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: percocet / vicodin attending: chief complaint: chest pain major surgical or invasive procedure: s/p cabgx2(lima->lad, svg->om)/maze history of present illness: 68 yo m with history of cad and abnormal stress test referred for cardiac cath which showed 3vd. referred for surgery. past medical history: atrial fibrillation s/p cardioversion and , on coumadin tonsillectomy hypertension hyperlipidemia gout low back pain bilateral carpal tunnel release ? sleep apnea social history: he is married with five grown children. he is a retired sheet metal worker. he smokes cigars and drinks alcohol on occasion. prior smoking history of ~ 80 pack-years, quit 20 years ago family history: father died of heart failure ~68. physical exam: hr 84 rr 14 bp 146/68 nad lungs ctab heart irregular abdomen soft, nt, obese no varicosities neuro grossly intact 1+ femoral pulses, dp/pt non-palp, 1+ radial pulses no carotid bruits pertinent results: 04:52am blood wbc-7.6 rbc-2.95* hgb-9.3* hct-28.1* mcv-95 mch-31.4 mchc-33.0 rdw-14.1 plt ct-354 01:10am blood wbc-8.7 rbc-3.01* hgb-9.3* hct-28.3* mcv-94 mch-30.9 mchc-32.8 rdw-14.3 plt ct-360 04:52am blood glucose-123* urean-21* creat-1.0 na-136 k-4.6 cl-99 hco3-35* angap-7* 01:10am blood glucose-123* urean-21* creat-0.9 na-136 k-4.7 cl-99 hco3-34* angap-8 **final report ** gram stain (final ): >25 pmns and <10 epithelial cells/100x field. no microorganisms seen. respiratory culture (final ): sparse growth oropharyngeal flora. gram negative rod(s). rare growth. haemophilus influenzae, beta-lactamase negative. rare growth. beta-lactamse negative: presumptively sensitive to ampicillin. confirmation should be requested in cases of treatment failure in life-threatening infections.. radiology final report chest (pa & lat) 9:30 am chest (pa & lat) reason: r/o inf, eff medical condition: 68 year old man with reason for this examination: r/o inf, eff ap chest, 9:38 a.m., history: status post cabg. impression: ap chest compared to : moderate left pleural effusion has increased, and new obscuration of the left heart border could be due either to that effusion surrounding the heart or co-existent abnormality in the lingula, probably collapse. small right pleural effusion is unchanged. right-sided cardiac shadow is unchanged, and mediastinal vascular engorgement has cleared, but i cannot comment heart size. no pneumothorax. right picc line tip projects low over the svc. dr. approved: sun 9:24 pm radiology final report unilat lower ext veins left 7:52 pm unilat lower ext veins left reason: r/o dvt swelling medical condition: 68 year old man with s/p cabg reason for this examination: r/o dvt history: 68-year-old male status post cabg. comparison: bilateral lower extremity venous ultrasound of . left lower extremity venous ultrasound: -scale and doppler ultrasound examination of the left common femoral, superficial femoral, and popliteal veins demonstrate normal compressibility, flow, and augmentation. no intraluminal thrombus is seen. the patient is status post harvest of greater saphenous vein for cabg; a small amount of fluid is seen in the soft tissues along the expected course of the greater saphenous vein. lymph nodes measuring up to 1 cm in short axis and demonstrating fatty hila are noted in both groins. impression: no evidence of deep venous thrombosis in the left lower extremity. the study and the report were reviewed by the staff radiologist. dr. dr. approved: fri 9:32 am radiology final report ct chest w/o contrast 11:14 am ct chest w/o contrast reason: r/o consolidation vs. pleural effusion medical condition: 68 year old man with reason for this examination: r/o consolidation vs. pleural effusion contraindications for iv contrast: none. procedure: ct chest without contrast on . comparison: multiple previous chest radiographs and a chest ct scan examination on . technique: contiguous axial images were obtained from the thoracic inlet to the subdiaphragmatic area without contrast. thinner slice 5 mm and 1.25 mm images were reconstructed in the axial plane at different window algorithms. sagittal/coronal reformatted images were also obtained for further evaluation. history: 68-year-old man status post cabg procedure on . rule out consolidation versus pleural effusion. findings: lower most three sternal wires are off line to the left, better seen on the scanogram with sternal dehiscence, which is most pronounced at the inferior most sternal wire (3:29) and measures 1.6 cm in width. extending through this wide dehiscence into the anterior inferior mediastinal compartment is a collection of high attenuation, which measures 3.5 x 6.5 cm. postoperative changes in the mediastinal fat pad anteriorly is seen from a cabg procedure. moderate cardiomegaly is stable. multiple extensively atherosclerotic coronary vasculature are seen. the lungs are clear with the exception of the bases where there is minimal bilateral pleural effusion and adjacent basilar atelectasis. there are no pathologically enlarged lymph nodes according to ct criteria in the mediastinum or in the hilar area. the limited evaluation of the abdomen show hyperdense stones or sludge in the gallbladder. no other abnormality is seen. impression: 1. sternal dehiscence involving the three inferior wires most pronounced with a 1.6 cm bony separation and a collection extending from that site into the anterior left mediastinal compartment suggestive of a potentially inflammated fluid collection. 2. small bibasilar atelectasis and effusion are seen. without a contrast examination, no pneumonia can be excluded at these sites; however, the remainder of the lungs are relatively clear. 3. sludge/stones in the gallbladder, which do not show any signs of inflammation. the content of this report has been discussed with the referring physician, . , at approximately 12 p.m. the study and the report were reviewed by the staff radiologist. dr. dr. echocardiography report , (complete) done at 1:16:28 pm final referring physician information , w. , status: inpatient dob: age (years): 68 m hgt (in): bp (mm hg): / wgt (lb): hr (bpm): bsa (m2): indication: intraoperative tee for cabg, maze procedure icd-9 codes: 427.31, 440.0 test information date/time: at 13:16 interpret md: , md test type: tee (complete) son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: suboptimal tape #: 2008aw4-: machine: aw5 echocardiographic measurements results measurements normal range left atrium - long axis dimension: *5.2 cm <= 4.0 cm left atrium - four chamber length: *5.8 cm <= 5.2 cm left ventricle - ejection fraction: 50% to 55% >= 55% aorta - ascending: 2.9 cm <= 3.4 cm aorta - descending thoracic: 2.5 cm <= 2.5 cm findings left atrium: moderate la enlargement. elongated la. mild spontaneous echo contrast in the body of the la. good (>20 cm/s) laa ejection velocity. cannot exclude laa thrombus. right atrium/interatrial septum: a catheter or pacing wire is seen in the ra and extending into the rv. no asd by 2d or color doppler. left ventricle: suboptimal technical quality, a focal lv wall motion abnormality cannot be fully excluded. low normal lvef. right ventricle: normal rv systolic function. aorta: normal ascending aorta diameter. simple atheroma in ascending aorta. focal calcifications in ascending aorta. mildly dilated descending aorta. complex (>4mm) atheroma in the descending thoracic aorta. aortic valve: mildly thickened aortic valve leaflets (3). no as. trace ar. mitral valve: mildly thickened mitral valve leaflets. mild mitral annular calcification. trivial mr. tricuspid valve: tricuspid valve not well visualized. physiologic tr. pulmonic valve/pulmonary artery: pulmonic valve not well seen. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was under general anesthesia throughout the procedure. no tee related complications. suboptimal image quality - poor echo windows. the patient appears to be in sinus the patient. conclusions pre cpb poor image quality secodary to poor echo windows. the left atrium is moderately dilated. the left atrium is elongated. mild spontaneous echo contrast is seen in the body of the left atrium. a left atrial appendage thrombus cannot be excluded secondary to poor imaging. no atrial septal defect is seen by 2d or color doppler. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is low normal (lvef 50-55%). the right ventricle displays normal free wall contractility. there are simple atheroma in the ascending aorta. the descending thoracic aorta is mildly dilated. there are complex (>4mm) atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. dr. was notified in person of the results in the operating room at the time of the procedure. post cpb the patient is being atrially paced. normal overall biventricular systolic function although a focal wall motion abnormality cannot be fully excluded due to poor image quality. no significant changes from the pre bypass findings. i certify that i was present for this procedure in compliance with hcfa regulations. brief hospital course: he was taken to the operating room on where he underwent a cabg x 2 and maze with laa ligation. he was transferred to the icu in stable condition. he was initally hypotensive with low ci and svo2, and hypoxic. he was transfused. he was started on amiodarone for atrial fibrillation. his urine output decreased, however bladder scan showed retention and his foley was changed. he developed hematuria and was seen by urology who replaced his foley and started cbi and his hematuria cleared. he was started on tube feeds. he was pancultured for fever, and started on cipro for a uti. he was cardioverted on for atrial flutter. ep was consulted for arrythmias. he was started on cefepime for potential pseudomonas pneumonia. he continued to have fevers, and remained on the ventilator. he underwent left thoracentesis on for 150 cc. he began to improve and vent weaning which he was extubated. all antibiotics were discontinued, he remained afebrile. he developed some sternal drainage and ct scan revealed dehiscence of distal sternal wires but sternum remains stable and the drainage resolved. he continued to progress and was transferred to the floor for the remained of his care. he was noted to have sleep apnea accompanied by bradycardia with pauses. he underwent a modified sleep study and was placed on cpap. he will require a follow up sleep study after discharge from rehab. ep was reconsulted and his beta blockers were discontinued, he will be transferred to rehab telemetry unit with cpap at night. medications on admission: coumadin 5 ( tab daily), asa 81(1), allopurinol 300(1), amiodarone 200(1), doxazosin 4(1), zocor 40(1), diovan 80(1) discharge medications: 1. respiratory auto cpap with heated humidifier to treat obstructive sleep apnea 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 4. ranitidine hcl 150 mg tablet sig: one (1) tablet po once a day. 5. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. 6. ipratropium-albuterol 18-103 mcg/actuation aerosol sig: two (2) puff inhalation q4h (every 4 hours). 7. norvasc 10 mg tablet sig: one (1) tablet po once a day. 8. warfarin 2 mg tablet sig: one (1) tablet po once a day: please give 2mg coumadin sat and sun - please check pt/inr on mon-wed-fri and dose for goal inr 2.0-2.5 for atrial fibrillation . 9. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 10. furosemide 40 mg tablet sig: one (1) tablet po twice a day: please evaluate edema and weights and titrate lasix. 11. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 12. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 13. doxazosin 4 mg tablet sig: one (1) tablet po hs (at bedtime). 14. allopurinol 300 mg tablet sig: one (1) tablet po once a day. 15. potassium chloride 10 meq tablet sustained release sig: two (2) tablet sustained release po twice a day: with lasix. discharge disposition: extended care facility: - discharge diagnosis: coronary artery disease atrial fibrillation gout htn sleep apnea respiratory failure discharge condition: good discharge instructions: follow medications in discharge instructions. do not drive for 4 weeks. do not lift more than 10 lbs for 2 months. shower daily, let water flow over wounds, pat dry with a towel. do not use lotions, powders, or creams on wounds. call our office for temp >101.5, sternal drainage . beta blockers were discontinued for pauses - please follow up with cardiology prior to restarting, he continues on amiodarone followup instructions: please call to schedule appointments dr. after discharge from rehab dr. in 4 weeks see dr. on :20 (.provider: , m.d. phone: date/time: 2:20 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery insertion of endotracheal tube enteral infusion of concentrated nutritional substances thoracentesis non-invasive mechanical ventilation excision or destruction of other lesion or tissue of heart, open approach (aorto)coronary bypass of one coronary artery atrial cardioversion other operations on heart and pericardium transfusion of packed cells continuous intra-arterial blood gas monitoring diagnoses: thrombocytopenia, unspecified anemia, unspecified coronary atherosclerosis of native coronary artery unspecified pleural effusion urinary tract infection, site not specified unspecified essential hypertension acute kidney failure, unspecified atrial fibrillation atrial flutter other and unspecified hyperlipidemia other specified cardiac dysrhythmias unspecified sleep apnea old myocardial infarction retention of urine, unspecified family history of ischemic heart disease other and unspecified complications of medical care, not elsewhere classified pneumonia due to hemophilus influenzae [h. influenzae] other abnormal glucose disruption of external operation (surgical) wound 

Answer: The patient is high likely exposed to