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: valium / warfarin / morphine attending: chief complaint: pain in right chest major surgical or invasive procedure: paravertebral catheter placement for pain management history of present illness: this is a 85 year old male who was struck by a car while walking across the street. prior to the event, he states he was feeling well without dizziness or loss of balance. he states he lost consciousness for approximately 4-5 minutes, but he has no amnesia to the event. upon arrival to via ems, he was found to have a r pelvic acetabular fracture, as well as a r pneumothorax. he currently denies ha, nausea/vomiting, blurred vision. he takes asa and plavix daily for his proximal lad stent. past medical history: 1. dyslipidemia 2. hypertension 3. stenting of proximal lad 4. cva x 2 without residual disability. location of cva unknown 5. basal cell ca 6. l cea with stent social history: married, lives with wife. at nursing home as as custodial worker. former tobacco smoker. no etoh abuse. family history: non contributory physical exam: o: t: afebrile bp: 120/31 hr:73 r:23 o2sats:100% face tent gen: wd/wn, comfortable, nad. heent: normocephalic. staples intact to r parietal laceration. not actively bleeding. pupils: 3-2.5 bilat eoms: intact extrem: warm and well-perfused. neuro: mental status: awake and alert, cooperative with exam, normal affect. orientation: oriented to person, place, and date. cranial nerves: i: not tested ii: pupils equally round and reactive to light, 3 to 2.5 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. difficult to assess r leg acetabular fracture, but able to isolate muscle groups and good strength is noted. no pronator drift toes downgoing bilaterally pertinent results: 11:30am wbc-18.9* rbc-2.95* hgb-8.8* hct-26.4* mcv-90 mch-29.9 mchc-33.4 rdw-13.8 11:30am neuts-89.2* lymphs-6.2* monos-4.2 eos-0.3 basos-0.2 11:30am plt count-205 11:30am glucose-143* urea n-20 creat-1.1 sodium-144 potassium-4.4 chloride-115* total co2-21* anion gap-12 11:30am alt(sgpt)-64* ast(sgot)-100* ck(cpk)-977* alk phos-54 tot bili-0.4 11:30am alt(sgpt)-64* ast(sgot)-100* ck(cpk)-977* alk phos-54 tot bili-0.4 11:30am lipase-56 01:09pm glucose-133* urea n-19 creat-1.1 sodium-144 potassium-4.4 chloride-115* total co2-24 anion gap-9 01:09pm wbc-16.4* rbc-2.95* hgb-8.8* hct-26.2* mcv-89 mch-29.9 mchc-33.6 rdw-14.0 wbc rbc hgb hct mcv mch mchc rdw plt ct 07:30am 8.8 3.19* 9.4* 27.2* 85 29.4 34.6 15.2 99* !0/28/09 cardiac echo : the left atrium is mildly dilated. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the aortic arch is mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. the left ventricular inflow pattern suggests impaired relaxation. the tricuspid valve leaflets are mildly thickened. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. ct chest/abd/pelvis : 1. interval development of soft tissue stranding and haziness in the anterior mediastinum concerning for mediastinal hematoma. 2. interval placement of a right chest tube with interval decrease in size of right pneumothorax, now small, and with decreased shift of the mediastinum. subcutaneous emphysema extending along the right lateral and posterior chest, abdomen and pelvis. multiple right-sided rib fractures, with a displaced fracture of the right posterior 8th rib and multiple additional nondisplaced fractures, as above. 3. left upper lobe ground-glass opacity, may represent pulmonary contusion. 4. multiple areas of mesenteric stranding and haziness likely reflect mesenteric contusions with more confluent area inferior to the spleen containing areas of high density, likely reflecting small hemoperitoneum. 5. multiple pelvic fractures including right superior and inferior pubic rami with extension into the right acetabulum and a right iliac fracture. right pelvic hematoma adjacent to the right superior pubic rami fractures, grossly stable in size as compared to the prior study. large lateral right buttock hematoma with extensive overlying contusions/soft tissue induration. mild anterolisthesis of l4 over l5 of indeterminate age, but moderate adjacent degenerative changes suggests this could be chronic. recommend clinical correlation with point tenderness. 6. collapsed distal descending colon/proximal sigmoid colon with suggestion of mild wall thickening, new since prior study, bowel injury cannot be excluded. adjacent mild fat stranding in this area. 7. infrarenal abdominal aortic aneurysm. study not tailored for evaluation for dissection. 8. multiple incidental findings, including cholelithiasis. innumerable splenic calcifications as well as calcified mediastinal/hilar lymph nodes, most likely reflect prior granulomatous disease. head ct : 1. no evidence of fractures or misalignment of the cervical spine. 2. moderate-to-severe degenerative changes along the cervical spine, most severe from c3 through c7, with associated moderate spinal canal stenosis. 3. significant right pneumothorax. ct c spine : . small left acute subdural hematoma overlying the left temporal lobe, without significant mass effect or shift of normally midline structures. 2. large right pneumothorax, with shift of the mediastinum to the left, suggestive of tension. 3. small focus of contusion within the left upper lobe in the lung. 4. patchy areas of stranding throughout the mesentery, suspicious for mesenteric injury. 5. small focus of hemoperitoneum inferior to the tip of the spleen, without definite splenic injury identified, though limited by respiratory motion. 6. mildly displaced fractures involving the right inferior and superior pubic rami, likely extending into the acetabulum. mildly displaced right iliac fracture. 7. mildly displaced right eighth rib fracture. 8. marked atheromatous disease of the abdominal aorta, without definite acute aortic injury. head ct : 1. redistribution of subdural hemorrhage. minimal subarachnoid hemorrhage now detected. no mass effect. 2. minor sinus mucosal changes in the ethmoidal sinus. 3. new surgical staples at the skin overlying the right parietal bone towards the vertex. cxr : no evident pneumothorax. no interval change from prior. brief hospital course: mr. was evaluated by the trauma service in the emergency room then admitted to the trauma icu for further evaluation and management. he was seen by the cardiology service as he had st depression anterior, septal and laterally on his ekg. his troponin and ckmb index was normal so he underwent tte in light of his past history of nstemi'. there was no wall motion abnormalities and his ef was normal. the ekg changes were due to demand ischemia (ie pain, trauma ) in the setting of anemia. due to his rib fractures and uncontrolled pain, he had a paravertebral block placed for pain control which also helped his pain from a right chest tube placement for pneumothorax. subsequently a continuous infusion of ropivacaine was used through the paravertebral catheter which effectively controlled his pain. he was transfused with a total of 4 units of packed rbc's during his hospitalization. his lowest hematocrit was 26 and most recently has stabilized in the 27-30 range. he remained in the icu for close neuro monitoring due to his left subdural hematoma. he was placed on keppra for seizure prophylaxis as well. he had no neurologic deficits and a repeat head ct was unchanged. his aspirin and plavix were then resumed. during his stay in the icu he was evaluated by the orthopedic service for his pelvic fractures and they will be treated in a closed manner therefore his weight bearing status is advance weight bearing as tolerated. on he was transferred to the trauma floor where he continued to make good progress. his chest tube was removed on and a post pull film showed no pneumothorax or effusion. his oxygen was weaned off easily and he was able to participate in limited physical therapy due to his injuries. following removal of his paravertebral catheter his pain was controlled with oxycodone effectively. he continued to work with physical therapy and was able to stand and pivot from bed to chair with 1 assist. his appetite was gradually improving and he was having normal bowel movements. hopefully after a stint in rehab he will be able to go home with increased independence. medications on admission: zocor (unknown dose) metoprolol 50 mg po bid plavix 75 mg daily asa 81 mg po daily study drug for cad discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. senna 8.6 mg tablet sig: two (2) tablet po hs (at bedtime). 5. levetiracetam 500 mg tablet sig: one (1) tablet po bid (2 times a day): thru 11//. 6. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 7. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 8. fondaparinux 2.5 mg/0.5 ml syringe sig: 2.5 mg subcutaneous daily (daily). 9. oxycodone 5 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 10. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours). discharge disposition: extended care facility: discharge diagnosis: primary diagnosis s/p fall, pedestrian struck by car with 1. subdural hematoma 2. pelvic fracture (right inf pubic ramus,right iliac fracture, right ischium fracture, right posterior acetabular fracture) 3. right pneumothorax 4. right rib fractures 5,6,8 and 9 5. left upper lobe pulmonary contusion secondary diagnoses 1. cad with nstemi withstents in lad & circ 2. dyslipidemia 3. hypertension 4. cva x 2 without residual disability. location of cva unknown 5. basal cell ca 6. l cea with stent discharge condition: stable, tolerating a heart healthy diet,pain controlled with oxycodone discharge instructions: call your neurosurgeon( immediately if you experience any of the following ?????? new onset of tremors or seizures. ?????? any confusion, lethargy or change in mental status. ?????? any numbness, tingling, weakness in your extremities. ?????? pain or headache that is continually increasing, or not relieved by pain medication. ?????? take your pain medicine as prescribed. ?????? exercise should be limited to walking; no lifting, straining, or excessive bending. ?????? increase your intake of fluids and fiber, as narcotic pain medicine can cause constipation. we generally recommend taking an over the counter stool softener, such as docusate (colace) while taking narcotic pain medication. ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, or ibuprofen etc. call your doctor immediately if you experience any of the following ?????? new onset of tremors or seizures. ?????? any confusion, lethargy or change in mental status. ?????? any numbness, tingling, weakness in your extremities. ?????? pain or headache that is continually increasing, or not relieved by pain medication. ?????? new onset of the loss of function, or decrease of function on one whole side of your body. followup instructions: follow-up appointment instructions ??????please call ( to schedule an appointment with dr., to be seen in 4 weeks. ??????you will need a ct scan of the brain without contrast. call dr. at for a follow up appointment in 2 weeks call the clinic at for a follow up appointment in 4 weeks with dr. procedure: insertion of intercostal catheter for drainage injection or infusion of other therapeutic or prophylactic substance injection of other agent into spinal canal diagnoses: coronary atherosclerosis of native coronary artery unspecified pleural effusion unspecified essential hypertension acute posthemorrhagic anemia personal history of tobacco use percutaneous transluminal coronary angioplasty status motor vehicle traffic accident involving collision with pedestrian injuring pedestrian other and unspecified hyperlipidemia personal history of other malignant neoplasm of skin old myocardial infarction personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits traumatic pneumothorax without mention of open wound into thorax subdural hemorrhage following injury without mention of open intracranial wound, with brief [less than one hour] loss of consciousness traumatic subcutaneous emphysema contusion of lung without mention of open wound into thorax street and highway accidents closed fracture of pubis closed fracture of acetabulum closed fracture of four ribs closed fracture of ischium closed fracture of ilium unspecified external cause status 

Answer: The patient is high likely exposed to