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: heparin agents attending: chief complaint: s/p mvc, multiple traumatic injuries major surgical or invasive procedure: 1. tfn fixation of left hip with 11 x 170 x 130 nail. 2. open reduction internal fixation right ankle with examination under anesthesia with fluoroscopy for assessment of stability. 3. open reduction internal fixation left ankle with examination under anesthesia with fluoroscopy for assessment of mortise stability. 4. open reduction internal fixation of right tibial plateau fracture with examination under anesthesia with fluorosocopy for stability. 5. closed treatment left fibular shaft fracture 1. ultrasound-guided puncture of right common femoral vein. 2. inferior venacavogram. 3. deployment of celect inferior vena cava filter at l4. right chest tube thoracostomy picc line placement history of present illness: mrs. is a 79 year old woman t-boned during an mvc during which she lost consciousness. she was initially transferred to hospital where imaging revealed multiple injuries, including posterior l 6th rib fx, l intertrochanteric fracture, l ankle fracture, l superior ramus fracture, r tibial plateau fracture, and r ankle fracture. she became hypotensive while at hospital so was urgently transferred to our institution for further management. past medical history: pmh: "cardiac disease"+angina, diabetes, htn social history: denies smoking, no etoh family history: non-contributory physical exam: exam on admission: hr:60 bp:97/p resp:18 o(2)sat:92% low constitutional: comfortable heent: ecchymosis r forehead, eomi c collar in place chest: clear to auscultation cardiovascular: regular rate and rhythm, normal first and second heart sounds abdominal: soft, nontender, nondistended gu/flank: stable pelvis extr/back: + dp pulses on doppler skin: ecchymosis r thigh neuro: speech fluent psych: normal mood, normal mentation heme//: no petechiae pertinent results: cxr: there is a large right pneumothorax with right upper lobe and likely right middle lobe collapse. the right hemidiaphragm is depressed. no mediastinal shift is appreciated. heart size is top normal. the left lung is well aerated. a left seventh rib fracture is seen. echo: the left atrium is normal in size. no atrial septal defect is seen by 2d or color doppler. the estimated right atrial pressure is 10-15mmhg. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). there is no ventricular septal defect. the right ventricular cavity is mildly dilated with borderline normal free wall function. there is abnormal systolic septal motion/position consistent with right ventricular pressure overload. the ascending aorta is mildly dilated. the aortic valve leaflets (3) are mildly thickened. there is mild aortic valve stenosis (valve area 1.2-1.9cm2). no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is moderate pulmonary artery systolic hypertension. there is an anterior space which most likely represents a prominent fat pad. xr pelvis: left femoral intertrochanteric fracture. no definite pelvic fracture, but if there is clinical concern for occult fracture, ct could be performed. renal us : 1. no evidence for renal artery stenosis. 2. multiple parenchymal and parapelvic cysts bilaterally. no evidence of hydronephrosis. head ct : normal head ct. a small amount of subcutaneous air in the neck posteriorly mri head : no evidence of acute intracranial process. scattered flair hyperintensities within the periventricular and subcortical white matter are present which likely represent the sequela of chronic small vessel ischemic disease. duplex scan b/l lower extremities : 1. thrombus in the right greater saphenous vein, and non-occlusive thrombus within the right common femoral vein. 2. occlusive thrombus within the left common femoral vein extending into the left proximal superficial vein and greater saphenous vein. 3. the right popliteal vein was noted to demonstrate flow; however, was not interrogated for compression. the left popliteal vein and bilateral calf veins were not assessed due to presence of brace. cxr : ap single view of the chest has been obtained with patient in upright position. available for comparison is the next preceding portable supine chest examination of the same day obtained nine hours earlier. during the interval, the previously existing right-sided chest tube has been removed. the lung remains well aerated and no pneumothorax has developed. no new pulmonary abnormalities are seen. 03:50pm wbc-20.4* rbc-3.50* hgb-10.7* hct-30.8* mcv-88 mch-30.5 mchc-34.7 rdw-13.7 03:50pm pt-14.8* ptt-22.6 inr(pt)-1.3* 03:50pm plt count-158 03:50pm asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 03:50pm urea n-53* creat-1.8* 03:53pm hgb-11.1* calchct-33 o2 sat-78 carboxyhb-2 met hgb-0 03:53pm glucose-219* lactate-4.0* na+-139 k+-4.8 cl--101 tco2-25 test result ---- ------ heparin dependent antibodies positive comment: positive for heparin pf4 antibody test by . result reported to , rn on @3:58pm complete report on file in the laboratory. brief hospital course: after initial resuscitation and stabilization in the trauma bay, the patient was admitted to the trauma icu for close monitoring under the acute care surgery service. her hospital course is as follows by systems: neuro: the patient's pain was initially controlled with a dilaudid pca. later, after she was intubated, she was placed on a fentanyl drip. on , the patient had persistent decreased mental status and both ct and mr of her head were obtained. these showed no acute changes and her mental status changes were attributed to her metabolic derangements and acute disease. this was followed and returned to her baseline through the course of her icu stay. cvs: the patient was transferred to our institution because of hypotension with sbps down to the 70s. she received close to 5l of crystalloids and 2units of blood to support her bps on the first day of her accident. she was transiently placed on pressors (levophed) in the early morning . given her history of cad and chf, an echo was performed which revealed preserved lv global systolic function and lvef of >55%. pulm: at the outside hospital, the patient's o2 sats were 100% on 2l. in the trauma bay at our institution, in the course of attempting to place a r subclavian central line, there was aspiration of air. a post-procedure cxr was obtained which did not show evidence of ptx. however, later in the evening, the patient began to desat down into the mid-80s despite increasing her supplemental oxygen. a cxr that evening showed a large r-sided tension ptx. the next morning on hd2, the patient was intubated and a r-sided chest tube was placed. she remained intubated for several days and after return from the or with orthopedics, while her pulmonary mechanics were sufficient for extubation, it was determined that she would most likely not be able to protect her airway mental status and she was left intubated. she was left intubated until her mental status was improving, and developed a haemophilus influenzae pneumonia for which she was treated with vancomycin and zosyn, and this prolonged her intubation. a family meeting was held regarding this and the health care proxy requested extubation, acknowledging that this could potentially be a terminal extubation. after further discussing between the icu team, acs team, ethics committee and the patients family, the patient was left intubated until at which point she was extubated successfully. fen/gi: the patient was initially kept npo on admission. she was initially started on iv fluids. however, when she started to have respiratory problems, her fluids were heplocked due to concerns that she might be developing pulmonary edema in light of her cardiac history. she was restarted on fluids in the evening of hd2 since her fena from the previous day showed that she was prerenal. the patient also developed hyperkalemia hd1 with a k as high as 6.0. an ekg was checked which did not show peaked t waves. she was given kayexalate the following day with improvement of her k level to 4.8. he electrolytes were stable for the remainder of her icu admission. gu: the patient's initial cr at the osh was 1.5. this gradually trended upwards over the course of the next few days and the patient was oliguric. fena was 0.5 so patient was given iv fluid resuscitation. following this her cr improved but remained elevated for the duration of her admission. heme: serial hct checks were performed. her initial hct on admission was 30.8. after 2 units of prbc, her hct was 33.4. her hct gradually drifted down to 24 by the next day and she was transfused another 2 units of prbc given her hypotension and cardiac history. she received several additional transfusions through her course to maintain an adequate hematocrit, but never demonstrated any acute bleeding. she also had thrombocytopenia noted just after admission to a low of 30k on . heparin was stopped and argatroban was used for anticoagulation. a hit panel was positive. coumadin was started on for bilateral dvt's for pprotection along with her ivc filter. endo: the patient was a type i diabetic and was initially put on a regular insulin sliding scale since we did not know what her normal insulin regimen was. her blood glucose levels were not well-controlled on this regimen so she was put on an insulin drip until adequate control was achieved after which she was maintained on an insulin sliding scale/basal insulin. id: during the patients icu course she developed an h. influenzae pneumonia for which she was treated with vancomycin and zosyn. following transfer to the trauma floor her mental status gradually improved though she had periods of being withdrawn. she was seen by the speech and swallow service and began a diet of nectar thick liquids and ground solids. after a period of time she was started on mirtazapine for appetite stimulation at a low dose. calorie counts along with protein supplements were also added. although she is able to feed herself, at times she needs assistance. she worked with the physical and occupational therapy services to help improve her ability to get from bed to chair as she remains non weight bearing on both lower extremities. on she was found obtunded in the early morning with a blood sugar of 26. she received d50 and her blood sugar increased along with her mantal status. she was transferred back to the icu to assure stabelization which was the case. unfortunately she was very discouraged and decided against rehab and actually expressed that she have nothing more done to promote recovery. both she and her family wanted to meet with the palliative care team: please see note in omr by dr. in regard to the outcome of this meeting. coumadin was held since as she had only 2 doses (5mg followed by 2.5 mg) and her inr rose to 7.1. she had an ivc filter in place and she had not received ffp or vitamin k. on a family meeting with the surgical team and social work had been scheduled to define goals of care and to determine wether the patient was going to be made cmo and, in case of discharge, wether she would go to a rehabilitation facility, an hospice or home to her family. on the same day, while the family was present, respiratory status started to rapidly deteriorate. the family decided to make her cmo and she expired shortly thereafter, with the family at the bedside. her death report was completed and the medical examiner notified (dr.) and accepted the case. medications on admission: atenolol, lipitor, kdur, ditropan, asa, zetia, accupril, humalog (70/30), lasix, nitrostat, imdur discharge disposition: expired discharge diagnosis: s/p mvc 1. bilateral ankle fractures 2. right tibial plateau fracture 3. left peritrochanteric hip fracture 4. right pubic rami fracture 5. left 6th rib fracture 6. right pneumothorax 7. + hit 8. haemophilus pneumonia 9. acute renal failure 10.acute blood loss anemia discharge condition: pt expired shortly after being made cmo by the family and hcp discharge instructions: na followup instructions: na procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube interruption of the vena cava enteral infusion of concentrated nutritional substances arterial catheterization other incision of pleura open reduction of fracture with internal fixation, tibia and fibula open reduction of fracture with internal fixation, tibia and fibula open reduction of fracture with internal fixation, tibia and fibula closed reduction of fracture without internal fixation, tibia and fibula closed reduction of fracture with internal fixation, femur angiocardiography of venae cavae other repair of knee central venous catheter placement with guidance diagnoses: hyperpotassemia thrombocytopenia, unspecified coronary atherosclerosis of native coronary artery pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension acute posthemorrhagic anemia acute kidney failure, unspecified hyposmolality and/or hyponatremia other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other and unspecified angina pectoris iatrogenic pneumothorax diabetes with other specified manifestations, type ii or unspecified type, not stated as uncontrolled insulins and antidiabetic agents causing adverse effects in therapeutic use chronic systolic heart failure long-term (current) use of anticoagulants pressure ulcer, lower back hypoxemia encounter for palliative care obesity, unspecified do not resuscitate status acute venous embolism and thrombosis of deep vessels of proximal lower extremity closed fracture of one rib emphysema (subcutaneous) (surgical) resulting from procedure other motor vehicle traffic accident involving collision with motor vehicle injuring driver of motor vehicle other than motorcycle other specified hypotension pneumonia due to hemophilus influenzae [h. influenzae] closed fracture of upper end of fibula with tibia other alteration of consciousness hip joint replacement closed fracture of pubis heparin-induced thrombocytopenia (hit) contusion of face, scalp, and neck except eye(s) pressure ulcer, stage ii closed fracture of intertrochanteric section of neck of femur bimalleolar fracture, closed dysphagia, unspecified closed fracture of upper end of fibula alone 

Answer: The patient is high likely exposed to