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: aspirin / valium attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: aortic valve replacement (19mm tissue) history of present illness: this is a 73 year old female with chronic diastolic congestive heart failure secondary to aortic and mitral valve disease. she is well known to our service and has been undergoing extensive evaluation prior to surgical intervention. she is high risk secondary to severe copd but was recently cleared by her local pulmonologist, dr. . currently, her symptoms include dyspnea on exertion and worsening fatigue. she denies recent chest pain and syncope. she has persistent lower extremity edema. past medical history: pmh: chronic diastolic heart failure, aortic stenosis/regurgitation, mitral regurgitation/stenosis, severe copd, reactive airway disease, asthma w/history of acute respiratory arrest(in her 40's), hypertension, paroxysmal atrial fibrillation, hyperlipidemia, degenerative arthritis, macular degeneration, gerd, mild urinary incontinence, **mrsa positive** psh: s/p bilateral knee replacements, s/p left elbow surgery, s/p bilateral ankle fusions, s/p bladder suspension social history: lives with: son and husband occupation: office work, retired tobacco: <1ppd x 10 yrs, quit over 30 years ago etoh: rare family history: negative for premature cad physical exam: pulse: 88 resp: 18 o2 sat: 100% room air b/p right: left: 154/58 height: weight: 162 lbs general: elderly female, slightly anxious, in no acute distress skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally insp/exp. wheezes, diminished heart: rrr irregular murmur syst abdomen: soft nd nt bowel sounds + extremities: warm , well-perfused edema 1+ bilaterally varicosities: none minimal spider veins neuro: grossly intact pulses: femoral right: 2+ left:2+ dp right: 1+ left:1+ pt : 1+ left:1+ radial right: 2+ left:2+ carotid bruit: transmitted murmur bilaterally pertinent results: conclusions pre-bypass: -no spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. -no spontaneous echo contrast or thrombus is seen in the body of the right atrium or the right atrial appendage. -no atrial septal defect is seen by 2d or color doppler. -left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%), with no segmental wall motion abnormalities. -there are complex (>4mm) and simple atheroma in the descending thoracic aorta. there are complex & simple atheroma in the aortic arch. -there are three aortic valve leaflets. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). mild to moderate (+) aortic regurgitation is seen. -the mitral valve leaflets are moderately thickened, with severe mitral annular calcification. moderate to severe (3+) mitral regurgitation is seen. -there is no pericardial effusion. postbypass: the patient is av paced on low dose phenylephrine infusion. there is a well seated bioprosthetic valve in the aortic position. there is appropriate leaflet excursion. there is no ai. gradients across aortic valve are appropriate. the mitral valve regurgitation is unchanged vs slightly worsened from prebypass exam. biventricular function is maintained. the aorta remains intact. dr. was notified of the results at the time of each study. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 13:41 06:50am blood wbc-13.7* rbc-3.03* hgb-9.2* hct-27.2* mcv-90 mch-30.4 mchc-33.9 rdw-14.3 plt ct-284 06:50am blood urean-24* creat-0.9 na-138 k-4.3 cl-96 brief hospital course: the patient was brought to the operating room on where the patient underwent aortic valve replacement with dr. . overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. pod 1 found the patient extubated, alert and oriented and breathing comfortably. the patient was neurologically intact and hemodynamically stable, weaned from inotropic and vasopressor support. beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. she remained in cvicu one day for pulmonary toilet and diuresis. she does have an aspirin allergy, and will take plavix instead. the patient was transferred to the telemetry floor on pod 2 for further recovery. chest tubes and pacing wires were discontinued without complication. the patient was evaluated by the physical therapy service for assistance with strength and mobility. by the time of discharge on pod#5 the patient was ambulating with assist,she needs continued diuretic therapy, her wound was healing and pain was controlled with oral analgesics. her discharge cxr showed left pleural effusion has improved. the patient was discharged to in good condition with appropriate follow up instructions. medications on admission: amiodarone 200mg daily budesonide-formoterol 2 puffs twice daily diltiazem hcl 180mg daily furosemide 40mg daily montelukast 10mg daily omeprazole 20mg daily potassium chloride 10meq daily simvastatin 40mg daily tiotropium bromide 1 daily zolpidem 10mg qhs calcium daily vicodin prn discharge medications: 1. outpatient lab work labs: pt/inr for coumadin ?????? indication goal inr 2-2.5 first draw **day after discharge** results to phone (confirmed with ) 2. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). 3. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed for wheeze. 4. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q4h (every 4 hours) as needed for wheezes. 5. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 6. montelukast 10 mg tablet sig: one (1) tablet po daily (daily). 7. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 8. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 9. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain. 10. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 11. glucagon (human recombinant) 1 mg recon soln sig: one (1) recon soln injection q15min () as needed for hypoglycemia protocol. 12. metoprolol tartrate 25 mg tablet sig: three (3) tablet po tid (3 times a day). 13. potassium chloride 10 meq tablet extended release sig: two (2) tablet extended release po q12h (every 12 hours). 14. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day). 15. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 16. docusate sodium 100 mg capsule sig: one (1) capsule po daily (daily) as needed for constipation. 17. warfarin 2.5 mg tablet sig: one (1) tablet po once (once) for 1 doses. 18. zolpidem 5 mg tablet sig: 0.5 tablet po hs (at bedtime) as needed for sleep. 19. zantac 150 mg tablet sig: one (1) tablet po once a day for 1 months. discharge disposition: extended care facility: hospital - discharge diagnosis: psh: chronic diastolic heart failure, aortic stenosis/regurgitation, mitral regurgitation/stenosis, severe copd, reactive airway disease, asthma w/history of acute respiratory arrest(in her 40's), hypertension, paroxysmal atrial fibrillation, hyperlipidemia, degenerative arthritis, macular degeneration, gerd, mild urinary incontinence, **mrsa positive** psh: s/p bilateral knee replacements, s/p left elbow surgery, s/p bilateral ankle fusions, s/p bladder suspension discharge condition: alert and oriented x3 nonfocal ambulating, deconditioned incisional pain managed with oral analgesics incisions: sternal - healing well, no erythema or drainage edema +1 generalized discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage please no lotions, cream, powder, or ointments to incisions each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart no driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive no lifting more than 10 pounds for 10 weeks please call with any questions or concerns females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: you are scheduled for the following appointments wound care, phone: date/time: 10:00 surgeon: dr , date/time: 1:00 cardiologist: dr. , office will call you with an appointment please call to schedule appointments with your primary care dr., m. in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** labs: pt/inr for coumadin ?????? indication goal inr 2-2.5 first draw **day after discharge** results to phone (confirmed with ) procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft diagnoses: esophageal reflux unspecified essential hypertension atrial fibrillation rheumatic heart failure (congestive) other and unspecified hyperlipidemia macular degeneration (senile), unspecified osteoarthrosis, unspecified whether generalized or localized, site unspecified multiple involvement of mitral and aortic valves carrier or suspected carrier of methicillin resistant staphylococcus aureus chronic obstructive asthma, unspecified examination of participant in clinical trial urinary incontinence, unspecified 

Answer: The patient is high likely exposed to