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 / zestril attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: - aortic valve replacement with a 21 mm magna ease bioprosthesis. history of present illness: 71yo female with known aortic stenosis. serial echocardiograms have shown worsening gradients. part of her pre-kidney transplant evaluation included a stress test which was not fully completed due to severe shortness of breath. current symptoms include dyspnea on exertion and decreased exercise tolerance. she denies chest pain, syncope, pre-syncope, orthopnea, pnd and pedal edema. she is able to perform routine adl without much difficulty. she occasionally requires a cane for balance, and frequently requires a wheelchair for walking long distance. cardiac surgery consulted for surgical correction. past medical history: past medical history - hypertension - dyslipidemia - diabetes mellitus type ii - history of renal cell carcinoma status post nephrectomy resulting in esrd, requires peritoneal dialysis since - history of peritonitis over five years ago - history of herpes zoster several years ago - history of c. difficile colitis - anemia - arthritis, history of gout - hyperparathyroidism past surgical history - s/p bilateral nephrectomy - s/p hernia repair - s/p dialysis catheter placement social history: lives: alone tobacco: quit over 40 years ago etoh: denies family history: non contributory physical exam: pulse:99 resp: 16 o2 sat: 98/ra b/p right: 121/74 left: 91/77 height: 4'9" weight: 139 lbs general: elderly female in no acute distress skin: dry intact - dialysis catheter noted lower abd heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur - 4/6 systolic murmur abdomen: soft non-distended non-tender bowel sounds extremities: warm , well-perfused edema - trace varicosities: none 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 murmurs pertinent results: echo pre-cpb: the left atrium is moderately dilated. no thrombus is seen in the left atrial appendage. no atrial septal defect is seen by 2d or color doppler. there is moderate symmetric left ventricular hypertrophy. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. there are simple atheroma in the descending thoracic aorta. no thoracic aortic dissection is seen. there are three aortic valve leaflets. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). two ai jets are seen: one central, the other at the commissure between the left and non-coronary cusps. mild to moderate (+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there appears to be mild mitral stenosis. mild to moderate (+) mitral regurgitation is seen. the mr jet is central. post-cpb: there is a bioprosthetic valve in the aortic position. the leaflets are freely mobile, the valve is well-seated. no paravalvular leaks are seen. there is no ai. the lv is hypertrophied, the chamber size is small, consistent with hypovolemic state. the lv systolic function is normal, estimated ef 55-60%. is seen with evidence of lvoto and increased mr. pt was treated with volume loading and phenylephrine with gradual resolution. mr remains mild to moderate. the gradient across the mitral valve is increased, peak gradient is 16mmhg, mean gradient is 7mmhg. the cardiac output remains comparable to pre-op. the rv systolic function remains normal. there is no evidence of aortic dissection. 04:53am blood wbc-7.9 rbc-3.47* hgb-10.4* hct-31.4* mcv-91 mch-30.1 mchc-33.1 rdw-14.8 plt ct-169 04:53am blood wbc-8.6 rbc-3.31*# hgb-10.2* hct-29.7* mcv-90 mch-30.7 mchc-34.3 rdw-15.0 plt ct-152 04:53am blood glucose-104* urean-56* creat-8.2* na-137 k-4.3 cl-93* hco3-26 angap-22* 05:34am blood glucose-58* urean-54* creat-7.7* na-135 k-4.5 cl-93* hco3-28 angap-19 04:53am blood calcium-8.4 phos-6.3* mg-2.4 05:34am blood calcium-8.6 phos-6.0* mg-2.3 brief hospital course: ms. was admitted to the on for surgical management of her aortic valve disease. she was taken to the operating room where she underwent an aortic valve replacement using a pericardial tissue valve. please see operative note for details. postoperatively she was transferred to the intensive care unit for recovery. the nephrology service followed her closely for her continuous peritoneal dialysis. over the next several hours, ms. neurologically intact and was extubated. on postoperative day one, blood tinged peritoneal dialysate was noted and the transplant surgery service was consulted. her hematocrit was stable and aspirin was held. peritoneal dialysis was resumed without issue. later on postoperative day one, she was trnasferred to the step down unit for further recovery. the physical therapy service was consulted for assistance with her postoperative strength and mobility. the goal was to make her a liter negative per day through her peritoneal dialysis. she did have a burst of rapid atrial fibrillation which converted to sinus rhythm with amiodarone and an increase in beta blockade. she continued to make steady progress and was discharged to , for rehabilitation on postoperative day 7. her follow-up appointments have been scheduled. medications on admission: allopurinol 150mg po daily atoarvastatin 10mg po daily cinacalcet 90mg po daily doxrecalciferol 2.5mcg po daily epogen 7500units mwf fluticasone 50mcg spray in each nostril daily gabapentin 100mg po prn qhs glyburide 5mg po daily ranitidine 150mg po daily docusate 100mg po bid ferrous sulfate 325mg daily magnesium 200mg daily discharge medications: 1. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for temperature >38.0. 2. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 5. cinacalcet 30 mg tablet sig: three (3) tablet po daily (daily). 6. gentamicin 0.1 % cream sig: one (1) appl topical daily (daily). 7. allopurinol 300 mg tablet sig: 0.5 tablet po daily (daily). 8. epoetin alfa 4,000 unit/ml solution sig: one (1) injection qmowefr (monday -wednesday-friday). 9. sodium chloride 0.65 % aerosol, spray sig: sprays nasal qid (4 times a day) as needed for dry nares. 10. gabapentin 100 mg capsule sig: one (1) capsule po daily (daily). 11. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 12. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 13. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po q6h (every 6 hours) as needed for constipation . 14. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*60 tablet(s)* refills:*0* 15. glyburide 5 mg tablet sig: one (1) tablet po daily (daily). 16. hydralazine 10 mg tablet sig: one (1) tablet po every six (6) hours as needed for sbp>140mmhg. 17. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed for wheezing. 18. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed for wheezing, sob. 19. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 20. sevelamer carbonate 800 mg tablet sig: two (2) tablet po tid w/meals (3 times a day with meals). 21. amiodarone 200 mg tablet sig: one (1) tablet po bid (2 times a day): 200mg x 1 week, then 200mg daily until further instructed. 22. insulin regular human 100 unit/ml solution sig: one (1) injection four times a day: per sliding scale. discharge disposition: extended care facility: northeast - discharge diagnosis: - aortic valve stenosis - hypertension - dyslipidemia - diabetes mellitus type ii - history of renal cell carcinoma status post nephrectomy resulting in esrd, requires peritoneal dialysis since - history of peritonitis over five years ago - history of herpes zoster several years ago - history of c. difficile colitis - anemia - arthritis, history of gout - hyperparathyroidism discharge condition: alert and oriented x3 nonfocal ambulating with assistance incisional pain managed with oral analgesia incisions: sternal - healing well, no erythema or drainage trace edema discharge instructions: 1) 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. 2) please no lotions, cream, powder, or ointments to incisions. 3) each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart provided. 4) no driving for approximately one month and while taking narcotics. driving will be discussed at follow up appointment with surgeon when you will likely be cleared to drive. 5) no lifting more than 10 pounds for 10 weeks 6) 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 surgeon: dr. #: date/time: 1:45 cardiologist: dr. : appointment on at 2pm please call to schedule appointments with your primary care dr. in weeks. please call to schedule your appointment. **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** procedure: venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft peritoneal dialysis diagnoses: end stage renal disease renal dialysis status diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation aortic valve disorders hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other and unspecified hyperlipidemia acute respiratory failure personal history of malignant neoplasm of kidney 

Answer: The patient is high likely exposed to