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: s/p pedestrian struck by truck c/o left hand pain and right leg pain major surgical or invasive procedure: 1. debridement and open reduction of left thumb. 2. soft tissue and bone debridement, primary arthrodesis of left ring finger. 3. open reduction, plate and screw fixation of left distal radius. 4. bone graft using both a fibular strut and demineralized bone morphogenic protein, left distal radius. 5. application of long-arm splint. orif right ankle 1. closed reduction left elbow dislocation. 2. examination under anesthesia for assessment of stability. 3. placement of hinged external fixator from a multiplane. 1. debridement left long finger. 2. full-thickness skin graft left long finger. 3. arthrodesis distal interphalangeal joint left long finger history of present illness: 84 y.o. female who was a pedestrian struck and presented as a trauma to the ed. she was walking and a pickup truck backed up, striking her to the ground, and then dragged for several feet. she was found to have left hand and wrist deformations as well as multiple abrasions. xrays were performed of her right ankle that revealed a distal medial tibial fracture in close proximity to a laceration. past medical history: (1) htn (2) hypercholesterolemia social history: tobacco none etoh none family history: non contributory physical exam: temp 98 hr 100 bp 123/87 rr22 o2 sat 99% sensorium: awake (x) awake impaired () unconscious () airway: intubated () not intubated (x) breathing: stable (x) unstable () circulation: stable (x) unstable () heent ncat conjunctiva pink aslera anicteris, perrla neck no tenderness or adenopathy chest clear cor rrr abd large, soft non tender pelvis stable skin multiple abrasions musculoskeletal exam neck normal () abnormal () comments: c-collar in place spine normal (x) abnormal () comments: clavicle r normal (x) abnormal () comments: l normal (x) abnormal () comments: shoulder r normal (x) abnormal () comments: l normal (x) abnormal () comments: arm r normal (x) abnormal () comments: l normal (x) abnormal () comments: elbow r normal (x) abnormal () comments: l normal (x) abnormal () comments: forearm r normal (x) abnormal () comments: l normal () abnormal (x) comments: radially angulated eformity of left wrist along with exposed third digit, middle phalanx, and likely comminuted fracture of 1st digit. wrist r normal (x) abnormal () comments: l normal () abnormal (x) comments: see above hand r normal (x) abnormal () comments: l normal () abnormal (x) comments: see above pelvis r normal (x) abnormal () comments: l normal (x) abnormal () comments: hip r normal (x) abnormal () comments: l normal (x) abnormal () comments: thigh r normal (x) abnormal () comments: l normal (x) abnormal () comments: knee r normal (x) abnormal () comments: l normal (x) abnormal () comments: leg r normal () abnormal (x) comments: proximal fibular tenderness; diffuse superficial abrasions. l normal (x) abnormal () comments: ankle r normal () abnormal (x) comments: tenderness along medial mallelous, anteriorly. laceration overlying this area which probes posteriorly about 1 cm to periosteum; does not invade fracture site. l normal (x) abnormal () comments: foot r normal (x) abnormal () comments: l normal (x) abnormal () comments: urethral bleeding yes () no (x) vaginal bleeding yes () no (x) rectal tone normal (x) abnormal () vascular: radial r palpable (x) non-palpable () doppler () l palpable (x) non-palpable () doppler () ulnar r palpable (x) non-palpable () doppler () l palpable (x) non-palpable () doppler () femoral r palpable (x) non-palpable () doppler () l palpable (x) non-palpable () doppler () poplitea r palpable (x) non-palpable () doppler () l palpable (x) non-palpable () doppler () dp r palpable (x) non-palpable () doppler () l palpable (x) non-palpable () doppler () pt r palpable (x) non-palpable () doppler () l palpable (x) non-palpable () doppler () quad r () l () ant tib r (not tested secondary to pain) l () r (not tested secondary to pain) l () peroneal r (not tested secondary to pain) l () gs r (not tested secondary to pain) l () pertinent results: ir angio : 1. no evidence of active arterial extravasation as described above. 2. large round area of diminished/absent parenchymal enhancement and displacement of adjacent vessels within upper pole of the right kidney is consistent with known focal lesion, as was seen on the ct scan. given the absence of any contrast enhancement, this likely represents a markedly hypovascular lesion such as a cyst. ct abd/pelvis : 1. multiple bilateral anterior/lateral rib fractures, involving ribs 5 to 11 on the left and 7 to 11 on the right. no evidence of segmental fracture to suggest flail chest. no current pneumothorax. 2. right perinephric hematoma and hemorrhage into a probable preexisting upper pole right renal mass (renal cell carcinoma highly suspect), with an internal hyperdensity which washes out on delayed imaging, suggestive of pseudoaneurysm. further evaluation by angiography is warranted. 3. grade-ii contained central hepatic laceration. 4. 1-cm preexisting splenic lesion such as hemangioma or cyst versus grade-i splenic laceration. 5. left gluteal hematoma without active hemorrhage. 6. comminuted left upper extremity fractures. correlate with dedicated accompanying radiographs. 7. high grade stenosis of proximal left subclavian artery by atheroma versus adherent thrombus. thi sis pre-existent and not related to trauma. diffuse moderate-to-severe atherosclerotic disease. 8. multiple renal cysts 9. calcified pleural plaque, consistent with prior asbestos exposure. left hand : 1. severely comminuted fracture of the distal radius as detailed above. there is suggestion of intra-articular extent and a small step-off on a select view. 2. severe soft tissue injury associated with severely comminuted bony fractures and missing bone fragments at the third middle phalanx and the first distal phalanx. this is highly consistent with compound fracture. there is a comminuted intraarticular fracture of the base of the second middle phalanx and to a much lesser severity of the fourth middle phalanx. a nondisplaced transverse fracture is suspected of the fifth middle phalanx. 3. baseline arthritis of the first cmc and chondrocalcinosis consistent with pseudogout right ankle : suggestion of a medial malleolar fracture, incompletely evaluated on this tibia, fibula protocol radiograph series. if indicated and clinically feasible, consider standard 3 view assessment of the ankle. additionally, there is an oblique nondisplaced fracture of the proximal fibula as noted on the accompanying knee radiograph series. right knee : 1. nondisplaced oblique fracture of the proximal right fibula. 2. extensive tricompartmental osteoarthritis of both knees, worse on the left. 3. there is chondrocalcinosis consistent with underlying pre-existing pseudogout brief hospital course: mrs. was evaluated by the trauma team in the emergency room as well as the orthopedic service for her multiple fractures. her scans were reviewed and she had a right perinephric hematoma with possible extravasation. although she was hemodynamically stable she was electively intubated in the emergency room in preparation for angiography. there was no extravasation in the renal area and 1 cyst was noted. her hematocrit was stable and she was subsequently transferred to the trauma icu for further management. she remained neurologically intact. due to her multiple rib fractures a thoracic epidural catheter was placed for pain relief. she taken to the operating room on for orif of the left hand and again on went to the operating room for orif of the right ankle. on both occasions she did well and was easily extubated after the procedure on . she maintained stable hemodynamics and her hematocrit was stable in the 24-25 range after receiving 2 units of packed red blood cells perioperatively. following transfer to the surgical floor she was tolerating a regular diet and had adequate pain control after her epidural catheter was removed. she had increased left elbow pain and exam showed a failed closed reduction of her left elbow dislocation therefore she returned to the operating room on for reduction and the application of an external fixator. again, she tolerated the procedure well. the plastic surgery hand service took her to the operating room on for a skin graft to the left long finger. the graft was taken from the abdomen and she did well. her left arm/hand should remain splinted and elevated and she will need to be avaluated by the hand surgeons next week. she was evaluated by both the physical therapy and occupational therapy services and due to her bilateral injuries, decreased mobility and weight bearing restrictions, rehabilitation was recommended with the hopes of getting her back to her baseline prior to the accident. medications on admission: lipitor 0 mg daily discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) units injection tid (3 times a day). 2. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 3. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 5. senna 8.6 mg tablet sig: two (2) tablet po hs (at bedtime). 6. lipitor 20 mg tablet sig: one (1) tablet po once a day. 7. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. discharge disposition: extended care facility: - discharge diagnosis: s/p pedestrian struk 1. right renal hematoma 2. right rib fractures and left rib fractures 3. left distal radius fracture 4. multiple left digital fractures 5. left gluteal hematoma 6. right medial malleolar fracture 7. right proximal fibula fracture 8. grade 2 liver laceration 9. acute blood loss anemia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: * you were admitted to the hospital after your accident with multiple fractures and internal bruising. * you have undergone multiple operations to stabilize your broken bones. * your injury caused left rib fractures 5 thru 11 and right rib fractures which can cause severe pain and subsequently cause you to take shallow breaths because of the pain. * you should take your pain medication as directed to stay ahead of the pain otherwise you won't be able to take deep breaths. if the pain medication is too sedating take half the dose and notify your physician. * pneumonia is a complication of rib fractures. in order to decrease your risk you must use your incentive spirometer 4 times every hour while awake. this will help expand the small airways in your lungs and assist in coughing up secretions that pool in the lungs. * you will be more comfortable if you use a cough pillow to hold against your chest and guard your rib cage while coughing and deep breathing. * symptomatic relief with ice packs or heating pads for short periods may ease the pain. * narcotic pain medication can cause constipation therefore you should take a stool softener twice daily and increase your fluid and fiber intake if possible. * do not smoke * return to the emergency room right away for any acute shortness of breath, increased pain or crackling sensation around your ribs ( crepitus ). * you must not bear weight on your right leg or left arm. * you will need vigorous rehabilitation to keep your muscles toned and occupational therapy for your upper extremities. followup instructions: call the acute care clinic at for a follow up appointment in weeks. please follow up in the hand clinic on tuesday, . you must call ( to make an appointment so they know you are coming. the clinic is open from 8-12pm most tuesdays and you may show up at any time between those hours, despite your formal appointment time. the clinic is located on the , building, . please make sure that you obtain a referral from your insurance company prior to your clinic appointment. md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube excisional debridement of wound, infection, or burn arteriography of other intra-abdominal arteries debridement of open fracture site, tibia and fibula open reduction of fracture with internal fixation, tibia and fibula closure of skin and subcutaneous tissue of other sites open reduction of fracture with internal fixation, radius and ulna arteriography of renal arteries open reduction of fracture with internal fixation, phalanges of hand bone graft, radius and ulna full-thickness skin graft to hand debridement of open fracture site, phalanges of hand application of external fixator device, radius and ulna insertion of recombinant bone morphogenetic protein closed reduction of fracture without internal fixation, phalanges of hand closed reduction of dislocation of elbow interphalangeal fusion interphalangeal fusion application of hybrid external fixator device diagnoses: pure hypercholesterolemia unspecified essential hypertension acute posthemorrhagic anemia motor vehicle traffic accident involving collision with pedestrian injuring pedestrian candidiasis of vulva and vagina closed fracture of eight or more ribs other closed fractures of distal end of radius (alone) fracture of medial malleolus, open contusion of buttock closed fracture of upper end of fibula alone injury to liver without mention of open wound into cavity, laceration, moderate injury to kidney without mention of open wound into cavity, hematoma without rupture of capsule traumatic amputation of thumb (complete)(partial), without mention of complication closed dislocation of elbow, unspecified open fracture of multiple sites of phalanx or phalanges of hand 

Answer: The patient is high likely exposed to