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: trauma: pedestrian hit by car: bilateral foci of sah intraventricular hemorrhage frontal sinus fx l occipital condyle fx t1 transverse process tip of clivus fx ? small epidural hematoma at c1 sternal fx spleen lac r pubic ramus fx r anterior acetabulum open r radius/ulna fx bilateral open tib/fib fx sacral fx injury to r tp trunk major surgical or invasive procedure: washout by ortho b/l le washout b/l le with vac placement on left b/l le washout rt humerus orif, b/l tibial nails washout b/l tib/fib, rle vac, ivc filter placement ex-lap, splenectomy evd ex fix bilateral tib/fib fxs, bilateral fasciotomy right elbow washout history of present illness: history of presenting illness this patient is a 30 year old male who complains of ped struck. patient says pushed and struck at high rate of speed. patient had a seizure at the event. the patient has bilateral lower extremity fractures, right upper extremity fracture, suspected open skull fracture. past medical history: unknown social history: unknown family history: unknown physical exam: physical examination: upon admission constitutional: agonal heent: right forehead laceration with likely open fracture c. collar chest: clear to auscultation cardiovascular: tachycardic abdominal: soft, nontender gu/flank: no costovertebral angle tenderness extr/back: bilateral lower extremity fractures, right upper extremity fracture with a large laceration measuring approximately 9 cm skin: abdominal abrasion, right hip abrasion, right shoulder abrasion neuro: posturing pertinent results: 05:00am blood wbc-19.3* rbc-3.26* hgb-10.0* hct-29.9* mcv-92 mch-30.7 mchc-33.5 rdw-16.4* plt ct-371 05:00am blood wbc-18.3* rbc-3.16* hgb-9.5* hct-29.3* mcv-93 mch-30.1 mchc-32.5 rdw-16.4* plt ct-335 06:30am blood wbc-16.5* rbc-3.07* hgb-8.8* hct-28.8* mcv-94 mch-28.8 mchc-30.6* rdw-16.9* plt ct-330 05:00am blood neuts-42.3* lymphs-45.7* monos-5.3 eos-5.8* baso-0.8 03:35am blood neuts-79.0* lymphs-15.1* monos-3.2 eos-1.3 baso-1.4 01:36am blood neuts-60 bands-2 lymphs-17* monos-15* eos-4 baso-0 atyps-0 metas-2* myelos-0 nrbc-1* 01:36am blood hypochr-2+ anisocy-1+ poiklo-normal macrocy-2+ microcy-normal polychr-1+ 05:00am blood plt ct-371 05:00am blood plt ct-335 01:59am blood pt-13.5* ptt-22.1 inr(pt)-1.2* 09:30pm blood pt-14.1* ptt-36.4* inr(pt)-1.2* 12:58am blood fibrino-414*# 03:40am blood fibrino-139* 09:05am blood glucose-125* urean-10 creat-0.5 na-137 k-3.9 cl-100 hco3-28 angap-13 05:00am blood glucose-379* urean-10 creat-0.5 na-132* k-5.2* cl-99 hco3-29 angap-9 06:30am blood glucose-89 urean-10 creat-0.5 na-144 k-3.3 cl-107 hco3-27 angap-13 01:25am blood alt-39 ast-41* ld(ldh)-268* alkphos-283* totbili-0.5 02:11am blood alt-49* ast-55* ld(ldh)-360* alkphos-319* amylase-240* totbili-0.5 01:36am blood alt-69* ast-78* ld(ldh)-323* alkphos-284* totbili-0.6 01:25am blood ggt-142* 02:11am blood lipase-129* ggt-199* 09:05am blood calcium-8.8 phos-4.0 mg-2.0 05:00am blood calcium-8.0* phos-3.7 mg-1.8 06:30am blood vanco-12.1 11:43pm blood vanco-23.9* 09:41am blood vanco-27.4* 02:25am blood phenyto-14.3 12:18am blood phenyto-12.9 01:42am blood phenyto-13.4 09:30pm blood asa-neg ethanol-22* acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 08:26am blood glucose-113* 09:29am blood hgb-7.1* calchct-21 12:31am blood freeca-1.07* : cat scan of abdomen and pelvis: impression: 1. hemoperitoneum and spleen laceration. active extravasation from the spleen. possible small pseudoaneurysm at the inferior tip of the spleen. 2. small liver hypodensity, could be focal sparing, less likely small laceration. 3. bulky right adrenal gland could be hematoma in the setting of trauma. 4. questionable abnormal loops of small bowel in the pelvis with bowel wall thickening could be related to trauma. 5. right superior and inferior pubic ramus fracture. comminuted fracture of the right anterior acetabulum. nondisplaced fracture through the sacrum. 6. small step-off at the sternum with similar step-off in the adjacent skin, likely artefact. if concern for fractrure lateral chest radiograph can be considered. : cat scan of the head: impression: 1. bilateral foci of subarachnoid hemorrhage. 2. intraventricular hemorrhage. 3. non-displaced fracture through the right frontal sinus involving both outer and inner table with blood in the right frontal sinus and several ethmoid air cells. 4. soft tissue contusion along the right frontal bone. 5. foci of air along the right stylohyoid process and dense material in the right external auditory canal; cannot exclude right temporal bone fracture. correlate clinically and if concern cosnider temporal bone ct. d/w dr. by dr. in person at 12:14 am on . : x-ray of the right forearm: findings: there is a linear displaced fracture through the mid shaft of the ulna. additionally, there is a second fracture line through the distal ulna which appears nondisplaced. the radial head appears displaced. findings are concerning for monteggia fracture. soft tissue abrasions in the forearm, likely post-traumatic. immobilization material gives suboptimal evaluation of subtle bony details. : x-ray of the pelvis: findings: there is a comminuted fracture of the right anterior acetabulum and right inferior pubic ramus which are better evaluated on the subsequent ct torso. additionally, there is a nondisplaced fracture line through the sacrum which is also evaluated better on the ct torso. contrast is in the urinary bladder from the recent ct scan : cat scan of the c-spine: impression: 1. non-displaced fracture through the left occipital condyle. 2. minimally displaced fracture through the right c7 and t1 transverse process. 3. nondisplaced fracture of the tip of clivus. 4. possible small epidural hematoma in the anterior epidural space at c1, near foramen magnum. : cta: impression: 1. bilateral comminuted fractures in tibia and fibula. 2. nondisplaced sacral fracture. 3. right comminuted acetabular and pubic rami fracture. 4. pseudoaneurysm at the right proximal tibial trunk and focus of active extravasation near proximal right fibular fracture. 5. distally from the pseudoaneurysm on the right, there is only faint flow in the right anterior tibial artery. 6. on the left only two-vessel runoff with the peroneal artery being best perfused. the posterior tibial artery could be compressed from a hematoma from the fracture : bil. tib/fib x-ray: left tibia and fibula: comminuted displaced fracture through left tibia. comminuted displaced fracture through proximal left fibula. fracture through patella : cat scan of the head: impression: 1. hypodensity of the cerebral parenchyma consistent with diffuse cerebral edema with effacement of the cisterna magna, and slightly low-lying cerebellar tonsils, concerning for central herniation. assessment for changes from ischemia is limited. correlate clinically and followup/consider further workup. 2. hypodense/isodense subdural collection in the bilateral frontal space without a component of hemorrhage, concerning for csf leak given the fracture through the right frontal sinus. 3. redistribution of subarachnoid hemorrhage with now blood in the intrapeduncular cistern as well as the fourth ventricle without evidence of new hemorrhage. 4. fluid in the maxillary sinuses bilaterally. : cat scan of the head: impression: no significant interval change. 1. hypodensity of the cerebral parenchyma consistent with diffuse cerebral edema. similar effacement of cisterna magna. 2. bilateral stable hypodense - isodense subdural collections in bilateral frontal spaces. 3. stable bilateral foci of subarachnoid hemorrhage and stable intraventricular hemorrhage. : right elbow x-ray: impression: no significant interval change. 1. hypodensity of the cerebral parenchyma consistent with diffuse cerebral edema. similar effacement of cisterna magna. 2. bilateral stable hypodense - isodense subdural collections in bilateral frontal spaces. 3. stable bilateral foci of subarachnoid hemorrhage and stable intraventricular hemorrhage. : eeg: impression: this is an abnormal continuous icu monitoring study because of severe diffuse background slowing and attenuation and periods of discontinuity. these findings are indicative of severe diffuse cerebral dysfunction which is etiologically non-specific. there were no epileptiform discharges or electrographic seizures. : cat scan of the head: impression: 1. evolving bilateral subdural collections, and bilateral subarachnoid hemorrhage with no new hemorrhage. decrease in bilateral intraventricular hemorrhage when compared to prior study. 2. interval removal of intracranial pressure device. 3. nondisplaced fracture of the right frontal sinus, with opacification of sinuses as mentioned above. this fracture line increases the risk of csf leak or infection. 4. pneumocephalus, likely from bolt placement and trauma, whihc has decreased from prior study. : mr of cervical spine: impression: limited study secondary to patient motion. within these limitations, no evidence of epidural hematoma. no spinal cord signal abnormality. the limited evaluation demonstrates multilevel degenerative changes : echo: conclusions the left atrium is normal in size. left ventricular wall thicknesses and cavity size are normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. left ventricular systolic function is hyperdynamic (ef>75%). tissue doppler imaging suggests a normal left ventricular filling pressure (pcwp<12mmhg). right ventricular chamber size and free wall motion are normal. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. impression: suboptimal image quality. normal left ventricular cavity size and wall thickness with hyperdynamic left ventricular systolic function. no clinically significant valvular disease. moderate pulmonary artery systolic hypertension. : chest x-ray: confluent left lower lobe opacity with a developing lingular opacity and moderate effusion could represent atelectasis or pneumonia. : cat scan of abdomen and pelvis: impression: 1. development of small bilateral pleural effusions with associated compressive atelectasis in both bases. 2. the patient is status post splenectomy and placement of infrarenal ivc filter. no intra-abdominal fluid collection. no free intra-abdominal gas or significant free fluid. 3. position of endotracheal tube as described. stable sacral and pelvic fractures as described. : mr of the head: impression: 1. multiple areas of increased signal intensity, specifically in corpus callosum, right corona radiata, right frontal lobe, and left medulla that are consistent with diffuse axonal injury in the setting of trauma. 2. small subdural collections along the occipital lobes, cerebellum, as and the falx. bilateral frontal subdural collections, likely a combination of hygroma and hematoma. 3. small amount of intraventricular blood bilaterally and unchanged from prior study. 3. opacification of the mastoid air cells on the right. : sinus and mandible: impression: 1. persistent opacification of the right frontal sinus, frontal bulla, and right frontal recess, related to the known nondisplaced fracture of the anterior and posterior walls of the right frontal sinus. superimposed infection cannot be excluded by imaging, but definite signs of new infection are seen. 2. persistent fluid in the right mastoid and left middle ear, partially visualized : chest x-ray: the feeding tube has been removed. there is a tracheostomy tube. there is a small amount of free air underneath the hemidiaphragm which can be consistent with recent splenectomy. there is no focal consolidation or definite signs for overt pulmonary edema. there is mild coarsening of the bronchovascular markings. there are no pneumothoraces on either side. : c-spine: findings: there are no signs for acute fractures or dislocations. intervertebral disc spaces are relatively preserved. the prevertebral soft tissues are normal. there is no abnormal antero- or retrolisthesis. with flexion and extension, there is no abnormal motion. the visualized lung apices are grossly clear. : video swallow: impression: 1. trace aspiration of nectar thick. 2. moderate amount of residue in the pharynx. 3. delayed oropharyngeal swallowing phase. : chest x-ray: lungs are fully expanded and clear. tracheostomy tube is in standard placement. heart size is normal. there is no obvious pleural abnormality. : bil. tib/fib films: impression: 1. unchanged alignment of comminuted fractures of the tibia and fibula bilaterally with minimal callus formation. 2. transversely oriented fracture through the mid left patella, little changed. 3. left tibial spine fracture and bony fragments within left knee joint, stable : x-ray of right forearm: impression: 1. orif of an ulnar fracture with small fracture line seen at the mid-to-distal right ulna. no hardware complication. 2. heterotopic ossification adjacent to the radial head and neck. : right elbow x-ray: impression: 1. orif of an ulnar fracture with small fracture line seen at the mid-to-distal right ulna. no hardware complication. 2. heterotopic ossification adjacent to the radial head and neck. : video swallow: penetration of nectar-thick contrast. 2. gross aspiration of thin liquids : chest xray: findings: in comparison with the study of , there is little change in the appearance of the heart and lungs. no evidence of acute pneumonia or vascular congestion. of incidental note is removal of the tracheostomy tube. 9/81/11: head cat scan: impression: 1. unchanged bilateral prefrontal hygromas with no new hemorrhage. 2. resolved bilateral intraventricular hemorrhages. 7:40 pm blood culture blood culture, routine (pending): 5:44 pm urine source: catheter. **final report ** urine culture (final ): no growth. 4:25 pm urine source: catheter. **final report ** urine culture (final ): no growth. : 2:00 pm sputum source: endotracheal. **final report ** gram stain (final ): <10 pmns and <10 epithelial cells/100x field. 3+ (5-10 per 1000x field): gram negative rod(s). quality of specimen cannot be assessed. respiratory culture (final ): rare growth commensal respiratory flora. pseudomonas aeruginosa. sparse growth. piperacillin/tazobactam sensitivity testing available on request. sensitivities: mic expressed in mcg/ml _________________________________________________________ pseudomonas aeruginosa | cefepime-------------- 16 i ceftazidime----------- 16 i ciprofloxacin--------- =>4 r gentamicin------------ 8 i meropenem------------- =>16 r tobramycin------------ <=1 s : 3:21 am sputum source: induced. **final report ** gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 2+ (1-5 per 1000x field): gram negative rod(s). respiratory culture (final ): commensal respiratory flora absent. pseudomonas aeruginosa. sparse growth of two colonial morphologies. sensitivities performed on culture # () : /13/11 3:35 am sputum source: induced. **final report ** gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 1+ (<1 per 1000x field): gram negative rod(s). smear reviewed; results confirmed. respiratory culture (final ): rare growth commensal respiratory flora. pseudomonas aeruginosa. moderate growth. of two colonial morphologies. piperacillin/tazobactam sensitivity testing performed by . klebsiella pneumoniae. sparse growth. piperacillin/tazobactam requested by dr.() on : pending. piperacillin/tazobactam sensitivity testing performed by . sensitivities: mic expressed in mcg/ml _________________________________________________________ pseudomonas aeruginosa | klebsiella pneumoniae | | ampicillin/sulbactam-- 16 i cefazolin------------- <=4 s cefepime-------------- 32 r <=1 s ceftazidime----------- =>64 r <=1 s ceftriaxone----------- <=1 s ciprofloxacin--------- =>4 r 2 i gentamicin------------ 8 i <=1 s meropenem------------- 1 s <=0.25 s piperacillin/tazo----- s i tobramycin------------ <=1 s <=1 s trimethoprim/sulfa---- <=1 s : 12:16 pm sputum source: endotracheal. **final report ** gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 3+ (5-10 per 1000x field): multiple organisms consistent with oropharyngeal flora. respiratory culture (final ): sparse growth commensal respiratory flora. klebsiella pneumoniae. moderate growth. piperacillin/tazobactam sensitivity testing available on request. sensitivities: mic expressed in mcg/ml _________________________________________________________ klebsiella pneumoniae | ampicillin/sulbactam-- 4 s cefazolin------------- <=4 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s ciprofloxacin---------<=0.25 s gentamicin------------ <=1 s meropenem-------------<=0.25 s tobramycin------------ <=1 s trimethoprim/sulfa---- <=1 s : 26/11 12:02 am mini-bal **final report ** gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 2+ (1-5 per 1000x field): gram negative rod(s). 2+ (1-5 per 1000x field): gram negative diplococci. respiratory culture (final ): sparse growth commensal respiratory flora. klebsiella pneumoniae. sparse growth. piperacillin/tazobactam sensitivity testing available on request. klebsiella pneumoniae. sparse growth. second morphology. piperacillin/tazobactam sensitivity testing available on request. sensitivities: mic expressed in mcg/ml _________________________________________________________ klebsiella pneumoniae | klebsiella pneumoniae | | ampicillin/sulbactam-- 4 s <=2 s cefazolin------------- <=4 s <=4 s cefepime-------------- <=1 s <=1 s ceftazidime----------- <=1 s <=1 s ceftriaxone----------- <=1 s <=1 s ciprofloxacin---------<=0.25 s <=0.25 s gentamicin------------ <=1 s <=1 s meropenem-------------<=0.25 s <=0.25 s tobramycin------------ <=1 s <=1 s trimethoprim/sulfa---- <=1 s <=1 s brief hospital course: this is a 50-ish gentleman who presented to after being struck by a car at high speed on route 9. he had serious injuries at the time of presentation, and was taken emergently to the operating room with general surgery, neurosurgery, and orthopedics. at that time, a bolt was placed, an exploratory laparotomy and splenectomy were performed, and he had his bilateral lower extremities washed out, ex-fixes placed to fractures, and fasciotomies performed. he was brought to the ticu post-operatively. his post-injury course has been long and complicated. please see below for summary of pertinent events by system. neuro: he was brought to the ed with a gcs of , and was sedated for the or. a bolt was placed for icp monitoring, and he was loaded with dilantin. he had a brief episode of seizure-like activity on hd 3, which resolved with ativan. his bolt was removed on hd 6. his mental status remained poor throughout his icu stay, with concern for diffuse axonal injury causing a permanent vegetative state. on (hd 20), he spontaneously opened his eyes and began tracking. his mental status slowly improved until , when he was felt to be able to protect his airway, and was extubated. cv: he had sinus tachycardia throughout his icu admission. despite beta-blockade, this was never fully controlled in the icu, nor was a clear etiology identified. cardiology was consulted, and did not have any recommendations for change in management. pulm: he was kept intubated while his mental status was poor, though did not have any other pulmonary issues. when he began to wake-up, the vent was weaned and he was successfully extubated on . fen/gi: he was kept npo while intubated and obtunded. tube feeds were started early in his hospital course and were advanced to goal. gu: a foley catheter was placed on admission, and was kept due to his altered mental status. heme: his hematocrit was closely monitored, and he received prbc transfusions when needed. he had an ivc filter placed on . id: he had a refractory leukocytosis and fevers throughout his stay. he underwent many lower extremity washouts with orthopedics for infection and necrosis of his fasciotomies and fracture sites. he ultimately grew klebsiella from a bal, acinetobactor from a sputum, and enterobacter cloacae from his leg wound, all of which were treated with appropriate antibiotics. despite appropriate antibiotics and wound debridement, he continued to spike fevers and have a leukocytosis at the time of transfer out of the icu. he was transferred to the surgical floor on . he continued to have an elevated white blood cell count at 22.9. within 24 hours of discharge, he returned to the intensive care unit after he became febrile and tachypneic. blood and sputum cultures were sent and he was found to have pseudomonas and klebseilla in his sputum. because he had copious secretions, a tracheostomy was performed on . at this time, he underwent placement of a feeding tube to provide him with nutrition. he continued to have temperature spikes and an elevated white blood cell count and infectious disease was consulted. his antibiotic coverage was broadened to tobramycin, meropenum, and a five day course of vancomycin. his tobramycin and meropenum were discontinued on . once his white blood cell count stabilized, he was taken to operating room on where he underwent a wash-out of his right tib/fib fracture and application of a vac dressing. he returned to the operating room in 24 hours for left lower extremity washout and vac change. his operative course was stable with minimal blood loss. his vac and jp drain were removed on . his cervical spine was cleared by ortho spine and his cervical collar was removed. he was evaulated by speech and swallow to determine his ability to take oral nutrition. a video swallow was obtained which showed trace aspiration with nectar-thick liquid, but no aspiration or penetration with any other consistency of contrast. he was started on pureed regular diet. his trach was down-sized to a #6 fenestrated, cuffless tube on . he coughed out his trach tube later that day and has maintained his oxygen saturation without evidence of respiratory compromise. he was re-evaluated by speech and swallow and cleared for a regular diet. since he was nutritionally depleted, a calorie count was ordered and tube feedings continued to be cycled at night alternating with a regular diet during the day. he has had no evidence of aspiration on a regular diet. both physical and occupational therapy have been involved in his care. with his reported history of bipolar disease, he was evaluated by the psychiatrist after his trach tube was removed and it was determined that his bipolar disease was not active and recommended haldol if he became agitated. he has been very cooperative and has not required haldol. since his admission, he was maintained on keppra and it was felt that provided him with adequate mood stablization. his keppra is currently being weaned. during the course of his hospitalization, he had been followed by social services who were closely working with outside resources to determine his identity. a guardian was appointed during this process. through investigative sources, he was identified and his family was contact. social services have continued to provide support to both the patient and family. one month after his admission, a repeat head cat scan was done to evaluate his tbi and it showed no new hemorrhages. his keppra is being weaned off. his vital signs are stable and he has been afebrile. he is maintaining an oxygen saturation of 100% on room air with a normal respiratory rate. he has been cleared to resume a regular diet after evaluation of speech and swallow with cyclic tube feedings at bedtime. he still requires straight bladder catherization every 6 hours for a neurogenic bladder. he is preparing for discharge to a rehabilitation facility to help him regain his strength and mobility. he has been ordered to receive his post-splenectomy immunizations prior to discharge. he has follow-up appointments with the acute care service, plastics, orthopedics, and neurology. medications on admission: unknown discharge medications: 1. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day): hold for loose stool. 2. levetiracetam 500 mg tablet sig: two (2) tablet po once a day: thru then decrease to 500 mg daily for 4 days then discontinue. 3. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 4. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q4h (every 4 hours) as needed for wheezing/sob. 5. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed for constipation: hold for diarrhea. 6. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily). 7. miconazole nitrate 2 % powder sig: one (1) appl topical (2 times a day) as needed for rash. 8. metoprolol tartrate 50 mg tablet sig: one (1) tablet po qid (4 times a day): hold for hr <60, systolic blood pressure <90. 9. enoxaparin 40 mg/0.4 ml syringe sig: forty (40) mg subcutaneous qpm (once a day (in the evening)). 10. colace 100 mg capsule sig: one (1) capsule po twice a day: hold for loose stool. 11. acetaminophen 325 mg tablet sig: 1-2 tablets po every six (6) hours: as needed for pain,fever. 12. oxycodone 5 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain: hold for increased sedation, resp. rate <12. disp:*35 tablet(s)* refills:*0* discharge disposition: extended care facility: discharge diagnosis: s/p pedestrian struck 1. bilateral subarachnoid hemorrhage 2. intraventricular hemorrhage 3. frontal sinus fracture 4. left occipital condyle fracture 5. t1 transverse process fracture 6. tip of clivus fracture 7. epidural hematoma at c1 8. sternal fracture 9. splenci laceration 10.right pubic rami fracture 11.right anterior acetabular fracture 12.open right radial and ulnar fracture 13.bilateral tibia/fibular fractures 14.sacral fracture 15.right transverse process trunk injury 16.acute blood loss anemia 17.pneumonia 18.tbi discharge condition: opens eyes to tactile and verbal stimulation disoriented to time, person, and place occasional words spoken after pmv placed discharge instructions: you were admitted to the hospital after you were struck by a car. you sustained a skull and sinus fractures along with injuries to your upper and lower extremities. you had exploratory surgery of your abdomen and had an injury to your spleen and it was removed. you were admitted to the intensive care unit where you required monitoring of the pressures in your head because of increased swelling. you underwent several surgical procedures for repair of your lower extremity injuries. you had a tracheostomy tube placed to help clear the secretions from your lungs because you were unable to clear them on your own. to maintain your nutritional status, you had a feeding tube placed through which you received additional supplements. you are now preparing for discharge to a rehabilitation facility where you can further regain your strength. followup instructions: please follow up with dr. in 1 month () for a non-contrast repeat head cat scan. the telephone number to make this appoinment is #. you should also remain on the keppra until then. please follow up with the acute care service in 2 weeks. you can schedule this appointment 24 hours after you are discharged. the telephone number is # . please follow up with plastic surgery, dr. , in 2 weeks. call for appointment. please follow up with orthopedics nurse practitioner, in 2 weeks. the telephone number is # md procedure: 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 percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy fasciotomy other skin graft to other sites graft of muscle or fascia attachment of pedicle or flap graft to other sites debridement of open fracture site, tibia and fibula debridement of open fracture site, tibia and fibula debridement of open fracture site, tibia and fibula debridement of open fracture site, tibia and fibula debridement of open fracture site, tibia and fibula debridement of open fracture site, tibia and fibula debridement of open fracture site, tibia and fibula 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 total splenectomy closure of skin and subcutaneous tissue of other sites nonexcisional debridement of wound, infection or burn open reduction of fracture with internal fixation, radius and ulna closed reduction of fracture without internal fixation, radius and ulna closed reduction of fracture without internal fixation, radius and ulna debridement of open fracture site, radius and ulna debridement of open fracture site, radius and ulna debridement of open fracture site, radius and ulna excision of lesion of other soft tissue closed reduction of fracture without internal fixation, tibia and fibula other suture of muscle or fascia removal of implanted devices from bone, tibia and fibula angiocardiography of venae cavae insertion or replacement of (cement) spacer application of external fixator device, monoplanar system intracranial pressure monitoring magnetic removal of embedded foreign body from cornea diagnoses: other postoperative infection friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site acute posthemorrhagic anemia motor vehicle traffic accident involving collision with pedestrian injuring pedestrian open wound of forehead, without mention of complication closed fracture of sternum alkalosis closed fracture of patella closed fracture of dorsal [thoracic] vertebra without mention of spinal cord injury hyperosmolality and/or hypernatremia ventilator associated pneumonia bipolar disorder, unspecified closed fracture of seventh cervical vertebra closed fracture of sacrum and coccyx without mention of spinal cord injury injury to other intra-abdominal organs without mention of open wound into cavity, peritoneum closed fracture of pubis open fracture of shaft of fibula with tibia other specified bacterial infections in conditions classified elsewhere and of unspecified site, other gram-negative organisms closed fracture of acetabulum c1-c4 level with other specified spinal cord injury injury to spleen without mention of open wound into cavity, capsular tears, without major disruption of parenchyma open fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, with loss of consciousness of unspecified duration open monteggia's fracture disruption of traumatic injury wound repair 

Answer: The patient is high likely exposed to