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: motor vehicle crash with multiple injuries major surgical or invasive procedure: tracheostomy peg history of present illness: 83 year-old diabetic who crashed his car into a barrier on the during a hypoglecemic episode. he was brought into the trauma bay where he was intubated for respiratory distress as well as aspiration precautions. after primary stabilization and thorough initial work-up, he was transferred to the trauma icu for further care. past medical history: iddm copd with chronic cough hearing loss, wears right prosthesis depression s/p prostatectomy social history: tobacco x45 years occassional etoh married, previously resided in facility family history: noncontributory physical exam: initial vs temp 98.6 hr 68 bp 146/81 rr 28 100% nrb , x4, withdraws to pain all extr x4 no head laceration, perrla, eomi gcs 14 gurgled speech, tongue laceration c-collar in place trachea in midline b cta, rrr, no murmur l chest/abd ecchymosis, tenderness over left chest abd soft, nd/nt, small umbilical hernia rectal no prostate, guaiac negative extr well perfused, no injuries neurologically intact pertinent results: injuries: small subarachnoid hemorrhage left temporal lobe type- dens fracture transverse fractures through the posterior elements of c5 severe degenerative c-spine changes serial rib fractures left ribs tongue laceration bilateral pneumothoraces 09:52pm type-art po2-112* pco2-52* ph-7.36 total co2-31* base xs-3 -assist/con intubated-intubated 09:52pm glucose-250* lactate-1.4 na+-131* k+-4.2 cl--101 09:52pm hgb-11.9* calchct-36 09:52pm freeca-1.14 04:50pm glucose-323* lactate-1.3 na+-131* k+-3.7 cl--97* tco2-28 04:50pm hgb-13.2* calchct-40 o2 sat-95 carboxyhb-2 met hgb-0 04:43pm amylase-81 04:43pm asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 04:43pm plt count-219 04:43pm pt-12.9 ptt-29.5 inr(pt)-1.1 chest one view, portable indication: 83-year-old man with intubation. comments: portable supine ap radiograph of the chest is reviewed. no previous study is available for comparison. the tip of the endotracheal tube is identified at the thoracic inlet. a chest tube is identified overlying the right hemithorax. there is no evidence for pneumothorax. there is prominence of the pulmonary vasculature with cardiomegaly indicating mild congestive heart failure. there is also prominence of the proximal pulmonary arteries indicating pulmonary hypertension. patchy opacity is seen in both lower lobes indicating aspiration versus atelectasis. the balloon of the endotracheal tube is slightly hyperinflated. impression: 1. no pneumothorax. 2. hyperinflation of the balloon of the endotracheal tube. 3. mild congestive heart failure with cardiomegaly. aspiration versus atelectasis in both lower lobes. pulmonary hypertension. ct c-spine w/o contrast; ct reconstruction reason: s/p mvc medical condition: 83 year old man reason for this examination: s/p mvc contraindications for iv contrast: none. addendum: dr. was telephoned to report a slight change in the final report for this ct. there is concern for spinal cord impingement and an mri is recommended. one has been ordered. this communication was on at 10:30 a.m. indication: 83-year-old in motor vehicle accident. technique: ct of the cervical spine without iv contrast. multiplanar reformatted images were obtained. no prior studies. findings: there is a type- fracture through the dens, without significant displacement of fracture fragments. the fracture involves the right articular mass, body and left articular mass, and extends through the left transverse process (and across the vertebral canal). a small fracture fragment seen posterior to the dens within the spinal canal, and may impress the cord. ther may also be an epidural hematoma. there is also a transverse fracture through the spinous process of c5. there is a questionable fracture at the c3 left facet joint, though this may just represent severe degenerative changes. soft tissue hematoma is seen within the prevertebral soft tissues anterior to c2 and 3. severe degenerative changes are noted throughout the cervical spine with disc space narrowing, subchondral cyst formation, and mild osteophyte formation. the cervical canal is also slightly narrowed in the mid cervical spine. several small lymph nodes are seen within the neck. impression: type- fracture through the dens. transverse fractures through the posterior elements of c5. severe degenerative changes throughout the cervical spine. evaluation of the spinal canal and cord with mri should be considered. these findings were communicated to dr. at the completion of the examination. mr cervical spine 10:24 am mr cervical spine reason: r/o c-spine injury medical condition: 83 year old man with mva , c-collar reason for this examination: r/o c-spine injury exam: mri of the cervical spine. clinical information: patient with mva and fracture of the odontoid process and c5 vertebra seen on the previous ct, for further evaluation. technique: t1-, t2- and inversion recovery sagittal and gradient echo and t2 axial images of the cervical spine were obtained. correlation was made with the ct of . findings: there is a fracture of the odontoid process visualized, as seen on the previous ct examination. subtle increased signal on inversion recovery images is seen in the c2 vertebral bodies indicative of marrow edema. additionally, there is increased signal seen between the posterior arch of c1 and spinous process of c2 indicative of ligamentous injury in this region. there is no widening of the interspinous distance seen. there is subtle soft tissue prominence at c1 and c2 level, both posteriorly and anterior to the thecal sac with mild indentation on the thecal sac without compression of the spinal cord. there is no abnormal signal seen within the spinal cord at this level. at c3-4, disc degenerative change and mild bulging is identified. no spinal stenosis is seen. at c4-5, low t1 and high t2 signal is seen in the c4 and c5 vertebral bodies secondary to marrow edema from trauma. ct has demonstrated posterior element fracture at c5 level. at this level, there is no evidence of ligamentous disruption seen involving the intraspinous or posterior longitudinal ligaments. no evidence of disruption of the anterior longitudinal ligament is seen. degenerative disc disease is noted with moderate bilateral foraminal narrowing. at c5-6 and c6-7 as well as inferiorly to t3-4, degenerative disc disease is identified without high-grade spinal stenosis. the spinal cord demonstrates no evidence of increased signal to indicate cord edema or contusion. impression: odontoid fracture with increased signal indicating ligamentous trauma posteriorly between the posterior arch of c1 and spinous process of c2. mild soft tissue prominence, both anterior and posterior to the thecal sac at c1-2 level indenting the thecal sac without high-grade spinal cord compression. these changes could be secondary to trauma. marrow edema within c4 and c5 vertebral bodies. multilevel degenerative changes. increased signal within the posterior soft tissues indicate soft tissue trauma. no evidence of increased signal within the spinal cord to indicate cord edema or contusion. cta chest w&w/o c &recons 5:58 pm cta chest w&w/o c &recons; ct 100cc non ionic contrast reason: r/o pe contrast: optiray medical condition: 83 year old man with tachycardia, tachypnea, elevated a-a gradient reason for this examination: r/o pe contraindications for iv contrast: none. the findings were reviewed with dr. at the completion of the examination. indication: 83-year-old in motor vehicle accident with increasing hypoxia and elevated aa gradient. assess for pulmonary embolus. technique: ct of the chest pre- and post-iv contrast. 100 cc of optiray were used for this examination. multiplanar reformatted images were obtained. comparison: . findings: there are large bilateral pleural effusions, left greater than right with associated atelectasis. several small lymph nodes are seen scattered throughout the prevascular and mediastinal spaces. again, are seen severe changes of emphysema with bilateral bullous disease. the small bilateral pneumothoraces seen on the prior examination are no longer present. the bulla in the left lung base with fluid within it appears to have slightly less fluid. a tracheostomy has been placed. there is overdistention of the cuff at the level of the thyroid. ct angiogram is suboptimal due to the lack of a peripheral iv for contrast administration. however, no central pulmonary embolus is seen within the right or left main pulmonary arteries. the first order vessels are probably normal, though definitive comment on the first and second order vessels is not possible. the main pulmonary artery is again noted to be enlarged, measuring 4 cm consistent with pulmonary hypertension. the aorta is normal in appearance. bilateral central venous catheters are seen with their tips terminating in the distal svc. aortic and coronary calcifications are identified. a calcified lymph node is seen in the subcarinal space. the visualized portion of the upper abdomen is unremarkable other than arterial calcifications. a gastrostomy tube has been placed. osseous structures again demonstrate numerous rib fractures as seen on the prior study. soft tissues are normal. multiplanar reformatted images confirm the above findings. mpr grade value = 3. impression: 1. no obvious central pulmonary embolus. however, the study is suboptimal for evaluation of more distal emboli. 2. severe emphysema with bullous changes. resolution of previously seen small bilateral pneumothoraces. 3. large bilateral pleural effusions, left greater than right. 4. overdistention of the tracheostomy tube cuff. these findings were reviewed with dr. _____ at the completion of the examination. cardiology report ecg study date of 12:57:58 pm atrial fibrillation with a mean ventricular response, rate 74. compared to the previous tracing of cardiac rhythm now atrial fibrillation. chest (portable ap) 8:38 am chest (portable ap) reason: assess for interval change medical condition: 83 year old man s/p mvc w/ c2 fx, s/p trach reason for this examination: assess for interval change portable chest indication: follow up pneumonia. the ij line and feeding tube have been removed since . the tracheostomy tube persists. there are stable bibasilar opacities, more at the left base than the right. the right subclavian line has also been withdrawn. a linear opaque catheter overlies the course of the left axillary and subclavian vein. impression: no change in the appearance of the bibasilar opacities since . brief hospital course: after intubation and evaluation in the trauma bay, patient was admitted to the trauma icu. a foley catheter could not be placed, however he was able to void spontaneously. a urethrogram showed a severe stricture of his proximal urethra. urology was consulted and dilated his urethra under cystoscopic vision and placed a foley catheter. the ortho spine service was consulted regarding his spinal fractures and recommended non-operative management with a cervical collar for 6-8 weeks, then reassesment with radiographs. he was started on tube feedings per ngt. patient -was weaned from the ventilator slowly and extubated. however, he had to be reintubated for respiratory distress 16 hrs later. during the next days he was unable to wean off the ventilator and an open tracheosomy was placed on . during the next days he was able to sit in the chair on trach mask during the day for several hours. at night, he was rested on the ventilator. on a peg tube was placed and the dobhoff was removed. cardiology consulted on secondary to sinus tacycardia and atrial fibrillation; recommendations for rate control with beta blocade and calcium channel blocker. his diltiazem was stopped on because of hypotension; lopressor is being continued. on patient transfused with one unit prbc's because of his hypotension; his pre-transfusion hct was 28; a post transfusion hct will need to be checked once patient arrives to . medications on admission: zoloft, hyzaar, asa, combivent, flonase, insulin, advair, wellbutrin discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 2. docusate sodium 150 mg/15 ml liquid sig: one (1) po bid (2 times a day). 3. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 4. heparin sodium (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 5. albuterol-ipratropium 103-18 mcg/actuation aerosol sig: puffs inhalation q6h (every 6 hours) as needed. 6. lansoprazole 30 mg susp,delayed release for recon sig: one (1) po bid (2 times a day). 7. trazodone 50 mg tablet sig: one (1) tablet po hs (at bedtime) as needed. 8. sertraline 50 mg tablet sig: three (3) tablet po daily (daily). 9. bupropion 75 mg tablet sig: one (1) tablet po bid (2 times a day). 10. albuterol sulfate 0.083 % solution sig: one (1) inhalation q4h (every 4 hours) as needed. 11. miconazole nitrate 2 % powder sig: one (1) appl topical (2 times a day). 12. nystatin 100,000 unit/g ointment sig: one (1) appl topical (2 times a day). 13. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). 14. heparin lock flush (porcine) 100 unit/ml syringe sig: one (1) ml intravenous daily (daily) as needed. 15. piperacillin-tazobactam 4.5 g recon soln sig: one (1) recon soln intravenous q8h (every 8 hours). 16. rosiglitazone maleate 2 mg tablet sig: one (1) tablet po bid (2 times a day). 17. acetylcysteine 20 % (200 mg/ml) solution sig: one (1) ml miscell. q4-6h (every 4 to 6 hours) as needed. discharge disposition: extended care facility: - discharge diagnosis: subarachnoid hemorrhage type i dens fx c5 transverse process left posterior rib fractures discharge condition: fair discharge instructions: you will need to continue to wear your cervical collar for a total of 8 weeks until you follow up with dr. , ortho-spine you will need to call to schedule an appointment with dr. in weeks. you will need to follow up in the trauma clinic in 1 month followup instructions: provider: , . call to schedule appointment provider: , . call to schedule appointment procedure: insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances thoracentesis percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy transfusion of packed cells dilation of urethra diagnoses: unspecified pleural effusion unspecified essential hypertension chronic airway obstruction, not elsewhere classified atrial fibrillation pneumonia due to pseudomonas diabetes with other specified manifestations, type ii or unspecified type, not stated as uncontrolled long-term (current) use of insulin closed fracture of second cervical vertebra unspecified hearing loss swelling, mass, or lump in head and neck other motor vehicle traffic accident involving collision on the highway injuring driver of motor vehicle other than motorcycle traumatic pneumothorax without mention of open wound into thorax hyperosmolality and/or hypernatremia closed fracture of fifth cervical vertebra urethral false passage other specified causes of urethral stricture subarachnoid hemorrhage following injury without mention of open intracranial wound, with no loss of consciousness closed fracture of four ribs open wound of tongue and floor of mouth, without mention of complication 

Answer: The patient is high likely exposed to