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 trauma, pedestrian struck major surgical or invasive procedure: r needle thoracostomy, right chest tube exploratory laparotomy, packing/unpacking of r liver lacerations orthopedic splinting for left knee and right elbow instability right renal artery upper lobar branch with avf/pseudoaneurysm coiled history of present illness: 35yo intoxicated male (etoh & heroin per report) struck by pickup at 35mph while walking . intubated for combativeness in the ed. ct torso revealed extensive liver lac, r renal lac. taken to or emergently for liver packing. past medical history: pmh: not obtainable psh: not obtainable social history: nc family history: nc physical exam: gen: intubated, sedated heent: pupils: 2-> pinpoint bilat neck: supple. lungs: cta bilaterally. r chest tube cardiac: rrr. s1/s2. abd: soft, nt, bs+ extrem: warm and well-perfused. neuro: mental status: intubated, sedated pupils 2->pinpoint bilaterally, + corneals, + gag, withdraws all extremities to pain, heavily sedated injuries: r renal lac r liver lacs r ptx r rib fractures facial fractures skull fracture r sacral fx l fibula fx r unstable elbow pertinent results: micro: : mrsa screen: neg : urine cx: ng : blood cx: p : sputum cx: cancelled : sputum cx: cancelled d/t contamination imaging: ct chest: large r ptx w/r lung collapse; b/l rib fxs; r>l opacities ?contusion vs pulmonary hemorrhage vs aspiration vs atelectasis. ct head: frontotemporal skull fx extending through l orbit; l zygoma fx; fluid opacifies ethmoid air cells & l maxillary sinus, l preseptal hematoma; extraconal gas in the superior l orbit suggests adjacent frontal fx. no ich, midline shift, mass effect. ct c-spine: no fx ct abdomen: multiple liver contusions w/adjacent free fluid c/w blood; ? splenic involvement; r kidney lac & ?sm contusion; r pubic symphysis fx, superior & inferior pubic rami fx, r sacral and anterior acetabular fx; pelvic hematoma. : cxr: in comparison with the earlier study of this date, there has been placement of a right subclavian catheter that extends to the mid portion of the svc. otherwise, little change. : r arm: views of the shoulder, arm, and forearm show no definite fracture or dislocation. no lateral view of the elbow was obtained, so that it is impossible to exclude joint effusion. : rle plain films: distracted fracture of the proximal fibula as well as opacification projected over the mid portion of the knee joint that could represent an avulsion. : echo: due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is probably preserved (lvef>50%). the mitral valve leaflets are structurally normal. : ct head: 1. no acute intracranial hemorrhage or mass effect. 2. extensive skull fractures involving the left frontal bone, left zygoma, and possibly the left orbit. recommend facial bone ct to help evaluate the left orbital floor, which is incompletely evaluated. cxr: ett 5.6cm from carina. r sc cvl stable. ngt in stomach. r ct stable in position w/o e/o ptx. : cxr: unchanged borderline size of the cardiac silhouette with left pleural effusion and moderate left retrocardiac atelectasis. no newly appeared focal parenchymal opacities suggesting pneumonia. 03:49pm blood hct-26.7* 04:20am blood wbc-8.7 rbc-3.25* hgb-9.4* hct-27.1* mcv-83 mch-28.9 mchc-34.7 rdw-14.5 plt ct-390 12:05am blood hct-29.3* 05:26am blood wbc-6.9# rbc-2.71* hgb-7.7* hct-22.7* mcv-84 mch-28.4 mchc-33.9 rdw-14.8 plt ct-545*# 01:50am blood wbc-3.4* rbc-3.03* hgb-8.8* hct-25.1* mcv-83 mch-29.0 mchc-35.1* rdw-14.2 plt ct-163 03:37am blood wbc-3.6* rbc-3.10* hgb-9.0* hct-25.8* mcv-83 mch-28.9 mchc-34.8 rdw-14.2 plt ct-147* 04:20am blood plt ct-390 05:26am blood plt ct-545*# 05:26am blood pt-12.6 ptt-25.8 inr(pt)-1.1 01:20am blood fibrino-131*# 11:15pm blood fibrino-295 05:26am blood glucose-112* urean-12 creat-0.8 na-133 k-4.2 cl-96 hco3-28 angap-13 01:50am blood glucose-97 urean-9 creat-0.7 na-136 k-3.3 cl-100 hco3-29 angap-10 03:37am blood glucose-94 urean-11 creat-0.7 na-137 k-3.6 cl-100 hco3-29 angap-12 12:54am blood alt-376* ast-453* alkphos-74 amylase-80 totbili-0.5 09:14pm blood ck(cpk)-* 02:20pm blood ck(cpk)-1779* 12:37pm blood alt-485* ast-664* alkphos-82 totbili-0.7 04:20am blood calcium-7.9* phos-3.5 mg-1.7 05:26am blood calcium-8.3* phos-3.6 mg-1.6 01:50am blood calcium-7.5* phos-3.8 mg-1.6 09:14pm blood ck-mb-8 ctropnt-0.01 02:20pm blood ck-mb-11* mb indx-0.6 ctropnt-0.03* 06:37am blood ck-mb-13* mb indx-1.1 ctropnt-0.08* : chest x-ray: findings: as compared to the previous radiograph, there is no longer any evidence of pneumothorax. no focal parenchymal opacity suggesting pneumonia. normal size of the cardiac silhouette. no nodules or masses. no pleural effusions. normal appearance of hilar and mediastinal structures : cat scan of abdomen/pelvis: impression: 1. tiny right upper pole renal arterial blush at the margin of laceration demonstrates non-enhancement on delayed imaging, suspicious for a renal pseudoaneurysm. recommend further evaluation by angiogram. 2. right renal mass, incompletely evaluated. 3. status post surgery with liver and splenic lacerations without active extravasation. 4. improved pulmonary aeration. persistent residual bibasilar consolidations. new left lower lobe widespread centrilobular andperipheral tree-in- opacities, suggestive of aspiration. 5. unchanged multiple rib fractures, sacral, pubic, and acetabular fractures : chest x-ray: impression: 1. resolution of pneumothorax. 2. hazy opacity in the right lung suggests either edema or aspiration. 3. stable left lower lobe atelectasis : mandible: findings: there is redemonstration of previously seen left frontotemporal fracture, the posterior margin of which is not fully imaged. the anterior margin extends through the frontal and temporal bones across the greater of the sphenoid, through the posterior orbit, and into the ethmoid, without displacement of fracture fragments. the fracture extends through the root of the medial and lateral pterygoid . there is fracture of the left nasal bone, non-displaced. additionally, there is a fracture through the outer table of the skull extending into the left frontal sinus. fluid is seen within the frontal sinuses bilaterally, the ethmoid air cells, the sphenoid sinuses. the mastoid air cells remain clear. the mandible is intact. the patient is intubated. an ng tube and an og tube are in place, which are not fully visualized. there is lymphadenopathy of the bilateral cervical chains. the globes and lenses are intact. there is no intraorbital hematoma. impression: facial fractures, catalogued above : left knee mri: 1. high-grade tear of the anterior cruciate ligament, including avulsion of the tibial insertion at the tibial spines. 2. additional focus of edema and slight depression extends into the medial tibial plateau, consistent with minimally displaced fracture. 3. high-grade posterolateral corner injury, including avulsion (arcuate) fracture of the fibular head, and probable injury to the fibular collateral ligament, and biceps femoris insertions. abnormal signal is seen within the iliotibial band, concerning for injury. 4. extensive abnormal signal in the myotendinous junction of the popliteus muscle, worrisome for rupture at the myotendinous junction. 5. large bone contusion in the medial femoral condyle. 6. small radial tear in the lateral meniscus. 7. increased signal in the peroneal nerve could reflect injury, vs. reactive change to trauma in the posterolateral corner. 8. moderate joint effusion. brief hospital course: discharge summary started by surgical resident in intensive care unit: patient found to have r ptx in trauma bay after ct (though cxr prior did not reveal this). required needle decompression r ptx--> followed by ct placed in ed. and taken emergently to or for ex lap for hemodynamic instability and free abdominal fluid. on he underwent ex-lap, liver packing for laceration. pt. admitted to tsicu. evaluated by ortho and ophtho. on taken back to or for liver packing and reassess. ce were trended and trop went from 0.08 --> 0.03. icu course: : ortho splinted r elbow and l fib fx. : ct head (-), keppra d/c'ed : extubated. reintubated for etoh w/drawal and inability to clear secretions in setting of need for increased sedation. : cxr (post-intub): lll and retrocardiac opacification, ?rll opacification (official read pending). : hinged elbow brace in place, ct to ws : extubated in the afternoon and started on a dilaudid pca. maintained on standing valium. overnight he pulled out his central line and foley. foley was replaced, 2 pivs established. required 2 doses of iv ativan ovenright. : chest tube removed, no ptx on follow up cxr. mental status waxing and , but hemodynamically stable and did well otherwise. : transferred to surgical floor : surgical floor: review of systems completed by , np neurological: s/p left frontal skull fracture: upon admission, was evaulated by neurology, no neurosurgical intervention required. no keppra or dilantin required. he will need to follow up with dr. 4 weeks for a non-contrast head cat scan. he is alert and oriented x 3 with clear speech. cardiovascular: he did sustain a cardiac contusion as a result of the accident. his initial electrocardiogram showed sinus tachycardia. his current electrocardiogram continues to show sinus tachycarida. he had an echocardiogram done with an ejection fraction >55%. pulmonary: s/p right pneuomthorax and rib fractures: right chest tube was discontinued on with no pneumothorax evident on chest x-ray. he did sustain bilateral rib fractures. he denies shortness of breath and is maintaining oxygen saturation of 96% on room air. gi: s/p exploratory laparotomy and hepatic packing for hemoperitoneum, liver and right renal laceration. he was taken to the operating room on for removal of packing and abdominal closure. his abdominal staples were removed . he is tolerating a regular diet without complaints of nausea and vomitting. gu: s/p renal laceration: he did fail a voiding trial and required replacment of foley catheter. after this was placed, he developed hematuria for which he required blood transfusion to maintain his hematocrit. he was taken to ir on where he underwent embolization of right lobar artery. although his hematocrit stabilized, he continued with the hematuria. urology was consulted on and he was underwent a cystogram with wash-out of clots. his hematuria has resolved and his bladder irrigations have been discontinued. his hematocrit is stable at 27.0. he did have his foley changed to a 2-way, but c/o of pain after placment and it was removed. he has not voided since removal of the catheter 12:30 pm, he is due to void in 6 hours. ext: s/p: right sacral fracture, left fibula fracture, and right unstable elbow fracture: he has been evaluated by orhthopedics who have made recommendations regarding his injuries. he does have a brace on his right elbow for ligamentous injury for which he has rom as tolerated. his left knee is supported in locked extension in a blesdoe brace for a high grade anterior cruciate injury for which he will need orthopedic follow-up. he has been evaluated by physical therapy. he is being discharged today to an extended care facility. transfer discussed with dr. about patient's removal of foley catheter. he is due to void in 6 hours. please bladder scan if not voided and replace foley if needed. if note increased bleeding after insertion of foley, or clots, please notify the acute care service (#) urology has been informed about removal of catheter, inability to void, and transfer to rehab facility. # urology: medications on admission: unknown discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) cc injection tid (3 times a day). 2. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation inhalation q4h (every 4 hours) as needed for sob. 3. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 4. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po hs (at bedtime). 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day): hold for diarrhea. 6. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for fever/pain: please do not exceed 2 grams po/pr due to elevated lft's. 7. sodium chloride 0.65 % aerosol, spray sig: sprays nasal qid (4 times a day) as needed for dry nose. 8. lidocaine hcl 2 % gel sig: one (1) appl mucous membrane once (once) for 1 doses. 9. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 10. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed for constipation. 11. oxycodone 5 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain. disp:*30 tablet(s)* refills:*0* discharge disposition: extended care facility: - discharge diagnosis: r renal laceration r liver lacerations r pneumothorax r rib fractures facial fractures skull fracture r sacral fx l fibula fx r unstable elbow discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. discharge instructions: you are being discharged from the hospital after you sustained injuries from being struck by a car. you sustained injuries to your kidney, liver, and pelvis and head. you also were found to have blood in your urine for which you required blood transfusions. you are being discharged with the following instructions: * your injury caused rigth sided rib fractures which can cause severe pain and subsequently cause you to take shallow breaths because of the pain. * you should take your pain medication as directed to stay ahead of the pain otherwise you won't be able to take deep breaths. if the pain medication is too sedating take half the dose and notify your physician. * pneumonia is a complication of rib fractures. in order to decrease your risk you must use your incentive spirometer 4 times every hour while awake. this will help expand the small airways in your lungs and assist in coughing up secretions that pool in the lungs. * you will be more comfortable if you use a cough pillow to hold against your chest and guard your rib cage while coughing and deep breathing. * symptomatic relief with ice packs or heating pads for short periods may ease the pain. * narcotic pain medication can cause constipation therefore you should take a stool softener twice daily and increase your fluid and fiber intake if possible. * do not smoke * if your doctor allows, non steroidal antiinflammatory drugs are very effective in controlling pain ( ie, ibuprofen, motrin, advil, aleve, naprosyn) but they have their own set of side effects so make sure your doctor approves. * return to the emergency room right away for any acute shortness of breath, increased pain or crackling sensation around your ribs ( crepitus) please call your doctor or return to the emergency room if you have any of the following: * you experience new chest pain, pressure, squeezing or tightness. * new or worsening cough or wheezing. * if you are vomiting and cannot keep in fluids or your medications. * you are getting dehydrated due to continued vomiting, diarrhea or other reasons. signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * you see blood or dark/black material when you vomit or have a bowel movement. * you have shaking chills, or a fever greater than 101.5 (f) degrees or 38(c) degrees. *please follow up in the emergency room if you develop: *severe headache *visual changes *weakness one side body *difficulty speaking *drooping of face followup instructions: follow up with dr in 4 weeks with a non contrast head cat scan. you can schedule this appointment by callling # and please tell them that you will need the head cat scan done prior to your visit. you will also need to follow-up with orthopedics, dr. in 2 weeks. you can schedult this appointment by calling # md, procedure: insertion of intercostal catheter for drainage continuous invasive mechanical ventilation for less than 96 consecutive hours continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube insertion of endotracheal tube enteral infusion of concentrated nutritional substances exploratory laparotomy control of hemorrhage, not otherwise specified reopening of recent laparotomy site other endovascular procedures on other vessels arteriography of renal arteries application of splint closed reduction of fracture without internal fixation, tibia and fibula transurethral clearance of bladder diagnoses: acute posthemorrhagic anemia motor vehicle traffic accident involving collision with pedestrian injuring pedestrian acute respiratory failure traumatic pneumothorax without mention of open wound into thorax closed fracture of two ribs closed fracture of malar and maxillary bones closed fracture of other facial bones opioid abuse, unspecified contusion of lung without mention of open wound into thorax injury to liver without mention of open wound into cavity laceration, unspecified closed fracture of pubis alcohol withdrawal closed fracture of acetabulum injury to kidney without mention of open wound into cavity, laceration acute alcoholic intoxication in alcoholism, unspecified physical restraints status injury to renal artery closed fracture of upper end of fibula alone closed fracture of vault of skull without mention of intracranial injury, with no loss of consciousness sprains and strains of other specified sites of elbow and forearm 

Answer: The patient is high likely exposed to