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: patient recorded as having no known allergies to drugs attending: chief complaint: urosepsis major surgical or invasive procedure: right internal jugular line placement picc line placement takedown colostomy history of present illness: mr is a 46 year-old man with a history of complex pelvic fracture and ruptured bladder after an mva, who presents with fever/sepsis. . recently admitted ( - ) after a 56 day hospitalization in following an mva complicated by open book pelvic fracture and right t12-l5 transverse process fracture. while in , he had a cystogram and ct cystogram that showed extraperitoneal bladder rupter to bladder neck (repaired by a suprapubic tube). that stay was complicated by ards requiring intubation. following extubation, he developed a soft tissue infection of his perineum involving his scrotum with subsequent debridement and exploration for a necrotizing infection, followed by ex-lap with diverting sigmoid colonostomy. . since discharge to , he has been feeling improved. he remains non-weight bearing on his right hip and has had resulting lower extremity weakness. . seen by dr. on ; the - drain was removed at this appointment. seen by urology on , after having failed a clamping of the suprapubic tube due to penile pain. per dr. note, the spt was unable to be extracted, felt to be due ot calcificatoins of the balloon. . on the day prior to admission, he underwent or replacement of his spt by urology. the tube was clamped at that time. on the morning of admission, he started having shaking chills at rehab and was febrile to 104. also noted nausea and increasing dysuria (has mild urethral dysuria at baseline). after placing foley he reports that the pain worsened. he was transferred to the er. . in the ed, initial vitals included t 102.8, hr 116, bp 141/80. he was treated with vancomycin iv and zosyn iv. for pain, morphine, then dilaudid were given. after his bp dropped to the 80s, a cvl was placed. . at the time of arrival to the micu, he was feeling signicantly better. past medical history: 1. history of mva with multiple surgery: - open book pelvic fracture, s/p oric - prophylactic ivf filter placed - right t12-l5 transverse process fracture - extraperitoneal bladder rupter to bladder neck, s/p pelvic binder and spt placement - ex-lap with no evidence of intra-abdominal injuries - diverting sigmoid colonostomy - right gracilis flap followed by split thickness skin graft - multiple split-thickness skin grafts - reimplantation of the left testicle into a neoscrotum. 2. fourniers gangrene 3. history of ards 4. gerd 5. depression 6. history of sacroiliitis social history: worked as a curator for city of . smoked 1ppd from age 18-40. drinks 2 beers per night. currently living at rehab. has a girlfriend. mother is medical decision maker but not official hcp. family history: noncontributory physical exam: vitals: bp 102/55, hr 113, o2 95% gen: awake, alert. shaking chills during exam. heent: anicteric. no pallor. rij in place. dry mm. cv: tachycardic and regular. no murmurs. pulm: clear. abd: soft. midline scar noted. left sided ostomy noted with air but without stool. gu: 22f spt draining yellow urine; site is slightly erythematous; perineum without crepitus, minimal tenderness; rectal (performed in ed by surgery): normal tone. no masses. no gross or occult blood. ext: warm. no edema. neuro: alert. oriented to person, "", "". cnii-xii intact. strength 5/5 in upper extremities. rle at hip and knee and 5-/5 at ankle. lle is 4-/5 at hip and 5-/5 at knee and ankle. patellar refexes are 1+ and equal. pertinent results: labs on admission: . ct ab/pelvis w/ contrast ct abdomen with contrast: the lung bases are clear. cardiac apex is unremarkable. the stomach, proximal small bowel, adrenal glands, pancreas, spleen, gallbladder, liver are unremarkable. small hypodensity at the upper pole of the left kidney (2:21) is too small to characterize. the kidneys are otherwise unremarkable. note is made of an infrarenal ivc filter. there is no retroperitoneal or mesenteric lymphadenopathy. a linear hyperdensity at the midline ventral abdominal wall (2:30) most likely represents suture material or post-op calcification. ct pelvis with contrast: a suprapubic catheter is positioned with its tip in the bladder. the urinary bladder and distal ureters are unremarkable. post- surgical defects of the scrotum are noted. there is no subcutaneous gas. there is no pelvic or inguinal lymphadenopathy. along the lower pelvic anterior wall just above the level of the pubic symphysus, there is heterogeneous soft tissue thickening along. in the same area is a 28 x 17mm fluid collection (300b:34), ?? seroma versus abscess. there is a left lower quadrant diverting colostomy with mucus fistula. the rectum contains a small amount of barium. the appendix is normal. steak artifact from pelvic hardware limits evaluuation at the symphysis pubis. osseous findings: patient is status post orif of a diastasis of the symphysis pubis and surgical hardware appears in appropriate position. a fixation screw also transverses both sacroiliac joints, also appearing in appropriate position. old fracture of the left femoral head is unchanged. there is new lucency at the posterior aspect of the left femoral head with adjacent soft tissue calcification (2:83). the cortex of bone is ill-defined in this region, raising concern for osteomyelitis. impression: 1. extensive post-surgical changes following scrotal debridement without definite evidence of fournier gangrene. heterogeneous thickening along the lower anterior pelvic wall with small seroma versus small abscess. evaluation limited due to streak artifact from orif hardware. 2. osseous lucency at the left posterior femoral head. findings are worrisome for osteomyelitis. recommend clinical correlation. 3. status post diverting colostomy with mucus fistula. 4. old pelvic fractures s/p orif, left femoral head fracture, old right lumbar transverse process fractures. . cxr findings: frontal view of the chest is obtained. right ij central venous catheter is seen with its tip in the expected region of the svc. lungs are clear bilaterally without evidence of consolidation or pneumothorax. cardiomediastinal silhouette is normal. bony structures appear intact. the very upper portion of the ivc filter is noted at the lower edge of the film. impression: right ij central venous catheter in appropriate position. no pneumothorax. 04:10pm urine color-amber appear-hazy sp -1.010 04:10pm urine blood-lg nitrite-pos protein-100 glucose-neg ketone-tr bilirubin-sm urobilngn-1 ph-8.0 leuk-mod 04:10pm urine rbc-* wbc-21-50* bacteria-mod yeast-none epi-0 03:58pm lactate-2.6* 03:55pm glucose-101 urea n-12 creat-0.8 sodium-137 potassium-3.2* chloride-101 total co2-25 anion gap-14 03:55pm wbc-8.2# rbc-3.99* hgb-11.1* hct-32.3* mcv-81* mch-27.9 mchc-34.4 rdw-15.5 03:55pm neuts-85.6* lymphs-12.5* monos-1.6* eos-0.2 basos-0.1 brief hospital course: in brief, mr is a 46m w h/o recent mva resulting complex pelvic fx, bladder rupture requiring spt, admitted for pseudomonas urosepsis, w micu stay c/b hap. . # pseudomonas uti: pt w prior bladder trauma/surgeries, w recent suprapubic tube replacement, p/w f/c, found to have urosepsis. s/p micu stay. urine cx grew pseudomonas (cipro resistant, zosyn sensitive), treated w a 14-day course of zosyn (). outpatient urology f/u scheduled (dr . 3-day course of pyridium, as well as tolterodine and percocet for bladder/urinary discomfort. clear urine on discharge. . # hospital-acquired pna: pt developed mild hypoxemia while in the micu, w possible new rll infiltrate on cxr. treated w zosyn for 7 days. vanc course (), stopped early given low suspicion for mrsa. zosyn continued through for pseudomonas uti. afebrile, sao2 > 95% on ra on discharge. . # pain control: chronic back pain, abdominal and penile discomfort, likely prior trauma, prolonged bed-stay, bladder spams. given dilaudid iv prn in hospital, transitioned to percocet prn. . # s/p pelvic fx: pt has ivc filter and was systemically anticoagulated prior to spt replacement. held coumadin throughout stay. discharged on 1mg coumadin for ppx, patient has ivc filter . # anemia: baseline hct ~30. mildly microcytic and stable from admission. on iron as outpatient. no transfusions required as inpatient. . # diverting colostomy: required s/p mva earlier in . pt had barium enema as inpatient to evaluate for rectal pouch, colostomy revision done on and patient tolerated diet well after surgery. he had multiple small bowel movements with relief. he did complain of some minor gas pain throughout his postoperative course but responded well with simethicone wafers. he was tolerating a normal diet on discharge and not on any antibiotics. medications on admission: 1. citalopram 20mg daily 2. omeprazole 20mg daily 3. trazodone 50mg qhs 4. oxybutynin er 10mg daily 5. penazopydridine 100mg tid 6. diazepam 5mg daily prn muscle spasm 7. ferrous sulfate 325 mg tid 8. colace 200mg 9. senna 10. bisacodyl 11. multivitamin daily 12. simethicone 80mg q4h prn 13. ondansetron 4mg q4h pn 14. oxycodone 5mg q4h prn discharge medications: 1. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 2. omeprazole 20 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 3. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h:prn as needed for pain for 30 days. disp:*30 tablet(s)* refills:*0* 4. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily) as needed for pain. disp:*25 adhesive patch, medicated(s)* refills:*0* 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 6. senna 8.6 mg tablet sig: one (1) tablet po bid:prn as needed for constipation. 7. tolterodine 2 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 8. warfarin 1 mg tablet sig: one (1) tablet po once daily at 4 pm: as directed by dr. . disp:*30 tablet(s)* refills:*2* 9. multivitamin tablet sig: one (1) tablet po once a day. 10. iron (ferrous sulfate) 325 mg (65 mg iron) tablet sig: one (1) tablet po once a day. 11. alum-mag hydroxide-simeth 200-200-20 mg/5 ml suspension sig: 15-30 mls po qid (4 times a day) as needed for indigestion. disp:*200 ml(s)* refills:*0* 12. phenazopyridine 100 mg tablet sig: one (1) tablet po tid (3 times a day) for 3 days. disp:*9 tablet(s)* refills:*0* discharge disposition: home with service facility: homecare discharge diagnosis: pseudomonas urosepsis hospital acquired pneumonia . diverting colostomy s/p closure s/p bladder rupture w suprapubic tube anemia gerd depression discharge condition: improved discharge instructions: you were admitted to the hospital with a urinary tract infection. while you were in the hospital, you also developed a lung infection. we treated you with antibiotics for both. surgery and urology evaluated you as well, they will continue seeing you as an outpatient for further management of your suprapubic tube. your colostomy was taken down by dr. and you are now able to have bowel movements on your own. you completed your course of antibiotics as deemed necessary by the urology team. . we changed your medications as follows: 1. started antibiotics - vancomycin and zosyn 2. continued your coumadin - you will need to have your inr checked regularly 3. percocet and lidocaine patch for pain 4. tolterodine for bladder spasms . if you have fevers, chills, shortness of breath, chest pain, abdominal pain, or any other concerning symptoms, please call your physician . followup instructions: appointment #1 md: dr specialty: surgery - re: colostomy reversal date and time: call for an appointment, follow up in weeks location: medical building, phone number: . appointment #2 md: dr specialty: urology date and time: follow up in weeks after discharge, call for an appointment location: clinical center, phone number: . follow up with dr. in 4 weeks, orthopaedic surgery, ( procedure: venous catheterization, not elsewhere classified closure of stoma of large intestine diagnoses: pneumonia, organism unspecified esophageal reflux urinary tract infection, site not specified depressive disorder, not elsewhere classified sepsis iron deficiency anemia, unspecified backache, unspecified abdominal pain, generalized infection and inflammatory reaction due to other genitourinary device, implant, and graft septicemia due to pseudomonas late effects of motor vehicle accident attention to colostomy late effect of fracture of spine and trunk without mention of spinal cord lesion surgical operation with formation of external stoma causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation chronic pain due to trauma unspecified disorder of penis other urogenital trichomoniasis 

Answer: The patient is high likely exposed to