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 fall epistaxis major surgical or invasive procedure: none history of present illness: 80yo female with a history of afib on coumadin. she tripped this evening and fell directly onto her face. ems was called and she was brought to . she had has persistent epistaxis from both sides of her nose since arrival that did not stop with afrin and pressure. she continues to have blood and clots going back into her oropharynx and has not been stable to go to ct scan due to excessive oropharyngeal bleeding. past medical history: atrial fibrillation - on coumadin social history: lives alone family history: noncontributory physical exam: upon admission: pe: 99.2 104 215/103 (then down to 146/58) 12 96%ra gen: awake and alert, answering questions appropriately. blood actively dripping from nose and covering chest and hands. eyes:bilateral periorbital ecchymosis face: depression over left frontal sinus. nasal dorsum widening. facial nerve intact. au: eacs clear. bilat hemotympanum. speech discrim ~20db bilat. nc: diffuse bleeding from both sides, l>r. pledgets soaked in afrin/lidocaine placed in bilat nares. laceration of nasal floor on left side. possible additional source of bleeding posteriorly. limited visualization due to blood in nasal cavity. septum deviated to the right. ten cm merocel placed on left with slowing of blood anteriorly. persistent clot in nasopharynx/oropharynx. right side initially slow ooze, then developing into a brisk bleed. unable to pass rhinorocket due to septal deviation. ten cm merocel placed on right. oc/op: bloody streaking. blood clots evacuated. no visible lesions. larynx/hp: deferred neck: soft, non-tender. no step-offs over laryngeal cartilage. no point tenderness. no lymphadenopathy. pertinent results: 09:37pm hgb-9.3* calchct-28 09:36pm wbc-12.5*# rbc-2.86*# hgb-8.8*# hct-26.1*# mcv-91 mch-30.6 mchc-33.5 rdw-13.5 09:36pm plt count-216 04:00pm glucose-121* urea n-16 creat-0.6 sodium-141 potassium-3.9 chloride-105 total co2-27 anion gap-13 04:00pm wbc-7.8 rbc-4.08* hgb-12.5 hct-37.0 mcv-91 mch-30.6 mchc-33.6 rdw-13.6 04:00pm plt count-257 04:00pm pt-23.0* ptt-35.2* inr(pt)-2.2* ct head w/o contrast 4:17 pm non-contrast head ct: there is no acute intracranial hemorrhage, edema, mass, shift of normally midline structures or hydrocephalus. density values of the brain parenchyma are within normal limits. there is opacification of the right maxillary sinus, and a fluid level in the left maxillary sinus. ethmoid air cells appear opacified. there is nasal bone fracture. facial bone fractures are described in the separate report of a maxillofacial ct. impression: 1. no acute intracranial hemorrhage. 2. for detailed description of facial bones fractures please refer to separate report of sinus ct. ct sinus/mandible/maxillofacial w/o contrast 4:18 pm technique: contiguous axial images were acquired through the paranasal sinuses. coronal reformatted images were obtained. no intravenous contrast was administered. findings: there are nondisplaced fractures of the nasal bones bilaterally, anterior nasal septum, and anterior nasal spine. there are nondisplaced fractures of the left lateral, medial and anterior wall of maxillary sinus as well as lateral and anterior walls of the right maxillary sinus. there is a displaced fracture of the medial wall of the right maxillary sinus. there is leftward deviation of the nasal septum, of uncertain chronicity. the inferior orbital wall, lamina papyracea, pterygoid plates, as well as zygomatic arches are intact. there is blood in the maxillary sinuses bilaterally, nasal cavity as well as ethmoid air cells. the globes are intact with no vitreous hemorrhage. there is extensive preseptal soft tissue swelling, however, there is no retrobulbar hematoma. the lenses are in place. there is no mandible fracture. the evaluation of the alveolar ridge is limited by significant artifact from dental hardware. there is packing material in the patient's right nasal cavity with two fluid filled balloons, one in the nasopharynx and another one just the very anterior aspect of the nasal cavity, as confirmed with clinical team. impression: multiple facial bone fractures, including nasal bones bilaterally, anterior nasal septum, anterior nasal spine, medial, lateral and anterior walls of maxillary sinuses bilaterally. ct c-spine w/o contrast 4:17 pm non-contrast cervical spine ct: there is no acute fracture or abnormal listhesis. osseous structures are diffusely demineralized. there is exaggerated cervical lordosis. atlantoaxial and atlanto-occipital relationships are maintained. prevertebral soft tissues are unremarkable. the airway is patent. fluid-filled balloon, related to packing is noted in the nasopharynx. small amount of secretions seen in the airways. imaged lung apices are clear. facial bone fractures are described in detail in the separate report of maxillofacial ct, dated . impression: 1. no evidence of acute fracture or abnormal alignment of the cervical spine. 2. for detailed description of the facial bones fractures, please see separate report of sinus ct. brief hospital course: she was admitted to the trauma service. she was given ffp and vitamin k in the emergency room given that she was on coumadin for a-fib. plastic surgery and ent/otrl were consulted given her injuries. she required nasal packing in the emergency room and was then transferred to the nursing unit where she was monitored closely. her hematocrit drop; serial values were followed and have been stable. her most recent hematocrit was 27.5 on . the nasal packing was removed several days after being placed and there have been no further signs of bleeding. she was transfused with 2 units packed cells. although patient reported that she tripped and fell, she is not sure if she in fact felt dizzy prior to her fall. an echo and duplex carotid ultrasound were ordered; her carotid study revealed 40% stenosis. the echo will be done as an outpatient. she will also need to follow up with her pcp : resuming her coumadin; this was not restarted in the hospital given her significant epistaxis. she was also evaluated by geriatrics given her age and mechanism of injury. physical and occupational therapy also evaluated her and have recommended home with services. medications on admission: coumadin discharge medications: 1. digoxin 125 mcg tablet sig: one (1) tablet po daily (daily). 2. therapeutic multivitamin liquid sig: five (5) ml po daily (daily). 3. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 4. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po daily (daily). 5. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 6. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain. 7. milk of magnesia 800 mg/5 ml suspension sig: thirty (30) ml's po twice a day as needed for constipation. 8. afrin 0.05 % aerosol, spray sig: one (1) nas nasal once a day as needed for nose bleed: use only once as directed prn for episode of any nose bleeding. discharge disposition: home with service facility: homecare discharge diagnosis: s/p fall epistaxis right orbital, nasal and maxillary fractures acute blood loss anemia discharge condition: good discharge instructions: return to the emergency room if you develop any fevers, chills, headache, dizzines, chest pain, shortness of breath, abdominal pain, nausea, vomiting, diarrhea and/or any other symptoms that are concerning to you. if you experience another episode of nose bleeding use the afrin spray immediatley and apply direst pressure; go to the nearest emergency room. we are recommending that your coumadin not be resumed; this decision will need to be discussed between you and your primary cae doctor. followup instructions: follow up in clinic only as needed for any concerns related to your facila fractures, which were non-operative call for an appointment if one is needed. follow up in clinic next week with dr. , call for an appointment. follow up with your primary care doctor next week regarding the need to resume your coumadin. you will need to call for an appointment. procedure: control of epistaxis by posterior (and anterior) packing diagnoses: acute posthemorrhagic anemia atrial fibrillation osteoporosis, unspecified long-term (current) use of anticoagulants fall from other slipping, tripping, or stumbling closed fracture of malar and maxillary bones closed fracture of other facial bones epistaxis street and highway accidents closed fracture of nasal bones other disorders of middle ear and mastoid 

Answer: The patient is high likely exposed to