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: zosyn attending: chief complaint: s/p 0 feet from ladder to concrete major surgical or invasive procedure: peg placement bronchoscopy tracheostomy history of present illness: this is a 63 year old male who was on a ladder and fell hitting his torso and head on concrete at approximately 4:50 pm.the patient reports that he is unable to move his legs or arms.he is unable to feel his legs, but states that he has sensation in his hands and arms. the interview/exam was brief as the patient was about to be intubated for airway protection and brought emergently to ct scanner. past medical history: none social history: lives with wife at home, professor family history: non contributory physical exam: gen: head laceration to occiput, comfortable, nad. heent: pupils: 3-2mm eoms:intact neck: hard collar extrem: warm and well-perfused. neuro: mental status: awake and alert, cooperative with exam, normal affect. orientation: oriented to person, place, and date. recall: did not test language: speech fluent with good comprehension and repetition. naming intact. no dysarthria or paraphasic errors. cranial nerves: i: not tested ii: pupils equally round and reactive to light, to mm bilaterally. visual fields unable to test 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 unable to test : sternocleidomastoid and trapezius- pt unable to move xii: tongue midline-did not test motor: normal bulk and tone bilaterally. no abnormal movements, tremors. strength: patient unable to move legs or arms. pronator drift-unable to test sensation: patient with equal sensation in arms, sensory level to t , no sensation in legs. coordination:unable to test exam upon discharge: ue motor , le 0 sensation level approx t9 with occasional "tingling" sensation to ble pertinent results: -ct chest/abdomen/pelvis 1. no acute osseous injury identified. 2. mild bibasilar atelectasis. -ct head 1. no acute intracranial process -ct c spine there is a fracture through the right transverse process of c1 vertebral body involving the foramen and the right and left posterior lamina of c1 (-type fracture). the dens is intact. a nondisplaced impaction-type fracture is noted in the lateral mass on the right of the c2 vertebral body. c3 is fractured through the right pars interarticularis extending into the proximal lamina with minimal displacement. the c4 right pedicle is fractured. a small triangular fragment at the right posterior inferior vertebral body corner representsa small avulsive type fracture. fracture is noted at the right c5 superior articulating facet extending longitudinally through the lamina terminating at the spinolaminar junction. slight hyperattenuation is noted posterior to the c3-c% vertebral bodies suspicious for epidural hemorrhage. high attenuation is also noted layering along the ventral cord at these levels suggesting subarachnoid hemorrhage. c6 and c7 are intact. there is multilevel disk space narrowing from pre-existing degenerative disease. there is a markedly anteriorly displaced anterior osetophyte at c4-5 suggesting extension-type injury at this level since reduced. this would be congruent with the posterior element fractures noted above (accounting for a rightward tilt to the trauma mechanism). current alignment is anatomic with cervical lordosis maintained. marked pervertebral soft tissue swelling noted. -mri cervical spine 1. hemorrhagic cord contusion with surrounding edema extending from the c2 through the c6 levels. 2. evidence of extensive ligamentous injury, as described above. 3. extramedullary intradural hematoma appears to extend to the cervicothoracic junction and at c5 causes leftward mass effect on the cord. 4. multiple cervical spinal fractures, right more than left, are better detailed on the recent ct of the cervical spine. high signal within the c4-5 and c6-7 disks is also likely related to trauma. -x ray l hand fractures of the left small and ring finger metacarpals, as above. --- 9:00 pm sputum source: endotracheal. gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 3+ (5-10 per 1000x field): gram positive cocci. in pairs and chains. 2+ (1-5 per 1000x field): gram negative rod(s). ---cta chest 1. acute isolated right apical subsegmental pulmonary embolism, the clinical significance of which is uncertain. 2. new moderately severe bilateral lower lobe atelectasis. 3. new bilateral small pleural effusions. 4. right upper and right lower lobe consolidation and clustered nodules are consistent with an acute infection, acute aspiration is also considered possible. --- 10:52 am bronchoalveolar lavage gram stain (final ): 4+ (>10 per 1000x field): polymorphonuclear leukocytes. 2+ (1-5 per 1000x field): gram positive cocci. in pairs and singly. : chest xr: findings: in comparison with the study of , allowing for the obliquity of the patient, there is no change in the monitoring and support devices. there appears to be some improved aeration in the retrocardiac region at the left base, though some atelectatic change persists. no evidence of vascular congestion or definite acute pneumonia cta chest 1. new segmental pe in vessels supplying right lower lobe posteriorly and lateral right middle lobe. possible additional subsegmental pe supplying left upper lobe posteriorly. no infarct or new right heart strain. 2. improvement in right middle and lower lobe peribronchial nodules and consolidation c/w improving infection or resolving aspiration. 3. persistent bronchial impaction and airway secretions (particularly on the left), with persistent near-complete left lower lobe collapse, which could be due to recurrent aspiration. 4. nearly resolved bilateral pleural effusions. brief hospital course: pt initially admitted to the icu and the trauma service after he was intubated for airway protection following a fall from 20 feet. multiple cervical spine fractures noted on ct scan and he remained in a hard cervical collar with flat bed rest until his thoracic and lumbar spine could be safely cleared. his exam on admission was limited movement of his r fingers and was able to shrug shoulders, his right side greater than his left side. mri of cervical spine was consistent with multiple cervical spine fractures and stir changes within the cord from c2-c6 but showed no canal compromise and no role for emergent surgical intervention. further treatment options of his cervical spine fractures were discussed with attending dr. and it was decided that patient would remain in a hard cervical collar for treatment of his fractures. he was found to have displaced fracture of his left ring finger and this was reduced by the hand surgery team and placed in a splint. on he spiked a temp and had increasing secretions. he underwent bronchoscopy and was started on 7 day course of antibiotics for presumed ventilator acquired pneumonia. ultimately all cultures were negative. he underwent an uncomplicated tracheostomy on . he was bronched after fever spike to 102.8 on and these cultures were also negative. he was working with pt and ot and is a good candidate for rehab. his antibiotics were discontinued after a 7 day course on . his upper extremity strength has improved slightly and is now a in both upper extremities. on pt was febrile to tmax of 103 and he underwent bronchoscopy with the sicu team on the morning of , sputum cultures were sent and consistent with gpc. he was restarted on vap protocol with vancomycin, ciprofloxacin and cefepime. he underwent chest ct on this day and it was positive for subsegmental pulmonary embolism. he was started on heparin iv gtt on the 18th with the goal to bridge to coumadin. his antibiotics were changed to vancomycin and zosyn. on , the patient's inr was only at 1.2 despite being on coumadin therapy for 2 days. because he had a bed at a rehab facility, the decision was made to d/c the heparin gtt and utilize lovenox in conjunction with the coumadin, until his inr reached the therapeutic level. on , his wbc count dropped to 1.2, from 4 the previous day. this was likely attributed to the zosyn. this was subsequently d/dc'd as was vancomycin. levaquin and flagyl were started as antibiotic coverage. it was decided that he would need to have his wbc count increase prior to discharge to rehab. on his wbc was 1.7 which was slightly improved. his exam continued to be stable as he awaited a rehab bed on his wbc was 1.3. infectious disease continued to give input and hematology was consulted. he was continued on his current antibiotics but placed on neutropenic precautions. it was ultimately decided that his pe was subsegmental and did not require formal anticoagulation - his coumadin was discontinued but he remained on heparin 5000 units sc three times daily. a lower extremity doppler was obtained on and this showed a superficial thrombus in the right peroneal vein. hematology team was consulted and they felt his neutropenia was likely medication related. they recommended neupogen to increase wbc production. he received 1 dose on and wbc increased on to 1.8. and was 11.8 on . his neupogen was discontinued on . on patient had an episode of decreased o2 saturations overnight and required deep suctioning and replacement of his tracheostomy. he had a repeat chest ct on that showed new segmental pe in right lung and he was started on lovenox 70mg sc q12 and he obtained an ivc filter on this was placed without complication. he currently is being anticoagulated with a goal inr of using a bridge of lovenox. his inr on is 1.3 our plan was to give coumadin 5mg. he was started on full coumadin on . on his wbc increased to 33. nupogen was held. he continued to spike fevers to 101, but wbc was 11. patient was pancultured. on wbc was 16.7, sputum culture grew gram negative rods so id was reconsulted and they recommended meropenem and linezolid. he was bronched and cultures pending though gram stain showed 1+ gnr and gpc. on his wbc trended down to 10.6 his antibiotics continue to be meropenum and linzolid. we recommend continuing until approximately for 14 days of coverage. medications on admission: none discharge medications: 1. polyvinyl alcohol-povidone 1.4-0.6 % dropperette : drops ophthalmic prn (as needed) as needed for dry eyes. 2. enoxaparin 80 mg/0.8 ml syringe : seventy (70) mg subcutaneous q12h (every 12 hours). 3. warfarin 5 mg tablet : one (1) tablet po once daily at 4 pm. 4. meropenem 500 mg recon soln : five hundred (500) mg intravenous q6h (every 6 hours). 5. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily) as needed for gi prophy. 6. tylenol 325 mg tablet : six y (650) mg po every six (6) hours as needed for fever or pain. 7. dulcolax 10 mg suppository : one (1) tab rectal once a day as needed for constipation. 8. colace 100 mg capsule : one (1) capsule po twice a day. 9. dilaudid 2 mg tablet : 1-2 tablets po every 4-6 hours as needed for pain. 10. ibuprofen 800 mg tablet : one (1) tablet po every eight (8) hours as needed for fever or pain. 11. lorazepam 0.5 mg tablet : one (1) tablet po every four (4) hours as needed for anxiety. 12. midrodrine : five (5) mg every eight (8) hours. 13. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler : four (4) puffs inhalation every four (4) hours as needed for wheezing. 14. quetiapine 25 mg tablet : 1.5 tablets po qhs (once a day (at bedtime)). 15. linezolid 600 mg/300 ml parenteral solution : one (1) intravenous q12h (every 12 hours). discharge disposition: extended care facility: - discharge diagnosis: cervical spine contusion ventilator aquired pneumonia quadraplegia respiratory failure dysphagia left hand fracture segmental pulmonary embolism discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: bedbound. discharge instructions: please wear the cervical collar at all times. followup instructions: follow-up appointment instructions ?????? please call ( to schedule an appointment with dr. to be seen in 12 weeks. please follow up with hand clinic for fractures orthopedics location: 2 phone: ( in 2 weeks. procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube interruption of the vena cava enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] arterial catheterization temporary tracheostomy closed [endoscopic] biopsy of bronchus bronchoscopy through artificial stoma bronchoscopy through artificial stoma bronchoscopy through artificial stoma bronchoscopy through artificial stoma bronchoscopy through artificial stoma bronchoscopy through artificial stoma bronchoscopy through artificial stoma bronchoscopy through artificial stoma bronchoscopy through artificial stoma bronchoscopy through artificial stoma angiocardiography of venae cavae closed reduction of fracture without internal fixation, phalanges of hand diagnoses: open wound of scalp, without mention of complication acute respiratory failure closed fracture of c1-c4 level with other specified spinal cord injury ventilator associated pneumonia drug induced neutropenia other specified antibiotics causing adverse effects in therapeutic use accidental fall from ladder other pulmonary embolism and infarction dependence on respirator, status dysphagia, unspecified closed fracture of c5-c7 level with other specified spinal cord injury closed fracture of phalanx or phalanges of hand, unspecified 

Answer: The patient is high likely exposed to