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: numbness and lower extremity weakness major surgical or invasive procedure: 1. anterior cervical diskectomy c5-c6. 2. fusion c5-c6. 3. instrumentation c5-c6. 4. total laminectomy of t10. 5. multiple thoracic laminotomies from t6 to t10. 6. fusion t6 to t11 for kyphosis. 7. removal of previous instrumentation t10. 8. application new instrumentation t6-t11. history of present illness: 65m who is 3 weeks post-op from t10-l3 fusion for l1 burst fx () with subsequent t12-l1 resvision (), subsequent development of paraplegia due to spinal cord infact at t10. the patient was previously able to feel sensation around his t10 level, but over the past 2 days at rehab has developed numbness up to the level of approximately t4. otherwise no new upper extremity weakness, but he has complained of incresing shortness of breath. he denies any recent fever, chills, chest pain, pleuritic pain, cough, abdominal pain. his foley has been in place since development of paraplegia. . in the ed, initial vitals were 98.2 72 103/44 17 96% 6lnc. noncontrast ct spine was concerning for new fracture above the level of instrumentation. he became hypotensive with sbp in low 90's for which he was given 5l of ns then started on norepinephrine. he subsequently developed hypoxia despite 6l n/c, and complained of increasing shortness of breath. throughout his course he continued to mentate normally, no decreased in urine output, and did not become tachycardic. he was started on ciprofloxacin for uti and vacnomycin and flagyl. he was admitted to the icu for hypoxia and hypotension. . on transfer to the micu he denied any shortness of breath, chest pain, pleuritic pain. he did have mild neck pain consistent with his chronic pain. he was initially weaned off the norepinephrine drip, but his sbp decreased to the upper 80's w/ map in mid 50's. he was restarted on phenylephrine to maintain map >65. . imaging studies were obtained that were concerning for a t10 fracture. past medical history: pmh: - obesity, 300 lbs, 66 inches tall - chronic pain in neck, per patient to arthritis - burst fracture of l1, s/p transpedicular decompression of l1, laminectomies of t11 and 12, and l2 and l3, fusion of t10-l3, instrumentation t10-l3, and autograft on - renal cancer, s/p unilateral nephrectomy, - iddm, poorly controlled per patient - htn, poorly controlled per patient - r knee replacement in djd - s/p thyroid surgery for goiter 10 years ago social history: married with 2 kids, lives in with his wife. in tech support. denies tobacco or drug use with occasional etoh. family history: dad - cad - cad, cva from dvt that left her comatose for several years physical exam: vitals: p 83 bp 87/43 rr 14 o2 sat 96% 5l n/c gen: no acute distress heent: mmm, perrl, eomi resp: no resp distress, ctab, mildly diminished rll cvs: regular rate, no m/r/g abd: protuberant, soft, nondistended ext: 2+ pulses all extremities, warm le bilaterally neuro: cniii-xii intact bilaterally, 0/5 le strength, upper extremity strength, complete loss of sensation below t4 level, otherwise intact, no dysmetria, gait not tested pertinent results: 09:29pm blood wbc-9.8 rbc-2.86* hgb-8.3* hct-25.1* mcv-88 mch-29.1 mchc-33.1 rdw-14.4 plt ct-416 04:52am blood wbc-10.8 rbc-2.85* hgb-7.9* hct-25.1* mcv-88 mch-27.9 mchc-31.6 rdw-14.4 plt ct-524* 12:00pm blood wbc-8.7 rbc-2.94* hgb-8.2* hct-25.8* mcv-88 mch-27.8 mchc-31.7 rdw-14.3 plt ct-450* 09:40pm blood pt-14.8* ptt-28.1 inr(pt)-1.4* 04:52am blood pt-13.2* ptt-29.1 inr(pt)-1.2* 12:00pm blood pt-13.0* ptt-33.7 inr(pt)-1.2* 09:29pm blood glucose-137* urean-22* creat-0.9 na-139 k-3.9 cl-103 hco3-30 angap-10 04:52am blood glucose-115* urean-25* creat-1.0 na-138 k-5.0 cl-99 hco3-34* angap-10 09:29pm blood calcium-8.3* phos-3.4 mg-1.7 04:52am blood calcium-8.5 phos-3.9 mg-2.0 02:14am blood freeca-1.23 cta chest: 1. within limits of motion artifact, no evidence of pulmonary embolus to the segmental level. 2. large multiloculated pleural effusion on the right with near complete collapse of the right lower lobe. 3. enlarged main pulmonary artery suggests pulmonary hypertension. 4. 13 mm lul nodule may be slightly larger, although technique and motion artifact limit comparison. pet-ct is recommended if not previously performed given the history of malignancy. mri of the cervical spine. again in comparison with the prior examination of the cervical spine dated , there is extensive soft tissue swelling posteriorly from c3 through c6 level involving the inter-and supraspinous ligaments, and again extending dorsally to the nuchal ligament. the alignment of the cervical spine demonstrates anterior angulation at c5/c6, the prior examination demonstrates straightening of the cervical lordosis, therefore the possibility of anterior widening in this patient with history of ankylosing spondylitis is a consideration. again there is severe spinal canal narrowing, more significant at c5/c6 level with bilateral neural foraminal narrowing. there is no evidence of abnormal enhancement within the spinal cord, however there is mild epidural enhancement with no definite fluid collection or epidural hematoma. increase in the pattern of edema is identified throughout the thoracic spinal cord extending from the lower cervical spine at c6/c7 throughout the t10 vertebral level, new since the most recent study, suggesting edema and possible ischemic changes. slight cord expansion is noted at c7/t1, no definite hematoma is identified at this level. mri of the thoracic spine. the alignment and configuration of the thoracic vertebral bodies from t1 through t9 appears unchanged. high signal intensity is noted throughout the thoracic spinal cord, new since the prior study, suggesting ischemic changes. fracture at t10 vertebral body is re-demonstrated. the images throughout the lower thoracic spine are limited due to hardware artifact, however, are grossly unchanged since the prior study. mri of the lumbar spine. again multilevel degenerative changes are re-demonstrated, more significant at l2/l3 and l4/l5 levels with mild posterior disc bulging, there is no evidence of abnormal enhancement throughout the lumbar spine. impression: 1. in comparison with the most recent mri examination, there is new pattern of edema along the lower cervical and the thoracic spinal cord, suggesting edema and ischemic changes with mild pattern of enhancement and no definite fluid collection, the possibility of a new infarct is a consideration. 2. in the cervical spine, there is anterior widening of the intervertebral disc space at c5/c6, apparently new since the prior study, with persistent edema from c3 through c6 levels posteriorly and extending at the ligamentum nuchae, with significant spinal canal stenosis at c5/c6. 3. the fixation hardware appears grossly unchanged since the prior studies and obscures the anatomical detail in the lower thoracic spine. unchanged multilevel degenerative changes throughout the lumbar spine as described above. brief hospital course: 65m now 3 weeks post-op from t10-l3 fusion for l1 burst fx with subsequent t12-l1 resvision, subsequent development of paraplegia due to spinal cord infact at t10, now with new development of numbness to the level of t4. found to be hypotensive w/ development of hypoxia in ed after 5l fluid bolus. transfered to micu for stabilization and further management. in the micu a noncontrast ct spine wasobtained and was concerning for new fracture above the level of instrumentation. he was admitted to the micu for hypoxia and hypotension in the ed. he was started on levophed and had 5l fluid resuscitation in the ed. was started on abx for a positive ua. in the micu patient had persistent pressor requirements, worsening hypoxia for which a cta was performed with no evidence of pe, but a a large multiloculated right pleural effusion with rll collapse. he was started on broad spectrum abx for possible sepsis and pna coverdage. his neuro exam progressed with worsening weakness in upper extremities, so he was taken back to the or by ortho spine for a t6 to t11 extension of posterior fusion for the t10 fracture and a c5-6 anterior discectomy and fusion for severe central stenosis. post-operatively, his lower extremity neurological exam did not improve. he had difficult weaning from the ventilator and a peg and tracheostomy was considered. mr. this intervention. a paliative care consult was obtained in addition to an ethics support service evaluation. mr. on requested a cessation of life-prolonging interventions, and tsicu staff called ethics support service for assistance in ensuring an appropriate patient-centered plan of care. after meeting with tsicu staff, and then in room with the staff and the patient, his wife , brother, and two adult children, it was unequivocally clear that the patient understands his current situation, choices, and almost certain likelihood of death (most likely in hours to days) if ventilator support is discontinued. he wants life support discontinued at this time. his wishes were granted and he expired. medications on admission: 1. atorvastatin 10 mg po hs 2. allopurinol 100 mg po daily 3. aspirin 325 mg po daily 4. acetaminophen 1000 mg po q6h 5. gabapentin 300 mg po q8h 6. oxycodone 40 mg extended release po q12h 7. oxycodone 5 mg po q3h prn pain 8. lidocaine 5 %(700 mg/patch) adhesive patch, medicated topical 9. bisacodyl 10 mg po daily 10. docusate sodium 100 mg po bid 11. pantoprazole 40 mg po q24h 12. gemfibrozil 600 mg tablet po daily 13. senna 8.6 mg po bid 14. polyethylene glycol 3350 17 gram/dose po 15. fleet enema 19-7 gram/118 ml 1 rectal daily (daily) prn for no bm in 48 hr. 16. sodium chloride 0.65 % aerosol, spray sig: sprays nasal tid prn congestion/dryness 17. insulin glargine 12 units sc bid: with breakfast and dinner. 18. insulin aspart per sliding scale qid 19. heparin (porcine) 5,000 unit/ml sc tid discharge medications: none discharge disposition: expired discharge diagnosis: t10 fracture t10 spinal cord infarct uti cervical stenosis discharge condition: expired discharge instructions: n/a followup instructions: n/a procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube closed [endoscopic] biopsy of bronchus other cervical fusion of the anterior column, anterior technique excision of intervertebral disc excision of bone for graft, other bones dorsal and dorsolumbar fusion of the posterior column, posterior technique repair of vertebral fracture fusion or refusion of 4-8 vertebrae central venous catheter placement with guidance diagnoses: unspecified pleural effusion urinary tract infection, site not specified unspecified essential hypertension long-term (current) use of insulin obesity, unspecified diabetes mellitus without mention of complication, type i [juvenile type], not stated as uncontrolled personal history of malignant neoplasm of kidney acquired absence of kidney knee joint replacement fall from other slipping, tripping, or stumbling kyphosis (acquired) (postural) mixed acid-base balance disorder cervical spondylosis with myelopathy closed dislocation, fifth cervical vertebra closed fracture of t7-t12 level with other specified spinal cord injury ankylosing spondylitis other pulmonary insufficiency, not elsewhere classified, following trauma and surgery 

Answer: The patient is high likely exposed to