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: iv dye, iodine containing / vasotec / levofloxacin / morphine attending: chief complaint: multi-trauma major surgical or invasive procedure: percutaneous tracheostomy tube and percutaneous endoscopic-guided gastrostomy tube. history of present illness: this 84-year-old female status post multiple trauma in the past now with hip fracture, t10 vertebral body fracture and multiple rib fractures. transported to for further management of her injuries. past medical history: hypertension parkinson's disease chronic headaches h/o cervical radiculopathies and myelopathy osteoarthritis osteoporosis w/ l3/l4 compression fractures choledocholithiasis s/p ercp w/ stent placement cardiac history: htn,heart block, presumed afib with rvr (on coumadin) pacemaker/icd placed: social history: russian speaking only, lives with elderly husband, has , and daughter live nearby. no history of alcohol abuse, smoking, illicits/ivdu. family history: no family history of premature coronary artery disease or sudden death. physical exam: upon admission: pe: 97.7, 62, 142/62, 18, 99 $l nc gen: awake, alert, oriented x 3, appears uncomfortable heent: yellow/bluish bruising over l. side of face, perrl, eomi heart: rrr lungs: ctab, l. chest wall tederness diffusely abd: obese, soft, nt/nd, +bs spine: tender to palpation approximately t3-4 and t10-11 regions; no c-spine tenderness le: warm, well perfused, no edema strength: ue b/l, quads b/l, unable to hold against gravity; dorsiflexion and plantar flexion b/l sensation: intact to light touch reflexes: unable to test propioception intact toes downgoing bilaterally rectal exam normal sphincter control pertinent results: 03:45pm lactate-2.4* k+-4.4 03:40pm glucose-150* urea n-30* creat-0.9 sodium-137 potassium-4.5 chloride-101 total co2-25 anion gap-16 03:40pm ck(cpk)-77 03:40pm ctropnt-0.01 03:40pm wbc-14.4*# rbc-4.05* hgb-11.5* hct-36.0 mcv-89 mch-28.5 mchc-32.0 rdw-16.0* 03:40pm plt count-316 03:40pm pt-25.3* ptt-30.2 inr(pt)-2.5* head ct scan findings: there is no acute intra- or extra-axial hemorrhage, edema, mass effect, shift of normally midline structures, or acute major vascular territorial infarction. the ventricles and sulci are prominent, compatible with age-related atrophy. there is extensive periventricular white matter low attenuation, compatible with chronic small-vessel ischemic disease. visualized paranasal sinuses reveal mild mucosal thickening of the right maxillary sinus. osseous structures reveal no evidence of a fracture. there is extensive calcification of the carotid arteries bilaterally in its cavernous portions. motion slightly limits evaluation. impression: no acute intracranial process. extensive chronic small-vessel ischemic disease. _ _ _ _ _ _ _ _ _ _ ________________________________________________________________ ct chest, abdomen, pelvis ct of the chest without iv contrast: coronary artery calcifications are seen. there is a small amount of pericardial fluid. otherwise, the heart is unremarkable. there are atherosclerotic calcifications of the thoracic aorta. no pathologic mediastinal, hilar or axillary lymphadenopathy is identified. there are small bilateral pleural effusions, left greater than right, with associated atelectasis on the left side. the lungs otherwise are grossly clear without focal consolidation or pulmonary edema. ct of the abdomen without iv contrast: non-contrast liver demonstrates tiny calcific densities, likely reflecting calcified granulomas. the spleen and right adrenal gland are unremarkable. both kidneys demonstrate rounded hypodensities, incompletely characterized without iv contrast. within the left adrenal gland, there is a 10-mm nodule, unchanged from , of indeterminant etiology. the stomach, small bowel, and colon are unremarkable. again noted is a spigelian hernia on the right containing a loop of large bowel. there is no free fluid, free air, or pathologic adenopathy. the pancreas is fatty infiltrated and atrophic. ct of the pelvis without iv contrast: foley catheter is present within the urinary bladder. the rectum is unremarkable. there is no pelvic free fluid or adenopathy. osseous structures: 1. there are fracture deformities of nearly every rib anterolaterally, some with bridging callus, and some without, suggesting that these are of varying ages of healing. 2. there is a comminuted fracture of the right inferior and superior pubic rami. there is a nondisplaced fracture of the left sacral ala, at the level of the promontory. the exact extent of this is difficult to assess secondary to diffuse osteopenia. 3. there is buckling of the medial acetabulum on the right, suggesting a nondisplaced fracture/buckling. 4. there are chronic compression deformities of l3 and l4, similar in appearance to . 5. there is an obliquely oriented fracture of the t10 vertebral body, extending from the mid portion of the intervertebral body wall, to the junction of the inferior endplate and posterior wall, involving both anterior middle columns, with distraction of the fracture fragments. this is an unstable fracture. 6. there is a compression deformity of the t3 vertebral body, of indeterminant age. 7. there is ankylosing of the long segment of the thoracic vertebral bodies. impression: 1. obliquely oriented fracture of the t10 vertebral body, involving both anterior middle columns, which is an unstable fracture. 2. multiple pelvic fractures, including right superior and inferior pubic rami, left sacral ala, and possibly the medial acetabulum on the right. 3. numerous rib fractures bilaterally, of varying ages of healing. 4. compression deformities of the l3, l4, and t3 vertebral bodies. the l3 and l4 are similar in appearance to . the t3 compression deformity is of indeterminant age. 5. left adrenal nodule, stable from . however, this is of indeterminant etiology, and if clinically indicated, mri may be obtained for further characterization. _ _ _ _ _ _ _ _ _ _ ________________________________________________________________ ct thoracic spine findings: distracted fracture of t10 vertebral body is redemonstrated. the fracture remains obliquely oriented, extending from the mid portion of the anterior vertebral body to the junction of the inferior endplate and posterior wall. as previously indicated, the fracture involves both the anterior and middle columns. there is approximately 14 mm of distraction in the craniocaudal dimension, greatest anteriorly. there is a moderate amount of dense material, best seen on axial images (3, 61), centered within this fracture, most consistent with hematoma. there is no retropulsion of bony fragments. visualized outline of the thecal sac appears unremarkable, but please note that ct is unable to provide intrathecal or ligamentous detail comparable to mri. diffuse osteopenia limits sensitivity for additional nondisplaced fractures. there is slight compression deformity of t3 vertebral body, with roughly 25% loss of vertebral body height. diffuse longitudinal ankylosis of the visualized spine is unchanged. incidental note made of small-to-moderate bilateral pleural effusions, left greater than right. pacemaker wires are seen in place. there is moderate three-vessel coronary artery calcification, and diffuse atherosclerotic calcification of the aorta. impression: 1. unchanged appearance of t10 vertebral body distracted fracture, which as previously indicated involves both the anterior and middle columns, and is unstable. 2. slight compression deformity of t3, with roughly 25% loss of vertebral body height. 3. unchanged diffuse longitudinal ankylosis of the thoracic spine. 4. small bilateral pleural effusions. 5. coronary artery calcification. echocardiography report left atrium - long axis dimension: *4.7 cm <= 4.0 cm left atrium - four chamber length: *6.0 cm <= 5.2 cm right atrium - four chamber length: *5.8 cm <= 5.0 cm left ventricle - septal wall thickness: 0.9 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: 1.0 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 4.5 cm <= 5.6 cm left ventricle - ejection fraction: >= 55% >= 55% left ventricle - lateral peak e': 0.09 m/s > 0.08 m/s left ventricle - septal peak e': *0.05 m/s > 0.08 m/s left ventricle - ratio e/e': 13 < 15 aorta - sinus level: 3.3 cm <= 3.6 cm aorta - ascending: *4.1 cm <= 3.4 cm mitral valve - e wave: 0.9 m/sec mitral valve - a wave: 1.0 m/sec mitral valve - e/a ratio: 0.90 mitral valve - e wave deceleration time: 224 ms 140-250 ms tr gradient (+ ra = pasp): *61 mm hg <= 25 mm hg findings this study was compared to the prior study of . left atrium: mild la enlargement. right atrium/interatrial septum: a catheter or pacing wire is seen in the ra and extending into the rv. increased ivc diameter (>2.1cm) with >55% decrease during respiration (estimated ra pressure (0-10mmhg). left ventricle: normal lv wall thickness, cavity size, and global systolic function (lvef>55%). suboptimal technical quality, a focal lv wall motion abnormality cannot be fully excluded. no resting lvot gradient. right ventricle: mildly dilated rv cavity. normal rv systolic function. aorta: normal aortic diameter at the sinus level. moderately dilated ascending aorta. aortic valve: mildly thickened aortic valve leaflets (3). no as. mild (1+) ar. mitral valve: mildly thickened mitral valve leaflets. moderate mitral annular calcification. trivial mr. tricuspid valve: normal tricuspid valve leaflets. mild tr. severe pa systolic hypertension. pulmonic valve/pulmonary artery: pulmonic valve not visualized. no ps. physiologic pr. pericardium: trivial/physiologic pericardial effusion. general comments: left pleural effusion. conclusions the left atrium is mildly dilated. the estimated right atrial pressure is 0-10mmhg. left ventricular wall thickness, cavity size, and global systolic function are normal (lvef>55%). due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. the right ventricular cavity is mildly dilated with normal free wall contractility. the ascending aorta is moderately dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is severe pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. impression: severe pulmonary hypertension. mildly dilated right ventricle with preserved biventricular systolic function. mild aortic regurgitation. compared with the prior study (images reviewed) of , right ventricle is slightly more dilated and pulmonary hypertension is more severe (precise difference in pa pressures between the studies is difficult to give, since prior study was technically suboptimal). _ _ _ _ _ _ _ _ _ _ ________________________________________________________________ kub findings: this is an extremely limited study. there are no definitive large or small bowel dilatation. there are no definitive air-fluid levels noted. the visualized lung bases are clear. there is noted to be a gastrotomy tube in place. the osseous structures demonstrate changes consistent with severe degenerative joint disease and old healed fractures. impression: no dilated loops of large and/or small bowel suggestive of possible obstruction or ileus. brief hospital course: she was admitted to the trauma service. orthopedic spine surgery was consulted given the unstable t10 fracture; initially discussions took place for surgical intervention and then it was decided to opt for conservative management. she was fitted for a tlso brace which will need to be worn a all times when out of bed. orthopedics was also consulted for the pelvic fractures and she can remain weight bearing as tolerated and will follow up in clinic in about 1 month after hospital discharge. she remained in the trauma icu for several days and was then transferred to the regular nursing unit. she developed respiratory distress while on the nursing unit and was then transferred back to the icu where she was sedated and intubated. because she was unable to be weaned from the ventilator the decision was made after family/team discussions to place a tracheostomy and percutaneous feeding tube. the procedure took place on without any complications. geriatrics was also consulted given her age, co-morbidities and history of multiple trauma from falls. several recommendations were made pertaining to her medications; including to withhold the coumadin given her risk of falling. it was recommended for pain control to schedule tylenol; use prn ultram and oxycodone in low dose. she did develop mrsa in her sputum and is being treated for the pneumonica with vancomycin; stop date . she was evaluated by physical therapy and is being recommended for rahb after her acute hospital stay. the screening process was initiated and she was discharged to rehab on hd #16. medications on admission: klonopin, ultram, asa, sinemet, carvidopa-levodopa, amio, hctz, fosamax, lopressor discharge medications: 1. carbidopa-levodopa 25-100 mg tablet sig: one (1) tablet po qid (4 times a day). 2. timolol maleate 0.5 % drops sig: one (1) drop ophthalmic (2 times a day): ou. 3. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 4. acetaminophen 500 mg tablet sig: two (2) tablet po tid (3 times a day). 5. heparin (porcine) 5,000 unit/ml solution sig: one (1) ml injection tid (3 times a day). 6. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 7. cyanocobalamin 100 mcg tablet sig: 0.5 tablet po daily (daily). 8. clonidine 0.1 mg/24 hr patch sig: one (1) patch transdermal qthur (every thursday). 9. docusate sodium 50 mg/5 ml liquid sig: ten (10) ml's po bid (2 times a day). 10. amiodarone 200 mg tablet sig: 1.5 tablets po bid (2 times a day). 11. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). 12. milk of magnesia 800 mg/5 ml suspension sig: thirty (30) ml's po twice a day as needed for constipation. 13. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation every six (6) hours as needed for shortness of breath or wheezing. 14. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation every six (6) hours as needed for shortness of breath or wheezing. 15. oxycodone 5 mg tablet sig: 0.5 tablet po q4h (every 4 hours) as needed for pain. 16. insulin regular human 100 unit/ml solution sig: one (1) dose injection four times a day as needed for per sliding scale: see attached sliding scale. 17. vancomycin in dextrose 1 gram/250 ml solution sig: one (1) gm intravenous every twelve (12) hours for 4 days: stop date . 18. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily): apply as directed to afected area. discharge disposition: extended care facility: - discharge diagnosis: s/p multiple trauma: respiratory failure pneumonia right hip fracture (subacute) left sacral ala fracture t10 vertebral body fracture (unstable) multiple rib fractures (indeterminate ages) discharge condition: hemodynamically stable followup instructions: follow up with dr. , orthoepdic spine surgery, in 4 weeks, call for an appointment. follow up in clinic in 4 weeks, call for an appointment. the following appointments were made prior to your reent hospitalization: provider: clinic phone: date/time: 1:30 provider: clinic phone: date/time: 2:30 provider: , md phone: date/time: 3:00 md, procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube percutaneous [endoscopic] gastrostomy [peg] arterial catheterization insertion of other (naso-)gastric tube temporary tracheostomy closed [endoscopic] biopsy of bronchus diagnoses: urinary tract infection, site not specified unspecified protein-calorie malnutrition atrial fibrillation constipation, unspecified paralysis agitans other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure acute respiratory failure brachial neuritis or radiculitis nos osteoporosis, unspecified methicillin susceptible pneumonia due to staphylococcus aureus closed fracture of dorsal [thoracic] vertebra without mention of spinal cord injury automatic implantable cardiac defibrillator in situ other and unspecified infection due to central venous catheter accidents occurring in residential institution proteus (mirabilis) (morganii) infection in conditions classified elsewhere and of unspecified site closed fracture of sacrum and coccyx without mention of spinal cord injury ulcer of heel and midfoot closed fracture of unspecified part of neck of femur other fall pathologic fracture of vertebrae other osteoporosis 

Answer: The patient is high likely exposed to