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: s/p motor vehicle collision major surgical or invasive procedure: - dr. , plastic surgery- 1. open reduction and internal fixation of bilateral lefort fractures. 2. closed reduction of nasal fracture. 3. placement of external splint. . -dr. of plastic surgery: 1. bilateral open reduction internal fixation of lefort fractures. 2. closed reduction of nasal fracture. . - open reduction and internal rigid fixation of the right mandibular body fracture and extraction of 5 teeth. . - gastrotomy by dr. and dr. history of present illness: mr. is a 49 year-old male found in drivers seat of truck that had hit tree. he was intoxicated and ambulatory on scene. he desaturated en route to the referring hospital, and upon arrival to the referring hospital he was unable to be intubated due to and a percutaneous tracheostomy was placed. he was transferred to for ongoing care. in the ed ct scans were obtained showing complicated facial fractures. social history: lives alone in . he has been unemployed recently after he was laid off from his job. reports occasional alcohol use. family history: non-contributory physical exam: physical exam on admission vitals: 90/p 81 15 98% blood r tm facial swelling, active bleeding from nose, loose teeth no spine stepoffs, no deformities neck: cricothyrotomy, c-collar coarse bs l>r, no crepitus abdomen soft pelvis stable rectal: good tone, guaiac negative pertinent results: portable chest x-ray -tracheostomy tube remains in place, with the tip terminating about 8 cm above the carina. cardiomediastinal contours have narrowed compared to the prior study, likely reflecting improved volume status of the patient, with associated clearing of interstitial pulmonary edema. patchy and linear opacities at both lung bases show interval improvement and probably represent resolving atelectasis and/or aspiration. small left pleural effusion is present. no pneumothorax is identified. . ct head -impression: 1. no intracranial hemorrhage or mass effect. 2. extensive comminuted fractures involving the paranasal sinuses and maxilla, nasal septum, and nasal bones. additional imaging is being performed . ct torso impression: 1. no evidence of traumatic injury in the abdomen or pelvis. 2. transverse process fracture of c7 and t1 on the right. 3. bilateral lower lobe atelectasis and/or aspiration. 4. several small pulmonary nodules. in the absence of a history of smoking, or known malignancy, followup ct in twelve months is recommended, otherwise 3 month follow up. . ct, facial bones : there are minimally displaced fractures involving the nasal bones bilaterally, the nasal septum, the anterior walls of both maxillary sinuses, the medial walls of both maxillary sinuses, and the lateral walls of both maxillary sinuses. there are fractures through the ethmoid air cells. the pterygoid processes appear to be fractured bilaterally. the zygomatic processes are intact. there is a displaced fracture of the right body of the mandible with roughly 4 mm of displacement of the two fragments. there is also a comminuted fracture involving the genu of the mandible and involving the alveolar ridge in this area. the questionable skull base fracture around the left appears well corticated on these images, and is likely a vascular channel. the temporomandibular joints articulate normally. there is a fracture through the left inferior orbital wall and a small intraorbital hematoma adjacent to the site, displacing the inferior rectus superiorly slightly. high-density material is noted within the maxillary sinuses, the ethmoid air cells, and the nasal cavity consistent with blood. there is an orogastric tube in place. there is extensive subcutaneous emphysema. impression: 1. comminuted fractures of the mandible as detailed above, involving the alveolar ridge. 2. comminuted fractures involving both maxillary sinuses, the left inferior orbit (without herniation of fat or muscle), both pterygoids, the nasal septum and nasal bones. . ct c-spine - impression: 1. nondisplaced fractures of the transverse process of c7 and t1 on the right. no other fractures of the cervical spine are identified. 2. probable left skull base fracture . mr - findings: at c5-6, there is a moderate posterior spondylytic ridge causing effacement of the subarachnoid space and mildly indenting the ventral spinal cord margin. as was noted on the prior ct scan of , uncovertebral spurring produces moderate left and prominent right-sided foraminal stenosis. at c6-7, a slightly more shallow posterior spondylytic ridge effaces of the ventral thecal sac margin and contacts the left ventrolateral cord margin, with uncovertebral spurring producing prominent bilateral neural foraminal stenosis. not surprisingly, the fractures involving the transverse process of c7 and t1 on the right are not well shown on this mr study. there is a suggestion of edema involving the nuchal ligament at the level of c1 through c3. there is also partial imaging of a fluid-filled 23 mm cyst, which is in the midline posterior cervical soft tissues at the cervicothoracic junction, also partially encompassed on the prior ct scan. the finding could represent a sebaceous cyst. there is no other definite cervical spine or paraspinal pathology seen, allowing for very poor signal-to-noise ratio of tissues anterior to the spinal cord. conclusion: probable nuchal ligament injury and other findings, as noted above. we spoke about these findings this afternoon () at 1:00 p.m. . ct sinus/mandible/maxillofacial w/o contrast impression: 1. reduction of the displaced fracture of the right body of the mandible with new overlying fixation plate and screws. fixation plate and screws overlying the comminuted anterior maxillary sinus wall fractures bilaterally. 2. resection of bone fragments and teeth related to the comminuted right mandibular alveolar fracture. 3. additional fractures as described above not significantly changed since the prior study. 4. new soft tissue density/fluid within the left middle ear cavity. . video oropharyngeal swallow : this exam was performed in conjunction with the speech therapist. the oral phase was normal. in the pharyngeal phase, there was mild impairment of laryngeal valve closure. there was no residue, penetration, or aspiration with barium of any consistency. impression: mild impairment of laryngeal valve closure, but no penetration or aspiration. . ecg -sinus rhythm. normal ecg.no previous tracing available for comparison. rate 65 qrs 98 qt 398/qtc 406 . ct temporal bone impression: 1. fluid within the middle ears and mastoid air cells bilaterally. as the patient was not intubated recently, and there is no evidence of fracture, an infectious process would be the primary consideration. this has been discussed with dr. at approximately 5 p.m. on . 2. comminuted bilateral maxillary fractures, status post surgical repair. please refer to the ct for details. marked mucosal thickening within both maxillary sinuses without air-fluid levels; this could represent sequelae of the trauma or less likely an infectious process. brief hospital course: mr. was admitted to the trauma surgery intensive care unit. he was was extubated on hospital day 4. he was transferred to the general surgical floor on hospital day 8. # facial fractures- ct of the face demonstrated multiple mid face fractures as well as an open displaced fracture of the right mandibular body and alveolar fractures of the mandibular anterior teeth. on , mr. open reduction and internal rigid fixation of the right mandibular body fracture and extraction of 5 teeth performed by dr. . on , dr. performed open reduction and internal fixation of bilateral lefort fractures, closed reduction of nasal fracture, and placement of an external splint. he took a five day course of unasyn. he was advised to continue a soft solid diet and to follow-up with plastic surgery and omfs. . # c-spine fractures- ct c-spine revealed right nondisplaced c7-t1 transverse process fractures. orthopedics spine service was consulted and recommended an mri of his cervical spine. mri revealed some mild increased signal along the posterior nuchal ligament in the upper cervical spine, but no significant injury around the fractures or significant disk injury. therefore, based on radiographic data and the need for omfs to take him to the operating room, orthopedics spine service the cleared and removed his collar based on radiographic criteria. . #tracheostomy- mr. had percutaneous tracheostomy placed prior to arrival at secondary to inability to intubate. he was fitted for a passy-muir valve on hospital day 9 which he tolerated well. he was decannulated prior to discharge and was tolerating a full liquid diet. . # gastrotomy- on hospital day 11, a gastrotomy was performed by dr. for alimentation given his inability to tolerate adequate oral nutrition and facial fractures prevent placement of a nasogastric tube. he was discharged with the tube in place and instructions to continue g-tube flushes. he will take ensure supplements with meals and record his nutritional intake. the need for the g-tube will be re-evaluated at his follow-up visit with dr. . . # hearing loss- on the day prior to discharge, mr. reported sense of muffled hearing of two days duration. he denied ear pain. ent was consulted and thought that this was secondary to fluid accumulation, possibly blood in the middle ear. given associated dizziness and known multiple facial fractures, a ct of the temporal bone was performed and was negative for temporal bone fracture. he was discharged with ent follow-up. . # pulmonary nodules on chest ct- several small pulmonary nodules were noted on chest ct. in the absence of a history of smoking, or known malignancy, followup ct in twelve months is recommended, otherwise 3 month follow up. he was advised to obtain a primary care doctor for further follow-up of his pulmonary nodule. medications on admission: none discharge medications: 1. oxycodone-acetaminophen 5-325 mg/5 ml solution sig: 5-10 mls po q4h (every 4 hours) as needed for pain. disp:*500 ml(s)* refills:*0* 2. hexavitamin tablet sig: one (1) cap po daily (daily). 3. chlorhexidine gluconate 0.12 % mouthwash sig: thirty (30) ml mucous membrane (2 times a day) for 2 weeks. disp:*1800 ml(s)* refills:*2* 4. ensure liquid sig: one (1) po three times a day: ensure liquid with meals. disp:*qs * refills:*2* discharge disposition: home with service facility: care discharge diagnosis: s/p trauma- motor vehicle collision multiple facial fractures- symphyseal and parasymphyseal mandibular fractures, anterior alveolar ridge mandible fracture, le fort type i fracture, bilateral maxillary medial, lateral and posterior wall fractures, bilateral nasal bone fractures, bilateral fractures anterior nasal spine of maxilla, comminuted septal fracture, minimally displaced left inferior orbital floor fracture, bilateral medial orbital wall blowout fracture. s/p placement of gastrotomy discharge condition: good discharge instructions: you should continue eating a liquid diet because of your facial fractures. you should supplement your diet with ensure at every meal to get adequate nutrition. you should flush your gastric tube three times a day as your were taught by your nurse. g nurse will come to your house and continue teaching about care of your gastric tube. you should not use a straw or blow your nose until otherwise advised by the plastic surgery doctors. you should continue using chlorhexidine mouthwash 3 times a day for 2 weeks. you should see the plastic surgery doctors 1 week in their clinic. you were seen by the ear, nose and throat (ent) doctors who thought that your hearing decrease was due to fluid in your ear. you should follow-up in their clinic in 2 weeks with a hearing test (audiogram). please call to make an appointment. . please call your doctor or return to the hospital if your experience: * fever, chills * nausea, vomiting * severe or new headache * neck stiffness * visual changes * worsening of your hearing * inability to eat soft foods * loss of consciousness * any other symptoms that concern you followup instructions: oral & maxillofacial surgery- call ( for an appointment with dr. on friday between 1:30 on 2. . you should attend an appointment in plastic surgery clinic on friday at 2:30 pm. phone (. . you have an appointment on at 10:30 with dr. t. . phone: to evaluate your hearing. . you should see dr. in trauma surgery clinic in weeks. he will evaluate your gastric tube. call ( to make an appointment. . you should find a primary care doctor as soon as possible. you may call a local hospital to get a list of primary care doctors available in your area. md, procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube temporary tracheostomy closure of skin and subcutaneous tissue of other sites extraction of other tooth open reduction of maxillary fracture insertion of synthetic implant in facial bone open reduction of mandibular fracture transfusion of packed cells closed reduction of nasal fracture other gastrostomy diagnoses: unspecified pleural effusion alcohol abuse, unspecified pneumonitis due to inhalation of food or vomitus closed fracture of dorsal [thoracic] vertebra without mention of spinal cord injury accidents occurring in other specified places other diseases of lung, not elsewhere classified open fracture of nasal bones closed fracture of orbital floor (blow-out) other motor vehicle nontraffic accident involving collision with stationary object injuring driver of motor vehicle other than motorcycle closed fracture of first cervical vertebra closed fracture of base of skull without mention of intra cranial injury, with no loss of consciousness open wound of cheek, without mention of complication open fracture of malar and maxillary bones open fracture of mandible, body, other and unspecified open wound of tooth (broken) (fractured) (due to trauma), complicated acute periodontitis 

Answer: The patient is high likely exposed to