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: no known allergies / adverse drug reactions attending: chief complaint: polytrauma/motor vehicle collision major surgical or invasive procedure: : 1. open reduction internal fixation posterior pelvic ring with bilateral sacroiliac screws. 2. anterior fixation pelvic ring with external fixator with closed reduction manipulation. 3. open reduction internal fixation of right sternoclavicular joint. 4. manipulation with manually applied stress under fluorosocopy for assessment of pelvis joint stability : 1. posterolateral arthrodesis c3-c6. 2. posterolateral instrumentation c3-c6. 3. open treatment of fracture of c4, c5, c3. 4. application of allograft and local autograft. 5. ivc filter placement : 1. open reduction internal fixation left humerus fracture with 3.5 mm proximal humerus locking plate. 1. surgical preparation and irrigation and debridement of left dorsal foot wound area, 16 x 8 cm. 2. partial closure of the distal foot wound over an area of 4 cm. 3. placement of vacuum-assistant closure device, 16 x 6 cm. 1. wide tangential debridement of left leg and left foot (greater than 400 cm2). 2. local flap to left foot. 3. split-thickness skin graft to left foot (20.0 cm x 8.0 cm). 4. split-thickness skin graft to left leg (40.0 cm x 10. 0 cm). 5. debridement and delayed primary closure of right lower quadrant of abdomen (15.0 cm). history of present illness: patient is a 21f pedestrian struck transferred from osh via with multiple traumatic injuries. she was in usual state of good health prior to being struck by motor vehicle and reportedly dragged a distance of 100 feet. patient required intubation in the field prior to transport to osh. at osh patient was resuscitated with 4l crystalloid and transferred to for further management after plain films obtained. reported injuries on arrival include multiple c spine fractures, l humerous fxs, pelvic fx, liver lacerations and degloving of her l foot. past medical history: pmh: none psh: none : none social history: patient is from and recently graduated from nyu. tobacco: denies. etoh: social. drugs: denies. family history: non-contributory physical exam: hr: 95 bp: 105/76 resp: 18 o(2)sat: 100 normal gen: wd, wn in nad heent: ncat, eomi, anicteric cv: rrr, +s1s2 w no m/r/g pulm: cta b/l w no w/r/r, normal excursion, no respiratory distress back: no vertebral tenderness, no cvat abd: soft, nt, nd, no mass, no hernia pelvis: deferred ext: wwp, no cce, no tenderness, 2+ b/l radial/dp/pt neuro: a&ox3, no focal neurologic deficits derm: no rashes/lesions/ulcers psych: normal judgment/insight, normal memory, normal mood/affect pertinent results: laboratories: (admission) 12:50am blood wbc-12.0* rbc-2.89* hgb-9.3* hct-27.3* mcv-94 mch-32.2* mchc-34.1 rdw-12.7 plt ct-272 12:50am blood pt-13.9* ptt-28.8 inr(pt)-1.2* 04:19am blood glucose-130* urean-18 creat-0.5 na-142 k-4.3 cl-114* hco3-18* angap-14 04:19am blood calcium-6.8* phos-3.6 mg-1.7 05:09am blood type-art temp-35.6 rates-/24 tidal v-350 peep-5 fio2-50 po2-218* pco2-41 ph-7.26* caltco2-19* base xs--8 -assist/con intubat-intubated 12:59am blood glucose-115* lactate-2.0 na-139 k-3.6 cl-114* calhco3-17* microbiology: mrsa screen - negative imaging: ct head : cephalohematoma. no evidence of intracranial injury ct c/a/p : 1. mult fxs involving sternoclavicular joints, l humerus, chest wall, spine, and pelvis. 2. severe pulmonary injury, w mod l and trace r pneumothoraces. 3. severe liver injury, w loculated surrounding hematoma 4. no evidence active vascular extravasation. ct c-spine : 1. c3-c5 r lamina and pedicle fxs. 2. bony fragment c4 transverse foramen w ? vertebral artery injury 3. c6-t2 spinous process fxs. epidural high attenuation was demonstrated to be artifactual on subsequent mr. 4. b/l pulmonary hemorrhage, w moderate l and trace r pneumothoraces. cta neck : 1. complete occlusion nondominant r vertebral artery at c4-c6 levels, spanning 4.1 cm, and irregularity of r vertebral artery at c7, likely intramural hematoma/dissection, given cervical fxs at involved levels. 2. upper mediastinal hematoma b/l le us : no evidence of lower extremity dvt. pathology: none brief hospital course: the patient was admitted to the acute care surgery service on for management of multiple traumatic injuries associated with motor vehicle collision. patient arrived via as transfer from osh intubated. atls protocol initiated and patient had clinical course as follows: admitted to the trauma icu. neuro: patient arrived intubated/sedated from osh. sedation regimen adjusted over course of intubation to minimize hypotension secondary to sedation. remained intubated for multiple orthopedic procedures and was extubated without incident . chronic pain service was consulted who made recommendations regarding patient's analgesic regimen. regimen consisted of long/short acting narcotics as well as topical anesthetic creams for road rash. regimen was effective and well tolerated. noted to have multiple cervical fractures as noted above though no focal neurologic deficits. patient was kept on logroll precautions related to this. patient was brought to or by spine for cervical fusion which was tolerated well. given c-spine injuries vascular imaging of neck was pursued that showed dissection of r vertebral artery with occlusion over 4cm segment at level of c4. logroll was discontinued following surgical stabilization. a soft collar was recommended until she is evaluated at her follow up appointment. neuro-stroke and neurosurgery were consulted regarding management of this who recommended asa 325 daily for six months with a follow up mra in three months time. cv: on arrival the patient was hypovolemic with hypotension and oliguria. patient was resuscitated with multiple boluses of crystalloid ivf over first 48 hours of admission. four units prbcs (2 in ed, 2 in tsicu) were transfused on hd#1 with stabilization of hct following this. three additional units prbc were transfused as hct drifted down from 32 () to 23(). hct bumped appropriately and hct remained stable throughout remainder of admission. the patient was persistently in sinus tachycardia throughout admission with pulse ranging from 100s to 110s. the patient was stable from a cardiovascular standpoint; vital signs were routinely monitored. pulmonary: on arrival patient was intubated and noted to have a l pneumothorax and b/l pulmonary contusions. left chest tube was placed in the ed. et tube was upsized as 6.5 tube was placed in field. chest tube was removed upon extubation. pulmonary toilet including incentive spirometry. the patient was stable from a pulmonary standpoint; vital signs were routinely monitored. gi/gu: on arrival patient was resuscitated as above. patient was given iv fluids until tolerating oral intake. tube feeds via ogt were initiated . these were tolerated well. ogt was removed . regular diet was started following extubation and patient tolerated this without issue. extensive bowel regimen was given secondary to narcotic usage and passed bowel movements without issue. liver laceration was sustained at time of injury though no active extravasation was seen on ct scan. serial hcts were monitored as above. transfusions administered though unlikely that blood loss was related to hepatic injury. lfts were noted to be elevated though this was as expected given known injury. foley was placed at osh and maintained until . currently she is voiding without difficulty. lasix was given to assist in diuresis and this had good effect. patient auto-diuresed following this. intake and output were closely monitored. msk: patient had injuries as listed above including c-spine fractures (see neuro), sternoclavicular dislocations bilaterally, pelvic fractures and degloving of l le. patient was taken to or by for anterior pelvic ex fix and posterior orif and this was tolerated well. displaced right sternoclavicular joint was reduced as well secondary to compression of adjacent subclavian artery and vein. mediastinal hematoma was stable both pre and post procedure. weight bearing status at that time was non-weight bearing in b/l lower extremities. returned to or for repair of proximal l humerus fracture and patient was kept non-weight bearing in upper extremities as well. she is however able to feed herself with her right hand. she developed a thrombocytosis over the last 12-12 days likely a reaction to her multiple trauma and operations. currently her platelet count is in the 1200 range and she is on 325 mg aspirin daily which will continue. podiatry initially followed patient for superficial injuries to left foot. their recommendations for wound management were followed. plastic surgery was also consulted for management of exposed tendon and have recommended operative managment. care of this was then assumed by plastics. she was taken to the operating room on and for debridement, closure then skin grafting to the dorsum of the left foot. see formal op note for details. she tolerated the procedures well with minimal pain. the donor site is clean and healing well and the left foot is healing well with the graft pink without drainage. physical therapy and occupational therapy services were consulted and followed her closely during her stay to maintain some functional mobility,and review transfers. she will need vigorous therapy once she is able to increase her weight bearing status. id: perioperative antibiotics were administered as appropriate for patient's procedures. no signs of infection were present during this admission. the patient's temperature was closely watched for signs of infection. prophylaxis: given mediastinal hematoma and concern for bleed the patient was maintained with scds only until . lenis performed b/l le and these were negative for dvt. they were performed again on to the left leg as she complained of left calf pain however they were again negative. given concern for immobility during recovery period an ivc filter was placed . gi prophylaxis was given until tolerating regular diet. at the time of discharge on , the patient was doing well, afebrile with stable vital signs, tolerating a regular diet and her pain was well controlled. medications on admission: none discharge medications: 1. lidocaine hcl 5 % ointment sig: one (1) appl topical daily (daily): mix w/ silver sulfadiazine and apply to left buttock. 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 3. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po at bedtime as needed for constipation. 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. 5. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 6. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily). 7. silver sulfadiazine 1 % cream sig: one (1) appl topical (2 times a day) as needed for deep skin excoriation: apply to excoriated areas on legs, bck and buttock. 8. lorazepam 0.5 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for anxiety. 9. gabapentin 300 mg capsule sig: one (1) capsule po bid (2 times a day). 10. ascorbic acid 500 mg tablet sig: one (1) tablet po daily (daily) for 10 days. 11. zinc sulfate 220 mg capsule sig: one (1) capsule po daily (daily) for 10 days. 12. multivitamin,tx-minerals tablet sig: one (1) tablet po daily (daily). 13. acetaminophen 325 mg tablet sig: two (2) tablet po q 8h (every 8 hours). 14. morphine 15 mg tablet extended release sig: three (3) tablet extended release po q8h (every 8 hours). 15. hydromorphone 2 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for break-through pain. 16. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) units injection tid (3 times a day). 17. polyethylene glycol 3350 17 gram/dose powder sig: one (1) packet po daily (daily) as needed for constipation. 18. simethicone 80 mg tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day) as needed for gas pains. 19. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. discharge disposition: extended care facility: - discharge diagnosis: s/p motor vehicle crash injuries: 1. cervical spine fractures (a-fracture with floating mass c4; b-fracture with floating mass c5; c-laminar fracture c3; d-spinous process fracture of c6 and c7) 2. right vertebral artery dissection with associated thrombotic occlusion 3. bilateral sternoclavicular dislocations 4. left pneumothorax 5. grade 3 segment vii liver laceration 6. windswept pelvic fracture (bilateral pelvic ring fracture with sacroiliac dissociation and anterior bilateral rami fractures) 7. proximal left humerus fracture 8. extensive abrasions/road rash to back/buttocks, bilateral lower extremities 9. full thickness laceration/skin defect dorsal aspect left foot with extensor tendon exposure 10.acute blood loss anemia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: you were admitted to the acute care surgery service for management of multiple traumatic injuries sustained in setting of motor vehicle collision. you required several operations to fix your spine and extremity fractures. becasue of the severity of your injuries it is being recommended that you not bear any weight on any of your extremtiies for at least the next weeks. upgrade of your activity status will be determined by the orthopedic doctors. a device called and ivc filter was placed into the major vein in your abdomen; this device is used to catch any blood clots that may come from your lower extremties as a result of your limited mobility. followup instructions: call dr. at from plastic surgery at for a follow up appointment in 1 week. also, follow up with the providers below: spine: provider: xray (scc 2) phone: date/time: 12:20 provider: . phone: date/time: 12:40 orthopedics: call for an appointment in 2 weeks. neuro-stroke: please arrange for mra neck in 3 months () and follow up with neuro-stroke team regarding right vertebral artery occlusion/dissection. (attending) you can call to arrange this. call the acute care clinic at upon discharge to arrange a follow up appointment in months. office is located at , medical office building, . procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube interruption of the vena cava enteral infusion of concentrated nutritional substances arterial catheterization other skin graft to other sites excisional debridement of wound, infection, or burn excisional debridement of wound, infection, or burn other incision of pleura closure of skin and subcutaneous tissue of other sites closure of skin and subcutaneous tissue of other sites excision of bone for graft, other bones application of external fixator device, other bones repair of vertebral fracture other cervical fusion of the posterior column, posterior technique open reduction of fracture with internal fixation, humerus closed reduction of fracture with internal fixation, other specified bone closed reduction of fracture with internal fixation, other specified bone fusion or refusion of 4-8 vertebrae open reduction of dislocation of other specified sites diagnoses: acidosis acute posthemorrhagic anemia motor vehicle traffic accident involving collision with pedestrian injuring pedestrian traumatic pneumohemothorax without mention of open wound into thorax contusion of lung without mention of open wound into thorax open wound of knee, leg [except thigh], and ankle, without mention of complication street and highway accidents closed fracture of c5-c7 level with unspecified spinal cord injury closed dislocation, sternum injury to liver without mention of open wound into cavity laceration, unspecified closed fracture of unspecified part of upper end of humerus closed fracture of multiple cervical vertebrae dissection of vertebral artery multiple closed pelvic fractures with disruption of pelvic circle abrasion or friction burn of other, multiple, and unspecified sites, without mention of infection open wound of foot except toe(s) alone, complicated open wound of abdominal wall, anterior, without mention of complication closed dislocation, sacrum 

Answer: The patient is high likely exposed to