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: patient recorded as having no known allergies to drugs attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: egd tee cardioversion aortic valvuloplasy coronary ptca with bms x2 to rca history of present illness: 79m w/ hx of critical as (valve area 0.5cm2), schf, alcoholic cirrhosis, dm, recently admitted w/ schf exacerbation and worsening of as, who no p/w persistent severe doe. (please see prior discharge summary for full details). during his last admission he received a thoracentesis. upon discharge plan was for cardiac catheterization and evaluation for aortic valve replacement if his symptoms did not improve. at discharge he did feel significantly better from when he came in, especially from the thoracentesis. that evening, he had significant difficulty even going up a couple steps. the next day he got up but went straight back to bed, because of severe fatigue. he was bedbound all of sat and sunday, and sun night had some chest tightness too while in bed. this morning he called his pcp saying think i should have gone to rehab, and his doctor told him to come in. he was admitted for evaluation of aortic valve replacement. currently he denies any sob, dyspnea, or cp. . in the ed, initial vitals were 98.1, 106/57, 83, 18, 99%ra . ros: denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. she denies recent fevers, chills or rigors. she denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. past medical history: # history of rheumatic heart disease # aortic stenosis echo - moderate-severe as (area 0.8-1.0cm2). # chf, systolic - lvef= 45 % # psoriasis # esophageal stricture # former smoking # cholecystectomy in the summer of . # hypertension # osteoporosis # diabetes mellitus, type ii, hba1c 7.2 # h/o cirrohsis - pt says it was noted during his ccy. likely etoh use. pt reports that he stopped drinking approx 1 year ago. social history: the patient has always been single. he is a pastoral associate, which he has been doing since . he does not smoke, quit in . he has 60+ py. he has not used illicit drugs. he reports heavy etoh use in the past but quit 1 year ago. family history: his mother died in her sleep at 91. his father died at 73 describing an attack. brother in good health. physical exam: on admission - vs: 98.1, 105/55, 87, 16, 96%ra, bs 118 general: nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with flat jvp cardiac: rr, normal s1, s2. 3/6 sem at rusb with radiation to carotids lungs: ctab, no rales or rhonchi 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. pertinent results: ========= labs ========= trop-t: 0.07 ck: 57 mb: notdone . 126 94 11 ---------------< 146 3.7 24 0.7 . alt: 22 ap: 67 tbili: 1.0 alb: 3.4 ast: 53 ldh: 241 dbili: tprot: . probnp: 3171 . mcv: 101 14.9 6.0 >-------< 110 43.6 . n:64.4 l:24.4 m:5.4 e:5.0 bas:0.8 . day of discharge 135 107 54 ---------------< 57 4.5 11 3 . 13.2 10 >-------< 89 37.9 . ============ microbiology ============ urine culture 5:15 pm urine source: cvs. previously reported as staphylococcus, coagulase negative . _________________________________________________________ staph aureus coag + | gentamicin------------ <=0.5 s levofloxacin----------<=0.12 s nitrofurantoin-------- <=16 s oxacillin------------- 0.5 s trimethoprim/sulfa---- <=0.5 s . blood culture 5/11x2 and 5/12x1 staph aureus coag +. final sensitivities. staphylococcus species may develop resistance during prolonged therapy with quinolones. therefore, isolates that are initially susceptible may become resistant within three to four days after initiation of therapy. testing of repeat isolates may be warranted. sensitivities: mic expressed in mcg/ml _________________________________________________________ staph aureus coag + | clindamycin-----------<=0.25 s erythromycin----------<=0.25 s gentamicin------------ <=0.5 s levofloxacin----------<=0.12 s oxacillin------------- 0.5 s trimethoprim/sulfa---- <=0.5 s . ========== cardiology ========== 2d-echocardiogram: the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size. regional left ventricular wall motion is normal. there is mild global left ventricular hypokinesis (lvef = 40-45 %). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area 0.5cm2). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild to moderate (+) mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. . /echo: there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. no masses or thrombi are seen in the left ventricle. left ventricular systolic function is severely depressed with anterior and anteroseptal akinesis with hypokinesis elsewhere. the right ventricular cavity is moderately dilated with depressed free wall contractility. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is severe mitral annular calcification. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is moderate pulmonary artery systolic hypertension. significant pulmonic regurgitation is seen. there is a trivial/physiologic pericardial effusion. compared with the prior study (images reviewed) of , left and right ventricular function have now significantly deteriorated. . c. cath final diagnosis: 1. three vessel coronary artery disease with critical lesion in rca 2. critical aortic stenosis. 3. moderate elevation of left and right sided filling pressures with pulmonary hypertension. 4. aortic valvuloplasty with 20 and 23mm balloons. 5. stenting of rca with 2 bare metal stents. ============ radiology ============ . cta : impression: 1. negative examination for pulmonary embolism. 2. bilateral moderate-to-large simple pleural effusion, right more than left. 3. adjacent compressive atelectasis involving the lower lobes. 4. moderate paraseptal emphysema. 5. interval increase in size of the right hilar lymph node could be reactive to the lung process. 6. minimal pulmonary edema. 7. 9mm calcified or metallic right pleural foreign body, present since . . . carotid us: impression: mild calcified plaque in the internal carotid and common carotid arteries bilaterally with less than 40% stenosis of the internal carotid arteries on both sides. . egd: normal, no varices . cxr mild pulmonary edema is new, left lower lobe atelectasis and small to moderate bilateral pleural effusions unchanged. heart size top normal, stable. no pneumothorax. brief hospital course: assessment and plan: 79m w/ hx of critical as (valve area 0.5cm2), schf, alcoholic cirrhosis, dm, recently admitted w/ schf exacerbation and worsening of as, who p/w persistent, severe doe and was additionally found to be bacteremic. he required icu-level care and pressors before he expired on . . hospital course by problems: # critical pt's recent echo showed valve area 0.5mm2. pt was diuresed well on last admission along with a thoracentesis, and schf was not contributing. pt did have new afib on this admission which could have been contributing to sob and pt was cardioverted (see below). pt's doe was most likely due to as, and was evaluated for surgery as inpatient since pt was not able to tolerate outpatient appointments. liver was consulted and thought pt's etoh cirhhosis was not severe was found to be child's a, and would be able to go through surgery. pulmonary similarly thought the patient was high operative risk and would likely have prolonged time on ventillator, but agreeble to surgery - and would recommend bilateral thoracentesis prior to surgery or pigtail after surgery due to pt's signficant pleural efffusions. pt had an extensive pre-op assesement, but in the end ct did not believe pt was a surgical candiate. pt was then assessed for valvuloplasty and he underwent successful aortic baloon valvuloplasty . at the same time, two bare metal stents were placed in the rca. # sepsis/hypotension - patient was transferred to the ccu for hypotension on . patient was bolused with ivf and culture data revealed mssa bacteremia and uti. patient was initially managed on vancomycin and zosyn which was narrowed to nafcillin when culture data finalized. patient was initially managed with levophed. he did not tolerate dopamine due to tachycardia. he remained on levophed but became progressively less responsive to pressors. on a trial of dobutamine was unsuccessful and not tolerated due to worsenng hypotension. abg revealed worsening acidosis likely responsible for lack of efficacy to pressors. patient demonstrated a mixed anion gap and non anion gap acidosis likely due to lactic acidemia and renal failure respectively. antibiotic coverage was broadened again to include vancomycin and zosyn. vasoprossin was added but maps did not improve above 50. a family meeting was held on and the decision was made to not escalate care, including use of more pressors, central venous lines, arterial lines and more ivfs. patient was pronounced dead on at 0416. # renal failure - patient initially developed renal failure in the setting of sepsis but cr corrected to 1.0 prior to cardiac cath as hemodynamics improved. after cardiac cath cr elevated to 3.0. urine sediment showed white cells which may have been due to infection or ain. contrast nephropathy was a presumed contributor as well. a renal consult was requested, but dialysis/cvvh were not possible because patient continue to be hypotensive at this time. # atrial fibrillation- new this admission. pt was in sinus rhythm on all prior ekgs. it was thought that pt may have become dyspneic at home due to new onset of afib, so pt was to be cardioverted. the egd was negative for varices, and so cardiology proceeded with a tee to look for a mural thombus which was negative. cards proceeded with cardioversion which was successful. pt was kept on heparin gtt, and started on dofetilide 250 mcg po q12h. pt's qtc remained stable. patient was managed on a heparin gtt while in house. he had a brief episode of afib again after cardiac cath but this self terminated. # schf, chronic- ef 40%, goal was to maintain even i/o goals. pt was continued on lasix 20mg daily. repeat echo in setting of r/o infectious endocarditis revealed ef now = 20%. # cirrhosis- first noted during ccy, likely etoh use. pt hepatitis panel negative for hep a,b,c. pt is currently at childs class a. pt reports that he stopped drinking approx 1 year ago. documented on mrcp as well as ct abdomen. pt was continued on vitamin k 5mg until pt needed to be on anticoagulation for recent cardioversion. # pt had loose stool on , and a fever 101.2. pt as c.diff negative x3 last admission, started on lomotil aferwards. this admission we checked c.diff again which was negative. # history of htn - not on any hypertensives, low-dose acei and spironolactone d/c on last admission, likely due to cirhhosis. pt also had hypotension last admission pt underwent cta which was negative for pe. pt initially remained stable w/ baseine systolic in 100s, but fell to sbp 70's on the day of transfer to the icu. he mentated well but had low urine output at this time. he was started on dobutamine drip but became tachychardic to 150's, tachypnic to 40's, and hypotensive to 60's, within one hour of administration. he was therefore switched to phenylephrine, and he returned to his bl vs with appropriate urine output. . # code - dnr/dni (briefly reversed for valvuloplasy and then re-initiated dnr/i) medications on admission: - vitamin k 5mg daily - mvi - glipizide 5mg - lasix 20mg daily - fluticasone 50mcg - lomotil 1 tab q6h prn discharge medications: none discharge disposition: expired discharge diagnosis: primary diagnosis: - critical aortic stenosis - atrial fibrillation - bacteremia secondary diagnosis: - cirrhosis - diabetes - systolic heart failure discharge condition: expired discharge instructions: none followup instructions: none. procedure: venous catheterization, not elsewhere classified insertion of non-drug-eluting coronary artery stent(s) combined right and left heart cardiac catheterization coronary arteriography using two catheters other endoscopy of small intestine diagnostic ultrasound of heart other electric countershock of heart percutaneous balloon valvuloplasty transposition of cranial and peripheral nerves insertion of two vascular stents excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: acidosis coronary atherosclerosis of native coronary artery acute kidney failure with lesion of tubular necrosis unspecified pleural effusion urinary tract infection, site not specified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled alcoholic cirrhosis of liver hyposmolality and/or hyponatremia severe sepsis other and unspecified alcohol dependence, in remission atrial fibrillation other chronic pulmonary heart diseases personal history of tobacco use methicillin susceptible staphylococcus aureus septicemia rheumatic heart failure (congestive) long-term (current) use of insulin osteoporosis, unspecified other emphysema encounter for palliative care duodenitis, without mention of hemorrhage tachycardia, unspecified other psoriasis stricture and stenosis of esophagus rheumatic aortic stenosis sympathomimetics [adrenergics] causing adverse effects in therapeutic use benign neoplasm of duodenum, jejunum, and ileum 

Answer: The patient is high likely exposed to