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: chief complaint: s/p scooter crash major surgical or invasive procedure: 1. anterior cervical decompression and diskectomy at c4-5, c5-6 and c6-7. 2. anterior fusion, c4 to 7. 3. anterior instrumentation c4-7. 4. structural allograft. 5. closed reduction of nasal fractures 6. open tracheostomy. 7. central line placement history of present illness: this is 48 year-old male who fell off his moped while intoxicated and not wearing a helmet. +loc and amnesia of events of injury. the patient was transported to where he was found to have nondisplaced fracture through the body of c3 and fracture of the posterior element of c4 as well as fractures of the nasal bones and right frontal sinus bones but no intracranial hemorrhage. he was transferred by ambulance to . past medical history: depression niddm (diet/exercise-controlled) h/o dvt social history: alcohol tobacco family history: noncontibutory; no fhx of neurologic disease physical exam: on arrival: afebrile p85 bp139/76 r20 95%o2 gen: awake and alert, intoxicated. no acute distress. heent: normocephalic. large complex right supraorbital laceration with exposed, fractured bone in wound bed. superficial laceration over bridge of nose and over upper lip. perrl, eoemi, vision grossly intact. no midface instability or step-offs. dentition in place, no oral lacs. no nasal septal hematoma. tms clear. neck: + collar. trachea midline chest: atraumatic. equal breath sounds bilaterally cv: regular rate and rhythm, s1s2. abd: soft, nontender. fast negative for free fluid/pericardial effusion. back: nontender, no stepoffs. atraumatic. pelvis/rectal: pelvis stable. rectal exam with normal tone, no blood. ext: mae, motor/sensory exam grossly normal. well-perfused. pertinent results: 07:53am glucose-165* urea n-10 creat-0.6 sodium-137 potassium-3.8 chloride-103 total co2-23 anion gap-15 07:53am alt(sgpt)-17 ast(sgot)-29 alk phos-62 amylase-38 tot bili-0.6 07:53am calcium-8.5 phosphate-2.7 magnesium-1.7 07:53am wbc-14.7* rbc-3.50* hgb-11.8* hct-34.6* mcv-99* mch-33.6* mchc-34.0 rdw-13.1 07:53am neuts-91.2* lymphs-6.5* monos-2.2 eos-0 basos-0 07:53am macrocyt-1+ 07:53am plt count-147* 11:12pm po2-48* pco2-46* ph-7.34* total co2-26 base xs--1 comments-green top 11:12pm glucose-189* lactate-2.6* na+-141 k+-4.3 cl--103 11:12pm hgb-12.4* calchct-37 o2 sat-80 carboxyhb-1 met hgb-1 11:12pm freeca-1.05* 11:05pm urea n-16 creat-0.8 11:05pm amylase-53 11:05pm asa-neg ethanol-154* acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 11:05pm wbc-17.3* rbc-3.73* hgb-12.9* hct-37.0* mcv-99* mch-34.5* mchc-34.8 rdw-13.0 11:05pm plt count-191 11:05pm pt-12.0 ptt-22.7 inr(pt)-1.0 11:05pm fibrinoge-219 ct reconstruction 11:50 pm ct c-spine w/o contrast; ct reconstruction reason: fx? medical condition: 48 year old man s/p scooter accident, no helmet reason for this examination: fx? contraindications for iv contrast: none. history: status post scooter accident without a helmet. outside hospital cervical spine ct suggested that the c3 vertebral body and c4 posterior elements are fractured. comparison: no comparison studies in pacs. technique: axial multidetector ct images of the cervical spine were obtained. sagittal and coronal reconstructions were performed. findings: there is a fracture of the spinous process of c4 which extends to the right lamina. there are prominent nutrient foramina within the body of c3. no definite c3 fracture is identified. there is swelling in the prevertebral soft tissues, concerning for traumatic injury. there is spondylosis and disc space narrowing at c5/6. there is a 9 x 6 mm focus of dependent soft tissue in the trachea, which may represent secretions versus a polypoid lesion. impression: 1. c4 spinous process fracture extending into the right lamina. no definite c3 fracture. 2. prevertebral soft tissue swelling. further evaluation by mri may be helpful. 3. dependent secretions versus polypoid lesion in the trachea. ct sinus/mandible/maxillofacial w/o contrast 11:47 pm ct sinus/mandible/maxillofacia; ct reconstruction reason: r/o fx medical condition: 48 year old man with fall from moped onto head/face without helmet reason for this examination: r/o fx contraindications for iv contrast: none. history: status post scooter accident without a helmet. outside hospital ct suggests facial fractures. comparison: no previous studies in pacs. technique: axial multidetector ct images of the facial bones were obtained without intravenous contrast. sagittal and coronal reformatted images were obtained. findings: there is a comminuted fracture of the anterior wall of the right frontal sinus, with a free fragment that is depressed into the sinus. the posterior wall of the sinus is intact. there is fluid and mucosal thickening within the sinus. there is a laceration overlying the fracture. multiple nasal bone fractures are present bilaterally, with angulation of the distal fracture fragments to the left. there is mucosal thickening and probably also fluid in the ethmoid air cells bilaterally. mild mucosal thickening is present in the maxillary and sphenoid sinuses. impression: 1. fracture of the anterior wall of the right frontal sinus with a depressed free fragment. 2. multiple nasal bone fractures. mr l spine scan 8:32 am mr l spine scan reason: acute changes in the l-spine medical condition: 48 year old man s/p trauma with weakness involving the right ankle reason for this examination: acute changes in the l-spine clinical information: status post trauma with right ankle weakness. mri of the lumbar spine. findings: there is a right-sided focal disc protrusion at l5-s1 with slight displacement of the right s1 nerve root sleeve. there is no evidence of canal or foraminal stenosis. there is no evidence of abnormal signal to suggest the presence of an acute vertebral body fracture or ligamentous injury. impression: right-sided disc herniation at l5-s1 with features as discussed above. mr head w & w/o contrast 4:40 pm mr head w & w/o contrast; mr contrast gadolin reason: with dwi and gadolinium, eval for evidence of brain injury contrast: magnevist medical condition: 48 year old man with recent onset seizure, ?hypoxic brain injury reason for this examination: with dwi and gadolinium, eval for evidence of brain injury mri of the brain. clinical information: patient with question of brain injury, for further evaluation. technique: t1 sagittal and axial and flair, t2, susceptibility and diffusion axial images of the brain were obtained before gadolinium. t1 sagittal, axial and coronal images were obtained following the administration of gadolinium. correlation was made with the head ct examination of . findings: the diffusion images demonstrate no evidence of slow diffusion. the ventricles and extraaxial spaces are normal in size. there is no evidence of midline shift, mass effect, or hydrocephalus seen. no evidence of acute or chronic blood products is seen within the brain. extensive soft-tissue changes are seen in the paranasal sinuses, which could be related to intubation. the basal cisterns are patent. there is no evidence of tonsillar herniation. the vascular flow voids are maintained. following gadolinium administration, no evidence of abnormal parenchymal, vascular or meningeal enhancement identified. mild soft-tissue swelling is seen in the right parietal scalp region. impression: no significant intracranial abnormalities detected on the mri of the brain with and without gadolinium. soft-tissue changes in the paranasal sinuses and mastoid air cells could be related to intubation. no abnormal enhancement seen. object: bedside eeg from to to . 48-yr-old man with s/p seizures. referring doctor: dr. dr. findings: the recording begins at 7:. the background rhythm is low voltage and supressed with intermittent fast activity and low voltage bursts of generalized slowing. through the record there are several brief runs with rhythmic, moderate voltage 2 hz delta frequency slowing -frontal predominance with occasional sharp features, lasting 5-30 seconds. in addition there are, bursts of generalized sharp slow wave discharges seen. cardiac monitor: normal sinus rhythm with a rate of 96 bpm. impression: this is an abnormal discontinued 48 hour bedside telemetry from to and shows a severe encephalopathy consistent with medication induced suppressive coma. there are brief episodes of rhythmic, generalized -frontal predominent delta frequency slowing with sharp features, these findings are consistent with brief electrographic seizures. regarding the previous eeg recording, these brief seizures seem to be less pronounced and more brief. also the seizures in the previous recording seem to correlate with discontinued propofol. chest (portable ap) 11:36 am chest (portable ap) reason: interval change? consolidation? medical condition: 48 year old man s/p scooter crash, tracheostomy, anoxic brain inj, frequent suctioning, acute breathing change this morning reason for this examination: interval change? consolidation? indication: status post motor vehicle collision, frequent suctioning, acute respiratory change. comparison: chest x-ray from . single portable ap upright chest radiograph: again seen is left lower lobe consolidation with air bronchograms as well as an associated elevation of the left hemidiaphragm, suggestive of atelectasis. a tracheostomy tube is in place. the cardiac and mediastinal contours are unchanged within normal limits. the right lung is clear. impression: persistent left lower lobe atelectasis with associated left hemidiaphragm elevation. these findings were discussed with dr. at the time of dictation. brief hospital course: on arrival, the patient was hemodynamically stable and complained of face and neck pain but no numbness, tingling, or back pain. his initial evaluation confirmed the cervical spine and facial fractures. antibiotics were given for the facial fractures and laceration and the plastic surgery service saw the patient in the ed. the spine surgery service was also consulted; a repeat neurologic exam revealed a right foot drop. the patient was admitted to the floor on the trauma surgery service. 1) c-spine fracture: the patient was kept in a hard cervical collar until hd 2, when the patient was taken to the or for an anterior cervical decompression and diskectomy at c4-5, c5-6 and c6-7 and an anterior fusion with instrumentation at c4 to 7. please see the operative note for details. postoperatively he was moving all extremities with intact sensation and full strength other than the foot drop. he was observed in the pacu and then transferred to the floor. physical and occupational therapies consulted and have recommended acute rehabilitation after discharge from hospital. 2) nasal fracture: the patient underwent closed reduction on (at the same time as the spine surgery). please see the operative note for details. 3) hypoxic brain injury: the night after surgery the patient began coughing and having difficulty breathing. a code blue was called; patient vitals were noted as bp 109/70, hr 52, o2 50-60%. per the anesthesia note, there were two unsuccessful attempts at direct laryngoscopy. an lma was placed, and using fiber optic scope, an ett was passed. the patient was transferred to the ticu and was sedated on propofol. after the propofol was discontinued, the patient began having seizure-like jerking of his extremities. neurology was consulted and an eeg was obtained, which was read as consistent with status epilepticus. the patient was loaded on dilantin; phenobarbitol and depakote were also started when dilantin alone failed to control the movements. repeated eegs showed decreased seizures, which was confirmed by physical exam. the patient regained alertness slowly in the icu and then on the floor and was able to respond to questions by nodding his head. he was observed to have episodes of extremity shaking but while conscious; these were felt to be a postural tremor and not seizures. his seizure medications were slowly decreased in dosage with daily monitoring of drug levels. on the patient was noted to have some brief, self-resolving tonic-clonic seizures. he was reloaded on dilantin, as that day's level was low (previous level had been in therapeutic range) and was transferred from the floor to the step-down unit. patient seen and evaluated by behavioral neurology for his brain injury. 4) tracheostomy: given the patient's respiratory distress on the floor and difficult intubation, he underwent an open tracheostomy on . he requires intermittent suctioning because of mucous plugging. he is on scheduled nebulizer treatments as well. 5) diabetes: he has a history of niddm and has been followed closely by diabetes center during his hospitalization. he is currently on humalog sliding scale and lantus qhs. medications on admission: paxil xanax no diabetes medications discharge medications: 1. colace 150 mg/15 ml liquid sig: thirty (30) ml po twice a day: give via g-tube. 2. artificial tear ointment 0.1-0.1 % ointment sig: one (1) appl ophthalmic prn (as needed). 3. polyvinyl alcohol-povidone 1.4-0.6 % dropperette sig: drops ophthalmic prn (as needed). 4. senna 8.8 mg/5 ml syrup sig: five (5) ml po bid (2 times a day): give via g-tube. 5. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed: give via g-tube. 6. bisacodyl 10 mg suppository sig: one (1) suppository rectal hs (at bedtime) as needed. 7. folic acid 1 mg tablet sig: one (1) tablet po daily (daily): give via g-tube. 8. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily): give via g-tube. 9. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h (every 6 hours) as needed. 10. metoprolol tartrate 25 mg tablet sig: three (3) tablet po tid (3 times a day): hold for hr less than 60 and sbp less than 110 mm hg. 11. enoxaparin 30 mg/0.3 ml syringe sig: one (1) subcutaneous (2 times a day). 12. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 13. albuterol sulfate 0.083 % solution sig: one (1) inhalation q6h (every 6 hours) as needed. 14. miconazole nitrate 2 % powder sig: one (1) appl topical tid (3 times a day) as needed. 15. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day). 16. valproate sodium 250 mg/5 ml syrup sig: one (1) po q8h (every 8 hours). 17. phenytoin 50 mg tablet, chewable sig: 6.5 tablet, chewables po tid (3 times a day): name brand only dilantin, ok by pharmacy to crush. 18. metoclopramide 10 mg tablet sig: one (1) tablet po qid (4 times a day). 19. phenobarbital 20 mg/5 ml elixir sig: one (1) po q12h (every 12 hours). 20. lantus 100 unit/ml solution sig: thirty six (36) units subcutaneous at bedtime: . 21. humalog 100 unit/ml solution sig: one (1) subcutaneous every six (6) hours: per sliding scale. discharge disposition: extended care facility: - discharge diagnosis: s/p scooter crash c4 spinous process fracture right frontal sinus fracture multiple nasal bone fractures right foot drop discharge condition: stable discharge instructions: follow up in trauma clinic after discharge from hospital. followup instructions: follow up in trauma clinic in one month, call for an appointment. procedure: enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy other cervical fusion of the anterior column, anterior technique closure of skin and subcutaneous tissue of other sites closed reduction of nasal fracture repair of vertebral fracture fusion or refusion of 4-8 vertebrae diagnoses: diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled alcohol abuse, unspecified anoxic brain damage grand mal status open wound of lip, without mention of complication other acquired deformities of ankle and foot closed fracture of nasal bones motor vehicle traffic accident of unspecified nature injuring motorcyclist respiratory arrest other late effects of cerebrovascular disease, dysphagia closed fracture of c1-c4 level with unspecified spinal cord injury open fracture of base of skull without mention of intracranial injury, with brief [less than one hour] loss of consciousness 

Answer: The patient is high likely exposed to