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: sdh with shift major surgical or invasive procedure: bolt icp monitor placement history of present illness: patient intubated and sedated, history obtained from record and patient's family mr. is a 21 y/o man with no pmh as per his family, who is transferred from osh for r sdh with shift. he was found by ems laying at the side of the road and was reportedly confused and combative. it is unclear exactly what happened to the patient, per notes he was struck by a car but he was not found to have any other injuries that would suggest this means of injury. he was intubated by ems at the scene. he was noted to have a blown right pupil at the osh and given this finding and the head ct, he was given mannitol 50 gm. at the osh, he was also loaded with dilantin and received 125 mg solumedrol, vecuronium 10 mg and ativan. he was transferred to for further management. past medical history: none social history: as per mother, he did not do any drugs. family history: unknown physical exam: on admission: o: t: 96.7 bp:119/57 hr: 80 r: on vent gen: laying in bed, intubated, sedated heent: r forehead hematoma. lungs: cta bilaterally anteriorly cardiac: rrr, s1/s2. abd: soft, nt, bs+ extrem: warm and well-perfused. neuro: mental status: intubated, sedated, unresponsive, no eye opening cranial nerves: pupils equally round and reactive to light 3 to 2.5 mm b/l, weak corneal reflexes, face symmetric, strong gag relfex. motor: initially was withdrawing all extremities to pain. however, he later appeared to have extensor posturing of his lue. no spontaneous movements. whole body jerking on initial assessment, ?myoclonus. reflexes: clonus at ankles b/l. toe upgoing on left and mute on right. on discharge: eo spontaneously. tracheostomy. cervical collar in place. moves right sided spontaneously. no movement lue, wd lle to noxious stimuli. pertinent results: ct head 1. since the prior examination, interval development of intraventricular hemorrhage at the junction of the cerebral aqueduct and fourth ventricle. stable ventricular size and configuration without evidence of hydrocephalus. 2. redistribution of a right subdural hemorrhage, which does not appear to be increased in size, and maybe slightly decreased. minimal to no leftward midline shift. slight medial prominence of the right uncus, very early uncal herniation cannot be excluded. 3. contrast limits evaluation, though within these limitations, new areas of linear high attenuation in the left frontal region and right sylvian fissure, may be due to subarachnoid hemorrhage vs contrast in vessel. attention at follow-up. 4. loss of sulcation (although young patient) suggests stable diffuse cerebral edema, with preservation of -white matter differentiation. ct head w/o contrast 1. right subdural hemorrhage, smaller and redistributed since the prior examination. it measures approximately 6 mm in maximal transverse dimension. 2. further washout of intravenous contrast with no convincing evidence of subarachnoid hemorrhage. 3. stable focus of intraventricular hemorrhage at the junction of the cerebral aqueduct/fourth ventricle with stable size and configuration of the ventricular system and no developing hydrocephalus. 4. some degree of diffuse cerebral edema with sulcal effacement- correlate with icp measurements. follow up as clinically indicated. ct head : 1. subdural hemorrhage along the right cerebral convexity is less extensive and decreased in density since most recent study of . no new focus of hemorrhage is noted. 2. right frontal approach intracranial pressure monitoring device is unchanged in position. ct c-spine no evidence of acute fracture or malalignment mri c-spine moderate upper cervical prevertebral soft tissue swelling, certainly could be posttraumatic in etiology. no sign of cervical cord injury. possible minimal traumatic disc injury at c6/7, as noted above. mri brain : the principal vascular flow patterns are identified. there is a very shallow (1 mm) residual right cerebral convexity subdural hemorrhage, overlying the right temporal and parietal lobes. there is moderate mucosal thickening and/or fluid within the mastoid sinuses, which presumably reflects the intubated status of the patient, as well as fluid accumulating within the nasal and oropharyngeal portions. there is a minimal degree of mucosal thickening seen within the sphenoid sinus. conclusion: extensive areas of restricted diffusion, of concern for anoxic damage. other findings noted above. cta neck : normal cta of the head and neck. ct head w/o contrast : continued diffuse cerebral edema. the apparent hyperdensity along sulci may be likely due to brain edema. no acute hemorrhage. cxr : opacification in the left lower lobe consistent with pneumonia lens no dvt markedly abnormal portable eeg due to the low voltage slow background. there were no prominent focal abnormalities, but encephalopathies may obscure focal findings. there were no definite epileptiform features. there was an occasional tachycardia. kub pfi: normal bowel gas pattern. brief hospital course: 21 y/o m found down on side of road by ems, ? of assault, presents from osh with r sdh and cerebral edema. patient was admitted to neurosurgery for further management. a bolt icp monitor was placed at bedside with opening pressure of 10. mannitol x1 was given at osh and d/t normal icp, no further mannitol was given. on examination, patient's pupils were perrla, eo to noxious stimuli and w/d all 4 extremities. on , patient's head ct showed improvement, icps still within normal range and exam unchanged. he is intubated and c-collar in place. he has also been febrile with tmax of 102.3. he was pancultured. on his dilantin level was 9.4. he required mannitol overnight for increase in icp's, as he was on a large amoumt of sedation. ct was performed and this was stable. his wbc count was 9.1 and he was febrile to 102 overnight. with increase in sedation, his icp was 15 in pm. on , his icp was well controlled and his bolt was removed and the ancef was discontinued. his sputum was thought to be cause of his fever. cultures were sent. he was cleared for sqh. mannitol was decreased to 75tid. a family meeting was held. and mri brain and c-spine were discussed. it was decided that if he was not awake enough to be extubated on he should have a trach/peg. his cta of the neck was a normal imaging study. on , the patient had a repeat ct for decreased mental status today, showing continued diffuse cerebral edema and hyper density along sulci likely due to brain edema. there was no evidence of hemorrhage. the patient continued to have a poor neurologic exam off propofol gtt. on , his exam remained unchanged off propofol sedation. fentanyl boluses were intermittently given for pain control and agitation. mannitol was discontinued. on , percutaneous tracheostomy was performed along with a peg tube for nutrition was inserted without issue. on , patient continued to have intermittent low grade fevers, with episodic hypertension and tachycardia. a bal was performed. empiric antibiotic coverage was initiated for ventilator-associated pneumonia as well as a uti. he was on cipro, vancomycin and cefepime. on he was tolerating a trach mask well and was transferred to the step down unit. on his fever curve was declining, he vanco trough was low so his dose was increased to 1gm tid. his bal grew out hflu so his antibiotics were tailored to only vanco and cefepime. on , patient was afebrile, had one episode of vomiting, a kub was order to evaluate for ileus. the was a normal gas pattern. he did not have constipation. he had some tachycardia with agitation overnight and ativan was ordered. hematuria overnight was treated with an irrigating cathter. this improved. he was discharged to rehab on . medications on admission: none discharge medications: 1. ibuprofen 100 mg/5 ml suspension sig: six hundred (600) mg mg po q8h (every 8 hours) as needed for fever. 2. metoprolol tartrate 25 mg tablet sig: three (3) tablet po tid (3 times a day). 3. hydralazine 20 mg/ml solution sig: ten (10) mg injection q6h (every 6 hours) as needed for sbp>160. 4. lorazepam 2 mg/ml syringe sig: 0.5 mg mg injection q6h (every 6 hours) as needed for agitation. 5. cefepime 2 gram recon soln sig: two (2) recon soln injection q12h (every 12 hours). 6. propranolol 10 mg tablet sig: one (1) tablet po tid (3 times a day). 7. hydromorphone (pf) 1 mg/ml syringe sig: 0.25 mg injection q6h (every 6 hours) as needed for pain. 8. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 9. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) units units injection tid (3 times a day). 10. acetaminophen 650 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for fever or pain. 11. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 12. vancomycin 500 mg recon soln sig: 1250 (1250) mg intravenous q 8h (every 8 hours). 13. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 14. docusate sodium 50 mg/5 ml liquid sig: one hundred (100) mg mg po bid (2 times a day). 15. insulin regular human 100 unit/ml solution sig: two (2) units injection asdir (as directed): see ssiv. 16. chlorhexidine gluconate 0.12 % mouthwash sig: fifteen (15) ml mucous membrane (2 times a day) as needed for oral care. discharge disposition: extended care facility: hospital - discharge diagnosis: r sdh cerebral edema anoxic brain injury respiratory failure vap discharge condition: mental status: confused - always. level of consciousness: lethargic but arousable. activity status: bedbound. discharge 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, aspirin, advil, or ibuprofen etc. 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. ?????? new onset of the loss of function, or decrease of function on one whole side of your body. **your cervical collar must be worn for a total of 3 months. followup instructions: follow-up appointment instructions ??????please call ( to schedule an appointment with dr. , to be seen in 4 weeks from the time of discharge. you will need a ct scan of the brain without contrast prior to your appointment. this can be scheduled when you call to make your office visit appointment you will need to wear your cervical collar for 3 months. you should return to the office at that time with a mri c-spine. md procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more other endoscopy of small intestine enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy closed [endoscopic] biopsy of bronchus intracranial pressure monitoring magnetic removal of embedded foreign body from cornea diagnoses: pneumonia, organism unspecified urinary tract infection, site not specified motor vehicle traffic accident involving collision with pedestrian injuring pedestrian compression of brain acute respiratory failure anoxic brain damage cerebral edema ventilator associated pneumonia subarachnoid hemorrhage following injury without mention of open intracranial wound, with prolonged [more than 24 hours] loss of consciousness without return to pre-existing conscious level subdural hemorrhage following injury without mention of open intracranial wound, with prolonged [more than 24 hours] loss of consciousness without return to pre-existing conscious level 

Answer: The patient is high likely exposed to