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 / aspirin / nsaids / erythromycin base / bactrim ds / atenolol / heparin agents / nitroglycerin / iodine containing agents classifier attending: chief complaint: chest pain, shortness of breath major surgical or invasive procedure: open tracheostomy and placement of percutaneous endoscopic gastrostomy tube. redo sternotomy, aortic valve replacement(19mm ce pericardial valve), and single vessel coronary artery bypass grafting(vein graft to left anterior descending). cardiac catheterization history of present illness: mrs. is a 86 year old woman with severe aortic stenosis (valve area 0.6cm, peak gradient 66mmhg) and coronary artery disease s/p cabg and recent des to rca, lcx w/ 80% stenosis-unable to intervene who presented with right-sided chest pressure, which is her typical anginal equivalent. in brief, angina resolved by time she reached ed, but she had ekg with deepening st depressions in lateral leads. cardiac biomarkers were negative. cxr showed pulmonary edema and bilateral effusions. she was admitted for further evaluation and treatment. past medical history: # coronary artery disease s/p 2v cabg (svg to lad, svg to ramus), history of stemi , s/p pci of left main , s/p pci/des to rca and lcx in # aortic stenosis/insufficiency # atrial fibrillation, with history of tachy-brady, s/p ppm placement # hypertension # hypercholesterolemia # mild mitral regurgitation # breast ca s/p bilateral mastectomies approx , and , xrt # rectal cancer s/p lar in # radiation induced l axillary sarcoma, s/p xrt and resection # oa # osteoporosis # history of colon polyps- adenomas, last screened # s/p right thr # s/p spinal fusion # history hit # acute cholecystitis s/p lap chol social history: widowed, lives indepently in . she performs all adls except for grocery shopping, where package lifting requires help. she does not drive. 2 daughters are and live locally. no tobacco, history of alcohol abuse. family history: there is no family history of premature coronary artery disease or sudden death. physical exam: admit exam vs: t 93.7 bp 153/39 hr 61 rr 21 o2 93% 2l gen: elderly woman, grimacing, shallow, labored breathing with mild use of accessory muscles. aaox3. heent: mm slightly dry, jvp elevated to jaw. cv: late peaking harsh systolic murmur @ usb and diastolic murmur. nl s1 and s2. rrr. chest: dullness at bases bilaterally l>r with mild crackles above, occ. inspiratory wheeze. pacer site- dressing c/d/e, no hematoma abd: soft, moderately distended, with reproducible epigastric pain ext: r arm 1+ pitting edema, le with 2+ pitting edema above knees. neuro: cnii-xii intact, moving all 4 ext., with nl. sensation. pertinent results: preop labs: 09:40am blood wbc-6.0 rbc-3.13* hgb-10.6* hct-30.5* mcv-98 mch-33.9* mchc-34.7 rdw-14.2 plt ct-335 09:40am blood pt-11.3 ptt-30.0 inr(pt)-0.9 09:40am blood glucose-92 urean-40* creat-1.5* na-132* k-5.3* cl-98 hco3-26 angap-13 09:40am blood ck(cpk)-31 09:40am blood ctropnt-<0.01 02:10am blood albumin-3.1* calcium-8.2* mg-2.2 02:31pm blood %hba1c-5.5 cardiac cath: 1. limited resting hemodynamics demonstrated an elevated right and left heart filling pressures with an rvedp of 18 mm hg and an lvedp of 34 mm hg. the cardiac index was low at 2.17 l/min/m2 via the fick. 2. hemodynamics demonstrated a mean gradient of 17 mm hg across the aortic valve. the aortic valve area was 0.6 cm2. hemodynamics demonstrated equalization of the left ventricle and femoral diastolic pressures indicating significant aortic regurgitation. a echocardiogram obtained in the cath lab demonstrated moderate - severe (3+) aortic regurgitation. decision made not to perform the aortic vavlvuloplasty. echocardiogram: right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are severely thickened/deformed. significant aortic stenosis is present (not quantified). there is probably moderate to severe (3+) aortic regurgitation is seen (pressure half time 200 ms, holodiastolic flow reversal in the descending aorta). the aortic regurgitation jet is eccentric and difficult ot assess visually. the mitral valve leaflets are mildly thickened. mild to moderate (+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. carotid ultrasound: duplex evaluation was performed of bilateral carotid arteries. there is no significant plaque seen bilaterally. the velocities are 96, 74, and 56 cm/sec in the ica, cca, and eca respectively. this is consistent with no stenosis. intraop tee: pre bypass - the left atrium is dilated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. there is symmetric left ventricular hypertrophy. there is mild to moderate regional left ventricular systolic dysfunction with with focal septal hypokinesis as well as overall global hypokinesis (ef 45%). the right ventricular cavity is mildly dilated with normal free wall contractility. there are complex (>4mm) atheroma in the aortic arch. there is severe aortic valve stenosis (area <0.8cm2). severe (4+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild mitral regurgitation. post bypass - a well-seated bioprosthetic valve is seen in the aortic position with normal leaflet motion and gradients (mean gradient = 5 mmhg, peak 11 mmhg). no aortic regurgitation is seen. there is a mild perivalvular leak in between the right and left coronary cusps. overall left ventricular function is similar. no aortic dissection is seen. all findings discussed with surgeons at the time of the exam. postop labs: brief hospital course: mrs. was admitted under cardiology with congestive heart failure. she ruled out for myocardial infarction. she was noted to have acute renal insufficiency, likely prerenal etiology for which the ace inhibitor was discontinued. ep interrogation of her pacemaker revealed normal function. she continued on amiodarone for atrial fibrillation. she experienced increasing dyspnea and oxygen requirements which prompted transfer to the ccu for initiation of lasix drip and cpap. her oxygenation gradually improved but she remained critical. given that she was a poor surgical candidate, it was decided to attempt aortic valvuloplasty. aortic valvuloplasty was aborted however secondary to hemodynamic and echocardiographic evidence of severe aortic insufficiency. cardiac surgery was therefore consulted for redo aortic valve replacment surgery. after extensive discussion with the patient and her family, it was decided to proceed high risk redo operation. please see result section preoperative workup. of note, preop hit assays were negative for pf4 heparin antibodies. on , dr. performed redo sternotomy, aortic valve replacement and coronary artery bypass grafting surgery. for surgical details, please see seperate dictated operative note. following the operation, she was brought to the cvicu for invasive monitoring. initial postoperative course was complicated by shock and coagulopathy. she required significant pressor support and multiple blood products. she also required re-exploration on postoperative day zero. due to a prolonged critical condition and failure to wean from mechanical ventilation, tube feedings were initiated. she concomitantly became oliguric despite fluid and volume resuscitation. she was unresponsive to natrecor and lasix drip. the renal service was consulted, and cvvh was eventually initiated. due to eventual mechanical problems with cvvh, hemodialysis was temporarily required. over several days, her urine output improved as did volume status. she gradually transitioned back to lasix drip with adequate response, and dialysis was no longer required. from a cardiac standpoint, she maintained stable hemodynamics and eventually weaned from inotropic support. despite some improvement in renal function, she continued to remain ventilator dependent. a right sided chest tube was placed on for worsening right pleural effusion. on , she failed extubation trial. the thoracic service was therefore consulted and performed open tracheostomy and placement of peg tube on without complication. following placement of tracheostomy, she went on to develop worsening lethargy, altered mental status, and a rising bun. stools were concomitantly noted to be guaiac positive. she was transfused with prbcs to maintain hematocrit near 30% and all narcotics were discontinued. rectal tube was placed for persistent dark liquid stools. over several days, her mental status improved. rising bun was attributed to guaiac positive stools. on , she developed an acute abdomen for which she needed intervention by the general surgery team. given her current conditon and her age and fraility the family decided not to proceed with this and after a long discussion with them she was made cmo. a morphine drip was initiated and the ventilator was withdrawn after discussion with dr. . she expired at 12:15 am on with her family at her bedside. medications on admission: furosemide 20 mg po daily aspirin 325 mg po daily lisinopril 5 mg po daily clopidogrel 75 mg po daily vitamin d 400u daily calcium carb 500mg daily lopressor 12.5mg po tid amiodarone 400mg po bid levofloxacin 250mg po daily discharge disposition: extended care facility: - discharge diagnosis: coronary artery disease aortic stenosis/insufficiency s/p redo sternotomy/avr/cabg s/p tracheostomy/peg placement chronic diastolic congestive heart failure acute on chronic renal insufficiency atrial fibrillation postoperative respiratory failure postoperaive bleeding/coagulopathy discharge condition: expired md procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization enteral infusion of concentrated nutritional substances hemodialysis other bronchoscopy percutaneous [endoscopic] gastrostomy [peg] (aorto)coronary bypass of one coronary artery temporary tracheostomy open and other replacement of aortic valve with tissue graft diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia unspecified pleural effusion urinary tract infection, site not specified unspecified essential hypertension acute kidney failure, unspecified unspecified protein-calorie malnutrition hyposmolality and/or hyponatremia aortic valve disorders hemorrhage complicating a procedure other and unspecified angina pectoris primary pulmonary hypertension urinary complications, not elsewhere classified personal history of malignant neoplasm of other gastrointestinal tract personal history of malignant neoplasm of rectum, rectosigmoid junction, and anus 

Answer: The patient is high likely exposed to