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: history of present illness: the patient is a 41-year-old male brought to the trauma resuscitation bay following a motor vehicle crash involving his vehicle crashing into a house. immediately following the impact, the patient noted immediate loss of motor and sensory function in his bilateral lower extremities. past medical history: the patient's only known past medical history is that of type 2 diabetes mellitus. past surgical history: none. allergies: no known drug allergies. medications: the patient takes no medications at home. physical examination: general: in the trauma bay upon evaluation, the patient was found to be somnolent with a degree of combativeness for which he was immediately intubated. he was afebrile and hemodynamically stable. heent: pupils equal, round and reactive to light and accommodation with no evidence of obvious head trauma. cervical spine was nontender. cervical block, collar, and chest were clear. abdomen: soft. rectal: he was noted to have no rectal tone. hospital course: on trauma series the patient was noted to have c4 burst fracture, and c5, c6, and c7 fractures. he was noted to have no movement or sensation in his bilateral lower extremities. the patient was also noticed to have no sensation in his abdomen. for these injuries, the patient was started immediately on solu-medrol infusion per spinal injury protocol. the patient was immediately taken for ct scan of his head which revealed no acute injury and no bleed. ct of his cervical spine revealed fractures at c4, c6, t2, and t12, and also most significantly was his c7 fracture which appeared to be the worst which showed the vertebral body had been burst into many pieces. ct of the abdomen and pelvis was negative. neurosurgical consult was immediately obtained. the patient was kept on strict c-spine logroll precautions and required pressor support to keep his systolics greater than 100. mri of the cervical spine showed findings consistent with that of his ct scan along with significant cord damage in that area. over the next few days, the patient's steroid drip was weaned off, and plans were made for neurosurgical open reduction and internal fixation stabilization of his cervical and thoracic spine. on , the patient was hemodynamically stable and taken to the operating room by the neurosurgical service where a c7 vertebrectomy was performed, a c6-t1 anterior arthrodesis infusion was performed along with ............... interbody titanium surgical .............. cage was placed which was packed with vertebral autograft. the patient also received anterior screw with plate fixation. the patient tolerated the procedure well, and there were no complications. the patient was transferred back to the trauma surgical intensive care unit where he remained intubated and was hemodynamically stable. the orthopedic surgeons had addressed his orthopedic fractures which included a left wrist fracture and right ankle fracture which were splinted. the patient was also found to have a right lower lobe pneumonia with spiking fevers for which antibiotics were started. although initially in the trauma bay the patient was noted to have no sensation in his bilateral lower extremities and decreased movement of his upper extremities, over the following few days in the intensive care unit, he began to move his upper extremities significantly more and began to become sensate; however, no function appeared to return to his lower extremities. his intensive care unit course at this time remained complicated by several episodes of ventilator associated pneumonia intermittently requiring pressors. the patient underwent several bronchoscopic exams for removal of secretions and plugs. several attempts were made to wean to extubate which were unsuccessful. a nasoenteric feeding tube was placed, and tube feeds were started with success. the patient's intensive care unit course continued to be complicated by multiple episodes of ventilator associated pneumonia and central line sepsis. on , the patient was taken to the interventional radiology suite where a percutaneous gastrojejunostomy feeding tube was placed. the patient tolerated the procedure without complication. because of the multiple episodes of line sepsis and problems with central access for this patient, a picc line was placed; however, the patient also had spiking fevers following this, and this picc line was removed. following several attempts at weaning and failures requiring increased pressure support, on , the patient underwent bedside percutaneous tracheostomy and bronchoscopy to verify placement. he tolerated this procedure well without complication. following this, the patient's tube feeds were advanced by his percutaneous gastrojejunostomy tube which he tolerated well. he slowly became more awake, and his pressure support wean continued slowly which he was tolerating well. the patient underwent speech and swallow study which revealed that his swallowing mechanism was intact. due to continued spiking temperatures, the patient underwent a cardiac echocardiogram which revealed no evidence of valve vegetation. following this, all intravenous and intra-arterial catheters were discontinued in this patient, and all antibiotics were stopped. he continued on tube feeds with a slow ventilator wean. the patient was pancultured several times following this which revealed sterile cavities. the patient also grew one blood culture of methicillin resistant staphylococcus epidermidis; however, this presumably was the only source of infection, so a course of vancomycin was started and completed. although the patient had passed speech and swallow study, he still had copious secretions and was deemed unsafe to begin p.o. intake. for this reason, he underwent an additional bronchoscopy which revealed secretions but non-occluded airway. at this point, his ventilatory support decreased. he began to slowly wean from the standpoint of his requirement for pressure support. he was screened for placement and vent rehabilitation. following this course of vancomycin, the patient for the first time in weeks, had become afebrile. he began to take small sips of clears and advanced to soft solids and eventually was taking a regular diet. after 48 hours or regular diet, the patient was seen to have coughed and not tolerated some of this, so his p.o. feeds were discontinued, and his tube feeds were resumed by his pej tube. on , the patient remained afebrile with stable vitals signs. his vent support was at pressure support of 10, peep of 7.5, fio2 50%. he was taking tidal volumes of 650, breathing 22 times a minute. on exam he was awake, alert, and oriented times three, and was in no distress. he was in a cervical collar without spinal tenderness. heart was regular. pulmonary exam showed coarse breath sounds bilaterally but was oxygenating well, and he was in no distress. his abdomen was soft, nontender, nondistended. his pej tube site was clean, dry, and intact. extremities were edematous but warm and dry with triphasic doppler signals and bilateral dorsalis pedis posterior tibial pulses. he has no invasive central venous monitoring and no arterial monitoring. he is maintained on a peripheral iv only. the patient was doing well. he was screened for discharge and will be discharged to a ventilatory rehabilitation facility. condition on discharge: stable. discharge status: to rehabilitation. discharge medications: zoloft 50 mg per pej tube q.d., lovenox 40 mg subcue b.i.d., regular insulin sliding scale, zantac 150 mg per pej tube b.i.d., nystatin swish and swallow 5 cc p.o. q.i.d., nph insulin 27 u subcue b.i.d., tylenol 650 mg per pej tube q.4-6 hours p.r.n., albuterol and atrovent mdis 4-6 puffs q.4 hours p.r.n., lacrilube drops o.u. p.r.n., imodium per peg tube p.r.n., the patient is receiving tube feeds impact with fiber at 80 cc/hr at goal through his pej tube. it should be noted that the anatomy of the patient's feeding tube is a percutaneous gastroduodenal jejunostomy tube. , md dictated by: medquist36 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more enteral infusion of concentrated nutritional substances other bronchoscopy temporary tracheostomy other cervical fusion of the anterior column, anterior technique excision of intervertebral disc percutaneous (endoscopic) jejunostomy [pej] application of splint diagnoses: pneumonia, organism unspecified acute respiratory failure closed fracture of c1-c4 level with other specified spinal cord injury motor vehicle traffic accident due to loss of control, without collision on the highway, injuring driver of motor vehicle other than motorcycle unspecified fracture of ankle, closed closed fracture of t7-t12 level with other specified spinal cord injury closed fracture of c5-c7 level with other specified spinal cord injury closed fracture of t1-t6 level with other specified spinal cord injury closed fracture of carpal bone, unspecified 

Answer: The patient is high likely exposed to