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 contrast media attending: chief complaint: trauma: mvc: l hemo/pneumothorax s/p ct nondisplaced r iliac fracture l rib fxs flail grade iii splenic laceration major surgical or invasive procedure: chest tube placement removal of chest tube history of present illness: history of presenting illness hope eu critical is a 19-year-old woman who was the unrestrained driver of a car without airbags who hit a tree. the patient was seen and stabilized at hospital where she was diagnosed with a left hemopneumothorax, spleen laceration, pulmonary contusions, right iliac fracture. she had a left chest tube placed without difficulty, received a blood transfusion and has been hemodynamically stable during transport. timing: sudden onset quality: sharp severity: moderate duration: hours location: left upper quadrant context/circumstances: status post motor vehicle collision mod.factors: worse with movement associated signs/symptoms: hypotension past medical history: hypothyroidism social history: denies drugs and smoking family history: nc physical exam: physical examination: upon admission: temp: 98.8 hr: 95 bp: 135/85 resp: 20 o(2)sat: 100 normal constitutional: patient is awake, alert and responding to my questions. she is nontoxic in appearance heent: no evidence of head trauma, pupils are equal and reactive, extraocular muscles intact no cervical bony tenderness chest: lungs are clear bilaterally cardiovascular: normal s1-s2 abdominal: her belly is soft, but tender in the left upper quadrant, no peritoneal signs pelvic: pelvis is stable rectal: normal rectal exam gu/flank: no cva tenderness extr/back: no extremity deformities neuro: speech fluent psych: normal mood, normal mentation heme//: no petechiae pertinent results: 06:20am blood hct-23.4* 07:15am blood wbc-7.1 rbc-3.03* hgb-9.3* hct-25.3* mcv-84 mch-30.7 mchc-36.8* rdw-13.9 plt ct-118* 05:59pm blood hct-24.6* 03:57am blood wbc-11.4* rbc-3.63* hgb-11.0* hct-29.8* mcv-82 mch-30.3 mchc-36.9* rdw-14.1 plt ct-144* 03:45pm blood wbc-17.7* rbc-4.04* hgb-12.3 hct-33.7* mcv-83 mch-30.5 mchc-36.5* rdw-14.1 plt ct-188 01:25pm blood wbc-17.8* rbc-3.79* hgb-11.8* hct-32.2* mcv-85 mch-31.0 mchc-36.6* rdw-13.6 plt ct-205 07:15am blood plt ct-118* 09:00am blood plt ct-117* 01:25pm blood pt-13.1 ptt-21.7* inr(pt)-1.1 07:15am blood glucose-104* urean-9 creat-0.6 na-140 k-4.1 cl-105 hco3-28 angap-11 09:00am blood glucose-99 urean-12 creat-0.7 na-138 k-4.0 cl-105 hco3-27 angap-10 07:15am blood calcium-8.6 phos-3.4 mg-2.1 09:00am blood calcium-8.3* phos-2.0*# mg-2.0 : chest x-ray: impression: left-sided chest tube with likely left hemothorax. there may be an air component as well when correlated to the outside imaging. diffuse opacity in particular in the left lower lobe likely indicates some element of pulmonary contusion as well. mediastinal shift and splaying of the ipsilateral ribs is worrisome for at least in part tension physiology. left-sided rib fractures noted. : cat scan of the abdomen and pelvis: impression: 1. extensive left lower lobe pulmonary contusion and laceration with a small residual hemopneumothorax on the left and an indwelling chest tube as above. chest tube repositioning is likely indicated. the trauma surgery team is aware. 2. grade iii splenic lacerations as detailed above. there is no active extravasation appreciated or significant increase in the perisplenic hemorrhage; however, there has been interval increase in the amount of pelvic hemoperitoneum identified. 3. question low grade right renal laceration. correlate with hematuria. collecting system intact. 4. deep pelvic linear high attenuation adjacent to the left aspect of the uterus. the overall course suggests an accessory uterine vein or arterial however, the morphology is slightly irregular and the possibility of extravasation from a small injured vessel is raised. the lack of extravasated contrast from prior imaging is reassuring; however, in light of the increasing pelvic hemoperitoneum and continued hemodynamic instability, attention on for further scanning is advised. this was discussed at length with dr. at approximately 3:00 p.m. on the day of study. : angiogram: impression: left common iliac and splenic arteriograms without evidence of active extravasation. : angiogram: findings: 1. left common iliac arteriogram demonstrated normal anatomy with no contrast extravasation. 2. splenic artery digital subtraction angiogram demonstrated parenchymal contrast blush in the spleen, corresponding to areas of post-traumatic hyperemia. avascular areas were also noted within the spleen corresponding to known lacerations. no extra splenic contrast extravasation was visualized. : chest x-ray: findings: ap single view of the chest obtained with patient in supine position is analyzed in direct comparison with the next preceding supine chest examination obtained four and a half hours earlier during the same day. the patient is now intubated and ett seen to terminate in the trachea some 4 cm above the level of the carina. an ng tube has been advanced and reaches below the diaphragm including its side port. a left-sided chest tube is in place and has changed its position in comparison with the next previous study. whereas it earlier terminated in the upper hemithorax at the level of the fourth and fifth vertebral body, it has now been pulled back and the tip points towards the area of the seventh and eighth thoracic vertebral body. a diffuse haze that was overlying the left hemithorax on the previous study has regressed but basal density exists and coincides with the area of previously by chest ct identified pulmonary parenchymal contusion area. as on the previous examination, there may be a small left-sided apical pneumothorax but it has not increased during the latest examination interval. no new major displacements of the previously identified left-sided multiple rib fractures. the right-sided hemithorax appears intact. : chest x-ray: findings: in comparison to the earlier film, a small pneumothorax is seen apically in the left lung. the left chest tube remains in place. patchy opacification of the left base persists; however, it is less dense than earlier today. : chest x-ray: findings: ap single view of the chest has been obtained with patient in upright position. comparison is made with the next preceding supine chest examination of . during the interval, the left-sided chest tube has been removed. the previously described hazy density over the left lung base persists and is compatible with some pleural effusion. the tube has been removed, but no pneumothorax is identified anywhere in the left hemithorax, and the apical area is free. no new pulmonary abnormalities are seen, and no mediastinal shift can be identified : chest x-ray: findings: in comparison to the previous examination this radiograph is grossly unchanged. there remains a haziness in the left lower lung field which is likely a combination of atelectasis, pulmonary contusion, and pleural hemorrhage or effusion. the right lung is grossly clear. mediastinal silhouette is unremarkable. brief hospital course: 19 year old female, unrestrained driver, involved in a motor vehicle accident admitted to the acute care service from an outside hospital. she sustained a left hemo-pneumothorax for which a left sided chest tube was placed prior to admission. she also sustained left sided rib fractures. radiographic imaging showed a grade 4 splenic laceration and a right iliac fracture. she was hypotensive upon arrival to the emergency room and her chest tube was replaced. she underwent a cat scan with iv contrast and experienced shortness of breath and anxiety. she was subsequently treated with benadryl. upon arrival to the intensive care unit, she was intubated for airway protection and because there was a concern for a contrast allergy. to further investigate any further bleeding into her abdomen, she underwent angiography to investigate the possibilty of a left pelvic bleed and bleeding from the spleen. no contrast extravasation was noted. she was extubated on . she was evaluated by orthopedics for her iliac fracture and recommendations made for follow-up in 4 weeks. transferred to the surgical floor on . her left sided chest tube was discontinued. she was started on clear liquids with gradual advancement to to a regular diet. her pain was controlled with oral analgesia. she was evaluated by physical therapy who recommended a walker for ambulation and home physical therapy. because she had poor recollection of the accident, cognitive evaluation is recommended 1-2 weeks after discharge. her vital signs are stable and she is afebrile. her current hematocrit is 29 which is elevated from her baseline of 23-25. she is voiding without difficulty. she is preparing for discharge home with vna physical therapy and follow-up visit with the acute care service, orthopedics, and cognitive neurology. medications on admission: : levothyroxine discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day): hold for loose stools. 2. fexofenadine 60 mg tablet sig: one (1) tablet po bid (2 times a day). 3. levothyroxine 88 mcg tablet sig: one (1) tablet po daily (daily). 4. senna 8.6 mg tablet sig: one (1) tablet po daily (daily). 5. oxycodone 5 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for pain: may cause drowsiness, avoid driving while on this medication. disp:*25 tablet(s)* refills:*0* 6. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours): as needed for pain. discharge disposition: home with service facility: homecare discharge diagnosis: trauma: mvc: l hemo/pneumothorax s/p ct nondisplaced r iliac fracture l rib fxs flail discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane)( walker for support) discharge instructions: you were admitted to the hospital with after you were involved in a motor vehicle accident. you sustained a injury to your spleen and a fracture to the part of your hip. you also received a bruise to your lungs with a fluid collection for which you needed a chest tube placed. you were seen by orthopedics and they determined that you did not need surgery to repair your hip. as a result of the accident you did sustain left sided rib fractures. you are slowly recovering and you are ready to be discharged home with the following instructions: because you had a splenic laceration please follow these instructions: avoid contact sports and/or any activity that may cause injury to your abdominal area for the next 6-8 weeks. *if you suddenly become dizzy, lightheaded, feeling as if you are going to pass out go to the nearest emergency room as this could be a sign that you are having inernal bleeding from your liver or spleen injury. *avoid any blood thinners such as motrin, naprosyn, indocin, aspirin, coumadin or plavix for at least 3-5 days unless otherwise instructed by the md/np/pa. you also sustained rib fractures from the accident, please follow these instructions: your injury caused left sided rib fractures which can cause severe pain and subsequently cause you to take shallow breaths because of the pain. * you should take your pain medication as directed to stay ahead of the pain otherwise you won't be able to take deep breaths. if the pain medication is too sedating take half the dose and notify your physician. * pneumonia is a complication of rib fractures. in order to decrease your risk you must use your incentive spirometer 4 times every hour while awake. this will help expand the small airways in your lungs and assist in coughing up secretions that pool in the lungs. * you will be more comfortable if you use a cough pillow to hold against your chest and guard your rib cage while coughing and deep breathing. * symptomatic relief with ice packs or heating pads for short periods may ease the pain. * narcotic pain medication can cause constipation therefore you should take a stool softener twice daily and increase your fluid and fiber intake if possible. * do not smoke followup instructions: please follow up with the acute care service in 2 weeks. you can schedule your appointment 24 hours after you are discharged by calling #. please let them know that you will need a chest x-ray prior to your visit. please follow up with the dr. in 1 week. you can schedule your appointment by calling # you will also need to follow up with orthopedics, dr. in weeks. you can schedule this appointment by calling # procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube arteriography of other intra-abdominal arteries diagnoses: unspecified acquired hypothyroidism other injury into spleen without mention of open wound into cavity traumatic pneumohemothorax without mention of open wound into thorax contusion of lung without mention of open wound into thorax flail chest motor vehicle traffic accident due to loss of control, without collision on the highway, injuring driver of motor vehicle other than motorcycle closed fracture of eight or more ribs closed fracture of ilium 

Answer: The patient is high likely exposed to