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: s/p motor vehicle crash major surgical or invasive procedure: exploratory lap and repair of diaphragmatic injury washout and debridement of left open tibia fracture to bone; closed reduction left supracondylar femur fracture with manipulation; closed reduction left proximal tibia fracture with manipulation; application multiplanar external fixator; im nail left femur and closed reduction right wrist fracture with manipulation. history of present illness: 22-year-old male restrained driver, who was involved in a motor vehicle crash. he was speaking in the field; was brought to an area hospital and ultimately intubated electively. he was found to have a tension pneumothorax, initially treated by needle decompression followed by placement of a left chest tube. a chest x-ray suggested the presence of the stomach within the left chest, supporting the diagnosis of a traumatic diaphragmatic eventration. he was hemodynamically stable. he was also noted to have a comminuted closed femur fracture with intact distal pulses. he was transferred emergently to for further care given his injuries. past medical history: none social history: graduate student at suffock. patient graduated from . he is a talented musician. family history: noncontributory physical exam: vitals: t 96.2f, tm 99.8f, bp 131/89, hr 115, rr 24, sat 99%ra general: well-appearing, no acute distress heent: mild anisocoria, mucus membranes moist, no sinus tenderness neck: supple, trachea midline card: tachycardic, normal s1/s2, no m/r/g resp: clear to auscultation bilaterally abd: soft, non-distended. mildly tender to palpation over surgical scar. no rebound/guarding. normal bowel sounds. ext: lle in brace, rle leg wrapped; right forearm in cast, lue wrapped; non-pitting edema of ue, le neuro: difficult to perform exam. able to move all extremities, alert and oriented x 3. fluent speech that psych: denies si/hi. endorses occasional visual and auditory hallucinations (no command auditory hallucinations). pertinent results: 12/12/07ct head w/o contrast impression: no acute intracranial hemorrhage. . ct torso with intravenous contrast impression: 1. stomach and spleen located within the thoracic cavity, very concerning for extensive left diaphragmatic rupture, with retraction. 2. left lower lobe collapse/consolidation. 3. patchy opacities predominantly at the right lung base, in the setting of trauma likely represent parenchymal contusions; aspiration is another diagnostic consideration. 3. small amount of intraperitoneal air, an unusual finding in a setting of blunt trauma, and free fluid, likely related to chest tube placement, traversing the peritoneal space. while no bowel injury is seen, this cannot be completely excluded. comparison with any ct done prior to the chest tube placement would be most helpful if available. . . left elbow film. impression: extensively comminuted, intra-articular left olecranon fracture. . . left leg film. impression: extensively comminuted fractures of the distal femur and proximal tibia, with displaced and angulated fractures of the proximal femur and fibula. . . brain mri. impression: normal study. . . lenis. impression: no ultrasonographic evidence of dvt. . . echo. impression: normal study. normal biventricular cavity sizes with preserved global and regional biventricular systolic function. no pericardial effusion. resting tachycardia. wbc-9.3 rbc-4.44* hgb-13.2* hct-39.4* plt ct-844* glucose-163* urean-18 creat-0.7 na-138 k-4.3 cl-96 hco3-31 alt-106* ast-23 ld(ldh)-258* alkphos-405* totbili-0.8 09:55am blood albumin-4.0 calcium-10.4* phos-5.3* mg-2.0 brief hospital course: in summary, mr. is a 22 year old male admitted following motor vehicle accident for multiple fractures and diaphragmatic rupture. hospital course was complicated by delerium, peristent tachycardia, and transaminitis. . s/p mva. patient was admitted to the trauma service and taken directly to the operating room for exploratory lap and repair of his diaphragmatic injury. orthopedics was consulted given his multiple bone fractures; he was taken to the operating room for washout and debridement of left open tibia fracture to bone; closed reduction left supracondylar femur fracture with manipulation; closed reduction left proximal tibia fracture with manipulation; application multiplanar external fixator; im nail left femur and closed reduction right wrist fracture with manipulation. there were no intraoperative complications. . pain. patient had difficulty with pain control initially. pca dilaudid was initiated and the dose was quickly increased to 0.37 mg. dilaudid 1-2 mg iv prn for rescue pain was also added and he did seem to benefit from this. it was discussed with patient and his mother that at some point long acting narcotics would likely be initiated for long term pain control. he was placed on an aggressive bowel regimen. however, patient developed delerium in setting of opioid use, so opioids were discontinued and patient was started on ultram. tylenol is being avoided due to elevated lfts. nsaids are being avoided due to impaired bone healing. opioids are being avoided due to recent delerium. pain was adequately controlled at time of discharge on standing ultram. . delerium. patient developed delerium during hospitalization. it was felt to be due to opioid pain medications which were stopped. patient was evaluated by neurology and psychiatry. vit b12, folate, tsh, rpr within normal limits. lp performed showed no evidence of infection. eeg and brain mri were normal. he was placed on standing seroquel at night. opioids were avoided. delerium resolved and patient was alert and oriented on day of discharged. . elevated transaminases. likely multifactorial etiology, including systemic inflammatory response, medications including zosyn. lfts continue to trend down. alt peaked at 385 on , ast peaked at 220 on , ldh peaked at 457 on . alk phos continued to trend up on discharge, likely secondary to active bone remodeling. acetaminophen was discontinued on . please check lfts weekly until fully resolved. . thrombocytosis. patient had elevated platelet count to 1.5 million, likely reactive thrombocytosis due to systemic inflammatory state due to trauma and multiple operations. platelets were trending down and were 1 million at time of discharge. . tachycardia. patient had sinus tachycardia post-operatively to the 150s, that was thought to be pain and stress related. a pe ct was done and was negative for pe. metoprolol was started to prevent tachycardia-induced cardiomyopathy. an echo was done and was normal. metoprolol is being titrated down beginning on . goal is to stop metoprolol as hr improves. overall tachycardia is improving. . insomnia. patient reported difficulty sleeping due to discomfort, multiple braces/casts in place, etc. he was getting standing seroquel at night with minimal improvement. benzodiazepines and ambien were avoided due to delerium. he was given prn benadryl and standing seroquel. seroquel should ultimately be stopped but patient is currently using it for insomina. . prophylaxis. patient was maintained on lovenox daily. s/p prophylactic ivc filter placement. . communication. patient and mother . medications on admission: none discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. enoxaparin 40 mg/0.4 ml syringe sig: one (1) subcutaneous qd (). 3. miconazole nitrate 2 % powder sig: one (1) appl topical qid (4 times a day) as needed. 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 5. quetiapine 25 mg tablet sig: two (2) tablet po hs (at bedtime). 6. diphenhydramine hcl 25 mg capsule sig: one (1) capsule po q6h (every 6 hours) as needed for itching. 7. hexavitamin tablet sig: one (1) cap po daily (daily). 8. tramadol 50 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain. 9. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po q 8h (every 8 hours). discharge disposition: extended care facility: medical center - discharge diagnosis: primary diagnosis: s/p motor vehicle crash right pulmonary contusion left diaphragmatic rupture left olecranon fracture left femoral shaft fracture left supracondylar femur fracture left proximal tibia fracture left distal radius fracture delirium, resolved discharge condition: good. patient is tolerating oral intake with assistance and able to work effectively with physical therapy. discharge instructions: you were admitted to the hospital after your car accident. you were found to have broken many bones and to have ruptured your diaphragm. you were treated in surgery for your bone fractures and your diaphragm rupture and have done well after surgery. you also became quite confused after your surgery, which was thought most likely secondary to your strong pain medications. after your narcotic pain medications were stopped, your confusion improved greatly. . please take all your medications as prescribed. we have started you on ultram as needed for pain. . if you have any symptoms of fevers, chills, night sweats, shortness of breath, chest pain, lower extremity swelling, upper extremity swelling, lightheadedness, or dizziness, please seek immediate medical attention. followup instructions: please follow-up with your primary care doctor dr. . his address office is: the medical group, inc, , , , . please call him at to schedule an appointment. . follow up with dr. , orthopedics, thursday :10 pm. call if you need to re-schedule your appointment. please arrive 20 minutes early. the office is located on the of clinical center on the of . . follow up with dr. , trauma/surgery in at 10 am. his office is located on the of the clinical center on the of . please call if you need to re-schedule. md procedure: venous catheterization, not elsewhere classified interruption of the vena cava debridement of open fracture site, tibia and fibula open reduction of fracture with internal fixation, tibia and fibula removal of external immobilization device open reduction of fracture with internal fixation, femur open reduction of fracture with internal fixation, radius and ulna closed reduction of fracture without internal fixation, radius and ulna internal fixation of bone without fracture reduction, femur closed reduction of fracture without internal fixation, tibia and fibula closed reduction of fracture without internal fixation, femur other repair of diaphragm computer assisted surgery with fluoroscopy diagnoses: other specified cardiac dysrhythmias other motor vehicle traffic accident involving collision on the highway injuring driver of motor vehicle other than motorcycle traumatic pneumothorax without mention of open wound into thorax drug-induced delirium other and unspecified alcohol dependence, unspecified hepatitis, unspecified closed supracondylar fracture of femur closed fracture of shaft of femur other specified analgesics and antipyretics causing adverse effects in therapeutic use other closed fractures of distal end of radius (alone) closed fracture of olecranon process of ulna essential thrombocythemia systemic inflammatory response syndrome, unspecified open fracture of unspecified part of fibula with tibia injury to diaphragm, with open wound into cavity 

Answer: The patient is high likely exposed to