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: unstable neck fracture major surgical or invasive procedure: occipito cervical fusion o to c4 fusion history of present illness: 81m with pmhx of primary speech apraxia, dm2, copd, asbestosis, and recent fall for which he was admitted and placed in a -j collar (noted to have an old c1-c2 fracture) who presents from rehab with concern for ill-fitting collar and possible mental status changes. patient was discharged to rehab yesterday to rehab, and was reportedly complaining of nausea, anorexia, dizziness, and headache. there was a question of worsening of his apraxia. he required a 1:1 sitter last night for agitation and was sent to the ed from his rehab for further evaluation. in the ed, initial vs were 98 90 157/70 15 95%. labs were significant for stable hyponatremia & anemia. preliminary read of non-contrast head ct showed no acute process. u/a was negative. patient did not receive any medications or fluids in the ed; they did note that the patient fell asleep twice during interview. patient was seen by neurosurgery who felt that his mental status was at baseline. they determined that there was no acute neurosurgical issues and that his c-collar was appropriately fit. patient reportedly denied weakness or gait abnormalities. patient was admitted to medicine for placement, as his rehab facility refused to take him back. vital signs on transfer were 98.5 ??????f (36.9 ??????c), pulse: 99, rr: 16, bp: 139/70, o2sat: 94%ra. on arrival to the floor, patient appears calm and comfortable. communication is difficult apraxia, but pt able to answer yes/no. he correctly circled (on a piece of paper) that he is at the hospital and said "no" when asked if he was in pain. past medical history: copd, asbestosis, diabetes, primary speech apraxia social history: widowed, remote etoh and smoking history, lives in in : . family history: nc physical exam: physical examination on admission: o: t: 98 bp: 157/70 hr:90 r 15 o2sats 95% gen: wd/wn, comfortable, nad. heent: pupils: eoms neck: supple. lungs: cta bilaterally. cardiac: rrr. s1/s2. abd: soft, nt, bs+ extrem: warm and well-perfused. neuro: mental status: awake and alert, cooperative with exam, normal affect. orientation: oriented to person, place, and date. language: at baseline dysarthria. primarily communicates by writing cranial nerves: i: not tested ii: pupils equally round and reactive to light, to mm bilaterally. visual fields are full to confrontation. iii, iv, vi: extraocular movements intact bilaterally without nystagmus. v, vii: facial strength and sensation intact and symmetric. viii: hearing intact to voice. ix, x: palatal elevation symmetrical. : sternocleidomastoid and trapezius normal bilaterally. xii: tongue midline without fasciculations. motor: normal bulk and tone bilaterally. no abnormal movements, tremors. strength full power throughout. no pronator drift sensation: intact to light touch bilaterally. reflexes: b t br pa ac right: + + + + + left + + + + + physical examination on discharge: same pertinent results: head ct: impression: no evidence of acute intracranial process. cxr: impression: extensive bilateral calcified pleural plaque, likely reflecting prior asbestos exposure. no signs of superimposed pneumonia. 07:56pm urine hours-random 07:56pm urine gr hold-hold 07:56pm urine color-yellow appear-clear sp -1.020 07:02am glucose-101* urea n-10 creat-0.5 sodium-126* potassium-4.3 chloride-88* total co2-29 anion gap-13 07:02am wbc-8.0 rbc-4.18* hgb-12.8* hct-38.7* mcv-93 mch-30.7 mchc-33.1 rdw-13.6 07:02am plt count-266 brief hospital course: initially, the patient was admitted to the medical service. an extensive conversation with the hcp was had, who felt the patient was at his baseline. he was noted to be hypovolemic, no worse than previous admission, and this was felt to be secondary to hypovolemia, so he was managed with gentle iv hydration. he was transferred to the neurosurgery service for work-up of his cervical spine fracture. on , after discussion with the hcp, it was determined that the patient would be electively intubated on and placed in traction prior to undergoing occipital-cranial fusion. he remained hyponatremic with a sodium of 125. on , patient remained intubated. he was taken out of traction in ct scanner for a ct c-spine which showed stable c1/c2 fracture with good reduction. on exam, mae and squeezes hand. he was pre-oped for or on . on he was stable in the icu, intubated, and on cervical traction while awaiting or for occipital to c2 fusion. c0-c4 fusion was performed on without any intraoperative complications.on patient remained stable, intubated in the icu. he was leethargic, but opened his eyes, squeezes hands and moves toes bilaterally on command. bronchoscopy showed airway edema necesitating general surgery consult for tracheostomy. traheostomy was performed on , he remained in the icu until when he was transferred to floor. he was evaluated by speech therapy prior to his transfer, on and was seen again once he was on the floor. on he failed the speech and swallow study and poorly tolerated his pmv. at that time peg was suggested but both patient and his hcp/nephew declined the peg citing limited evidence that it would improve his survival. after further discussion on the patient changed his mind and agreed to have the peg placed. peg was placed on , tube feeds were started on and stopped. tube feeds restarted on and found to be at goal per gi. staples removed from incisional wound on . medications on admission: 1. acetaminophen 325-650 mg po q6h:prn pain 2. albuterol 0.083% neb soln 1 neb ih tid copd 3. aspirin 81 mg po daily 4. docusate sodium 100 mg po bid patient may refuse. hold if patient has loose stools. 5. folic acid 1 mg po daily 6. ipratropium bromide neb 1 neb ih tid copd 7. metformin (glucophage) 500 mg po bid 8. multivitamins 1 tab po daily 9. nitroglycerin sl 0.4 mg sl prn chest pain 10. omeprazole 20 mg po daily 11. quinapril 10 mg po daily 12. simvastatin 20 mg po daily 13. tramadol (ultram) 25 mg po q6h:prn pain 14. tamsulosin 0.4 mg po hs 15. vitamin d 800 unit po daily discharge medications: 1. vitamin d 800 unit po daily 2. tramadol (ultram) 25 mg po q6h:prn pain rx *ultram 50 mg 1 tablet(s) by mouth q6h:prn disp #*100 tablet refills:*0 3. tamsulosin 0.4 mg po hs 4. simvastatin 20 mg po daily 5. senna 1 tab po bid 6. metformin (glucophage) 500 mg po bid 7. quinapril 10 mg po daily hold for sbp < 100 8. multivitamins 1 tab po daily 9. heparin 5000 unit sc tid 10. folic acid 1 mg po daily 11. docusate sodium 100 mg po bid patient may refuse. hold if patient has loose stools. 12. bisacodyl 10 mg po/pr daily 13. ipratropium bromide neb 1 neb ih q6h discharge disposition: extended care facility: hospital - discharge diagnosis: odontoid type 2 fracture unstable. discharge condition: level of consciousness: alert and interactive. mental status: confused - sometimes. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: ?????? do not smoke. ?????? keep your wound(s) clean and dry / no tub baths or pool swimming for two weeks from your date of surgery. ?????? dressing may be removed on day 2 after surgery. ?????? if you have steri-strips in place, you must keep them dry for 72 hours. do not pull them off. they will fall off on their own or be taken off in the office. you may trim the edges if they begin to curl. ?????? no pulling up, lifting more than 10 lbs., or excessive bending or twisting. ?????? limit your use of stairs to 2-3 times per day. ?????? have a friend or family member check your incision daily for signs of infection. ?????? if you are required to wear one, wear your cervical collar or back brace as instructed. ?????? you may shower briefly without the collar or back brace; unless you have been instructed otherwise. ?????? take your pain medication as instructed; you may find it best if taken in the morning when you wake-up for morning stiffness, and before bed for sleeping discomfort. ?????? do not take any medications such as aspirin unless directed by your doctor. ?????? unless you had a fusion, you should take advil/ibuprofen 400mg three times daily ?????? increase your intake of fluids and fiber, as pain medicine (narcotics) can cause constipation. we recommend taking an over the counter stool softener, such as docusate (colace) while taking narcotic pain medication. ?????? clearance to drive and return to work will be addressed at your post-operative office visit. call your surgeon immediately if you experience any of the following: ?????? pain that is continually increasing or not relieved by pain medicine. ?????? any weakness, numbness, tingling in your extremities. ?????? any signs of infection at the wound site: redness, swelling, tenderness, and drainage. ?????? fever greater than or equal to 101?????? f. ?????? any change in your bowel or bladder habits (such as loss of bowl or urine control). physical therapy: activity as tolerated. brace to be worn out of bed while ambulating. no need of brace in bed or in chair. treatments frequency: see discharge instructions. keep incisions dry followup instructions: follow up instructions/appointments ??????please return to the office in days (from date of surgery) for removal of your staples/sutures and/or a wound check. this appointment can be made with the physician assistant or practitioner. please make this appointment by calling . if you live quite a distance from our office, please make arrangements for the same, with your pcp. ??????please call ( to schedule an appointment with dr. to be seen in 2 weeks. ??????you will need x-rays/ct-scan prior to your appointment. procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances other bronchoscopy percutaneous [endoscopic] gastrostomy [peg] arterial catheterization temporary tracheostomy excision of bone for graft, other bones repair of vertebral fracture atlas-axis spinal fusion spinal traction using skull device fusion or refusion of 2-3 vertebrae diagnoses: other iatrogenic hypotension anemia, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified protein-calorie malnutrition hyposmolality and/or hyponatremia chronic airway obstruction, not elsewhere classified unspecified fall personal history of tobacco use hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) closed fracture of second cervical vertebra do not resuscitate status hypovolemia asbestosis unspecified gastritis and gastroduodenitis, without mention of hemorrhage closed fracture of first cervical vertebra edema of larynx acute respiratory failure following trauma and surgery dysphagia, unspecified other diseases of vocal cords body mass index between 19-24, adult other symbolic dysfunction 

Answer: The patient is high likely exposed to