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: agitation, s/p fall with right shoulder dislocation major surgical or invasive procedure: right shoulder close reduction under anesthesia on history of present illness: 64 yom with history of iddm, seizure d/o, had fall at home last night. has fairly frequent falls per wife ( x month), especially when taking excess benzos (per wife, will often go through a one month prescription in 10 days). last night fell and told wife to call 911; initially at mwmc where found to have right shoulder dislocation. they were unable to reduce (given etomidate for sedation) thus transferred to . also unable to reduce in our ed. while in the ed, noted to be confused and intermittently agitated. took to or for closed reduction under sedation, post intervention pt severely agitated and combative. given risk for damage to shoulder joint, patient was intubated and sedated. in the pt was also found to have groin and scrotal wounds and was given antibiotic. central line place as no other access available. past medical history: hypertension s/p cva ***per va neuro, some sxs c/w parkinson's --> sinnemet*** (avoid anti-dopa agents!) depression anxiety ptsd social history: pt is married and lives with his wife. has many psych hospitalizations for depression overtakes home benzos (i.e., full month of klonopin gone in 10 days). he states to smokes occ and denies using alcohol. family history: nc physical exam: vitals: t: 96.8 bp: 110/52 p: 62 o2 100% on ac 550/15 peep 5 fio2 0.5 general: sedated heent: sclera anicteric, mmm, oropharynx clear, pupils 2 mm reactive to light neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema, right arm in orthopedic sling pertinent results: admission labs: 08:00am blood wbc-26.4*# rbc-4.61 hgb-11.7*# hct-35.8*# mcv-78* mch-25.3* mchc-32.6 rdw-14.4 plt ct-448*# 08:00am blood neuts-87.3* lymphs-10.1* monos-2.1 eos-0.1 baso-0.3 08:00am blood plt ct-448*# 09:29am blood pt-13.6* ptt-26.9 inr(pt)-1.2* 08:00am blood glucose-148* urean-18 creat-1.2 na-136 k-4.5 cl-99 hco3-26 angap-16 08:00am blood alt-21 ast-62* ld(ldh)-417* ck(cpk)-1748* alkphos-109 totbili-0.3 08:00am blood ck-mb-17* mb indx-1.0 08:00am blood calcium-8.5 phos-4.4 mg-1.7 08:30pm blood %hba1c-10.8* eag-263* 08:00am blood tsh-0.94 02:40am blood crp-100.2* 08:43am blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg micro data: - swab wound culture- swab source: right groin cyst. wound culture (preliminary): results pending. blood culture blood culture, routine-pending inpatient blood culture blood culture, routine-pending inpatient urine urine culture-final inpatient blood culture blood culture, routine-pending inpatient mrsa screen mrsa screen-pending inpatient blood culture blood culture, routine-pending inpatient urine urine culture-**final report ** urine culture (final ): no growth. imaging: forearm (ap & lat) right study date of 4:53: right shoulder, two views; right elbow, two views: the humeral head is located anteriorly and inferomedially to the glenoid fossa difficult to assess on the axially view. there is a lucency through the glenoid fossa concerning for a fracture. there is an large bone fragment proximal to this lucency suggestive of a greater tubercle fracture the acromioclavicular joint appears intact. no rib fractures are visualized in the field of view. the upper lung visualized appears normal. impression: 1. right shoulder dislocation with greater tubercle fracture and possible fracture of the glenoid fossa. 2. chondroid lession of the humeral head. ct head w/o contrast study date of 6:46 am non-contrast head ct was performed. there is no intracranial hemorrhage, and no parenchymal edema or mass effect. prominence of the sulci and ventricles, most likely reflects parenchymal atrophy. there is minimal periventricular white matter hypodensity, compatible with sequelae of chronic small vessel infarction, and a more focal lacunar infarct in the left centrum semiovale. there is no shift of normally midline structures, and the basal cisterns are preserved. -white matter differentiation is preserved, without ct evidence of acute large vascular territory infarction. there are no acute fractures identified. deformity of the left zygomatic arch may reflect prior trauma. there is partial opacification of the left mastoid air cells, without apparent temporal bone fracture. mucus retention cystversus polyp is seen in the left sphenoid sinus. the remainder of the paranasal sinuses are normally aerated. impression: 1. no acute intracranial process, including no hemorrhage. 2. partial opacification of the left mastoid air cells. no evidence for fracture. deformity of the left zygomatic arch, without associated soft tissue contusion, may reflect chronic injury. 3. parenchymal atrophy and mild chronic small vessel infarcts.medial temporal atrophy. ct c-spine w/o contrast study date of 6:47 am impression: no definite fracture or traumatic malalignment involving the cervical spine. degenerative at c4-5 and c5-6 is noted, with posterior disc osteophyte causing moderate canal stenosis at c4-5, and some anterior disc space widening at c5-6 with fragmented osteophytes, which appear well corticated and likely chronic. there is no prevertebral soft tissue swelling. ct up ext w/o c study date of 7:21 am findings: there is anterior inferior dislocation of the humeral head which lies inferior to the glenoid. there is a comminuted fracture of the greater tuberosity with superior lateral displacement. the fracture fragment measures 3.4 x 2.2 cm (series 2:30). the glenoid is grossly intact. there are mild degenerative changes. a chondroid lesion is seen within the humeral head, suggestive of an enchondroma. there is a large lipohemarthrosis. this examination is not dedicated to evaluation of the soft tissues. there is edema and hematoma within the adjacent muscles. the supra- and infra-spinatus tendons insert upon the greater tuberosity fracture fragment. the visualized lung fields demonstrate dependent atelectasis. impression: 1. anterior inferior glenohumeral joint dislocation with humeral head lying inferior to the glenoid. 2. 3.4 cm displaced greater tuberosity fracture fragment. ct abdomen w/o contrast study date of 5:16 pm ct abdomen: the heart is top normal in size. there is atherosclerotic calcification of the coronary arteries. there is a trace amount of pericardial fluid. bibasilar airspace disease is identified, right greater than left. the spleen, liver, adrenal glands, gallbladder, pancreas, and kidneys are normal in appearance given lack of intravenous contrast. incidentally noted is a small duodenal diverticulum. the remainder of the bowel is unremarkable in appearance with no evidence of bowel obstruction or bowel wall thickening. calcification is noted within the descending aorta. there is no retroperitoneal or mesenteric lymphadenopathy. no free air or free fluid is noted in the abdomen. ct pelvis: there are no pelvic masses or lymphadenopathy. calcifications are noted centrally within the prostate gland. a tiny focus of air is noted within the bladder which may be related to recent foley catheterization. the seminal vesicles and rectum are normal in appearance. several prominent left inguinal lymph nodes are identified which are not enlarged by size criterion. the penile urethra appears dilated proximally with an abrupt termination of the dilation distal to the external catheter. there is a tiny punctate calcification within the right scrotal sac. further evaluation with ultrasound is recommended if there isclinical concern for scrotal abscess. no air is noted within the scrotum/perineal soft tissues. no focal fluid collection is identified within the pelvis or inguinal regions. ct bone windows: no suspicious lytic or sclerotic lesions are identified. mild degenerative change is noted within the lumbar spine. impression: 1. no evidence of pelvic abscess or air within the perineal soft tissues. a scrotal ultrasound may be obtained for further evaluation of the scrotal contents and is planned for the following day. 2. dilated proximal penile urethra which abruptly terminates at the point distal to the external catheter. 3. bibasilar airspace disease, right greater than left. cxray on : findings: cardiomediastinal contours are stable in appearance. worsening atelectasis at right lung base, accompanied by small right pleural effusion. improving aeration in left lung base with better visualization of left hemidiaphragm. remainder of lungs are grossly clear. brief hospital course: 1. pneumonia: treated with vanc/zosyn for a total of seven days. 2. mental status change: most likely acute delirium due to sedating medication effect versus infection/pneumonia. patient's sensorium cleared upon arrival to the general medicine floor, and he was oriented x 3 and able to state the days of the month backward with minimal difficulty. he was continued on ciwa with short acting ativan for two days, but did not require any ativan. he was also continued on his home clonazepam, fluoxetine, keppra, and carbidopa-levodopa. antispychotics were avoided given history of mild parkinsons disease. 3. shoulder dislocation: fall thought to be secondary to klonopin in excess. underwent closed reduction glenohumeral dislocation and closed treatment greater tuberosity fracture on . post-op was non-weight bearing status, in sling. he did have persistent weakness and mild sensory deficit in the right hand and required significant physical therapy. the patient requires a walker to walk and therefore is unable to ambulate independently given the ability to only use 1 arm for the walker. 4. seizure disorder: controlled with keppra, no witnessed seizures this admission. 5. hydratinitis suppurativa of groin: planned treatment with doxycylcine for 6 months (to be complete in ) 6. leukocytosis: despite treatment for presumptive hospital acquired pneumonia and hydratinitis, remained elevated. afebrile without signs of infection. 7. hypertension: discharged on lisinopril and amlodipine. 8, diabetes: discharged on nph 22 u qam and nph 12 u qpm and humalog sliding scale, his bg were very well controlled on this regimen, he had been on much higher doses at home and the differences in insulin requirements are likely due to change in dietary intake. medications on admission: home meds (per wife, then confirmed with va list) prozac 40 mg daily atenolol 75 mg daily amlodipine 10 mg daily asa 81 levetiracetam 500 mg doxazosin 4 mg daily carbidopa/levidopa 25/100 1 tab tid calcium, vitamin d hctz 25 lisinopril 40 mg daily klonopin 0.5 mg daily ambien 10 nph insulin 60-65 units qam, 60 units qhs travoprost eye drops both eyes discharge medications: 1. levetiracetam 500 mg tablet sig: one (1) tablet po bid (2 times a day). 2. carbidopa-levodopa 25-100 mg tablet sig: one (1) tablet po tid (3 times a day). 3. fluoxetine 20 mg capsule sig: two (2) capsule po daily (daily). 4. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 5. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 6. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). 7. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 8. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 9. clonazepam 0.5 mg tablet sig: one (1) tablet po daily (daily). 10. oxycodone 5 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 11. doxycycline hyclate 100 mg capsule sig: one (1) capsule po q12h (every 12 hours): for 6 months. 12. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 13. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 14. acetaminophen 500 mg tablet sig: two (2) tablet po q 8h (every 8 hours): for 1 additional week. 15. lisinopril 20 mg tablet sig: two (2) tablet po daily (daily). 16. insulin regular human 100 unit/ml solution sig: as directed units injection four times a day: nph 22u qam, nph 12u qpm. humalog sliding scale with 2u humalog starting at bg of 151-200. discharge disposition: extended care facility: discharge diagnosis: 1) shoulder dislocation and fracture s/p reduction 2) diabetes 3) seizure disorder 4) leukocytosis 5) hiadrenitis supporitiva 6) possible hospital acquired pna discharge condition: stable, pain and mobility improving discharge instructions: you were admitted following a fall and dislocated and fractured your shoulder. you had a reduction of your shoulder, but this was complicated by nerve injury. you werea also noted to have an elevated white count. followup instructions: department: orthopedics please call for an appointment within 2 weeks of your discharge from the hospital. , please follow up with your primary care physician 4 weeks of your discharge from the hospital. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified closed reduction of fracture without internal fixation, humerus closed reduction of dislocation of shoulder diagnoses: pneumonia, organism unspecified thrombocytopenia, unspecified unspecified essential hypertension unspecified fall unspecified transient mental disorder in conditions classified elsewhere epilepsy, unspecified, without mention of intractable epilepsy diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled closed fracture of greater tuberosity of humerus injury to brachial plexus closed dislocation of shoulder, other 

Answer: The patient is high likely exposed to