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: penicillins / sulfa (sulfonamide antibiotics) attending: chief complaint: right leg pain major surgical or invasive procedure: 1. open reduction internal fixation bimalleolar ankle fracture with lateral plating and medial screws. 2. open reduction internal fixation of right distal femur fracture. 3. revision debridement of left knee wound. history of present illness: this patient is a 17 year old male who complains of mvc. by report the patient was last seen one hour prior to being found in a single car crash into a tree. he was the driver of a volvo that struck a tree with significant intrusion into the car. the patient was wearing a seatbelt -it is unclear if airbags were deployed. he had a positive loss consciousness at the scene and was perseverating en route to the hospital. he presents somewhat confused but complaining of pain in his legs. past medical history: pmh 1. depression 2. asthma social history: at academy, lives with parents, denies etoh or tobacco, h/o depression, ?possible suicide ideation in the past. family history: non contributory physical exam: hr:tachycardic, 110's bp:within normal limits resp:16 o(2)sat:90 low constitutional: 4 day, collared with left leg splinted heent: dried blood in bilateral nares without nasal bone deformity, no septal hematoma, op clear and face otherwise stable, pupils equal and sluggishly reactive bilaterally abrasions to anterior neck midline and to the left over the clavicle consistent with seatbelt injuries chest: clear to auscultation, no burst chest wall deformity but diffusely tender to palpation without crepitus cardiovascular: normal abdominal: soft, nondistended extr/back: right knee with gross deformity and significant irregular laceration over the distal femur/patella skin: warm and dry, well-perfused psych: gcs 13 -1 for speech and eyes pertinent results: 03:55pm wbc-17.4* rbc-4.99 hgb-14.3 hct-42.6 mcv-85 mch-28.6 mchc-33.5 rdw-13.9 03:55pm plt count-300 03:55pm asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 03:55pm lipase-66* 03:55pm urea n-18 creat-1.1 04:23pm glucose-149* lactate-2.3* na+-140 k+-4.2 cl--113* tco2-18* 08:20pm pt-13.4 ptt-21.2* inr(pt)-1.1 head ct : 1. no acute intracranial process. 2. mild sinus disease. ct torso : 1. left first rib fracture with adjacent stranding which encompasses the left common carotid artery. the neighboring appear patent and normal in caliber. 2. right fifth through eighth rib fractures. 3. pulmonary contusions within the anterior aspect of the right middle and upper lobes and posterior aspect of the left lower lobe, with a small laceration within the lower lobe. 4. tiny left apical pneumothorax. 5. stranding about the left groin near the external iliac , likely secondary to attempted vascular access. 6. a small focus of air posterior to the right humeral head is likely from a recent intramuscular injection. ct c spine : 1. no acute fracture or traumatic malalignment of the cervical spine. 2. thickening and focal hyperdensities witin epidural space raises concern for an epidural hematoma. mri is recommended for further evaluation. 3. tiny left pneumothorax. 4. left first rib fracture with neighboring soft tissue stranding. ct right leg : comminuted and impacted fracture of the distal femur, resulting in splaying of the femoral condyles against an intact tibial plateau. there are neighboring multiple hematomas and areas of intramuscular edema. overlying subcutaneous air is compatible with an open-type fracture. right hand : non-displaced fracture of the distal ulna mri spine : 1. unusual anterior cervical spinal subdural ("extra-arachnoid") fluid collection, extending from c2 to the t2 level. there is stable longitudinal extent and degree of mass effect on the spinal cord, with no cord signal abnormality or evidence of evolving blood products, within. given the significant injuries elsewere, as well as evidence of cervical posterior ligamentous sprain, this likely represents a post-traumatic subdural "hygroma," related to csf leak from occult injury to the -arachnoid membrane. 2. likely dva in the left cerebellar hemisphere, incompletely imaged. mri head : 1. no acute intracranial pathology. 2. stable fluid collection posterior to the clivus compatible with known spinal subdural hygroma. mri head : 1. no acute intracranial pathology. 2. stable fluid collection posterior to the clivus compatible with known spinal subdural hygroma. brief hospital course: mr. was evaluated by the trauma team in the emergency room and scns were reviewed. he had multiple orthopedic injuries for which the ortho trauma service took care for and he also had multiple rib fractures, a tiny left pneumothorax and a spinal epidural hygroma. he was admitted to the trauma icu for frequent neurologic checks, pain management and pulmonary toilet due to his multiple rib fractures. following 24 hours of neurologic stability he was taken to the operating room on for orif of the right femur and malleolus. he tolerated the procedure well and returned to the ticu in stable condition. he maintained stable hemodynamics and his pain was well controlled. he continued with pulmonary toilet and remained free of any pulmonary complications. from a neurologic standpoint, the initial ct of the c spine noted a possible epidural hematoma and therefore he underwent an mri of the c spine to further define the anatomy. there was a substantial size extra-arachnoidal fluid collection both anterior and posterior to the spinal cord. he had no change in his neurologic exam but developed a positional headache, quite severe at times and dr. was consulted. after reviewing the imaging and examining the patient, he felt that there was a csf leak due to a spinal dural tear. an mri of the head ruled out any other central etiologies. treatment was a blood patch to the thoracic and lumbar spine which lead to the successful resolution of headache. the psychiatric service also followed mr. given his prior history of adjustment disorder/depression. they contact his outside therapist and spoke in detail with both the patient and his parents. all agree that he needs close follow up and their preference is with his own therapist which his parents will arrange. in general he has been quiet and slightly withdrawn as opposed to agitated. he was placed back on his prozac. medications on admission: prozac 30 mg daily discharge medications: 1. fluoxetine 10 mg capsule sig: three (3) capsule po daily (daily). 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. oxycodone 5 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*60 tablet(s)* refills:*0* 4. acetaminophen 500 mg tablet sig: two (2) tablet po q6h (every 6 hours). 5. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 6. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. disp:*60 tablet(s)* refills:*0* 7. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). disp:*90 * refills:*2* discharge disposition: extended care facility: - discharge diagnosis: s/p mvc 1. left 1st rib fracture 2. right rib fractures 3. right pulmonary contusion 4. small left pneumothorax 5. distal right femur fracture 6. distal right fibula fracture 7. right medial malleolus fracture 8. right distal ulnar fracture 9. spinal epidural hygroma c1-t3 10.positional headache discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: * you were admitted to the hospital after your car accident with multiple injuries including broken bones, rib fractures and a severe headache. * your orthopedic injuries have been repaired in the operating room and your weight bearing status on the right leg is touch down weight bearing as tolerated. * your right arm fracture is non operative and will be managed with a splint. the right arm is non weight bearing. * you will need to wear a hard cervical collar for 4 weeks. * your injury also caused bilateral rib fractures which can cause severe pain and subsequently cause you to take shallow breaths because of the pain. * you should take your pain medication as directed to stay ahead of the pain otherwise you won't be able to take deep breaths. if the pain medication is too sedating take half the dose and notify your physician. * pneumonia is a complication of rib fractures. in order to decrease your risk you must use your incentive spirometer 4 times every hour while awake. this will help expand the small airways in your lungs and assist in coughing up secretions that pool in the lungs. * you will be more comfortable if you use a cough pillow to hold against your chest and guard your rib cage while coughing and deep breathing. * symptomatic relief with ice packs or heating pads for short periods may ease the pain. * narcotic pain medication can cause constipation therefore you should take a stool softener twice daily and increase your fluid and fiber intake if possible. * do not smoke * return to the emergency room right away for any acute shortness of breath, increased pain or crackling sensation around your ribs ( crepitus ). followup instructions: call the clinic at for a follow up appointment in 2 weeks with dr. and 4 weeks with dr. . call the acute care clinic at for a follow up appointment in weeks. call your psychotherapist for a follow up appointment next week. procedure: open reduction of fracture with internal fixation, tibia and fibula open reduction of fracture with internal fixation, femur nonexcisional debridement of wound, infection or burn spinal blood patch diagnoses: asthma, unspecified type, unspecified depressive disorder, not elsewhere classified traumatic pneumothorax without mention of open wound into thorax open wound of knee, leg [except thigh], and ankle, without mention of complication closed fracture of five ribs motor vehicle traffic accident due to loss of control, without collision on the highway, injuring driver of motor vehicle other than motorcycle bimalleolar fracture, closed sprain of tibiofibular (ligament), distal of ankle closed fracture of shaft of ulna (alone) intracranial injury of other and unspecified nature without mention of open intracranial wound, with brief [less than one hour] loss of consciousness other closed fracture of lower end of femur laceration of lung without mention of open wound into thorax adjustment disorder with mixed disturbance of emotions and conduct multiple sites of spinal cord injury without evidence of spinal bone injury 

Answer: The patient is high likely exposed to