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: drainage from sternotomy major surgical or invasive procedure: sternal debridement cardioversion sternal plating bronchoscopy insertion of chest tube history of present illness: 76 year old male s/p aortic valve replacement/three vesel coronary artery bypass grafting, readmitted for 3 day history of bloody nonpurulent drainage in setting of supratherapeutic inr greater then 8 on newly initiated coumadin therapy. admitting workup significant for the ct scan of the chest showing anterior mediastinal small fluid collection and displacement of sternal wires, as well as elevated wbc to 19 without fevers. he was discharged on keflex and is now on levofloxacin. past medical history: hypertension peptic ulcer disease - history of upper gi bleed chronic obstructive pulmonary disease spinal stenosis s/p laminectomy s/p appendectomy status post three vessel coronary artery bypass grafting and aortic valve replacement atrial fibrillation new sternal wound drainage/infection social history: over 50 pack year history of tobacco, quit . admits to 1-3 beers per day. denies history of etoh abuse. retired, lives with his wife. family history: no premature coronary artery disease. physical exam: general no acute distress neuro alert and oriented x3 non focal gait unsteady cardiac irregular no murmur/rub/gallop respiratory cta bilaterally except no airation left base abdomen soft, nontender, nondistended, +bs extremities cool pulses palpable cr > 5 sec skin left leg evh healing no erythema chest skin closure intact except for tiny area draining old blood. no clear surrounding cellulitis, healthy presternal skin unatable sternum discharge - changes sternal incision no drainage mild erythema at distal end, 1 jp to bulb suction lungs cta bilaterally pertinent results: 01:10pm pt-67.7* ptt-48.7* inr(pt)-8.3* 01:10pm plt count-658*# 01:10pm wbc-19.1*# rbc-4.01*# hgb-12.2* hct-37.4*# mcv-93 mch-30.4 mchc-32.7 rdw-14.7 01:10pm albumin-3.8 calcium-8.9 phosphate-2.6*# magnesium-2.4 01:10pm alt(sgpt)-49* ast(sgot)-31 ld(ldh)-329* alk phos-141* amylase-98 tot bili-0.5 01:10pm glucose-143* urea n-24* creat-1.0 sodium-144 potassium-3.8 chloride-108 total co2-28 anion gap-12 06:13pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 06:13pm urine color-yellow appear-clear sp -1.012 echo due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. a bioprosthetic aortic valve prosthesis is present. the aortic valve prosthesis appears well seated, with normal leaflet/disc motion and transvalvular gradients. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. there is an anterior space which most likely represents a fat pad. impression: poor technical quality due to patient's body habitus. no pericardial effusion. left ventricular function is probably normal, a focal wall motion abnormality cannot be fully excluded (the basal and mid inferior and inferolateral segments may be mildly hypokinetic). the right ventricle is not well seen but is probably normal. normally functioning aortic bioprosthesis. pulmonary artery systolic pressure could not be determined. ct chest 1. dehiscence and fragmentation of the sternum up to 18 mm at the level of the manubrium and 23 mm in the body of the sternum. heterogeneous collection with foci of air, which could be a hematoma or developing abscess, should be closely followed. 2. minimally improved multifocal peribronchial and peripheral ground-glass opacity, likely due to residual bronchiolitis, could be inflammatory or infectious. 3. tracheal and bilateral main stem bronchi secretions. emphysema and signs of small airway disease. 4. small pericardial and left pleural effusion with dependent atelectasis. 5. moderate aortic calcifications. dense coronary artery calcifications. 6. wedge compression fracture of l1, l2 and l4 of indeterminate chronicity. 4/9/090 echo the left atrium is mildly dilated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. the left atrial appendage emptying velocity is depressed (<0.2m/s). no atrial septal defect is seen by 2d or color doppler. right ventricular chamber size and free wall motion are normal. there are complex (>4mm) atheroma in the descending thoracic aorta. a bioprosthetic aortic valve prosthesis is present. the prosthetic aortic valve leaflets appear normal. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. there is no pericardial effusion. impression: no left atrial/left atrial appendage thrombus identified. well-seated prosthetic aortic valve without regurgitation. mild mitral regurgitation. chest x-ray small left pleural effusion, no other changes. brief hospital course: admitted evaluation of sternal drainage. coumadin for his atrial fibrillation was held due to his elevated inr. a ct scan was obtained which revealed an anterior mediastinal small fluid collection with displacement of his sternal wires. he was cultured and vancomycin and zosyn were started. the plastic surgery service was consulted for assistance who felt he would be a good candidate for sternal plating. vitamin k and fresh frozen plasma were given to reverse his inr. on , he was taken to the operating room where he underwent a sternal debridement with placement of a vac dressing. he remained intubated and sedated on paralytics, transfer to the intensive care unit for monitoring. given his persistent atrial fibrillation, a transesophageal echocardiogram was performed which confirmed no left atrial thrombus. he was then successfully cardioverted to normal sinus rhythm. he remained in normal sinus rhythm throughout the remainder of his hospital stay thus coumadin was not resumed. he remained sedated as he had an open chest to a vac dressing. he was transfused with packed red blood cells for anemia. on , the plastic surgery service took him to the operating room where he underwent sternal debridement, followed by sternal plating with four synthes plates and bilateral pectoralis musculocutaneous flap. intraoperatively he was noted to have complete collapse of the left lung. chest tube was placed and then thoracic surgery service performed a bronchoscopy for left upper lobe collapse. please see operative note for details. he remained intubated, paralytics stopped and then sedation weaned. he awoke neurologically intact and was extubated. on he was transferred to the step down unit for further recovery. beta blockade was advanced as tolerated. he remained in normal sinus rhythm and it was decided to not resume coumadin. as all cultures remained negative, his antibiotics were discontinued. his drains were managed closely by the plastic surgery service. he continued to make steady progres and was discharged to rehabilitation on . he will follow-up with dr. , his cardiologist, dr. of the plastic surgery service and his primary care provider as an outpatient. one jp drain to bulb suction to be evaluated on follow up visit with dr . medications on admission: colace 100", coumadin for post op afib, asa 81', atorvastatin 20', duonebs"", pantoprazole 40', percocet prn, lisinopril 5', amiodarone 200", lopressor 75"', kcl 20" , levaquin 500', lasix 80' discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 3. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 4. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 5. atorvastatin 20 mg tablet sig: one (1) tablet po at bedtime. 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 7. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q6h (every 6 hours). 8. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 9. sodium chloride 0.9% flush 10 ml iv prn line flush picc, non-heparin dependent: flush with 10 ml normal saline daily and prn per lumen. 10. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed. 11. lisinopril 5 mg tablet sig: one (1) tablet po once a day. 12. lopressor 100 mg tablet sig: one (1) tablet po twice a day. 13. picc per protocol non heparin picc line 14. furosemide 10 mg/ml solution sig: twenty (20) mg injection once a day: daily weights to evaluate . 15. potassium chloride 10 meq tablet sustained release sig: one (1) tablet sustained release po once a day: while on lasix . 16. outpatient lab work please check biweekly potassium, magnesium and cr while on iv lasix 17. heparin (porcine) 5,000 unit/ml solution sig: one (1) ml injection three times a day: dvt prophalaxis . 18. medication instructions no anticoagulation with coumadin, lovenox, or iv heparin unless discussed with dr and dr steroids except inhaled flovent unless discussed with dr and dr discharge disposition: extended care facility: - discharge diagnosis: sternal wound dehiscence supertherapeutic inr chronic obstructive pulmonary disease atrial fibrillation hypertension hyperlipidemia discharge condition: good discharge instructions: 1) please bath daily including washing incisions, no baths or swimming until jp out, then may shower daily 2) monitor wounds for infection - redness, drainage, or increased pain 3) report any fever greater than 101 4) report any weight gain of greater than 2 pounds in 24 hours or 5 pounds in a week 5) no creams, lotions, powders, or ointments to incisions 6) no driving for approximately one month 7) no lifting more than 10 pounds 8) please call with any questions or concerns followup instructions: dr date/time: 2:15 () dr thrusday at 1:45pm please call to schedule appointment: dr () pcp please call for appointment procedure: insertion of intercostal catheter for drainage continuous invasive mechanical ventilation for 96 consecutive hours or more diagnostic ultrasound of heart enteral infusion of concentrated nutritional substances other intubation of respiratory tract atrial cardioversion local excision of lesion or tissue of bone, scapula, clavicle, and thorax [ribs and sternum] graft of muscle or fascia other repair or plastic operations on bone, scapula, clavicle, and thorax [ribs and sternum] excisional debridement of wound, infection, or burn diagnoses: unspecified essential hypertension acute posthemorrhagic anemia chronic airway obstruction, not elsewhere classified atrial fibrillation disruption of internal operation (surgical) wound hematoma complicating a procedure atrial flutter pulmonary collapse surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation other respiratory complications anticoagulants causing adverse effects in therapeutic use heart valve replaced by transplant peptic ulcer of unspecified site, unspecified as acute or chronic, without mention of hemorrhage or perforation, without mention of obstruction 

Answer: The patient is high likely exposed to