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: trauma transfer major surgical or invasive procedure: right forehead lacerations repaired x 2 right shin laceration repaired intubation in ed left radial a-line ngt central line left subclavian site history of present illness: 63ym s/p fall, trauma transfer from osh with known sdh and ip bleed. found at bottom of stairwell. gcs of 11 at osh. no apparent loc, but confused and unable to ambulate when found by wife. intubated at osh for ct scan showing r frontal sdh and l frontal sdh and ip bleed at falx. ct head also showed right maxillary sinus, zygomatic arch fractures, right lateral orbital wall fracture with extension into the infraorbital fissure, possible fracture of the roof of the right orbit. past medical history: vascilitis nos hx ischemic cva dm htn diverticulitis glaucoma basal cell carcinoma asymptomatic sinus arrythmia hypercholesterolemia hyperhomocystinemia on folate therapy cri (baseline 1.2 to 1.5) factor v leiden mutation, heterozygous state autoimmune sensory neural hearing loss causing right-sided deafness. alopecia universalis mesenteric ischemia from small vessel vasculitis s/p small bowel resection social history: pt was manager at lucent technology 15 pack year tobacco hx, quit 30 years ago. no etoh lives in , ma and is married. pt has children. family history: mother died of cva at 67yrs old father died of prostate cancer at older age, mi at earlier age of 67 no clotting or bleeding hx in family physical exam: t hr 104 irregular 162/79 100% intubated breath sounds equal bilaterally heent: ou pupil 3 to 2 mm, + corneal reflexes, large r temporal/forehead laceration about 3 to 4 cm each. full thickness cv: irregular rate, tachcardic +bs, nt, nd good rectal tone and guaic negative spontaneous movement on right, decreased on left skin degloving injury to right anterior shin about 3 x 5 cm. pertinent results: 11:06pm hct-30.6* 10:03pm type-art po2-99 pco2-33* ph-7.43 total co2-23 base xs-0 10:03pm glucose-155* lactate-2.2* k+-4.7 10:03pm freeca-1.06* 05:05pm hct-29.1* 01:27pm type-art po2-298* pco2-35 ph-7.43 total co2-24 base xs-0 01:27pm lactate-2.4* 01:20pm hct-27.4* 08:00am glucose-179* urea n-15 creat-1.3* sodium-138 potassium-4.3 chloride-109* total co2-18* anion gap-15 08:00am alt(sgpt)-23 ast(sgot)-23 amylase-74 tot bili-0.1 08:00am lipase-33 08:00am calcium-7.5* phosphate-2.5* 08:00am wbc-17.1* rbc-2.94* hgb-8.2* hct-23.2* mcv-79* mch-28.0 mchc-35.6* rdw-16.3* 08:00am neuts-81.8* lymphs-8.2* monos-7.9 eos-1.8 basos-0.3 08:00am plt count-322 08:00am pt-12.7 ptt-21.3* inr(pt)-1.1 07:45am pt-13.2 ptt-19.4* inr(pt)-1.2 07:03am lactate-3.3* 07:45am fibrinoge-42* 07:03am lactate-3.3* 07:03am hgb-9.0* calchct-27 06:50am urea n-17 creat-1.3* 06:50am amylase-84 06:50am asa-neg ethanol-25* acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 06:50am urine bnzodzpn-pos barbitrt-neg opiates-neg cocaine-neg amphetmn-neg mthdone-neg 06:50am urine color-straw appear-clear sp -1.012 06:50am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 06:49am glucose-205* lactate-3.5* na+-140 k+-6.4* cl--107 tco2-17* 06:49am hgb-8.8* calchct-26 tib/fib (ap & lat) right 11:23 am no specific localizing history is available. allowing for this, no fracture is detected involving the tibia or fibula. vascular calcification is present. assessment of the right knee and ankle are quite limited on these views. if there is clinical concern for injury to either joint, then dedicated views of that joint would be recommended for full assessment. t - l spine: impression: 1) limited exam without evidence of fracture or listhesis in the thoracic or lumbar spine. see comment. 2) slight prominence of the superior mediastinum. is there any clinical concern for mediastinal injury? if so, additional work-up is recommended. in any event, a dedicated upright pa view should be considered when the patient is stable. radiology final report ct head w/o contrast 9:00 am ct head w/o contrast reason: reevalaute known head injury medical condition: s/p fall from stairs reason for this examination: reevalaute known head injury contraindications for iv contrast: none. history: reevaluate known head injury. technique: non-contrast head ct scan. findings: no preceding head imaging studies from this hospital are available. therefore, it is impossible to assess for any interval changes of the following abnormalities: there is a moderate-sized left parafalcine acute subdural hemorrhage causing minor impression upon the left parasagittal cortex. there is a smaller acute left frontal temporal subdural hemorrhage, again causing slight impression upon the adjacent cortex. there is also presumed small quantity of acute subdural hemorrhage seen extending along the leaves of the tentorium on both sides. there is no definite sign for intraaxial hemorrhage. there is a question of a tiny amount of hemorrhage sedimenting within the left occipital , as seen only on image 18. there is no hydrocephalus, shift of normally midline structures, or visible minor or major vascular territorial infarction. there are small air-fluid levels seen within both maxillary sinuses with extensive opacification of both ethmoid sinuses by soft tissue material. there is moderately extensive opacification of the sphenoid sinus. there is minimal mucosal thickening within the left frontal air cell. the sinus abnormalities are likely inflammatory in origin. no other overt osseous pathology is seen. conclusion: multicompartmental acute subdural hemorrhages. dr. approved: wed 7:31 pm radiology final report ct 150cc nonionic contrast 6:52 am ct abdomen w/contrast; ct pelvis w/contrast reason: evalaute for solid organ injury field of view: 36 contrast: optiray medical condition: s/p fall from stairs, severe head trauma reason for this examination: evalaute for solid organ injury contraindications for iv contrast: none. indication: status post fall downstairs with severe head trauma, evaluate for solid organ injury. comparisons: none. technique: axial mdct images through the abdomen and pelvis with iv contrast per trauma protocol. coronal and sagittal reformatted images were performed. ct abdomen with iv contrast: there are small bilateral pleural effusions. no evidence of pneumothorax or contusion at the lung base. there is trace amount of atelectasis at the left lung base. the visualized portion of the heart and pericardium are normal. liver, gallbladder, pancreas, stomach, and proximal small bowel is normal. the ng tube tip is in the body of the stomach. the spleen demonstrates multiple ill-defined hypodense areas, likely consistent with laceration/contusions. there is no subcapsular hematoma. the splenic vessels at the hilum are intact. no evidence of arterial extravasation. multiple exophytic, likely simple cysts within the kidneys, greater on the right. there is no free air or free fluid in the abdomen. the intra- abdominal small bowel appears normal. ct pelvis with iv contrast: the intrapelvic large and small bowels are unremarkable. there is no evidence of mesenteric hemorrhage. foley catheter in a nondistended bladder. no free fluid in the pelvis. no abnormal lymphadenopathy. no evidence of arterial extravasation in the deep pelvis. bone windows: no evidence of spinal or rib fracture. specific attention to the ribs adjacent to the spleen demonstrate no evidence of fracture. mild degenerative changes and bilateral spondylolysis at the l5 level. isolated bone islands in the iliac bones. coronal and sagittal reformatted images confirm the above findings. sagittal images confirm the spine is intact. impression: 1) moderately sized splenic contusions/lacerations; no subcapsular hematoma and no evidence of vascular injury/arterial extravasation. 2) no evidence of other solid organ injury, fracture, or other traumatic injury throughout the abdomen and pelvis. 3) small bilateral pleural effusions. 4) bilateral, exophytic, likely simple renal cysts. the study and the report were reviewed by the staff radiologist. dr. dr. approved: wed 10:13 am radiology final report trauma #2 (ap cxr & pelvis port) 6:41 am trauma #2 (ap cxr & pelvis por reason: r/o injury medical condition: s/p fall from stairs reason for this examination: r/o injury indication: known severe head injury, patient fell downstairs. trauma two series: no prior studies for comparison. portable ap chest with underlying trauma board straightens endotracheal tube in good position, with its tip 5 cm above the carina. the heart size is normal. there is no pneumothorax. subtle opacity in the left lower lobe likely represents atelectasis rather than contusion. mediastinum is within normal limits for ap technique. no evidence of rib or clavicular fractures. single ap view of the pelvis demonstrates no evidence of fracture or dislocation. the sacrum is suboptimally visualized. the si joints are congruent. impression: 1) no evidence of traumatic injury within the chest and pelvis; underlying trauma board limits sensitivity. 2) endotracheal tube in good position. the study and the report were reviewed by the staff radiologist. dr. dr. approved: 7:39 am radiology final report ct reconstruction 9:46 pm ct abdomen w/contrast; ct pelvis w/contrast reason: iv contrast only - rule out evolution of splenic laceration/ field of view: 38 contrast: optiray medical condition: s/p fall from stairs, severe head trauma, intubated for airway protection reason for this examination: iv contrast only - rule out evolution of splenic laceration/infarction, r/i intrabdominal bleeding contraindications for iv contrast: none. indication: fell from stairs with severe head trauma one day ago, prior ct demonstrating splenic laceration/contusions. evaluate for interval change. comparisons: ct abdomen and pelvis of . technique: axial mdct images of the abdomen and pelvis with iv contrast per trauma protocol. coronal and sagittal reformatted images were performed. ct abdomen with iv contrast: again demonstrated are small bilateral pleural effusion/atelectasis, unchanged from the prior study. the liver is unremarkable without traumatic injury. the gallbladder contains excreted contrast but is otherwise normal. again demonstrated in the spleen are multiple organizing contusions, slightly more prominent than on the prior day's ct. there is no evidence of subcapsular hematoma or arterial extravasation to suggest arterial injury. ng tube tip in the stomach. the pancreas and adrenal glands are unremarkable. the stomach and proximal small bowel are grossly normal. there is no free air in the abdomen. ct pelvis with iv contrast: again multiple likely simple exophytic cysts are demonstrated in the kidney. following the lateral cortex of the mid portion of the left kidney, there are two segmental areas of hypoattenuation, which likely represent segmental infarcts. this was not present on the prior abdominal ct. kidneys otherwise enhance normally and excrete contrast in a normal fashion. there is no evidence to suggest small bowel injury or mesenteric hematoma. foley catheter in an otherwise nondistended bladder. no free fluid in the deep pelvis. bone windows: no suspicious lytic or blastic lesions are seen. again, bone windows demonstrate no evidence of fracture. impression: 1) organizing splenic contusions. no subcapsular hematoma or arterial extravasation. 2) interval development of two segmental areas of underperfusion in the left kidney, compatible with segmental infarction, not present on the prior ct. multiple areas of cortical scarring bilaterally suggestive of chronic infarction. 3) small bilateral pleural effusion/atelectasis, unchanged from prior study. 4) multiple bilateral, exophytic, likely simple renal cysts. the study and the report were reviewed by the staff radiologist. dr. dr. approved: 11:04 am radiology final report ct head w/o contrast 9:06 am reason: r/o interval change of known subdural medical condition: 63 year old man s/p fall with sdh reason for this examination: r/o interval change of known subdural contraindications for iv contrast: none. history: evaluate for interval change of known subdural hematoma. technique: non-contrast head ct scan. comparison: . findings: again seen is a moderate-sized left parafalcine subdural hematoma with minimal impression upon the left parasagittal cortex, not significantly changed from the study of one day prior. the small left frontotemporal subdural hematoma is unchanged in size as well. hemorrhage seen along the tentorium on both sides is unchanged as well. there is a large area of low density in the right temporal and parietal lobes with foci of increased density, with these findings suggesting an evolving hemorrhagic contusion. there is a smaller similar area in the left frontal lobe, again likely a hemorrhagic contusion. alternatively, but much less likely, the large area of low density in the right temporal and parietal lobe also raises the possibility of evolving venous infarction. a small amount of hemorrhage is seen layering in the left occipital , seen on series 2, image 14. there is a small focus of low attenuation seen left of the fourth ventricle on series 2, image 8, not well appreciated on the prior study, but seen on the patient's scanned in study from an outside hospital of . there is no hydrocephalus or shift of normally midline structures. there is fluid in the maxillary and ethmoid sinuses, likely related to the patient's intubated state. findings were discussed with dr. on . impression: 1. bilateral hemorrhagic contusions, right greater than left in the temporal lobes. these have become more visible since the prior study. 2. stable appearance of left parafalcine and left frontotemporal subdural hemorrhages. the study and the report were reviewed by the staff radiologist. dr. . dr. approved: 8:15 pm : ct head: right maxillary sinus and zygomatic arch fractures as well as right lateral orbital wall fracture with extension into the infraorbital fissure as described above. possible fracture of the roof of the right orbit as well. tee: + mr, ef 55%. brief hospital course: pt transfered from osh intubated. pt seen in ed and admitted to trauma service and takent to the trauma intensive care unit. by systems neuro: neurosurgery was consulted and assessed patient with b/l sdh and possible evolving contusion. pt on dilantin for seizure prophylaxis. head ct shows worsening cva. mri/mra of head/neck pending. mri of c-spine pending. neurology consulted. on profofol and morphine sulfate. cthead: stable appearance of subdural hemorrhages and bilateral hemorrhagic contusions. right maxillary sinus and zygomatic arch fractures as well as right lateral orbital wall fracture with extension into the infraorbital fissure as described above. possible fracture of the roof of the right orbit as well. cv: no pressors. on metoprolol for rate control. echo : conclusions: 1. the left atrium is mildly dilated. 2. left ventricular wall thickness, cavity size, and systolic function are normal (lvef>55%). regional left ventricular wall motion is normal. 3. the aortic valve leaflets are mildly thickened. 4. the mitral valve leaflets are mildly thickened. mild to moderate (+) mitral regurgitation is seen. 5. no cardiac source of embolus seen. resp: on ventilator. cpap & ps: .40/540x17/peep 5/psv 5 gi: dobhoff. abdominal ct obtained for dropping hct in setting of possible splenic injury. fen: tube feeds. 1. npo as diet except meds; 2. tubefeeding: promote w/ fiber full strength; starting rate: 10 ml/hr; advance rate by 10 ml q4h goal rate: 70 ml/hr residual check: q4h hold feeding for residual >= : 100 ml flush w/ 30 ml water q6h. renal: possible new left renal infarct, foley, good uop. heme: dropping hct. max 30.6 and low 24.5. pt transfused 1 unit. endo: dm, ssi, on methylprednisolone id: no antibiotics tld: lsc tlc, dobhoff, foley, l radial aline wound: 2 r forehead lacs with 4-0 prolene on , r shin with 3-0 nylons on . imaging as per pertinent results: mri head, neck, carotid us pending consulted: rheumatology, neurosurgery, neurology prophylaxis: hep sq, protonix dispo: ticu, possible transfer to . code status: dnr. medications on admission: meds on admit (per d/c summary at ): 1. lisinopril 20 mg daily 2. protonix 40 mg daily 3. bactrim prophylaxis 4. folate 5. asa 81 mg 6. glyburide (felt to be hyperglycemic induced by steroids) 7. cytoxan 125 mg daily (didn't tolerate and was subsequently changed to monthly infusions) 8. prednisone 60 mg daily, had tapered to 10 mg by and was still tapering by 1 mg per month discharge medications: latanoprost 0.005% ophth. soln. 1 drop ou hs heparin 5000 unit sc tid propofol 20-100 mcg/kg/min iv drip titrate to sedation insulin sc (per insulin flowsheet) sliding scale sodium chloride 0.9% flush 3 ml iv daily:prn phenytoin 100 mg iv q8h metoprolol 5 mg iv q6h hold for bp < 110, hr < 60 morphine sulfate 2 mg iv q4h:prn methylprednisolone na succ 10 mg iv q24h potassium chloride 20 meq / 250 ml ns iv prn k<4 magnesium sulfate 2 gm / 100 ml d5w iv prn mg<2 calcium gluconate 2 gm / 100 ml d5w iv prn ica<1.1 pantoprazole 40 mg iv q12h discharge disposition: extended care facility: medical center discharge diagnosis: right frontal subdural hematoma left frontal subdural hematoma intraparenchymal bleed at falx splenic laceration vs infarct right forehead head laceration right shin laceration vascilitis nos hx ischemic cva ischemic colitis s/p bowel resection dm glaucoma discharge condition: fair discharge instructions: code status: do not resuscitate (dnr/dni) patient already intubated, dnr corroborated with dr. . medications as per medication sheet. npo * increasing pain * fever (>101.5 f) or vomiting * inability to eat or drink * reddness/swelling/discharge from wounds * anything that concerns you. vent settings: cpap & ps: .40/540x17/peep 5/psv 5 followup instructions: please see your neurologist (dr. or dr. at as soon as you arrive there. you may follow-up with dr. at if desired in 4 weeks. please call ( to schedule an appointment. please follow-up with your rheumatologist dr. when you arrive at . please call to schedule a visit. please keep all previously scheduled appointments proir to this hospitalization. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified diagnostic ultrasound of heart arterial catheterization closure of skin and subcutaneous tissue of other sites closure of skin and subcutaneous tissue of other sites transfusion of packed cells diagnoses: pure hypercholesterolemia unspecified pleural effusion unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation unspecified glaucoma pulmonary collapse open wound of forehead, without mention of complication closed fracture of malar and maxillary bones closed fracture of other facial bones home accidents open wound of knee, leg [except thigh], and ankle, without mention of complication vascular disorders of kidney lumbosacral spondylosis without myelopathy other fall injury to spleen without mention of open wound into cavity, unspecified injury cyst of kidney, acquired closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, with no loss of consciousness 

Answer: The patient is high likely exposed to