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: pedestrian struck by car major surgical or invasive procedure: debridement and irrigation of a r open tibia and fibula fracture; application of an external fixator; application of a vacuum sponge; debridement of a posterior knee wound and irrigation of posterior knee wound; application of vacuum sponge to the r posterior knee wound; debridement and irrigation of an open l tibia fracture; application of an external fixator l tibia fracture; debridement of r possible olecranon fracture with irrigation. inferior vena cava filter placement via the femoral route 1. irrigation and debridement down to and inclusive of bone left tibia. 2. irrigation debridement down to and inclusive of bone right tibia. 3. open reduction internal fixation of left proximal tibia and proximal shaft fracture. 4. intramedullary nailing right tibia fracture, modifier 22. 5. removal left lower extremity external fixator 6. removal right lower extremity external fixator. 7. wound closure right posterior popliteal area wound. 8. vac application of right tibia. 9. vac application left tibia. 1. irrigation and debridement superficial down to and inclusive of muscle of bilateral lower extremity open tibia fractures and change of vacuum dressings. 2. open reduction internal fixation right olecranon fracture. history of present illness: 65 yo m was a pediatrian struck by a vehicle. the pt was found 100 ft from his shoes. the car was significantly damaged. he was hypotensive in the field, and he was noted to have rle angularization. he was found awake with a gcs12 but intubated for protection, brought to where trauma survey including pan imaging reportedly significant for ble open tib-fib fractures with preserved distal pulses, forehead contusion, isolated posterior max wall fracture, cervical fracture, multiple rib fractures with pulm contusion, poss aspiration, small unilateral ptx, and no obvious intra-abdominal injury. past medical history: cad diabetes mellitus ii asthma copd social history: previously independent, married, owns retail store family history: noncontributory physical exam: vital signs stable, afebrile gen: nad, follows simple commands with hands neck: stoma lungs: bilateral rhonchi cv: rrr, nl s1 and s2 abd: soft, nt, nd jp x . ext: b/l mutipodous boots, r arm in brace, r le with 2+ edema and flap pertinent results: 04:32am blood wbc-6.3 rbc-2.98* hgb-9.0* hct-28.9* mcv-97 mch-30.1 mchc-31.0 rdw-16.5* plt ct-492* 05:23am blood neuts-75.1* bands-0 lymphs-15.7* monos-5.0 eos-3.9 baso-0.3 06:31am blood pt-14.9* ptt-26.7 inr(pt)-1.3* 08:21pm blood glucose-338* urean-18 creat-0.8 na-146* k-4.4 cl-117* hco3-22 angap-11 04:19am blood alt-48* ast-24 alkphos-278* amylase-110* totbili-0.8 08:21pm blood calcium-7.2* phos-2.8 mg-2.1 studies at admission: ct head (): 1. small foci of subarachnoid hemorrhage, without mass effect. 2. depressed fracture through the posterior wall of the right maxillary sinus with hemosinus. 3. incompletely imaged fracture through the left lateral mass of c2. please refer to ct of the cervical spine for further details. ct abd/pelvis (): 1. multiple injuries involving the right chest including fractures of ribs three through nine, fracture of the right coracoid process, and contusions with traumatic pneumatoceles in the right lung as well as a small medial right pneumothorax. some degree of aspiration may also be present as there are secretions within the trachea. 2. possible small right hepatic contusion, with a tiny amount of perihepatic fluid. no additional intra-abdominal injury identified. 3. additional fractures involving the right inferior and superior pubic rami. 4. slit-like ivc, suggesting hypotension. 5. incompletely characterized 3.1 cm right adrenal lesion. an mri can be obtained on a non-emergent basis for further characterization. 6. large right thyroid nodule - thyroid ultrasound is recommended on a non- emergent basis. 7. incidentally: 3 cm infrarenal aaa, left renal cyst, cholelithiasis, sigmoid diverticulosis. ct c-spine (): 1. left c2 lateral mass fracture extending into the transverse foramen. 2. left supraclavicular hematoma, not seen on the ct of the torso. 3. partially imaged right maxillary sinus opacification due to posterior wall fractures seen on head ct. 4. large right thyroid nodule measuring up to 4.6 cm, for which thyroid ultrasound is recommended on a non-emergent basis. cta lower extremity (): 1. patent vascularity in both lower extremities without evidence of extravasation. 2. comminuted fracture of tibia and fibula bilaterally, extending into the tibial plateau. brief hospital course: pt was brought to the ed intubated. orthopedics was consulted for the open bilateral tib-fib fractures. orthopedics brought the pt to the or for bialteral lower extremity stabilization and debridement of wounds. vascular surgery was consulted postoperatively for concern over possible vascular injury to b/l le. q1 hour vascular checks were initiated. neurosurgery was consulted due to head trauma which included a small sah, c2 fracture, and a r maxillary sinus posterior wall fracture. neurosurgery recommended continuing the c-collar and to withold anticoagulation. a short chronological description of mr. stay follows: : to or. decreased doppler signal from rle pulse but resolved intraoperatively. received 3 units packed red blood cells, 2 ffp, 4l crystolloid, 800 estimated blood loss. blood from ett. hematocrit declined overnight - 2 units prbc. : patient with left pneumothorax - treated with chest tube, and required temporary assist control for respiratory acidosis. hematocrit dropping, 2 u prbc transfused. : to or with ortho for orif left tibial (plate) and right tibial nail, ivc filter placed, 2 u prbcs transfused, repeat washout r elbow. left ct with no respiratory variation, but no respiratory status changes. : weaned to cpap/ps; lasix gtt / albumin started. plan for or on for skin graft/muscle flap le. fever 101 - cultured. hct 20.6, transfuse 2uprbc. : or postponed given long procedure which pt. would be unable to tolerate. cta of the neck to rule out vertebral artery dissection. lasix drip started. : s/p or with ortho for elbow; no further operative ortho needs. got 1 unit prbcs intra-operative. continued lasix gtt. weaning vent. increased free water gi flushes given rising na and cl. : lasix gtt d'ced; replaced arterial line. : started vanc/zosyn; pt. arouses to voice, opens eyes spontaneously, +gag/+strong productive cough. pt communicates by nodding/mouthing words, copious bloody secretions from pulmonary contusion. : trach/peg, started lasix, increase vanc to q8, plastics considered taking to or rehab planning started, temp spiked-->pan cx : paient persistently febrile, pancx sent, bronched today--> mild thick secretion, bal sent, left chest d/c, ct scan shows no evidence of sinusitis, but c2 vertebrae slightly rotated. pt. tested for h1n1 flu, currently placed on droplet & contact precautions until virus can be ruled out. : or with plastics for left lower extremity closure, right lower extremity vac change. prs to change vac q3-4 days, plan for right lower extremity flap. vascular consult for right lower extremity formal angiogram for pre-op planning. : i.d. consult for ?influenza given fever and exposure to rn with influenza a. prelim recs: doubt flu, but given critical care pt would recommend tamiflu prophylaxis. consider ct torso (deferred for now per trauma) to eval for fever source. : on physical exam at 0400, pt. noted to be less responsive than usual. labs recently drawn, bg at the time 39, insulin gtt off. immediate recheck fs 103. pt also with fever spike at the time to 101.5, blood (peripheral and picc) and urine sent for cx. ruq u/s c/w gall bladder sludging; ct torso pending; : off antibiotics, off the vent, tolerating trach, and off the contact precaution. pt remained off the ventilator overnight with respiratory status unchanged. pt required frequent suctioning for blood tinge/ rusty secretions. trach mask weaning as tolerated. : decreased free water boluses to 250 q8, added ambien. temp spike to 101.4 at , blood cx and urine cx sent. : transferred to floor : angio done. : ruq u/s: no evidence of cholecystitis : lateral free flap and split thickness skin graft done by plastics. please see operative note. cxr: bibasilar atelectasis/effusion vs pna : tf advanced. : no events. : no events. : bolus tube feeds begun. : plastics begins dangling leg checks to test viability of flap rle. ct head done to evaluate mental status. tf held due ?aspiration. vanc and flagyl d'ced. : erythromycin d'ced. neurosurgery consulted again and believes burr holes for increased subdural effusions not necessary. tube feeds restarted. : patient hep locked. : staples and sutures discontinued with exception of around flap. trach changed to 6 fenestrated noncuffed. : pt d/c'ed to rehab in stable condition medications on admission: nitroglycerin, ace-i, metformin, isosorbide, albuterol, salmeterol, creon discharge medications: 1. white petrolatum-mineral oil 42.5-56.8 % ointment sig: one (1) appl ophthalmic tid (3 times a day) as needed for dry eye. 2. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection injection tid (3 times a day). 3. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 4. polyethylene glycol 3350 100 % powder sig: seventeen (17) g po daily (daily) as needed for constipation. 5. oxycodone-acetaminophen 5-325 mg/5 ml solution sig: 5-10 mls po q4h (every 4 hours) as needed for pain. 6. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 7. acetaminophen 160 mg/5 ml solution sig: 320-640 mg po q6h (every 6 hours) as needed for fever. 8. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). 9. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: two (2) puffs inhalation q4h (every 4 hours) as needed for trach mask. 10. ipratropium bromide 0.02 % solution sig: one (1) puff inhalation q4h (every 4 hours) as needed for while on trach mask. 11. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 12. metoprolol tartrate 5 mg/5 ml solution sig: 5-10 mg intravenous q4h (every 4 hours) as needed for hr > 100, sbp > 160. 13. piperacillin-tazobactam-dextrs 4.5 gram/100 ml piggyback sig: 4.5 g intravenous q8h (every 8 hours): continue till . 14. metoclopramide 5 mg/ml solution sig: fifteen (15) mg injection q6h (every 6 hours). 15. trach pt has been down-sized to a fenestrated trach. he can be evaluated & decannulated at your facility as appropriate. 16. insulin fsbs: 0-70 mg/dl 1 amp d50 71-160 mg/dl 0 units 161-180 mg/dl 6 units 181-200 mg/dl 10 units 201-220 mg/dl 14 units 221-240 mg/dl 18 units 241-260 mg/dl 22 units 261-280 mg/dl 26 units 281-300 mg/dl 30 units 301-320 mg/dl 34 units 17. lantus 100 unit/ml cartridge sig: thirty five (35) units subcutaneous at bedtime. discharge disposition: extended care facility: - discharge diagnosis: primary diagnosis: s/p pedestrian struck by car -small foci of subarachnoid hemorrhage -right maxillary sinus posterior wall fracture w/hemosinus -c2 fracture of left pedicle extending to transverse foramen -right pulmonary contusion/traumatic pneumatoceles -right #3-9th rib fractures -right coracoid process fracture -right acromion fracture -left supraclavicular hematoma -right hepatic contusion, tiny amount of perihepatic fluid -right superior/inferior pubic ramus fracture -bilateral lower extremity open fracture discharge condition: stable. discharge instructions: resume all home medications. seek immediate medical attention for fever >101.5, chills, increased redness, swelling, bleeding or discharge from incision, chest pain, shortness of breath, difficulty breathing, severe headache, increasing neurological deficit, or anything else that is troubling you. no strenuous exercise or heavy lifting until follow up appointment, at least. do not drive or drink alcohol while taking narcotic pain medications. call your surgeon to make follow up appointment. followup instructions: -please follow-up with trauma clinic in 2 weeks. call ( to make an appointment. . -please call to make a follow up appointment in 4 weeks with dr. from neurosurgery for your c-spine fx and head bleed / subdural fluid collections. you will need a head ct and prior to your appointment, please let the secretary know this when you make the appointment and she will arrage the scan as well. . -please call ( to make an appointment to be seen in dr. plastic surgery clinic in 2 weeks. procedure: insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more interruption of the vena cava enteral infusion of concentrated nutritional substances arteriography of femoral and other lower extremity arteries other bronchoscopy percutaneous [endoscopic] gastrostomy [peg] arterial catheterization temporary tracheostomy graft of muscle or fascia advancement of pedicle graft debridement of open fracture site, tibia and fibula debridement of open fracture site, tibia and fibula application of external fixator device, tibia and fibula open reduction of fracture with internal fixation, tibia and fibula open reduction of fracture with internal fixation, radius and ulna debridement of open fracture site, radius and ulna debridement of open fracture site, radius and ulna closed reduction of mandibular fracture other myectomy removal of implanted devices from bone, tibia and fibula application of external fixator device, radius and ulna diagnoses: coronary atherosclerosis of native coronary artery diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified protein-calorie malnutrition motor vehicle traffic accident involving collision with pedestrian injuring pedestrian other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure pneumonia due to pseudomonas pneumonitis due to inhalation of food or vomitus closed fracture of second cervical vertebra pressure ulcer, lower back chronic obstructive asthma, unspecified traumatic pneumothorax without mention of open wound into thorax hyperosmolality and/or hypernatremia ventilator associated pneumonia other and unspecified complications of medical care, not elsewhere classified injury to liver without mention of open wound into cavity, hematoma and contusion contusion of lung without mention of open wound into thorax flail chest closed fracture of pubis open fracture of shaft of fibula with tibia pressure ulcer, stage i closed fracture of seven ribs closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, with no loss of consciousness methicillin resistant pneumonia due to staphylococcus aureus open fracture of upper end of tibia alone open fracture of olecranon process of ulna closed fracture of mandible, coronoid process closed fracture of acromial process of scapula 

Answer: The patient is high likely exposed to