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: no known allergies / adverse drug reactions attending: chief complaint: diving accident major surgical or invasive procedure: cervical laminectomy and instrumented fusion c4-c5 with allograft and allograft; open treatment cervical fracture dislocation inferior venacavagram, ivc filter insertion with fluoroscopy; percutaneous gastrostomy percutaneousendoscopic (peg); tracheostomy percutaneous history of present illness: the patient is a 43-year-old male who by report had a diving accident on the afternoon of , in . this was unwitnessed. he was removed from the pool by his companion and resuscitated by paramedics at the scene. he was brought to an outside hospital, hospital in , where it was recognized that he likely had a cervical spinal cord injury and imaging demonstrated fracture dislocation c4-c5. he was subsequently transferred by helicopter to for tertiary trauma care evaluation for definitive spinal management. past medical history: asthma social history: lives with fiance and 2 children in family history: noncontributory physical exam: upon presentation to : general: intubated, on propofol and vecuronium; c-collar in place, backboard; unresponsive; examined a second time when off propofol/vecuronium heent: pupils 3mm, very slight response neurologic examination: no reflexes elicited bue, ble; no response to or babinski; no rectal tone. pertinent results: 07:00am blood wbc-5.2 rbc-3.41* hgb-10.8* hct-32.0* mcv-94 mch-31.8 mchc-33.8 rdw-14.4 plt ct-269 01:00pm blood plt ct-296 imaging: (cxr) - no ptx, no effusion, no mediastinal widening (c-spine osh) - c4-5 subluxation fx (ct head osh) - (reportedly) negative (mri c-spine) - 1. intramedullary cord signal abnormality spanning the levels of c2-c6, most compatible with cord edema and with a more focal heterogeneous component which expands the cord at the level c4-c5 that raises the possibility of underlying intramedullary focal hemorrhage/hematoma. 2. status post c4-c5 posterior fusion with improvement in previously noted acute malalignment. 3. strongly suspected disruption of the posterior longitudinal ligament. c4-c5 disc protrusion with superior extrusion of contents demonstrated immediately posterior to the c4 vertebral body which at this point results in elevation of the posterior longitudinal ligament and abuts the ventral aspect of the spinal cord. (kub - peg contrast scan): no contrast extrav (cxr): desaturation and increased fio2 with right lung base consolidation on cxr - bronchoscopy with bal (bronchus intermedius bal and rll bal with left bal) performed; patient started on vanco/zosyn/cipro for suspected vap. (cxr): rll pneumonia, unchanged pneumoperitoneum (renal us): normal renal ultrasound (2d-echo): lvef 65%. suboptimal image quality. no definite vegetations. no as. (cxr): interval worsening of rll pna w/ new opacity in the lingula suggests ?sequelae of aspiration. (kub): contrast study peg w no extrav; +significant free air (ct torso): b pleural effusions, complete collapse of rll c/w consolidation, mod pneumoperitoneum likely d/t peg air leak, no e/o solid viscus perf, rounded focus of consolidation in lul likely infection (lenis): no evidence dvt (ct neck/torso): no fluid collxn, lymphadenopathy or bony destruction in neck. rll consolidation decr in size w/remaining rounded density c/w atelectasis. 6x5cm rim-enhancing fluid collxn in l obturator internus muscle, 2.5cm fluid collxn in l gluteux maximus likely phlegmon (cxr): there is a tracheostomy tube whose tip is 4.7 cm above the carina. lung fields are grossly clear. brief hospital course: mr. was taken the operating room by the ortho spine surgery team on by dr. to restore stability to his c4-c5 fracture. post-operatively, he was taken to the trauma icu for further care. he returned to the or on with dr. of the acute care surgery service for a peg, trach and ivc filter. his hospitalization by systems: neuro: mr. was noted to be paraplegic in the lower extremities with minimal function of the upper extremities. as noted, he was taken to the or on the day of his admission, for operative repair of his c4/c5 instability. his motor exam stabilized over the course of his icu stay with 3-4/5 strength in his bilateral biceps. he was continued on ativan for anxiety and dilaudid as needed for pain, both to decent effect. he did exhibit some brief periods of delirium in the initial days of his hospitalization as well as depression. psychiatry assessed and believed his delirium to be multifactorial in nature and to avoid psychiatric medications for the short term. his delirium did clear over the next few days. his depression was thought to be an appropriate response given the circumstances and he was started on antidepressant therapy and followed closely by social work during his stay who felt his coping was appropriate as well. he was kept in the c-collar for a period after his surgery and per ortho spine his c-collar was removed on . he is alert and oriented x3.currently he is out of bed to a motorized wheelchair; he has some movement in his bilateral upper extremities and is able to feed himself with assistive device. cv: he was initially in neurogenic shock, briefly on pressor support in the early days but able to be weaned off by hd 5. midodrine for blood pressure support was started on hd 4 and continued intermittently throughout his stay but was eventually stopped. at time of discharge, his blood pressures are stable ranging between 98-114 systolic. resp: given the nature of his spinal cord injury, he was intubated early in his hospitalization. he underwent tracheostomy on hd 3. early he had continued desaturation episodes and cxr imaging was concerning for mucous plugging. he was also noted to develop a right lower lobe consolidation, concerning for ventilator associated pneumonia, and he was started on broad spectrum antibiotic therapy consisting of vanc/cipro/zosyn on . he had several bronchoscopies in the icu showing a combination of mucous plugging and evidence of pneumonia. bal cultures were sent when appropriate. he continued to intermittently have episodes of mucous plugging requiring return to icu then step down unit and back to the regular surgical floor. these episodes decreased significantly over the course of his stay and at time of this dictation are no longer an active issue. his saturations ranging 97-98%. his trach was downsized so that he presently has a 6 fr cuffless, fenestrated in place. as he improves during his rehab course he should be able to be de-cannulated. gi: he underwent peg tube placement on hd 3, he was started on tube feeds (replete with fiber) which were advanced to goal without difficulty. on pod 2 from the peg placement, routine cxr showed large amount of pneumoperitoneum (he also spiked a temperature and showed signs of consolidation. his tube feeds were held and a tube contrast study was performed to rule out malposition or contrast extravasation and it was negative. pneumoperitoneum was demonstrated on multiple subsequent cxrs but this was consistent with the normal amount expected after peg tube placement and continued to decrease. his tube feedings were resumed. over the course of his stay he was evaluated by speech & swallow and was given an oral diet. his tube feedings are currently being cycled and he is on a regular diet and tolerating both without any difficulties. gu: he had a foley catheter initally and as he progressed he was switched to being straight catheterized every 6 hours. id: he was followed by infectious disease during his stay. as noted above, he was started on vanc/cipro/zosyn for presumed pna which was ultimately tailored after cultures from sputum/bal showed mssa. additionally he was started on micafungin on due to blood cultures growing yeast. as a result, an id consult was obtained and recommended echo, renal ultrasound and ophtho exam to rule out complications of fungemia. his echo showed no definite vegetations and normal ef%. his renal ultrasound was also normal and ophth exam unremarkable. heme: he has been receiving subcutaneous heparin since admission and should have his plt count monitored at lead every days. his most recent plt count was 296 on . an ivc filter was placed on hd 3. dispo: he was evaluated early on by physical and occupational who worked intensely with him. physiatry was also consulted who made some recommedations pertaining to pulmonary and cardiovascular treatments. rehab screening became challenging due to insurance issues but eventually he was accepted to a facility near his home. medications on admission: "asthma meds" discharge medications: 1. senna 8.8 mg/5 ml syrup sig: one (1) tablet po bid (2 times a day) as needed for constipation. 2. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 3. miconazole nitrate 2 % powder sig: one (1) appl topical (2 times a day) as needed for groin rash . 4. polyvinyl alcohol 1.4 % drops sig: 1-2 drops ophthalmic prn (as needed) as needed for dry eyes. 5. docusate sodium 100 mg capsule sig: one (1) capsule po daily (daily). 6. heparin (porcine) 5,000 unit/ml solution sig: one (1) ml injection tid (3 times a day). 7. trazodone 50 mg tablet sig: 1-2 tablets po hs (at bedtime) as needed for insomnia . 8. sertraline 50 mg tablet sig: one (1) tablet po daily (daily). 9. chlorhexidine gluconate 0.12 % mouthwash sig: fifteen (15) ml mucous membrane (2 times a day). 10. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q6h (every 6 hours) as needed for wheeze/sob. 11. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours). 12. bisacodyl 10 mg suppository sig: one (1) suppository rectal every other day (every other day) as needed for constipation. 13. lidocaine hcl 2 % gel sig: one (1) appl mucous membrane prn (as needed) as needed for for straight cath. 14. oxycodone 5 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for pain. 15. acetaminophen 325 mg tablet sig: two (2) tablet po every hours as needed for fever/pain. discharge disposition: extended care facility: discharge diagnosis: s/p diving accident: spinal cord injury - c4-c5 fracture dislocation respiratory failure pneumonia fungemia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to motorized wheelchair. discharge instructions: you were admitted to the hospital after a sustaining an injury to your spinal cord which required that you undergo an operation to fuse the area that was damaged. as a result of your injuries you were left with some paralysis in your extremities. while you have started to regain some function in your upper extrmeities you are going to require intensive long term physical therapy for continued progression. and for this reason you are being recommended to go to a rehabilitiation facility after discharge from the hospital. followup instructions: follow up in 4 weeks with dr. in clinic, call for an appointment. follow up in 4 weeks with acute care surgery, call for an appointment. md procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more interruption of the vena cava enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus repair of vertebral fracture other cervical fusion of the posterior column, posterior technique aspiration of other soft tissue fusion or refusion of 2-3 vertebrae insertion of recombinant bone morphogenetic protein diagnoses: friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site asthma, unspecified type, unspecified alcohol abuse, unspecified other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site nontraumatic hematoma of soft tissue ventilator associated pneumonia other candidiasis of other specified sites delirium due to conditions classified elsewhere traumatic shock accident from diving or jumping into water [swimming pool] foreign body in main bronchus inhalation and ingestion of other object causing obstruction of respiratory tract or suffocation adjustment disorder with depressed mood closed fracture of c1-c4 level with complete lesion of cord 

Answer: The patient is high likely exposed to