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: unresponsive, presumptive head trauma, unwitnessed major surgical or invasive procedure: : emergent left craniectomy for decompression of brain tracheostomy 11/12cranioplasty peg tube placement picc line placement history of present illness: patient is a 50m of unknown identity who was found unresponsive this morning by a walker-by on a bike trail in , who had apparently suffered trauma to his head, and possibly other areas of the body. her ems/ed records it is presumed he is a indigent individual. it is presently unknown who next of is. per ed report, he was unresponsive upon arrival and intubated. the ed pupillary exam was significant for aniscoria r>l with minimal light reflex. he did smell of alcohol, with labs pending at the time of examination. per ed he was also noted to have a fair amount of coffee ground emesis, and obvious trauma to the occiput of the head. past medical history: ivcf right burr holes /craniotomy brain aneurysm --> tx'd surgically (per pt has had sz's in / reportedly related to aneurysm) - seizures - etoh abuse - question hep c (pt thinks he has it) **pt has gotten care at & per his report. social history: homeless single, homeless, originally from . he smokes one ppd. he drinks several 40 oz beers per day. he occasionally uses marijuana and smokes cocaine/crack. family history: non-contributory physical exam: on admission: on neurosurgical examination(intubated at the time of exam): pupils are rt: 3mm lt: 2.5mm, minimally reactive, no response to commands, bilateral extensor posturing noted in the upper extremities. on discharge: upon dishcharge pt is non-verbal, pupils equal, round and flicker to light, does not open eyes to noxious, sporadically follows commands however could be possibly reflexive, does localize with rue to noxious, plegic lue and triple flexion to noxious with lowers. pertinent results: labs on admission: 08:50am blood wbc-10.1 rbc-4.44* hgb-12.1* hct-34.8* mcv-79* mch-27.2 mchc-34.7 rdw-15.9* plt ct-270 11:40pm blood neuts-84.6* lymphs-8.5* monos-6.4 eos-0.3 baso-0.2 08:50am blood pt-12.9 ptt-24.2 inr(pt)-1.1 12:14pm blood glucose-114* urean-16 creat-1.2 na-127* k-4.5 cl-83* hco3-33* angap-16 08:50am blood ck(cpk)-517* 11:40pm blood alt-431* ast-1164* alkphos-132* totbili-0.4 08:50am blood lipase-66* 08:50am blood ctropnt-0.12* 08:50am blood ck-mb-14* mb indx-2.7 12:14pm blood albumin-3.9 calcium-9.8 phos-5.9* mg-1.5* 08:50am blood asa-neg ethanol-26* acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg labs on discharge: wbc:10.3 hgb/hct 9.5/27.9 plts 592 na-136 k-4.4 bun-13 creat-0.5 glu-125 ekg : sinus tachycardia possible right atrial abnormality borderline right axis deviation rsr' in lead v1 modest st-t wave changes findings are nonspecific - within normal limits for possible in part right ventricular overload since previous tracing of the same date, preocrdial lead t waves less prominent imaging: ct c-spine : conclusion: 1. deformity of the anteroinferior body of c2 with a well-corticated bony fragment projected anteriorly suggestive of an old injury. 2. there is apparent asymmetry in the distance between the odontoid and the lateral masses of c1 which may be due to rotatory subluxation versus positional and can be imaged further as per clinical need. 3. fracture through the right lateral transverse process of t1 which has the appearance of subacute/chronic injury. 4. multilevel degenerative changes in the cervical spine with most significant disc narrowing at c6-7. head ct : 18-mm left subdural hematoma with mass effect and midline shift towards the right of approximately 11 mm. acute hemorrhage is also seen in the left sylvian fissure as well as the right thalamus and fourth ventricle. there is subfalcine and subtentorial herniation with loss of -white matter differentiation suggesting raised intracranial pressure. ct chest, abdomen, pelvis : impression: 1. comminuted fracture of the distal right clavicle and would recommend dedicated films to further evaluate. multiple nondisplaced chronic-appearing rib fractures. 2. filling defect within the right portal vein, which could represent non- occlusive thrombus and would recommend ultrasound evaluation to further evaluate. there is an ivc filter present within the ivc, which is infrarenal. there are right-sided dependent lung consolidations which could represent aspiration or lung contusion. there is a small right apical pneumothorax and right apical blebs. 3. there is an endotracheal tube present in satisfactory position. 4. there is diffuse fatty liver. 5. the right testicle is high within the inguinal canal and could be related to patient's trauma. head ct (post-surgery): impression: 1. reduction in size of large left convexity subdural hematoma with decreased mass effect and decreased rightward subfalcine herniation as described. persistent rightward uncal herniation noted. 2. right thalamic and potential right midbrain small intraparenchymal hemorrhages. 3. persistent enlargement of the right lateral ventricle with transependymal resorption of csf noted. lenis :impression: non-occlusive thrombosis of the right common femoral vein. head ct : impression: 1. interval decrease in size of left subdural hematoma, associated midline shift and mass effect and resolution of left uncal herniation. 2. left temporal hypodensity may relate to evolving infarction. continued attention on followup studies is recommended. 3. thalamic and brainstem hemorrhages appear stable. ct head w/o contrast final report impression: 1. no new intracranial hemorrhage or significant changes since prior scan. 2. mild improvement in rightward midline shift from 3 mm to 2 mm. hypodensity seen within the right thalamus consistent with evolution of previously noted hemorrhage in this area. eeg impression: abnormal portable eeg due to the right fronto-central slowing and due to the relatively monotonous mildly slow background throughout. the first abnormality suggests a focal subcortical dysfunction in the left anterior quadrant. the tracing cannot specify the etiology. nevertheless, there were no clearly epileptiform features there or elsewhere. the widespread 7 hz rhythm suggests a widespread encephalopathy, with a regularity raising the possibility of medication effect. head ct impression: 1. patient is status post cranioplasty. hyperdense area adjacent to the left frontal lobe in subdural location that is likely secondary to post- operative changes, however, cannot exclude small amount of subdural hemorrhage. possible mild cerebrale dema without shift of midline structures, likely due to post-surgical changes. recommend close followup as clinically indicated. expected post- operative changes with pneumocephalus, extra-axial air, and soft tissue swelling. head ct impression: interval decrease in size of fluid collection, with decrease in mass effect upon left frontal hemisphere. associated decrease in left to right shift of midline structures. persistent edema and mass effect. hypodensities both occipital lobes are unchanged. head ct mpression: 1. stable appearance of a small left frontal epidural fluid collection with mild mass effect upon the left frontal hemisphere. no new foci of hemorrhage are identified. 2. low attenuation subgaleal fluid collection at the cranioplasty site which could relate to postoperative change, although its persistence raises the possibility of a csf leak. clinical correlation is recommended. 3. mild paranasal sinus mucosal thickening and mastoid air cell opacification. complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 05:58am 10.3 3.65* 9.5* 27.9* 76* 25.9* 33.9 16.4* 592* source: line-r picc differential neuts bands lymphs monos eos baso atyps metas 03:35am 90.5* 5.9* 3.2 0.3 0.1 source: line-picc red cell morphology hypochr anisocy poiklo macrocy microcy polychr ovalocy envelop bite 02:09am 3+ 1+ 1+ occasional 1+ normal occasional 1+ occasional basic coagulation (pt, ptt, plt, inr) pt ptt plt ct inr(pt) 05:58am 592* source: line-r picc basic coagulation (fibrinogen, dd, tt, reptilase, bt) fibrino 08:50am 272 trauma hemolytic workup ret aut 04:49am 3.7* source: line-tlc chemistry renal & glucose glucose urean creat na k cl hco3 angap 05:58am 125* 13 0.5 136 4.4 94* 32 14 source: line-r picc brief hospital course: pt was biba to the emergency department after being found unresponsive on a bicycle path - ct scan revealed that he had an left sided acute subdural with significant mid line shift and mass effect. on exam he was extensor posturing and had significant anisicoria. he was brought to the operating room for emergent decompression via left hemicraniectomy. he was maintained in a cervical collar during his stay. he was placed on dilantin for sz prophylaxis and later transitioned to keppra as his serum levels were difficult to keep in the therapeutic range. social work eval revealed that he is known to the system. there was no family available for consents. it was noted that the pt had an alcohol like odor on his breath on admission - he was placed on a ciwa scale. the legal department was contact for guardianship. inital eval revealed that 1. pt had ivcf (infrarenal)previously placed, 2. small right apical pneumothorax, 3. filling defect in right portal vein may represent non occlusive thrombus, 4. comminuted proximal right clavicular fracture, 5. right lung dependent consolidations could be aspiration or contusion injury, 6.right testicle high in canal could be result of trauma, 7.distended bladder. he remained intubated postoperatively and an oral-gastric tube was placed. a small amount of coffee ground drainage was noted that evolved to be bilious in nature without further concern. his hematocrit did drop during the hospitalization and the surgical icu determined that this was enamia of chronic disease. his serial exams showed some improvement, he was localizing with his right upper extremity, there was also some spontaneous movement on the right side. significant lue weakenss is noted. post operatvie ct scan was stable. he had a a subdural drain in place that was removed on day #1. a temp spike to 102.1 occurred on and fever workup was initiated - it revealed that he had citrobacter in the sputum and treated with cipro for this. x 2 weeks. urine and blood cultures at that time were negative. serial cxr's for the right apical pneumothorax showed spontaneous resolution of this-he did not require a chest tube. his incision remained clean and dry - his staples were removed on # 10. laboratory values on #13 revealed thrombocytosis (1,000) - aspirin was started for this. this has since resolved. a trial of extubation was initiated. he was re-intubated later that same day. cervical collar was cleared by dr. on . guardianship was obtained by the court and trach and peg were performed at the bedside that day. pt did have an episode of bradycardia after this procedure which was successfully treated with atropine. he was cleared for transferred out of the icu but did require neuro stepdown unit due to amount of suctioning needed. he went to the or for cranioplasty, he tolerated this procedure well and returned to step down. his neuro exam showed that he followed commands at times on the right upper and bilat lower extremities. he remained weak on the left upper and non-verbal. on pt developed a subgaleal collection on l side of head which was subsequently drained 4 times and head wrap most recently on with improvement. pt has moderate amounts of secretions, however has a strong cough and negative sputum samples. he is afebrile and remains hemodynamically stable. case manager assisted with long term placement. medications on admission: unknown discharge medications: 1. docusate sodium oral 2. insulin regular human 100 unit/ml solution : one (1) units injection asdir (as directed): sliding scale regular insulin sq. 3. levetiracetam 500 mg tablet : three (3) tablet po bid (2 times a day). 4. albuterol 90 mcg/actuation aerosol : two (2) puff inhalation q6h (every 6 hours) as needed. 5. ferrous sulfate 300 mg (60 mg iron)/5 ml liquid : one (1) po daily (daily). 6. folic acid 1 mg tablet : one (1) tablet po daily (daily). 7. acetaminophen 160 mg/5 ml solution : one (1) po q6h (every 6 hours) as needed. 8. heparin (porcine) 5,000 unit/ml solution : one (1) 5,000units injection tid (3 times a day). 9. bisacodyl 5 mg tablet, delayed release (e.c.) : two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 10. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) as needed. 11. modafinil 100 mg tablet : two (2) tablet po qd (). 12. miconazole nitrate 2 % cream : one (1) appl topical (2 times a day). 13. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr po bid (2 times a day). discharge disposition: extended care facility: hospital discharge diagnosis: traumatic acute sdh(left) hyponatremia respiratory failure peg tube placement tracheostomy anemia of chronic disease post operative fevers deep vein thrombosis / right common femoral vein pneumonia small pneumothorax right apical /traumatic comminuted proximal right clavicular fracture, thrombocytosis hemiparesis / left sided bradycardia discharge condition: neurologically stable discharge instructions: ?????? take your pain medicine as prescribed. ?????? exercise should be limited to walking; no lifting, straining, or excessive bending ?????? increase your intake of fluids and fiber, as narcotic pain medicine can cause constipation. we generally recommend taking an over the counter stool softener, such as docusate (colace) while taking narcotic pain medication. ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, and ibuprofen etc. avoid asprin and any asprin containing products. ?????? you have been prescribed an anti-seizure medicine, take it as prescribed. call your surgeon immediately if you experience any of the following ?????? new onset of tremors or seizures. ?????? any confusion or change in mental status. ?????? any numbness, tingling, weakness in your extremities. ?????? pain or headache that is continually increasing, or not relieved by pain medication. ?????? any signs of infection at the wound site: redness, swelling, tenderness, or drainage of any color. ?????? fever greater than or equal to 101?????? f. followup instructions: follow-up appointment instructions ??????please call ( to schedule an appointment with dr. , to be seen in 4 weeks. ??????you will need a ct scan of the brain without contrast for this appointment. ***you have been placed on keppra for seizure control (levetriactam) - do not stop taking medication unless instructed by a physician. md procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube other lavage of bronchus and trachea percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy other cranial osteoplasty bronchoscopy through artificial stoma other craniotomy injection or infusion of immunoglobulin diagnoses: pneumonia, organism unspecified anemia of other chronic disease unspecified protein-calorie malnutrition hyposmolality and/or hyponatremia acute respiratory failure other specified cardiac dysrhythmias other specified complications of procedures not elsewhere classified acute venous embolism and thrombosis of deep vessels of proximal lower extremity traumatic pneumothorax without mention of open wound into thorax assault by unspecified means essential thrombocythemia other specified hemiplegia and hemiparesis affecting nondominant side closed fracture of sternal end of clavicle postprocedural fever subdural hemorrhage following injury without mention of open intracranial wound, with prolonged [more than 24 hours] loss of consciousness and return to pre-existing conscious level 

Answer: The patient is high likely exposed to