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: pedestrian struck by car major surgical or invasive procedure: intubation, mechanical ventilation 1/13 r craniotomy and epidural evacuation ivc placement lle plate for tib fib fracture history of present illness: 35-year-old male pedestrian struck by a motor vehicle traveling at unknown speed, interactive at first then decreasing mental status. right ear, nose bleeding. taken to , intubated, given ffp for inr 1.4, transferred to for further management. found to have right edh, left sdh, sah, pneumocephalus, right temporal fracture, occipital fracutre, skull base fracture, right ica intimal flap, left superior and inferior pubic rami fractures, left tibial plateau fracture. admitted to the tsicu. past medical history: none social history: 1. home country: el . illegal immigrant with no insurance. bulk of family lives in . 2. husband in 3. denies tobacco or drug abuse family history: nc physical exam: on arrival: intubated vs: bp 118/46 hr 88 rr 12 sat. 100 gen: intubated, moving all extr heent: grossly disrupted r eac, blood in nasopharynx, c-collar, trachea midline, no jvd cardio: s1s2, rrr pulm: ctab, atraumatic : soft, nd, ventral ecchymoses pelvis: blood from perineum, no vaginal tears, rectal tone normal, guaiac positive ortho: back atraumatic, no deformities, extremities atraumatic, distal pulses palpable neuro: gcs e4, vt, m5: 9t pertinent results: 09:10pm urine blood-mod nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.5 leuk-neg 09:10pm urine rbc-* wbc-0 bacteria-none yeast-none epi-0 09:10pm wbc-19.0* rbc-3.67* hgb-10.2* hct-31.2* mcv-85 mch-27.8 mchc-32.7 rdw-14.1 09:10pm urine bnzodzpn-pos barbitrt-neg opiates-neg cocaine-neg amphetmn-neg mthdone-neg 09:10pm asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 09:11pm type-art po2-394* pco2-41 ph-7.41 total co2-27 base xs-1 intubated-intubated 10:41pm wbc-20.4* rbc-3.37* hgb-9.4* hct-28.5* mcv-84 mch-28.0 mchc-33.1 rdw-14.0 10:56pm type-art temp-38.9 rates-14/ tidal vol-500 peep-5 o2-100 po2-557* pco2-41 ph-7.41 total co2-27 base xs-1 aado2-136 req o2-32 -assist/con intubated-intubated ## ct orbit impression: multiple fractures as described above including right skull base fracture, temporal bone fracture extending to the nasopharynx. addendum: there may be a fracture fragment extending to the right jugular foramen. ## xr extremity and pelvis impression: 1. left lateral tibial plateau fracture. 2. fracture proximal left tibia. 3. fracture left superior and inferior pubic rami. ## ct cspine impression: no visualized cervical spine fractures. small bubble of air adjacent to the anterior arch of c1 and in the right parapharyngeal space, likely related to adjacent injuries, though there is no clear explaination of these findings on the given images. motion at c4-5, if this is an area of concern a repeat scan could be performed. ## ct head impression: left subdural hematoma, subarachnoid hemorrhage, and right epidural hemorrhage. brain edema and mass effect on basilar cisterns. occipital, parietal, and temporal bone fractures on the right with fluid/hemorrhage in the right mastoid and other sinuses. pneumocephalus. these findings were discussed with dr. at 10 pm. fracture extends across the jugular foramen and near the right carotid canal, as well ad through the skull base, and angiography may be warranted to evaluated for vascular injury. ## ct cerbral angio impression: traumatic dissection of the right internal carotid artery at the carotid bifurcation with a small raised intimal flap compromising approximately 40 to 50% of the cross-sectional luminal area. these findings were discussed with the trauma team. recommendations were made for repeat imaging with ct angiography or cerebral angiography. ## ivc filter impression 1. normal-appearing ivc without evidence of intraluminal thrombus or extrinsic compression. 2. uncomplicated placement of an ivc retrievable filter into the infrarenal position. this filter can be retrieved at any time when the patient is no longer at risk for possible pulmonary embolism. ## eeg impression: this is an abormal portable eeg due to the presence of a low-voltage background rhythm, somewhat more so over the left hemisphere. these findings suggest diffuse subcortical dysfunction consistent with a severe encephalopathy, and may be secondary to a medication affect from pentobarbital. the voltage asymmetry suggests the left hemisphere is more affected and could suggest a structural abnormality such as an increased recording distance as can be seen with extra axial blood or scalp edema. no epileptiform abnormalities were seen. ## mri brain mra head impression: no evidence of acute infarct. left frontal and temporal contusions. thin rim of left-sided subdural collection. right-sided frontoparietal fracture with associated soft tissue changes. extensive soft tissue changes in the mastoid air cells and in the paranasal sinuses including blood products. the basal cisterns are patent without evidence of herniation. impression: flow signal is seen in the arteries of anterior and posterior circulation without evidence of occlusion. ## repeat ct head impression: 1) evolving left frontal contusion with interval decrease in subarachnoid blood. 2) collapse, slit-like left lateral ventricle. 3) increased fluid in the paranasal sinuses and mastoid air cells. ## or tib/fib clinical history: tibial plateau fracture. three fluoroscopic images from the operating room are provided during orif of a tibial plateau fracture, side nonspecified. radiologist was not present. lateral buttress plate with screws is present. there is also a fibular metaphysis fracture. ## ct head/cta impression: 1. no hydrocephalus. interval re-expansion of the left lateral ventricle status post removal of the ventricular drainage catheter on that side. 2. stable appearance of complex right temporal bone fracture. 3. no significant change in size and appearance of the previously seen dissection at the origin of the right internal carotid artery in the neck. ## ruq us impression: 1) normal appearing gallbladder; no evidence of cholecystitis. 2) simple cyst in the mid/upper pole of the right kidney. 3) otherwise normal abdominal ultrasound brief hospital course: 35yo f pedestrian struck by mva traveling @ unknown speed, interactive at first then decreasing mental status. r ear, nose bleeding. taken to hosp, intubated, ffp for inr 1.4, tx to . found to have r edh, l sdh, sah, pneumocephalus, r temporal fracture, occipital fracture, and skull base fracture. went to or with neurosurgery from ed for emergent craniotomy and epidural evacuation after which she was admitted to tsicu for neuro checks and further management. further imaging demonstrated a r ica intimal dissection, a l superior and inferior pubic rami fractures and a l tibial plateau fracture. ## neuro: over hd pt remained with poor neurologic status, then began to recover some baseline function of right sided extremity movement, and eye opening. brain scan hd 7 demonstrated no evidence of brain death. extubated on hd 12 which she tolerated well, and transfered to floor on hd 14. repeat cta head/neck demonstrated stable intimal dissection of therefore neurosurgery recommended aspirin 325qd and followup for repeat imaging 1 month which also demonstrated stable flap with no other intervention required. slow but progressive neurologic improvement hd 15 to discharge from flaccid left upper extremity and unresponsiveness to communicating verbally well and moving all extremities- physical therapy and occupational therapy continue to work with her. pt has made slow, but steady progress in learning english and becoming more interactive, but still exhibits deficits in intellect, memory and cognitive ability. ## ortho: went to or with ortho on hd 14 for orif of l tib plateau fracture after which she extubated without difficulty. continuous passive movement and physical therapy throughout hospital stay. pt needs to remain nonweightbearing for an additional 6-8weeks. ## id: fever spike on hd 15, pancultured negative, but with profuse diarrhea treated with flagyl x 14days for likely cdif colitis, after which she remained afebrile. after her second trip to the sicu on hd#36, she was started on vanco/levo/flagyl for pna vs. empyema ## gi: pt continued to fail speech and swallow evaluations, and had a peg placed which she tolerated well for first three days then started to be concerned with abdominal pain around the site; a clot was aspirated and pt found to have guaiac pos stools and large hct drop. she was transfered to the tsicu (hd 33), had a left sc cvl placed, was transfused 3u rbcs, also had a gi scope which demonstrated no active bleed but possible pressure ulcers from peg bolster. remained stable without further s/s of gib, tolerated tube feeds well. she passed a speech and swallow study on hd 36 and began po nutrition with tube feed supplementation which she tolerated well. will likely be discharged on tube feeds with pos as tolerated. ## pulm: after transfer back to tsicu for gib, she remained comfortable although tachycardic during tsicu day 1 however ct abd demonstrated large left pneumothorax since cxr after cvl placement. chest tube placed which resolved pneumothorax and ct placed to suction hd 35 and removed hd 36. however, soon thereafter, she developed chest pain and tachycardia, and was transferred back to the unit on hd36. she was there diagnosed with a l pna/empyema and was started on levo/flagyl/vanco. ## omfs/orl: trisms, studies, tm, resolving with use/therapy. the patient achieved over 2 cm mouth opening and was placed on nutritional supplements which she took both orally and through her peg. the patient's family was instructed on the use of her feeding tube and on her jaw exercises. ## dispo: the patient initially wanted to return to to be close to her family. later, her husband agreed to remain in and hire a caretaker to supervise mrs. . he and the caretaker were instructed on how to care for her feeding tube and on jaw exercises. medications on admission: none discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po four times a day as needed for pain. 2. zantac 150 mg tablet sig: one (1) tablet po twice a day. discharge disposition: home with service facility: homecare discharge diagnosis: 1. right epidural hematoma 2. left subdural hematoma 3. subarachnoid hematoma 4. pneumocephalus 5. right temporal fracture 6. occipital fracture 7. skull base fracture 8. right internal carotid artery intimal flap 9. left superior/inferior pubic rami fracture 10. left tibial plateau fracture 11. gastrointestinal bleed status post peg placement 12. left pneumothorax status post central venous line placement discharge condition: fair, slowly improving discharge instructions: discharge to home with instructions to either follow up as indicated below, or find services in at which to follow up on your medical conditions. take your medications as perscribed. follow pts recommendations regarding your ambulation and activity; you must remain non-weight-bearing on your r lower extremity until the end of . keep your leg in the brace until then. take your regular diet as tolerated with supplementary tube feeds at least overnight; these will not make you fat, but rather are a very important part of your recovery (your body cannot heal without proper nutrition). followup instructions: 1. neurosurgery - dr : , call for an appointment 2. neuroradiology dr , in months for follow-up for your ica 3. orthopaedic surgery for your leg injury 4. provider: , . call to schedule appointment procedure: insertion of intercostal catheter for drainage continuous invasive mechanical ventilation for 96 consecutive hours or more other endoscopy of small intestine interruption of the vena cava enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] arteriography of cerebral arteries open reduction of fracture with internal fixation, tibia and fibula transfusion of packed cells diagnostic ultrasound of other sites of thorax transfusion of other serum other craniotomy other diagnostic procedures on brain and cerebral meninges ventricular shunt to extracranial site nec transfusion of platelets angiocardiography of venae cavae other operations on vessels diagnoses: pneumonia, organism unspecified motor vehicle traffic accident involving collision with pedestrian injuring pedestrian iatrogenic pneumothorax intestinal infection due to clostridium difficile hemorrhage of gastrointestinal tract, unspecified closed fracture of upper end of fibula with tibia closed fracture of pubis other gastrostomy complications injury to internal carotid artery other closed skull fracture with subarachnoid, subdural, and extradural hemorrhage, with brief [less than one hour] loss of consciousness other specified temporomandibular joint disorders 

Answer: The patient is high likely exposed to