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: s/p motor vehicle crash major surgical or invasive procedure: : 1. irrigation and debridement of open pelvic fracture. 2. open reduction, internal fixation anterior ring pelvic fracture. 3. external fixation distal femur fracture with closed treatment and traction of the distal femur and placement of external fixation. 4. irrigation and debridement, right leg wound. 5. irrigation and debridement of right dorsal foot. : fasciotomies of left lateral thigh and 4 compartments of the left lower extremities. : 1. exploratory laparotomy. 2. exploration of the retroperitoneum. 3. control of bleeding of the retroperitoneum and pelvis. 4. exploration of complex wounds of the thigh, groin and perineum with packing to control bleeding. 5. temporary closure of the abdomen. : 1. ultrasound-guided puncture of the right common femoral artery. 2. contralateral third-order catheterization of the left superficial femoral artery. 3. abdominal aortogram. 4. serial arteriogram of the left lower extremity. 5. percutaneous thrombectomy of the left common and external iliac artery. 6. primary stenting of the left external iliac artery. 7. exploration of left groin wound. : right frontal intracranial pressure monitor. : 1. above-knee amputation left lower extremity. 2. removal of the external fixator for amputation. 3. irrigation and debridement and repacking of open pelvic fracture. 4. irrigation and debridement right lower extremity dorsal foot wound. 5. irrigation and debridement right lower extremity leg wound. 6. examination of right ankle under anesthesia for assessment of talus fracture. : exploratory laparotomy. : 1. catheter placement into the abdominal aorta. 2. abdominal aortogram and pelvic angiogram. 3. serial arteriogram of the left lower extremity. 4. ultrasound-guided puncture of the right common femoral vein. 5. catheter placement in the inferior vena cava. 6. angiogram of the inferior vena cava. 7. placement of tulip inferior vena cava filter below the level of the renal veins. 8. perclose closure of the right common femoral arteriotomy. : debridement to the left thigh, colostomy and feeding j-tube. : 1. debridement, medial thigh compartments. 2. debridement, lateral thigh compartments secondary to likely compartment syndrome. 3. drainage deep abscess, pelvis. 4. exploration and debridement left gluteus maximus. : 1. debridement down to and inclusive of bone of open pelvic fracture with repacking. 2. desarticulation of the left hip. 3. removal of external fixator from left femur. 4. debridement skin to bone right wound leg. 5. debridement skin to bone right ankle and closure. 6. debridement down to bone right foot dorsal wound. 7. placement of vacuum sponges at right lower extremity leg and dorsal wound of foot. : perineal debridement. : debridement of left corpora cavernosa crus, evaluation of urethra, covering of urethra with reapproximating bulbospongiosus muscle. : irrigation and debridement left necrotic thigh, debridement of pelvis, both down to and inclsuive of bone. : staged irrigation and debridement left thigh stump with pelvic repacking. : 1. left perineal wound debridement. 2. abdominal closure. 3. percutaneous tracheostomy. 4. suture repair of scalp laceration. : debridement open pelvic fracture and disarticulated stump and repacking. : debridement of ischemic muscle in the pelvis. : exploration of left perineal and pelvic wound. : 1. washout and debridement deep abscess left pelvis. 2. debridement to bone left hip. : 1. irrigation and debridement and open packing of pelvic fracture. 2. irrigation and debridement disarticulated hip. 3. irrigation and debridement of right anterior compartment which was found to be necrotic and placement of vacuum sponge. : change of pelvic packign and dressings in open pelvic fracture. : 1. staged debridement and packing of open pelvis and disarticulation. 2. debridement in anterolateral compartment and posterior compartment and deep posterior compartment of right lower extremity and placement of vacuum sponge, muscle biopsy, right lower extremity. : 1. irrigation and debridement of open pelvic wound down to and inclusive of bone. 2. repacking of pelvic wound and disarticulation of stump. 3. aggressive debridement of right deep posterior compartment and remnants of anterolateral compartments. 4. placement of vacuum sponge on the right lower extremity. : 1. irrigation and debridement of left traumatic hemipelvectomy. 2. irrigation and debridement of right leg traumatic wound. 3. open bone biopsy left ischium. 4. open bone biopsy right fibula. 5. application of negative pressure wound dressing (greater than 50 cm2) right lower extremity. : 1. incision and drainage pelvis/hip joint deep abscess hematoma, left side. 2. biopsy ileum on the left side. 3. debridement skin to bone right tibia. 4. application of vac sponge right tibia. history of present illness: patient is 20 year old male unrestrained front passenger in high speed mva tree vs car, speed of approximately 100 mph. was ejected from vehicle. fatality of driver, backseat passenger also critically injured. pt combative at osh and intubated. transferred for care of open book pelvic fracture and left femur fracture. on arrival intubated and sedated, gcs 3t, unknown gcs at scene. past medical history: pmh: -headaches treated with ibuprofen -right femur fracture psh: -right femur fracture repair family history: non-contributory physical exam: upon presentation to : hr:120 bp:170 over palp resp:12 o(2)sat:99% normal constitutional: intubated heent: large greater than 5 cm forehead laceration, multiple facial abrasions pupils small and minimally reactive oropharynx within normal limits chest: clear to auscultation cardiovascular: tachycardic abdominal: soft, nontender gu/flank: back multiple abrasions extr/back: large open pelvis fracture greater than 20 cm perineal laceration multiple fractures left and right leg right leg with open foot and ankle fracture obvious deformity and fractures of the thigh and tib-fib large gaping 15 x 20 cm wound over the right anterior thigh with significant tissue loss left leg with obvious fractures of the femur and tib-fib skin: multiple lacerations and abrasions neuro: intubated seemed to move both upper extremities pertinent results: imaging: ct head w/o contrast there is increased density along the tentorium and posterior to cerebellum (best seen on sagittal reformats) suggestive of small subdural hematoma. there is small quadrigeminal cistern this can be related to patient's young age or due to mild cerebral edema. ct c-spine w/o contrast no fracture or subluxation in cervical spine. cta aorta/bifem/iliac 1. severe open-book deformity of the left hemipelvis with wide space symphyseal distraction and si joint diastasis, associated with left common iliac artery disruption and distal nonperfusion of the left lower extremity. no active extravasation. this is associated with severe left inguinal laceration, extensive subcutaneous emphysema, and a large left retroperitoneal hematoma extending along left psoas muscle, extending into posterior left hemiabdomen. 2. comminuted and displaced left distal femur fracture. 3. mild pulmonary contusion, in combination with aspiration and atelectasis. 4. no solid organ injury. ct head without contrast - repeat 5 pm 1. stable density along the tentorium and posterior cerebellum suggesting stable small subdural hematoma; this could relate to transverse dural sinus injury. 2. stable appearance of the quadrigeminal plate and other basal cisterns and ventricules. 3. new round focus of hyperdensity in the left frontal lobe could represent evolving contusion, in a typical location, or relate to partial volume averaging. attention to this region on follow-up studies is recommended. head ct : 1. new right frontal icp bolt device with small pneumocephalus likely as a result of the procedure. checking of the functionality of the device is recommended as the tip of the device is in close proximity to the inner table of the skull. 2. diffuse effacement of the sulci suggestive of diffuse cerebral edema. correlation with intracranial pressure is recommended. hypodense areas in the brain- mr may be helpful if not ci. 3. previously visualized small density along the tentorium and posterior cerebellum suggesting small subdural hematoma. it is now less dense and likely resolved. 4. possible drusen- bilateral- correlate with opthalmologic examination. cxr : left picc projects over mid svc. microbiology: ucx: no growth /mrsa screen: neg 9:30 am tissue site: pelvis lt pelvic bone. gram stain (final ): 2+ (1-5 per 1000x field): polymorphonuclear leukocytes. 4+ (>10 per 1000x field): gram negative rod(s). 2+ (1-5 per 1000x field): gram positive cocci. in pairs and singly. 1+ (<1 per 1000x field): yeast(s). tissue (final ): due to mixed bacterial types (>=3) an abbreviated workup is performed; p.aeruginosa, s.aureus and beta strep. are reported if present. susceptibility will be performed on p.aeruginosa and s.aureus if sparse growth or greater.. enterococcus sp.. moderate growth. sensitivities performed on culture # (). stenotrophomonas (xanthomonas) maltophilia. heavy growth. identification and sensitivities performed on culture # 310-9415c . stenotrophomonas (xanthomonas) maltophilia. heavy growth second type. identification and sensitivities performed on culture # 310-9415c . albicans, presumptive identification. quantitation not available. anaerobic culture (final ): no anaerobes isolated. acid fast smear (final ): no acid fast bacilli seen on concentrated smear. acid fast culture (preliminary): no mycobacteria isolated. fungal culture (final ): albicans. potassium hydroxide preparation (final ): budding yeast with pseudohyphae. suggestive of species. laboratory: 05:32am hgb-6.7* calchct-20 04:30am glucose-162* urea n-15 creat-1.4* sodium-148* potassium-3.6 chloride-114* total co2-11* anion gap-27* 05:32am glucose-103 lactate-5.3* na+-140 k+-3.3* cl--119* 05:35am fibrinoge-92* 05:35am pt-20.3* ptt-44.6* inr(pt)-1.9* 04:30am glucose-162* urea n-15 creat-1.4* sodium-148* potassium-3.6 chloride-114* total co2-11* anion gap-27* brief hospital course: he was admitted to the acs service; his icu course as follows: neuro: he sustained tentorial subdural hematoma and cerebral edema, for which neurosurgery was consulted. an intracranial bolt was placed and icp was monitored. the patient was given mannitol and hypertonic saline. after icp stabilized to , the bolt was removed. intracranial injury was monitored by neurological exam and serial ct head and the patient progressively improved. pain was well-controlled by narcotic analgesics. cv: on admission, the patient was massively transfused for hemodynamic instability. he was transiently supported on pressors but was weaned off. over the course of his admission, he was transfused for post-operative anemia. pulmonary: he was intubated and mechanically ventilated for a prolonged period of time, and thus he underwent tracheostomy. thereafter he was weaned off the ventilator and tolerated trach collar. gi: feeding j-tube was placed, through which the patient received enteral nutrition. gu: he was originally seen by dr. with findings of left corpora cavernosum transection. his urethra and corpus spongiosum appear viable/intact and bulbospongiosus muscle was reappoximated over urethra. he also had scrotal edama ecchymosis and mottling without any evidence of necrosis or infection. integumentary: he underwent multiple surgical repairs and debridments and ultimately left hemipelvectomy. a vac dressing was placed to heis right lower extremitiy wound. id: he was on a variety of broad spectrum antibiotics during his icu stay for both emperic therapy and eventually positive blood cultures for enterococcus, stentrophomonas pneumonia, multiple organisms in his wound, vre and osteomylitis with hardware in place. the infectious disease servvice follows him closely. hematology: the patient's complete blood count was examined routinely and is stable. prophylaxis: the patient received subcutaneous heparin and venodyne boots were used during this stay; was encouraged to get up and ambulate as early as possible. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ________________________________________________________________ his hospital course as follows following transfer to the regular nursing unit: neuro - he was intermittently delirious requiring psychiatric consult. several recommendations were made and he was started on neurontin and olanzapine with improvement in his mental status. he is currently awake, alert and oriented x3. cardiac - there have been no acute issues. he continues on his beta blockers. resp - he was decannulated on and is doing well. he has no shortness of breath and is able to cough up his secretions well. his voice is strong. gi - he continued on his tube feedings upon transfer and seemed to have tolerated them. at one point he was noted with intermittent nausea and his tube feedings were held. in the meantime he was also taking a regular diet. it was decided to trial oral diet with calorie counts. he exceeded his required nutritional requirements and so the tube feedings were stopped. his feeding tube was removed on . his ostomy is funcitonal and he was followed closely by the wound gu - because of his genitourinary injuries he continues with the suprapubic catheter which he will ultimately need long term. musculoskeletal - he has worked closely with physical and occupational therapy and will require intensive rehab after his acute hospital stay. integumentary - he has undergone multiple debridements and most recently a gricalis flap done by plastics. at time of this dictation no near future surgery's are being planned. he has a vac to his remaining extremity that remains which has been managed by orthopedics. id - he has been followed by id because of his many skin and bone infections (vre/stenotrophomonas/) and is currently receiving long term antibiotic therapy. a picc line was placed for this therapy. he will require 2 week follow up in clinic after discharge. see medication list for the duration of daptomycin, fluconozole and bactrim. the antibiotic course including the fluconazole was discussed with dr. at who would be assuming his care upon admission to their facility. pain - he has been maintained on methadone over the last month with adequate pain control. he does require additional dilaudid for dressing changes. his methadone is currently being tapered. medications on admission: ibuprofen discharge medications: 1. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 1-2 puffs inhalation q6h (every 6 hours) as needed for wheezing. 2. senna 8.8 mg/5 ml syrup sig: 1-2 tablets po bid (2 times a day) as needed for constipation. 3. heparin (porcine) 5,000 unit/ml solution sig: one (1) ml injection tid (3 times a day). 4. metoprolol tartrate 50 mg tablet sig: two (2) tablet po tid (3 times a day). 5. gabapentin 400 mg capsule sig: one (1) capsule po tid (3 times a day). 6. olanzapine 10 mg tablet sig: tablet po hs (at bedtime). 7. diphenhydramine 25 mg iv q6h:prn itching 8. sulfamethoxazole-trimethoprim 800-160 mg tablet sig: three (3) tablet po tid (3 times a day): thru . 9. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours) as needed for sob, wheeze. 10. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical qid (4 times a day) as needed for pruritis. 11. daptomycin 500 mg recon soln sig: three y (350) mg intravenous q24h (every 24 hours): thru . 12. hydromorphone 2 mg/ml syringe sig: 1-2 mg injection q3h (every 3 hours) as needed for pain: administer before vac dressing changes prn. 13. heparin flush (10 units/ml) 2 ml iv prn line flush picc, heparin dependent: flush with 10ml normal saline followed by heparin as above daily and prn per lumen. 14. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day). 15. acetaminophen 650 mg/20.3 ml solution sig: twenty (20) ml po q6h (every 6 hours) as needed for fever. 16. docusate sodium 100 mg capsule sig: two (2) capsule po bid (2 times a day) as needed for constipation. 17. hydromorphone 2 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. 18. methadone 10 mg tablet sig: two (2) tablet po tid (3 times a day) for 3 days: on tapering doses. 19. methadone 10 mg tablet sig: one (1) tablet po three times a day for 3 days: begin 0n for a total of 3 days. . 20. methadone 5 mg tablet sig: one (1) tablet po three times a day for 3 days: begin on , the ndecrease to 5 mg for 3 days and then stop. 21. fluconazole 400 mg iv q 24 hours until then discontinue after last dose. discharge disposition: extended care facility: - discharge diagnosis: s/p motor vehicle crash 1. severe open-book deformity of the left hemipelvis with wide space symphyseal distraction and si joint diastasis, associated with left common iliac artery disruption and distal nonperfusion of the left lower extremity 2. severe left inguinal laceration 3. large left retroperitoneal hematoma extending along left psoas muscle, extending into posterior left hemiabdomen 3. comminuted and displaced left distal femur fracture 4. mild pulmonary contusion, in combination with aspiration and atelectasis 5. right tib/fib with soft tissue defect, exposed bone 6. ostoemyelitis 7. left corpora cavernosum transection 8. rhabdomyolysis 9. acute blood loss anemia 10.osteomylitis with hardware 11.vre 12.right foot open wound (dorsum) discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: you were admitted to the hopsital after a motor vehicle crash where you sustained mutliple injuries. your injuries were life threatening requiring mutliple oprations. several specialists were involoved in your care during your hospital stay. you will require extensive outpatient follow up. it is being recommended that you go to an acute rehab facility as you will need extensive physical and occupational therapy to assist you with alternate methods for mobility. you are also being treated for skin and bone infections for at least the next 6-8 weeks possibly longer. the anitibiotics are being deliverd through a specialized catheter called a picc. followup instructions: provider: unit phone: date/time: 8:00 follow up in infectious disease clinic in 2 weeks; call( for an appointment. follow up in 2 weeks in clinic, for an appointment. follow up in 2 weeks in clinic, call for an appointment. follow up in clinic in 2 weeks call for an appointment. procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more interruption of the vena cava angioplasty of other non-coronary vessel(s) temporary tracheostomy colostomy, not otherwise specified graft of muscle or fascia attachment of pedicle or flap graft to other sites local excision of lesion or tissue of bone, other bones local excision of lesion or tissue of bone, other bones amputation above knee open reduction of fracture with internal fixation, other specified bone percutaneous (endoscopic) jejunostomy [pej] repair of vertebral fracture biopsy of bone, other bones other myectomy other myectomy other myectomy other repair and reconstruction of skin and subcutaneous tissue percutaneous cystostomy abdominopelvic amputation debridement of open fracture site, other specified bone intracranial pressure monitoring magnetic removal of embedded foreign body from cornea other local excision or destruction of lesion or tissue of urethra other operations on penis diagnoses: acute kidney failure, unspecified defibrination syndrome bacteremia surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] delirium due to conditions classified elsewhere closed fracture of condyle, femoral traumatic compartment syndrome of lower extremity contusion of lung without mention of open wound into thorax rhabdomyolysis traumatic shock closed fracture of sacrum and coccyx without mention of spinal cord injury other and unspecified mycoses infection and inflammatory reaction due to other internal orthopedic device, implant, and graft motor vehicle traffic accident due to loss of control, without collision on the highway, injuring passenger in motor vehicle other than motorcycle vascular disorders of penis acute osteomyelitis, pelvic region and thigh other and unspecified cerebral laceration and contusion, without mention of open intracranial wound, with prolonged [more than 24 hours] loss of consciousness without return to pre-existing conscious level injury to other intra-abdominal organs with open wound into cavity, peritoneum open wound of other and unspecified parts of trunk, complicated pneumonia due to other specified organism multiple open pelvic fractures with disruption of pelvic circle open wound of penis, without mention of complication open wound of foot except toe(s) alone, with tendon involvement 

Answer: The patient is high likely exposed to