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: addendum: 17 yo male who was jumping on a trampoline and landed on his head. pt was taken to osh. osh noted no movement in bilateral lower extremities and no sensation from nipple line down. pt was med flighted to on . imaging showed c4-c5 disc herniation, ligament injury and spinal cord contusion at this level causing complete c4-c5 cord injury. pt went to the or for an anterior c4-5 discectomy and fusion and posterior c4-5 laminectomy and fusion on .. percutaneous tracheostomy and gastrostomy was performed on . diagnostic venogram of ivc and iliac veins and placement of optease ivc filter was perform for dvt prophylaxis on chest ct on showed near collapse of the left lower lobe and diffuse nodular ground-glass opacity throughout the right lower lobe, suggestive of atypical infection and/or very early consolidation. a bronch was performed on for persistent hight temperatures bal cultures negative. pt was pan cultured several times for increased temperature all cultures had been negative. id consult was obtained recommending coverage for 14 days of unasyn.pt had picc line placement on . psychiatry assessment revealed normal greef.psychiatry recommendations were the following: 1) the pt appears to be experiencing normal grief 2) continue to monitor mood and sleep 3) offer ativan 1mg po prn anxiety or panic if it develops 4) continue to involve sw in case, offer educational materials 5) cont to involve pt??????s family in case 6) discussed with primary team, ,, md beeper#: 7) psychiatry will continue to follow, please page with questions #, or psychiatry on call nights/weekends #; last evaluation form speech and swallow where the following: secretions / ability to handle cuff deflation:cuff was deflated prior to our evaluation and pt was tolerating cuff deflation without o2 desaturation or distress. rn was present to suction pt from the trach tube with minimal/scant white, thick secretions retrieved. unlike the last evaluation, pt did not request oral suctioning via the yankauer during the evaluation. according to the rn, pt has not requested oral suctioning this morning. pmv tolerance / vocal quality / o2 sats:pt was able to achieve voicing upon placement of the valve and at first noted that it felt hard to exhale with the valve in place. the valve remained in place to allow the pt to adjust and pt stated that he was trying to get used to it. pt's tracheal pressure measures were between -2 to +10 cm h20(normal range is between -/+10 cm h20). pt's vocal quality was adequate and his o2 sats were between 94-99% while for 15 minutes while the valve was in place. summary: at this time pt is able to tolerate the pmv without respiratory distress, o2 desaturation, or c/o significant discomfort. it is recommended that the valve be removed when pt complains of discomfort, effortful breathing, or fatigue. it was discussed with the pt that he will need time to build up endurance to wear the valve for extended periods of time. we also discussed adjusting positioning as needed if valve tolerance appears difficult. pt was last seen on for a pmv eval only and the recs were to return on . however, the re consult was placed today for both the pmv and swallowing. however, as per the recommendations from previous evaluations, swallow eval was deferred today, especially in light of potential discharge to rehab yesterday, and evidence of lll collapse, rll ground opacity on prior chest ct. pt is just beginning to demonstrate improved endurance and respiratory drive to tolerate the valve. as such, would prefer to allow him to establish consistent strength/endurance for this prior to assessing swallowing, as he has already demonstrated inability to tolerate aspiration (prior to trach placement) in the setting of poor respiratory reserve. recommendations: 1. always deflate cuff prior to placing the passy-muir valve! 2. monitor o2 sats / respiration while valve is in place. 3. do not allow the patient to sleep with the valve in place. 4. pmv wear schedule is up to the discretion of the nurse and/or respiratory therapist. pt as remained afebrile for 36 hours. will be send to rehab today. pt will have to follow up with neurosurgery, and trauma surgery as an out patient. chief complaint: s/p fall onto head while on trampoline major surgical or invasive procedure: acdf/pclf c4-c5 ivc filter history of present illness: 17 yo male s/p fall onto his head while on a trampoline; loss of sensation below nipple line. he was taken to an area hospital, solumedrol protocol initiated. he was later transferred to for continued trauma care past medical history: none social history: the patient was born and raised in , nh, where he lives in a trailer with his parents and brother who is 4 years older. the patient is in the 11th grade at high school, and was working in the produce department of a grocery store. he enjoys english class and has some difficulty with math. he was an active athlete, playing soccer and snowboarding. he plans to be the assistant coach to his soccer team. he has been dating his girlfriend for 4 months total, with a hiatus in between ??????for stupid reasons.?????? family history: noncontributory physical exam: physical exam: lunga cta heart rrr nm ng abd soft nt nd ext no movement inferior extremities no fine motor activity pertinent results: 10.4 4.03* 12.1* 35.3* 88 30.1 34.4 13.4 339 import result 04:45am 10.9 4.11* 12.2* 35.7* 87 29.7 34.1 13.3 282 import result 06:43am 12.9* 4.04* 12.1* 35.4* 87 30.0 34.3 13.2 299 import result 09:08am 10.5 4.39* 13.0* 38.4* 87 29.6 33.9 13.0 302 import result 02:02am 10.9 4.11* 12.2* 36.0* 88 29.7 33.9 13.1 267 import result 02:49am 12.8* 4.10* 12.1* 35.9* 88 29.5 33.7 13.3 245 import result 05:28am 11.9* 4.05* 12.2* 35.6* 88 30.2 34.4 13.0 237 import result 02:03am 9.1 3.92* 12.0* 34.5* 88 30.6 34.8 13.0 207 import result 10:07pm 15.5*# 3.79* 11.6* 32.5* 86 30.5 35.6* 12.7 176 import result 12:34am 8.9 4.21* 12.7* 35.6* 85 30.3 35.7* 12.6 164 import result 12:59am 9.6 4.49* 13.5* 38.4* 86 30.0 35.1* 12.7 190 import result 02:35am 10.1 4.38* 13.5* 37.7* 86 30.8 35.8* 12.4 159 import result 02:59am 8.6 4.67 13.8* 39.6* 85 29.5 34.8 12.3 159 import result 01:58am 37.7* import result 07:58pm 10.5 3.93* 12.3* 33.9* 86 31.2 36.1* 12.7 158 import result 04:14am 14.5* 4.52* 13.7* 38.6* 85 30.3 35.6* 12.6 191 import result 02:48am 11.9* 4.78 14.4 40.1 84 30.0 35.8* 12.5 245 import result 01:12am 10.7 5.14 15.4 43.5 85 29.9 35.3* 12.5 233 import result differential neuts bands lymphs monos eos baso atyps metas myelos promyel 09:08am 73* 1 11* 3 2 0 0 7* 1* 2* import result 02:03am 79.8* 13.2* 4.8 2.0 0.2 import result red cell morphology hypochr anisocy poiklo macrocy microcy polychr 09:08am normal normal normal normal normal normal import result basic coagulation (pt, ptt, plt, inr) pt ptt plt smr plt ct inr(pt) 05:10am 339 import result 05:10am 13.4* 26.4 1.2* import result 04:45am 282 import result 04:45am 13.1 25.8 1.1 import result 06:43am 299 import result 06:43am 13.2* 25.9 1.2* import result 09:08am normal 302 import result 02:02am 267 import result 02:02am 13.8* 26.9 1.2* import result 02:49am 245 import result 02:49am 14.2* 27.6 1.3* import result 05:28am 237 import result 02:03am 207 import result 10:07pm 176 import result 12:34am 164 import result 04:53am 12.8 30.8 1.1 import result 12:59am 190 import result 02:35am 159 import result 02:59am 159 import result 07:58pm 158 import result 04:14am 191 import result 02:48am 245 import result 02:48am 14.5* 31.6 1.3* import result 01:12am 233 import result 01:12am 12.9 25.0 1.1 import result basic coagulation (fibrinogen, dd, tt, reptilase, bt) fibrino 01:12am 208 import result chemistry renal & glucose glucose urean creat na k cl hco3 angap 05:10am 126* 27* 0.7 140 4.3 104 27 13 import result 04:45am 131* 25* 0.6 139 4.1 104 28 11 import result 06:43am 127* 29* 0.6 139 3.9 102 27 14 import result 02:02am 115* 29* 0.8 138 4.7 101 29 13 import result 02:49am 157* 24* 0.7 138 4.6 101 28 14 import result 05:28am 127* 26* 0.7 138 4.9 101 28 14 import result 02:03am 134* 19 0.8 139 4.5 102 28 14 import result 12:34am 115* 16 0.7 133 5.1 99 25 14 import result 12:59am 121* 15 0.6 134 4.7 102 26 11 import result 02:35am 122* 21* 0.8 137 4.6 103 28 11 import result 02:59am 108 18 0.7 138 4.3 104 27 11 import result 01:58am 115* 19 0.8 143 3.9 108 29 10 import result 07:58pm 104 22* 1.0 145 3.7 111* 27 11 import result 04:14am 123* 22* 0.8 141 4.2 106 27 12 import result 02:48am 181* 18 1.0 140 4.4 106 24 14 import result 01:12am 15 1.1 import result enzymes & bilirubin alt ast ld(ldh) ck(cpk) alkphos amylase totbili dirbili 05:10am 182* 69* import result 04:45am 208* 87* 210 130* 41 0.5 import result 03:48am 238* 133* 243 161* 57 0.8 import result 01:51pm 205* 181* 274* 221* 0.7 import result 01:12am 37 import result other enzymes & bilirubins lipase 04:45am 74* import result 03:48am 100* import result chemistry totprot albumin globuln calcium phos mg uricacd iron 05:10am 9.3 4.4 2.3* import result 04:45am 9.1 4.3 2.2 import result 06:43am 9.3 3.7 2.3* import result 03:48am 3.5 import result 02:02am 9.0 2.9# 2.3* import result 02:49am 9.1 5.7*# 2.2 import result 05:28am 9.0 3.2 1.9 import result 12:34am 2.6* 1.7 import result 12:59am 2.7 1.9 import result 02:35am 8.2* 2.7 2.0 import result 02:59am 8.1* 4.0 1.8 import result 01:58am 8.2* 3.6 2.3* import result 07:58pm 1.8 import result 04:14am 8.7* 4.1 2.0 import result 02:48am 9.2 4.4 1.9 import result pituitary tsh 02:02am 3.5 import result hepatitis hbsag hbsab hav ab igm hav 01:31pm negative pnd import result 02:02am positive negative import result immunology 01:31pm negative import result antibiotics vanco 01:51pm 34.2 import result 07:49pm 2.7* import result 02:03am 8.8* import result toxicology, serum and other drugs asa ethanol acetmnp bnzodzp barbitr tricycl 03:48am neg import result 01:12am neg neg 5.5 neg neg neg import result lab use only holdblu redhold 04:14am hold import result 01:12am hold import result hepatitis c serology hcv ab 02:02am negative import result blood gas blood gases type temp rates tidal v peep fio2 o2 flow po2 pco2 ph calhco3 base xs intubat vent 05:13am art 60 114* 39 7.48* 30 6 import result 04:06am art 203* 50* 7.36 29 2 import result 01:08am art 56* 49* 7.39 31* 3 import result 12:00pm art 35.8 /16 450 0 40 112* 48* 7.38 29 2 intubated spontaneou import result 08:35am art 35.8 /14 400 5 30 73* 45 7.38 28 0 intubated import result 02:07am art 35.8 155* 46* 7.43 32* 5 import result 08:10pm art 37.3 237* 46* 7.38 28 1 intubated import result 04:08pm art 182* 36 7.50* 29 5 intubated import result 01:12am 7.39 import result whole blood, miscellaneous chemistry glucose lactate na k cl calhco3 01:08am 121* import result 08:35am 91 import result 02:07am 0.9 import result 08:10pm 95 2.5* 3.2* import result 04:08pm 99 1.5 143 3.8 107 import result 01:12am 132* 1.2 142 4.4 104 27 import result hemogloblin fractions ( cooximetry) hgb calchct 04:08pm 13.6* 41 import result calcium freeca 05:13am 1.20 import result 01:08am 1.22 import result 02:07am 1.16 import result 08:10pm 1.07* import result 04:08pm 1.13 import result 01:12am 1.16 import result brief hospital course: 17 yo male who was jumping on a trampoline and landed on his head. pt was taken to osh. osh noted no movement in bilateral lower extremities and no sensation from nipple line down. pt was med flighted to on . imaging showed c4-c5 disc herniation, ligament injury and spinal cord contusion at this level causing complete c4-c5 cord injury. pt went to the or for an anterior c4-5 discectomy and fusion and posterior c4-5 laminectomy and fusion on .. percutaneous tracheostomy and gastrostomy was performed on . diagnostic venogram of ivc and iliac veins and placement of optease ivc filter was perform for dvt prophylaxis on chest ct on showed near collapse of the left lower lobe and diffuse nodular ground-glass opacity throughout the right lower lobe, suggestive of atypical infection and/or very early consolidation. a bronch was performed on for persistent hight temperatures bal cultures negative. pt was pan cultured several times for increased temperature all cultures had been negative. id consult was obtained recommending coverage for 14 days of unasyn.pt had picc line placement on . psychiatry assessment revealed normal greef.psychiatry recommendations were the following: 1) the pt appears to be experiencing normal grief 2) continue to monitor mood and sleep 3) offer ativan 1mg po prn anxiety or panic if it develops 4) continue to involve sw in case, offer educational materials 5) cont to involve pt??????s family in case 6) discussed with primary team, ,, md beeper#: 7) psychiatry will continue to follow, please page with questions #, or psychiatry on call nights/weekends #; last evaluation form speech and swallow where the following: secretions / ability to handle cuff deflation:cuff was deflated prior to our evaluation and pt was tolerating cuff deflation without o2 desaturation or distress. rn was present to suction pt from the trach tube with minimal/scant white, thick secretions retrieved. unlike the last evaluation, pt did not request oral suctioning via the yankauer during the evaluation. according to the rn, pt has not requested oral suctioning this morning. pmv tolerance / vocal quality / o2 sats:pt was able to achieve voicing upon placement of the valve and at first noted that it felt hard to exhale with the valve in place. the valve remained in place to allow the pt to adjust and pt stated that he was trying to get used to it. pt's tracheal pressure measures were between -2 to +10 cm h20(normal range is between -/+10 cm h20). pt's vocal quality was adequate and his o2 sats were between 94-99% while for 15 minutes while the valve was in place. summary: at this time pt is able to tolerate the pmv without respiratory distress, o2 desaturation, or c/o significant discomfort. it is recommended that the valve be removed when pt complains of discomfort, effortful breathing, or fatigue. it was discussed with the pt that he will need time to build up endurance to wear the valve for extended periods of time. we also discussed adjusting positioning as needed if valve tolerance appears difficult. pt was last seen on for a pmv eval only and the recs were to return on . however, the re consult was placed today for both the pmv and swallowing. however, as per the recommendations from previous evaluations, swallow eval was deferred today, especially in light of potential discharge to rehab yesterday, and evidence of lll collapse, rll ground opacity on prior chest ct. pt is just beginning to demonstrate improved endurance and respiratory drive to tolerate the valve. as such, would prefer to allow him to establish consistent strength/endurance for this prior to assessing swallowing, as he has already demonstrated inability to tolerate aspiration (prior to trach placement) in the setting of poor respiratory reserve. recommendations: 1. always deflate cuff prior to placing the passy-muir valve! 2. monitor o2 sats / respiration while valve is in place. 3. do not allow the patient to sleep with the valve in place. 4. pmv wear schedule is up to the discretion of the nurse and/or respiratory therapist. pt as remained afebrile for 36 hours. will be send to rehab today. pt will have to follow up with neurosurgery, and trauma surgery as an out patient. discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection (2 times a day). 2. docusate sodium 150 mg/15 ml liquid sig: one (1) po bid (2 times a day). 3. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily). 4. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 5. metoclopramide 10 mg tablet sig: one (1) tablet po qidachs (4 times a day (before meals and at bedtime)). 6. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 7. lactulose 10 g/15 ml syrup sig: thirty (30) ml po q8h (every 8 hours) as needed for constipation. 8. ibuprofen 100 mg/5 ml suspension sig: one (1) po q8h (every 8 hours) as needed for pain. 9. albuterol sulfate 0.083 % solution sig: one (1) inhalation q2h (every 2 hours) as needed for shortness of breath or wheezing. 10. quetiapine 25 mg tablet sig: two (2) tablet po twice a day as needed for agitation/anxiety. 11. quetiapine 100 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)) as needed for insomnia. 12. oxycodone 5 mg/5 ml solution sig: po q4-6h (every 4 to 6 hours) as needed for pain. discharge disposition: extended care facility: - discharge diagnosis: s/p fall onto head spinal cord injury c4-c5 (complete) discharge condition: stable discharge instructions: follow up with orthopedic spine and trauma surgery followup instructions: follow up with dr. in weeks, call for an appointment. follow up in trauma clinic in the next 4-8 weeks, call for an appointment. md procedure: 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 percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy other cervical fusion of the anterior column, anterior technique excision of intervertebral disc repair of vertebral fracture other cervical fusion of the posterior column, posterior technique insertion of interbody spinal fusion device fusion or refusion of 2-3 vertebrae insertion of recombinant bone morphogenetic protein diagnoses: pulmonary collapse pneumonitis due to inhalation of food or vomitus iatrogenic pneumothorax nonspecific abnormal results of function study of liver closed fracture of c1-c4 level with complete lesion of cord pneumonia due to streptococcus, group b accidental fall from playground equipment 

Answer: The patient is high likely exposed to