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: fall major surgical or invasive procedure: open reduction internal fixation of the tibia. history of present illness: 40m fell while intoxicated w/ alcohol from the and broke his leg, open tib-fib. past medical history: noncontributory social history: +etoh denies illicits denies tob family history: noncontributory physical exam: 119 181/108 100% on o2 bag combative, subsequently intubated. rrr cta bilaterally anteriorly abd soft nd pelvis stable rectal tone: nl; guaiac neg neck/back: no stepoffs, no deformity extr: palp distal pulses; rle 1cm lac c/w bone, not puncture wound; rle externally rotated. pertinent results: 05:01pm type-art temp-36.9 rates-14/ tidal vol-500 peep-5 o2-50 po2-227* pco2-45 ph-7.38 total co2-28 base xs-1 intubated-intubated vent-controlled 12:49pm glucose-96 urea n-8 creat-1.0 sodium-142 potassium-4.1 chloride-104 total co2-25 anion gap-17 12:49pm calcium-8.5 phosphate-2.1* magnesium-1.7 12:49pm wbc-8.8 rbc-4.06* hgb-11.4* hct-34.3* mcv-84 mch-28.1 mchc-33.3 rdw-14.4 12:49pm plt count-175 12:49pm pt-10.6 ptt-17.5* inr(pt)-0.9 04:10am urine bnzodzpn-neg barbitrt-neg opiates-neg cocaine-pos amphetmn-neg mthdone-neg 04:10am urine color-straw appear-clear sp -1.009 04:10am urine blood-mod nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.5 leuk-neg 03:30am amylase-109* 03:30am asa-neg ethanol-250* acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 03:30am wbc-8.8 rbc-5.01 hgb-14.0 hct-42.0 mcv-84 mch-28.0 mchc-33.4 rdw-14.3 . lower extremity fluoro without radiologist right 11:39 am tib/fib (ap & lat) right; lower extremity fluoro without reason: orif open tib fib fx fluoroscopic study, left tibia/fibula, comparison: left tibia and fibula radiographs of earlier the same date. indication: orif. fluoroscopic guidance was provided for open reduction and internal fixation of comminuted fracture of the tibia. no radiologists were involved in the procedure. a series of spot fluoroscopic images demonstrate open reduction and internal fixation of the tibial fracture which is maintained in alignment with an intramedullary rod and interlocking screws. fracture of the fibula is again noted. . tib/fib (ap & lat) right 11:39 am tib/fib (ap & lat) right; lower extremity fluoro without reason: orif open tib fib fx fluoroscopic study, left tibia/fibula, comparison: left tibia and fibula radiographs of earlier the same date. indication: orif. fluoroscopic guidance was provided for open reduction and internal fixation of comminuted fracture of the tibia. no radiologists were involved in the procedure. a series of spot fluoroscopic images demonstrate open reduction and internal fixation of the tibial fracture which is maintained in alignment with an intramedullary rod and interlocking screws. fracture of the fibula is again noted. . ankle (2 views) right 4:59 am tib/fib (ap & lat) soft tissue; foot ap,lat & obl right reason: frac medical condition: 54 year old man with fall reason for this examination: frac indication: 54-year-old male with fall. technique: seven views of right tibia and fibula. no comparison. findings: note is made of comminuted fracture, medial angulation at the fracture site with multiple oblique fracture lines in distal tibia. the fracture line does not seem to extend to the articular surface of the ankle, however, the evaluation is somewhat limited due to overlying cast. there is oblique fracture of the proximal fibula as well. the evaluation of ankle joint and foot are somewhat limited due to overlying materials. no gross fracture of the foot is seen. impression: comminuted fracture of the distal tibia with angulation with multiple oblique fracture lines. oblique fracture of the proximal fibula. the information has been communicated to the ed dashboard. . pelvis (ap only) 4:58 am pelvis (ap only) reason: ? medical condition: 54 year old man with fall reason for this examination: ? inj indication: 54-year-old man status post fall. technique: frontal view of the pelvis. comparison: ct torso study performed on the same day. findings: note is made of small bone fragment at the superior aspect of right acetabulum, which may represent small avulsion fracture. otherwise, no gross fracture or diastasis is seen. bowel gas pattern is unremarkable. bilateral si joints are symmetric. impression: small bone fragment at the superior aspect of the right acetabulum, which may represent an accessory ossification center or avulsed bone fragment, as noted on the prior ct scan. . ct chest w/contrast; ct abdomen w/contrast reason: trauma,fall from fourth floor field of view: 34 contrast: medical condition: s/p fall from reason for this examination: ? inj contraindications for iv contrast: none. indication: 54-year-old male with fall. technique: contiguous axial ct images of the chest, abdomen, and pelvis were obtained with the administration of iv contrast , 150 cc of optiray. multiplanar reformation images are reconstructed. no comparison. findings: there is no evidence of mediastinal hematoma. the patient is status post placement of endotracheal tube and nasogastric tube. no evidence of pneumothorax. the heart is normal in size, and there is no evidence of pericardial or pleural effusion. in the lung window, note is made of patchy peribronchial opacities in right lower lobe, probably due to aspiration. dependent atelectasis are seen. note is made of centrilobular emphysema. there is mucous secretion in the right main bronchus. abdomen: there is no evidence of intraperitoneal bleeding. no evidence of free air. liver, gallbladder, spleen, pancreas, adrenal glands, and the visualized portion of large and small intestines are within normal limits. note is made of bilateral renal cysts. no ascites. no lymphadenopathy. pelvis: the visualized portion of large and small intestines are within normal limits. no evidence of bleeding. no ascites. no lymphadenopathy. no fracture seen. impression: 1. patchy peribronchial opacity in right lower lobe, which may due to aspiration. . ct c-spine w/o contrast reason: ? medical condition: s/p fall from reason for this examination: ? inj contraindications for iv contrast: none. indication: 54-year-old man status post fall. technique: contiguous axial ct images of the c-spine. comparison: no comparison. findings: note is made of extensive degenerative disc disease with osteophyte formation and vacuum phenomena at multiple levels, however, there is no significant fracture or dislocation is noted. the patient is status post intubation. nasogastric tube is noted. the prevertebral soft tissue is unremarkable. note is made of fluid in the nasopharynx. emphysema is seen in the apices. impression: marked degenerative disc disease. no evidence of fracture or dislocation. . ct chest w/contrast; ct abdomen w/contrast reason: trauma,fall from fourth floor field of view: 34 contrast: medical condition: s/p fall from reason for this examination: ? inj contraindications for iv contrast: none. indication: 54-year-old male with fall. technique: contiguous axial ct images of the chest, abdomen, and pelvis were obtained with the administration of iv contrast , 150 cc of optiray. multiplanar reformation images are reconstructed. no comparison. findings: there is no evidence of mediastinal hematoma. the patient is status post placement of endotracheal tube and nasogastric tube. no evidence of pneumothorax. the heart is normal in size, and there is no evidence of pericardial or pleural effusion. in the lung window, note is made of patchy peribronchial opacities in right lower lobe, probably due to aspiration. dependent atelectasis are seen. note is made of centrilobular emphysema. there is mucous secretion in the right main bronchus. abdomen: there is no evidence of intraperitoneal bleeding. no evidence of free air. liver, gallbladder, spleen, pancreas, adrenal glands, and the visualized portion of large and small intestines are within normal limits. note is made of bilateral renal cysts. no ascites. no lymphadenopathy. pelvis: the visualized portion of large and small intestines are within normal limits. no evidence of bleeding. no ascites. no lymphadenopathy. no fracture seen. impression: 1. patchy peribronchial opacity in right lower lobe, which may due to aspiration. . ct head w/o contrast 4:08 am ct head w/o contrast reason: ? fractures, injuries medical condition: s/p fall from reason for this examination: ? fractures, injuries contraindications for iv contrast: none. indication: 54-year-old man status post fall. technique: contiguous axial ct images of the head. there is no definite acute intracranial hemorrhage. note is made of somewhat questionable area of hyperdensity anterior to the pons in the posterior fossa, at the area of beam-hardening artifact, most likely artifactual. no mass effect is seen. the osseous and soft tissue structures are unremarkable. impression: no definite evidence of intracranial hemorrhage. questionable area of hypodensity anterior to the pons, which is felt to be artifactual, however, please perform short time followup if clinically warranted. brief hospital course: mr was combative and in severe pain upon entry into the hospital. he was intubated and subsequently taken to the or for an orif (intramedullary nail) of the right tibia and fibula on . he stayed in the trauma icu and was extubated pod 1. pt had a couple episodes of post op fever which resolved with pulmonary toilet (studies negative for source of fever). physical therapy saw the patient for the duration of his stay. he was ultimately cleared with partial weight bearing status on crutches. for anticoagulation, the patient was maintained on lovenox during his stay. however, he indicated that he would not do the injections under any circumstances outside the hospital. in discussion with the orthopedists, it was decided that aspirin 325mg ec po bid was the next best option for him. the patient was discharged in stable condition with his friend. medications on admission: none discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po twice a day: take with food. disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 2. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for indigestion. disp:*60 tablet(s)* refills:*2* 3. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed for pain for 7 days: maximum: 12 pills in 24 hours. disp:*25 tablet(s)* refills:*0* 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation for 1 weeks: do not take the medicine if you have more than 1 bm per day. disp:*14 capsule(s)* refills:*0* 5. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed for constipation for 1 weeks. disp:*1 bottle (at least 800ml)* refills:*0* discharge disposition: home discharge diagnosis: fracture of tibia and fibula. discharge condition: good. discharge instructions: you broke your lower leg bones. you should only partially bear weight on that leg. follow the instructions of the orthopedic doctors and the physical therapists about how to partially weight bear. take your medications as directed. followup instructions: call dr. of orthopedics at ( for a follow up appointment in 2 weeks. you need to do this to get more medicines and to look at your broken leg. if you cannot follow up because you're moving to as you mentioned, you should either go to an orthopedic doctor there, or go to the er to have the staples out. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube debridement of open fracture site, tibia and fibula open reduction of fracture with internal fixation, tibia and fibula diagnoses: alcohol abuse, unspecified cocaine abuse, unspecified unspecified fracture of ankle, open accidental fall from or out of building or other structure 

Answer: The patient is high likely exposed to