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: seasonal attending: chief complaint: neck and bilateral arm pain major surgical or invasive procedure: : anterior cervical, removal of hardware and loose screws : neck exploration, repair of pharynx, direct laryngoscopy history of present illness: patient comes in today for discussion of surgery - revision of cervical fusion, that is scheduled for this week. patient states he has pain in his neck to 2 inches below his elbow bilateral. he states that the pain in his neck is sharp, shooting in nature and the arms are a constant dull ache. left side is worse and he feels his neck cracking. he was initially seen . he also notes difficulty swallowing ct reviewed at that visit. per dr. note: prior surgery with a plate lying anterior at the c4 through c6 levels. the screws at c5 are slightly inferior placed. there is probably nonunion at c4-c5. there are two completely extruded screws inferior to that plate probably coming from the c4 and c5 areas. they are in close contact with the esophagus and potentially causing the symptoms of dysphagia. the risks and benefits of undergoing surgical intervention were discussed with the patient. he now electively presents for acdf revision. past medical history: 1. recurrent syncope of unclear etiology with no arrhythmia identified on extended monitoring with a reveal implanted monitor 2. single, brief episode of atrial fibrillation 3. hypertension 4. hyperlipidemia 5. obesity 6. copd (pft's : moderately severe obstructive defect with significant improvement in bronchodilator, mild reduction in diffusing capacity) 7. prior failed cervical fusion (c3-c5) with implanted hardware 8. history of heavy alcohol use 9. chronic pain 10. benign prostatic hypertrophy 11. anxiety/depression 12. multiple prior infections (reveal pocket, cystitis, multiple abscesses, prostatitis) 13. dysphagia 14. tobacco abuse social history: smokes 1ppd ongoing 13 years, admits to 3 beers a night. he was a manager in retail now applying for disability family history: non-contributory physical exam: from clinic gen: anxious uncomfortable gentleman in no acute distress. hr 100 and bp 146/100 heent: pupils: perrl eoms intact extrem: warm and well-perfused. no c/c/e. neuro: mental status: awake and alert, cooperative with exam, normal affect. orientation: oriented to person, place, and date. language: speech fluent with good comprehension and repetition. cranial nerves: i: not tested ii: pupils equally round and reactive to light, visual fields are full to confrontation. iii, iv, vi: extraocular movements intact bilaterally without nystagmus. v, vii: facial strength and sensation intact and symmetric. viii: hearing intact to finger rub bilaterally. ix, x: palatal elevation symmetrical. : sternocleidomastoid and trapezius normal bilaterally. xii: tongue midline without fasciculations. motor: normal bulk and tone bilaterally. no abnormal movements, tremors. strength full power throughout except in shoulders . no pronator drift. gait is slow sensation: intact to light touch reflexes: 3 + symmetrical throughout toes downgoing bilaterally discharge: avss nad tolerating thick liquids upon swallow evaluation symmetric chest rise full strength ue/ue. incision c/d/i drain removed. dry no focal or diffuse neurologic deficits appreciated. pertinent results: cervical xr - interval removal of metallic hardware from anterior cervical spine. leni: no right lower extremity deep vein thrombosis. cyst in the right popliteal fossa with an area of irregularity possibly representing rupture. : video swallow: 1. no large leak or collection of barium is visible, however, small leak along the left pharyngeal mucosa cannot be excluded. 2. trace penetration with thin liquids. see also the note from the speech pathology division in the electronic medical records for further assessment and recommendations. brief hospital course: pt electively presented and underwent a revision of his previous acdf. surgery was without complication and he tolerated it well. please see operative report for details, but of note there was a hypopharyngeal fenestration discovered during surgery likely caused by free floating hardware. given the injury to his pharynx he remained intubated for 48 hours. on the patient was safely extubated after being seen by ent. during extubation his dobhoff was accidentally removed. ent made two separate attempts to replace it fiberoptically was they were not successful. he had a temperature to 101 overnight. chest xray showed no signs of pneumonia. he was started on unasyn to continue until jp drain was removed. on the patient was stable and was transfered out of the icu. on , patient reported some discomfort overnight and anxiety. he was started on xanax. ent to evaluate and remove jp drain. on patient was complaining of right lower extremity pain and swelling, on exam we noted 1+ pitting edema and ordered a doppler ultrasound which showed a leaking cyst and no dvt. on , patient underwent video swallow which showed no definitive leak. full liquids were started and patient had no evidence of leak overnight. on , drain was removed, patient continued to have a nonfocal intact neurologic exam and was discharged home with instructions to follow up in one week for repeat swallow evaluation to advance diet. medications on admission: . information was obtained from . 1. albuterol inhaler puff ih q6h:prn sob/wheeze 2. citalopram 20 mg po daily 3. dicyclomine 10 mg po qid 4. fluticasone-salmeterol diskus (250/50) 1 inh ih 5. hydrochlorothiazide 25 mg po daily 6. losartan potassium 50 mg po bid 7. tramadol (ultram) 50 mg po q6h:prn pain 8. aspirin 81 mg po daily 9. vitamin d 1000 unit po bid discharge medications: 1. albuterol inhaler puff ih q6h:prn sob/wheeze 2. fluticasone-salmeterol diskus (250/50) 1 inh ih 3. alprazolam 0.5 mg po tid:prn anxiety can be crushed and placed sublingual rx *alprazolam 0.5 mg 1 tablet(s) by mouth three times a day disp #*30 tablet refills:*0 4. aspirin 81 mg po daily 5. citalopram 20 mg po daily 6. dicyclomine 10 mg po qid 7. hydrochlorothiazide 25 mg po daily 8. losartan potassium 50 mg po bid 9. tramadol (ultram) 50 mg po q6h:prn pain 10. vitamin d 1000 unit po bid 11. amoxicillin-clavulanic acid 500 mg po q12h duration: 10 days rx *amoxicillin-pot clavulanate 500 mg-125 mg 1 tablet by mouth q12hr disp #*20 tablet refills:*0 12. oxycodone (immediate release) 5 mg po q4h:prn pain rx *oxycodone 5 mg 1 tablet(s) by mouth q4hr disp #*60 tablet refills:*0 discharge disposition: home discharge diagnosis: failed cervical fusion discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: anterior cervical discectomy and fusion dr. ?????? your large dressing should be off 2 days after surgery. ?????? you have steri-strips in place, you must keep them dry for 72 hours. do not pull them off. they will fall off on their own or be taken off in the office. you may trim the edges if they begin to curl. ?????? do not smoke. ?????? no tub baths or pool swimming for two weeks from your date of surgery. ?????? no pulling up, lifting more than 10 lbs., or excessive bending or twisting. ?????? limit your use of stairs to 2-3 times per day. ?????? have a friend or family member check your incision daily for signs of infection. ?????? you may shower briefly without the collar on if you are sitting and not as risk of falling in the tub or shower. ?????? take your pain medication as instructed; you may find it best if taken in the morning when you wake-up for morning stiffness, and before bed for sleeping discomfort. this medication is as needed for pain, you do not need to take it if you have no pain. ?????? do not take any anti-inflammatory medications such as motrin, advil, aspirin, and ibuprofen etc for 2 weeks. ?????? increase your intake of fluids and fiber, as pain medicine (narcotics) can cause constipation. we recommend taking an over the counter stool softener, such as docusate (colace) while taking narcotic pain medication. ?????? clearance to drive and return to work will be addressed at your post-operative office visit. followup instructions: follow up instructions/appointments ??????please call paresa at ( to schedule an appointment with dr. to be seen in 4 weeks. you will need ap and lateral cervical spine x-rays prior to your appointment. please call upon discharge to schedule an evaluation with speech and swallow to re-evaluate in 1 week. provider: , md phone: date/time: 11:30 provider: , md phone: date/time: 1:00 provider: scan phone: date/time: 11:30 md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours enteral infusion of concentrated nutritional substances laryngoscopy and other tracheoscopy removal of implanted devices from bone, other bones other incision of thyroid field suture of laceration of pharynx diagnoses: other chronic pain tobacco use disorder depressive disorder, not elsewhere classified hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) anxiety state, unspecified hypotension, unspecified surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation obesity, unspecified chronic obstructive asthma, unspecified unilateral paralysis of vocal cords or larynx, partial arthrodesis status other mechanical complication of other internal orthopedic device, implant, and graft dysphagia, unspecified open wound of pharynx, without mention of complication synovial cyst of popliteal space body mass index 36.0-36.9, adult other specified anomalies of upper alimentary tract 

Answer: The patient is high likely exposed to