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: history of present illness: this 86-year-old female was struck by an suv with significant damage to the suv's front end on . the patient had a loss of consciousness after this collision and was taken to an outside hospital where her systolic blood pressure was in the 60s. she was intubated and transfused. she was subsequently transferred to where she was hemodynamically unstable in the trauma bay. she received 6 units of packed red blood cells and 5 liters of crystalloid. status post this treatment her blood pressure improved to about the 120s systolic. the patient was taken to the ct scan for scanning of her head, neck, chest and belly but this scan was aborted once her systolic blood pressures again fell to the 70s. she was then taken to the intensive care unit where bedside echocardiogram was performed and was negative for tamponade. a dpl was also performed which was negative. a chest x-ray showed widened mediastinum and this was followed up by the patient being taken to the angiography suite where no bleeding from the aortic arch or pelvic vessels was demonstrated. as the patient was hemodynamically stable she was taken back to the intensive care unit where a repeat echocardiogram was performed. this study was consistent with significant pericardial fluid. other physical findings in this patient included a right scalp laceration which was closed with staples. her belly was soft but her left thigh was tense on examination with an obvious open left tibia-fibula fracture. admission laboratory studies were significant for an initial hematocrit of 41.0 which fell to 25.8 over the course of a four-hour period. admission electrolytes were largely unremarkable and her initial blood gas was 7.51, 24, 599, 20 and -1. after her hypotensive episodes the gases changed to 7.10, 92, 359, 30 and -3. pelvic x-ray showed no obvious fracture or dislocation and left tibia-fibula film showed an open displaced and comminuted fracture of the tibia and fibula. the orthopedic service was consulted while the patient was in the intensive care unit and their recommendation was that the patient be taken to the operating room on the following day for external fixator placement and open fracture washout of the open fracture. hospital course: in the intensive care unit the plan consisted of aggressive fluid resuscitation including packed red blood cells, fresh frozen plasma and platelets. the respiratory plan was for assisted ventilation. serial hematocrits were checked q. 1 hour. her neurological status was maintained under sedation. bladder pressures were controlled and protonix was initiated. on hospital day two the patient was maintaining her blood pressures at 87/45 with a heart rate of 119. her morning hematocrit was 21.8 which had decreased from 30.2 and 25.8 the previous night. on examination the patient was intubated and sedated, unresponsive in a hard cervical collar. the patient was taken to the operating room early on hospital day two for exploratory laparotomy and pericardial window. this procedure was performed with no complications and a blood loss of approximately 100 cc. there was no obvious source of bleeding identified with either of these procedures. on hospital day two the hematology service was also consulted and their recommendations for fluid resuscitation for this patient included fresh frozen plasma to keep the pt and ptt within normal limits, vitamin k 2 mg intravenous, transfusion of platelets to maintain the platelet count close to 100,000, repletion of calcium, repeat of fibrinogen levels and a search for the patient's source of bleeding. these recommendations were followed by the intensive care unit team. on hospital day three/postoperative day two status post an open tibia-fibula washout, exploratory laparotomy and pericardial window the patient was in stable condition and her hematocrit had increased to 30.4. her blood pressure was 118/65 with a heart rate of 85. the patient was awake but sedated with notable bilateral periorbital edema. she had notable left expiratory wheezes and her abdomen was distended and edematous. she was moving all four extremities spontaneously. the patient was started on levofloxacin for her open fractures until the patient's condition was stabilized sufficiently for closure of her open fractures. on , the orthopedic service took the patient to the operating room where an incision and drainage of her open left tibia-fibula fracture and intramedullary rod fixation was performed. postoperative orders included nonweight-bearing status on the left lower extremity and levaquin intravenous to be continued in light of the patient's previously open fracture. plastic surgery was also consulted and the patient was seen and examined with the plastic surgery attending. recommendation was for bedside debridement. also notable was a vacuum-assisted closure dressing which was in place on the left lower extremity. on postoperative day three the patient was in stable condition with an hematocrit of 32. plastic surgery, orthopedics and interventional radiology services continued to follow and were pleased with the recovery from their respective procedures. the plan from the standpoint of the intensive care unit team was for continued close monitoring of the patient's cardiovascular status, and continuation of the antibiotics for the patient's previously open fracture. on the patient was alert and following commands. her cervical collar was still in place and her cardiovascular status was regular with a chest examination that was clear to auscultation bilaterally. the patient's condition continued to improve in the intensive care unit over the subsequent days. on postoperative days six and four the vacuum-assisted closure dressing was still in place but was scheduled to be changed and the plastic surgery service suggested a soleus flap once the patient's condition stabilized. the vacuum-assisted closure dressing was indeed changed on this day by the orthopedic service and per their description the underlying skin was red and warm with a necrotic edge. there was a large seroma in the lateral aspect of the thigh and palpation of the wound easily expressed a small amount of brownish fluid. in light of the appearance of the wound ancef was added to the antibiotic regimen for broader antibiotic coverage. over the subsequent three intensive care unit days the patient's condition continued to improve including her mental status where she was awake and responsive and following commands. on the patient was taken to the operating room by plastic surgery where a soleus flap to her left leg defect was performed by dr. with the assistance of dr. . the patient was noted to have a significant amount of oozing despite normal coagulations and a platelet count of 96,000. postoperatively the patient recovered well and was weaned to pressor support and cpap. the left leg was bandaged with a moderate amount of serosanguinous oozing. the patient was returned to the surgical intensive care unit for management consistent and appropriate with the patient's postoperative condition. on bilateral pleural effusions were noted in this patient and bilateral chest tubes were placed which were immediately productive of 200-300 cc of serosanguinous fluid. these tubes continued to have high output until approximately when the left chest tube was discontinued as its output had diminished considerably. the right chest tube was continued and the patient was extubated and was saturating well on four liters of oxygen by nasal cannula. on the patient's foley catheter was discontinued and the patient was evaluated by physical therapy who commented that the patient's knee range of motion was still limited and questioned institution of a continuous passive motion therapy. on the patient was transferred to the floor where she received a video swallow evaluation that initially showed aspiration. however repeat video swallow examination showed no overt signs of aspiration and the patient was placed on a diet consisting of honey-thickened liquids with supervised p.o. intake. as the patient's right chest tube output had declined the patient's right chest tube was discontinued on hospital day 17, which was . plastic surgery continued to follow the patient and on the patient was taken to the operating room with the plastic surgery service for a stsg. this procedure was performed by dr. and was more specifically a stsg to the left soleus flap and left lower extremity lateral wound. the procedure also included a wound debridement, evacuation of hematoma of bilateral thighs with wound debridement. the estimated blood loss from this procedure was minimal and the patient was transferred in stable condition to the recovery room. one day after this procedure the plastic surgery service noted that the vacuum-assisted closure on the soleus flaps was outputting minimal amounts of fluid and the setting was changed to 75 mmhg. wet-to-dry dressings were continued at the sites of the hematoma evacuation. on the patient was in stable condition and the plan from the standpoint of the trauma service was to continue pulmonary toilet, to assist the patient out of bed to chair with the assistance of the physical therapy service, continuing the tube feeds, and discontinuing her antibiotics which consisted of vancomycin after her sputum culture had been positive for methicillin-resistant staphylococcus aureus. over the subsequent days the patient was evaluated by physical therapy who commented that the patient's range of motion on her left side was improving but that transfer to an appropriate rehabilitation center for further assistance before resuming her activities of daily living would be necessary. over the subsequent days the patient's condition continued to be stable and as the flap care per the plastic surgery service was followed the patient was assessed to be suitable for discharge on . on the patient was discharged to an appropriate rehabilitation center in stable condition. status at discharge: approved. condition on discharge: good. , m.d. dictated by: medquist36 procedure: insertion of intercostal catheter for drainage continuous invasive mechanical ventilation for 96 consecutive hours or more arteriography of femoral and other lower extremity arteries exploratory laparotomy arterial catheterization other skin graft to other sites graft of muscle or fascia excisional debridement of wound, infection, or burn aortography pericardiotomy debridement of open fracture site, tibia and fibula open reduction of fracture with internal fixation, tibia and fibula closure of skin and subcutaneous tissue of other sites other endovascular procedures on other vessels diagnoses: unspecified pleural effusion acute posthemorrhagic anemia motor vehicle traffic accident involving collision with pedestrian injuring pedestrian open wound of forehead, without mention of complication unspecified disease of pericardium defibrination syndrome closed fracture of pubis open fracture of shaft of fibula with tibia injury to iliac artery 

Answer: The patient is high likely exposed to