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: trauma major surgical or invasive procedure: posterior cervical fusion c2-4 acdf c3-4 history of present illness: hpi: 47 year old male who presented to an osh after a diving accident. he was diving into a pool and collided with someone else striking his neck. per family reports he was immediately flaccid and unable to breathe. ems was called and he was intubated for lack of ability to attempt to breathe on his own. he was transported to an osh in where plain c-spine films were obtained which showed subluxation in his cervical spine and as a result he was transferred to via helicopter for further evaluation. upon arrival he is sedated on propofol and it is reported that he had been overbreathing the vent and was chewing on the endotracheal tube. after receiving his ct scans his sedation was lightened and he was awake alert and interactive. past medical history: parkinson white syndrome s/p ablation social history: married family history: non-contributory physical exam: gen: intubated, not sedated heent: ncat pupils: perrl bilaterally eoms full without nystagmus neck: c-collar in place, trachea appears deviated to left neuro: mental status: awake and alert, cooperative with exam, intubated orientation: oriented to self, hospital, and date when given choices via blinking to answer motor: d b t we wf ip q h at g sensation: intact to light touch consistent with c3 sensory level reflexes: absent no proprioception toes mute rectal exam : zero rectal tone physical exam on discharge ******* pertinent results: head ct: impression: no acute intracranial injury seen. c-spine ct: impressions: 1. multiple fractures and ligamentous injuries result in disruption of all three columns at c3-4 as delineated above, with severe canal narrowing at this level, down to 6 mm in the ap dimension and anterior displacement and clockwise rotation of the c3 vertebral body and bilateral facets with respect to c4. for assessment of extent of cord injury, mri is recommended. 2. transverse fracture extends through the right c4 transverse foramen. ct or mr angiographic study would be recommended to evaluate for injury to the right vertebral artery. c-spine cta: ******** c-spine mri: mpression: 1. disruption of all three columns of the cervical spine at c3-4, with fractures, an anterolisthesis and epidural hematoma, resulting in severe spinal canal narrowing. spinal cord contusion at the levels of c3 and c4. 2. intramural hematoma involving the visualized cervical course of the right vertebral artery, indicative of a dissection. concurrent neck cta indicates complete occlusion of the true lumen from c2-3 through c4-5. ct cspine findings: interval placement of endotracheal tube as well as surgical repair of previously described fracture dislocation of c3-c4 with anterolisthesis and bilateral locked facet. note interval c3-c4 laminectomy and bilateral c3-c4 facetectomy with fusion of c3-c4 with anterior plate and screws fixing c3-c4 with intermediate bone allograft. the surgical hardware is intact. there continues to be c3 on c4 anterolisthesis however improved from grade 4 to grade 1 on this study. again note is made of the left c3 pedicle fracture line. the prominence of the epidural soft tissue is improved compared to prior study and likely related to a combination of venous plexus and resolving traumatic edema. there is opacification of the bilateral mastoid air cells and middle ear spaces (right greater than left) as well as the sphenoid and bilateral maxillary sinuses. impression: status post c3-c4 laminectomy and bilateral facetectomy with fusion of c3-c4 with placement of bone strut. hardware intact, improved anterolisthesis of c3 on c4, from grade 4 to grade 1. prominence of epidural soft tissue from c2-c4 is improved. brief hospital course: the patient was admitted to the icu under the neurosurgery service for close monitoring. he was loaded with decadron and kept on sedation while intubated. an mri was obtained which demonstrated subluxation at c3 with severe cord damage. he was initially placed on pressors for blood pressure support, but on hd #3 he no longer reauired this. he was thoroughly pre-op screened for surgery to undergo c2-5 posterior fusion and laminectomies. : pt underwent c2-5 laminectomies and fusion on this day. he tolerated this procedure very well with minimal blood loss. a jp drain was placed post operatively and the pt was transfered back to the icu for continued care. pt was started on antiobiotics on for presumed pneumonia. upon post op exam the pt remained unchanged. he was awake and alert and following commands with shrugging shoulders. he had no motor movement in his four extremities and he remained intubated though he was breathing over the ventilator. : the patient was taken to the operating room for a c3-4 acdf on this day. he tolerated this procedure well with minimal blood loss and no complications. he did undergo an ivc filter after his acdf and did tolerate this very well. post operatively pt continued his cervical collar and was again transfered back to the icu for continued management. his jp drain had minimal output overnight and it was removed on . on , a cxr demosntrated a new l lobe consolidation. he underwent brochoscopy and thick secretions were found. infectious disease team was consulted for proper abx coverage recommendations and he was started on vancomycin, ciprofloxacin and meropenem for ventilator aquired pneumonia. additionally and he was continued on iv fluids. blood cultures were obtained and were negative as of this date. pt continued on triple antibiotic coverage for pna and vancomycin levels were followed prior to every fourth dose. his current level is 16.1 and within the therapeutic range. he is planned for tracheostomy and peg today. he will continue his vap protocol for a total of ten days. 8/4-5 pt started on tubefeeds and advanced to goal without difficulty. sedation was weaned and he was noted to be more awake and alert. his physical exam remained stable and still showed a t5 sensory level and full trapezius strength. he underwent another bronchoscopy and continued on his antibiotic regimen for ventilator aquired pneumonia. his serum sodium was noted to increase to 150 and he was started on free water boluses of 200cc every 8 hours and serum na levels were checked every 12 hours. pt required bronchoscopy again for desaturations and bradycardia. tube feeds on hold for severe dilatation of bowels. sutures and staples removed from posterior cervical incision site. exam remained neurologically stable. pt has remained afebrile and has finished a 10 day course for pneumonia. his antibiotics have been discontinued and he has been doing well. pt will be discharged to rehab facility in stable condition. medications on admission: none discharge medications: . 1. magnesium hydroxide 400 mg/5 ml suspension : thirty (30) ml po q6h (every 6 hours) as needed for constipation. 2. chlorhexidine gluconate 0.12 % mouthwash : fifteen (15) ml mucous membrane (2 times a day). 3. docusate sodium 50 mg/5 ml liquid : one (1) po bid (2 times a day). 4. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) as needed for constipation. 5. bisacodyl 10 mg suppository : one (1) suppository rectal hs (at bedtime) as needed for constipation. 6. phenol 1.4 % aerosol, spray : one (1) spray mucous membrane prn (as needed) as needed for sore throat. 7. oxycodone 5 mg/5 ml solution : ml po q3h (every 3 hours) as needed for pain. 8. acetaminophen 650 mg/20.3 ml solution : 650-1000mg mg po q6h (every 6 hours) as needed for fever/pain. 9. heparin (porcine) 5,000 unit/ml solution : 5000 (5000) units injection tid (3 times a day). 10. white petrolatum-mineral oil 56.8-42.5 % ointment : one (1) appl ophthalmic prn (as needed) as needed for dry eyes. 11. polyvinyl alcohol 1.4 % drops : 1-2 drops ophthalmic prn (as needed) as needed for dry eyes. 12. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 13. lorazepam 0.5 mg tablet : one (1) tablet po q8h (every 8 hours) as needed for agitation. 14. citalopram 20 mg tablet : one (1) tablet po daily (daily). 15. ondansetron 4 mg iv q8h:prn nausea 16. metoclopramide 10 mg iv q8h 17. hydromorphone (dilaudid) 0.5-1 mg iv q2h:prn pain discharge disposition: extended care facility: - discharge diagnosis: c3-c4 displaced fractures with resulting spinal cord injury discharge condition: activity status: get oob to cardiac chair as tolerated. cervical collar at all times. discharge instructions: cervical spine surgery wound care: ?????? you may shower, however try not to let the water run directly over the incision. you not soak the incision in a bathtub or pool for 4 weeks. if your wound gets wet, gently , not rub the wound dry. ?????? your incision was closed with dissolvable sutures under the skin. there are steri-strips in place, and these should stay on until the fall off on their own. the edges may begin to curl, and these may be trimmed. ?????? you may remove the dressing after 2 days after surgery. if there is still a small amount of bloody drainage, you can place a new sterile gauze dressing, otherwise you can leave the wound open to air. pain: ?????? hoarseness, sore throat, or difficulty swallowing may occur in some patients and should not be cause for alarm. these symptoms usually resolve in 1 to 4 weeks. ?????? take your pain medication as prescribed. you will likely only require narcotic pain medication for 2-3 days. after that timeframe, over the counter tylenol or acetaminophen will be sufficient. medications: ?????? take all of your medications as ordered. you do not have to take pain medication unless it is needed. it is important that you are able to cough, breathe deeply, and be comfortable enough to walk. ?????? do not use alcohol while taking pain medication. ?????? medications that may be prescribed include: ?????? narcotic pain medication such as dilaudid, percocet or vicodin ?????? muscle relaxant such as robaxin, flexeril or valium. take these as needed for muscle spasm. they will make you sleepy, so do not drive while taking these medications ?????? an over the counter stool softener for constipation (try dulcolax, milk of magnesia or ?????? correctal at first and magnesium citrate or fleets enema if needed). miscellaneous: * you have had a fusion, do not use non-steroidal anti-inflammatory drugs (nsaids) (e.g., aspirin; ibuprofen, advil, motrin, nuprin; naproxen sodium, aleve) for 6 months after surgery. nsaids may cause bleeding and interfere with bone healing. * do not smoke. smoking delays healing by increasing the risk of complications (e.g., infection) and inhibits the bones' ability to fuse. followup instructions: follow-up appointment instructions ??????please call ( to schedule an appointment with dr. to be seen in 4 weeks. you will need ap and lateral cervical spine x rays in your collar at follow up appointment procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more interruption of the vena cava enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] other intubation of respiratory tract other exploration and decompression of spinal canal temporary tracheostomy closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus other cervical fusion of the anterior column, anterior technique excision of intervertebral disc repair of vertebral fracture angiocardiography of venae cavae fusion or refusion of 2-3 vertebrae diagnoses: acute kidney failure, unspecified occlusion and stenosis of vertebral artery without mention of cerebral infarction pulmonary collapse acute respiratory failure hypotension, unspecified methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site paralytic ileus hyperosmolality and/or hypernatremia ventilator associated pneumonia accidents occurring in residential institution quadriplegia, unspecified accident from diving or jumping into water [swimming pool] inhalation and ingestion of other object causing obstruction of respiratory tract or suffocation closed fracture of c1-c4 level with unspecified spinal cord injury foreign body in other specified parts bronchus and lung 

Answer: The patient is high likely exposed to