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: morphine attending: chief complaint: trauma: fall small rigth pneumothorax with pulmonary contusion right rib fracture (3, have segmental fracture) right scapula fracture right clavicular fracture t2,t6,t7 transverse process fracture major surgical or invasive procedure: none history of present illness: history of presenting illness this patient is a 80 year old male who complains of s/p fall. time seen was 6:15, upon arrival. the patient fell 15-20 feet. he is complaining of right-sided rib pain. the pressure was 1:30 systolic. his heart rate was 70. he is breathing at 32-36. he has right shoulder pain according to the paramedics previous complaining of slight shortness of breath. there was no loss of consciousness. he got up and walked into his house. past medical history: 1. coronary artery disease status post cabg, mvr in . 2. peripheral vascular disease status post bilateral carotid stenting 3. htn 4. rcc s/p resection 5. dm 6. aaa 7. hyperparathyroidism social history: married, russian only speaking and lives with his wife who works at and translates for him. has one daughter and two granddaughters. his daughter will drive them to and from the hospital. family history: father had cva. physical exam: physical examination: upon admission: constitutional: back board and collar heent: normocephalic, atraumatic, pupils equal, round and reactive to light, extraocular muscles intact, right occipital abrasion neck is nontender chest: clear to auscultation, right chest wall tenderness cardiovascular: regular rate and rhythm, normal first and second heart sounds abdominal: soft, nontender pelvic: pelvis stable rectal: rectal is normal tone normal sensory extr/back: back is nontender. there is no extremity tenderness. right shoulder is without deformity or tenderness. neuro: a/o x 3, cn 3-12 intact, normal sensory, normal motor, normal cerebellar function, normal gait, downgoing toes, dtrs normal physical examination upon discharge: vital signs: t=97.6, hr=73, bp=152/47, rr 20, oxygen sat 90% room air general: sitting in chair cv: ns1, s2, -s3, ,-s4, +grade 2 systolic murmur, 2nd ics, lsb, rsb resp: diminished bs right base abdomen: rounded, soft, non-tender ext: no calf tenderness bil. neuro: speaking broken english, follows commands musculskeltal: right sided rib tenderness, right arm in sling, fingers warm, + radial pulse pertinent results: 01:25am blood wbc-6.8 rbc-3.29* hgb-10.0* hct-30.0* mcv-91 mch-30.2 mchc-33.2 rdw-14.9 plt ct-211 12:45am blood wbc-7.8 rbc-3.26* hgb-9.9* hct-29.6* mcv-91 mch-30.5 mchc-33.6 rdw-14.7 plt ct-180 07:45pm blood wbc-13.6* rbc-4.33* hgb-13.2* hct-38.8* mcv-90 mch-30.5 mchc-34.1 rdw-14.1 plt ct-188 01:25am blood plt ct-211 12:45am blood plt ct-180 07:45pm blood pt-10.7 ptt-26.4 inr(pt)-1.0 07:45pm blood fibrino-257 06:35am blood glucose-211* urean-42* creat-1.5* na-139 k-4.1 cl-97 hco3-33* angap-13 09:23am blood glucose-86 urean-46* creat-1.6* na-142 k-4.0 cl-99 hco3-35* angap-12 01:25am blood glucose-121* urean-46* creat-1.5* na-145 k-4.5 cl-103 hco3-35* angap-12 07:45pm blood urean-36* creat-1.7* 01:15am blood ck(cpk)-224 07:45pm blood lipase-52 05:14pm blood ctropnt-0.21* 01:15am blood ck-mb-4 ctropnt-0.30* 04:31pm blood ck-mb-7 ctropnt-0.31* 08:26am blood ck-mb-8 ctropnt-0.23* 04:13am blood ck-mb-4 ctropnt-0.10* 09:23am blood calcium-10.3 phos-2.9 mg-2.2 07:45pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 01:38am blood freeca-1.40* : ekg: sinus rhythm. left bundle-branch block. occasional ventricular premature beats. prolonged p-r interval. compared to the previous tracing of no clear change. : chest x-ray: impression: limited exam. multiple displaced right-sided rib fractures with adjacent subcutaneous emphysema. comminuted right scapular fracture. atelectasis versus contusions in the right lung base. : cat scan of abdomen and pelvis: impression: 1. small right pneumothorax without evidence of tension. right upper lobe and right lower lobe pulmonary contusions. 2. comminuted right scapular fracture with right subscapular hematoma. no evidence of active extravasation. 3. flail chest with right 6th-8th rib segmental fractures. multiple additional minimally displaced rib fractures as detailed above, with small associated extrapleural hematomas. extensive right posterolateral chest wall subcutaneous emphysema. minimally displaced right proximal clavicle fracture. 4. multiple right thoracic vertebrae transverse process fractures, as detailed above. 5. esophagus is fluid-filled and may predispose the patient to aspiration. 6. intact infrarenal aortobiiliac stent-graft without evidence of endoleak. excluded aneurysm sac measures 5.9 x 5.4 cm. : cat scan of the c-spine: impression: 1. no cervical spine fracture, acute alignment abnormality, or prevertebral soft tissue abnormality. 2. fractures of right t2 transverse process, right 1st, 2nd, and 3rd posterolateral ribs, right proximal clavicle, and right scapula. numerous other transverse process and rib fractures are not imaged, seen on accompanying ct torso. 3. irregular sclerosis in right aspect of c2 vertebral body. clinical correlation with history of malignancy should be made and a bone scan can be obtained for further evaluation. : cat scan of the head: impression: 1. no intracranial hemorrhage or calvarial fracture. 2. probable subacute to chronic infarct within the right frontal lobe, with chronic infarcts in the left cerebellum and right subinsular region as well. if there is concern for an acute stroke, mr may be obtained for further evaluation : right shoulder x-ray: comminuted fracture of the right scapula and displaced fracture of the right proximal clavicle. known right-sided rib fractures are better seen on the previous ct. no dislocation. : echo: impression: suboptimal image quality. well seated mitral valve bioprosthesis with high normal gradient and mild mitral regurgitation. normal left ventricular cavity size with regional systolic dysfunction c/w cad. pulmonary artery hypertension. pulmonary artery hypertension. mild aortic valve stenosis. compared with the prior study (images reviewed) of , the severity of aortic stenosis has increased. the mitral valve gradient, severity of mitral regurgitation, and the egional and global left ventricular systolic function are similar. : ekg: sinus rhythm with ventricular premature contractions. variable a-v conduction, possible dual a-v nodal pathways. compared to the previous tracing of variable a-v nodal conduction is seen. the other findings are similar. : ekg: sinus rhythm with atrial ectopy. left axis deviation. non-specific intraventricular conduction delay. non-specific st-t wave changes. compared to the previous tracing of atrial ectopy is new. : x-ray of abdomen: impression: nonspecific bowel gas pattern with no obvious signs of ileus or obstruction : chest x-ray: current study demonstrates that the patient has been extubated. heart size and mediastinum are stable. no pneumothorax is seen on the current examination. bibasal atelectasis and bilateral pleural effusions appear to be slightly improved as compared to the prior study. : chest x-ray: heart size and mediastinum are stable. there is interval improvement in pulmonary edema with also improvement of bibasal lung aeration. current study demonstrates no evidence of pneumothorax. bilateral pleural effusion is most likely present. 5:00 pm sputum source: induced. **final report ** gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 4+ (>10 per 1000x field): gram negative rod(s). 3+ (5-10 per 1000x field): gram positive cocci. in pairs and clusters and in short chains. 1+ (<1 per 1000x field): gram positive rod(s). respiratory culture (final ): moderate growth commensal respiratory flora. staph aureus coag +. moderate growth. staphylococcus species may develop resistance during prolonged therapy with quinolones. therefore, isolates that are initially susceptible may become resistant within three to four days after initiation of therapy. testing of repeat isolates may be warranted. haemophilus influenzae, beta-lactamase negative. heavy growth. beta-lactamse negative: presumptively sensitive to ampicillin. confirmation should be requested in cases of treatment failure in life-threatening infections.. sensitivities: mic expressed in mcg/ml _________________________________________________________ staph aureus coag + | clindamycin-----------<=0.25 s erythromycin---------- =>8 r gentamicin------------ <=0.5 s levofloxacin---------- 0.25 s oxacillin------------- 0.5 s tetracycline---------- =>16 r trimethoprim/sulfa---- <=0.5 s brief hospital course: the patient was admitted to the acute care service after falling off a ladder and stricking a tree on the way to the ground. upon admission he was complaining of right shoulder and rib pain. he was made npo, given intravenous fluids, and imaging. review of the imaging showed right sided rib fractures (3, segmental fractures, right clavicle and scapular fracture, and t2-7 transverse process fracture. he was also reported to have a small right pneumothorax. he was admitted to the intensive care unit for monitoring where he had an epidural cathete placed for pain control with a resultant drop in his blood pressure requiring additional intravenous fluids. the epidural catheter was removed on hd #2. on hd #4, he was intubated for increased work of breathing, progressive hypoxia, and copious secretions. he was bronched with minimal remaining secretions. sputum cultures grew mssa and h. flu and he was started on vancomycin, nafcillin, and ceftriaxone. the vancomycin was discontinued within 24 hours and he was maintained on nafcillin and cetriaxone. during this time, he had an eppisode of blood pressure instability where he required pressor support. he was also noted to have an irregular heart rate which was controlled with metoprolol. his pulmonary status worsened and on chest x-ray was found to have a right lung collapse requiring placement of a chest tube with re-expansion of the lung. with his hemodynamic instability, cardiology was consulted for a mild elevation in the troponins and an echocardiogram was done on hd # 4. the echo showed an ejection fraction of 40% and an increase in the severtiy of the aortic stenosis. his troponins were monitored and they gradually decreased. recommendations were made by cardiology for resumption of his home medications. they recommended holding his metoprolol because of progression on ekg to type 1 second degree heart block. the patient self-extubated on #5, and required re-intubation. he was reported to have periods of agitation and the weaning process was delayed. on hd #8, he developed stridor and difficulty ventilating. he was bronched and his pulmonary status markedly improved. he was extubated on hd #8. at this time his chest tube was removed and his pain medication was changed to patient controlled analgesia. on hd #9, after his pulmonary and cardiac status stabilized, he was transferred to the surgical floor. his rib pain has been controlled with oral analgesics. his vital signs have been stable. he has resumed his home medications except for his metoprolol. his intravenous antibiotics were discontinued on hd # 12 and he will start a 10 day renal course of levofloxacin for mssa in his sputum. he has been tolerating a regular diet and voiding without difficulty. he has been instructed in the use of the incentive spirometer. he has been evaluated by physical therapy and recommendations made for discharge to an extended care facility where he can further regain his strength and mobility. follow-up appoinments have been made with orthopedic service, acute care service, and with his cardiologist. medications on admission: amlodipine 10', lipitor 80', hctz 25', lisinopril 40', metformin 850', glipizide 10', metoprolol 25'', asa' discharge medications: 1. acetaminophen 650 mg po q6h 2. amlodipine 10 mg po daily hold for systolic blood pressure <110, hr <60 3. aspirin 81 mg po daily 4. atorvastatin 80 mg po daily 5. calcium carbonate 500 mg po qid:prn indigestion 6. glipizide 10 mg po daily please monitor blood sugar 7. heparin 5000 unit sc tid 8. hydrochlorothiazide 25 mg po daily 9. lidocaine 5% patch 1 ptch td daily rib pain apply to right posterior chest 10. lisinopril 40 mg po daily hold for systolic blood pressure <110, hr <60 11. milk of magnesia 30 ml po q6h:prn constipation 12. omeprazole 20 mg po daily 13. oxycodone (immediate release) 5-15 mg po q3h:prn pain hold for increased sedation, resp. rate <10 14. sarna lotion 1 appl tp qid:prn itching 15. senna 1 tab po bid 16. trazodone 25 mg po hs:prn insomnia 17. albuterol 0.083% neb soln 1 neb ih q6h:prn wheezing/shortness of breath 18. ipratropium bromide neb 1 neb ih q6h 19. metformin (glucophage) 850 mg po daily on hold...elevated creat 1.5, resume when creat <1.5 20. levofloxacin 750 mg po q48h duration: 10 days started on 21. docusate sodium 100 mg po bid hold for diarrhea discharge disposition: extended care facility: - discharge diagnosis: trauma: fall small right pneumothorax with pulmonary contusion right rib fracture (3, have segmental fracture) right scapula fracture right clavicular fracture t2,t6,t7 transverse process fracture discharge condition: mental status: clear and coherent ( russian speaking, but speaks broken english) level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to the hospital after falling from a ladder and striking a tree. you were brought to the hospital. after imaging, you were found to have several rib fractures, fractures segments to your spine, clavicle and scapula fractures, and a collapse to your lung. you were noted to have increased difficulty breathing and required a breathing tube for assistance. you were also noted to have an irregular heart rate and mild increase in cardiac blood work. you were seen by cardiology and recommendations made for your care. fortunately, you did not require any surgery and you are slowly recovering from your fall. your vital signs and blood work have been stable. you are now preparing for discharge to an extended care facility where you can further regain your strength. followup instructions: name: , md specialty: primary care location: /east address: , e/cc-6, , phone: please discuss with the staff at the facility a follow up appointment with your pcp when you are ready for discharge. department: orthopedics when: tuesday at 1:20 pm with: xray (scc 2) building: sc clinical ctr campus: east best parking: garage department: orthopedics when: tuesday at 1:40 pm with: , np building: campus: east best parking: garage department: general surgery/ with: , md when: friday at 11:00 am with: acute care clinic building: lm bldg () campus: west best parking: garage you will need a chest x-ray prior to this appointment. please go to , clinical center, radiology 30 minutes prior to your appointment. please arrive at 10:30am. procedure: insertion of intercostal catheter for drainage continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube insertion of endotracheal tube fiber-optic bronchoscopy enteral infusion of concentrated nutritional substances other bronchoscopy other intubation of respiratory tract insertion of catheter into spinal canal for infusion of therapeutic or palliative substances systemic to pulmonary artery shunt diagnoses: pneumonia, organism unspecified anemia, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status aortic valve disorders peripheral vascular disease, unspecified pulmonary collapse chronic kidney disease, stage iii (moderate) acute respiratory failure closed fracture of dorsal [thoracic] vertebra without mention of spinal cord injury personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits heart valve replaced by transplant traumatic pneumothorax without mention of open wound into thorax personal history of malignant neoplasm of kidney accidental fall from ladder traumatic subcutaneous emphysema contusion of lung without mention of open wound into thorax flail chest other alteration of consciousness closed fracture of scapula, unspecified part other second degree atrioventricular block closed fracture of clavicle, unspecified part other acute and subacute forms of ischemic heart disease, other inhalation and ingestion of other object causing obstruction of respiratory tract or suffocation foreign body in trachea 

Answer: The patient is high likely exposed to