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: history of present illness: mr. is a 32 year old man from . on the , he was a pedestrian who was struck at high speed by either a motor vehicle or a motor vehicle that hit a pole and struck him. he is a spanish speaking male. there was positive loss of consciousness and a questionable change in mental status. the patient was found standing at the scene. notable at the scene were right orbital lacerations, a left open leg fracture. he was subsequently transported by ems to . at , mr. had a seizure on the ct scan table and desaturated to 58%. he was subsequently intubated on the ct scanner and further history was unobtainable. past medical history: none. medications: none. allergies: no known drug allergies. social history: mr. is originally from . physical examination: on admission, temperature was 96.2; heart rate 84; blood pressure 181/68; respirations 18 by bagged mask, intubated. saturation 100% on room air. in general, mild distress, alert and oriented times one, moving all extremities, somewhat agitated. he is following commands in spanish. head, eyes, ears, nose and throat: head is stable. trachea is midline. no hemotympanum. large left eye ecchymosis, with a left pupil going from four to 3.5. right pupil going from two to one mm. large amount of blood over the right forehead. bilateral ecchymosis around the upper eyelids. pupils are bilaterally four mms to two mms and reactive bilaterally. bilateral corneal reflexes present. neck is in a "c" collar. cardiovascular: regular rate and rhythm, normal s1 and s2. chest: moving air in both air fields. decreased breath sounds on the right. abdomen: soft, nontender, nondistended. rectal: normal tone. heme positive with a normal prostate. extremities: open fracture of the left lower leg and the left foot with bones that are visible. left dorsalis pedis and posterior tibial pulses are palpable. no other deformities noticed. the patient is moving all extremities. laboratory data: white blood cell count of 13; hematocrit of 44.9; platelets 387. inr 1. ptt of 23.8. sodium of 138; potassium of 3.4; chloride 103; bicarbonate 25; bun 19; creatinine 1; glucose 146. arterial blood gases 7.41, 34, 109, 22 and -1. fibrinogen 180. lactate 4.8. amylase 48. toxicology screen negative. radiographic studies: chest x-ray revealed no pneumothorax. rotated pelvis film revealed no evidence of fracture. head ct revealed open skull fracture; bilateral frontal contusions; right frontal intracranial hemorrhage; right frontal epidural hemorrhage; right frontal subdural hematoma. left orbital fracture. left retrobulbar hematoma. medial an lateral orbital wall fractures of the left orbit and lateral wall fracture of the right orbit. cervical spine ct revealed no fracture, no dislocation. chest ct revealed atelectasis with right lower lobe aspiration, no rib fractures. abdominal ct: no apparent solid organ injury. no free air. pelvic ct: cystic replacement of the right kidney. left lower extremity: left talus open fracture; multiple metatarsal fractures and dislocations. hospital course: on presentation, given mr. severe intracranial hemorrhages, he was taken immediately to the operating room with both the neurosurgery team and the orthopedic team. in the operating room, an emergent craniotomy as well as evacuation of the epidural hematoma was performed. at the same time, the orthopedic team performed an irrigation and debridement, as well as an open reduction and internal fixation of the left foot, metatarsal fracture and dislocation. also, at the time of the surgery, an intracranial pressure monitor was placed intraoperatively to monitor the patient's intracranial pressure. mr. was subsequently transferred to the trauma intensive care unit for further management of his intracranial pressure and his other injuries. he remained intubated for several days and his intracranial pressures were controlled. mr. was started on dilantin and mannitol was used to keep his intracranial pressure below 20. a repeat head cat scan on the did not show any progression for reaccumulation of the epidural hematoma. on , mr. returned to the operating room for a wash-out of his left lower extremity. a vac dressing was placed. also on that day, he was self extubated. there was no need for reintubation given that mr. maintained his oxygen saturation with supplemental oxygen. on , he returned to the operating room for another irrigation and debridement as well as a vac change. on the , mr. became somewhat agitated. he self-discontinued his intracranial pressure monitor, all his peripheral intravenous and his nasogastric tube. also on that day, he was transferred to the regular floor because he was considered stable. an angiogram of the left lower extremity on the showed a normal vascular pattern, except for an occluded dorsalis pedis at the talonavicular joint. on the , mr. returned to the operating room for debridement and wash-out again of his left lower extremity. on the , mr. experienced respiratory distress as well as acute chest pain with decreased saturation to 91% and increasing respiratory rate to 40. he was intubated and subsequently transferred to the intensive care unit again. a cta of his chest revealed a large pulmonary embolus and he was subsequently started on a heparin drip. his respiratory status slowly improved over the next several days. on the , angiogram of his left orbit was performed which did not show an arteriovenous fistula. he was also extubated on the . it was also discovered on the that he was growing methicillin resistant staphylococcus aureus from his left lower extremity wound. he was started on vancomycin and levaquin. on the , inferior vena cava filter was placed by the vascular surgery service. he was again transferred to the floor on . he was taken back to the operating room with both plastic service and orthopedic service for external fixation of his fractures as well as a lateral rectus abdominous free flap to close the tissue defect on his left lower extremity. postoperatively, he was taken back to the intensive care unit for frequent flap checks and he has done quite well with his flap. the plastic service is satisfied with how the flap has continued to heal. on , he was transferred back to the regular floor where he has remained stable until discharge. on , all his antibiotics were discontinued, including levaquin and vancomycin. he had been afebrile with a stable white count of 10 at the time of discontinuation of his antibiotics. on the , he returned to the vascular laboratory for potential removal of his inferior vena cava filter. however, on venogram, there was noted to be a large clot at the bifurcation of the aorta; therefore, the inferior vena cava filter was left in place and will be permanent. he was subsequently started on systemic anticoagulation with lovenox, dosed at 70 mg/kg twice a day as well as coumadin. throughout the course of his hospital stay, multiple consult services have been involved in mr. care. immediately, at the time of his injuries, the oral maxillofacial surgery team was consulted and worked in conjunction with all other teams in managing his facial injuries. ophthalmology was emergently consulted on admission for a left retrobulbar hematoma. the ophthalmology consult team did not feel that there was any need for lateral canthotomy and with no obvious ptosis or elevated pressures, the ophthalmology team did continue to follow him throughout his hospital stay. unfortunately, mr. did suffer a traumatic injury to his left eye and the result is that he is blind in that left eye. the plastic surgery service has continued to follow mr. throughout his hospital stay and has directed flap care to his left lower extremity. the orthopedic service has also been very involved with care, with placement of the external fixation device on his left lower extremity and the open reduction and internal fixation of his metatarsals. psychiatry service was also consulted initially on for evaluation of depression. the conclusion of the psychiatry service was that he was not depressed but likely abulic due to his head injury and maybe mildly encephalopathic as well. subsequently, the behavioral psychiatry team was consulted. upon their evaluation by , she determined that most of mr. deficits are neurologic in nature and recommended a more comprehensive evaluation upon the patient's discharge, to provide further information about the patient's cognitive strength and the extent of his cognitive deficits following a significant head injury. the nutrition service has also been involved during the course of his stay and has helped obtain adequate nutrition as well as calorie counts throughout his hospital stay. discharge instructions: per the plastics team, mr. is to keep his left lower extremity elevated and non weight bearing through without any dangling. he is also non weight bearing for the ortho and plastics team through . mr. will follow-up in the trauma clinic, in the plastic surgery clinic, in the orthopedic clinic, with neuropsychiatry clinic. upon discharge, mr. will be given instructions for follow-up with all of these different clinics and the specific dates he was to attend. discharge medications: percocet one to two tablets p.o. every four to six hours prn. tylenol 325 to 650 mg p.o. every four to six hours. colace 100 mg p.o. twice a day. bacitracin ointment. artificial tears, one to two drops o.u. four times a day. multi-vitamins one cap p.o. q. day. vitamin c 500 mg p.o. q. day. zinc sulfate 220 mg p.o. q. day. dilantin 100 mg p.o. three times a day. lovenox 70 mg subcutaneous every 12 hours. this will be terminated when therapeutic on coumadin. coumadin 5 mg p.o. q h.s. this dose may need to be adjusted given his inr. discharge status: to home with family. discharge condition: stable. - , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube interruption of the vena cava amputation of toe other skin graft to other sites graft of muscle or fascia excisional debridement of wound, infection, or burn other incision of brain application of external fixator device, tarsals and metatarsals other diagnostic procedures on brain and cerebral meninges other partial ostectomy, tarsals and metatarsals other partial ostectomy, tarsals and metatarsals debridement of open fracture site, tarsals and metatarsals diagnoses: other convulsions iatrogenic pulmonary embolism and infarction open fracture of metatarsal bone(s) open fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, with brief [less than one hour] loss of consciousness open fracture of base of skull with cerebral laceration and contusion, with brief [less than one hour] loss of consciousness open fracture of astragalus open fracture of other facial bones open wound of foot except toe(s) alone, complicated injury to unspecified optic nerve and pathways 

Answer: The patient is high likely exposed to