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: the patient is a 75-year-old, portuguese female, with a past medical history of hypertension, who presented to the trauma service as a trauma plus on . this was activated secondary to the fact that the patient's mechanism of injury was a large tree branch that had fallen and struck her head hitting her in the back of her head and knocking her down. she had an obvious open left ankle fracture, as well as a deformed left forearm confirming radius and ulnar fractures. she was minimally responsive in the field, was intubated, and brought in by . past medical history: notable for just hypertension. medications on admission: diltiazem sr 360 mg p.o. q.d., potassium supplement. allergies: no known drug allergies. social history: she lives with her daughter. she is widowed. she has multiple children. she is otherwise high functioning at baseline. she does not smoke or drink. family history: noncontributory. review of systems: otherwise unremarkable and not obtainable at the time of this discharge note; she was well however up until the timing of this event. physical examination: vital signs: on presentation temperature was 98.5??????, heart rate 83, blood pressure 130/60, she was vented with an oxygen saturation of 100% on the vent. heent: pupils were and sluggish and reactive. her midface was stable. she had an obvious large scalp deformity. oropharynx was otherwise satisfactory with endotracheal tube in place 21 cm at the lip. trachea was midline. there was no neck crepitus. chest: stable. there was no stepoff deformity. she had equal breath sounds bilaterally. abdomen: soft. could not assess tenderness. her fast exam in the trauma bay was otherwise negative. extremities: pelvis was stable. she had an obvious open fracture with the tibia exposed of the tibiotalar joint complex at the left ankle. there was no active bleeding. she did have a palpable but thready distal dorsalis pedis pulse. her posterior tibial pulse however was not obtainable. the foot was somewhat cool however was not cyanotic. capillary refill was somewhat delayed at 3-4 sec. her left upper extremity had an obvious deformity; however, her radius and ulnar arteries were easily palpable. her fingers were a little bit dusky, but capillary refill again delayed. all extremities were somewhat cool, and she was somewhat clamped. upon rolling, she had multiple abrasions but no stepoff or deformity. she had abrasions across the kyphotic upper thoracic spine noted. rectal: loose tone. no mass. guaiac negative. genitourinary: unremarkable. a foley catheter had been placed. the patient thereafter was brought to the operating room where an emergent scalp laceration repair and exploration was done. prior to going to scan, she did get a ct of her head, at which time she actually began to move more. her initial gcs was 3t in the trauma bay. this rapidly improved to a 10t while in the ct scanner. she was able to localize and follow commands and open her eyes spontaneously. ct scan of the head revealed no intracranial injury or fracture. she had an obvious hematoma and laceration to her scalp noted by these films. ct of her cervical spine was somewhat limited by motion but was otherwise negative. a tls survey was initially read as possible wedge compression fracture of t11. ct of chest and abdomen were without any obvious visceral injury. catalog of her injuries at this time showed that she had what looked like a large occipital scalp avulsion/laceration, no active exsanguination. she had an obvious left arm deformity confirmed by plain films to show a distal radius and ulnar fracture, but this was a closed fracture. she had an obvious open fracture of the left lower extremity at the tibia and fibula involving the tibiocalcaneal complex of the left ankle. this was reduced and splinted in the trauma bay by the orthopedic service. she was then whisked off to the operating room where her left ankle was washed out. she had previously received tetanus, kefzol, and gentamicin. her scalp flap was also washed and repaired. she received a two-layer closure, interrupted to the deep suturing to the galea aponeurotica and then skin staples thereafter. the orthopedic portion of the procedure was open reduction and internal fixation of her left upper extremity and lower extremity were completed. please refer to dr. dictation noted for further details regarding that procedure. she was left intubated and sent back to the trauma intensive care unit over night. she required some volume. she had been transfused at least 2 u of packed red blood cells on . she did not require any further transfusions. by postoperative day #1, hospital day #2, she was on kefzol and gentamicin periprocedurally per the orthopedic service. repeat ct of the head was done on the following day which again showed no evidence of bleeding or intracranial injury. at this time she was moving all four extremities and actually following commands. we opted to extubate the patient at this time. she did quite well and progressed quite well. her cervical collar was then cleared over the next 48 hours. she was kept on logroll precautions, and follow-up mrs the cervical spine revealed in fact a possible acute compression fracture at t11. at this time consultants with dr. of the neurosurgical service recommended a fitting and tlso bracing. she did have some mild degree of agitation within the first 24 hours on the floor requiring a 1:1 sitter and intermittent haldol; however, her mental status rapidly improved to the point of where she was discontinued from her sitter. she was only receiving p.r.n. tylenol and percocet for pain control. she was placed on an aggressive bowel regimen. she was placed back on her diltiazem 360 mg sr q.d. for blood pressure maintenance. her fractures were healing well, and the orthopedic service was following for dressing care to her left lower extremity. she ultimately received a short-leg cast on . her weightbearing status was determined to be nonweightbearing on the left lower extremity and upper extremity. she may bear weight on her left elbow. her right upper and lower extremity were full weightbearing. she was participating with physical therapy and wearing a tlso brace per the recommendations of the neurosurgical spine consultation with dr. . she was deemed appropriate and stable for discharge on . prior to her discharge, her lab test on , revealed a white count of 7.5, hematocrit 28.3, and platelet count 269. this was otherwise stable. her chemistries at this time were a sodium of 138, potassium 3.9, chloride 102, bicarb 29, bun and creatinine 11 and 0.6, glucose 102, magnesium 2.0. she had received ekgs during her hospitalization which were otherwise normal. she was on telemetry during her intensive care unit stay and for several days on the floor, and there was no apparent electrocardiogram activity. she otherwise looked quite well clinically and was discharged to acute rehabilitation. discharge medications: diltiazem sr 360 mg p.o. q.d., lovenox 30 mg subcue q.12 while in rehabilitation, protonix 40 mg p.o. q.d., colace 100 mg p.o. b.i.d., tylenol 325 mg p.o. q. p.r.n., percocet 5/325 p.o. q. p.r.n., she should be on a sliding scale insulin regimen as well to check her fingersticks, as she did have some mild stress-induced hyperglycemia, it was unclear of whether or normal the patient had some undiagnosed type 2 diabetes, however, this did not come with her admission information from her family, and she was not on any outpatient insulin regimens or oral hypoglycemics. discharge diagnosis: status post tree branch falling on head and back with long bone fractures, possible closed head injury with concussion only, no obvious intracranial lesion by ct scans times two, massive occipital scalp laceration and avulsion status post washout and repair on , closed left radius and ulnar fracture status post open reduction and internal fixation on , with dr. of the orthopedic surgery service, status post washout and stabilization of left open tibial and fibula fracture of left lower extremity, possible recent acute compression fracture of t11 vertebra which is stable. major invasive procedures: 1. exploration and washout of the occipital scalp laceration and avulsion with dr. of the trauma surgical service; please see the dictation of the operative note for further details. 2. status post washout and stabilization of left lower extremity open tibia and fibula fracture with dr. . 3. status post open reduction and internal fixation of left upper extremity radius and ulnar fracture. treatments and frequency: she will require aggressive physical therapy, feeding assistance, and occupational therapy evaluation as a rehabilitation patient. her diet should be as tolerated. she has no evidence of clinical aspiration. follow-up: 1. she will be seen in the trauma clinic one week from the time of discharge for skin clip removal from her scalp laceration; call for outpatient clinic appointment. 2. she should call dr. neurosurgical service and be seen in weeks for her t11 compression fracture, wear her tlso brace in the interim. it is not clear if the patient will require any further imaging as an outpatient. this can be coordinated with her follow-up plan with dr. by calling the office at . 3. the patient is to follow-up with dr. of the orthopedic trauma service; follow-up is in weeks; call . discharge instructions: the patient at this time is deemed appropriate for discharge. she will be discharged and follow-up as noted above. her weightbearing activity will be nonweightbearing to the left lower extremity, nonweightbearing to the left upper extremity; however, she may weightbear on the left elbow. she will wear her tlso brace for her t11 compression fracture. she has full weightbearing privileges of right upper and lower extremity. , m.d. dictated by: medquist36 procedure: debridement of open fracture site, tibia and fibula open reduction of fracture with internal fixation, tibia and fibula closure of skin and subcutaneous tissue of other sites open reduction of fracture with internal fixation, radius and ulna diagnoses: urinary tract infection, site not specified unspecified essential hypertension open wound of scalp, without mention of complication struck accidentally by falling object other alteration of consciousness bimalleolar fracture, open closed fracture of unspecified part of radius with ulna 

Answer: The patient is high likely exposed to