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: past medical history: 1. lupus erythematosus. 2. raynaud's disease. 3. prior skull fracture. past surgical history: 1. significant for laparoscopy for infertility. 2. carpel tunnel release. medications: 1. plaquenil 200 mg once a day. 2. aspirin. allergies: 1. penicillin. 2. tetracycline. 3. bactrim. physical examination: upon presentation at the , the patient's vital signs were 96.5 f, 92, 98/47, 12 and 95%. the patient was intubated and sedated. her pupils were round and reactive to light from 3 to 2 mm bilaterally. the patient had good bilateral breath sounds with rhonchi heard on the right side. cardiovascular exam revealed regular rate and rhythm. abdominal exam was soft. rectal heme negative. pelvic exam was stable as far as osseous structures. extremity exam showed a right upper extremity that was splinted and a right lower leg approximately 4 cm laceration with bone visible deep within the wound. laboratory data on admission: included a blood gas of 7.48, 26, 404, 20 and negative 1. cbc revealed a white count of 24.4, hematocrit of 27.6 and platelets of 227. chemistries were significant for a sodium of 137, potassium 3.7, chloride 114, bicarbonate 17, bun 13 and creatinine of 0.6 with a glucose of 202. chest x-ray revealed a right second rib fracture with subcutaneous air, right pneumothorax, left superior and inferior pubic rami fractures. ct scan of the head revealed a left temporal intraparenchymal hemorrhage and a right extraaxial hemorrhage at the middle cranial fossa. ct scan of the chest showed, again, the right rib fracture, a pneumothorax on the right and a right hemothorax. ct scan of the abdomen was positive for free fluid, grade ii to iii splenic laceration, left kidney hypodensity, right sacral fracture and a probable right superior ramus fracture as well as a left superior and inferior rami fractures. right upper extremity plain films showed a mid shaft transverse fracture of the right humerus and right lower extremity plain films showed a fracture of the proximal right fibula which was nondisplaced. hospital course: plan at time of admission was for minimal sedation and dilantin loading subsequent to the intraparenchymal hemorrhage and subdural and epidural hemorrhage on the right. orthopedics was additionally consulted for evaluation of the patient's numerous osseous fractures. neurosurgery was also consulted for further management of the patient's intracranial hemorrhages. on hospital day #2, the neurosurgery service was consulted for placement of icp pressure monitor. this procedure was performed by dr. , the neurosurgery chief resident at the bedside and the procedure was completed without complication. the patient continued to be intubated and sedated. also on hospital day #2, the patient was taken to the operating room for repair of her short gastric vessels. abdominal - drains were placed at the time of the surgery. on hospital day #3, the patient began to receive mannitol for increasing intracranial pressure and also received a repeat head ct scan after placement of the intracranial pressure monitor. in addition, a jugular bulb catheter was placed. the patient continued to receive care in the trauma sicu where she continued to intubated and sedated. on postoperative ay #1, her midline abdominal wound was open with dry sterile dressing and her abdomen was overall soft and nontender. on hospital day #3, the patient had a temperature of 101.5 f overnight, but otherwise had stable vital signs. in addition, her intracranial pressure was under better control after receiving mannitol. on hospital day #3, the patient continued to be intubated and sedated and was maintaining good cerebral profusion pressures (cpp) under the regimen of p.r.n. mannitol for a sustained intracranial pressure greater than 20 mghg. on hospital day #4, the patient continued in the trauma sicu. as the patient's hematocrit continued to trend downwards, the patient was assessed to require a splenectomy which was performed on . this procedure was performed by dr. . on hospital day #5, the patient was improving neurologically, which as assessed during q. four hour scheduled breaks in her sedation. during these times she was following commands. her pupils were responsive. chest clear. heart regular. as the patient's intracranial pressure had been stable for greater than 48 hours, the intracranial pressure monitor was discontinued on . on , the patient also received an angiogram performed by dr. from the neurosurgery service. this study revealed vertebral artery dissection. subsequent to these findings, the recommendation of the neurosurgery service was to obtain a baseline mra, mri as well as to start antiplatelet agents as well as these medications could be tolerated by the patient in view of her other system problems. the patient neurological status continued to improve steadily in the trauma sicu and the patient was was responding to questions appropriately, consistently. no major changes to the management plan were made for this patient during her recovery in the trauma sicu until when the patient's ventilator settings were titrated down to 5 cm pressure support above 5 cm of peep. the patient continued to be weaned off ventilation and otherwise neurologically stable as assessed both clinical and by repeat head ct scan. on , otolaryngology service was consulted to evaluate this patient's injuries including left temporal lobe fracture, temporal bone fracture and other hospital sources of her recurrent low grade fever. their recommendations were that facial nerve functions would need to be reassessed when the patient was less sedated and able to follow commands. regarding the fluid observed by ct scan in the temporal bone, otolaryngology service opinion that this was likely secondary to positioning and fracture. they did not believe this was the likely source of fever. their recommendation for work up of this temporal bone fluid was repeat ct scan in one week if no other source of fever was found. on , the patient was extubated and was saturating well on oxygen by face mask. on , the patient was nodding appropriately to questions and complaining of right arm and throat pain. the patient continued to have low grade fevers with increased heart rate and respiratory rate consistent with physiologic response to fever. over the next several days, the patient continued to be awake, alert and interactive with normal neurologic findings. on , the oral and maxillofacial surgery service was called to assess the patient for possible mid face fractures. their recommendation was to obtain head ct scan for better visualization of the fascial skeleton. also on , the patient received a consult by the speech and swallow service. the patient did not display any overt signs or symptoms of aspiration at the bedside, however final aspiration was not able to be assessed due to the patient's inability to participate in the video swallow study due to pain and lethargy. on , the patient continued to recover nicely in the trauma sicu and she was started on a diet of clear and thickened liquids. on , the patient received an evaluation by physical and occupational therapy. occupational therapy recommended that the patient be fitted for a soft splint for her right hand to correct her wrist drop. the order for this device was placed through the ortho service. physical therapy's assessment of the patient was that the patient present was functioning well below her baseline function with impaired mobility and cognition and that she would benefit from inpatient rehabilitation. on , the patient received a video swallow study which showed functional swallowing ability for soft solids and thin liquids without aspiration. the recommendations of the oropharyngeal swallowing team was that the patient eat only when she is sitting upright, preferably in a chair and that the patient swallow with chin to chest to prevent pocketing of the food in her valleculae. on , the patient was awake, alert and oriented to self and date. this represented a substantial neurologic improvement from the time of her admission and from the time that the patient spent in the trauma sicu. on hospital day #18, the patient continued to recover nicely on the floor showing gradual improvement in her neurologic function from day to day. on , a psychiatry consultation was obtained. recommendations of the psychiatry service were that haldol was appropriate for agitation p.r.n. a one to one observer was recommended for the safety of the patient and it was suggested that benzodiazepines be excluded from medical regimen upon the possibility that these may paradoxically disinhibit her. for the remainder of the hospital course, the patient continued to be followed by the neurosurgery service as well as physical therapy. social work was consulted to arrangement for placement of the patient in an appropriate rehabilitation and such a placement was obtained on . at this time, the patient was discharged to the rehabilitation center in good condition with instructions appropriate to her hospital course. condition on discharge: good. discharge status: approved. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances other surgical occlusion of vessels, abdominal arteries total splenectomy closure of skin and subcutaneous tissue of other sites delayed closure of granulating abdominal wound other diagnostic procedures on brain and cerebral meninges open reduction of fracture with internal fixation, humerus other irrigation of wound diagnoses: motor vehicle traffic accident involving collision with pedestrian injuring pedestrian hemorrhage complicating a procedure closed fracture of one rib traumatic pneumothorax without mention of open wound into thorax injury to spleen without mention of open wound into cavity, laceration extending into parenchyma closed fracture of shaft of humerus open fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, with brief [less than one hour] loss of consciousness open fracture of base of skull with other and unspecified intracranial hemorrhage, with brief [less than one hour] loss of consciousness injury to gastric artery 

Answer: The patient is high likely exposed to