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: pedestrian struck by car major surgical or invasive procedure: d.l. picc peg history of present illness: this is a 24 year old female pedestrian struck at approximately 40mph, per ems report "obliterated" windshield. trauma stat called to ed for altered mental status, on arrival gcs 3 with roving eye movements. intubated immediately on arrival. found to have a subdural and occipital condyle fracture as well as rib fractures and pneumothorax. neurosurgery and orthopedics consult were placed. injuries: l sdh subtle parafalcine sah bilateral posterior temporal bone fracture fracture through carotid canal, sella, sphenoid sinus l occipital condyle fracture r 1st, 4th, 5th rib fractures r small pneumothorax r scapular spine fracture l scapular fracture l clavicle fracture l superior ramus fracture l sacral fracture past medical history: none social history: supportive parents at bedside. law student. family history: non-contributory. physical exam: on admission: hr: 120 bp: 80 systolic resp: 4 o(2)sat: 93% low constitutional: the patient is brought in by the paramedics being bagged in boarded and collared. her gcs is 4. heent: she has roving eye movements going to either side of the midline. pupils are 3 mm and both reactive 2 mm. there is some blood in both nares but appears it may be from external source. no obvious step-off chest: bilateral breath sounds cardiovascular: normal first and second heart sounds abdominal: soft extr/back: no long bone findings. she has bilateral knee abrasions. the great toe on the right side is bleeding. bilateral scapular and left hip abrasions but no step-off on the spine. neuro: her neurological evaluation is very limited. she is not speaking. she is not moving anything. upon discharge: t99.8 hr 106 bp 142/82 resp 18 o2sat 98%onra heent: she has appropriate movements. pupils are equal and reactive. no obvious step-off chest: bilateral breath sounds cardiovascular: normal first and second heart sounds abdominal: soft, peg site is clean and minimally tender extr/back: no long bone findings. she has bilateral knee abrasions. bilateral scapular and left hip abrasions but no step-off on the spine. neuro: she is speaking coherently with some word salad. still some confusion moving all four extremities with limited motion of r upper extremity. follows commands. pertinent results: ct head () - bilateral scapula fractures, fx of right posterolateral first, 4th and 5th rib, right pneumothorax, bilateral opacifications likely aspiration, however hemorrhage/contusion can't be excluded in setting of trauma ct () - no evidence of a fracture or malalignment in the cervical spine. nondisplaced left occipital condyle fracture. the left occipital condyle articulates normally with the left lateral mass of c1. temporal bone and skull base fractures are described in the concurrent head ct report. nondisplaced fractures of the right first, second, and third ribs, with a small right apical pneumothorax. biapical pulmonary contusions versus atelectasis. enlarged and heterogeneous thyroid gland with a 1-cm nodule in the left lobe. this may be evaluated by son when the patient is stable. ct torso () - right pneumothorax. bilateral opacifications, likely aspiration, however, hemorrhage or contusion cannot be excluded in the setting of trauma. comminuted right scapular fracture, left lateral scapular fracture. left sacral fracture and superior ramus fracture. left clavicular fracture. bilateral lower extremity xr () - there is no evidence of acute fracture or traumatic dislocation. there is no knee joint effusion bilaterally. no soft tissue calcifications or radiopaque foreign bodies are identified. repeat ct head () - stable subdural hemorrhage along the left convexity, right tentorium, and posterior falx. increased conspicuity of bihemispheric subarachnoid hemorrhage. increased nodular hemorrhage in left temporal region, which could represent an evolving hemorrhagic contusion or nodular subarachnoid hemorrhage. multiple skull base and bilateral temporal bone fractures are again noted. mr () - bone marrow edema in the left occipital condyle at the site of known fracture. no abnormalities in the cervical spine. mra brain/neck () - technically limited neck mra without evidence of obvious abnormalities. while evaluation for dissection or intramural hematoma is limited in the absence of axial t1-weighted fat-suppressed images, there is no irregularity in the carotid siphons to suggest an injury related to the bilateral sphenoid fractures. ct head () - stable subdural hemorrhage along the left cerebral convexity and right tentorium with minimally decreased hemorrhage along the posterior falx. redistribution of subarachnoid hemorrhage with less conspicuity of bihemispheric subarachnoid hemorrhage. nodular hemorrhagic focus in left temporal region is relatively stable in appearance and size compared with most recent prior examination. multiple skull base fractures and bilateral temporal bone fractures are again noted. ct head () - stable small subdural hemorrhage and few residual small foci of subarachnoid hemorrhage. stable left temporal hemorrhagic contusion with more prominent edema. cta head/neck () - questionable small dissection flap in the right cavernous carotid artery near the known sphenoid fracture, versus artifact. aberrant right subclavian artery. eeg () - this is an abnormal routine eeg due to the presence of a slow background which represents a moderate encephalopathy. it is also abnormal due to the presence of bursts of generalized delta frequency slowing which may represent deep midline dysfunction. there was left hemisphere delta frequency slowing which represents focal subcortical dysfunction. there were no epileptiform discharges or electrographic seizures. mr head () - hemorrhagic contusion in the left temporal lobe. several small foci of hemorrhage and diffusion abnormalities in the white matter suggest diffusion axonal injury. shallow left-sided subdural fluid collection is slightly increased since the recent ct study. fluid and blood in the bilateral mastoid air cells, sphenoid sinuses and the ethmoid air cells from recent trauma. ct sinus' : there are soft tissue changes in the left sphenoid sinus, likely related to trauma with blood products and small bony ossicles in the floor of the sinus, which have slightly changed, but better visualized on the initial head ct of . the right sphenoid sinus changes are new, could be related to intubation. mucosal thickening is seen in the left maxillary sinus. no fluid levels are visualized in the sphenoid sinus and in the maxillary sinuses. 01:30am wbc-9.8 rbc-3.82* hgb-11.2* hct-32.4* mcv-85 mch-29.3 mchc-34.6 rdw-12.9 01:30am pt-14.5* ptt-29.4 inr(pt)-1.3* 01:30am fibrinoge-229 01:30am asa-neg ethanol-236* acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 01:30am urea n-11 creat-0.7 01:44am hgb-11.2* calchct-34 o2 sat-92 carboxyhb-6* met hgb-0 01:53am urine bnzodzpn-neg barbitrt-neg opiates-neg cocaine-neg amphetmn-neg mthdone-neg brief hospital course: : the patient was initially admitted to the trauma icu. on admission she was evaluated by ortho spine, ortho trauma and neurosurgery. csf leakage was initially draining from her right ear but slowed down and per neurosurgery required no treatment. per ortho spine was she was kept in a hard collar. per ortho trauma her fractures were nonoperative and required slings. : her propofol was weaned to off. her sbp was maintained at less than 160 per neurosurgery. : her head ct and cta's of her head and neck were repeated and were normal. prophylactic heparin was started. : she was noted to have thick secretions and was bronched, and a bal was sent. neurology was asked to see her for her failure to wake up off sedation. an eeg was obtained. - : an mri was obtained which showed . her mental status slowly improved and was noted to wax and wane. precedex was utilized for agitation and her dilantin was discontinued. : ortho spine recommended c-collar for another 6-8 weeks. neurology recommended a repeat eeg. she remains on minimal ventilator settings but is unable to extubate secondary to mental status. : her wbc was noted to be rising so cultures were repeated and a c.diff was ordered. following transfer to the surgical floor her wbc peaked at 23k and all cultures were negative except for some sparse growth of sa in a sputum culture without chest xray findings or symptoms. she remained afebrile off antibiotics and her wbc continued to trend down. it was 15k at the time of discharge. she was tolerating her tube feedings at goal rate and was seen by the speech and swallow therapist as her mental status improved. she was inconsistent in her ability to follow commands and as she was at such a high risk for silent aspiration she underwent a video swallow on which indicated she was ready for trials by mouth of thick liquids like honey given by teaspoon. both the physical therapy and occupational therapy services evaluated her on a daily basis and noted modest progression. her attention span was gradually longer and she was beginning to say a few words. the physical therapist was limited in increasing her mobilization as she was non weight bearing to both upper extremities, required a hard cervical collar and she was impulsive. nevertheless she was out of bed and attempting gait training. her speech has improved immensely and she can give coherent responses. she is moving all her extremeties with limited movement of her r upper extremity. after an unfortunate accident she was transferred to rehab on for vigorous physical and cognitive therapy in the hopes that she will get back to her baseline in time. medications on admission: ocp discharge medications: 1. senna 8.8 mg/5 ml syrup sig: one (1) tablet po bid (2 times a day) as needed for constipation. 2. docusate sodium 50 mg/5 ml liquid sig: ten (10) ml po bid (2 times a day). 3. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) units injection tid (3 times a day). 4. acetaminophen 650 mg/20.3 ml solution sig: twenty (20) ml po q6h (every 6 hours). 5. oxycodone 5 mg/5 ml solution sig: 5-10 mls po q4h (every 4 hours) as needed for pain. 6. olanzapine 5 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po tid (3 times a day) as needed for agitation . discharge disposition: extended care facility: - discharge diagnosis: s/p pedestrian struck 1. right sah 2. left sdh and right tentorium 3. bilateral scapular fractures 4. bilateral temporal bone fractures 5. left occipital condyle fracture 6. comminuted fractures of both sphenoid sinus walls 7. left sacral fracture and superior ramus fracture 8. right rib fractures 1, 9. tbi 10.right pneumothorax 11.tracheobronchitis discharge condition: mental status: confused - sometimes. level of consciousness: lethargic but arousable and sometimes agitated and impulsive activity status: out of bed with assistance to chair or wheelchair. discharge instructions: * you were admitted to the hospital after being hit by a car. you sustained multiple injuries including head injuries and broken bones. currently you are making slow progress and you are being transferred to rehab so that you can get vigorous therapy for your head injury. you will need to work hard with the occupational therapists and physical therapists so that you can get back to your baseline. * even though you are going to rehab you will still need to come back to so that you can follow up with your doctors . * currently you are getting all of your nutrition thru a feeding tube in your stomach but that is only temporary until you can safely swallow. therapists at the rehab will be testing your swallowing when they see fit. * you have bilateral scapula fractures which means that you cannot bear weight thru your upper extremities. you should have gentle range of motion to both shoulders to prevent frozen shoulder. * you will need to wear the hard cervical collar at all times for 8 weeks. followup instructions: please follow up with neurosurgery dr. on at 2pm in thelowry building . you will also need a ct scan of the brain at that time.... the ct is scheduled at 1pm (west, clinical ctr. 3rd fl). please call our office at should any questions come up. call the acute care clinic at for a follow up appointment in weeks. call the clinic at for a follow up appointment in 4 weeks. call dr. from cognitive neurology at for a follow up appointment in 4 weeks. procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] closed [endoscopic] biopsy of bronchus central venous catheter placement with guidance diagnoses: unspecified protein-calorie malnutrition motor vehicle traffic accident involving collision with pedestrian injuring pedestrian methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site acute bronchitis traumatic pneumothorax without mention of open wound into thorax ventilator associated pneumonia closed fracture of sacrum and coccyx without mention of spinal cord injury closed fracture of pubis closed fracture of clavicle, unspecified part closed fracture of three ribs other closed skull fracture with subarachnoid, subdural, and extradural hemorrhage, unspecified state of consciousness closed fracture of glenoid cavity and neck of scapula cerebrospinal fluid otorrhea 

Answer: The patient is high likely exposed to