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: r thumb traumatic amputation major surgical or invasive procedure: procedures performed: 1. right thumb arthrodesis metacarpophalangeal joint with a 0.45 kirschner wires. 2. repair of ulnar digital artery. 3. repair of the dorsal veins x2. 4. repair of digital nerves x2. 5. local advancement flap closure. 6. use of operating microscope. 7. repair of extensor tendons. history of present illness: 57ym rhd using while ice fishing - caught mittened r hand and avulsed r thumb completely. occurred 13:30. flighted directly here. arrive ~17:00. no prior hand trauma or surgery. last ate 13:00. past medical history: childhood injury to same thumb w/distal tip amputation social history: sh: works for secretary of state. 2 cigarettes per day. 1 drink etoh per day. family history: n/a physical exam: exam on presentation: vs 98.2 80sr 138/75 18 96ra cvs rrr res ctab abd sntnd rue amputation r thumb through mcp at joint; distal part on ice with 10-20cm of flex/ex tendons and nerves avulsed from arm; all other digits neurovasc intact pertinent results: 06:10pm blood wbc-9.3 rbc-4.72 hgb-14.3 hct-41.8 mcv-89 mch-30.4 mchc-34.3 rdw-13.6 plt ct-226 02:55am blood wbc-10.4 rbc-4.33* hgb-13.5* hct-38.7* mcv-89 mch-31.2 mchc-34.9 rdw-13.6 plt ct-218 03:41am blood wbc-7.4 rbc-3.90* hgb-12.0* hct-35.2* mcv-90 mch-30.7 mchc-34.0 rdw-13.8 plt ct-203 03:41am blood glucose-119* urean-9 creat-0.8 na-141 k-4.2 cl-107 hco3-31 angap-7* 03:41am blood calcium-8.3* phos-3.6 mg-2.0 . radiographic studies: hand, ap & lat. views right: findings: there is an amputation of the first digit with disarticulation at the first metacarpal joint. there is also a fracture seen through the head the first metacarpal with tiny fracture fragment embedded in proximal soft tissues of the amputated first digit. there is suspected fragmentation of the radial sesamoid at the first metacarpal. no other bony injury is identified. brief hospital course: pt admitted post-operatively after re-implantation of r thumb. pt had an unremarkable post-operative course with good perfusion seen to re-attached digit post-operatively. he was initially kept in the icu for 24 hours for q1h digit checks but was able to be transitioned to q2h checks and moved to the floor the next day. a bear hugger was kept over the r thumb throughout his stay to keep the extremity warm. the patient was initially anticoagulated with asa and a heparin drip at 500cc/hr flap pathway. an attempt was made to up-titrate his heparin to a therapeutic ptt but after several adjustments his ptt remained in the 40's and the patient was transitioned to a therapeutic dose of lovenox in preparation for d/c. throughout his stay, the patient remained afebrile, his vital signs were stable, and his pain was well controlled. medications on admission: med: asa 81qd, stratera discharge medications: 1. aspirin 81 mg tablet, chewable sig: 1.5 tablet, chewables po daily (daily). 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain, ha. 4. hydromorphone 2 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain for 2 weeks. disp:*50 tablet(s)* refills:*0* 5. enoxaparin 100 mg/ml syringe sig: one (1) cc subcutaneous q 12h (every 12 hours) for 10 days. disp:*20 doses* refills:*0* 6. clindamycin hcl 150 mg capsule sig: two (2) capsule po q6h (every 6 hours) for 1 weeks. disp:*56 capsule(s)* refills:*0* discharge disposition: home discharge diagnosis: traumatic right thumb amputation discharge condition: good condition discharge instructions: please resume all regular home medications and take any new meds as ordered. do not drive or operate heavy machinery while taking any narcotic pain medication. you may have constipation when taking narcotic pain medications (oxycodone, percocet, vicodin, hydrocodone, dilaudid, etc.); you should continue drinking fluids, you may take stool softeners, and should eat foods that are high in fiber. please be sure to keep your hand warm at all times to help with blood flow and healing. return to the er if: * if you are vomiting and cannot keep in fluids or your medications. * if you have shaking chills, fever greater than 101.5 (f) degrees or 38 (c) degrees, increased redness, swelling or discharge from incision, chest pain, shortness of breath, or anything else that is troubling you. * any serious change in your symptoms, or any new symptoms that concern you. followup instructions: we have found the name of a hand surgeon in that you can follow up with in days from today to have the stitches out of your hand. we will call you today with the name and number for this physician, call tomorrow to schedule an appointment. please call the hand clinic today or tomorrow at to schedule a follow-up appointment for 1 month from your operation date. procedure: thumb reattachment diagnoses: tobacco use disorder long-term (current) use of anticoagulants traumatic amputation of thumb (complete)(partial), without mention of complication accidents caused by other hand tools and implements 

Answer: The patient is high likely exposed to