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: penicillins attending: chief complaint: trauma: pedestrian struck major surgical or invasive procedure: orif left distal radius fracture history of present illness: 60yo woman medflighted from s/p ped struck. per report, pt was crossing the street when she was struck by a car moving at high speed. pt hit the windshield with her face hard enough to spider the glass. no loc at scene, pt a&ox2 with full recall of the event at osh. pt intubated for airway protection during transfer. per outside records, pt sustained multiple facial fx, l radial ulnar fx, r sdh, and sah. past medical history: pm: osa, hyperthyroidism ps: none social history: supportive partner family history: noncontributory physical exam: physical examination; upon admission: hr: 80 bp: 137/60 resp: 15 o(2)sat: 100% on the vent normal constitutional: boarded and collared, intubated and pharmacologically sedated. heent: both eyes are nearly swollen shut, the last one being less so in the pupil the left is 1 mm and nonreactive. she has diffuse facial and forehead ecchymoses. she has blood in the mouth. she has blood in the nares. she also has a nasal bridge laceration. there is a lot of swelling and some deformity over both maxillae. collared chest: breath sounds symmetrical cardiovascular: heart sounds are normal abdominal: soft gu/flank: foley catheter is in place and draining clear yellow urine. extr/back: spine is without step-offs. upper extremities show a deformity in the left wrist area with intact distal pulses. this is a closed injury. she has a tense right thigh ecchymosis which was not present according to the med flight crew earlier. she has a left knee abrasion which is minimal. distal pulses in both feet are normal. pertinent results: ct head stable appearance of right frontal contusions. bifrontal and probable left occipital subarachnoid blood. right and possible left subdural hematomas. multiple calvarial, facial, anterior and middle skull base fractures as above including mildly displaced right frontal bone fracture, all better assessed on prior facial ct. ct c-spine 1. no fracture or malalignment of the cervical spine. 2. focal retro-dens density concerning for epidural hematoma - mr may be considered for further characterization. 3. enlarged thyroid gland with multiple partially calcified nodules. nonurgent ultrasound should be considered if not already performed. mr 1. abnormal signal at c5-c6 disc space with an associated disc bulge, while this could all be related to degenerative changes, an acute disc bulge cannot be excluded. otherwise, mild multilevel degenerative changes of the cervical spine. 2. mild increased signal in the posterior paraspinal soft tissues, which may represent edema, or muscle strain/ligamentous injury. 3. increased signal along the prevertebral space, which may represent edema in this patient that appears to be intubated and has a nasogastric tube. 4. enlarged and heterogeneous thyroid gland. corrrelation with ultrasound is advised if clinically indicated. r forearm x-ray there is no elbow joint effusion. there are no signs for acute fractures or dislocations. peripheral catheters are seen within the right wrist and right antecubital region. mineralization is normal. bony structures are intact. there are mild degenerative changes of the first cmc joint. pelvis, rle films there are degenerative changes of both hips, which are mild to moderate. there is some mild joint space narrowing and spurring of both hip joints. no acute fractures or dislocations are seen. there are moderate degenerative changes of the lower lumbar spine with disc space narrowing particularly at l4-l5. focused imaging of the right femur show no acute fractures. there are some mild degenerative changes of the right knee joint with joint space narrowing medially and laterally. there is some surrounding soft tissue swelling. a foley catheter is seen. r ankle 1. no acute fracture. 2. soft tissue swelling. 3. corticated densities adjacent to the medial malleolus suggestive of prior avulsion injuries likely of the deltoid ligament. left hand, wrist there has been improved alignment of the distal radius fracture with less impaction. there is again seen a transverse facture which has intra-articular extension in joint space. fine bony detail is limited by the overlying splint material. there is also a small ulnar styloid fracture which is unchanged. mild degenerative changes of the first cmc joint is seen. there are no bony erosions. ct maxillofacial there is a displaced right paramedian fracture of the frontal bone. known orbitofrontal parenchymal hemorrhages, subarachnoid, intraventricular, and subdural hematomas are evaluated on concurrent nect. there are comminuted fractures involving the lateral, medial, and anterior walls of the maxillary sinus. the fractures extend into the ethmoids bilaterally. the sinuses, particularly the naris, are filled with blood as are the sphenoid sinuses. the right lateral pterygoid plate is fractured (402b:82). no mandibular fracture is seen. the bilateral nasal bones are fractured. extraconal hemorrhage extends into the right orbit and orbital fat herniates into the right maxillary sinus (402b:54). the globes appear intact, but there is some suggestion of telecanthus. the greater of the right sphenoid is fractured. bilateral diastasis of the frontozygomatic sutures is seen. no definite fracture of the left orbital floor is seen. et and ng tubes are seen coursing through the oropharynx. extensive facial soft tissue edema and right lateral frontal subgaleal scalp hematoma are again noted. impression: 1. unilateral right lefort 1, 2, and 3 fractures as described above. 2. minimal herniation of right intraorbital fat into the maxillary sinus. 3. displaced right paracentral frontal bone fracture. 4. inferior displacement of the right medial inferior rectus muscle, but no definite entrapment. 5. diastatic frontozygomatic sutures. repeat ct head 1. stable right orbito-frontal hemorrhagic contusions. 2. stable right parietal vertex subdural hematoma. no mass effect. 3. small foci of subarachnoid and intraventricular hemorrhage, unchanged. 4. extensive facial fractures described on concurrent sinus ct. : video swallowing: impression: no frank aspiration. penetration with thin and nectar barium consistencies. for further details, please refer to full report by speech and swallow division : left wrist x-ray: impression: 1. interval placement of fiberglass cast. 2. slight improvement of intra-articular distal radius fracture with minimal volar displacement. unchanged ulnar styloid fracture. : portable abdomen: no evidence of radiopaque metal : mr abdomen: impression: limited study demonstrating bifrontal hemorrhagic contusion with small subarachnoid hemorrhage, right greater than left. recommend repeating the study after adequate premedication and sedation. : mr of orbit: impression: limited study demonstrating bifrontal hemorrhagic contusion with small subarachnoid hemorrhage, right greater than left. recommend repeating the study after adequate premedication and sedation : mr of the head: impression: 1. slow diffusion along the optic nerves, left more than right, suspicious for injury to the optic nerve either related to ischemia or edema particularly on the left. 2. intraparenchymal hematoma in the right frontal lobe as described. small areas of slow diffusion in the right cerebellar peduncle and left occipital lobe, probably ischemia vs shear injury. 3. subdural and subarachnoid blood products. 4. extensive sinus disease with blood products in the maxillary sinuses. 5. multiple facial fractures. please refer to ct scan of for additional details. 6. other findings as described. brief hospital course: the patient arrived intubated but was moving all extremities in the emergency room and making purposeful movements directed towards the endothracheal tube. imaging studies done at the osh showed multiple facial fractures, a sdh, sah and a left radial fracture. because of the head injury, the patient was started on keppra. upon admission to the , the patient was admitted to the intensive care unit for vital sign and neurological monitoring. she developed an episode of hypotension and required dopamine infusion for cardiovascular support which was weaned off. the patient's hemodynamic status remained stable. a picc line was placed on hd #2 because of poor iv access. while in the intensive care unit, the patient was maintained on ventilatory support. the neurosurgery service was consulted and recommended a repeat head cat scan which remained unchanged. there was a question of edema and ligamentous injury of c5-c6, as well as within the paraspinal and prevertebral soft tissue. a j collar was recommended with neurosurgical out-patient follow-up. because of the multiple facial fractures, the plastic surgery service recommended surgical intervention after the swelling subsided. they also recommended follow-up with the opthamology service who closely followed the patient because of a concern for left optic neuropathy. to further evalute this, the patient underwent further testing on the day of discharge. the patient was placed on sinus precautions and started on broad spectrum antibiotics. she was transitioned to amoxicillin prior to discharge. the facial fractures prevented placement of a -gastric tube and an oral gastric tube was placed to provide nutrition. the patient's hematocrit decreased on hd #3, likely reatled to fluid shifts, and the patient was given 2 units packed red blood cells. the hematocrit remained stable throughtout the remainer of the hospital course. the patient was successfully weaned and extubated on hd #4 and was making purposeful movements of all extremities. the patient was transferred to the surgical floor. during the hospital course, the patient had bouts of delirium which limited participation in daily care. with the addition of zyprexa, the patient became more oriented to her surroundings and by the time of discharge was alert, oriented, and conversant. on hd # 9, because of prior failed attempts in tolerting oral supplements, a speech and swallow study was done and the patient was cleared for thin liquids and soft ground solids. on hd #10, the patient was taken to the operating room for an orif of the left distal radius fracture, left carpal tunnel release, and a tenotomy of the brachioradialis tendon. the operative course was stable with a 20cc blood loss. the patient was extubated after the procedure and monitored in the recovery room. a sling was applied to the left arm for support and the patient was started on oral analgesia for post-operative pain. as part of discharge planning, the patient was evaluated by physical therapy and recommendations made for discharge to an extended care facility. social worker was available to provide support to the patient and family. the right picc line was removed prior to discharge. the patient was discharged to a rehabilitation facility on hd #13 with stable vital signs. her electorlytes normalized and the hematocrit stabilized at 27. follow-up appointments were scheduled with neurosurgey, orthopedics, plastic surgery, and opthamology. medications on admission: methimazole 5', asa 81', ranitidine otc discharge medications: 1. acetaminophen 1000 mg po q6h:prn pain 2. amoxicillin-clavulanic acid 875 mg po q12h last dose 3. artificial tear ointment 1 appl both eyes 6x/day 4. artificial tears 1-2 drop both eyes tid 5. bisacodyl 10 mg po/pr daily:prn constipation 6. docusate sodium (liquid) 100 mg po bid 7. erythromycin 0.5% ophth oint 0.5 in both eyes 8. heparin 5000 unit sc tid 9. hydrocortisone (rectal) 2.5% cream 1 appl pr qid:prn after each bowel movement 10. hydromorphone (dilaudid) 2-4 mg po q4h:prn pain hold for systolic blood pressure <110, hr <60 11. insulin sc sliding scale fingerstick qachs insulin sc sliding scale using reg insulin 12. methimazole 5 mg po daily 13. senna 1 tab po bid constipation 14. quetiapine fumarate 50 mg po hs 15. olanzapine (disintegrating tablet) 7.5 mg po qid hold for increased sedation and notify team 16. aspirin ec 81 mg po daily discharge disposition: extended care facility: - discharge diagnosis: trauma: bifrontal sah right subdural hemorrhage suprasellar cistern hemorrhage right maxillary/frontal/zyg/ethmoid fracture depressed fracture right anterior wall maxillary sinus depressed fracture right orbital floor bilateral nasal bone fractures nondisplaced left zygomatic arch fracture left distal radial fracture/ulnar styloid fracture 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 you were struck by a car. initially you were brought to an outside hospital where you had a breathing tube enroute to maintain your airway. you had radiographic images taken and you were found to have a small bleed in your head, facial fractures, a right frontal bone fracture, and a left radial fracture. you also were found to have a ligamentous injury to your neck and had a special collar applied which you will need to wear until your follow-up visit. you were seen by several consulting services who provided your care. you were monitored in the intensive care unit and when your vital signs stabilized, you were transferred to the surgical floor. you have progressed nicely and are now being discharged to a rehabilitation facility where you can further regain your strength and mobility. followup instructions: your contact information and insurance records are incomplete- please call our registration department at ( before your first appointment. department: orthopedics when: tuesday at 10:00 am with: hand clinic building: sc clinical ctr campus: east best parking: garage department: radiology when: friday at 8:30 am with: cat scan building: cc campus: west best parking: garage department: neurosurgery when: friday at 9:30 am with: , md building: lm bldg () campus: west best parking: garage name: , md specialty: opthalmology location: address: , 5, , phone: we are working on a follow up appointment for you to be seen by dr. in neuro-opthalmology. you will be called at rehab with the appt. if you have not heard within 2 business days or have questions, please call the number listed above. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours enteral infusion of concentrated nutritional substances open reduction of fracture with internal fixation, radius and ulna closed reduction of fracture without internal fixation, radius and ulna release of carpal tunnel other tenotomy central venous catheter placement with guidance diagnoses: obstructive sleep apnea (adult)(pediatric) esophageal reflux subarachnoid hemorrhage thyrotoxicosis without mention of goiter or other cause, and without mention of thyrotoxic crisis or storm motor vehicle traffic accident involving collision with pedestrian injuring pedestrian anxiety state, unspecified hypotension, unspecified subdural hemorrhage closed fracture of malar and maxillary bones open fracture of nasal bones closed fracture of orbital floor (blow-out) sprain of neck other alteration of consciousness street and highway accidents conjunctival hemorrhage closed fracture of base of skull without mention of intra cranial injury, with no loss of consciousness closed fracture of lower end of radius with ulna other optic neuritis carpal tunnel syndrome conjunctival edema closed fracture of vault of skull without mention of intracranial injury, with no loss of consciousness 

Answer: The patient is high likely exposed to