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: 2 days of headache and neck pain major surgical or invasive procedure: exploration of neck wound with posterior decompression and evacuation of hematoma ivc filter placement history of present illness: this is a 24 year old man admitted to the neurosurgery service on following flu like symptoms including neckache and headache. imaging of head and spine demonstrated chiari malformation/cervical and thoracic syringomyelia. suboccipital craniectomy was performed on . post operative course was complicated by r pulmonary artery pe. he was also treated for possible pneumonia. there was some l arm weakness and l sided arm and leg numbness several days post operatively without clear cause identified despite ct brain/repeat imaging of c-spine. he was discharged to rehab on . he had been progressing well at rehab. inr had been low (1.45) and increased coumadin given. also covered over last several days with therapeutic doses of lovenox. rehab notes indicate anticipation of discharge home today. unable to participate in ot today due to neck pain and referred for mri. the patient notes increasing neck discomfort and headache over the last 2 days. he has persistent lue weakness much the same as previously. denies fall at rehab. mri was performed at which showed postoperative changes and small r paraspinal hematoma. he was transferred here for further care. the patient admits to some low mood recently. overwhelmed by current illness. appetite has been okay. he has no complaints of fever, cough, rhinorrhoea, nausea, vomiting, diarrhoea, urinary symptoms. past medical history: -chiari i malformation with cervical/thoracic syringomyelia s/p suboccipital craniectomy with posterior fossa decompression () -pe -pneumonia asthma social history: rehab. previously living alone in . working at a school for children with autistic spectrum disorders. has girlfriend. mother resident in . lifetime non-smoker. denies etoh and drugs. family history: noncontributory physical exam: t-98.6 bp-137-138/76-83 hr-62-106 rr-20 o2sat 96-97% ra gen: lying in bed on left side heent: nc/at, moist oral mucosa, thick coating around inside of lips neck: well healed midline posterior cervical wound without warmth or discharge. generalised tenderness to palpation midline neck. decr rom. back: no point tenderness or erythema cv: rrr, nl s1 and s2, no murmurs/gallops/rubs lung: decr ce bilat; decr ae bilat; clear to auscultation, no added sounds abd: +bs soft, nontender ext: no edema neurologic examination: mental status: awake and alert, cooperative with exam, flat affect. oriented to person, place, and date. speech is fluent with normal comprehension and repetition; naming intact. no dysarthria. no right left confusion. no evidence of apraxia or neglect. cranial nerves: pupils equally round and reactive to light, 3 to 2 mm bilaterally. visual fields are full to confrontation. extraocular movements intact bilaterally, nystagmus bilat extremes of horizontal gaze. sensation intact v1-v3. facial movement symmetric. hearing intact to finger rub bilaterally. palate elevation symmetrical. sternocleidomastoid and trapezius normal bilaterally. tongue midline, movements intact. motor: normal bulk bilaterally. tone normal. no observed myoclonus or tremor no pronator drift tri wf we fe ff ip h q df pf te tf r 5 5 5 5 5 5 5 5 5 5 5 5 5 5 l 4 4+ 4- 5- 5- 5- 5- 5 5 5 5 5 5 5 sensation: intact to light touch sl decr on left foot, vibration and proprioception intact bilat le. no extinction to dss reflexes: +2 and symmetric throughout. toes downgoing r, up on l. coordination: finger-nose-finger normal. gait/romberg: deferred pertinent results: 135 98 12 111 agap=16 4.3 25 0.9 estgfr: >75 (click for details 78 20.5 d 15.8 368 d 43.1 n:91.4 l:6.3 m:1.8 e:0.2 bas:0.3 pt: 20.8 ptt: 34.3 inr: 2.0 osh mri of c-spine shows rounded fluid collection in paraspinal muscles on r side of cervical spine with fluid level. possible hematoma ?acute versus subacute. post-operative changes with seroma. ct neck: large complex fluid collection in the surgical bed with characteristics consistent with new hemorrhage in this region. the mild enhancement could be post-operative, though infection cannot be excluded. nchct:no intracranial hemorrhage. postsurgical change in the 4th ventricle, posterior fossa, and c1 related to recent surgery for chiari malformation. cxr: decr lung volumes, no consolidation mri c-spine : new hemorrhage into the fluid collection within the surgical bed, causing increasing compression of the cervicomedullary junction and an increase in the size of the syrinx. the new enhancement of the dural graft could represent inflammation or infection. brief hospital course: 24y man s/p posterior decompression for chiari malformation type 1 on with increasing neck pain and headache. examination showed progressive lue weakness and mri of c-spine showed hematoma in operative site. on the day of admission, he had decreased o2 saturation in abg; cta done and acute pe was ruled out. aspiration pneumonia was indicated and is treated with ceftriaxone for 10 days. his abg improved to normal after the surgery. bilateral lower extremity ultrasound was also performed which no evidence of dvt. the patient was taken to the or for evacuation of hematoma on , following reversal of inr and ivc filter placement. the following day () patient was extubated, placed in a soft collar and transferred to the step down unit. a hematology consult was then obtained. hematoloy recommended coumadin for possible hypercoagulable state for 6 months while pulmonology recommended no anticoagulation. after thorough discussion, it was agreed that the patient should be anticoagulated and a heparin drip was to be started pod 7 to reduce the risk of head bleed. on a speech and swallow consult was obtained and after performing a bedside swallow they recommended that the pt be advanced to a diet of thin liquid (by cup) and soft consistency solids and pills were to be given whole or crushed. culture from the operating room showed no growth, blood culture showed no growth; and sputum cultures were positive for gnr and gpc, which was treated with ceftriaxone and placed on aspiration precautions. on patient's surgical drain was removed. patient is to continue on ceftriaxone until and to have his soft collar in place for 2 weeks medications on admission: coumadin 5mg po qhs flexeril 5mg po tid prn colace 100mg po bid bisacodyl 5mg po qd protonix 40mg po qd tylenol 650mg po q4h prn percocet-5 5/325 q4h pr prn hydromorphone 1-2mg po q6h prn nystatin 5ml po qid prn discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. cyclobenzaprine 10 mg tablet sig: one (1) tablet po tid (3 times a day) as needed for neck pain. 3. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 4. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h (every 6 hours) as needed. 5. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day) as needed. 6. albuterol sulfate 0.083 % (0.83 mg/ml) solution sig: one (1) inhalation q6h (every 6 hours) as needed. 7. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed. 8. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed). 9. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) units injection tid (3 times a day): sc injection. 10. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 11. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily). 12. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 13. ceftriaxone-dextrose (iso-osm) 1 g/50 ml piggyback sig: one (1) gm intravenous q24h (every 24 hours). discharge disposition: extended care facility: northeast - discharge diagnosis: 1) posterior cervical hematoma 2) aspiration pneunomia 3) chiari malformation type i s/p posterior fossa/chiari decompression including c1 and partial c12 laminectomy. discharge condition: stable discharge instructions: ** please start iv heparin drip / po coumadin on . 1) heparin drip: please start with 800 units/hr; no bolus; adjust heparin dose to ptt goal 40-60; check ptt q6h until 2 consecutive therapeutic then can be checked qd; d/c heparin when coumadin therapeutic. 2) coumadin goal is inr 2.0 - 3.0. ** please have your staples removed between - ?????? do not smoke ?????? keep wound(s) clean and dry / no tub baths or pools for two weeks from your date of surgery ?????? no pulling up, lifting> 10 lbs., excessive bending or twisting ?????? limit your use of stairs to 2-3 times per day ?????? have your incision checked daily for signs of infection ?????? please wear soft cervical collar for two weeks from your date of surgery. * you may shower briefly and pat dry your incision with clean towel. ?????? take pain medication as instructed; you may find it best if taken in the a.m. when you wake for morning stiffness and before bed for sleeping discomfort ?????? do not take any anti-inflammatory medications such as motrin, advil, aspirin, ibuprofen etc. unless directed by your doctor ?????? increase your intake of fluids and fiber as pain medicine (narcotics) can cause constipation ?????? clearance to drive and return to work will be addressed at your post-operative office visit call your surgeon immediately if you experience any of the following: ?????? pain that is continually increasing or not relieved by pain medicine ?????? any weakness, numbness, tingling in your extremities ?????? any signs of infection at the wound site: redness, swelling, tenderness, drainage ?????? fever greater than or equal to 101?????? f ?????? any change in your bowel or bladder habits followup instructions: you have been scheduled to see dr , md (phone:) on at 11:00. please have a brain mri done in radiology (phone:) on 10:00 prior to your appointment with dr . procedure: interruption of the vena cava reopening of laminectomy site diagnoses: hematoma complicating a procedure asthma, unspecified type, unspecified pneumonitis due to inhalation of food or vomitus other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation personal history of venous thrombosis and embolism 

Answer: The patient is high likely exposed to