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: no known allergies / adverse drug reactions attending: chief complaint: trauma: s/p mvc major surgical or invasive procedure: - exploratory laparotomy, left nephrectomy - left posterior auricular advancement flap - anterior odontoid orif history of present illness: 42m unrestrained driver, ejected in high-speed mvc. presented with hypovolemic shock in setting of shattered l kidney, as well as type 2 odontoid fracture and multiple other spine fractures. brought to or for exploratory laparotomy and left nephrectomy. past medical history: pmh: none psh: none social history: drinks 1 case of beer/night. family history: n/c physical exam: physical examination: upon admission: hr: 112 bp: 94/66 resp: 19 o(2)sat: 100 normal constitutional: intubated, sedated heent: pupils equal, round and reactive to light, abrasions to scalp ett in place chest: clear to auscultation cardiovascular: regular rate and rhythm, normal first and second heart sounds abdominal: soft, nondistended gu/flank: no evidence of trauma extr/back: no cyanosis, clubbing or edema skin: no rash, warm and dry neuro: intubated, no movement of ext's psych: unresponsive heme//: no petechiae physical examination upon discharge: : vital signs: 97.7, hr=95, bp 128/85, resp. rate 18, oxygen sat 95% room air general: resting comfortably in bed, nad cv: ns1, s2, -s3, -s4 lungs: decreased breath sounds bases bil. abdomen: soft, non-tender ext: + dp bil., no pedal edema bil. neuro: oriented to name, disoriented to time and place, random movement of upper ext., wiggles toes randomly skin: head laceration clean and dry, right ear lacertion clean, no ulcerations coccyx pertinent results: chemistry renal & glucose glucose urean creat na k cl hco3 angap 11:05 66*1 25* 1.3* 128* 5.3* 89* 26 18 05:09 991 22* 1.1 129* 5.2* 92* 25 17 06:02am blood wbc-12.1* rbc-3.84* hgb-11.3* hct-34.7* mcv-91 mch-29.3 mchc-32.4 rdw-14.7 plt ct-456* 05:45am blood wbc-9.1 rbc-3.52* hgb-10.6* hct-31.9* mcv-91 mch-30.0 mchc-33.1 rdw-14.5 plt ct-388 10:23am blood neuts-84.7* lymphs-10.9* monos-3.8 eos-0.4 baso-0.3 06:02am blood plt ct-456* 05:45am blood plt ct-388 01:27pm blood pt-11.3 ptt-25.8 inr(pt)-1.0 12:51am blood pt-11.4 ptt-25.2 inr(pt)-1.1 06:40am blood pt-12.9* ptt-26.7 inr(pt)-1.2* 10:23am blood fibrino-252# 06:40am blood fibrino-123* 06:02am blood glucose-94 urean-15 creat-1.0 na-136 k-3.5 cl-101 hco3-24 angap-15 05:45am blood glucose-99 urean-16 creat-1.0 na-139 k-3.8 cl-101 hco3-25 angap-17 08:00am blood glucose-84 urean-20 creat-1.0 na-143 k-4.0 cl-105 hco3-27 angap-15 06:02am blood alt-32 ast-31 alkphos-82 totbili-2.0* 05:45am blood alt-35 ast-46* alkphos-75 amylase-135* totbili-2.9* 06:02am blood lipase-184* 05:45am blood lipase-235* 06:02am blood albumin-3.4* calcium-8.9 phos-2.9 mg-1.9 05:45am blood calcium-8.8 phos-3.0 mg-2.0 03:43am blood asa-neg ethanol-230* acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 09:09am blood lactate-0.9 01:42pm blood glucose-102 lactate-1.2 09:09am blood freeca-1.02* 01:42pm blood freeca-1.04* : cat scan of the c-spine: impression: odontoid fracture extending into the articulating surface of the left lateral mass (type 2 odontoid fracture) as well as additionalfracture of the lateral mass extending down into the transverse process. left c3 and c4 and possibly c5 transverse foramen fractures. pre-vertebral soft tissue swelling evident. these injuries are concerning for injury to the left vertebral artery, particularly in patient with gcs of 3 and no obvious intracranial hemorrhage. recommend evaluation with cta. ligamentous injury also likely. additional possible anterior inferior endplate fracture at c5 no pre-vertebral soft tissue swelling evident at this level. : head cat scan: impression: no intracranial process. no evidence of edema. large right-sided subgaleal hematoma : cat scan of abdomen and pelvis: impression: 1. shattered left kidney (grade v injury) with devascularied lower and interpolar regions. vascularized fragment in the upper pole has a laceration extending to renal pelvis. right kidney is uninjured. 2. splenic hematoma/laceration extending towards but not definitively involving the hilum. 3. large retroperitoneal hematoma extending down the left iliopsoas to the level of the femoral head. 4. multiple fractures of the spine and pelvis as described above. : cta neck: impression: the left vertebral artery is hypoplastic as apparent from this smaller transverse foramen on the left side. the left vertebral arteries opacified from the origin in the subclavian to the region of left posterior inferior cerebellar artery. there is no evidence of flap visualized of the vertebral arteries to indicate dissection. there is no compression seen in the region of fracture. no other vascular abnormalities are seen. no extravasation of contrast to indicate vascular tear identified. an endotracheal tube tip is in the glottic region. : mr cervical spine: impression: fracture of the odontoid process identified without significant edema or displacement. small amount of fluid is seen within the left atlantoaxial joint. prevertebral soft tissue swelling is identified indicating small hematoma extending from c2-c5. posterior ligamentous signal changes are seen indicating trauma without evidence of ligamentous disruption. no evidence of intraspinal hematoma or spinal cord compression seen. : cat scan of sinus and mandible: 1. loculated fluid within right frontal, bilateral ethmoid, and bilateral maxillary sinuses. mucosal thickening of the sphenoid sinuses. 2. status post screw fixation of an odontoid fracture. fractures of c2 left lateral mass and left transverse foramen are similar to the prior study. : cat scan of abdomen and pelvis: 1. status post left nephrectomy. multiple splenic lacerations, similar to the prior study. 2. no new interval bleed within the abdomen and pelvis. small amount of ascites in the perihepatic region, right paracolic gutter and pelvis. 3. mild ileus. no evidence of bowel obstruction. 4. multiple lumbar spine and right iliac fractures. : cat scan of the head: several new small -white junction hypodensities, one of which is associated with a small amount of blood product, concerning for diffuse axonal injury. mri may be obtained for further evaluation. 2. bifrontal subdural spaces have increased, compatible with small subdural effusion. no ventriculomegaly. : chest x-ray: findings: as compared to the previous radiograph, there is no relevant change. the monitoring and support devices are constant. borderline size of the cardiac silhouette, bilateral pleural effusions that might have slightly increased. subsequent areas of atelectasis bilaterally. no newly appeared focal parenchymal opacities. no pneumothorax. : chest x-ray: findings: interval extubation and removal of nasogastric tube. heart size is upper limits of normal. worsening pulmonary vascular congestion with accompanying mild-to-moderate edema. moderate bilateral effusions are again demonstrated with associated lower lobe atelectasis. 8:49 am swab source: right piv site. wound culture (preliminary): results pending. ; cat scan of the chest: impression: 1. no fluid collection or infectious process to explain rising wbcs and fever. 2. decreased small left pleural effusion. 3. splenic lacerations 4. nearly completely resorbed retroperitoneal hematoma 5. multiple fractures of the right iliac , t5, t11, and l4 spinous processes and l2,3,4,5 right transverse processes. 6. right hilar adenopathy and small left hilar and mediastinal lymph nodes stable from . this can ce seen in sarcoidosis. follow-up chest ct in 3 months is recommended to evaluate for resolution. brief hospital course: the patient was admitted to the trauma service after being involved in a motor vehicle accident. he was intubated at the scene with a gcs of 3. the emergency room course was complicated by hemodynamic instability with fast and then cat scan demonstrating left renal grade 4 injury. the patient was taken to the operating room for emergent exploratory laparotomy necessiating a left nephrectomy. in the operating room he received 6uprbs, 5uffp, 2u cryo, and 5 liters of crystalloid with a liter blood loss. his hematocrit post-op was 33. he was monitored in the intensive care unit after the procedure. course of events while in the intensive care unit: neuro: he was unresponsive upon arrival to the ed. post-operatively his mental status improved and he was able to be extubated. he was found on head cat scan to have a large right-sided subgaleal hematoma. no intervention was recommended by neurology. post-extubation he remained lethargic, but was alert and oriented, and followed commands. he admitted to a significant alcohol history, and was started on a ciwa protocol. he had an unstable c2 fracture, which was repaired by ortho spine. he is to stay in his j brace until follow-up with ortho spine. he also has multiple cervical, lumbar and thoracic spine fractures. cv: post-operatively he remained hemodynamically stable. he was tachycardic and hypertensive, which was treated with beta-blockers and pain medication. after discovering his alcohol history and starting the ciwa protocol, his hypertension and tachycardia improved with the addition of beta-blockers. resp: he was extubated on pod 1 and was stable. he vomited and aspirated on , which progressed to respiratory distress and required intubation. a bronchoscopy performed that morning showed bilious fluid in the lungs. gi: a small serosal tear of the 4th portion of the duodenum was noted intra-operatively, and primarily repaired. he was kept npo with intravenous fluids. he had increasing emesis into , associated with abdominal distention. an oral gastric tube was placed after intubation, and a significant amount of bilious fluid was removed. a cat scan was performed to evaluate for ileus, obstruction, or worsening of duodenal injury. no new bleed was identified. gu: he underwent emergent left nephrectomy for a shattered kidney and hemodynamic instability. his foley was kept to gravity post-operatively, and his hematuria slowly cleared. when acceptable to urology, his foley catheter was removed and he was able to void without difficulty. his creatinine peaked at 1.3, and then trended down to 1.1. heme: he required multiple transfusions immediately after presentation and while in the operating room. he received a total of 4u cryoprecipitate, 6u ffp, and 8u prbc. his hematocrit stabilized immediately post-operatively, and he did not require any further transfusion. his hematocrit is currently stable at 38. id: he received appropriate peri-operative antibiotics. he had a complex left posterior auricular laceration, which was repaired by plastic surgery. he was kept on cipro x5 days after repair. msk: right iliac fracture was reported on imaging. orthopedics was consulted and recommended closed treatment with weight bearing as tolerated bilateral lower extremities. splints were applied to his lower extremities. social services have been involved in his care providing support to the family. his vital signs have remained stable with the addition of beta-blockers. his white blood cell count is decreasing to 14.6 form 16.6. he underwent a cat scan of the abdomen on and no abdominal collections were noted. he is tolerating a regular diet with supervision and voiding without difficulty. he is preparing for discharge to an extended care facility where he can further regain his strength and mobility. of note: hilar and mediastinal lymph nodes reported stable on cat scan, but follow-up cat scan recommended in 3 months per radiology of note: electrolytes repeated prior to discharge: na= 128, k=5.3, creat 1.3. rehabilitation facilty informed of results and results faxed. informed of need to repeat electrolytes in morning. medications on admission: none discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) cc injection tid (3 times a day). 2. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 3. acetaminophen 500 mg tablet sig: two (2) tablet po q8h (every 8 hours). 4. olanzapine 2.5 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for agitation. 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day): hold for diarrhea. 6. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 7. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 8. oxycodone 5 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain: hold for increased sedation, resp. rate <12. 9. atenolol 50 mg tablet sig: two (2) tablet po daily (daily): hold for systolic blood pressure <120, hr <60. 10. nicotine 14 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily). 11. hydralazine 50 mg tablet sig: one (1) tablet po every six (6) hours: hold for systolic blood pressure <120, hr <60. discharge disposition: extended care facility: hospital - discharge diagnosis: trauma: type 2 odontoid fracture left c3, c4 transverse foramen fracture right subgaleal hematoma shattered left kidney (grade ) splenic hematoma/laceration t5, t11, l4 spinous process fracture right l1, l2, l5 transverse process fracture comminuted right iliac fracture right posterior ear laceration discharge condition: mental status: oriented to name, answeres questions, follows commands level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: you were admitted to the hospital after you were involved in a car accident. you sustained injuries to your neck, head, back and pelvis as well as a laceration to your spleen and an injury to your left kidney. because of the extent of your injuries, you were seen by neurology, orthopedics, and the plastic service and you were monitored in the intensive care unit. you were taken to the operating room where you had your left kidney removed and a tear in your intestine repaired. you returned to the operating room for stabilization of your neck and repair of a right ear laceration. your vital signs have stabilized and you were discharged from the intensive care unit to the surgical floor. you have been evaulated by physical therapy. your white blood cell count is slowly coming down. your vital signs are stable and you are preparing for discharge to an extended care facility where you can further regain your strength and mobility. followup instructions: department: general surgery/ when: tuesday at 2:30 pm with: dr. in acute care clinic building: lm bldg () campus: west best parking: garage department: orthopedics when: wednesday at 10:25 am with: ortho xray (scc 2) building: sc clinical ctr campus: east best parking: garage department: spine center when: wednesday at 10:45 am with: , md building: campus: east best parking: garage procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube incision of abdominal wall nephroureterectomy alcohol detoxification repair of vertebral fracture internal fixation of bone without fracture reduction, other bones suture of laceration of duodenum other plastic repair of external ear diagnoses: acidosis unspecified essential hypertension acute posthemorrhagic anemia other specified cardiac dysrhythmias pneumonitis due to inhalation of food or vomitus closed fracture of second cervical vertebra closed fracture of dorsal [thoracic] vertebra without mention of spinal cord injury altered mental status other motor vehicle traffic accident involving collision with motor vehicle injuring driver of motor vehicle other than motorcycle enlargement of lymph nodes closed fracture of lumbar vertebra without mention of spinal cord injury open wound of other and multiple sites of face, without mention of complication traumatic shock contusion of face, scalp, and neck except eye(s) injury to other intra-abdominal organs without mention of open wound into cavity, retroperitoneum acute alcoholic intoxication in alcoholism, continuous injury to spleen without mention of open wound into cavity, hematoma without rupture of capsule dysphagia, oropharyngeal phase closed fracture of ilium injury to duodenum, without open wound into cavity late effect of intracranial injury without mention of skull fracture closed fracture of third cervical vertebra open wound of auricle, ear, without mention of complication injury to kidney without mention of open wound into cavity, complete disruption of kidney parenchyma other pulmonary insufficiency, not elsewhere classified, following trauma and surgery subdural hemorrhage following injury without mention of open intracranial wound, with prolonged [more than 24 hours] loss of consciousness and return to pre-existing conscious level 

Answer: The patient is high likely exposed to