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: penicillins / iodine; iodine containing attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: avr/asc ao replacement peg history of present illness: 49 yo m with history of bicuspid av sent to er from pcp 2 weeks of shortness of breath. pcp started on zithromax. cxr showed chf. cath showed severe ai and dilated ascending aorta and he was transferred for surgical evaluation. past medical history: bicuspid av social history: denies etoh 1 ppd x 30 years, quit 1 week ago lives with wife and daughter family history: mother with cad in 70s physical exam: admission vs hr 86 rr 22 bp 112/78 nad lungs ctab heart rrr, systolic murmur abdomen benign extrem warm, no edema 2+ pulses no carotid bruits discharge vs 98.9 78sr 123/60 18 100% om 4lnp gen: nad neuro: awake, follows commmands, answers simple questions. moves right upper and lower extremities, no movement left upper or lower extrem. pulm: scattered rhonchi cv: rrr s1-s2. sternum stable, incision cdi. abdm: soft, nt, +bs. peg site cdi ext: warm, no edema pertinent results: 12:30am blood wbc-11.3* rbc-4.34* hgb-12.5* hct-36.8* mcv-85 mch-28.9 mchc-34.1 rdw-14.0 plt ct-202 12:30am blood pt-15.5* ptt-26.6 inr(pt)-1.4* 12:30am blood glucose-179* urean-19 creat-1.1 na-136 k-5.0 cl-104 hco3-25 angap-12 12:50pm blood alt-41* ast-23 ld(ldh)-241 alkphos-77 totbili-0.5 12:30am blood calcium-9.0 phos-3.9 mg-2.3 12:50pm blood %hba1c-5.6 02:00am blood wbc-10.9 rbc-3.71* hgb-10.1* hct-30.5* mcv-82 mch-27.2 mchc-33.0 rdw-15.2 plt ct-439# 02:07am blood pt-13.8* ptt-33.9 inr(pt)-1.2* 02:07am blood plt ct-415 02:07am blood glucose-116* urean-19 creat-0.8 na-132* k-5.5* cl-99 hco3-24 angap-15 radiology preliminary report chest (portable ap) 1:17 pm chest (portable ap) reason: r/o ptx medical condition: 49 year old man ascaorepair/avr and s/p ct removal reason for this examination: r/o ptx history: 49-year-old male with ascending aorta repair, status post chest tube removal. evaluate for pneumothorax. comparison: . portable supine chest: left chest tube has been removed with no evidence of pneumothorax. an endotracheal tube has been placed with tip 6 cm from the carina, in standard position. tip of right ij catheter terminates in the mid svc. ng tube is coiled within the stomach, unchanged from prior study. lungs are grossly clear without focal consolidation. no large pleural effusions are identified. the mediastinal contours are stable. impression: 1. no pneumothorax identified. 2. ng tube is coiled within the stomach. dr. dr. radiology final report mra brain w/o contrast 2:47 pm mr head w & w/o contrast; mra brain w/o contrast reason: assess brain stem infarct vs mass effect contrast: magnevist medical condition: 49 year old man s/p asc ao repair/avr post-op cva reason for this examination: assess brain stem infarct vs mass effect contraindications for iv contrast: none. indication: 49-year-old man status post ascending aorta repair with post- operative cva. technique: multiplanar t1- and t2-weighted images of the brain were acquired with and without the administration of intravenous contrast . comaparison: multiple prior cts including the most recent head ct dated . there is no prior mri for comparison. findings: the study is somewhat limited due to patient motion especially on flair imaging and pre-contrast t1. there is a large area of abnormal signal intensity representing high signal on flair imaging in the right pca distribution, representing subacute right pca infarct. on diffusion-weighted images, there are evidence of restricted diffusion in the right pca territory including right occipital lobe as well as the right superior cerebellar territory. the area of slow effusion now also seen in the right thalamus, mid brain and cerebral peduncle as well as pulvinar of the thalamus. there are small foci of restricted diffusion in the left occipital lobe as well as left cerebral hemisphere. the involvement of the contralateral side suggests embolic event. these restricted-diffusion areas are low signal on adc map. there is slight enhancement in the involved area of right pca distribution which could represent luxury perfusion. mr angiography: there is hypoplastic right a1 segment. otherwise, anterior circulation is within normal limit. right posterior cerebral artery is not visualized representing occlusion or thrombosis, causing stroke. right superior cerebellar artery is not clearly identified either. the rest of the posterior circulation is within normal limit. 1. large area of subacute infarct with slow diffusion involving right pca and right superior cerebellar territory. 2. small foci of slow diffusion in the left occipital lobe and cerebellum, suggestive of embolic events. slow diffusion also involves mid brain and thalamus. right side of the pons. 3. mr angiography shows lack of flow in right pca, and right superior cerebellar artery is not clearly noted. hypoplasia of right a1 segment suggestive of restricted or limited flow. the study and the report were reviewed by the staff radiologist. dr. dr. echocardiography report , portable tee (complete) done at 5:42:26 pm final referring physician information , division of cardiothoracic , status: inpatient dob: age (years): 49 m hgt (in): bp (mm hg): 126/76 wgt (lb): hr (bpm): 87 bsa (m2): indication: cerebrovascular event/tia. aortic valve disease. icd-9 codes: 427.89, 441.2, 424.1, 435.9 test information date/time: at 17:42 interpret md: , md test type: portable tee (complete) son: doppler: full doppler and color doppler test location: west sicu/ctic/vicu contrast: none tech quality: adequate tape #: 2007w000-: machine: vivid i-4 sedation: versed: 0 mg fentanyl: 0 mcg patient was monitored by a nurse throughout the procedure echocardiographic measurements results measurements normal range left ventricle - ejection fraction: 45% to 50% >= 55% aortic valve - peak velocity: *2.7 m/sec <= 2.0 m/sec aortic valve - peak gradient: *30 mm hg < 20 mm hg aortic valve - mean gradient: 15 mm hg findings this study was compared to the prior study of . left atrium: no spontaneous echo contrast or thrombus in the body of the laa. right atrium/interatrial septum: a catheter or pacing wire is seen in the ra and extending into the rv. left ventricle: mildly depressed lvef. right ventricle: normal rv chamber size and free wall motion. aorta: no atheroma in ascending aorta. aortic valve: mechanical aortic valve prosthesis (avr). mitral valve: mild (1+) mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: pulmonic valve not well seen. no pr. pericardium: no pericardial effusion. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was monitored by a nurse throughout the procedure. the patient was monitored by a nurse in throughout the procedure. local anesthesia was provided by benzocaine topical spray. no tee related complications. compared to the findings of the prior study, left ventricular systolic function has improved. conclusions no spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. overall left ventricular systolic function is mildly depressed (lvef= 45-50 %) with mild global hypokinesis. right ventricular chamber size and free wall motion are normal. a mechanical aortic valve prosthesis is present, which appears well-seated and has normal gradients. mild (1+) mitral regurgitation is seen. there is no pericardial effusion. the ascending aorta and aortic arch show no evidence of thrombus or dissection. the left subclavian artery ostium is visualized, which also shows no evidence of thrombus. the innominate artery and left common carotid artery ostium is not visualized. compared to the findings of the prior study of (images reviewed), left ventricular systolic function has improved. there is a new aortic valve prosthesis in place on the current study. impression: mild global lv hypokinesis with a properly functioning mechanical aortic valve prosthesis. no evidence of dissection or thrombus in the aortic graft or descending aorta. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 21:11 brief hospital course: he was admitted to cardiac surgery. he underwent preoperative workup and was taken to the operating room on where he underwent an avr (mechanical) and ascending aorta and hemiarch. he was transferred to the icu in critical but stable condition on milrinone, levophed and propofol. he was given 48 hours of peroperative vancomycin as he was in house for greater than 24 hours preop and he is allergic to penicillin. he was found to be agitated, with left sided weakness the night after surgery, ct head revealed a right pca stroke. he was extubated on pod #2. repeat ct scan was unchanged. he was started on mannitol. a left chest tube was placed on for pneumothorax. he was started on tube feeds. his vasoactive drips were weaned to off by pod #5. he was started on heparin and coumadin for his mechanical valve.on 12.26 he underwent peg tube placement. on he was transferred to rehabilitation at in . medications on admission: none. discharge medications: 1. warfarin 1 mg tablet sig: as directed tablet po once a day: target inr 2.5-3.0. 2. acetaminophen 500 mg/5 ml liquid sig: five (5) ml po q4h (every 4 hours) as needed for temperature >38.0. 3. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 4. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 5. docusate sodium 50 mg/5 ml liquid sig: ten (10) ml po bid (2 times a day). 6. ranitidine hcl 15 mg/ml syrup sig: one y (150) mg po bid (2 times a day). 7. warfarin 1 mg tablet sig: as directed tablet po once a day. 8. heparin (porcine) in d5w 100 unit/ml parenteral solution sig: 1400 (1400) units intravenous asdir (as directed): goal ptt 60-80. until inr therapeudic. discharge disposition: extended care facility: st hospital rehabilitation unit - , nh discharge diagnosis: bicuspid av/as/ai now s/p avr(#21 on-x mech)asc ao & hemiarch replacement. post operative cva post operative dysphagia discharge condition: stable discharge instructions: keep wounds clean and dry. ok to shower, no bathing or swimming. call with fever, redness or drainage from incision or weight gain more than 2 pounds in one day or five in one week. no lotions, creams or powders to incisions. no lifting more than 10 pounds or driving until follow up with surgeon. p instructions: dr. 2 weeks dr. 2 weeks dr. 4 weeks -pt to call for all appointments procedure: venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] open and other replacement of aortic valve resection of vessel with replacement, thoracic vessels diagnoses: thoracic aneurysm without mention of rupture iatrogenic pneumothorax congenital insufficiency of aortic valve iatrogenic cerebrovascular infarction or hemorrhage 

Answer: The patient is high likely exposed to