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: no known allergies / adverse drug reactions attending: chief complaint: shortness of breath major surgical or invasive procedure: aortic valve replacement(23mm st. mechanical) history of present illness: this 28 year old female with a suspected bicuspid aortic valve currently on intravenous antibiotics for endocarditis. she is being followed closely by the infectious disease service. she continues to experience exertional shortness of breath with minimal exertion. she denies orthopnea, paroxysmal nocturnal dyspnea, pedal edema, palpitations, syncope, presyncope and chest pain. she was admitted for aortic valve replacement. past medical history: culture negative aorticendocarditis h/o embolic stroke anxiety disorder/panic disorder cyclothymia h/o recurrent urinary tract infections history of migraines social history: denies tobacco use. former alcoholic, last drink was new years. marijuana use few times a year. no ivdu or other recreational drugs. works as software designer. family history: grandmother had heart disease and was a chronic smoker. no history of cancer, hyperlipidemia, diabetes. no sick contacts in her family. physical exam: 9:25 am tissue site: aorta aortic valve leaflet. gram stain (final ): 1+ (<1 per 1000x field): polymorphonuclear leukocytes. no microorganisms seen. tissue (final ): no growth. anaerobic culture (preliminary): no growth. pulse: 95 resp:16 o2 sat: 100% bp 128/75 height: 5'4" weight:73 kgs general: non-toxic, no acute distress skin: dry intact no rash heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur diastolic murmur- loudest at rusb abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema- none varicosities: none neuro: grossly intact x pulses: femoral right: 2+ left: 2+ dp right: 2+ left: 2+ pt : 2+ left: 2+ radial right: 2+ left: 2+ carotid bruit: none pertinent results: 9:25 am tissue site: aorta aortic valve leaflet. gram stain (final ): 1+ (<1 per 1000x field): polymorphonuclear leukocytes. no microorganisms seen. tissue (final ): no growth. anaerobic culture (preliminary): no growth. 05:18am blood wbc-5.0 rbc-2.39* hgb-7.1* hct-20.8* mcv-87 mch-29.5 mchc-34.0 rdw-15.3 plt ct-263 07:02am blood wbc-5.3 rbc-2.31* hgb-6.8* hct-20.0* mcv-87 mch-29.4 mchc-33.9 rdw-15.6* plt ct-190 11:02am blood wbc-11.2*# rbc-2.46*# hgb-7.1*# hct-21.3*# mcv-87 mch-28.9 mchc-33.4 rdw-14.9 plt ct-149* 05:18am blood pt-22.2* inr(pt)-2.1* 04:53pm blood pt-38.3* inr(pt)-4.0* 07:02am blood pt-30.1* inr(pt)-3.0* 05:33am blood pt-16.4* ptt-29.1 inr(pt)-1.5* 12:17pm blood pt-15.5* ptt-35.4* inr(pt)-1.4* 05:18am blood urean-6 creat-0.6 na-139 k-4.1 cl-103 12:17pm blood urean-14 creat-0.7 na-137 k-4.6 cl-109* hco3-23 angap-10 05:24am blood wbc-6.3 rbc-2.65* hgb-7.6* hct-22.7* mcv-86 mch-28.8 mchc-33.7 rdw-14.7 plt ct-497* 05:24am blood pt-24.5* ptt-81.9* inr(pt)-2.3* 05:24am blood glucose-93 urean-8 creat-0.8 na-139 k-4.3 cl-103 hco3-30 angap-10 brief hospital course: ms. was admitted and underwent mechanical aortic valve replacement with a 23-mm st. mechanical valve, model #23agfn with dr. . cross-clamp time: 88 minutes.bypass time:106 minutes. for surgical details, please see operative note. following the operation, she was brought to the cvicu in stable condition. within 24 hours, she awoke neurologically intact and was extubated without incident. she maintained stable hemodynamics and transferred to the sdu on postoperative day one. chest tubes and pacing wires were eventually removed without complication. antibiotics were continued postoperatively until operative culture returned negative and were discontinued per infectious disease recommendations. warfarin was initiated for mechanical aortic valve, and dosed for a goal inr between 2.0 to 3.0. she was supratherapeutic on and received vitamin k. coumadin was resumed the following day. coumadin dosing will be manged by her primary care physician. postoperative anemia, she continued to make clinical improvements. hematocrit dropped as low as 20% on day of discharge her hct had increased to 22.7. her inr was therapeutic and dr. cleared her for discharge to home with vna. all follow up appointments were advised. medications on admission: acyclovir - 400 mg - 1 (s) by mouth tid x 5 days prn clonazepam - 0.5 mg - 1 (s) by mouth twice a day duloxetine - 60 mg capsule, delayed release(e.c.) - 1 capsule(s) by mouth in am and tab in pm lamotrigine - 100 mg - 2 (s) by mouth once a day zolmitriptan - 5 mg - 1 (s) by mouth w/ ha onset, mr in 2 hr prn --max 2 tabs in 24hs--- ferrous gluconate - 324 mg - 1 (s) by mouth once a day lactobacillus rhamnosus gg - 10 billion cells capsule - 2 capsule(s) by mouth twice a day multivitamin - (otc) - capsule - 1 capsule(s) by mouth once discharge medications: 1. clonazepam 0.5 mg sig: one (1) po bid (2 times a day). disp:*60 (s)* refills:*0* 2. lamotrigine 100 mg sig: two (2) po daily (daily). disp:*30 (s)* refills:*2* 3. multivitamin sig: one (1) po daily (daily). disp:*30 (s)* refills:*2* 4. ferrous gluconate 325 mg (37.5 mg iron) sig: one (1) po daily (daily). disp:*30 (s)* refills:*2* 5. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). disp:*30 * refills:*2* 6. ranitidine hcl 150 mg sig: one (1) po bid (2 times a day). disp:*60 (s)* refills:*2* 7. aspirin 81 mg , delayed release (e.c.) sig: one (1) , delayed release (e.c.) po daily (daily). disp:*30 , delayed release (e.c.)(s)* refills:*2* 8. duloxetine 30 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po qam (once a day (in the morning)). disp:*60 capsule, delayed release(e.c.)(s)* refills:*2* 9. warfarin 1 mg sig: md daily (daily) as needed for mechanical valve: inr goal=2.5-3 for mechanical avr. disp:*150 (s)* refills:*0* 10. duloxetine 30 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po hs (at bedtime). disp:*60 capsule, delayed release(e.c.)(s)* refills:*2* 11. hydromorphone 2 mg sig: 1-2 tablets po q3h (every 3 hours) as needed for pain. disp:*50 (s)* refills:*0* 12. ascorbic acid 500 mg sig: one (1) po bid (2 times a day). disp:*60 (s)* refills:*2* 13. potassium chloride 10 meq extended release sig: two (2) extended release po once a day for 10 days. disp:*20 extended release(s)* refills:*0* 14. furosemide 20 mg sig: one (1) po daily (daily) for 10 days. disp:*10 (s)* refills:*0* 15. magnesium oxide 400 mg sig: one (1) po daily (daily). disp:*30 (s)* refills:*2* 16. folic acid 1 mg sig: one (1) po daily (daily). disp:*30 (s)* refills:*2* 17. metoprolol tartrate 25 mg sig: one (1) po tid (3 times a day). disp:*90 (s)* refills:*2* 18. warfarin 2 mg sig: one (1) po once (once) for 1 doses. disp:*1 (s)* refills:*0* discharge disposition: home with service facility: vna carenetwork discharge diagnosis: culture negative aortic valve endocarditis s/p aortic valve replacement h/o embolic stroke anxiety/panic disorder/cyclothymia h/o migraine headaches discharge condition: alert and oriented x3, nonfocal ambulating with steady gait incisional pain managed with oral analgesics incisions: sternal - healing well, no erythema or drainage discharge instructions: 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 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 and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive no lifting more than 10 pounds for 10 weeks please call with any questions or concerns females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge labs: pt/inr for coumadin ?????? indication mechanical avr goal inr 2.0 - 3.0 first inr draw should be within 48 hours of discharge. please monitor inr every monday, wed, friday until inr stablizes. results to dr. phone /fax **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. (on at 1pm cardiologist: dr. on at 10:45 am infectious disease: dr on 2:30pm wound check appointment - cardiac surgery office medical bldg at 1030 () please call to schedule appointments with your primary care: dr. (in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** labs: pt/inr for coumadin ?????? indication mechanical avr goal inr 2.5 - 3.0 first inr draw wednesday please monitor inr every monday and wednesday and friday for two weeks and then decrease per pcp results to dr. phone /fax procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve diagnoses: aortic valve disorders acute and subacute bacterial endocarditis congenital insufficiency of aortic valve 

Answer: The patient is high likely exposed to