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: left mandibular swelling and pain major surgical or invasive procedure: : left jaw incision and drainage history of present illness: mr. is a 59 yo mandarin-speaking only male with a history of atrial fibrillation (on warfarin and carvidelol), hypertension and chronic hepatitis b who presented to on with 2 weeks of worsening pain and swelling of the left maxilla/mandible after a dental appointment for teeth cleaning, found to have large jaw abcess, now s/p i&d by omfs on with 3 drains in place, transferred to for management for atrial fibrillation. following surgery, pt was transfered to the sicu and intubated for airway protection, sucessfully extubated and transferred to the floor for monitoring while drains remained in place. while in the sicu and on the surgery floor, pt has had several episodes of asymptomatic afib with rvr to as high as the 200s, for which his home carvidelol dose was restarted on . he was then switched to metoprolol 25 on when he continued to have afib with rvr. during the most recent episode of afib this am, hr maxed in the 200s and bp dropped to the 80s but responded to a 500 cc bolus, with subsequent decrease in hr to the 80s-100s after 5 mg iv metoprolol this morning. pt was also asymptomatic throughout this episode as well. pt is being transferred to for titration of beta- blocker with consideration of cardioversion. on arrival to the floor, patient's hr is in the 160's, although he denies any shortness of breath, chest pain, lightheadedness or dizziness. he was given 5 mg of iv metoprolol and 25 mg of po metoprolol with a fall in sustained hr from 160 to 110, increase in sbp in the 80's to 90's. past medical history: - atrial fibrillation on warfarin () - hypertension - systolic dysfunction (ef of 30-35% in ) - chronic hepatitis b infection - history of peptic ulcer disease - s/p ? vascular surgery of right thigh in years ago (unable to understand exact nature of surgery) social history: originally from and speaks mandarin. lives with his wife, son and daughter. off-and-on in restaurant work (not regular employment). no tobacco, no alcohol. family history: unknown physical exam: phyiscal exam on transfer: vs: t= 98.3 bp= 90/60 hr = 150 rr= 18 o2 sat= 98% on ra general: nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. swellling of left neck and jaw with three drains in place without any significant drainage neck: supple with jvp of 6 cm. cardiac: pmi located in 5th intercostal space, midclavicular line. tachycardic, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. crackles bilaterally at the bases abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ physical exam on discharge: vs: tmax 99.1 bp 108/83 (100's-110's/70's-80's) p= 63 (70's-90's)rr= 18 o2 sat= 99% on ra general: nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. swellling of left neck and jaw with three drains in place without any significant drainage neck: supple with jvp of 6 cm. cardiac: pmi located in 5th intercostal space, midclavicular line. tachycardic, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. crackles bilaterally at the bases abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ pertinent results: labs on admission: 03:15pm blood wbc-16.3*# rbc-5.17 hgb-15.2 hct-47.3 mcv-92 mch-29.3 mchc-32.1 rdw-13.3 plt ct-202# 03:15pm blood neuts-83.1* lymphs-11.8* monos-4.7 eos-0.2 baso-0.1 05:31pm blood pt-150* ptt-66.3* inr(pt)-15.7* 07:22pm blood pt-150* ptt-78.7* inr(pt)-15.7* 10:31pm blood pt-26.7* ptt-36.9* inr(pt)-2.6* 03:15pm blood glucose-91 urean-19 creat-0.9 na-138 k-4.3 cl-101 hco3-26 angap-15 03:15pm blood ast-27 alkphos-55 totbili-0.4 10:31pm blood calcium-8.6 phos-2.8 mg-1.9 02:18am blood hbsag-positive* hbsab-negative hbcab-positive 03:31pm blood type-art po2-415* pco2-38 ph-7.44 caltco2-27 base xs-2 intubat-intubated vent-controlled 03:25pm blood lactate-1.4 09:31pm blood lactate-2.1* 06:05pm blood lactate-2.6* 02:32am blood glucose-144* lactate-1.5 labs on discharge: 06:05am blood wbc-6.6 rbc-4.25* hgb-12.5* hct-38.1* mcv-90 mch-29.5 mchc-33.0 rdw-13.0 plt ct-142* 06:05am blood pt-32.6* ptt-56.5* inr(pt)-3.2* 06:05am blood glucose-102* urean-14 creat-0.8 na-135 k-4.0 cl-103 hco3-28 angap-8 06:05am blood calcium-8.3* phos-2.5* mg-2.2 imaging: ct sinus/mandible/maxilla : impression: drain fragment lying deep to the inferior aspect of the left angle of the mandible. a neighboring fluid collection surrounding the inferior aspect of the left side of the mandible has enlarged since . active infection in this region cannot be excluded by imaging. comment: the initial findings regarding the retained drain fragment were discussed by dr. with dr. (internal medicine service), via telephone, at the time of interpretation, 7:23 p.m. on . chest pa and lateral : severe cardiomegaly is unchanged. some of the large amount of the cardiac silhouette could be due to pericardial effusion, but there is no indication that this is hemodynamically significant since mediastinal veins are normal caliber. minimal redistribution of pulmonary circulation to the upper lungs is stable, but there is no pulmonary edema or more than minimal right pleural effusion, if any. no pneumothorax. cxr portable : impression: left lower lung and retrocardiac opacity improved over last 24 hours, is likely a combination of atelectasis and small effusion. no new opacities in the lungs. ct neck with contrat : impression: residual prominence of soft tissues involving the left parotid gland, pterygoid and masseter muscles, status post drainage of an abscess. no rim-enhancing collections are seen, but evaluation is suboptimal due to early arterial phase of contrast enhancement ct sinus/mandible : impression: 1. large multiloculated abscess surrounding the ramus of the left mandible. there is no retropharyngeal extension. large left upper 1st molar periapical lucency concerning for infection/osteomyelitis. 2. mild rightward mass effect on the airway, which remains widely patent. 3. no mandible erosion seen. microbiology: hbv viral load (final ): 1,221 iu/ml. gram stain (final ): no polymorphonuclear leukocytes seen. no microorganisms seen. wound culture (final ): this culture contains mixed bacterial types (>=3) so an abbreviated workup is performed. any growth of p.aeruginosa, s.aureus and beta hemolytic streptococci will be reported. if these bacteria are not reported below, they are not present in this culture.. work up per dr. # . viridans streptococci. sparse growth. viridans streptococci. sparse growth. second morphology. streptococcus anginosus (milleri) group. sparse growth. anaerobic culture (final ): no anaerobes isolated. blood cultures x 2 : negative brief hospital course: mr. is a 59 mandarin-speaking only male with a history of atrial fibrillation (on warfarin), hypertension and chronic hepatitis b who presented to on with 2 weeks of worsening pain and swelling of the left maxilla/mandible after a dental appointment for teeth cleaning, found to have large jaw abcess, s/p i&d by omfs on with placement of five drains on transferred to for management for atrial fibrillation, discharged on metoprolol and digoxin for rate control. active issues: # mandibular abscess: given concern that patient would not be able to protect airway, patient was admitted to ticu. on hd 1 he remained on room air and his pain was controlled with iv pain medication. he presented with an inr of 15 he was given ffp prior to being taken to the or for incision and drainage. on hd 2 he underwent: extraoral and intraoral incision and drainage of left masticator, submandibular, lateral pharyngeal, infratemporal, buccal space infections, extraction of teeth #14, 16, 17, 18, 19, 31, & 32. he tolerated the procedure well and was left nasally intubated post op given concern for post op inflammation and airway compromise. id was consulted and recommended treatment with unasyn (as culture grew strep viridans and strep anginosus) as an inpateint with plan to transition to augmentin on discharge. he will complete a three week course of augmentin (last day: ). omfs pulled drains on , although was concern for a retained drain. therefore a ct of the mandible and maxilla was performed that did show a retained drain. omfs removed the last drain on the evening of at bedside. he was scheduled with a f/u with omfs with dr. on . # atrial fibrillation with rvr: during his icu stay patient had intermittent episodes of afib with rvr controlled with iv metoprolol. once advanced to a soft solid diet he was started on his home dose of po, however continued to have intermittent episodes of rvr. on hd 8, pod 6 he became hypotensive to 85/60 with an episode of rvr. this improved with an iv fluid bolus after which the was converted to po lopressor 25 . he was transferred to the medical service for further management of this. on the medical floor his heart rate with initially controlled on po metoprolol (up to 37.5 mg ) with stabalization of sbp's in the 90's-100's without symptoms. however, on the day of discharge he became tachycardic to the 150's-180's with ambulation. given his relative hypotension, he was loaded with digoxin 0.25 mg x 2 days, 0.25 mg daily afterwards for additional rate control. given the addition of digoxin, his metoprolol was decreased to 25 mg xl daily. as far as anticoagulation, pt's inr was 3.2 on discharge. we held his coumadin on the day of discharge with a plan to have his inr rechecked on with results faxed to dr. . we believe that his inr on admission was largely influenced by addition of augmentin. # decreased cardiac output: pt with decreased ef on echo in . pt without chf signs or symptoms at home or in hospital. we started lisinopril 2.5 mg for afterload reduction and to decrease cardiac remodeling. he was also discharged on metoprolol as above. he will have further follow up of his decreased cardiac output as an outpt with dr. . transitional issues: -pt will be discharged with a koh to monitor his hr. he will follow up with dr. for his a fib and for further work-up of his decreased cardiac output -pt will have inr checked on with results faxed to dr. -pt will complete a three week course of augmentin for left jaw abscess and follow up with omfs on . medications on admission: - coumadin 7.5 mg on t,r,sa, 5 mg on w,f, - 3.125 - augmentin 875-125 (scheduled to finish on ) - pain medication (patient does not know name/dose of medication he was taking prior to admission) discharge medications: 1. chlorhexidine gluconate 0.12 % mouthwash sig: five (5) ml mucous membrane (2 times a day) for 2 weeks. disp:*140 ml(s)* refills:*0* 2. augmentin 875-125 mg tablet sig: one (1) tablet po twice a day for 12 days. disp:*24 tablet(s)* refills:*0* 3. warfarin 2.5 mg tablet sig: one (1) tablet po once a day: please start on . disp:*14 tablet(s)* refills:*0* 4. lisinopril 2.5 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 5. outpatient lab work please have inr drawn on and have results faxed to dr. at 6. metoprolol succinate 25 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po once a day. disp:*30 tablet extended release 24 hr(s)* refills:*2* 7. digoxin 250 mcg tablet sig: one (1) tablet po once a day: start taking this medication on friday, . disp:*30 tablet(s)* refills:*2* 8. digoxin 250 mcg tablet sig: one (1) tablet po twice a day for 2 days: take 1 pill twice daily for two days, last dose at night on thursday . disp:*4 tablet(s)* refills:*0* discharge disposition: home with service facility: multicultural home care discharge diagnosis: primary: left mandibular abscess secondary: atrial fibrillation with a rapid ventricular rate discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mr. , it was a pleasure taking care of you during your hospitalization at . you were admitted with an abscess in your left jaw. the oral surgeons drained this infection and you will need to take oral antibiotics for the next two weeks. you also had a fast heart rate related to your atrial fibrillation. we gave you medications called metoprolol and digoxin, which were successful in slowing your heart rate. you will need to follow up with the oral surgeons on -----, as well as your primary care doctor and your cardiologist dr. . please note the following medication changes: started metoprolol succinate 25 mg daily (please take first dose tonight) started digoxin 0.25 mg twice daily today () and tomorrow (), then once daily thereafter started chlorhexadine rinse twice a day for the next 14 days started lisinopril 2.5 mg a day decreased coumadin (warfarin) to 2.5 mg daily; do not take any coumadin today (), and start tomorrow () at this lower dose. please adjust dosing based on your blood test (inr level) and discussions with your primary care doctor followup instructions: 100 east bu dental school at the oral and maxillofacial surgery clinic (dr. on tues at 8:45 a.m. name: , md location: address: , , phone: when: tuesday, :45 am we are working on a follow up appt in the cardiology department with dr. within 2-4 weeks. you will be called at home with the appointment. if you have not heard or have questions, please call . md, procedure: enteral infusion of concentrated nutritional substances other incision with drainage of skin and subcutaneous tissue extraction of other tooth drainage of face and floor of mouth incision and drainage of tonsil and peritonsillar structures diagnoses: other iatrogenic hypotension unspecified essential hypertension atrial fibrillation pulmonary collapse long-term (current) use of anticoagulants other and unspecified coagulation defects chronic viral hepatitis b without mention of hepatic coma without mention of hepatitis delta dental caries, unspecified edema of larynx cellulitis and abscess of other specified sites inflammatory conditions of jaw parapharyngeal abscess alveolitis of jaw 

Answer: The patient is high likely exposed to