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: keflex / benadryl attending: chief complaint: s/p fall major surgical or invasive procedure: procedures: 1. open reduction internal fixation, left anterior column posterior hemi-transverse acetabular fracture. 2. open reduction position of left bimalleolar ankle fracture. 3. left chest thoracostomy tube history of present illness: 89f with history of a-fib on coumadin and previous cva w/o deficits presents to as transfer from osh s/p fall with multiple fractures. she was reportedly found down at her home after fall from feet from interior balcony in her home when she was last seen normal. patient states she remembers the entire episode and falling to the floor, with no loc. at osh had neg ct head, cxr showing rib fracture, and hct down 10pts from three weeks ago. she was given 1 unit of prbc's and vitamin k to reverse anticoagulation prior to transport. there was report of impacted hip fracture as well as left ankle fracture. she was transferred to for further management. past medical history: - atrial fibrillation on coumadin - htn - osteoarthritis - glaucoma - right total hip replacement - hysterectomy social history: lives at home on her own family history: noncontributory physical exam: (on presentation to er) temp: 97.0 hr: 142 bp: 148/92 resp: 18 o(2)sat: 99 normal constitutional: opens eyes to commands heent: ecchymosis on right cheek, pupils equal, round and reactive to light, extraocular muscles intact, no proptosis c-collar placed on arival, no tenderness chest: clear to auscultation; no chest wall crepitus or ttp cardiovascular: irregular, tachy abdominal: soft, nontender, nondistended extr/back: left ankle swelling/injury without deformity, equal radial pulses, dopplerable dp and pt pulses bilaterally skin: warm and dry neuro: speech fluent psych: normal mentation (alert and oriented though slightly slow to open eyes and follow commands) pertinent results: 05:00pm glucose-149* urea n-29* creat-0.8 sodium-133 potassium-4.4 chloride-97 total co2-27 anion gap-13 05:00pm wbc-12.1* rbc-3.75* hgb-10.4* hct-31.1* mcv-83 mch-27.8 mchc-33.6 rdw-14.1 05:00pm pt-21.6* ptt-36.3 inr(pt)-2.1* imaging: xray left ankle : acute fractures involving the medial malleolus, distal fibula ( b) with syndesmotic disruption and widened medial mortise. xray pelvis : multiple pelvic fractures detailed above including right superior and inferior pubic ramus fractures, left acetabular fracture with protrusio defect and left inferior pubic ramus fractures. ct c-spine : no acute fracture ct chest w/contrast : multiple pulmonary nodules, nondisplaced posteriorlateral 8th and 9th rib fx ct abd/pelvis : hepatic cyst, l psoas hematoma 8.7 by 4.6 by 11.7cm, intermuscular hematomas of the pelvic girdle w/o active extravasation ct head w/o contrast (): negative for ischemia or hemorrhage brief hospital course: her emergency department course as follows: on arrival to ed she had a gcs 15 with dopperable pulses in both lower extremities. she underwent ct imaging - ct c-spine was negative but cervical collar was left in place initially due to potential of orthopedic injuries being a distracting factor; the collar was eventually removed. ct scan of the chest, abdomen and pelvis confirming rib fractures on left non-displaced and complex pelvic fracture without evidence of active extravasation. it should also be noted that there were 4-mm pulmonary nodules in the left lower lobe and lingula for which follow up with a repeat chest ct in one year is being recommended. hematocrits in ed remained stable. her ck and lactate were initially elevated which was concerning for rhabdomyolysis but her creatinine remained stable; she was given fluid resuscitation. she was noted to be in atrial fibrillation with hr up to 120's and was given diltiazem and started on a drip. no other hemodynamic instability was noted. two units of ffp were given to reverse her inr in the ed. orthopedic consultation was obtained. icu course as follows: she was admitted to the acute care surgery team and transferred to the trauma icu for close monitoring and stabilization prior to orthopedic repair of her injuries. she was taken to the operating room on for open reduction internal fixation, left anterior column posterior hemi-transverse acetabular fracture and open reduction position of left bimalleolar ankle fracture. there were no intraoperative complications. postoperatively she had significant pain control issues prompting acute pain service consultation. her hematocrit dropped from admission value of 31.1 to 21.2 on and she was transfused with 4 units prbc's for anemia due to acute blood loss which was felt likely due to her pelvic fracture. she also received 3 units of ffp to correct her coumadin-induced coagulopathy. she was also started on zosyn for treatment of a recent complicated uti that had failed bactrim therapy as outpatient. on pod#2 she was transferred to a surgical floor, however after only a short time she was found to be minimally responsive and was transferred back to the icu for further workup. by the time of arrival back to the icu her mental status began to show some improvement as she was waking up more. a ct scan of the head was done and revealed no acute processes; her change in mental status was felt likely due narcotic medication. a chest x ray obtained on pod#3 was concerning for left pleural effusion and an ultrasound supported this. a chest tube was placed with drainage of ~400cc serosanguinous fluid. she was started on a ketamine drip and clonidine patch for pain control. the following day pod#4 her chest xray was markedly improved and the chest tube was removed with concomitant improvement in pain. the ketamine was weaned off and pain control accomplished with clonidine patch, gabapentin, and oxycodone for breakthrough. by pod#4 she underwent a swallow evaluation and her diet was upgraded to mechanical soft and thin liquids. her floor course as follows: she was transferred from the icu to the floor for ongoing care. she underwent left lower extremity ultrasound to assess for dvt given swelling but no evidence of clot was found. she did however have a significant cellulitis near her left ankle surgical site and was recommended for vancomycin iv. a formal infectious disease consult was obtained who recommended continuation of the vancomycin through . a picc line was placed. she will need her esr and crp checked on ; vanco levels will also need to be followed and dosing adjusted accordingly. next vanco trough to be done . her inr was noted to be elevated and her home dose of 6.5 mg coumadin was held on for an inr 3.2. her inr will need to be followed closely and when restarting it is being recommended that she be given at least half of her usual home dose. physical and occupational evaluations were obtained and she is being recommended for acute level rehab after her hospital stay. medications on admission: - coumadin 6.5 mg daily - metoprolol 50 mg - diltiazem 120 mg daily - digoxin 0.125 mg daily - lisinopril 5 mg daily - xalantan eye gtt discharge medications: 1. insulin regular human 100 unit/ml solution sig: one (1) dose injection four times a day as needed for per sliding scale. 2. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime): both eyes. 3. diltiazem hcl 30 mg tablet sig: one (1) tablet po qid (4 times a day). 4. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 6. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 7. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed for constipation. 8. digoxin 125 mcg tablet sig: one (1) tablet po daily (daily). 9. acetaminophen 500 mg tablet sig: one (1) tablet po tid (3 times a day). 10. oxycodone 5 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 11. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily): apply over left chest region rib fx site . 12. clonidine 0.2 mg/24 hr patch weekly sig: one (1) patch weekly transdermal qtues (every tuesday). 13. coumadin 3 mg tablet sig: one (1) tablet po once a day: new dose being recommneded - home dose previously 6.5 mg but stopped d/t elevated inr. . 14. vancomycin in d5w 1 gram/200 ml piggyback sig: one (1) gm intravenous q 24h (every 24 hours) for 7 days. 15. 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. 16. gabapentin 100 mg capsule sig: one (1) capsule po tid (3 times a day). 17. ultram 50 mg tablet sig: 0.5 tablet po four times a day as needed for pain. 18. protonix 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. discharge disposition: extended care facility: hospital discharge diagnosis: s/p fall injuries: 1. left anterior column posterior hemi-transverse acetabular fracture 2. left bimalleolar fracture 3. rib fractures on left (non-displaced) 4. moderate left pleural effusion 5. wound cellulitis left ankle 6. cyst left popliteal fossa 7. acute blood loss anemia discharge condition: mental status: confused - sometimes. level of consciousness: lethargic but arousable. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: you were admitted to the hospital following a fall where you sustained multiple injuires including rib fractures and fractures of your pelvic/hip, fibula (lower leg) and ankle bones. you required surgery to fix the broken bones and now being recommended for a rehabilitation facility to help strengthen you. during your hospital stay you also developed an infection on the leg where your fractures are located. intravenous antibiotics were recommended and a special intravenous catheter line called a picc was placed into your veins to deliver the medications. your blood thinning medication called coumadin required some adjustments while you were in the hospital based on your inr blood levels. you are being discharged to rehab on a lower dose than you were on at home. the rehab facility will be able to monitor your blood levels closely and will adjust the dose accordingly. followup instructions: * department: general surgery/ when: thursday at 1:15 pm with: acute care clinic building: lm bldg () campus: west best parking: garage department: orthopedics when: thursday at 12:00 pm with: dr. phone: md procedure: thoracentesis open reduction of fracture with internal fixation, tibia and fibula closed reduction of fracture with internal fixation, other specified bone diagnoses: other postoperative infection unspecified pleural effusion urinary tract infection, site not specified unspecified essential hypertension acute posthemorrhagic anemia atrial fibrillation cellulitis and abscess of leg, except foot long-term (current) use of anticoagulants methicillin resistant staphylococcus aureus in conditions classified elsewhere and of unspecified site closed fracture of two ribs acute pain due to trauma home accidents other alteration of consciousness hip joint replacement closed fracture of pubis unspecified analgesic and antipyretic causing adverse effects in therapeutic use closed fracture of acetabulum other accidental fall from one level to another history of fall personal history, urinary (tract) infection solitary pulmonary nodule other restorative surgery causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation bimalleolar fracture, closed synovial cyst of popliteal space contusion of back 

Answer: The patient is high likely exposed to