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: no known allergies / adverse drug reactions attending: chief complaint: trauma: pedestrian struck: complex fx of the right acetabulum comm fx of right sup+inf pubic rami fx left pubic body to pubic symphysis right sacral ala fracture right l4 transverse process fracture. pelvic wall hematoma, increasing r fibula, r medial malleolus fx fx of the distal radius enterotomy l ankle fx major surgical or invasive procedure: exploratory laparotomy, ileal resection : placement of ivc filter : open reduction and internal fixation of right medial malleolus fracture with internal fixation. manual application of stress by surgeon for right ankle. closed treatment right lateral malleolus fracture with manipulation. vac dressing placed vac dressin removed history of present illness: 86yo f presents as pedestrian struck by motor vehicle going approx 20mph. there was heavy damage sustained to the of thecar. patient had +loc for several minutes. past medical history: - htn - cva 8 years ago (left cerebellar w/ some balance deficits) - back surgery social history: lives with husband, able to care for self with no difficulty. no smoking, social etoh, no drug use family history: nc physical exam: physical examination upon admission: hr: 50 bp: 268/88 o(2)sat: 100 normal constitutional: agitated, uncomfortbale. combative and uncooperative. heent: midface stable. no cranial step offs. pupils 2mm and reactive. no ht. c-spine immobilized on arrival. chest: airway intact. bilateral breath sounds equal. o2 sat to 100% after intubation. sternum stable. no lesions to the chest wall. cardiovascular: regular, bradycardic, strong distal pulses abdominal: soft, nontender, nondistended. fast negative. rectal: heme positive, brown stool. extr/back: good radial pulses. right hip ecchymosis. pelvis is stable. no spinal step off. +deformity right wrist. skin: abrasion to knees l>r. left-sided paraspinal lacerations. cool, clammy. neuro: initially minimal le movement to pain b/l, later was noted to be moving legs more. repetitive questions, not able to cooperate with exam. physical examination upon discharge: : vital signs: 97.7, bp=148/78, hr=71, rr=20, oxygen sat 98% room air general: resting comfortalbly in bed, nad cv: ns1, s2, s-3 -s4 resp: clear, diminshed in bases abdomen: lower aspect of wound open with dsd, scattered staples in place, staples left lower quadrant, wound edges intact, except where staples had been removed, abd. soft, non-tender ext: splint right wrist, ext. warm, + sensations, new cast right lower ext.,, + dp left foot skin: knee abrasions bil. neuro: alert and oriented x 3, speech clear, no tremors pertinent results: injuries: - pelvic fractures 1. complex fx right acetabulum 2. comminuted fx of right superior & inferior pubic rami 3. fx left pubic body to pubic symphysis 4. right sacral ala fx - right l4 transveres process fx - right fibula & medial malleolus fx - small bowel injury imaging: - ct head: no acute intracranial hemorrhage or fx; old infarct medial left cerebellar hemisphere - ct c-spine: no acute spine fracture - ct torso: no thoracic trauma; complex fx right acetabulum involving anterior wall & posterior column. comminuted fx r superior & inf pubic rami. fx left pubic body to symphysis. pelvic wall hematoma along r and anterior aspect involving r piriformis and obturator w/ possible sites of extravasation adjacent to l superior pubic ramus. urinary bladder displaced superiorly by hematoma. r sacral ala fracture. r l4 transverse process fx. - ct pelvis (contrast): no bladder rupture; mild sm bowel wall thickening, small amount interloop fluid, possible small bowel injury not seen on prior ct. small hyperdense foci in l anterior pelvis likely represents bone fragments. interval increase in pelvic hematoma & extra-peritoneal hematoma tracking along lower quadrants of abdomen. - right forearm & elbow: possible distal right radial fracture. rec dedicated r wrist radiographs. no fx or dislocation of elbow. : a-gram: impression: negative pelvic aortograms and bilateral selective internal iliac arteriograms. a 5 french arterial sheath is left in place in the common femoral artery for arterial blood pressure monitoring, per request of the icu team. the arterial sheath has to be constantly flushed, to prevent arterial thrombosis. : x-ray of the right wrist: there is a non-displaced transverse fracture of the distal radius. there is no dislocation. there is edema of the soft tissues in the wrist. : x-ray of the right ankle: there is an oblique nondisplaced fracture of the lower fibular shaft. there is an oblique nondisplaced fracture of the upper fibula. there is a nondisplaced transverse fracture of the medial malleolus and posterior tibial malleolus. there is a small calcaneus spur. there is an enthesophite at the insertion of the quadriceps tendon. there are no osteoblastic, osteolytic osseous lesions or dislocations. : cat scan of abdomen and pelvis: impression: 1. new intra- and extra-peritoneal fluid identified which although appearing dense on ct value measurement, does not demonstrate layering hematocrit and may represent complex fluid from aggressive fluid resuscitation. foci of intra- and extra-peritoneal hemorrhage are felt to be less likely. 2. no evidence of abdominal or pelvic visceral injury. 3. mural edema noted involving the colon, rectum and distal ileum again may be secondary to fluid resuscitation; however, the possibility of ischemic bowel injury should be considered. 4. pelvic fractures as described. 5. retained contrast material in keeping with contrast nephropathy. : abdominal fluro: a single spot fluoroscopic image is obtained from an ivc filter placement. assuming the lowermost rib to be the 12th rib, the tip of the filter is positioned at the l1/l2 interspace. the total fluoroscopic time is listed as 122 seconds. for full details, please consult the operative report in the online medical record. : x-ray of the pelvis: findings: images from the operating suite show fixation devices about the right acetabulum and si joints as well as the medial malleolus. there is also evidence of a fracture of the more proximal portion of the fibula. : left ankle x-ray: impression: probable capsular avulsion fracture at the dorsal aspect of the talar head. : x-ray of the abdomen: impression: 1. no specific evidence of bowel obstruction. 2. known pelvic fractures, with unchanged right hemipelvic fracture orif. : cat scan of abdomen and pelvis: reportimpression: preliminary report1. no evidence of acute intra-abdominal infectious process to explain preliminary reportleukocytosis. preliminary report2. grossly intact small bowel anastomosis. no free air to suggest recurrent preliminary reportbowel perforation. preliminary report3. trace amount of ascites, without intra-abdominal fluid collection to preliminary reportsuggest abscess. preliminary report4. normal colonic wall without abnormal thickening to suggest colitis. preliminary reportdiverticulosis without diverticulitis. preliminary report5. moderate bilateral pleural effusions, with adjacent atelectasis. preliminary report6. unchanged orif of right hemipelvic fractures. unchanged left pubic rami preliminary reportfractures. 05:17am blood wbc-17.7* rbc-3.82* hgb-11.7* hct-34.8* mcv-91 mch-30.7 mchc-33.7 rdw-13.8 plt ct-294 03:27am blood wbc-15.3* rbc-3.87* hgb-12.0 hct-35.3* mcv-91 mch-31.0 mchc-33.9 rdw-13.6 plt ct-282 02:10am blood wbc-14.5* rbc-3.83* hgb-12.1 hct-34.6* mcv-90 mch-31.6 mchc-34.9 rdw-13.7 plt ct-210 05:17am blood plt ct-294 03:27am blood plt ct-282 02:16am blood pt-14.4* ptt-28.3 inr(pt)-1.3* 04:28am blood fibrino-130* 05:17am blood glucose-111* urean-22* creat-0.5 na-140 k-3.3 cl-101 hco3-29 angap-13 03:27am blood glucose-127* urean-27* creat-0.5 na-143 k-3.9 cl-104 hco3-32 angap-11 01:42am blood alt-30 ast-67* ld(ldh)-310* alkphos-41 totbili-0.8 07:00pm blood lipase-65* 10:49am blood ck-mb-13* mb indx-1.1 ctropnt-0.03* 09:48pm blood ck-mb-18* mb indx-1.0 ctropnt-0.06* 02:31pm blood ck-mb-26* mb indx-1.4 ctropnt-0.06* 05:56am blood ck-mb-43* mb indx-2.3 ctropnt-0.04* 05:17am blood calcium-7.5* phos-2.4* mg-2.0 02:28am blood freeca-1.08* 01:53am blood freeca-1.09* brief hospital course: 70 year old female who was struck by a vehicle, admitted to the acute care service. upon arrival to the emergency room, she was awake but somewhat combative and had repetitive questioning. she was intubated due to agitation and concern for further injury. no respiratory distress or hemodynamic compromise was reported, although she was hypertensive with systolic blood pressures in the 200s. she was taken for a cat scan where she had imaging of her head, spine, chest and abdomen. cat scan findings were notable for multiple complex bilateral pevlic fractures and a pelvic hematoma that displaced the bladder. to evaluate for possible bladder injury she underwent a repeat abdominal cat scan with contrast (a ct cystogram); while this demonstrated an intact bladder, there was an interval increase in the size of the pelvic hematoma as well as a new finding of small bowel wall thickening concerning for a small bowel injury. she had no acute intracranial processes and no cervical spine injuries. an l4 transverse process fracture was identified. she also had bilateral knee abrasions and a right forearm laceration for which orthopedic surgery recommended plain films for evaluation. she was admitted to the t-sicu for close monitoring. she remained intubated and sedated. on the evening of admission her blood pressure dropped to 70-80s systolic. she was responsive to fluid boluses and in the setting of her pelvic fractures there was concern for ongoing pelvic bleeding. interventional radiology was consulted and she proceeded to the angiography suite, however no active sites of arterial bleeding were identified and no embolization was performed. on hd 2 she was noted to have an exquisitely tender abdomen and so was taken to the operating room after her lactate level did not fall. she was found to have a small bowel injury and underwent small bowel resection with primary anastamosis. post operatively she remained intubated and was brought to the intensive care unit. she was weaned off pressors post operatively and was taken back to the operating room on , pod2 for orif of right ankle, pelvic, and acetabular fractures, as well as ivc filter placement. she was again taken back to the icu intubated and remained intubated until pod . at extubation she was noted to be mentating well and following commands. she was given lasix over pod and pod with good result. on pod she underwent a speech and swallow evaluation which she passed and was advanced to clears. she was transferred to the surgical floor on pod doing well. she was noted to have large amount of serosanguinous drainage from her suprapubic incision and so a wound vac was placed over this. this was discontinued on pod# 10 and a dry dressing was applied. she continued to report abdmominal pain despite pain medication and she underwent a x-ray of the abdomen which did not show any evidence of bowel obstruction. during this time, she had an increasing white blood cell count and and diarrhea and there was concern for an abdomimal process. she underwent a cat scan of the abdomen which showed no evidence of a acute intra-abdominal infectious process. the small bowel anastomosis appeared to be intact. her diarrhea decreased in frequency and her c.diff cultures were negative. her muscluo-skeletal pain continued to cause her discomfort and delayed her mobilization. pain service was consulted and made adjustments in her pain medications which seemed to allow her increased mobility. her foley catheter was replaced after she was unable to void. she has resumed a regular diet and her vital signs are stable. she has been afebrile and her white blood cell count is 15.7 and her hematocrit is 35. she was evaulated by physical therapy and had been out of bed into the chair. she is preparing for discharge to a rehabilitation facililty where she can further regain her strength and mobility. new cast applied to right leg medications on admission: - lisinopril 20mg daily - asa 81mg daily - hctz 25mg daily discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) cc injection tid (3 times a day). 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation . 4. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 5. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 6. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily): hold for systolic blood pressure <110,hr <60. 7. acetaminophen 325 mg tablet sig: two (2) tablet po tid (3 times a day). 8. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 9. omeprazole 20 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po daily (daily). 10. tramadol 50 mg tablet sig: 0.5 tablet po qid (4 times a day). 11. gabapentin 100 mg capsule sig: one (1) capsule po hs (at bedtime). 12. simethicone 80 mg tablet, chewable sig: . tablet, chewable po qid (4 times a day) as needed for bloating/gas. 13. acetaminophen 500 mg tablet sig: two (2) tablet po q6h (every 6 hours). 14. oxycodone 5 mg tablet sig: 2-3 tablets po q3h (every 3 hours) as needed for pain: hold for increased sedation, resp rate <12. 15. bisacodyl 10 mg suppository sig: one (1) suppository rectal once a day as needed for constipation: hold for diarrhea. discharge disposition: extended care facility: - discharge diagnosis: trauma: pedestrian struck: complex fx of the right acetabulum comm fx of right sup+inf pubic rami fx left pubic body to pubic symphysis right sacral ala fracture right l4 transverse process fracture. pelvic wall hematoma, increasing r fibula, r medial malleolus fx fx of the distal radius enterotomy left ankle fracture discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you were admitted to the hospital after you were hit by a car. you sustained a pelvic fracture, right arm fracture, and a right lower left fracture. you were taken to the operating room for repair of the pelvic and ankle fracture. you also had an filter placed to prevent any blood clots from reaching your lungs. you had increasing abdominal pain and you were taken to the operating room for an abdominal exploraton. you were found to have a small hole in your bowel and part of your bowel was resected. you were monitored in the intensive care unit. your vital signs have stablized and you are preparing for dishcharge ti a rehabilitation facility where you can further regain your strenght. followup instructions: department: orthopedics when: tuesday at 12:20 pm with: ortho xray (scc 2) building: sc clinical ctr campus: east best parking: garage department: orthopedics when: tuesday at 12:40 pm with: , np building: campus: east best parking: garage department: general surgery/ with: , md when: tuesday at 3:15 pm with: acute care clinic building: lm bldg () campus: west best parking: garage name: , iii location: internists address: , , , phone: please discuss with the staff at the facility a follow up appointment with your pcp when you are ready for discharge. procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more other partial resection of small intestine interruption of the vena cava arteriography of other intra-abdominal arteries open reduction of fracture with internal fixation, tibia and fibula repair of vertebral fracture closed reduction of fracture without internal fixation, tibia and fibula closed reduction of fracture with internal fixation, other specified bone diagnoses: acidosis thrombocytopenia, unspecified unspecified essential hypertension acute posthemorrhagic anemia acute kidney failure, unspecified motor vehicle traffic accident involving collision with pedestrian injuring pedestrian personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits closed fracture of lumbar vertebra without mention of spinal cord injury other and unspecified coagulation defects closed fracture of sacrum and coccyx without mention of spinal cord injury closed fracture of pubis closed fracture of acetabulum fracture of lateral malleolus, closed other closed fractures of distal end of radius (alone) fracture of medial malleolus, closed intracranial injury of other and unspecified nature without mention of open intracranial wound, with brief [less than one hour] loss of consciousness other injury to small intestine, without mention of open wound into cavity closed fracture of shaft of fibula alone 

Answer: The patient is high likely exposed to