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: traumatic motor vehicle collision major surgical or invasive procedure: 1. placement of inferior vena cava filter. 2. fluoroscopic control for vena cava filter placement. 3. orif right posterior wall transverse acetabular fracture. 4. orif right proximal tibia unilateral fracture. 5. open reduction internal fixation of nasal orbital ethmoid fracture. 6. open reduction internal fixation of right zygomatic maxillary fracture. 7. open tracheostomy (#8 ). 8. open g-tube (#24 foley with 30 cc balloon). history of present illness: pt is a 64m who drifted into a 10-; he was a restrained driver with no loc. the patient oringinally presented to hospital and was subsequently transferred to for further care in the setting of multiple bony fractures, a splenic laceration, decreasing hematocrit, and questionable aortic rupture. he was intubated and sedated on arrival in the ed with a gcs of 3. past medical history: dmii htn depression hypothyroidism prostate ca gerd hyperlipidemia social history: lives with wife on . has three children. son is an internist at . occasional etoh, no tobacco, no recreational drug use. family history: noncontributory physical exam: vitals: 98.2/96.0 hr 78 bp 130/67 rr 20 sat 100 on trach mask wn/wd 64 y/o male in nad cv rrr, no m/r/g pulm cta b with transmitted upper airway noise, no obvious r/r/c abd nt/nd, (+) bs, g-tube site c/d/i ext warm and well perfused, rle in knee brace, no c/c/e neuro: overall improving strength and awareness eyes open spontaneously, will follow and show interest moves all four extremities spontaneously will follow simple commands babinski negative pertinent results: mr head w/o contrast: impression: 1. no acute intracranial abnormality; sphenoid sinus blood is redemonstrated. 2. no mr explanation for focal weakness. . cxr: impression: ap chest compared to : 1. tip of the tracheostomy tube is within 2 cm over the carina. lung volumes are low, but lungs are grossly clear. heart is mildly enlarged but stable. tip of the left subclavian line ends in the upper superior vena cava. tracheostomy tube is midline. . eeg: impression: abnormal eeg due to diffuse theta slowing with shifting asymmetries but no consistent or lateralized slowing. the record is consistent with a moderate diffuse encephalopathy. . ct chest abd pelvis: impression: 1. trach tube with its tip in the origin of the right main stem bronchus. 2. nondisplaced comminuted superior sternal fracture is unchanged. 3. multiple bilateral rib fractures. 4. right acetabulum hardware is new since . 5. grade 3 splenic laceration without evidence of extravasation. 6. unchanged appearance of focal dissection at the aortic arch. 7. slightly increased bilateral pleural effusions (now moderate) and pericardial effusion (small). . ct head: impression: no intracranial bleed or pneumocephalus but sinus fractures and likely hemorrhage in the maxillary sinus; please refer to the today's dedicated ct of the sinus for further details. . ct head: no ich or edema. complex facial fractures (nasal fractures, anterior ethmoid wall, bl maxilla, and bl inferior orbital) . cta chest/torso: focal aortic dissection distal to left subclavian artery. minimal mediastinal hematoma. small intramural hematoma involving left common carotid artery. grade iii splenic laceration. right acetabular comminuted fracture. . cta chest (repeat): new large right pneumothorax occupying approximately 50% of the hemithorax, with deep tissue air on the right. overall unchanged appearance of the focal dissection at the aortic arch with outpouching measuring 5 x 10 mm, representing possible small pseudoaneurysm just distal to the left subclavian artery takeoff, unchanged since prior . cxr: no ptx s/p chest tube removal; new left plate-like atelectasis mid lung zone, . ruq us: gb is unremarkable, no wall edema or pericholecystic fluid. liver with fatty infiltration. no intra- or extra-hepatic biliary dilatation. the portal vein is patent . cbc white blood cells 15.0* k/ul red blood cells 2.98* m/ul hemoglobin 9.2* g/dl 14.0 - 18.0 hematocrit 27.1* % 40 - 52 mcv 91 fl 82 - 98 mch 30.8 pg 27 - 32 mchc 33.8 % 31 - 35 rdw 16.8* % 10.5 - 15.5 platelet count 459* . 06:10am blood glucose-89 urean-26* creat-0.8 na-133 k-3.8 cl-101 hco3-21* angap-15 brief hospital course: the patient was admitted to the trauma team after preliminary evaluation. the patient was evaluated with ct scans, and orthopedics was consulted for evaluation of the right acetabular and rle fractures. neuro: the patient was intubated and sedated on arrival to the ed with a gcs of 3. follwoing extubation and cease of sedation, his neurologic status has made steady improvement over the course of his stay. he has become increasingly more aware of his surroundings with now all four extremities moving spontaneously, following of simple commands, and nodding yes to simple questions. he is babinksi negative. all head scans (mri, ct) have been nonfocal. his eeg was read significant only for moderate diffuse encephalopathy. . cv: vascular surgery was consulted for evaluation of aortic and carotid injury; a carotid ultrasound was performed, as well as a cta. he was put on strict blood pressure and heart rate restrictions, whcih were maintained with various antihypertensives and beta blockers with good result. no surgical intervention was deemed warranted. the patient's vital sign parameters were liberalized when appropriate with good result. at the time of discharge, mr. was restarted on his home po blood pressure medication with a standing breakthrough order for iv lopressor as necessary. his rate and pressure were within normal limits. . pulm: the patient was intubated and sedated for much of his icu stay. he failed to wean from the vent initially, and subsequently had a tracheostomy placed with no complications and good result. the patient was weaned as from the vent to trach mask. he was routinely evaluated with chest x-rays for pneumonia and other issues. the patient initially required a chest tubefollowing his accident for pneumothorax secondary to rib fractures. this chest tube was managed and removed in the standard fashion without complication. at the time of discharge, mr. was satting 100 percent on 0.35 fio2 trach mask with no issues. . prior to discharge, mr. was evaluated by speech and swallow with the following summary: summary: mr. placement of the pmv with stable vital signs and safe tracheal pressures, but made few attempts to speak his ms. the pt can wear the valve, but would suggest wearing it with supervision at this point. i also discussed with the mds that the pt may have a cuff leak as i attempted to inflate the cuff several times without success. there was no concern for aspiration of oral or pharyngeal secretions and he can likely tolerate an essentially cuffless trach at this time. . recommendations: . 1. always deflate cuff prior to placing the passy-muir valve! . 2. monitor o2 sats / respiration while valve is in place. . 3. do not allow the patient to sleep with the valve in place. . 4. pmv wear schedule is up to the discretion of the nurse and/or respiratory therapist. . 5. remain npo with continued tube feedings until pt's ms improves further. . gi: tube feeds were started when appropriate, and an open g tube was placed as the patient was tube feed dependent initially. the patient received motility agents such as reglan when his tube feed residuals were elevated with good result. mr. did stuggle intermittently with hypernatremia and osmotic diarrhea, which was resolved by decreasing his tube strength to normal and giving multiple free water boluses. at the time of discharge he was tolerating this regimen well and not requiring supplemental boluses. . gu: the pt's urinary output was closely monitored; he received colloid when appropriate, adn was diuresed when fluid overloaded. his electrolyte and metabolic status was routinely examined, adn treated if necessary. heme: the patient's hematocrit and coagulation profiles were monitored adn the pt received transfusions as necessary. the patient had episodes of epistaxis for which ent was consulted; he received afrin with good result. . id: the patient routinely spiked fevers, and was pan cultured during these episodes. he had positive sputum cultures for which he was put on antibiotics. he was routinely monitored for c. diff, and other signs of infection. at one point, his right ankle was noted to be erythematous, warm and edematous; ortho was consulted, however the cellulitic appearance gradually disappeared without treatment. uric acid levels at that time were normal. id was consulted, and the patient was put on prophylactic vanco for presumed c.diff infection as the patient was having copious bowel movements. . endo: the patient was put on an appropriate sliding scale insulin regimen to maintain blood glucose control. he was followed by the diabetes clinic with excellent blood sugar management. . musculoskeletal: the patient's r acetabulum was pinned and put in traction by orthopedics. a cast was put on his right wrist. the patient went to the operating room for an orif of the pelvis with ortho; for details, please see operative note. a wound vac was placed to the right hip and was removed at pod 10. . proph: the patient had an ivc filter placed and received dvt and gi prophylaxis throughout his stay. . other: the patient had multiple facial fractures which were repaired surgically by the pra/plastic surgery team. the patient was put on prophylactic antibiotics when appropriate. . medications on admission: atenolol 50' cymbalta 30" diovan 80' doxazosin 4' elavil 100 qhs glyburide 5" levoxyl 100mcg' neurontin 800" prilosec 20' zocor 20' discharge medications: 1. heparin (porcine) 5,000 unit/ml solution : 5000 (5000) units injection tid (3 times a day). 2. acetaminophen 325 mg tablet : two (2) tablet po q6h (every 6 hours) as needed for pain, fever. 3. artificial tear with lanolin 0.1-0.1 % ointment : one (1) appl ophthalmic prn (as needed). 4. influenza tri-split vac 45 mcg/0.5 ml suspension : one (1) ml intramuscular asdir (as directed). 5. therapeutic multivitamin liquid : five (5) ml po daily (daily). 6. bisacodyl 10 mg suppository : one (1) suppository rectal daily (daily) as needed. 7. docusate sodium 50 mg/5 ml liquid : ten (10) ml po bid (2 times a day). 8. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 9. senna 8.8 mg/5 ml syrup : one (1) tablet po bid (2 times a day). 10. ibuprofen 100 mg/5 ml suspension : twenty (20) ml po q6h (every 6 hours) as needed for fever. 11. levothyroxine 125 mcg tablet : one (1) tablet po daily (daily). 12. albuterol 90 mcg/actuation aerosol : two (2) puff inhalation q6h (every 6 hours) as needed. 13. albuterol sulfate 0.083 % (0.83 mg/ml) solution : one (1) treatment inhalation q6h (every 6 hours) as needed for wheezing. 14. ipratropium bromide 0.02 % solution : one (1) treament inhalation q6h (every 6 hours) as needed for wheezing. 15. valsartan 80 mg tablet : one (1) tablet po daily (daily). 16. doxazosin 4 mg tablet : one (1) tablet po daily (daily). 17. atenolol 50 mg tablet : one (1) tablet po daily (daily). 18. simvastatin 10 mg tablet : two (2) tablet po daily (daily). 19. duloxetine 30 mg capsule, delayed release(e.c.) : one (1) capsule, delayed release(e.c.) po bid (2 times a day). 20. amitriptyline 50 mg tablet : two (2) tablet po hs (at bedtime). 21. psyllium 1.7 g wafer : one (1) wafer po bid (2 times a day). 22. bacitracin zinc 500 unit/g ointment : one (1) appl topical tid (3 times a day). 23. insulin sliding scale: 0-60 mg/dl amp d50 61-120 mg/dl 0 units 121-140 mg/dl 6 units 141-160 mg/dl 9 units 161-180 mg/dl 12 units 181-200 mg/dl 15 units 201-220 mg/dl 18 units 221-240 mg/dl 21 units 241-260 mg/dl 24 units 261-280 mg/dl 27 units 281-300 mg/dl 30 units 301-320 mg/dl 33 units 321-340 mg/dl 36 units 341-360 mg/dl 39 units 26. insulin standing dose: glargine q24 hrs 50 units. discharge disposition: extended care facility: & rehab center - discharge diagnosis: right acetabular fracture right tibial plateau fracture grade ii splenic laceration left carotid hematoma type b focal aortic dissection vs. pseudoaneurysm discharge condition: stable, to rehab discharge instructions: please report to the ed for any of the following: shortness of breath, chest pain, increased work of breathing, fever > 100.5 f, persistent nausea and vomiting, increasing abdominal pain, increased drainage to your wound site or increasing redness, or obvious signs of infection. take your medications exactly as prescribed. attend all follow up appointments as scheduled. followup instructions: follow up with dr. , trauma surgery , in 2 weeks after your discharge. please call ( to schedule an appointment. follow up with dr. .k. , ortho trauma , in 2 weeks after your discharge. please call ( to schedule an appointment. md, procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more interruption of the vena cava enteral infusion of concentrated nutritional substances temporary tracheostomy closed endoscopic biopsy of lung open reduction of fracture with internal fixation, tibia and fibula open reduction of fracture with internal fixation, other specified bone other gastrostomy elevation of skull fracture fragments open reduction of malar and zygomatic fracture suture of laceration of nose other skin traction of limbs diagnoses: esophageal reflux unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism acute respiratory failure dissection of carotid artery intestinal infection due to clostridium difficile methicillin susceptible pneumonia due to staphylococcus aureus other motor vehicle traffic accident involving collision with motor vehicle injuring driver of motor vehicle other than motorcycle closed fracture of malar and maxillary bones closed fracture of upper end of tibia alone contusion of lung without mention of open wound into thorax closed fracture of multiple ribs, unspecified closed fracture of base of skull without mention of intra cranial injury, with no loss of consciousness closed fracture of acetabulum injury to spleen without mention of open wound into cavity, unspecified injury open wound of nose, unspecified site, without mention of complication 

Answer: The patient is high likely exposed to