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 pedestrian vs. car with resultant polytrauma major surgical or invasive procedure: : 1. irrigation and debridement of soft tissue, muscle including bone of the right distal tibia open fracture. 2. application of multiplanar external fixator to the right lower extremity. : 1. inferior vena caval filter placed by the right femoral route. : 1. open reduction, internal fixation left supracondylar femur fracture. : 1) irrigation and debridement open right tibia fracture 2) adjustment of external fixator with the addition of calcaneal tibial pins and 3) closed reduction of the distal tibia fracture and distal fibular fracture with traction and manipulation. history of present illness: mr. is a 51 year old gentleman who was struck by a car while intoxicated. there was no loc. he was transferred from an osh for further management of his injuries, which influded a comminuted left femur fracture, an open right ankle fracture, and right lateral 2nd and 3rd rib fractures. past medical history: none social history: homeless smokes cigarettes drinks ~12 beers a day, long history of alcohol abuse family history: not applicable physical exam: upon admission: general evaluation exam bp: 120/73 hr: 93 rr:14 temp:97.3 sensorium: awake () awake impaired (x) unconscious () airway: intubated () not intubated (x) breathing: stable () unstable (x) circulation: stable (x) unstable () musculoskeletal exam neck normal () abnormal () comments: in c-collar spine normal (x) abnormal () comments: clavicle r normal (x) abnormal () comments: l normal (x) abnormal () comments: shoulder r normal (x) abnormal () comments: l normal (x) abnormal () comments: arm r normal (x) abnormal () comments: l normal (x) abnormal () comments: elbow r normal (x) abnormal () comments: l normal (x) abnormal () comments: forearm r normal (x) abnormal () comments: l normal (x) abnormal () comments: wrist r normal (x) abnormal () comments: l normal (x) abnormal () comments: hand r normal (x) abnormal () comments: l normal (x) abnormal () comments: pelvis r normal (x) abnormal () comments: l normal (x) abnormal () comments: hip r normal (x) abnormal () comments: l normal (x) abnormal () comments: thigh r normal (x) abnormal () comments: l normal () abnormal (x) comments: swelling distal femur knee r normal () abnormal (x) comments: l normal () abnormal (x) comments:swelling/deformity leg r normal () abnormal (x) comments: l normal () abnormal (x) comments: grade iiia open fx ankle r normal () abnormal (x) comments: open distal tib/fib l normal (x) abnormal () comments: foot r normal (x) abnormal () comments: l normal (x) abnormal () comments: urethral bleeding yes () no (x) vascular: radial r palpable (x) non-palpable () doppler () l palpable (x) non-palpable () doppler () dp r palpable () non-palpable () doppler (x) l palpable () non-palpable () doppler (x) pt r palpable (x) non-palpable () doppler () l palpable (x) non-palpable () doppler () neuro: (not following commands) ant tib r (weakly fires) l () r (-) l (-) peroneal r (-) l (-) gs r (-) l (-) on discharge: avss nad, a&o x3 cv: rrr pulm: ctab abd: soft, nt/nd rle: exfix in place, pin sites c/d/i, brisk capillary refill, sensation intact to light touch, motor intact - moving all toes lle: knee immobilizer in place, incision c/d/i, brisk capillary refill, sensation intact to light touch, /gs/ta pertinent results: 12:55am blood wbc-11.6* rbc-3.78* hgb-11.8* hct-35.9* mcv-95 mch-31.3 mchc-33.0 rdw-14.7 plt ct-223 04:17am blood wbc-8.9 rbc-3.71* hgb-11.5* hct-35.1* mcv-95 mch-31.0 mchc-32.8 rdw-14.6 plt ct-204 08:15am blood wbc-10.1 rbc-3.12* hgb-9.6* hct-28.8* mcv-92 mch-30.7 mchc-33.3 rdw-14.6 plt ct-156 04:50am blood wbc-9.3 rbc-2.79* hgb-8.7* hct-26.0* mcv-93 mch-31.3 mchc-33.7 rdw-14.7 plt ct-152 04:13am blood wbc-6.6 rbc-2.24* hgb-7.0* hct-21.3* mcv-95 mch-31.4 mchc-33.0 rdw-14.1 plt ct-153 11:04am blood wbc-8.3 rbc-2.74* hgb-8.4* hct-25.5* mcv-93 mch-30.8 mchc-33.0 rdw-15.4 plt ct-164 06:45pm blood wbc-8.7 rbc-3.23* hgb-9.8* hct-29.5* mcv-92 mch-30.3 mchc-33.1 rdw-16.2* plt ct-141* 08:17pm blood wbc-7.5 rbc-3.26* hgb-9.7* hct-29.8* mcv-91 mch-29.9 mchc-32.8 rdw-16.3* plt ct-154 02:17am blood wbc-8.7 rbc-3.20* hgb-9.9* hct-28.7* mcv-90 mch-31.0 mchc-34.6 rdw-15.9* plt ct-169 08:16pm blood hct-26.8* 01:03am blood wbc-8.0 rbc-2.83* hgb-8.7* hct-25.8* mcv-91 mch-30.6 mchc-33.6 rdw-15.1 plt ct-226 05:00am blood wbc-8.1 rbc-2.92* hgb-8.9* hct-26.6* mcv-91 mch-30.4 mchc-33.3 rdw-15.0 plt ct-259 02:41am blood wbc-7.8 rbc-2.87* hgb-8.7* hct-25.4* mcv-89 mch-30.4 mchc-34.3 rdw-14.9 plt ct-307 01:53am blood wbc-7.1 rbc-2.95* hgb-9.0* hct-27.0* mcv-91 mch-30.4 mchc-33.3 rdw-15.0 plt ct-327 01:50am blood wbc-8.6 rbc-3.05* hgb-9.1* hct-27.7* mcv-91 mch-30.0 mchc-33.0 rdw-15.0 plt ct-390 10:58am blood wbc-12.3* rbc-3.31* hgb-9.7* hct-30.2* mcv-91 mch-29.5 mchc-32.3 rdw-15.0 plt ct-455* 02:30am blood wbc-9.6 rbc-2.92* hgb-8.8* hct-27.2* mcv-93 mch-30.2 mchc-32.5 rdw-15.1 plt ct-433 08:13am blood hct-29.1* 06:40am blood wbc-8.5 rbc-3.17* hgb-9.5* hct-28.6* mcv-90 mch-29.9 mchc-33.2 rdw-14.9 plt ct-454* 06:45am blood wbc-9.2 rbc-3.23* hgb-9.8* hct-29.2* mcv-91 mch-30.3 mchc-33.4 rdw-14.4 plt ct-511* 03:44am blood wbc-12.1* rbc-3.31* hgb-9.8* hct-29.8* mcv-90 mch-29.5 mchc-32.8 rdw-14.7 plt ct-504* 04:31am blood wbc-6.7 rbc-3.47* hgb-10.1* hct-30.6* mcv-88 mch-29.1 mchc-32.9 rdw-14.5 plt ct-474* 12:55am blood pt-13.3 ptt-24.2 inr(pt)-1.1 08:15am blood pt-12.8 ptt-27.1 inr(pt)-1.1 02:17am blood pt-12.0 ptt-26.5 inr(pt)-1.0 04:17am blood glucose-120* urean-11 creat-0.6 na-138 k-4.3 cl-104 hco3-26 angap-12 08:15am blood glucose-120* urean-10 creat-0.8 na-136 k-4.2 cl-100 hco3-28 angap-12 04:50am blood glucose-124* urean-9 creat-0.7 na-138 k-3.8 cl-102 hco3-28 angap-12 04:13am blood glucose-83 urean-13 creat-0.6 na-137 k-5.1 cl-105 hco3-28 angap-9 02:17am blood glucose-104 urean-9 creat-0.7 na-141 k-3.8 cl-108 hco3-27 angap-10 01:55am blood glucose-121* urean-9 creat-0.6 na-141 k-4.0 cl-108 hco3-28 angap-9 05:00am blood glucose-120* urean-9 creat-0.5 na-138 k-3.9 cl-103 hco3-28 angap-11 01:53am blood glucose-119* urean-13 creat-0.6 na-142 k-3.9 cl-107 hco3-26 angap-13 10:58am blood glucose-125* urean-16 creat-0.8 na-143 k-4.4 cl-109* hco3-25 angap-13 03:44am blood glucose-105 urean-14 creat-0.8 na-138 k-4.2 cl-105 hco3-23 angap-14 04:31am blood glucose-111* urean-10 creat-0.7 na-141 k-4.1 cl-109* hco3-24 angap-12 04:17am blood alt-55* ast-70* alkphos-78 amylase-141* totbili-0.1 07:11pm blood ck(cpk)-569* 04:50am blood alt-25 ast-46* alkphos-60 amylase-27 totbili-1.0 12:55am blood lipase-427* 04:17am blood lipase-177* 08:15am blood lipase-17 04:50am blood lipase-15 04:17am blood calcium-7.8* phos-3.8 mg-1.8 02:17am blood calcium-8.2* phos-3.5 mg-2.0 10:00pm blood calcium-7.6* phos-3.4 mg-1.7 02:41am blood calcium-8.4 phos-3.3 mg-2.1 01:53am blood calcium-8.4 phos-3.1 mg-2.1 01:53am blood calcium-8.4 phos-3.1 mg-2.1 01:50am blood calcium-8.6 phos-3.1 mg-2.1 10:58am blood calcium-8.8 phos-3.6 mg-2.1 03:44am blood calcium-8.9 phos-2.9 mg-2.0 04:31am blood calcium-8.8 phos-3.7 mg-2.4 02:41am blood t4-6.2 02:41am blood tsh-4.0 12:55am blood asa-neg ethanol-275* acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg ct torso: impression: 1. rib fractures, appearing both chronic and with acute rib fractures seen at the second and third ribs on the right as well as in the twelfth rib. there is no pneumothorax. 2. bilateral spondylolysis, without spondylolisthesis at l5. 3. bilateral dependent atelectasis as well as a poorly marginated opacity in the right upper lobe. considerations for the latter finding include nodule or, less likely aspiration. followup is recommended to document resolution/progression when clinically stable. ct rle: impression: 1. comminuted displaced left distal femur fracture without intra-articular extension. 2. segond fracture concerning for anterior cruciate ligament injury. 3. fracture through the fibular head which may signify posterolateral corner injury. further evaluation can be performed with mri if indicated. left tib/fib xray: impression: comminuted fractures of the distal tibia and fibula brief hospital course: the patient arrived in the ed on . on primary and secondary survey, the patient was intoxicated but was otherwise hemodynamically stable and following commands with a gcs of 15. imaging studies ultimately revealed the following injuries: comminuted l femur fx open right ankle fx / near amputation r lateral 2nd and 3rd rib fxs the patient's admission labs also revealed pancreatitis with a lipase of 427 and an alcohol level greater than 400. the patient was admitted to the trauma service. the orthopedic team was consulted and the patient was brought to the or for washout and ex fix placement of the r ankle. he was started on lovenox. ortho intended to take the patient back to the or for orif of his r tib/fib fractures. however, on pod1, the patient was noted to have fevers and tachycardia. he was also diaphoretic, agitated and disoriented. he was put on ciwa protocol for alcohol withdrawal and later transferred to the icu on because he was developing delirium tremens. while in the icu, the patient required large amounts of valium. he was also receiving haldol and dilaudid with little effect. an ngt was used to decompress his stomach and reduce the risk of aspiration. because of his worsening progression and increased somnolence, he was later intubated by the sicu team . he was noted to have a hct of 21 and was therefore received 4 units of prbcs. on , the patient was again brought to the or for orif of his left femur fracture. at the same time, an ivc filter was placed by the trauma surgery service. post-op, the patient was left intubated and transferred back to the sicu. he was noted to have fevers overnight and was therefore pancultured and started on broad-spectrum antibiotics. his sputum eventually grew out gnrs. his antibiotics were adjusted appropriately. the patient was eventually started on tube feeds. his vent was weaned and he was extubated . he continued to have altered mental status, delirium and agitation, which was controlled with zyprexa. he was seen by physical therapy, who recommended discharge to rehab. on , ortho again took the patient to the or for washout of the right ankle, adjustment of the ex fix, and closed reduction of the tib fib fractures. he was intubated a few hours prior to the or for increased agitation. it was determined to keep the patient intubated post-op and obtain a head ct to assess for any potential etiology of his prolonged agitation and delirium. this was ultimately negative. the patient was then extubated and transferred to the floor. after this, the patient's mental status was noted to improve markedly. he was then transferred to the orthopedics service for continued management. on , he was confused and agitated for most of the day. he received many doses of haldol, zyprexa, valium with no avail. he tried to get oob many times and despite mutiple restraints, he fell onto his left side suffering a small left eyebrow abrasion. xrays were taken of his left femur. the hardware was intact, with slighly more displacement compared to the fluoroscopic images taken in the or. he was transferred back to the sicu for more close supervision an medical management of his agitation/delirium. he became stable and oriented thereafter. in the am of he was alert and oriented to person, time, and place. all antibiotics and iv medications were stopped prior to discharge. he is being discharged to today in stable condition, with a knee immoblizer on his left leg and an ex-fix to the right. his staples from his left leg were removed just prior to discharge. medications on admission: none discharge medications: 1. cyanocobalamin 100 mcg tablet sig: one (1) tablet po daily (daily). 2. oxycodone 5 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. 3. nicotine 21 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily). 4. colace 100 mg capsule sig: one (1) capsule po twice a day. 5. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po tid (3 times a day). 6. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection injection (2 times a day). 7. haloperidol 5 mg tablet sig: one (1) tablet po q 8h (every 8 hours). 8. senna 8.6 mg tablet sig: one (1) tablet po twice a day. 9. folic acid 400 mcg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: - discharge diagnosis: primary diagnosis s/p pedestrian v. car 1. comminuted left femur fracture 2. open right ankle fracture/near amputation 3. right lateral rib fractures 2&3 4. delirium tremens 5. acute blood loss anemia secondary diagnoses 1. etoh abuse 2. pancreatitis discharge condition: stable. ex-fix to rle, ki to lle discharge instructions: do not drink alcohol. you had life threatening delirium tremens during your hospitalization. a good addictions program will help you to stay sober after your discharge, maybe aa. you suffered a broken left leg which was surgically repaired and you have a broken right ankle which needs surgery in a few weeks. you can get up but do not bear weight on the right leg. the left leg can be touch down weight bearing. the orthopedic service will re evaluate you in a few weeks. call dr. if you have any fevers > 101 or increased redness or swelling over the right leg. physical therapy: activity: bedrest right lower extremity: non weight bearing left lower extremity: touchdown weight bearing knee immobilizer: at all times treatments frequency: site: rle ex-fix type: surgical comment: pin care - 50/50 mix of ns and peroxide site: r shin type: surgical dressing: nonadherent dsg (adaptic) comment: change daily, reinforce as needed with abd site: left knee type: surgical dressing: gauze - dry comment: cover only for drainage followup instructions: call dr. at for a follow up appointment in 2 weeks call the clinic at for a follow up appointment in 2 weeks with , np md, procedure: venous catheterization, not elsewhere classified interruption of the vena cava enteral infusion of concentrated nutritional substances debridement of open fracture site, tibia and fibula debridement of open fracture site, tibia and fibula application of external fixator device, tibia and fibula application of external fixator device, tibia and fibula open reduction of fracture with internal fixation, femur closed reduction of fracture without internal fixation, tibia and fibula diagnoses: acute posthemorrhagic anemia motor vehicle traffic accident involving collision with pedestrian injuring pedestrian unspecified fracture of ankle, open lack of housing closed supracondylar fracture of femur acute pancreatitis closed fracture of multiple ribs, unspecified street and highway accidents alcohol withdrawal acute alcoholic intoxication in alcoholism, continuous activities involving walking, marching and hiking unspecified external cause status 

Answer: The patient is high likely exposed to