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: history of present illness: mr. is a 41 year old man who fell 28 feet from a roof after slipping on some ice. there was reported loss of consciousness at the scene. he landed on his left side and was found to have crepitus in the left pelvis and deformity of the right arm. he was taken to hospital where a chest x-ray was negative. pelvic films showed left iliac fractures. a foley catheter was placed, intravenous lines were placed and he was given four liters of intravenous fluid. he was hemodynamically stable and air lifted to the . on arrival in our emergency room, he complained of abdominal and left pelvic pain. his coma score was 15. his hematocrit was 38. his systolic blood pressure was in the 70s to 80s. he was given one unit of red cells which resulted in an increase into the 120s. a fast scan in the trauma bay was negative. past medical history: 1. perforated ulcer status post operative repair. 2. he is allergic to penicillin. medications: 1. zantac and prilosec p.r.n. physical examination: on admission, was significant for a heart rate of 72; blood pressure of 150/palp. he was boarded and collared. his pupils are equal and reactive. extraocular movements intact. he had two facial lacerations. his trachea was midline. his mid-face was stable. his heart was regular. his lungs were clear. his abdomen was firm and distended, tender in bilateral upper quadrants. he had an upper midline abdominal scar. pelvis was tender to palpation with ecchymoses on the left hip. extremities were without deformity. he had a left abrasion and a left elbow laceration. the back with no step-offs. rectal was heme negative, normal prostate. he is alert and oriented times three. coma score is 15 and he moved all extremities. laboratory: initial labs were significant for a white count of 18.7, hematocrit of 31, normal coagulation studies, normal chemistries. amylase is 46. alcohol level of 107. his initial trauma films included a chest x-ray which was negative, cervical spine which was negative to c7. pelvis film showed a left iliac comminuted fracture. bilateral femurs were negative. left elbow showed comminuted olecranon fracture. right wrist showed distal ulnar and radius fractures. head ct scan was negative. chest ct scan showed right rib fractures of ribs 6 through 8, a left scapular fracture, right lung contusion. abdominal ct scan revealed bilateral superior and inferior pubic rami fractures, a left iliac fracture, si joint widening and a small retroperitoneal hematoma as well as a small mesenteric hematoma. ekg was normal sinus with no signs of ischemia. hospital course: the patient was admitted to the trauma intensive care unit. orthopedics consultation was obtained. he was resuscitated and then taken to the operating room on hospital day number two for an incision and drainage of his open left olecranon fracture as well as open reduction and internal fixation of same, open reduction and internal fixation of right distal radius fracture. he had a left chest tube placed in the operating room for a small pneumothorax. he was also noted to have a left acromioclavicular joint separation which was treated conservatively. orthopedics also commented on his multiple pelvic fractures and recommended conservative therapy without any indication for operations at this time. the patient was transferred from the operating room to the floor where he did well. on the final of his chest ct scan, it was thought that he may have a small aortic intimal flap, not associated with any hematoma. repeat ct scan confirmed the same and a cardiothoracic surgery consultation was obtained. at the same time, the patient was transferred on , back to the intensive care unit for intensive blood pressure control, using variously esmolol drips, nipride drips and intravenous lopressor, clonidine and hydralazine. the patient underwent an angiogram on , that showed an aortic isthmus contour irregularity with a question of a ductus diverticulum. recommendations were for a transesophageal echocardiogram, which was carried out, which showed an aortic tear at 30 cm just distal to the arch. at this point, the patient had been electively intubated, but subsequently developed florid adult respiratory distress syndrome, likely secondary to his right lung contusion. early cultures showed hemophilus for which he was started on ceftriaxone. the patient remained in the intensive care unit requiring intensive ventilatory support. during this time, he was placed on lovenox for deep venous thrombosis prophylaxis and he began developing fevers. levofloxacin was added on , for gram negative rod coverage. the patient was also started on tpn as he had not tolerated trophic tube feeds. on , the patient had a bronchoscopy and had a right pleural effusion tapped. he remained in the intensive care unit. a repeat transesophageal echocardiogram on showed a persistent tear and a question of a small hematoma associated with his aortic injury. he was also started on vancomycin at the time for gram positive cocci in his sputum. subsequent cultures from this sample grew out methicillin resistant staphylococcus aureus. on , the patient underwent placement of ivc filter for pulmonary embolism prophylaxis. he continued to spike and had an elevated white count. pseudomonas was cultured from nasal swabs for which he was started initially on gentamicin which was changed then to ceftazidime. infectious disease consultation was obtained on . on , the vancomycin and ceftazidime were stopped. ent consultation saw the patient on ; did not recommended having his sinuses. on , the patient underwent delayed repair of his aortic intimal injury without any graft material. subsequent to this material, the patient suffered acute renal failure likely secondary to perioperative hypotension. his maximum creatinine was 2.1 and this subsequently normalized. on , the antibiotics were changed to ciprofloxacin, ceftazidime and vancomycin for methicillin resistant staphylococcus aureus pneumonia and pseudomonas pneumonia. on , he underwent a bedside percutaneous tracheostomy and antibiotics were discontinued. the patient suffered from hypercalcemia. pth levels eventually came back as maximally suppressed. he received one dose of pamidronate due to this hypercalcemia likely secondary to immobilization. subsequently calcium levels have been normal. on , the patient had a low-grade temperature and was found to have gram negative rods and gram positive cocci in his sputum. he subsequently grew out again methicillin resistant staphylococcus aureus and pseudomonas. he was started on vancomycin and imipenem for a 14 day course. on , he underwent a renal ultrasound which was normal. throughout his postoperative course from his aortic repair, he intermittently was very agitated, requiring sedation. sedation was eventually weaned and the patient's ventilatory support was weaned. on , he was on sufficient support to allow for passe muir valve trials. he rapidly advanced to a tracheostomy mask and was transferred to the floor on . since his transfer to the floor, he has had no respiratory distress. he has remained hemodynamically stable with a blood pressure of less than 150. he requires minimal pain medications and his neurologic status has been alert and oriented times three. the patient has been working with physical therapy and occupational therapy and is very motivated to make a full recovery. status by systems at this time: 1. neurologically: minimal pain and requiring tylenol only for pain control. he is alert and oriented times three, appropriate. he has suffered from insomnia and is receiving benadryl at night time. 2. cardiovascular: again, his goal systolic blood pressures should remain below 150. please see his list of medications at the end of this summary for current cardiac medications. 3. respiratory: the patient is on room air through his tracheostomy. the tracheostomy was placed on , so it is approximately two weeks old. within the next week or two, the patient can be decannulated provided he has no further respiratory complications. he is finishing up vancomycin and imipenem for his pseudomonas and methicillin resistant staphylococcus aureus pneumonias tomorrow, which will be day 14 of his most recent course of antibiotics. 4. gastrointestinal: he is tolerating tube feeds at goal through a dobbhoff tube. the patient initially failed a bedside swallow evaluation shortly after his extubation around . a subsequent video swallow study was requested, however, the no longer has the capability to perform this study, therefore, the patient is being transferred to a rehabilitation facility that can perform the modified barium swallow. should he pass this, the dobbhoff may be removed and he can start p.o. feeds. he remains on zantac prophylaxis. 5. genitourinary: the patient's foley catheter was removed and he voided without difficulty. his acute renal failure has resolved with a creatinine most recently of 0.5 on . 6. hematology: the patient has an ivc filter and has been continued on subcutaneous heparin for deep venous thrombosis prophylaxis. his most recent hematocrit was 34.8. 7. infectious disease: the patient has been afebrile since discharge from the intensive care unit. his white count on , was 9.9. he is to complete a 14 day course of vancomycin and imipenem which will be finished with tomorrow's doses. please see this discharge summary medication list for current dosing schedule. 8. endocrine: the patient had issues with hyperglycemia in the intensive care unit while receiving tpn and tube feeds. since transfer to the floor, his fingersticks have been consistently in the 120s and he received no sliding scale insulin coverage. he, therefore, no longer needs fingersticks or insulin coverage. his calcium most recently was 9.5, which is within the normal range. he has received no further doses of pamidronate for his hypercalcemia. die instructions: 1. at this point, the patient is being discharged from the trauma service. he should follow-up in the trauma clinic which is the of the building, on , at 01:00 p.m. phone number there is , should a change need to be made. 2. dr. is the orthopedic surgeon following his pelvic fractures. the patient should follow-up with dr. in mid-. dr. office number is . 3. dr. saw the patient for his upper extremity fractures. he should be seen in the office in one to two weeks' time. the number to schedule his appointment is , and ask for the orthopedic surgery clinic with dr. . 4. current weight bearing recommendations: the patient is non-weight bearing on the right hand but may use a platform walker on the right using his proximal forearm. the patient may use a crutch in the left hand. he is weight bear as tolerated on the left. he is touch-down weight bearing only on bilateral lower extremities. please see page three provided by physical therapy and occupational therapy for their assisted recommendations. 5. should the patient have any concerns regarding his aortic repair, he should follow-up with dr. , whose office number is . no specific follow-up appointment is required with dr. . medications on discharge: 1. hydralazine 100 mg per the ng tube q. eight hours; hold for systolic less than 110. 2. zantac 150 mg per ng tube twice a day. 3. enalapril 15 mg per ng tube twice a day; hold for systolic less than 110. 4. lopressor 150 mg per ng tube three times a day; hold for systolic less than 100, heart rate less than 60. 5. amlodipine 5 mg p.o. q. day; hold for systolic less than 100. 6. vancomycin, 1 gram, intravenous q. 18 hours through . 7. imipenem 1 gram intravenously q. six hours through . 8. colace 100 mg per ng tube twice a day. 9. heparin 5000 units subcutaneously twice a day. 10. ativan 0.5 mg intravenous q. four hours p.r.n. 11. tylenol 650 mg per ng tube q. four to six hours p.r.n. 12. benadryl 25 mg per ng tube q. h.s. p.r.n. please note, the patient should have his systolic blood pressure less than 150 mm of mercury at all times. other care needs: 1. he has a tracheostomy which is a #8 portex placed on . 2. the patient needs a video or modified barium swallow study early in his rehabilitation course as well as a cognitive and communication assessment by a speech pathologist. 3. the patient's diet is currently impact with fibre via a ng dobbhoff tube at 95 cc per hour. , m.d. dictated by: medquist36 procedure: insertion of intercostal catheter for drainage interruption of the vena cava thoracentesis arteriography of other intrathoracic vessels temporary tracheostomy closed [endoscopic] biopsy of bronchus open reduction of fracture with internal fixation, radius and ulna suture of artery debridement of open fracture site, radius and ulna diagnoses: acute kidney failure, unspecified closed fracture of scapula, unspecified part accidental fall from or out of building or other structure closed fracture of other specified part of pelvis closed fracture of four ribs closed fracture of lower end of radius with ulna injury to thoracic aorta open fracture of olecranon process of ulna 

Answer: The patient is high likely exposed to