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: sulfa (sulfonamide antibiotics) attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: coronary artery bypass grafting x4 with left internal mammary artery to left anterior descending artery, reverse saphenous vein graft to diagonal artery, reverse saphenous vein graft to obtuse marginal artery, reverse saphenous vein graft to posterior diagonal artery), mitral valve repair with 28 cg future annuloplasty ring history of present illness: 60 year old white male with recent dyspnea on exertion. stress test was abnormal during work up for revision of right total knee. cardiac catheterization revealed coronary artery disease and he was referred for surgical evaluation past medical history: coronary artery disease hypertension myocardial infarction (remote by ekg) nephrolithiasis (42 yrs. ago) neurogenic bladder (self cath 4-5x/day) urinary tract infection with sepsis obesity bilateral rotator cuff tear spinal stenosis gout diverticulosis osteoarthritis past surgical history: bilateral total knee replacements (2x each) transurethral resection of prostate cholecystectomy left inguinal hernia repair x2 tonsillectomy social history: lives with: alone, divorced occupation: nstar mechanic tobacco: none etoh: occasional family history: mom died of mi 68yo, dad living 87 (h/o mi) sister died 40yo , brother 59 living with dm physical exam: pulse: 79 resp: 17 o2 sat: 99%ra b/p right: 130/70 left: height: 5'9" weight: 225lb general: skin: dry intact no rash heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema varicosities: none no varicosities, trace edema b/l healed scars over b/l knees s/p tkr neuro: grossly intact x pulses: femoral right: cath left: 2+ dp right: 2+ left: 2+ pt : 2+ left: 2+ radial right: 2+ left: 2+ carotid bruit right: left: no carotid bruits pertinent results: pre-op 05:03pm pt-11.5 ptt-24.8 inr(pt)-1.0 05:03pm plt count-196 05:03pm wbc-9.3 rbc-4.46* hgb-12.7* hct-36.6* mcv-82 mch-28.5 mchc-34.7 rdw-15.2 05:03pm magnesium-1.9 05:03pm glucose-85 urea n-28* creat-1.2 sodium-142 potassium-3.9 chloride-106 total co2-26 anion gap-14 08:46pm urine rbc-* wbc->50 bacteria-many yeast-none epi-0 08:46pm urine blood-sm nitrite-neg protein-150 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-8.0 leuk-mod 08:46pm urine color-straw appear-hazy sp -1.012 discharge 06:30am blood wbc-14.0* rbc-3.91* hgb-11.0* hct-34.1* mcv-87 mch-28.1 mchc-32.2 rdw-14.7 plt ct-102* 06:30am blood plt ct-102* 02:44pm blood pt-13.1 ptt-29.4 inr(pt)-1.1 06:30am blood glucose-120* urean-24* creat-1.2 na-140 k-4.3 cl-106 hco3-26 angap-12 06:30am blood mg-2.1 chest (portable ap) 8:07 am medical condition: 60 year old man with cabg/mvrep reason for this examination: ? after ct removal final report chest, ap: examination is limited by underpenetration. endotracheal tube, nasogastric tube, mediastinal drains, and chest tubes have been removed. swan-ganz catheter remains in standard position. there is no pneumothorax. moderate layering left effusion persists. the cardiomediastinal silhouette is stably enlarged, post-cabg and mitral valve replacement. lung volumes are low, with mild bibasilar atelectasis. impression: post-operative changes. moderate left effusion. the study and the report were reviewed by the staff radiologist. dr. ho dr. echocardiography report echocardiographic measurements results measurements normal range left atrium - long axis dimension: *6.0 cm <= 4.0 cm left atrium - four chamber length: *7.3 cm <= 5.2 cm left ventricle - inferolateral thickness: 0.9 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: *6.6 cm <= 5.6 cm left ventricle - ejection fraction: 30% to 35% >= 55% aorta - sinus level: 3.4 cm <= 3.6 cm aorta - sinotubular ridge: 2.9 cm <= 3.0 cm aorta - ascending: *3.8 cm <= 3.4 cm aorta - descending thoracic: *2.7 cm <= 2.5 cm aortic valve - lvot diam: 1.9 cm findings left atrium: marked la enlargement. elongated la. no spontaneous echo contrast or thrombus in the la/laa or the ra/raa. good (>20 cm/s) laa ejection velocity. all four pulmonary veins identified and enter the left atrium. 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: wall thickness and cavity dimensions were obtained from 2d images. normal lv wall thickness. moderately dilated lv cavity. moderate regional lv systolic dysfunction. inferobasal lv aneurysm. moderately depressed lvef. right ventricle: moderate global rv free wall hypokinesis. aorta: normal aortic diameter at the sinus level. focal calcifications in aortic root. mildly dilated ascending aorta. simple atheroma in ascending aorta. simple atheroma in aortic arch. 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. no ms. moderate (2+) mr. tricuspid valve: tricuspid valve not well visualized. physiologic tr. pulmonic valve/pulmonary artery: pulmonic valve not well seen. physiologic (normal) pr. pericardium: trivial/physiologic 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 under general anesthesia throughout the procedure. no tee related complications. suboptimal image quality. frequent atrial premature beats. results were conclusions pre bypass the left atrium is markedly dilated. the left atrium is elongated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses are normal. the left ventricular cavity is moderately dilated. there is moderate regional left ventricular systolic dysfunction with severe hypokinesis of the lateral, anterolateral and inferolateral walls. the rest of the walls are moderately depressed. there is a likely inferobasal left ventricular aneurysm. overall left ventricular systolic function is moderately to severely depressed (lvef= 30 %). the right ventricle displays moderate global free wall hypokinesis. the ascending aorta is mildly dilated. there are simple atheroma in the ascending aorta. there are simple atheroma in the aortic arch. 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. moderate (2+) centrally directed mitral regurgitation is seen. it is likely due to a combination of bileaflet restriction and annular dilitation. there is a trivial/physiologic pericardial effusion. dr. was notified in person of the results in the operating room at the time of the study. post bypass the patient is receiving epinephrine by infusion. the patient is being atrial paced. right ventricular free wall systolic function is improved and is now normal. the left ventricle dispalys improved function as well. the lateral, anterolateral, and inferolateral walls are still mild to moderately hypokinetic. the ejection fraction is about 45%. a mitral annular ring is in situ. there is trace to mild mitral regurgitation. the peak gradient across the mitral valve is 11 mmhg with a mean gradient of 7 mmhg at a cardiac output of 9 liters/minute. the thoracic aorta appears intact. no other significant changes from the pre-bypass study. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 14:47 brief hospital course: he was admitted to for coronary artery bypass grafting and mitral valve repair versus replacement. he was found to have a klebsiella urinary tract infection and was treated preoperatively with iv cefepime. on he was brought to the operating room please see operative report for details. he tolerated the operation well and was transferred from the operating room to the cardiac surgery icu in stable condition. he remained hemodynamically stable in the immediate post-operative period, woke nuerologically intact and was extubated. on pod1 he was transferred from the cardiac surgery icu to the stepdown unit. all tubes, lines and drains were removed per cardiac surgery protocol. once on the stepdown unit he worked with physical therapy and nursing to increase her activity and endurance. the remainder of his post operative course was uneventful. on pod four he was discharged home with services. medications on admission: amlodipine 10', asa 325', metoprolol 25 mg , simvastatin 80mg daily discharge medications: 1. simvastatin 80 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 3. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 5. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 6. hydromorphone 2 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for pain. disp:*60 tablet(s)* refills:*0* discharge disposition: home with service facility: - discharge diagnosis: coronary artery disease s/p cabg and mv repair hypertension myocardial infarction nephrolithiasis neurogenic bladder (self cath 4-5x/day) urinary tract infection with sepsis obesity bilateral rotator cuff tear spinal stenosis gout diverticulosis osteoarthritis discharge condition: mental status: clear and coherent level of consciousness: alert and interactive activity status: ambulatory - independent sternal wound healing well, no erythema or drainage discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions 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 until follow up with surgeon no lifting more than 10 pounds for 10 weeks please call the cardiac surgery office for any questions or concerns. answering service will page on-call staff during off hours followup instructions: provider: , md phone: date/time: 1:00 please call to schedule appointments pcp: in weeks cardiologist: in weeks please call the cardiac surgery office for any questions or concerns. answering service will page on-call staff during off hours procedure: (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart cardioplegia annuloplasty diagnoses: coronary atherosclerosis of native coronary artery mitral valve disorders urinary tract infection, site not specified unspecified essential hypertension friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site gout, unspecified paroxysmal ventricular tachycardia old myocardial infarction obesity, unspecified neurogenic bladder nos 

Answer: The patient is high likely exposed to