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: penicillins / sulfonamides attending: chief complaint: fall major surgical or invasive procedure: none history of present illness: patient is an 83 year old femal who went out on the porch to get her mail, slipped on steps and fell about 5 feet and struck here head on the rail and ground. she denies loss of conciousness, lightheadedness, chest pain, shortness of breath, prior to fall. she complains of a headache and a large centimeter laceration to her parietal/posterior aspect of her scalp. no other obvious injuries. also complains of some back pain in upper thoracic/lower c-spine area. patient takes coupmadin for afib. she has also had 2 falls in the last 6 months past medical history: 1. hypertension 2. atrial fibrillation 3. congestive heart failure, echo in with ejection fraction of 55%. 4. status post cholecystectomy 5. bilateral masectomy 6. history of appendectomy social history: lives alone with no alcohol or no tobacco family history: non contributory physical exam: temperature 99.0, pulse 73, blood pressure 94/49, respirations 21, oxygen saturation 96% on room air general: awake, alert and oriented times 3 head and neck: centimeter laceration ot posterior scalp with some debris/. no involvement of the galea. pupils equal round and reactive to light. extraocular movements intact. midface stable. tympanic membranes clear. dentition intact. c collar in place pulmonary: clear to auscultation bilaterally cardiac: regular rate and rhythm with no murmurs rubs or gallops abdomen: soft, nontender, nondistended genitourinary: foley in place, no gross blood rectal: normal tone, no gross blood extremities: no clubbing, cyanosis or edema pelvis: stable to back: no abrasions, tender on palpation of spinous processes of upper thoracic or lower cervical spine neuro: alert and oriented times three. cranial nerves 2 through 12 intact. motor and sensation intact bilaterally pertinent results: ct abdomen : there is a 1.4 x 1 cm area of low attenuation seen in the right lobe of the liver likely representing a simple cyst. it was previously seen on the study from . another small subcentimeter area of low attenuation is present in the right lobe which is too small to characterize. the rest of the liver is unremarkable. the gallbladder is not visualized. the spleen, adrenals, kidneys, pancreas appear unremarkable. there is no free air or free fluid. there is no mesenteric or retroperitoneal lymph adenopathy. the evaluation of the bowel is incomplete due to lack of oral contrast. however, it grossly appears unremarkable. the inferior vena cava appears thin in the antero-posterior diameter. this is of inknown clinical significance. ct of the pelvis with iv contrast: multiple diverticula are present in the large bowel without evidence of diverticulitis. there is no free air or free fluid. the urinary bladder and distal ureters appear unremarkable. there is no pelvic or inguinal lymph adenopathy. no suspicious lytic or blastic lesions are identified. no fractures are seen. there is a lumbar dextroscoliosis. degenerative changes are seen in the spine. ct reconstructions: multiplanar reconstructions confirm the absence of an acute abdominal pathology. impression: no evidence of traumatic injury. ct cspine : the occipital condyles are well-aligned with the c1 lateral masses. c2 through c7 alignment is anatomic. there is multilevel degenerative disk disease from c3 to c6. there is some multilevel uncovertebral joint hypertrophic changes. no prevertebral soft tissue. impression: fracture of the right superior facet at c7 without associated widening or malalignment of the facet joint. no evidence of traumatic malalignment of the cervical spine. multilevel degenerative changes. ct head : impression: 1. extensive scalp injury near the vertex with associated subcutaneous emphysema. no associated calvarial abnormalities. prominent diploic veins of uncertain clinical significance. gadolinium enhanced brain mri may be helpful for excluding underlying vascular abnormalities. xray clavicle : no evidence of clavicular fracture. poor visualization of the sternoclavicular joint mri c-spine, : impression: 1. spinal stenosis most notably at c4-c5 and c5-c6 with evidence of bilateral neural foraminal narrowing at these levels, consistent with degenerative disease. 2. no evidence of cord impingement at c6-c7 or c7-c8. no subluxation of the component vertebrae. the alignment of the cervical spine is normal. no paraspinal pathology is seen. brief hospital course: the patient had her head laceratoin closed, and was resusccitated with 2 liters of fluid for systolic blood pressures in the 80's-90s. she also received two units of packed red blood cells. her inr was 2.4, and she was also given ffp. she had a 10 point drop in her hematocrit. he was admitted to the intensive care unit for the transfusion and for regular neuro checks. the orthopaedic spine was consulted for a c7 fracture, who suggested a hard c collar for 3 months, and to follow up in three weeks. she was transferred to the floor on hospital day 2 in stable condition. she remained hemodynamically and neurologically stable, and the patient was evaluated by physical therapy who suggested physical therapy rehab for strengtheniing, mobility and balance training and education regarding her recent falls and her deconditioning. the patient was tolerating regualr food. she did complain of some shoulder pain but an xray of her clavicle was negative. it was decided that the patient should not be anticoagulated for 2 weeks for spinal healing, but the patient should resume anticoagulation with her primary care physician 2 weeks. she was in stable condition and ready for transfer to rehab. on discharge the patient had asymptomatic bactiuria. we spoke to the infectious disease people at , and they felt that this was not a urinary tract infection and should not be treated, given that the patient is not having dysuria, an elevated white count, or fevers over the 6 days in the hospital. if the patient develops symptoms (fever, pain with urination) you can send a repeat urinalysis and treat her for a uti, but this does not require her to come back to the hospital. she can call , , md, in infectious disease if there are any questions, who was consulted on this. medications on admission: atenolol 50 mg daily, diltiazem 240 mg daily, prilosec 20 mg daily, coumadin 4 mg daily, albuteraol, diovan, lasix 10 mg daily, prinivil 40 mg daily, zoloft 100 mg daily, vioxx 25 mg daily, searax 15 mg nightly discharge medications: 1. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 2. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h (every 6 hours) as needed. disp:*2 inhalers* refills:*0* 3. atenolol 50 mg tablet sig: one (1) tablet po qd (once a day). disp:*30 tablet(s)* refills:*2* 4. diltiazem hcl 60 mg tablet sig: one (1) tablet po qid (4 times a day). disp:*120 tablet(s)* refills:*2* 5. furosemide 20 mg tablet sig: 0.5 tablet po qd (once a day). disp:*15 tablet(s)* refills:*2* 6. sertraline hcl 100 mg tablet sig: one (1) tablet po qd (once a day). disp:*30 tablet(s)* refills:*2* 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 8. oxazepam 15 mg capsule sig: one (1) capsule po hs (at bedtime) as needed. disp:*30 capsule(s)* refills:*0* 9. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. disp:*120 tablet(s)* refills:*1* discharge disposition: extended care facility: home - discharge diagnosis: 1. head laceration 2. cervical spinal fracture 3. cardiac arrhythmia/atrial fibrillation 4. hypertension 5. congestive heart failure 6. history of falls 7. acute hypotension 8. blood loss anemia requiring transfusion discharge condition: good discharge instructions: please md with any spiking fevers, intractable nausea or inability to tolerate food, increasing dizziness, increasing neck pain, numbness, tingling, or weakness in your arms or legs you should resume taking the medication you were taking prior to this admission you need to wear the cervical collar at all times for 3 months. followup instructions: you should follow up with dr. in orthopaedics in 3 weeks you should call his office to schedule any cervical spine xrays that he may want prior to the appointment. () you can follow up with dr. for your wrist injury you should follow up with your primary care physician, will need to restart your coumadin in 2 weeks. you can follow up in the trauma clinic in 2 weeks to have your sutures removed. ( procedure: closure of skin and subcutaneous tissue of other sites transfusion of packed cells diagnoses: congestive heart failure, unspecified iron deficiency anemia secondary to blood loss (chronic) atrial fibrillation open wound of scalp, without mention of complication accidental fall on or from other stairs or steps closed fracture of seventh cervical vertebra traumatic subcutaneous emphysema other specified disorders of liver 

Answer: The patient is high likely exposed to