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: history of present illness: the patient is a 67-year-old russian-speaking gentleman with a history of parkinson disease who was impaled in the right thigh after being struck by a vehicle at low speed. his primary survey was significant for an intact airway and respirations, but there was a right lower extremity deformity with a long 3-inch laceration on his right side. he was hypotensive in the trauma bay and was transfused with packed red blood cells. a central line was placed. an arterial line was placed. an echocardiogram showed intravascular volume depletion. in addition, his chest x-ray showed a questionable right mediastinum and fracture of ribs two, three, four, five, and seven. his anterior/posterior pelvis film in the trauma bay showed a right acetabular fracture. concise summary of hospital course: he was taken emergently to angiography where a branch of the right profunda femoral artery was embolized. he was stabilized, and further evaluation with an abdominal computed tomography showed a left perinephric hematoma with no free air or free fluid within the abdomen. additionally, a computed tomography angiogram of the chest was done which showed a small venous bleed in the mediastinum and an anterior sternal fracture. his other injuries included a right fibular fracture, right acetabular fracture (as mentioned above), the left rib fractures (as mentioned above), and the left perinephric hematoma. the patient was then transferred from computed tomography angiogram to the trauma intensive care unit where he received further resuscitation with blood products, and his acidosis subsequently improved. however, he was noted to have ongoing bleeding with a further hematocrit drop. his leg wound was examined without additional bleeding. however, a repeat computed tomography scan showed extension of the retroperitoneal hematoma and extensive intraperitoneal fluid. the patient was taken to the operating room for an exploratory laparotomy and was found to have a large amount of bloody/ascitic fluid with a left retroperitoneal hematoma. this was observed directly with no worsening, and the patient was closed and transferred intubated back to the trauma intensive care unit. from there, the patient had a prolonged intensive care unit course. significantly, he had a left common femoral vein deep venous thrombosis; for which a removable inferior vena cava filter was placed on . his right leg wound had been treated with packs and dressing changes; however, the skin developed increasing necrosis and cellulitis; for which he underwent extensive debridement on . he subsequently had a hemovac dressing placed over that wound. on he underwent a split-thickness skin graft from the left lateral and posterior thigh to the right posterior thigh with good results. currently, the patient has a small area of granulation on his posteromedial thigh with otherwise take of his skin graft. his hospital course was otherwise significant for an ileus; for which he had a nasogastric tube placed. he eventually was extubated and was transferred to the regular floor. however, he developed increasing respiratory distress with abdominal pain and was found to have elevated liver function tests and pancreatitis. he was taken for endoscopic retrograde cholangiopancreatography. however, on the first attempt the patient desaturated and was transferred to the intensive care unit where he was again intubated. endoscopic retrograde cholangiopancreatography and sphincterotomy were performed with findings of nonocclusive sludge in the common bile duct. his pancreatitis resolved, and he was stabilized from a gastroenterology standpoint. of note, during this time, the patient was septic with copious respiratory secretions. sputum cultures subsequently grew methicillin-resistant staphylococcus aureus; for which he was placed on vancomycin. his initial wound had grown escherichia coli bacillus corynebacterium enterococcus, and he additionally had grown serratia marcescens from his sputum. he was maintained on vancomycin and aztreonam for a course, after which his antibiotics were stopped. at the time of redevelopment of his pancreatitis, he was empirically placed on vancomycin (which he is currently on). he was extubated again on and transferred to the regular floor. at this time, the patient was alert and mildly tachycardic with a stable blood pressure. respiratory wise, he continued to have coarse breath sounds with right lower lobe collapse on his chest x-ray and required chest physical therapy and nebulizers to help him manage copious secretions. his initial swallow study was equivocal; however, subsequent swallow studies showed the patient did not have signs of aspiration; however, he fatigued easily. he was able to tolerate a regular diet via frequent intervals with small amounts. on , the patient was noted to have increasing respiratory distress and tachypnea. he was again transferred to the intensive care unit where aggressive chest physical therapy and suctioning were performed. he subsequently stabilized and was able to be weaned to a nasal cannula with a return to his previous baseline respiratory status. he continued to have copious secretions but was able to manage them well. 1. neurology issues: on brief review of systems, as above, neurologic wise, the patient has parkinson disease. a neurology consultation was pending for further recommendations. he is continues on sinemet. 2. cardiovascular issues: the patient has a history of hypertension. however, his blood pressure here has been lower and his blood pressure medications have been held at this time. 3. gastrointestinal issues: the patient was tolerating a regular diet; per speech and swallow recommendations, will have small frequent meals with supervision. he can drink thin liquids through a straw with a calorie count currently ongoing to determine if he is able to meet his nutritional goals orally. 4. genitourinary issues: the patient has a history of prostate cancer; status post prostatectomy. 5. renal issues: the patient has an indwelling foley catheter due to his instability and requires this for wound hygiene. he is also on protonix for ulceration prophylaxis. 6. hematologic issues: the patient is currently on lovenox given his history of deep venous thrombosis for pulmonary embolism prophylaxis. his white blood cell count and hematocrit have been stable. 7. endocrine issues: the patient is on a regular insulin sliding-scale given the multiple stressors and traumatic nature of his injuries. he is not a diabetic, and his glucose levels have been stable in the 80s to low 100 range. 8. respiratory issues: the patient has currently been weaned to nasal cannula with respiratory rates varying in the 20s to 30s. he is receiving frequent chest physiotherapy with albuterol and atrovent nebulizer treatments and occasional nasogastric tube suctioning for retained secretions. current chest x-rays show no infiltrate; however, there was persistent collapse of the right lower and middle lobes. physical examination on discharge: the patient was afebrile, heart rate was 100, his blood pressure was 140s/70s, his respiratory rate was 30 to 40, and his oxygen saturation was 96% on 4 liters via nasal cannula. the patient was alert and tremulousness. he followed commands and moved all extremities. the neck was supple and nontender. chest was coarse bilaterally with decreased breath sounds at the right base. heart was regular in rate and rhythm. the abdomen was soft and nondistended. the incision was healing well. the pelvis was stable. extremities were warm with generalized anasarca. the medial thigh skin graft with good take. there was no evidence of cellulitis. there was approximately a 1-cm area with granulation tissue. discharge disposition: the patient is currently awaiting placement in an acute rehabilitation facility with special attention to pulmonary toilet. discharge instructions/followup: 1. the patient is to receive aggressive and frequent chest physiotherapy in addition to regular physiotherapy for severe deconditioning. 2. the patient's diet consists of frequent small meals given fatigue on his recent swallow evaluation. thin liquids should be administered via a straw with supervision. 3. the patient is to have a nonadherent dressing to his right medial thigh wound changed twice per day. 4. the patient was instructed to follow up with dr. from plastic surgery one to two weeks after discharge. 5. the patient was instructed to follow up with the orthopaedic surgery clinic in one week from discharge. 6. the patient was instructed to follow up with the trauma clinic two weeks from discharge. medications on discharge: 1. protonix 40 mg by mouth q.24h. 2. carbidopa/levodopa 25/25-mg tablets one tablet by mouth q.4h. 3. lovenox 40 mg subcutaneously q.12h. 4. albuterol nebulizers q.4h. 5. atrovent nebulizers q.4h. 6. combivent inhaler 1 to 2 puffs inhaled q.6h. as needed. 7. tylenol 325 mg to 650 mg by mouth q.4-6h. as needed. of note, during this hospitalization, the patient was noted to have an allergic reaction to both zosyn and levofloxacin. , e. m.d. dictated by: medquist36 procedure: insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube interruption of the vena cava exploratory laparotomy arterial catheterization transfusion of packed cells transfusion of other serum other myectomy transfusion of platelets other irrigation of wound other immobilization, pressure, and attention to wound phlebography of other intra-abdominal veins using contrast material diagnoses: closed fracture of sternum injury to other intra-abdominal organs without mention of open wound into cavity, peritoneum closed fracture of five ribs closed fracture of acetabulum injury to other specified blood vessels of lower extremity closed fracture of shaft of fibula alone injury to kidney without mention of open wound into cavity, hematoma without rupture of capsule open wound of hip and thigh, complicated 

Answer: The patient is high likely exposed to