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: trauma major surgical or invasive procedure: open reduction internal fixation of left monteggia fracture and examination under anesthesia for assessment of elbow-radial head stability . open reduction and internal fixation of left fracture. . debridement and split thickness skin graft to left forearm history of present illness: 29m s/p high speed mvc rollover, brought in by med flight from , associated with loss of consciousness, gcs 15 at scene. he was pulled from vehicle at scene as it had caught fire. given pulmonary contusions and concern for airway protection given burns he was intubated at the outside hospital. urine tox screen was positive for benzodiazepines, amphetamines, and opiates but serum tox was negative. past medical history: pmh: none per family psh: left shoulder surgery, s/p orif l ulna and thumb repair () social history: denies tobacco, alcohol and illicit drugs family history: non-contributory physical exam: admission vitals- 97.4, 93, 131/66, 15, 99% intubated gen- sedated heent- perrl, 2 superficial abrasions on scalp- one 3 cm long and the other 4 cm long. some 1 and 2 degree burns over anterior scalp area. no other visible injuries cardiac- rrr, no mrg, normal s1/s2 resp- cta bilaterally, mild crackels in right middle lobe, no wheezing abd- soft, non distended, normal bs ext- right ue: blistering on dorsal aspect of all digits. full passive range of motion without crepitus; no deformity; 2+ radial; compartments soft. left ue: several large blisters on elblow, forearm and first two digits. there is an obvious forearm deformity. there is diffuse swelling along this extremity. there is some minimal crepitus with wrist rom but markedly more at the base of the 1st mc. 2+ radial pulse. full prom of shoulder without crepitus lower extremities show no injuries pertinent results: 10:57pm wbc-11.6* rbc-5.52 hgb-15.6 hct-47.3 mcv-86 mch-28.2 mchc-33.0 rdw-13.8 07:35pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 07:35pm urine bnzodzp-pos barbitr-neg opiates-pos cocaine-neg amphetm-pos mthdone-neg . ct chest, abdomen, pelvis: impression: 1. bilateral pulmonary contusion, most notable in the left upper lobe. 2. multiple left rib fractures as described, several displaced with associated extrapleural hematoma along the left apex. 3. manubrial fracture with retromanubrial hematoma. 4. subtle thickening and stranding adjacent to the left adrenal gland, mild injury is difficult to exclude. . cxr impression: 1. left upper lung consolidation which is partially imaged on the ct c-spine from outside hospital. consider ct chest to futher assess extent of injury. 2. low position of et tube, retraction by at least 1 cm advised. . wrist impression: 1. interval reduction of radial head. no definite fracture. elbow fusion. 2. improved alignment of comminuted ulnar diaphyseal fracture. 3. unchanged thumb base of the metacarpal fracture. . shoulder : on both of the axillary views, there is no evidence of dislocation or displaced fracture. if a fracture remains of clinical concern, a full dedicated humeral series should be obtained. . microbiology: 10:57 pm mrsa screen **final report ** mrsa screen (final ): no mrsa isolated. . 12:08 pm skin scrapings viral culture: r/o herpes simplex virus (preliminary): herpes simplex like cytopathic effect. culture confirmation pending. . 6:10 pm serology/blood **final report ** rapid plasma reagin test (final ): nonreactive. reference range: non-reactive. . 4:23 pm urine source: cvs. **final report ** neisseria gonorrhoeae (gc), nucleic acid probe, with amplification (final ): negative for neisseria gonorrhoeae by pcr. brief hospital course: mr. was transferred to from , intubated due to pulmonary contusions. at the outside hosptial he was found to have left rib fractures, left humerus fracture, left ulnar facture, left sided head laceration, bilateral pulmonary contusions, and burns on left forearm, scalp and right hand. in the emergency department he was kept intubated and transferred to the trauma icu for close monitoring due to mechanism of injury and intubation. he was hemodynamically stable in the trauma bay. on hd 1 his left forearm eschar was debrided by acs service. he was kept intubated for ortho/plastics procedures, which were orif of left fracture and left forearm ulnar moteggai fracture. he was extubated shortly after these procedures on pod0. pod1: he was stable post-operatively, had epidural placed for pain, left arm placed in sugartong splint with burns covered with silvadene/xeroform, and was transferred to the floor on pod 1 from orif, after having an uneventful icu. he had his cervical spine cleared and his diet was advanced to regular. on the floor the acute pain service was following him for pain control. pod2: on pod 2 he noted tenderness to plapation of his left shoulder and so x-rays were done that showed no fracture. he was tolerating a regular diet. he continued to have pain control issues and was started on a dilaudid pca pump in addition to his epidural that was running bupivacaine only. he had problem maintaining adequate oxygen saturations. social work has been following patient and discovered he has been out of work on workmans comp for shoulder injury. occupational therapy and physical therapy began working with patient. pod3: epidural was discontinued as it was not providing adequate pain control. patient was given po dilaudid and dilaudid pca. he was continued on silvadene applications to burns with arm splinted. pod 4: continued adjustments for pain control were made with better control. patient was ambulating with physical therapy. his oxygen saturation was high 90s on room air. he commented on penile lesions, non-painful, nonerythematous, non-vesiculr, that appeared consistent with hsv. pod5/0: infectious disease was consulted for penile lesions and recommended an std workup. he was also taken back to operating room for split thickness skin graft, donor site left thigh, for his left forearm. a vac dressing was placed over this arm. he tolerated the procedure well and by that evening he was back on a regular diet. pod6/1: he required intermittent iv dilaudid for pain control in addition to his po regimen. he continued to work with physical therapy and occupational therapy. he continued to have burn care and vac remained in place. pod7/2: partial results from std workup, showing negative rpr and ghonnorhea and chlamydia. his hiv test was negative. his hsv skin scrapings were suspicious for herpes simplex and final culture results were 'pending' at time of discharge. patient was transferred to the plastics service at this point for management of wound vac. pod7-12/2-7: wound vac taken down lue with good-appearing skin graft (almost 100% take). dressings changed daily. donor site kept dry and exposed with xeroform drying in place. thumb spica splint modified and resized to lue. on pod#2 s/p stsg, patient was complaining of poor pain control with oxycontin 20 mg po bid and oxycodone 15mg po q3h prn regimen. patient was changed to a regimen of oxycontin 30mg po bid with diluadid 10mg po q4h prn for breakthrough. patient reported excellent pain control on this regimen and was comfortable for the next 3-4 days. on pod#10, patient's dilaudid was reduced to dilaudid 8 mg po/ng q6h:prn pain. on pod#11 patient became increasingly agitated that his dilaudid had been changed to q6h complaining that he was in more pain. we discussed that this was a normal time period to start tapering pain meds since the vac dressing had been removed 2 days prior and his left thigh donor site was completely dried out. patient disagreed and reported that his pain control was poor so order was changed to dilaudid 6mg po q4h prn. patient was given the initial dose and immediately complained that we had reduced his dose again. it was explained to patient that although the actual dose of the med was reduced to 6mg, the frequency was increased to every 4 hours, rather than every 8 hours and he was actually getting more dilaudid, in 24 hours, than he was with dilaudid 8mg q6 prn. encouraged patient to try this regimen and see if he had improved pain control. on pod#12, patient reported improved pain control. patient was tolerating po, ambulating, pain controlled with po dilaudid prior to discharge. discharged to: -, nh medications on admission: none discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 2. silver sulfadiazine 1 % cream sig: one (1) appl topical (2 times a day): apply to burn wounds/blistered areas. disp:*1 container* refills:*2* 3. gabapentin 400 mg capsule sig: one (1) capsule po tid (3 times a day). 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 5. polyethylene glycol 3350 17 gram/dose powder sig: seventeen (17) grams po daily (daily) as needed for constipation. 6. xeroform petrolatum dressing 5 x 9 bandage sig: one (1) dressing topical once a day: apply xeroform dressing to skin graft site on left arm. disp:*14 dressings* refills:*1* 7. bacitracin 500 unit/g ointment sig: one (1) layer topical once a day: apply thin layer to skin graft site left arm. disp:*1 tube* refills:*3* 8. oxycontin 30 mg tablet extended release 12 hr sig: one (1) tablet extended release 12 hr po every twelve (12) hours. 9. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily): apply to left shoulder . 10. ativan 0.5 mg tablet sig: 1-2 tablets po every six (6) hours as needed for anxiety. 11. senna 8.6 mg tablet sig: two (2) tablet po at bedtime. 12. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection injection twice a day. 13. tylenol extra strength 500 mg tablet sig: two (2) tablet po every six (6) hours. 14. gabapentin 400 mg capsule sig: one (1) capsule po three times a day. 15. hydromorphone 2 mg tablet sig: three (3) tablet po q4h (every 4 hours) as needed for pain. discharge disposition: extended care facility: discharge diagnosis: 1) left rib fractures 2) bilateral pulmonary contusion 3) 2nd degree burns on left arm, right hand, and right forehead 4) manubrium fracture 5) mediastinal hematoma 6) mesenteric root hematoma 7) left forearm ulnar monteggia fracture 8) left fracture (1st metacarpal) discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. trouble with adl's due to bilateral upper extremity burns, skin graft, splints. non wt bear on lue. discharge instructions: you were seen in the hospital after a motor vehicle accident. you were found to have left rib fractures, bilateral pulmonary contusion, left forearm/hand fractures, 2nd degree burns on left arm, right hand, and right forehead, manubrium fracture, mediastinal hematoma, mesenteric root hematoma. you had multiple services following you for these injuries. the orthopedic and plastic surgery doctors your hand and forearm fractures. plastic surgery also put a skin graft on your left forearm burn. the acute pain service was following you for your pain control. you also had the infectious disease doctors following to advise on the penile lesions you had brought to our attention. hsv test is still pending. also, you were complaining of left shoulder pain and had a x-ray done of the shoulder that showed no fracture. . followup instructions: -you should continue taking your current medication. -elevate your left arm as much as possible and maintain it in your splints. -please keep your left arm dry - if your left arm skin graft site begins to worsen after discharge with an acute increase in swelling or pain, please call dr. office at (. - you should keep your left thigh donor site open to air and leave the yellow xeroform dressing in place to dry out. do not get this area wet. - your left arm skin graft and repair sites will be dressed with a xeroform dressing and bacitracin to graft areas, fluffed gauzes covered with kerlix and then ace wrap. your splints should be warn at all times. - your right hand burns will be dressed with silver sulfadiazine 1% cream and covered with xeroform dressing and clean, dry dressing daily. - you will need to go to all of your follow up appointments. . diet/activity: 1. you may resume your regular diet. 2. avoid heavy lifting and do not engage in strenuous activity until instructed by dr. . . medications: 1. resume your regular medications unless instructed otherwise and take any new meds as ordered. 2. you may take your prescribed pain medication for moderate to severe pain. you may switch to tylenol or extra strength tylenol for mild pain as directed on the packaging. please note that percocet and vicodin have tylenol as an active ingredient so do not take these meds with additional tylenol. 4. take prescription pain medications for pain not relieved by tylenol. 5. take colace, 100 mg by mouth 2 times per day, while taking the prescription pain medication. you may use a different over-the-counter stool softener if you wish. 6. do not drive or operate heavy machinery while taking any narcotic pain medication. you may have constipation when taking narcotic pain medications (oxycodone, percocet, vicodin, hydrocodone, dilaudid, etc.); you should continue drinking fluids, you may take stool softeners, and should eat foods that are high in fiber. 7. do not take any medicines such as motrin, aspirin, advil or ibuprofen etc . call the office immediately if you have any of the following: 1. signs of infection: fever with chills, increased redness, swelling, warmth or tenderness at the surgical site, or unusual drainage from the incision(s). 2. a large amount of bleeding from the incision(s). 3. fever greater than 101.5 of 4. severe pain not relieved by your medication. . return to the er if: * if you are vomiting and cannot keep in fluids or your medications. * if you have shaking chills, fever greater than 101.5 (f) degrees or 38 (c) degrees, increased redness, swelling or discharge from incision, chest pain, shortness of breath, or anything else that is troubling you. * any serious change in your symptoms, or any new symptoms that concern you. followup instructions: hand clinic: ( , building, please follow up with dr. , in the hand clinic on tuesday, at 9:40am. the clinic is located on the , building, , orthopaedics. . please follow up with the acute care surgery service on at 1:45pm. the office is located in the medical office building on the , , , ., ma. you will get a follow up chest x-ray prior to this appointment. please call the acute care surgery service at if you need to reschedule this appointment and to schedule the chest x-ray, which should be done prior to the appointment. . please follow-up on tuesday at the orthopaedic sports/shoulder clinic, with dr. , at 11:30am. please follow-up on tuesday at the orthopaedic trauma clinic, , np at 12:20 pm both appointments are located at , , center, . to change appointment time, please call . you will need to follow up with your pcp regarding the results of your herpes simplex virus (hsv) testing. the final results of the test are still pending but, preliminary testing appear suspicious. if you do test positive for this virus then you will require a prescription for an antiviral medication to treat future outbreaks. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours other skin graft to other sites open reduction of fracture with internal fixation, radius and ulna closed reduction of fracture without internal fixation, radius and ulna open reduction of fracture with internal fixation, carpals and metacarpals diagnoses: acidosis closed fracture of sternum contusion of lung without mention of open wound into thorax other and unspecified open wound of head without mention of complication pain in joint, shoulder region motor vehicle traffic accident due to loss of control, without collision on the highway, injuring driver of motor vehicle other than motorcycle closed fracture of six ribs injury to other gastrointestinal sites, without mention of open wound into cavity intracranial injury of other and unspecified nature without mention of open intracranial wound, with brief [less than one hour] loss of consciousness closed fracture of base of thumb [first] metacarpal closed monteggia's fracture blisters, epidermal loss [second degree] of two or more digits of hand, not including thumb herpetic infection of penis blisters, epidermal loss [second degree] of scalp [any part] blisters, epidermal loss [second degree] of forearm 

Answer: The patient is high likely exposed to