerative changes most pronounced at c4-5 and c5-6. the were visualized aspects of the cervical cord were unremarkable as were the lung apices. the patient subsequently underwent a computerized tomography scan of the torso and pelvis that was significant for the following: great vessels, trachea, esophagus and heart were unremarkable. there was a right-sided aortic arch noted. incidentally there was no mediastinal or hilar lymphadenopathy, no pleural effusion pneumothorax. there were bibasilar posterior opacifications suggestive of dependent atelectasis. there was no pneumothorax and no pulmonary infiltrates. the liver, spleen, pancreas, gallbladder, adrenals and kidneys were all normal. there was no free fluid. the pelvis demonstrated an intact bladder with no free fluid within the cul-de-sac. osseous structures were normal. there were no refractures noted. the patient underwent multiple radiographic films including the shoulder, chest and elbow as follows: the shoulder showed no fractures visible; the elbow demonstrated normal alignment and articulation without any fractures. the patient was transferred to the surgical intensive care unit for further observation. an ophthalmology consult was obtained. their evaluation was notable for no diplopia and no evidence of medial rectus entrapment. an oromaxillofacial surgery consult was obtained for the orbital fractures which requested a orbital computerized tomography scan for further evaluation and the patient was noted to have a very large scalp avulsion type injury which was irrigated in the intensive care unit with 1 liter of normal saline, infiltrated with lidocaine. the galea was reapproximated with interrupted 3-0 vicryl sutures. the skin was reapproximated with a combination of staples and 2-0 nylon sutures. also at that time, the right shoulder and right eyebrow lacerations as well as the nasal laceration were reapproximated using prolene. the patient also had a neurosurgery consult. a re-evaluation of the patient's computerized tomography scan demonstrated a right lamina process t9 fracture. for these reasons, the patient was placed on log-roll precautions. the patient was in the surgical intensive care unit for one day and was transferred to the regular floor on hospital day #2. she underwent an magnetic resonance imaging scan at this time of her thoracic spine which was inadequate. she was evaluated by neurosurgery who deemed that her thoracic spine could be cleared with flexion, extension views. she underwent flexion, extension views on hospital day #4 which were normal and hence her thoracic spine was clear. she also underwent a repeat computerized tomography scan of the orbits and sella which demonstrated both medial and inferior wall blow-out fractures. oromaxillofacial surgery was notified and the decision was made to have her follow up with dr. in his clinic during the following week for discussions about repair of the orbital fractures. the patient had been placed on clindamycin prophylactically for her fractures. at this point she was doing well, ambulating, tolerating a regular diet. it was felt that she was stable for discharge. her family was present and wanting to take her home. discharge medications: 1. prinivil 2. prilosec 3. albuterol 4. atrovent 5. serevent 6. vicodin discharge instructions: the patient was instructed to follow up in trauma clinic this coming thursday, phone . the patient was also instructed to follow up with dr. during the following week. she was discharged on a regular diet. discharge diagnosis: 1. status post motor vehicle accident, complicated by right orbital fracture and scalp avulsion as well as multiple soft tissue injuries 2. hypertension 3. chronic obstructive pulmonary disease 4. gastroesophageal reflux disease 5. diverticulosis discharge condition: the patient was discharged in stable condition. , md dictated by: medquist36 procedure: closure of skin and subcutaneous tissue of other sites diagnoses: chronic airway obstruction, not elsewhere classified alcohol abuse, unspecified open wound of scalp, without mention of complication closed fracture of dorsal [thoracic] vertebra without mention of spinal cord injury other motor vehicle traffic accident involving collision with motor vehicle injuring driver of motor vehicle other than motorcycle closed fracture of two ribs closed fracture of orbital floor (blow-out) closed fracture of nasal bones 

Answer: The patient is high likely exposed to