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: unsucessful suicide attempt via method of hanging major surgical or invasive procedure: - tracheostomy and percutaneous g tube history of present illness: patient is a 50 year old male who was brought to the trauma bay after an unsucessful suicide attempt via the method of hanging. patient hung himself in the attic and rope reportedly broke and he was found walking down the stairs. the ambulance was called. he was intubated on the scene and transferred to - gcs 3t. past medical history: hypertension social history: patient has a 16 year old daughter. recently lost a job and was to be evicted from his apartment on the day he attmpted suicide. has relationships with ex-spouses x2 family history: non-contributory physical exam: upon presentation: hr:74 bp:173/90 resp:15 o(2)sat:100% normal constitutional: comfortable heent: pupils equal, round and reactive to light large amount of neck edema and subcutaneous air, circumferential ligature mark on neck, no expanding hematoma or bruit, intubated, dried blood in nares chest: clear to auscultation cardiovascular: regular rate and rhythm abdominal: nondistended, soft gu/flank: no costovertebral angle tenderness extr/back: no edema skin: no rash, warm and dry neuro: sedated psych: sedated heme//: no petechiae pertinent results: inr(pt) 1.5* wbc rbc hgb hct mcv mch mchc rdw plt ct 05:10 10.2 3.30* 9.7* 29.4* 89 29.3 32.9 13.9 531* imaging: ct head without contrast no acute intracranial process. significant soft tissue emphysema in the anterior tissues of the neck and face. ct c-spine w/o contrast 1. fracture of the posterior pedicles of c2 vertebral body bilaterally. 2. question fracture of hyoid bone . 3. likely fracture of the left lamina of the thyroid cartilage posteriorly. ct torso 1. multiple fractures of the left transverse processes of the lumbar spine and left seventh rib as detailed above. 2. anterior chest wall subcutaneous air. 3. no mediastinal hematoma or evidence of extravasation. 4. endobronchial debris causes atelectasis of the right upper lobe. cta neck 1. occlusion of the left common carotid and the left internal carotid artery extending up to the level of the cavernous carotid on the left with good flow from collaterals from the circle of seen in the supraclinoid carotid and left mca is felt to be secondary to a dissection given mechanism of injury. 2. thrombosis left external carotid artery. 3. irregularity in the wall of the right common carotid artery just inferior to the carotid bulb is likely secondary to a small dissection. 4. c-spine fractures as detailed on the cervical spine ct. 5. left hyoid bone inferiorly displaced fracture of the greater cornu. 6. left thyroid cartilage mildly displaced fracture. 7. significant subcutaneous emphysema in the anterior neck is felt to be secondary to a tracheal injury at the level of the thyroid cartilage. mr cervical spine known fracture at c2, better seen on the previous ct scan. injury to the posterior interspinous ligament at c1-c2 as well as possibly to the all and pll. increased signal within the c2-c3 disc space, concerning for acute injury to the disc. small csf density collection anteriorly in the epidural space extending from c2-c3 to c5-c6 which could represent a hygroma or epidural hematoma without significant compromise of the cord. there is no evidence for cord contusion. ct torso compressive atelectasis/comsolidation at both lung bases with no evidence for intra-abdominal abscess identified. cta neck 1. persistent occlusion of the left common carotid near its takeoff from the aortic arch, at the level of the clavicular head with distal reconstitution of the external carotid branch via muscular collaterals, as well as the petrous portion of the internal carotid artery, likely via filling from an ophthalmic artery collateral as well as via the circle of , which is intact. 2. interval improvement in irregularity previously seen in the region of the right carotid bulb. 3. though mri is more sensitive for this, there is no evidence of territorial cerebral infarct. 4. previously described soft tissue and bony traumatic changes of the neck and oropharynx including fracture of the bilateral c2 pedicles, subcutaneous emphysema, soft tissue stranding, and mottled density filling the nares and oropharynx. left hyoid and thyroid fractures are again noted, though subcutaneous emphysema has improved. ct neck w/o contrast 1. diffuse edema such that infection cannot be excluded; however, no drainable fluid collection or abscess formation is seen at this time. 2. small area of enhancement with central hypodensity, which could represent a developing fluid collection in the right oropharynx. this area may be amenable to direct visualization. 3. similar additional findings including fractures of the pedicles at c2 and left transverse foramen. fracture of the left hyoid. 4. stable appearance of occlusion of the left carotid artery with distal reconstitution of the external carotid. 5. diffuse edema and subcutaneous emphysema, overall slightly decreased from initial examination and similar to the immediate prior examination of . neck us multiple hematomas extending throughout the neck soft tissues, right greater than left. given the heterogeneous contents, these are not amenable to aspiration. microbiology: mrsa screen positive bcx x2: pending ucx: f-no growth ucx: f- no growth sputum cx: gs- >25 pmns, 3+ gpcs; cx- moderate growth mrsa bcx x2: f- no growth packing x3: 1. mrsa 2. strep anginosus sensitive to gent, rifamp, tetra, bactrim, and vanco 11/7 l fem tlc tip cx: no significant growth. brief hospital course: the patient was admitted to the trauma surgical service for evaluation and treatment after unsuccessful suicide attempt. neuro: a mri head and c-spine were obtained at neurosurgery's request. his head ct showed no acute intracranial processes. ct cervical spine showed fracture of the posterior pedicles of c2 vertebral body bilaterally; their final recommendation was for a hard cervical collar to be worn for six weeks. he will follow up with neurosurgery at that time. cv: the patient remained stable from a cardiovascular standpoint; vital signs were routinely monitored. pulmonary: patient was brought in intubated. the tracheostomy was done by the thoracic service on . he was transitioned to a trach mask and was stable. his tracheostomy was eventually removed and he is on room air with stable oxygen saturations in the high 90% range. gi/gu/fen: a peg was placed on hd11 and tube feedings were started and advanced to goal. he underwent video swallow x 2 for which he failed requiring that he remain on tube feedings. the plan is for him to follow up as an outpatient with ent and speech for video swallow and electrical stimulation. in the meantime he is npo except for no more than 8 oz water in 24 hour period for swishing and spitting. he is receiving blous tube feedings; he was provided with teaching by nursing on how to administer the bolus feedings. id: no active issues. fever curve and wbc were monitored, his last wbc on was 10.2 which is within normal range; his t max was 98.4 on at time of this dictation. endocrine: blood sugars were monitored and treated. hematology: he was treated with a heparin drip for his carotid dissection and transitioned to coumadin. his goal inr is , on his inr was 1.5; he received coumadin 10 mg on and will need to receive 10 mg on with an inr check for to adjust dose if necessary. he will require at least daily inr's until he is therapeutic and then the inr can be checked 1-2x/week. he will remain on the coumadin for ~6 months, a carotid ultrasound will need to be done prior to stopping the coumadin. prophylaxis: he received compression boots and pepcid. psychiatry: psychiatry was consulted who followed patient; he was maintained on a one-to-one sitter and suicide precautions. he has been recommended for inpatient psychiatric stay. he was evaluted by physical therapy and is independent with transfers, ambulation, feeding himself and personal hygiene. medications on admission: none discharge medications: 1. outpatient work pt/inr 2-3x/week and prn based on goal inr 2-3 range 2. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily): via feeding tube. disp:*30 tablet(s)* refills:*2* 3. docusate sodium 50 mg/5 ml liquid sig: ten (10) ml's po bid (2 times a day) as needed for constipation: via feeding tube. 4. sodium chloride 0.65 % aerosol, spray sig: two (2) spray nasal tid (3 times a day). disp:*1 * refills:*2* 5. polyethylene glycol 3350 17 gram/dose powder sig: seventeen (17) grams po q12h (every 12 hours) as needed for constipation. 6. oxycodone-acetaminophen 5-325 mg/5 ml solution sig: 5-10 mls po q4h (every 4 hours) as needed for pain. disp:*350 ml(s)* refills:*0* 7. citalopram 20 mg tablet sig: one (1) tablet po daily (daily): via feeding tube. 8. warfarin 5 mg tablet sig: two (2) tablet po daily (daily): goal inr ; adjust dose based on inr please. 9. heparin flush (10 units/ml) 2 ml iv prn line flush picc, heparin dependent: flush with 10ml normal saline followed by heparin as above daily and prn per lumen. 10. sodium chloride 0.9% flush 3 ml iv daily:prn line maintenance peripheral iv - inspect site every shift 11. diazepam 5 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for spasms. 12. milk of magnesia 400 mg/5 ml suspension sig: thirty (30) ml's po twice a day as needed for constipation. discharge disposition: extended care facility: 4 discharge diagnosis: s/p self hanging attempt injuries: c2 posterior lamina fracture right 7th rib fracture bilateral carotid dissection thrombosis of the left common carotid, w/ ext into left internal & external carotid arteries hyoid bone fracture l1-l5 mildly displaced transverse process fractures respiratory failure dysphagia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to the hospital after a self hanging attempt. your trauma caused significant bodily injuries. you were required to have an operation which provided you with a protective airway for breathing and a special feeding tube was placed to provide you with nutrition. you underwent swallowing tests in the hospital and it has been determined at this time that your swallowing muscles are still weak. in 4 weeks you will see the ear, nose & throat doctors followed by appointment with the speech specialist, a repeat video swallow test will be done then. until that time you will need to continue with your tube feedings as instructed. do no eat anything by mouth. the cervical collar will needto remain in palce until told to remove it by the neurosurgeon, dr. . it is ok for you to shower. avoid tub baths for now until your feeding tube is removed. avoid lifting heavy objects greater than 10 lbs. you will need to continue on the blood thinning medication called coumadin for at least 6 months because of the injury to the artery in your neck (carotid artery). blood tests will need to be drawn at least 1-2x/week called an inr to measure how thin your blood is followup instructions: follow up in 4 weeks in clinic, call for an appointment. after you follow up with ent you will need to have a repeat swallow study done in 4 weeks to determine if you can be upgraded to a diet. please call to request to have a vital stim test done. you will also need to have the video swallow test repeated at that time. follow-up with dr. , neurosurgery in 4 weeks with a non-contrast ct scan of the cervical spine. call for an appointment. the clinic our is located in the medical building, , , , . follow up in clinic in 4 weeks, call for an appointment. it was notedthat you do not have a pcp; there are 2 options for obtaing one: 1. contact the md referral line at - patients or their families must call 2. dr. at which is closer to the / area that you have indicated you will be going to after discharge, is taking new patients, the office number is . md procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy control of epistaxis by anterior nasal packing pharyngoscopy diagnoses: pulmonary collapse closed fracture of second cervical vertebra dissection of carotid artery major depressive affective disorder, single episode, unspecified long-term (current) use of anticoagulants closed fracture of one rib closed fracture of lumbar vertebra without mention of spinal cord injury precipitous drop in hematocrit traumatic subcutaneous emphysema epistaxis cocaine dependence, unspecified dysphagia, unspecified suicide and self-inflicted injury by hanging injury to internal carotid artery closed fracture of larynx and trachea injury to common carotid artery injury to external carotid artery injury to cervical nerve root 

Answer: The patient is high likely exposed to