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: mr. was seen at after a mechanical fall from a height of 10 feet. ct scan noted unstable fracture of c6-7 & posterior elements. major surgical or invasive procedure: 1. anterior cervical osteotomy, c6-c7, with decompression and excision of ossification of the posterior longitudinal ligament. 2. anterior cervical deformity correction. 3. interbody reconstruction. 4. anterior cervical fusion, c5-c6-c7. 5. plate instrumentation, c5-c6-c7. 6. cervical laminectomy c6-c7, t1. 7. posterior cervical arthrodesis c4-t1. 8. cervical instrumentation c4-t1. 9. arthrodesis augmentation with autograft, allograft and demineralized bone matrix. history of present illness: mr. is a 82 year old male who had a slip and fall of approximately 10 feet from a balcony. he was ambulatory at the scene. he presented to the ed here at . ct scan revealed unstable c spine fracture. he was intubated secondary to agitation. patient admitted to trauma surgery service past medical history: coronary artery disease s/p cabg chf htn aicd atrial fibrillation stroke social history: patient recently discharged from for severe depression. family reports patient was very sad and attempted to kill himself by wrapping a telephone cord around his neck. lives with his elderly wife, worked as a chemist in . family history: non contributory physical exam: phycial exam prior to surgery was not obtained since patient was intubated and sedated. post surgical physical exam: (tsicu per surgery team) breathing without assistance nad vitals: t 97.5, hr 61, bp 145/67, rr22, sao2 98 a-fib, rate controlled abd soft non-tender anterior/posterior cervical incisions pt is edemitous in all four extremities, no facial edema able to grossly move all four extremities, neurointact to light touch distal pulses weakly intact medicine consult: vs: tm/c 98.9 142/70 61 20 96%ra i/o bm yesterday 220/770 gen: awake, calm, cooperative and pleasant, lying in bed neck: c-collar removed cv: irregular, normal s1, s2. no m/r/g. lungs: cta anteriolry abd: obese, soft, ntnd, decreased bs ext: trace b/l le edema, 1+ ue edema neuro/cognition: thought , "8", not to place, pertinent results: ==================== admission labs ==================== wbc-8.4 rbc-4.43* hgb-11.9* hct-38.6* mcv-87 mch-26.9* mchc-30.9* rdw-17.3* plt ct-191 pt-20.4* ptt-28.1 inr(pt)-1.9* ck(cpk)-183* amylase-70 calcium-8.5 phos-2.0* mg-1.9 glucose-121* lactate-2.3* na-140 k-4.3 cl-101 calhco3-26 ================== radiology ================== ct scan c spine : impression: 1. fracture of the c6 as described involving the right pedicle (extending to the inferior facet) and left lamina. anterior widening at the c6-7 disc space and mild widening of left c6-7 facet also noted. prevertebral hematoma at c6 with likely rupture of the anterior longitudinal ligament. 2. lucency in the right posterior c1 ring may represent a chronic injury. likely old avulsion fracture at t2 pedicle on the left. 3. ossification of both anterior and posterior longitudinal ligaments with compromise of the central spinal canal. degenerative disease is further described above. ct abdomen/pelvis () impression: 1. no acute injuries in the chest, abdomen, or pelvis. 2. three discrete pleural fluid collections in the right hemithorax, likely pseudotumors. 3. small hypodense lesion in the pancreatic body is of unclear etiology, may represent pseudicyst or cystic tumor. further evaluation with mri may be performed on a non- emergent basis. 4. bilateral renal cysts. 5. foley catheter balloon inflated within the prostatic urethra. recommend emergent repositioning. ct sinus/maxillofacial () 1. bilateral nasal bone fractures. 2. left frontal scalp hematoma with preseptal soft tissue swelling. question foreign body anterior to the left globe. recommend clinical correlation. small amount of extraconal hematoma in the superior aspect of the left orbit. 3. linear lucency in the right posterior ring of c1. correlate with ct c- spine performed concurrently. head ct () 1. no acute intracranial hemprrhage. 2. left frontal scalp hematoma. 3. nasal bone fractures. recommend correlation with report from facial bone ct scan. 4. lucency in the right posterior ring of c1. please refer to dedeicated ct c-spine for further detail. 5. left cerebellar encephalomalacia, likely due to old infarction. chest the dobbhoff tube passes below the diaphragm with its tip most likely terminating in the stomach. the bilateral pacemakers are demonstrated with one lead terminating in right atrium and three leads terminating in right ventricle. the patient is in mild pulmonary edema with no change in the loculated pleural fluid within the major fissure. ct head 1. a tiny amount of intraventricular hemorrhage layers along the occipital horns of the ventricles bilaterally. recommend followp imaging. 2. left frontal scalp hematoma has decreased in size. 3. unchanged left cerebellar encephalomalacia. 4. nasal bone fractures are better evaluated on dedicated maxillofacial ct. right shoulder x-ray () mild glenohumeral and acromioclavicular joint osteoarthritis. nonspecific ossification projecting over the upper margin of the scapular body and adjacent to the lesser tuberosity. diagnostic considerations include the sequela of chronic calcific bursitis, intraarticular bodies, and/or calcific tendinitis of the subscapularis tendon. increased opacity projecting over the right hemithorax and minor fissure, better delineated on recent chest radiographs and chest ct right upper extremity ultrasound () 1. deep venous thrombosis in the right axillary vein, extending proximally into the right subclavian vein, and distally to involve the brachial veins, portion of the basilic vein, and the right cephalic vein. 2. likely 2.0 cm left axillary lymph node, with unusual son features somewhat suspicious for malignancy. followup ultrasound is recommended in 4 weeks, and fna/biopsy may be considered at that time if no interval improvement. ct abdomen with iv contrast: there are small-to-moderate bilateral pleural effusions, on the right with a loculated appearance. there is associated compressive atelectasis. the visualized portion of the heart suggests mild cardiomegaly. there is no pericardial effusion. there is a 9-mm hypoattenuating, well-defined lesion in the left lobe of the liver (2:12) too small to accurately characterize but statistically most likely representing a cyst. there are bilateral, partially exophytic renal cysts. the spleen is normal in size. there is a 5-mm hypoattenuating focus in the pancreatic body, most likely representing focal fat. the gallbladder and adrenal glands are unremarkable. an ng tube terminates in the stomach. there is no ascites. the large and small bowel loops appear unremarkable without wall thickening or pneumatosis. oral contrast material has passed into the ascending colon without evidence of obstruction. there is no ascites and no free air. there is a small pocket of air in the left rectus muscle, tracking over a distance of approximately 10 cm. ct pelvis with iv contrast: the pelvic small and large bowel loops, collapsed bladder containing foley catheter and seminal vesicles appear unremarkable. the prostate is enlarged, measuring 5.9 cm in transverse diameter. the rectum contains a moderate amount of dried stool. there is no free air or free fluid. bone windows: no suspicious lytic or sclerotic lesions. there is dish of the entire visualized thoracolumbar spine. there also are degenerative changes about the hip joints with large acetabular osteophytes. impression: 1. stable bilateral pleural effusions, loculated on the right. 2. new focus of air tracking within the left rectus muscle with associated tiny amount of extraperitoneal air (2:53). no associated stranding or fluid collection. please correlate clinically if this could be iatrogenic, such as due to s.q. injections. 3. 5-mm hypoattenuating focus in the pancreatic body. this could represent focal fat, although a cystic tumor cannot be excluded. if this is of concern, then mri is again recommended for further evaluation. 4. hypoattenuating focus in the left lobe of the liver, too small to accurately characterize. 5. bilateral partially exophytic renal cysts. 6. moderate amount of dried stool within the rectum. a wet read was placed and the pertinent findings were discussed by dr. with dr. at 11:30 p.m. on . video oropharyngeal swallow findings: real-time video fluoroscopic evaluation was performed after oral administration of thin and puree consistency of barium, in conjunction with the speech pathologist. oral phase: normal bolus formation, bolus control, ap tongue movement, oral transit time, and no oral cavity residue. pharyngeal phase: there is normal swallow initiation and velar elevation. there is mild-to-moderate impairment of laryngeal elevation with absent epiglottic deflection. there is moderate-to-severe increase in pharyngeal transit time. there is residue in the valleculae and piriform sinuses with moderate impairment of bolus propulsion. there was aspiration of both thin and puree barium. impression: aspiration of thin liquids and puree. for additional information, please see the speech and swallow therapist's report from the same day. ct head w/out: findings: there is a small amount of blood layering in the occipital horns of both lateral ventricles, unchanged though not as dense given evolution. no new hemorrhage is identified. the ventricles, cisterns, and sulci are enlarged secondary to involutional change. periventricular white matter hyperdensities are sequelae of chronic small vessel ischemia. encephalomalacia in the left cerebellar hemisphere secondary to old infarction is unchanged. the osseous structures are unremarkable. the visualized paranasal sinuses and mastoid air cells are clear. skin staples are noted along the superior- posterior neck secondary to recent spinal surgery. impression: no interval change with a very small intraventricular hemorrhage. no discharge labs as patient cmo. brief hospital course: mr. was seen at after his fall from a height of approximatly 10 feet. ct scans of his chest, abdomen and pelvis were negative for pathology. ct scan of his c-spine showed fracture of anterior and posterior elements at c6-7. he was also shown to have a right nasal bone fracture. c-spine fracture: mr. two surgical procedures to stabilized his c-spine. : anterior cervical decompression/fusion at c6-7. : cervical laminectomy c6-c7 & t1 with posterior cervical arthrodesis c4-t1. he tolerated the procedures well. he was extubated without complication. after his surgical procedures, mr. was transfered to the medicine service at for his medical care. while on the medicine service, patient was found to be persistently aspirating and failed his speech and swallow evaluation. patient and family were not interested in an ng tube or peg for nutrition. patient also developed a venous clot of the right upper extremity and the decision was made to not proceed with medical treatment. goals of care were changed to comfort measures only. a foley was placed after patient had difficulty with urinary retention and straight cathing. a palliative care consult was obtained for symptom management and patient was discharged to hospice with morphine, olanzapine, and a foley in place for symptomatic relief. medications on admission: coumadin seroquel docusate metoprolol folate lovastatin captopril asa ipratroium inhaler ferrous sulfate furosemide citalopram isosorbide meprazole discharge medications: 1. bisacodyl 10 mg suppository sig: suppositorys rectal daily (daily) as needed for constipation. 2. ipratropium bromide 0.02 % solution sig: one (1) nebulizer inhalation q6h (every 6 hours) as needed for wheezing. 3. albuterol sulfate 2.5 mg/3 ml solution for nebulization sig: one (1) solution inhalation q6h (every 6 hours) as needed for wheezing. 4. morphine concentrate 20 mg/ml solution sig: 5-10 mg po q4h (every 4 hours) as needed for pain: may shorten interval as needed to control pain. 5. olanzapine 5 mg tablet, rapid dissolve sig: 0.5 tablet, rapid dissolve po qhs (once a day (at bedtime)) as needed for agitation. 6. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po daily (daily): may be discontinued if patient not tolerating pills or refusing to take. discharge disposition: extended care facility: of discharge diagnosis: 1. cervical spondylosis with calcification of posterior longitudinal ligament. 2. fracture dislocation c6-c7. 3. ossification of the posterior longitudinal ligament. 4. aspiration pneumonia 1. cervical spondylosis with calcification of posterior longitudinal ligament. 2. fracture dislocation c6-c7. 3. ossification of the posterior longitudinal ligament. 4. aspiration pneumonia 1. cervical spondylosis with calcification of posterior longitudinal ligament. 2. fracture dislocation c6-c7. 3. ossification of the posterior longitudinal ligament. 4. aspiration pneumonia discharge condition: stable to outside facility discharge instructions: patient has been made cmo at the request of him and his family. he has a foley placed for urinary retention. please use morphine as needed for pain and olanzapine as needed for agitiation. patient has known history of aspiration documented on speech and swallow. it is the patient and the family's wish for him to continue to eat and drink as desired. followup instructions: follow up with your primary care physician as needed. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube other cervical fusion of the anterior column, anterior technique repair of vertebral fracture other cervical fusion of the posterior column, posterior technique fusion or refusion of 4-8 vertebrae diagnoses: congestive heart failure, unspecified atrial fibrillation aortocoronary bypass status pneumonitis due to inhalation of food or vomitus retention of urine, unspecified automatic implantable cardiac defibrillator in situ personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits acute on chronic systolic heart failure delirium due to conditions classified elsewhere accidental fall from or out of building or other structure closed fracture of nasal bones benign essential hypertension closed fracture of sixth cervical vertebra 

Answer: The patient is high likely exposed to