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: bactrim ds attending: chief complaint: s/p mvc major surgical or invasive procedure: 1. total laminectomies of t10, t11, l1, and l2. 2. extra cavitary decompression of t12. 3. fusion of t10 to l2. 4. instrumentation of t10 to l2. 5. autograft. history of present illness: 85m s/p mvc vs pole, then veered into a tree. does not remember losing control of the car, ? loc. notes low back pain on arrival to ed. found to have c4 spinous process, c7 left transverse process, t12 vertebral body and spinous process fractures. taken to or for thoracic/lumber fusion. was neurologically normal until pt was flipped prone. now have b/l le paralysis (although pt is able to move left toes). significant blood loss in or of ~ 3.5l. transferred to ticu from or intubated with levophed and phenylephrine gtt. past medical history: pmh: cad, htn, hl, bph, bppv, spinal stenosis, pacemaker ,tinnitus, renal insufficiency (lasix recently stopped for cr 2.2, new baseline since 2.1-2.3) psh: pacemaker implantation, cabg x 4 , avr with st. epic tissue valve , turp, back surgery for spinal stenosis, bilateral knee replacement social history: -tobacco history: never -etoh: never -illicit drugs: never pt is a former design and land development professor. lives in with grandson and a close friend. his friend helps out with cooking, and he bathes himself. pt is still active in planning an intergenerational apartment complex in . family history: father died at yo of chf. mother had a " problem" since her youth but died at yo of complications after hip fx. two sisters both 80 and 82 yo with hx of colon cancer. physical exam: on arrival to the ed at : hr: 104 bp: 169/98 resp: 16 o(2)sat: 100 normal constitutional: uncomfortable heent: pupils equal, round and reactive to light tympanic membranes clear, no tenderness in back of neck chest: airways intact, bilateral breath sounds, no crepitus, chest stable cardiovascular: 2+ radial and pedal pulses bilaterally abdominal: soft extr/back: upper and lower extremities stable bilaterally, 2+ radial and 2+ pedal pulses bilaterally skin: warm and dry neuro: speech fluent upon discharge: hr: 97 bp: 118/70 resp: 18 o2 sat: 95% on ra temp:97.8 neuro: alert and oriented x 3, follows commands, speech fluent and clear, + sensation bilateral le, + movement bilat le strength 2-3/5, perrla chest: cta bilaterally, normal s1s2 abd: soft, nondistended, nontender, +bs, +flatus gi: foley in place, clear yellow urine ext: +pp, warm and pink pertinent results: ct head () - no acute process ct cspine () 1. acute fracture of c4 spinous process, c7 left transverse process, and bilateral first ribs. 2. hematoma in the paraspinal muscles posterior to c2 through c5. consider mr for ligamentous injury if not contraindicated. 3. multilevel degenerative changes with bilateral moderate to severe neural foraminal narrowing at multiple levels and mild to moderate central canal narrowing, most prominent at c3-c4. ct torso () 1. no acute intraabdominal process. 2. unstable transverse fracture through the t12 vertebral body with anterior distraction and extension through the posterior elements, highly concerning for cord and ligamentous injury. 3. fracture of the left first, second, and third ribs with associated chest wall hematoma. fracture of the right first rib and the fourth anterior costochondral junction. 4. fracture of the sternum with associated mediastinal hematoma. 5. stable pancreatic and renal cysts. 6. 2-mm right lower lobe pulmonary nodule. follow chest ct in 1 year is recommended if the patient has a history of smoking or prior malignancy; otherwise no further follow up is required. ct t spine : 1. t12 fracture, status post fusion of t10 through l2. no evidence of hardware loosening. 2. limited evaluation of spinal canal due to a ct modality and streak artifacts from hardware. if there is continued concern for significant spinal canal stenosis, ct myelography is recommended. ct l spine : 1. limited study due to streak artifact from hardware and subcutaneous attenuation from prior surgeries. if there is continued concern for cord impingement, recommend correlation with a ct myelogram. 2. post-surgical changes from t10-l2 fusion and l3-s2 fusion cxr : stable position of support and monitoring devices. unchanged effusions. no evidence of pneumonia or new vascular congestion 10:28am wbc-10.0 rbc-3.71* hgb-11.2* hct-33.1* mcv-89 mch-30.3 mchc-34.0 rdw-14.9 10:28am neuts-59.7 lymphs-36.0 monos-3.3 eos-0.9 basos-0.1 10:28am plt count-258 10:28am pt-12.5 ptt-25.3 inr(pt)-1.1 10:28am glucose-123* urea n-25* creat-1.6* sodium-142 potassium-4.5 chloride-111* total co2-20* anion gap-16 02:52pm ck-mb-16* mb indx-2.2 ctropnt-0.02* 02:52pm ck(cpk)-720* 10:07pm ck-mb-22* mb indx-1.6 10:07pm ck(cpk)-1380* brief hospital course: tsicu course: mr. was admitted to the trauma icu on . ortho spine was consulted for is cervical and t12 fractures, and he was taken to the operating room on for t10-l2 spinal fusion. when flipped prone the patient was shown to have no motor function seen in the lower extremities. (please see operative report from dr. for details). also during the operation there was significant blood loss requiring txa infusion and massive transfusion. he was transferred out of the or with levophed and neo gtt. transfused rest of 200ml cell- blood. the patient came with noticable leak from 6.5 ett and cuff maximally inflated. dl with glidescope showed significant soft tissue redundancy, edematous airway/tongue, and herniation of cuff outside of the vocal cords. fiberoptic bronch placed inside ett until carina visualized to confirm placement within airway. ett advanced and cuff distal to vocal cords. on he was noted to be moving all extremities when sedation off. he received 500cc ns bolus for low uop, as well as 1u prbc in am. fena suggests pre-renal. when the icu team attempted to wean pressors but was unable to get past 0.06. 1u prbc given overnight. also of note, his creatinine bumped to 2.4. on , he was started on a lasix gtt. thrombocytopenia, no signs of bleeding, coags and fibrinogen within normal limits. he also received prbcx1 for mild hypotension. on he was extubated extubated and the lasix gtt off. he was advanced to a regular diet and betablockers were restarted (started labetolol instead of atenolol because atenolol renally cleared). he was on all po medications and began to autodiurese. on the surgical drain was removed by dr. and his urine output continued to improve. he remained hemodynamically stable and was transferred to the floor from the icu. floor course: on mr. was transferred to the surgical floor. his vital signs were routinely monitored and he remained afebrile and hemodynamically stable. his oxygen saturation was monitored with vital signs and remained in the mid to upper 90's on room air. incentive spirometry and pulmonary toileting were encouraged. his pain was well controlled with oral pain medication. he continued to have improved mobility and sensation in his lower extremities. at the time of discharge he was able to move both lower extremites, but had decreased strength 2-3/5, worse in the right than the left. he remained alert and oriented and was following commands appopriately. on in the morning he became nauseated when getting out of bed and had one episode of emesis. of note, the patient had not had a bowel movement since prior to admission. he had previously been started on a bowel regimen of miralax and colace, and was also given a dulcolax suppository on . his abdomen remained soft, nondistended and nontender. he had + bowel sounds and reported passing flatus at the time of discharge. aside from the one episode of vomiting, he was tolerating a regular diet. he failed a void trial on , and on his foley was replaced. he was voiding adequate amounts of clear yellow urine at the time of discharge via the foley. his creatinine continued to trend downward to his baseline and 1.4 at the time of discharge. he remained afebrile with a normal wbc count of 7.4 upon discharge. he was on sc heparin for dvt prophylaxis. physical therapy was consulted who recommended discharge to an extended care facility when medically stable for continued pt needs. he remained in a tlso brace when the head of the bed was greater than 45 degrees or when out of bed. he remained in the cervical collar at all times. on , he was discharged to an extended care facility with plans to return the following week for an anterior fusion with dr. for further stabilization of the spine. medications on admission: tylenol 2 tabs prn pain, calcium carbonate 1250', colace 100'', finasteride 5', folic acid 1', toprol xl 25', omeprazole 20', zocor 40', flomax .4', vitamin d 1000', miralax daily, meclizine 25', multivitamin discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 3. heparin (porcine) 5,000 unit/ml solution sig: one (1) inj injection tid (3 times a day). 4. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 5. oxycodone 5 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 6. polyethylene glycol 3350 17 gram/dose powder sig: one (1) packet po daily (daily). 7. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). 8. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 9. tamsulosin 0.4 mg capsule, ext release 24 hr sig: one (1) capsule, ext release 24 hr po hs (at bedtime). 10. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 11. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 12. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours). 13. calcium carbonate 500 mg calcium (1,250 mg) tablet sig: one (1) tablet po daily (daily). 14. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). discharge disposition: extended care facility: discharge diagnosis: s/p mvc injuries: c4 spinous process fracture c7 left transverse process fracture left first and second rib fracture right first rib fracture t12 vertebral body/spinous process fracture fracture of sternum with small associated mediastinal hematoma fracture of anterior costochondral junction of 4th rib right lower lobe contusion discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours other exploration and decompression of spinal canal dorsal and dorsolumbar fusion of the posterior column, posterior technique repair of vertebral fracture fusion or refusion of 4-8 vertebrae diagnoses: acute kidney failure with lesion of tubular necrosis acute posthemorrhagic anemia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified aortocoronary bypass status chronic kidney disease, unspecified nausea with vomiting other and unspecified hyperlipidemia hemorrhage complicating a procedure closed fracture of sternum other constipation cardiac pacemaker in situ heart valve replaced by transplant closed fracture of seventh cervical vertebra knee joint replacement contusion of lung without mention of open wound into thorax traumatic shock closed fracture of fourth cervical vertebra motor vehicle traffic accident due to loss of control, without collision on the highway, injuring driver of motor vehicle other than motorcycle edema of larynx closed fracture of four ribs other fluid overload closed fracture of t7-t12 level with other specified spinal cord injury 

Answer: The patient is high likely exposed to