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: no known allergies / adverse drug reactions attending: chief complaint: s/p fall major surgical or invasive procedure: orif r hand history of present illness: 62 year old man who fell from a tree about 15 feet while helping his son in law trim some branches. he fell onto his ladder. there was no syncopal episode. he presented to the ed with pneumocephalus and multiple facial fractures as well as a right frontal contusion. he was gcs 15 on admission. he reported a right frontal ha, mild neck pain and bilateral hand pain with the assistance of his family as he is portuguese speaking but does speak some english past medical history: pmhx: htn, gout, fatty liver, hypercholesterolemia, kidney stones s/p lithotripsy. social history: he is a right handed portuguese speaking man who is retired from working with glass/construction. he stopped smoking many years ago. he stopped drinking several weeks ago due to fatty liver disease. family history: nc physical exam: per neurosurgery eval: o: t: 96.6 bp: 127/68 hr: 92 r 22 o2sats 93% nc gen: wd/wn, comfortable, in c-collar, right periorbital blood, edema, ecchymosis. heent: pupils: neck: c-collar, tender extrem: warm and well-perfused, pain at hands neuro: mental status: awake and alert, cooperative with exam, normal affect. orientation: oriented to person, place-city/hospital, and date. cranial nerves: i: not tested ii: pupils equally round and reactive to light, 2 to 1 mm bilaterally. 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 voice. xii: tongue midline without fasciculations. motor: normal bulk and tone bilaterally. no abnormal movements, tremors. strength full power with the exception of testing of hand strength to pain and injury. no pronator drift sensation: intact to light touch. reflexes: b br pa ac right 1 1 1 1 left 1 1 1 1 per plastics/hand eval: heent: perrl, cn ii-xii grossly intact, bilateral peri-orbital ecchymosis, denies malocclusion, mid-face stable, blood in both nares, no -septal hematoma, tenderness along bilateral malar prominences, the is a abraded complex stellate laceration 5cm in width over the right brow. rh: the hand is edematous, painful throughout the wrist with a step-off distal to the carpal bones along rays . the is tenderness throughout. he has a normal neuro-sensory exam and the digits are warm and well perfused. specifically he has intact median nerve sensation and function. lh: the wrist is tender, there is less edema when compared to the rh, the hand is maximally tender at the distal radius, the hand is neurovascularly intact. pertinent results: cxr : no acute intrathoracic process. please refer to subsequent ct torso for further details. ct c-spine : no fracture or malalignment. ct head : 1. right frontal bone, left sphenoid and likely left temporal bone, bilateral zygomatic and superior orbital wall fractures. 2. right frontal lobe contusion. 3. extensive pneumocephalus. ct max/facial/sinus : 1. bilateral zygomatic, anterior and inferior maxillary sinus, orbital floor, left sphenoid bone and likely left temporal bone fractures. 2. right superior orbital rim, left posterior maxillary sinus wall fractures. 3. cta of the head is recommended since sphenoid fx extends into the left carotid canal. ct torso : 1. no acute process of the chest, abdomen or pelvis. 2. fluid filled esophagus putting the patient at risk for aspiration. l wrist : comminuted distal left radial fracture with intra-articular extension into the radiocarpal joint, impaction, fracture of the radial styloid and dorsal displacement. no additional fractures are identified. r arm/wrist : 1. carpal-metacarpal () dorsal dislocation with associated dorsal fracture fragments. 2. intact right elbow and humerus. cta neck : no evidence for dissection or other significant abnormalities. extensive sequela of craniofacial injury as detailed on the prior studies. ct head : extensive pneumocephalus has minimally improved. subarachnoid hemorrhage and moderate right frontal contusion is unchanged in extent since the prior study. no new intracranial hemorrhage. extensive fractures as described above and on multiple prior studies, stable. right parietal extraaxial hematoma has slightly increased in size as has the subdural hemorrhage along posterior falx. ct left wrist: comminuted distal left radial fracture with intra-articular extension into the radiocarpal joint, impaction, fracture of the radial styloid and dorsal displacement. possible fracture through the base of the thumb metacarpal. brief hospital course: he was admitted to the acute care service. he was initially evaluated by neurosurgery for pneumocephalus and right frontal contusion. this injury was managed non operatively; serial exams were followed closely and remained stable. he was loaded with dilantin which was recommended to continue for 7 days total. he will follow up in clinic in 4 weeks. he was evaluated by plastic/hand surgery for his right carpal-metacarpal dislocation and triquetral fracture. this required operative management and he was taken to the operating room for repair of this on day of admission. postoperatively he was taken to the trauma icu for close monitoring as there was concern for csf leak during surgery. he remined intubated for ~24 hours and wasthen extubated. several days postop he was splinted and later changed to a cast after xrays were obtained. his distal left radius fracture repair was deferred to a later date. this was also placed in a short arm cast. he is non weightbearing through the upper extremities distally but may put weight through the forearms. his follow up will be in plastic/hand clinic soon after discharge. he was also seen by ophthalmology due to the orbital fracture and to rule out entrapment for which there was no evidence of. he was re-examined 2 days later by ophthalmology and was noted with diplopia and rhinorrhea. the rhinorrhea was very concerning and neurosurgery was contact again. their recommendations included consults with ent who recommended beta-2 transferrin and other testing of the csf. it was further suggested by ophthalmology that neurology be consulted due to concern for cn iv injury. a brain and orbit mri was recommended showing a small subdural hematoma and orbital hematoma as well. on , neurosurgery performed lumbar puncture and drained of 30cc of csf. the patient's rhinorrhea then stopped on . the patient was observed until and had no further episodes of rhinorrhea. the patient was then cleared for home. he was evaluated by physical and occupational therapy and is being recommended for home with services when medically cleared for discharge. at time of discharge he is ambulating independently, pain controlled and tolerating a regular diet. medications on admission: none discharge medications: 1. acetaminophen 500 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain, fever. 2. allopurinol 300 mg tablet sig: one (1) tablet po daily (daily). 3. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 4. hydrochlorothiazide 12.5 mg capsule sig: one (1) capsule po daily (daily). 5. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 6. oxycodone 5 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain. disp:*40 tablet(s)* refills:*0* 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 8. senna 8.6 mg tablet sig: 1-2 tablets po once a day as needed for constipation. 9. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed for constipation. 10. bacitracin zinc 500 unit/g ointment sig: one (1) appl topical (2 times a day): apply to right orbital laceration . disp:*30 gm* refills:*1* discharge disposition: home with service facility: vna discharge diagnosis: s/p 15 ft fall: injuries - 1.pneumocephalus 2.right frontal contusion 3.facial fractures - right frontal bone, left sphenoid, left temporal bone, bilateral zygomatic and superior orbital wall fractures. 4.left radius fracture 5.triquetral fracture on right hand 6.proximal right phalangeal head fractures of indeterminate age. discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to the hospital after a fall sustaining facial fractures, and fractures of your left radius (arm) bone and your right hand. your left radius fracture will need to be repaired this week. your right hand fracture was operated on by the plastics hand surgeons. you will be discharged to home and will come back for your surgery as an outpatient. you were also found to have a small amount of bleeding in your head from the fall. you were seen by the neurosurgery doctors who recommended -seizure medications to be taken for 7 days - which you completed while in the hospital. you have also been prescribed narcotics for pain. do not drink alcohol, take illicit drugs, drive and/ or operate heavy machinery while taking these medications. also you should take a laxative and stool softener to prevent constipation. do not bear any weight through yout left wrist or right hand. you may put full weight through your elbows. . maintain both your arms in splints placed on left and right arms. . you may resume any home medications that have been prescribed for you. . activities: * no strenuous activity * exercise should be limited to walking; no lifting, straining, or excessive bending. * unless directed by your physician, not take any medicines such as motrin, aspirin, advil or ibuprofen etc . comments: * please sleep on several pillows and try to keep your head elevated to help with drainage. * please maintain soft diet for 4 weeks. * please avoid blowing your nose. * sneeze with your mouth open * try to avoid sipping liquids through a straw followup instructions: plastics/hand surgery office will contact you regarding your surgery that is scheduled for thursday . if you have any questions please call dr. , the office number is: (. please follow up with dr. in 4 weeks with a non contrast head ct. this appointment can be scheduled by calling . please call with further questions or concerns. provider: xray (scc 2) phone: date/time: 9:20 provider: , : date/time: 9:40 procedure: spinal tap incision of lung open reduction of fracture with internal fixation, carpals and metacarpals release of carpal tunnel open reduction of dislocation of hand and finger diagnoses: pure hypercholesterolemia unspecified essential hypertension gout, unspecified other and unspecified cerebral laceration and contusion, without mention of open intracranial wound, with no loss of consciousness closed fracture of malar and maxillary bones closed fracture of other facial bones closed colles' fracture other accidental fall from one level to another closed fracture of vault of skull with subarachnoid, subdural, and extradural hemorrhage, with no loss of consciousness other conditions of brain closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, with no loss of consciousness closed fracture of multiple sites of metacarpus cerebrospinal fluid rhinorrhea closed fracture of triquetral [cuneiform] bone of wrist closed fracture of other bone of wrist 

Answer: The patient is high likely exposed to