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: this is a 75 year old female patient with a history of a right coronary angioplasty in , who was referred for outpatient cardiac catheterization due to recurrence of anginal symptoms and a recent positive stress test. past medical history: significant for: 1. hypertension. 2. hypercholesterolemia. 3. significant smoking history, however, quit twenty years ago. 4. insulin dependent diabetes mellitus. 5. chronic anemia. 6. gastroesophageal reflux disease. 7. chronic renal insufficiency. 8. status post hernia repair as a child. allergies: the patient states no known drug allergies. medications on admission: 1. humalog sliding scale insulin before meals. 2. lantus insulin 25 units subcutaneous q.h.s. 3. imdur 120 mg p.o. q.a.m. 4. isordil 10 mg p.o. 2:00 p.m. daily. 5. aspirin 81 mg p.o. q.d. 6. lipitor 10 mg p.o. q.d. 7. captopril 25 mg p.o. t.i.d. 8. toprol 50 mg p.o. q.a.m. and 25 mg toprol at 6:00 p.m. and 25 mg toprol q.h.s. 9. prevacid 30 mg p.o. q.d. 10. vitamin e. 11. senokot. laboratory data: on admission to the hospital include a white blood cell count 5.3, hematocrit 32.8, platelets 187,000. sodium 141, potassium 4.0, chloride 107, co2 27, blood urea nitrogen 21, creatinine 1.2. inr 1.17. physical examination: upon admission to the hospital was unremarkable. her room air oxygen saturation was 98%. vital signs were stable. hospital course: the patient was taken to the cardiac catheterization laboratory which reveals an 80% left main occlusion as well as three vessel coronary artery disease, left ventricular ejection fraction of 25%. cardiothoracic surgery consultation was obtained at that time. the patient was taken to the operating room on , with dr. , and underwent coronary artery bypass graft times four with saphenous vein sequential graft to the left anterior descending and diagonal and saphenous vein sequential graft to the om and distal right coronary artery. postoperatively, the patient was transported from the operating room to the cardiac surgery recovery unit on intravenous dobutamine, neo-synephrine, insulin and caripoide, study drug. on postoperative day one, the patient was hemodynamically stable and was weaning off her vasoactive drips. the patient was transferred to the telemetry floor out of the intensive care unit late in the day on postoperative day one. on postoperative day two, the patient remained hemodynamically stable. she was begun with diuretics and ace inhibitors and was beginning with postoperative physical therapy. on postoperative day three, the patient was noted having increased lethargy with intermittent periods of agitation. an echocardiogram was performed later that day to rule out cardiac tamponade and this was ruled out by echocardiogram. her ejection fraction was estimated to be 35 to 40% which was essentially the same as her preoperative left ventricular ejection fraction and she had a small pericardial effusion with no evidence of tamponade by echocardiography. neurology consultation was obtained also on , which is postoperative day three due to her significant decline in mental status that was fairly acute in origin. their thought at the time was that her mental status change was probably multifactorial and possibly related to medication effect. general surgery consultation was obtained at that time because the patient in addition to having mental status changes had been transferred to the intensive care unit and was noted to have right lower quadrant abdominal pain for approximately one to two hours. a general surgery consultation was obtained for this reason. later that day, the patient was intubated due to worsening respiratory distress and placed on a mechanical ventilator. cat scan of the abdomen and pelvis revealed a distended gallbladder and hence the patient was taken late that night to the operating room for an exploratory laparotomy. necrotic gallbladder with bilious fluid in the abdomen was found at that time as well as scarring of the anterior duodenal surface. a cholecystectomy was performed and the patient was transported postoperatively from the operating room to the intensive care unit. she was on neo-synephrine, insulin, propofol and dobutamine drips postoperatively. the patient remained sedated over the next 48 hours, however, was noted to have decrease in urine output and an increasing creatinine and a renal medicine consultation was obtained at that time. it was their recommendation to dose medications for low creatinine clearance since her creatinine at that time had increased from a baseline of 1.2 to 2.0 and she was essentially oliguric. they also recommended to avoid diuretics and to avoid any nephrotoxic agents to try to maintain good blood flow to her periphery by maximizing hemodynamics. the patient had been started on amiodarone intravenous drip due to postoperative atrial fibrillation on postoperative day seven from her coronary artery bypass graft and postoperative day two from her cholecystectomy, exploratory laparotomy. she had begun to improve hemodynamically. her cardiac index had remained around 2.0 and remained on amiodarone, dobutamine, neo-synephrine, insulin and propofol drips. she was also at that time on broad spectrum antibiotics due to her operative findings. the following day, , the patient was noted to have decreasing metabolic acidosis. her creatinine had stabilized at about 2.1 and her urine output was beginning to increase. her antibiotics were continued at that time. the patient remained on full ventilator support throughout this course of her initial postoperative period due to fluid overload and need for continued sedation while she was stabilizing hemodynamically. on , the patient remained on full ventilatory support. she had become very tachypneic every time any vent weaning was attempted. pulmonary medicine consultation was obtained at that time. it was their recommendation to limit the fluid intake, to consider ultrafiltration due to her fluid overload and her marginal urine output and to attempt pressure support wean. the patient was initiated on low rate tube feedings enterally, however, she did not tolerate that due to high gastric residuals so she was placed on hyperalimentation at that time. over the next 48 to 72 hours, the patient began to wake up and became more interactive, was tolerating her hyperalimentation, remained on dobutamine which had been weaned down slowly and was on fentanyl intravenous drip for sedation, remained on amiodarone as well as triple antibiotic coverage for her bilious peritonitis. on , the patient's spiked a fever to 102. her intravenous central lines were changed. she was continued on antibiotics and continued on hyperalimentation. on , postoperative day eleven from her cardiac surgery and postoperative day five from her abdominal surgery, the patient remains afebrile at this point in time and remains on full ventilator support. she was weaned off her dobutamine, intravenous hydralazine was initiated, and she began diuresing. tube feeding was also reinstituted at this time. late in the day on , the patient had rapid atrial fibrillation and required electric cardioversion. she also received an extra bolus of intravenous amiodarone and was converted successfully to normal sinus rhythm. by , the patient was postoperative day seven from her abdominal surgery and had been weaned off all vasoactive drips. she had begun to be more awake and responsive and continued to diurese well. on , because the patient still required full ventilatory support, it was determined to be in her best interest to undergo tracheostomy for continued support with a ventilator. this was done percutaneously by dr. in the intensive care unit. the patient tolerated the procedure well. around this time, the patient also underwent a dermatology consultation for a rash of unknown etiology and it was believed after skin biopsy was taken that this was a contact dermatitis of some sort. no treatment was initiated for it. over the next few days, the patient began to become more awake and alert. she had been increasingly able to tolerate her tube feedings. her hyperalimentation was discontinued and she was increased on her tube feeds to goal which is 60 cc/hour through a nasogastric feeding tube. the patient was begun on pressure support ventilation and beginning to tolerate intermittent periods of pressure support rather than full ventilatory support on the ventilator. the patient continued to progress well and remained stable hemodynamically. there were no new results on her cultures over the next few days. she was continued on her triple antibiotics for her surgical events, and her diuresis was continued and she was tolerating that well. over the next few days, consultation was obtained due to the patient's ongoing need for insulin and variable blood sugar due to tube feedings being increased. they made recommendations regarding her insulin and they have been following the patient over the next few days as well. on , due to the patient become more awake and alert and more interactive, a bedside swallow evaluation was obtained as well as a video swallow which was obtained the following day. it was determined from the speech therapy evaluation that she can tolerate pudding, thick liquids and pureed solids but no thin liquids yet and she is to observed closely with aspiration precautions. the patient over the next two days has significantly been decreased from her ventilator and tolerating that quite well. she was noted , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters angiocardiography of left heart structures left heart cardiac catheterization (aorto)coronary bypass of four or more coronary arteries exploratory laparotomy cholecystectomy temporary tracheostomy diagnoses: acidosis coronary atherosclerosis of native coronary artery acute kidney failure with lesion of tubular necrosis unspecified pleural effusion unspecified essential hypertension atrial fibrillation acute cholecystitis 

Answer: The patient is high likely exposed to