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: abdominal pain major surgical or invasive procedure: diagnostic laparoscopy with evacuation of hematoma. history of present illness: 18 year old male restrained driver s/p mvc versus telephone pole requiring jaws of life for extracation. head-on collision; transfer from to for aortic dissection on imaging as well as a tiny right ptx. past medical history: pmh: none psh: none social history: + etoh, no tobacco family history: non contributory physical exam: temp: 97.5 rr: 18 pulse: 102 bp: 108/62 neuro/psych: oriented x3, affect normal, nad. neck: no masses, trachea midline, thyroid normal size, non-tender, no masses or nodules, no right carotid bruit, no left carotid bruit. nodes: no clavicular/cervical adenopathy, no inguinal adenopathy. skin: no atypical lesions. heart: regular rate and rhythm. lungs: clear, normal respiratory effort. gastrointestinal: non distended, no masses, no hepatosplenomegally. diffusely tender to palpation with +guarding, no rebound. positive seatbeat sign. extremities: no popiteal aneurysm, no femoral bruit/thrill, no rle edema, no lle edema, no varicosities, no skin changes. pertinent results: 04:05am wbc-18.9* rbc-4.65 hgb-14.8 hct-42.8 mcv-92 mch-31.8 mchc-34.5 rdw-13.2 03:55am glucose-108* lactate-3.3* na+-144 k+-3.9 cl--107 04:05am plt count-320 03:50am alt(sgpt)-41* ast(sgot)-70* alk phos-93 tot bili-0.6 03:50am lipase-44 03:50am asa-neg ethanol-166* acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 03:50am urine bnzodzpn-neg barbitrt-neg opiates-neg cocaine-neg amphetmn-neg mthdone-neg ct torso : 1. focal aortic dissection with flap at the level of the with surrounding hematoma. some more hyperdense material does suggest acute bleeding, but no definite active extravasation is present. 2. no flow is seen within the distal aspect of the , however, the celiac, sma, and bilateral renals appear patent. 3. fluid and blood within the pelvis. while this may arise from the aortic dissection, an occult mesenteric injury cannot be excluded. 4. equivocal dissection flap at the level just above the diaphragmatic hiatus in the descending thoracic aorta is likely due to motion artifact from the heart as there is no surrounding hematoma. 5. multifocal pulmonary contusions. no pneumothorax. 6. probable non-displaced manubrial fracture (discussed with dr. on the evening of the same day). 7. no definite evidence for solid organ injury. left tib/fib : no definite fracture; however, possible incomplete ossification, or result of prior injury at the medial malleolus. if patient has pain referable to this site, then dedicated ankle radiograph should be performed to better evaluate. cta torso : 1. stable abdominal aortic dissection at the level of the with adjacent hematoma. no active arterial extravasation from the aorta. 2. some increased volume of fluid in the pelvis containing blood. this continues to raise concern for a mesenteric injury which is occult. alternatively the aortic dissection with adjacent hematoma could contribute to this fluid collection and appearance. 3. no thoracic aortic dissection. 4. pulmonary contusions in the anterior lungs bilaterally which are little changed. no pneumothorax. 5. similar to the previous study, no solid organ injury. 6. suspected non-displaced fracture of the manubrium. cta torso : 1. stable abdominal aortic dissection at the level of the . no evidence of active extravasation or progression of dissection. 2. nonvisualization of the origin, with filling distally that is likely retrograde; the only change is decreased opacification along the residual take-off of the inferior mesenteric artery. 3. low-attenuation fluid in the pelvis, with hyperdensity layering posteriorly, compatible with known prior hemorrhage. 4. atypical configuration of the celiac artery, with focal stenosis seen 2 cm distal to the origin as the artery abruptly angles anteriorly. this is stable from prior studies and is unlikely to be post-traumatic although there may be signficant celiac stenosis. 5. redemonstration of pulmonary contusions. 6. new pneumoperitoneum and extensive subcutaneous emphysema reflects recent laparoscopy. 7. suspected nondisplaced manubrial fracture. left tib/fib : there is a nondisplaced, comminuted fracture predominantly transverse or slightly oblique, traversing medial malleolus extending into the mortise joint. the mortise remains congruent. no talar dome ocd or distal fibular fracture is detected. no fracture is seen along the posterior aspect of the distal tibia. there is surrounding soft tissue swelling most pronounced medially. no other fractures are detected. aortic us : there is a focal aortic dissection with a near circumferential luminal plaque in the aorta approximately 4 cm above the bifurcation, in a similar location to the ct examinations. the aortic diameter at the level of dissection measures 1.4 x 1.5 x 1.6 cm. the true lumen measures 8 x 8 x 7 mm. these measurements are all similar to the prior cta examinations allowing for differences in technique. no new areas concerning for aortic dissection are identified. the ivc appears normal. brief hospital course: patient was transferred from lgh to with possible aortic injury after his mva. he was evaluated in the trauma bay by the trauma team and the surgery team and attending. his ct torso showed a focal aortic dissection at the level of the with surrounding hematoma. no flow seen in the , but sma and celiac appear patent. there was some fluid and blood in the pelvis of unclear source. surgery did not think this was from his aorta. a decision was made to admit him immediately to the trauma icu and observe him. the images were extensively reviewed and after a repeat cta was performed showing a stable abdominal aortic dissection with no active arterial extravasation but increased volume of fluid in the pelvis containing blood, a decision was made to take him to the or for an exploratory laparoscopy. in the or a loop of proximal jejunum seemed bruised and edematous with a hematoma but viable. also bruising of the c-loop at the duodenum and the hepatic flexure was seen. approximately 450 cc of blood identified in the pelvis which was evacuated. patient did well postop. abdominal crepitus was felt after case, so a cxr was obtained to eval for ptx, which was negative. on tertiary survey a left ankle xr showed a nondisplaced, comminuted fx for which ortho recommended closed treatment with casting. he will be followed by aortic us for his aortic injury. on pod2 he was doing very well, hcts were stable and was transferred to the floor. following transfer to the trauma floor he continued to make good progress. he was tolerating a regular diet without difficulty and he maintained stable hemodynamics. his hematocrit remained stable in the 31 range. he had a short left leg cast placed for his ankle fracture and was using crutches to walk without difficulty. he had an uneventful recovery and will follow up with the orthopedic service as well as and acute care in the coming weeks. medications on admission: none discharge medications: 1. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*60 tablet(s)* refills:*2* 2. acetaminophen 500 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 5. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). discharge disposition: home discharge diagnosis: s/p mvc 1. aortic dissection 2. hemoperitoneum 3. left ankle fracture 4. right pneumothorax 5. pulmonary contusion 6. non displaced manubrium fracture discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory with crutches touch down weight bearing on left leg. discharge instructions: * you were admitted to the hospital after your car accident with multiple injuries. you underwent diagnostic surgery as there was fluid in your abdomen probably from the impact of the accident causing bruising and swelling of the small bowel. there was no active bleeding and it was not related to the aortic dissection. multiple scans were done to assess any interval changes in the aorta and they remain the same. your blood count has also been stable. * you are able to tolerate a regular diet and should continue to do so. stay well hydrated. * your left ankle is broken and will be managed in a short leg cast. you can walk with crutches and your weight bearing status on the left leg is touch down as opposed to full weight bearing. * make sure that you do not do any heavy lifting > 10 lbs for the next 6 weeks. * you had a small portion of your right lung collapse due to extra air but that has resolved. * make sure that you have regular bowel movements and if needed take a stool softener or gentle laxative. * if you develop any chest pain, shortness of breath, abdominal pain, weakness or any other symptoms that concern you please call your doctor or return to the emergency room. followup instructions: provider: lab phone: date/time: 8:30 provider: , md phone: date/time: 9:30 call the clinic at for a follow up appointment in 1 weeks. call the acute care clinic at for a follow up appointment in weeks. md, procedure: incision of peritoneum application of other cast diagnoses: closed fracture of sternum traumatic pneumothorax without mention of open wound into thorax contusion of lung without mention of open wound into thorax injury to other intra-abdominal organs without mention of open wound into cavity, peritoneum motor vehicle traffic accident due to loss of control, without collision on the highway, injuring driver of motor vehicle other than motorcycle dissection of aorta, abdominal fracture of medial malleolus, closed injury to other gastrointestinal sites, without mention of open wound into cavity 

Answer: The patient is high likely exposed to