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: erythromycin base / amoxicillin / penicillins attending: chief complaint: small small sah, gr iv liver lac, tib/'fib fx, bilateral femur fxs, l talus fx. major surgical or invasive procedure: principal procedure: 1. intramedullary rod fixation of right mid shaft femur fracture. 2. im rod fixation of right basocervical femoral neck fracture. 3. im rod fixation of left distal third femur fracture. 4. irrigation and debridement of grade open mid shaft femur fracture to bone. 5. incision and drainage of right medial knee laceration. 6. incision and drainage of left medial knee laceration. history of present illness: pt is a 23yo cauc m transf'd from hospital s/p high speed mvc car vs. tree in which pt was the unrestrained driver of a single occupant vehicle. per chart, + airbags, unknown loc. per chart, pt arrived to awake but confused w/ repetitive questioning- gcs 15 and not intubated until in the or for his femur fx orifs. etoh (bal) upon arrival at was 249. tox was otherwise neg. pt suffered a small small sah, gr iv liver lac, tib/'fib fx, bilateral femur fxs, l talus fx. past medical history: none social history: etoh family history: non contributory pertinent results: micro: : mrsa screen negative : urine cx. negative : mrsa screen pending, sputum contamination w/upper flora : mini bal no micro bl cx: no growth ucx: no growth : bal: no growth : bld x neg x2 : bl cx: no growth bl cx: no growth / urine cult no grown : stool cult neg c d-ff neg : stool cult neg c diff neg : stool culg pend c diff neg . imaging: ct head:limited by motion. possible subarachnoid hemorrhage in the left silvian fissure. this can be artifactual. repeat scan is recommended. ct c-spine: no fx ct torso: rul pulm contusion. severe liver injury (lac and hematoma involing both lobes.no defenite actice extrav. r adrnal hematoma. mesenteric hematoma-injury ?distal ileum mild dil can represent early ischemia (pls clinically correlate).small abd, perihepatic and pelvic hemorrhage. small mediastinal hematomalikely venous origin. right fem neck (likely open) fx with adj air. le x-rays: ? l talus and r tibial plateau fx (dedicated imaging can be obtained.) bilat femur fx. repeat l ankle xray= repeat head ct: no intracranial hemorrhage identified. previously noted possible subarachnoid hemorrhage in the left sylvian fissure was likely artifactual repeat a/p ct: 1. liver laceration as detailed above, now showing improved perfusion without interval progression. hemoperitoneum with increase seen in the right paracolic gutter. stable right adrenal hemorrhage. stable small mesenteric hematoma. interval development of small bilateral pleural effusions with bibasilar atelectasis. cta= 1. no pulmonary embolism. 2. widespread severe bronchocentric pulmonary abnormality could be pneumonia or atypical fat embolism syndrome, alternatively drug reaction, but unlikely pulmonary hemorrhage. 3. mild pulmonary edema cxr: severe diffuse airspace opacification, worse at the right base and improved at left base, enlarged rt small effusion. cxr: diffuse airspace opacities throghout worsened with pm cxr. ct torso: decreased hepati, mesenteric heamtoma, difuse airspace disease. slight increase in pelvic heamtoma. cxr: interval worsening c/ diffuse opacification of both lungs cxr: the consolidation in the left base inc cxr:bilateral parenchymal opacities have decreased cxr: unchanged lab results: 07:20am blood wbc-11.9* rbc-3.88* hgb-11.5* hct-34.3* mcv-88 mch-29.6 mchc-33.5 rdw-15.5 plt ct-726* 06:00am blood wbc-15.6* rbc-3.96* hgb-11.3* hct-33.9* mcv-86 mch-28.4 mchc-33.2 rdw-15.4 plt ct-842* 09:15am blood wbc-19.9* rbc-3.74* hgb-10.9* hct-32.7* mcv-87 mch-29.2 mchc-33.5 rdw-15.7* plt ct-780* 07:10am blood wbc-24.2* rbc-3.63* hgb-10.5* hct-31.0* mcv-85 mch-29.0 mchc-33.9 rdw-15.6* plt ct-883* 07:05am blood wbc-19.1* rbc-3.45* hgb-10.1* hct-29.7* mcv-86 mch-29.3 mchc-33.9 rdw-15.4 plt ct-794* 02:00am blood wbc-14.1* rbc-3.48* hgb-9.8* hct-29.6* mcv-85 mch-28.2 mchc-33.2 rdw-14.7 plt ct-768* 01:50am blood wbc-14.2* rbc-3.06* hgb-8.9* hct-26.2* mcv-86 mch-29.1 mchc-33.9 rdw-14.4 plt ct-514* 02:09am blood wbc-12.0* rbc-3.19* hgb-9.3* hct-27.6* mcv-87 mch-29.2 mchc-33.7 rdw-14.4 plt ct-473* 02:19am blood wbc-8.4 rbc-2.92* hgb-8.6* hct-25.6* mcv-88 mch-29.4 mchc-33.5 rdw-14.8 plt ct-327 02:13am blood wbc-9.3 rbc-2.55* hgb-7.5* hct-22.5* mcv-88 mch-29.5 mchc-33.4 rdw-15.1 plt ct-220 04:30am blood wbc-26.8* rbc-4.21* hgb-12.6* hct-37.4* mcv-89 mch-30.0 mchc-33.8 rdw-13.9 plt ct-263 07:20am blood plt ct-726* 06:00am blood plt ct-842* 09:15am blood plt ct-780* 07:10am blood plt ct-883* 07:05am blood plt ct-794* 02:00am blood plt ct-768* 01:50am blood plt ct-514* 02:09am blood plt ct-473* 02:19am blood plt ct-327 07:20am blood glucose-116* urean-18 creat-0.8 na-131* k-4.9 cl-100 hco3-23 angap-13 06:00am blood glucose-134* urean-20 creat-0.8 na-130* k-4.9 cl-97 hco3-22 angap-16 09:15am blood glucose-127* urean-23* creat-0.7 na-128* k-5.0 cl-95* hco3-20* angap-18 07:10am blood glucose-128* urean-21* creat-0.8 na-128* k-5.2* cl-92* hco3-22 angap-19 07:05am blood glucose-143* urean-16 creat-0.7 na-129* k-5.3* cl-94* hco3-24 angap-16 12:12pm blood glucose-128* urean-13 creat-1.2 na-147* k-4.3 cl-115* hco3-22 angap-14 04:24pm blood glucose-121* urean-12 creat-1.1 na-145 k-4.2 cl-113* hco3-23 angap-13 08:10pm blood glucose-123* urean-13 creat-1.1 na-146* k-4.0 cl-113* hco3-24 angap-13 09:30pm blood glucose-114* urean-12 creat-0.8 na-138 k-3.4 cl-104 hco3-26 angap-11 06:20am blood glucose-82 urean-12 creat-0.8 na-138 k-3.6 cl-104 hco3-25 angap-13 04:24pm blood alt-358* ast-753* alkphos-58 totbili-1.0 03:31am blood alt-73* ast-120* alkphos-56 totbili-1.0 07:10am blood alt-37 ast-31 alkphos-194* totbili-1.2 06:00am blood alt-30 ast-20 alkphos-254* totbili-0.9 01:03pm blood calcium-8.0* phos-4.7* mg-1.7 07:20am blood calcium-9.1 phos-5.0* mg-2.4 02:09am blood caltibc-181* ferritn-1312* trf-139* 02:09am blood triglyc-471* hdl-13 04:30am blood asa-neg ethanol-249* acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 10:35am blood type-art temp-38.6 fio2-100 po2-85 pco2-55* ph-7.35 caltco2-32* base xs-2 aado2-589 req o2-95 vent-spontaneou comment-non-rebrea 11:55am blood type-art po2-66* pco2-45 ph-7.39 caltco2-28 base xs-1 intubat-not intuba comment-non-rebrea 02:32pm blood type-art po2-63* pco2-40 ph-7.46* caltco2-29 base xs-4 02:56am blood type-art po2-173* pco2-42 ph-7.47* caltco2-31* base xs-7 06:02am blood type-art po2-136* pco2-45 ph-7.44 caltco2-32* base xs-6 08:39am blood type-art po2-119* pco2-36 ph-7.49* caltco2-28 base xs-5 04:24pm blood type-art po2-87 pco2-31* ph-7.47* caltco2-23 base xs-0 brief hospital course: pt arrived in ed glascow of 15, with grade iv liver laceration, small sah, bilateral femor fractures, laceration right medial knee. laceration left medial knee, both 7 cm. open grade 1 right mid shaft femur fracture. right basocervical neck fracture. left mid shaft femur fracture. after initial survey pt was taken directly to or with dr from orthopedics for bilateral femor fracture repair. between or and pt was transfused 8u prbc/2 ffp/cryo/plt. in or pt had intramedullary rod fixation of right mid shaft femur fracture. im rod fixation of right basocervical femoral neck fracture. im rod fixation of left distal third femur fracture. irrigation and debridement of grade open mid shaft femur fracture to bone. incision and drainage of right medial knee laceration. incision and drainage of left medial knee laceration. pt was kept intubated initially from or transfered to pacu. on pt extubated and on was transfered to the floor. on pt returned to hypoxemia and tachypnea, found to be in ards to fat emboli. on pt had a cta which showed 1. no pulmonary embolism. 2. widespread severe bronchocentric pulmonary abnormality could be pneumonia or atypical fat embolism syndrome, alternatively drug reaction, but unlikely pulmonary hemorrhage. 3. mild pulmonary edema after several days of supportive care and antibiotcs for possible pneumonia, pt improved. on was extubated improving resp status off abx. on pt cxr showed improvment, respiratory status was stable, pt was transfered to the floor. on had low grade fever, wbc rose to 25 pt started to have frequent loose stools. pt was placed on flaggyl for presumed c-diff (despite negative c-diff x3). pt fever deffervesed, wbc came down to 11.9, pt was afebrile for >24 prior to discharge, diarrhea had also supsided. pt recieved some ns and free water restriction for mild hyponatremia thought to be to secretory dirrhea. events: : orif bilat femur fx with ebl 500cc, arrives intubated to ticu. repeat head ct wnl and l ankle xray=?talar fx, ct +. trauma to decide thromboprophylaxis. abd more tense->repeat abd ct stable. o/n pt specific, writing requests. : extuabted will monitor, pca for pain, ciwa scale, banana bag tense abdomen, drop in hct will monitor. : readmitted, aline, meropenem due to pcn allergy (no zosyn), albuterol nebs, needs red stain in urine for marrow. hypoxemic. : intubated for resp failure : transfused 1 unit for hct 22 with repeat hct 24. worsening oxygenation with increased peep to 10, with concominant cxr worsening. febrile 103.3. tfs held (found in mouth by rn). : repeat thorax scan for fever workup->larger effusions. vanc trough low (4.5), increased dosing to 1250. bronch/bal w/, then tfs restarted (but off on due to tf suctioned from mouth). : ogt replaced. propofol -> versed for sedation. added clonidine. switched to pressure control. weaned fio2. abx d/c'd : ps with maintanence of maps, rsbi 48, precedex started. still hyperdynamic w fever. : d/c fent gtt. dilaudid pca. extubated. s/s eval. ortho recs lovenox/oob ok, trauma recs cont heparin sc. : lasix 10. cont pca. ortho recs cont short leg. pt therapy. : percocet. d/c foley. transferred to floor. : cxr aside from minimal atelectasis in the left lower lobe, the lungs are clear with resolution of previously seen extensive bilateral parenchymal opacities. there is no pneumothorax or pleural effusion. : cxr: cardiomediastinal contours are normal. the lungs are clear. there is no pneumothorax or pleural effusion. : discharged to rehab in summary by systems: neuro: no neurologic events, neuro exam wnl. . cvs: hyperdynamic with episodes of hypertension then hypotension around ticu course currently wnl. - pulm: ards, reintubated then extubated . using nebs, but cxr improved currently no respiratory issues on floor. . gi: grade iv liver lac. no active issues - regular diet . renal: hyponatremia to dirrhea, otherwise adequate uop. free water restricted and ns was given, pt responded appropriately. no active issues. . heme: grade iv liver lac/hematoma, transfusions 1u , 1u . started sch . . endo: no acute issues . id: febrile intermittantly to 101 with ards on ticu admit treated with vanc/ (). then started on flaggyl for ?c-diff on wbc trending down now at 11.9. . msk: bilat femur fx s/p orif , left talar/tibial fx. - ortho recs lle nwb, rle pwb. short leg cast neutral lle with splinting for l talar fx. . dispo: at the time of discharge the patient was doing well, afebrile with stable vital signs. the patient was tolerating a regular diet, working with physical therapy, voiding without assistance, and pain was well controlled. the patient received discharge teaching and follow-up instructions with understanding verbalized and agreement with the discharge plan. medications on admission: none discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 2. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: six (6) puff inhalation q4h (every 4 hours) as needed for wheezing. 3. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 4. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed for sob/wheezing. 5. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 6. acetaminophen 500 mg tablet sig: one (1) tablet po q 8h prn () as needed for pain. 7. metronidazole 500 mg tablet sig: one (1) tablet po q8h (every 8 hours): continue until 6/ 12. discharge disposition: extended care facility: five star, discharge diagnosis: small small sah, gr iv liver lac, tib/'fib fx, bilateral femur fxs, l talus fx. ards s/p fat emboli to lungs. discharge condition: alert and oriented x3 nad, regular diet, working with pt but non weight bearing. discharge instructions: you are recovering from major trauma with bilateral leg fractures and severe damage to your lungs. you will need time to recover. do not drink alcohol or smoke cigaretts as these will seriously impair recovery. you are not to bear weight on your left lower extemity, and only partial on your right. you will need physical therapy to recover, please stay as active as you can. please call your doctor or nurse practitioner or return to the emergency department for any of the following: *you experience new chest pain, pressure, squeezing or tightness. *new or worsening cough, shortness of breath, or wheeze. *if you are vomiting and cannot keep down fluids or your medications. *you are getting dehydrated due to continued vomiting, diarrhea, or other reasons. signs of dehydration include dry mouth, rapid heartbeat, or feeling dizzy or faint when standing. *you see blood or dark/black material when you vomit or have a bowel movement. *you experience burning when you urinate, have blood in your urine, or experience a discharge. *your pain in not improving. call or return immediately if your pain is getting worse or changes location or moving to your chest or back. *you have shaking chills, or fever greater than 101.5 degrees fahrenheit or 38 degrees celsius. *any change in your symptoms, or any new symptoms that concern you. please resume all regular home medications , unless specifically advised not to take a particular medication. also, please take any new medications as prescribed. please get plenty of rest, continue to work with physical therapy and be active several times per day, and drink adequate amounts of fluids. avoid driving or operating heavy machinery while taking pain medications. followup instructions: please follow up with dr. ,in orthopedics within 1 week of discharge. call for an appointment at please follow up with dr. in weeks call for an appointment at please follow up with your primary care physician weeks. call , r. for an appointment. md, procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances closed [endoscopic] biopsy of bronchus open reduction of fracture with internal fixation, femur open reduction of fracture with internal fixation, femur open reduction of fracture with internal fixation, femur debridement of open fracture site, femur excision of lesion of other soft tissue diagnoses: acute posthemorrhagic anemia hyposmolality and/or hyponatremia other motor vehicle traffic accident involving collision on the highway injuring driver of motor vehicle other than motorcycle open wound of knee, leg [except thigh], and ankle, without mention of complication closed fracture of shaft of femur open fracture of shaft of femur closed fracture of unspecified part of fibula with tibia injury to liver without mention of open wound into cavity laceration, unspecified fat embolism closed fracture of astragalus closed fracture of base of neck of femur 

Answer: The patient is high likely exposed to