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: naprosyn attending: chief complaint: 37m s/p fall 70ft major surgical or invasive procedure: left to right axillo-axillo bypass w/ ptfe and bilateral lower extremity arteriogram bilateral open reduction with external fixation of the tibia and ankle bones tracheostomy - decannulated peg left foot closed reduction, external fixation talonavicular dislocation and calcaneus fracture. right foot open reduction talar body dislocation, external fixation talar body dislocation pin replacement, d/c of g tube history of present illness: 37 y.o. male who had a 70foot fall , unconscious, initally unclear whether he fell or was pushed, presented to ed unstable with a gcs of 3, sbp 60's. difficulty intubating in the field, airway secured in ed and bilateral chest tubes placed. blood pressure stabilized and a bag of white powder was found in his rectum. he was taken to ct then x-ray where he dropped his pressure again, was transfused and transported to the tsicu. he was found on secondary survey to have the multiple injuries including right clavicle fx, open tib-fib fx bl, cold right upper extremity. past medical history: polysubstance abuse depression social history: unemployed, substance abuse family history: non-contributory physical exam: on arrival to the ed vitals: temp 98.2 hr 80 bp 110/70 sat 94% on vent gcs 3t gen: intubated, paralyzed, c-collar in place heent: perrl, trachea midline, 6 cm laceration above left eyebrow, 1.5 cm on left eye lid, no nasal deformity, midface stable, no step-offs, no oralpharyngeal trauma chest: decreased bs on right side with flail chest cv: rrr abd: snd back: no step-offs or visible abrasions pelvis: stable to ap and lateral compression gu: foley in place rectal: normal tone, bag of white powder inside rectum, no gross blood ext: ble with open fx bilaterally grossly deformed, dopplerable dp/pt pulses bilaterally, right arm with visible deformity pertinent results: ct sinus/mandible/maxillofacial w/o contrast 11:37 pm facial bones ct: transverse fractures through the left frontal bone and frontal sinus is present with associated small pneumocephalus. the frontal bone fracture extends inferiorly to the nasal bones. there are fractures involving the superior, medial, lateral and inferior walls of the right orbit as well as the superior and medial walls of the left orbit. there is no evidence of rectus muscle entrapment. the superior ophthalmic vein and optic nerves bilaterally are intact as well as the globes. significant amount of extraconal air is seen bilaterally. globes are intact and no significant proptosis is noted. preseptal edema is present and more pronounced on the right than on the left. additionally there is a fracture through the lateral wall of the right sphenoid sinus as well as the anterior, medial and lateral walls of the right maxillary sinus. fractures through the medial wall of the left maxillary sinus is also apparent. high density fluid is seen within both frontal, both maxillary, both ethmoid and both sphenoid sinuses consistent with blood. the visualized portion of the brain appears unremarkable without evidence of intra or extraaxial hemorrhage. the mastoid air cells appear well pneumatized. the sphenoid sinus fracture involves the right carotid canal, raising an concern of carotid artery injury. there is a fracture along the medial wall of the right optic canal, potentially injuring the right optic nerve. ct chest w&w/o c ; ct abdomen w/contrast impression: 1. bilateral pneumothoraces with pulmonary contusions. 2. numerous right-sided rib fractures, transverse fracture through the t1 vertebral body, comminuted fractures through the sacrum and left superior and inferior pubic rami as described above. large pelvic hematoma seen in the presacral space. 3. location of right superior chest tube with tip tracking along the medial aspect adjacent to the mediastinum. 4. no significant injury identified within the abdomen or pelvis. tib/fib (ap & lat) soft tissue bilat 12:02 am ankle/foot (ap & lat) soft tis; tib/fib (ap & lat) soft tissue impression: 1. comminuted fracture through the proximal third of the right fibula and medially displaced fracture of the proximal tibia. 2. comminuted fracture of the right calcaneus with rotation and dislocation of the left talus. 3. irregularity of the right ankle mortise and proximal compression deformity of the right talus. sel cath 2nd order 8:06 pm no evidence of carotid vertebral artery dissection or stenosis and no evidence of intracranial pseudoaneurysm or dural fistula. art dup ext up bilat comp 2:04 pm the bypass was patent, with no evidence of significant, flow limiting stenosis. the peak systolic velocities were measured at 119 cm/second in the native left subclavian artery, 90 cm/second at the left-sided bypass anastomosis, between 106 and 120 cm/second within the bypass itself, 68 cm/second at the right, distal bypass anastomosis, and 149 cm/second in the native right subclavian artery. us extremity nonvascular left 4:52 pm impression: heterogeneous collection is seen superior and anterior to the axillary graft at the site of the drainage. this would be in keeping with hematoma or infected collection as suspected clinically. uni-lat brachial 7:09 am infected left-to-right axillary-to-axillary artery bypass graft of ptfe status post trauma. brief hospital course: 45 yo male s/p jump/fall aprox 70 feet brought to ed by ems seen by trauma and orthopedics in ed x rays showed open bilateral tibal fxs and bilteral calcaneal fxs and rt calvicular fx open rt humerous fx lft cuniform and 1st mtp fx left thumb avulsion fx multiple pelvic fxs ptatient was seen by orthopedics and taken to or emergently and underwent bilateral open reduction and exfix of tibial fxs on on he went back to the or for bilateral exfix of his calcaneal fxs post op he was on the trauma service with orthopedics consulting and following his orthopedic injuries pt was intially evaluated with bilateral ue/le angiography (read as normal), lax-ax w/ ptfe()trach/peg bedside . an ivc filter was placed by ir on and removed on . pt went to the floor (hd #21). chest tubes were d/c'd after prolonged airleak that finally sealed. pt was decannulated . pt was diagnosed with several injuries while inpt as listed in d/c diagnosis section of this report. pt was on lovenox for dvt prophylaxis in light of immobility as inpt. hospital course is further notable for noncompliance with brace/splints. pt's pain was treated with morphine sulfate, oxycodone-acetaminophen as inpt and the pain service was consulted. psych was also consulted to address pt's anxiety while inpt. pt's gtube was removed without complication while inpatient. on hospital day 58 patient was noted to have a thick discharge from a pin site on his external fix of the rle, cultures were taken, the patient was started on vancomycin, and eventually the the pin was replaced intraoperatively by orthopedic surgery. of note during this hospital course pt also complained of rue pain. an emg was performed which was unable to be completed secondary to patient's refusal to continue. however, it appeared that the problem could be localized to the elbow or brachial plexus. a plain film of the elbow was obtained which was unchanged per ortho from previous studies. pt was sent for a cta of the right shoulder to assess for obvious vascular or bony pathology as a possible etiology of the pain, but this study revealed no abnormalities. on a follow-up us study of the pt's ax-ax graft was performed showing adequate perfusion. on , the pt complained of a small superficial abscess on his left chest wall. further inspection revealed this erythematous area to be directly over the graft site. us of the left chest showed a loculated collection superior and anterior to the graph site indicating the graft was infected. the pt was empirically started on vanc/levo/flagyl. wound cultures grew mrsa and the pt was continued on vanc only. the pt was taken to the or by the vascular team on 8/13t was for removal of the old graft and placement of a new right carotid, right axillary graft.patient was delined and transfered to nursing floor on postop day one. patient complained of persistant right hand pain after his revascularization with right axilo-femoral byp. screen for rehabilitation began. /04 methadone weaning so patient can be placed in rehabilitation .tee no vegitations or intracardiac abcess seen.picc line position adjusted.patient now with mass health insurance can now be more agressive with discharge planning. addiction service requested to see patient in reguards to continued tapering of methadone and ?? symptoms of with drawal. the addiction service didnot see any objective signs of withdrawal. recommendations were to continued methadone tapaering 10mgm daily.patient followed by dr. of adiction service. /04 skin staples of lower extremitiy discontinued. wounds clean , dry and intact.methadone taper continued. /04 off methadone. patient has been off narcotics and otherwise stable, he has required bed rest for three episodes of reported falls. patient has extensive history of malingering and drug seeking behavior. he continued to be seen by psychiatry and the addition nurse. his primary team has followed all their recommendations in order to facilitate the patient's discharge. the patient has been hemodynamically stable througout this entire period. he has asked numerous time for narcotics but his pain has been well controlled. the patient is no longer on antibiotics, he is afebrile and doing well. vascular service plans to transfer the patient to the orthopedic service for additional care on he was transfered back to the orthopedic service for further management of his orhtopedic injuries at this time he was on bedrest nwb on b/l le he still had in place his bilateral ex fixes on his tibias and calcaneous he was on the service of dr chief of orthopedic trauma over the month of serial xrays were done and the showed that there was not much healing of the tibial fxs he was given a bone stimulator on he returned to the or and underwent removal of left exfix and orif with ibg and a bivalved cast on he returned again for removal of rt ex fix and orif with ibg and a hinged brace through he has been pwb on the rt and tdwb on left which made him essentially bed to w/c only serial x rays showed slow progression of bone healing he was weaned down on his pain meds he was seen by pysch for some complaints of post tramatic distress syndrome but it was not validated on his last xrays 0n dr felt he had enought bone healing to be pwb 30% on the left and wbat on the rt he was given crutches and started to ambulate with pt he was wearing bilateral air cast boot for ambulation he did well with pt and they felt he could be dcd safely case managment spoke with him about his dc plans since no facility would take him he said he would be going to his parents house dr saw him the day of dc and told him to see him in one week he was then dcd from the hospital medications on admission: unknown discharge medications: 1. acetaminophen 500 mg tablet sig: two (2) tablet po q6h (every 6 hours). 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. enoxaparin sodium 30 mg/0.3 ml syringe sig: thirty (30) mgm subcutaneous q12h (every 12 hours). 4. oxycodone hcl 5 mg tablet sig: six (6) tablet po q3h (every 3 hours) as needed. 5. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical tid (3 times a day) as needed. 6. zinc sulfate 220 mg capsule sig: one (1) capsule po qd (once a day). 7. amitriptyline hcl 25 mg tablet sig: one (1) tablet po hs (at bedtime). 8. senna 8.6 mg tablet sig: two (2) tablet po hs (at bedtime). 9. multivitamin capsule sig: one (1) cap po qd (once a day). 10. ascorbic acid 500 mg tablet sig: one (1) tablet po bid (2 times a day). 11. lorazepam 0.5 mg tablet sig: 0.5-1mgm mgm po q4-6h (every 4 to 6 hours) as needed for agitation. 12. gabapentin 400 mg capsule sig: three (3) capsule po tid (3 times a day). 13. escitalopram oxalate 10 mg tablet sig: two (2) tablet po qam (once a day (in the morning)). 14. clonidine hcl 0.2 mg/24 hr patch weekly sig: 0.2mgm/hr patch patch weekly transdermal qmon (every monday). 15. trazodone hcl 100 mg tablet sig: one (1) tablet po hs (at bedtime) as needed. 16. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po qd (once a day) as needed. 17. oxycodone hcl 5 mg tablet sig: six (6) tablet po q3h (every 3 hours) as needed. 18. vancomycin hcl 10 g recon soln sig: 1gm recon soln intravenous q12h (every 12 hours) for 5 weeks: started . 19. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day) as needed. discharge disposition: home facility: - discharge diagnosis: frontal bone fracture with pneumocephalus multiple facial lacerations bilateral fronal sinus, maxillary sinus, ethmoid sinus and nasal bone fractures comminuted t1 vertebral body fx with likely interspinous ligament injury bilateral sacral fractures multiple pelvic fractures multiple right-sided rib fractures bilateral hemopneumothoracies with pulmonary contusion and flail chest right clavicle fracture, right elbow fracture right subclavian artery disruption bilateral open tib/fib fractues bilateral comminuted calcaneal, left lateral cuneiforn and 1st mtp fractures left thumb avulsion fracture discharge condition: stable. md, procedure: other revision of vascular procedure interruption of the vena cava arteriography of femoral and other lower extremity arteries other (peripheral) vascular shunt or bypass percutaneous [endoscopic] gastrostomy [peg] arteriography of cerebral arteries arteriography of other intrathoracic vessels temporary tracheostomy debridement of open fracture site, tibia and fibula application of external fixator device, tibia and fibula open reduction of fracture with internal fixation, tibia and fibula open reduction of fracture with internal fixation, tibia and fibula excision of bone for graft, other bones open reduction of fracture with internal fixation, tarsals and metatarsals application of external fixator device, tarsals and metatarsals removal of implanted devices from bone, tibia and fibula removal of implanted devices from bone, tarsals and metatarsals debridement of open fracture site, tarsals and metatarsals other operations on vessels closed reduction of fracture without internal fixation, tarsals and metatarsals bone graft, tibia and fibula diagnoses: pneumonia, organism unspecified infection and inflammatory reaction due to other vascular device, implant, and graft other and unspecified coagulation defects nonunion of fracture flail chest combinations of opioid type drug with any other drug dependence, continuous accidental fall from or out of building or other structure infection and inflammatory reaction due to other internal orthopedic device, implant, and graft multiple closed pelvic fractures with disruption of pelvic circle late effect of fracture of lower extremities closed fractures involving skull or face with other bones with subarachnoid, subdural, and extradural hemorrhage, with moderate [1-24 hours] loss of consciousness injury to innominate and subclavian arteries open multiple fractures involving both lower limbs, lower with upper limb, and lower limb(s) with rib(s) and sternum 

Answer: The patient is high likely exposed to