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: coronary artery disease major surgical or invasive procedure: coronary artery by pass graft x4 9lima-lad, svg-ramus, svg om1, svg-pda history of present illness: mr. is a 61-year-old gentleman who had a past medical history significant for hypertension, hyperlipidemia and renal failure necessitating renal transplant with a cadaveric kidney in . he has done well with this kidney until . in when he began to develop graft rejection he was also diagnosed with prostatic cancer. on , he presented to an outside hospital complaining of substernal chest pain radiating to his bilateral shoulders and arms. he underwent a cardiac catheterization which revealed severe three-vessel disease. he was subsequently referred for surgical revascularization. past medical history: past medical history: 1. chronic kidney disease in 20s d/t interstitial nephritis versus post-infectious gn -- 1.5 yrs of hd prior to transplantation -- cadaveric transplant -- elevated cr, since ~3.8 due to acute cellular rejection -- hyperparathyroidism with hypercalcemia 2. hypertension 3. stress in nl, ef 65%) 4. gerd with barrets esophagus 5. peripheral vascular disease 6. colonic polyps 7. prostatic adenocarcinoma, dx after found to have psa 6.6 8. s/p appy, hernia repair 9. tobacco use- quit social history: lives in with his wife and two kids. reports that he stopped drinking etoh 2/. he previously consumed drinks of hard alcohol on the weekends. smoked 1ppd x40yrs -quit . denies illicit drug use. family history: cad - mother cabg @ 60, father cabg @ 70 physical exam: vs: 97.6, 71, 144/82, 20. general: well appearing male in nad heent: unremarkable cor: rrr s1, s2 chest: right chest quinton catheter for hemodialysis lungs: cta bilat abd: soft, round, nt, +bs extrem: no le edema. no varicosities. +2 pedal pulses bilat. neuro: intact pertinent results: 07:20am blood wbc-10.2 rbc-2.72* hgb-8.0* hct-24.9* mcv-92 mch-29.4 mchc-32.0 rdw-16.0* plt ct-221 07:20am blood glucose-137* urean-52* creat-5.5* na-138 k-3.7 cl-102 hco3-27 angap-13 07:20am blood calcium-8.9 phos-3.6# mg-2.9* echocardiography report , (complete) done at 2:46:56 pm preliminary referring physician information , r. , division of cardiothorac , status: inpatient dob: age (years): 61 m hgt (in): 65 bp (mm hg): 143/69 wgt (lb): 160 hr (bpm): 60 bsa (m2): 1.80 m2 indication: 61 yr old male w/ htn, hpl, cad, esrd on dialysis for cabg icd-9 codes: 428.0, 402.90, 413.9, 414.8 test information date/time: at 14:46 interpret md: , md test type: tee (complete) 3d imaging. son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2009aw000-0:00 machine: echocardiographic measurements results measurements normal range left ventricle - septal wall thickness: *1.9 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.6 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 3.5 cm <= 5.6 cm left ventricle - systolic dimension: 2.8 cm left ventricle - fractional shortening: *0.20 >= 0.29 left ventricle - stroke volume: 68 ml/beat left ventricle - cardiac output: 4.11 l/min left ventricle - cardiac index: 2.28 >= 2.0 l/min/m2 left ventricle - peak resting lvot gradient: 3 mm hg <= 10 mm hg left ventricle - peak inducible lvot gradient: 1 mm hg aorta - sinus level: 3.6 cm <= 3.6 cm aorta - ascending: 3.0 cm <= 3.4 cm aorta - arch: *3.5 cm <= 3.0 cm aorta - descending thoracic: 2.5 cm <= 2.5 cm aortic valve - lvot vti: 18 aortic valve - lvot diam: 2.2 cm aortic valve - valve area: 3.6 cm2 >= 3.0 cm2 findings multiplanar reconstructions were generated and confirmed on an independent workstation. left atrium: mild la enlargement. no spontaneous echo contrast in the body of the la. right atrium/interatrial septum: normal ra size. a catheter or pacing wire is seen in the ra. a catheter or pacing wire is seen in the ra and extending into the rv. no asd by 2d or color doppler. left ventricle: mild symmetric lvh with normal cavity size. moderate symmetric lvh. moderately depressed lvef. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. aortic valve: mildly thickened aortic valve leaflets (3). no as. no ar. mitral valve: mildly thickened mitral valve leaflets. trivial mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflet. no ps. physiologic pr. pericardium: no pericardial effusion. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was monitored by a nurse throughout the procedure. the patient was under general anesthesia throughout the procedure. the patient received antibiotic prophylaxis. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. no tee related complications. post cpb: patient weaned off cpb on phenylephrine 0.5 mcg/kg/min and epi 0.012 mcg/kg/min. walll motion relatively unchanged from pre-cpb exam and ef similar at 35%. aorta was examined and no evidence of dissection was noted. findings were communicated to surgeon at the time of the exam. regional left ventricular wall motion: n = normal, h = hypokinetic, a = akinetic, d = dyskinetic conclusions the left atrium is mildly dilated. no spontaneous echo contrast is seen in the body of the left atrium. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is moderate symmetric left ventricular hypertrophy. overall left ventricular systolic function is moderately depressed (lvef= 35%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is no pericardial effusion. i certify that i was present for this procedure in compliance with hcfa regulations. interpretation assigned to , md, interpreting physician , r. csurg csru 9:29 am ct head w/o contrast clip # reason: assess for cva medical condition: 61 year old man s/p cabg now pod1 with sz activity.failed renal transplant/hd patient reason for this examination: assess for cva contraindications for iv contrast: esrd/renal transplant provisional findings impression: jkpe tue 11:23 am pfi: no intracranial hemorrhage or large vascular territory infarction. if high clinical suspicion remains, we will obtain dedicated mri when patient is able to tolerate. final report history: postop day #1 status post coronary bypass surgery with seizure activity. evaluate for intracranial pathology. no priors are available. non-contrast head ct there is no evidence of acute intracranial hemorrhage, mass effect, shift of midline structures, hydrocephalus, or acute major vascular territorial infarct. there is a subtle region of decreased attenuation within the periventricular white matter adjacent to the right frontal which is most suggestive of chronic small vessel ischemic changes (although acuity is unclear given lack of any prior exams). a few scattered punctate calcifications are noted within the posterior fossa which may project off the tentorium or relate to prior infection or inflammation. atherosclerotic calcifications are noted within the anterior and posterior circulation. there is pooling of secretions within the nasopharynx consistent with the patient's intubated status. mild mucosal thickening is present within the sphenoid sinuses, ethmoid air cells, and maxillary sinuses. the frontal sinuses remain well aerated. a tube noted in the region of - oropharynx on the lateral scout image ( series 1, im 1) is not well assessed and does not come through the nose/ mouth and likely external. impression: 1.no acute intracranial hemorrhage. please note mri is more sensitive for evaluation of acute ischemia. 2. bent tube in the region of the /oropharynx , likely external- correlate clinically. the study and the report were reviewed by the staff radiologist. brief hospital course: mr was admitted for coronary artery bypass graft. he was taken to the or on for a coronary artery bypass graft x4 (lima-lad; svg to pda;svg to ramus; svg to om). see operative note details. post operatively, mr. was transferred to the cardiac icu intubated, briefly on neo in stable condition. weaned from ventilator and extubated without difficulty. mr. was noted to have rapid eye movement, facial twitching, tongue fasciculations - question of seizure activity. eeg done-no seizure noted. ct scan negative. renal following for ongoing hemodialysis. on pod# 2 mr was transferred from the icu to the stepdown unit. he was started on betablockers and diuresed. temporary pacing wires and chest tubes were removed per protocol. mr. was evaluated by physical therapy and cleared for dischrage to home. he was discahrged to home with vna on pod# 5. medications on admission: lipitor, 80', calcitrol .25', plavix 75', epo, folate 1', imdur 30', lopressor 50", cellcept ", omeprazole 20', prednisone 10/qod, tacrolimus 2", bactreim 400/80', asa 325', mag oxide400", na bicarb 650" discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. tacrolimus 1 mg capsule sig: two (2) capsule po q12h (every 12 hours). 4. cellcept mg capsule sig: one (1) capsule po twice a day. 5. prednisone 10 mg tablet sig: one (1) tablet po every other day (every other day). 6. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 7. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 8. magnesium oxide 400 mg tablet sig: one (1) tablet po bid (2 times a day). 9. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 10. trimethoprim-sulfamethoxazole 80-400 mg tablet sig: one (1) tablet po qtuthsa (tu,th,sa). 11. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). disp:*30 cap(s)* refills:*2* 12. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*60 tablet(s)* refills:*0* 13. carvedilol 6.25 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* discharge disposition: home with service facility: all care vna of greater discharge diagnosis: coronary artery disease s/p coronary artery bypass x4 this admission hyperlipidemia hypertension chronic kidney disease in 20's (secondary to interstitial nephritis vs. post-infectious glomerulonephritis)- on hemodialysis for renal failure cadaver renal transplant with rejection prostate cancer hyperparathyroidism with hypercalcemia gastroesophageal reflux disease barrett's esophagus peripheral vascular disease colon polyps pyelonephritis discharge condition: good discharge instructions: adhere to 2 gm sodium diet no driving for one month no lifting greater than 10 pounds for 10 weeks no lotions, creams or powders on any incision shower daily and pat incisions dry no baths or swimming call for fever greater than 100, redness, drainage, or weight gain of 2 pounds in 2 days or 5 pounds in a week followup instructions: call and schedule the following appointments dr. in 4 weeks dr. in weeks dr in weeks the following appointments have already been scheduled for you: , md phone: date/time: 1:00 provider rad onc,pcc prostate cancer care (sb) phone: date/time: 2:00 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery hemodialysis diagnoses: hyperpotassemia end stage renal disease renal dialysis status coronary atherosclerosis of native coronary artery esophageal reflux long-term (current) use of steroids other convulsions peripheral vascular disease, unspecified personal history of tobacco use depressive disorder, not elsewhere classified occlusion and stenosis of carotid artery without mention of cerebral infarction hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other and unspecified hyperlipidemia malignant neoplasm of prostate other acquired absence of organ family history of ischemic heart disease hyperparathyroidism, unspecified surgical operation with transplant of whole organ causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation complications of transplanted kidney personal history of colonic polyps 

Answer: The patient is high likely exposed to