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: past medical history: 1. multiple history of falls felt to be multifactorial. 2. hypertension. 3. cva in and small cva or tia in . 4. left hemianopsia. 5. cabg with porcine aortic valve replacement in , on coumadin. 6. degenerative joint disease. 7. right total hip replacement in . 8. cataract surgery. 9. chf, questionable diastolic heart failure. echocardiogram in showed an ejection fraction greater than 65% and atrial myxoma 2 cm, symmetric lvh, mild dilation of the left atrium, 1+ aortic regurgitation. 10. history of paroxysmal atrial fibrillation. 11. mrsa uti in . 12. questionable aspiration pneumonia in the past. past surgical history: 1. total abdominal hysterectomy. 2. appendectomy. 3. hemorrhoidectomy. 4. colonic polypectomy. allergies: sulfa. social history: she is a resident at the home. she is a dnr/dni. physical examination on admission: vital signs: temperature 97.1, pulse 107, blood pressure 113/45 on levophed, respirations 22, saturations 100% on 4 liters nasal cannula. the patient was in no acute distress. lungs: bilaterally clear to auscultation. heart: irregularly/irregular. extremities: the lower extremities were with edema. abdomen: the belly was soft, nontender. sensation was intact. neurologic: the patient was alert and oriented times three. rectal: guaiac negative. laboratory/radiologic data: white blood cells 17.7, hematocrit 34.2, platelets 207,000. the laboratories were significant for a creatinine of 1.4, lactate 4.0. the urinalysis showed small leukocyte esterase, large blood, trace protein, a few bacteria. there were 2 epithelials. the lfts were within normal limits. head ct was negative for hemorrhage, showed no acute changes. a ct of the c-spine showed degenerative changes but no evidence of fracture. a chest x-ray showed a right ij line tip in the right atrium and diffuse bilateral interstitial opacities consistent with chf. ekg showed atrial fibrillation, rate 150s, t wave inversions in v4 through v6, lead ii and avf, new versus . admission medications: 1. artificial tears. 2. promod with fiber and juice. 3. detrol 1 mg b.i.d. 4. coumadin 3.5 mg q.h.s. 5. apap 650 mg p.r.n. 6. protonix 40 mg p.o. q.d. 7. zoloft 75 mg p.o. q.d. 8. aspirin 81 mg p.o. q.d. 9. multivitamin. 10. lopressor 12.5 mg p.o. b.i.d. 11. macrobid 100 mg p.o. b.i.d. since . 12. colace 100 mg q.d. 13. fosamax 10 mg q.d. 14. miacalcin. 15. lipitor 10 mg q.d. 16. calcium 500 b.i.d. 17. senna b.i.d. social history: former three pack per day smoker, stopped 20 years ago but smoked for 40 years. former heavy alcohol use, currently none. hospital course: 1. sepsis: it was thought that the patient had urosepsis due to her recent positive culture with mrsa in her urine. the patient was pan cultured upon admission; however, there is no growth to date of this dictation. the patient had an elevated white blood cell count with a left shift; however, remained afebrile. she was treated empirically with vancomycin and levaquin upon admission to the sicu; however, levaquin was discontinued within 24 hours and the patient was simply treated with vancomycin. the patient was fluid resuscitated, received 1 unit of packed red blood cells. levophed was weaned within the initial 24 hours. the patient's lactate trended downwards. the patient's cortisol was 36. she was not given steroids. the patient's blood pressure returned to her normal baseline of systolic 130s/diastolic 70s. her lopressor was held during her sicu course and should be restarted upon normalization of her blood pressures. the patient will likely receive a seven to ten day course of iv vancomycin for her mrsa urosepsis. 2. atrial fibrillation: upon admission, the patient received 2 units of ffp for an elevated inr of 6.6 upon admission. her coumadin was held until her inr reached 2.2. she was restarted on her coumadin at a lower dose than prior to admission since the patient is being treated with antibiotics. at the time of this dictation, the patient is currently on 1 mg p.o. q.h.s. but this should be adjusted as needed to keep her levels 2.5 to 3.5 as indicated for her aortic valve replacement. the patient's rate was better controlled during her course in the sicu. the patient was slightly tachycardiac to the 100 teens. however, she was not given nodal blockers due to her borderline hypotension. the patient was asymptomatic of her rapid rate and will likely be started on her lopressor in the next 24 hours once her blood pressures are stable. 3. congestive heart failure: an echocardiogram in shows likely diastolic dysfunction with an ejection fraction of greater than 65% and symmetric left ventricular hypertrophy. the patient will start on her beta blocker once blood pressure has normalized and has started lasix diuresis in the sicu prior to transfer to the floor. she had crackles on examination likely due to her aggressive fluid resuscitation upon admission as well as pitting edema in her lower extremities. the patient will benefit from gentle diuresis as her blood pressure allows. 4. coronary artery disease: the patient has a history of cabg. she was continued on her statin and aspirin therapy. her beta blocker was held for her urosepsis. 5. anemia: the patient's anemia was new during this hospitalization. trended hematocrits were within normal range prior to this hospitalization. the patient has no history of anemia. her stools were guaiaced and initially negative. iron studies, b12 and folate were sent and are pending at the time of this dictation. there is no record of a colonoscopy in the medical record; however, it is noted that she had a polypectomy in her surgical history. this should be followed as an outpatient. with the exception of a blood transfusion upon admission, the patient did not require any further packed red blood cells. her hematocrit remained stable in the low 30s. 6. hypertension: the patient's lopressor was held because of borderline hypotension. this will be restarted once the patient is stabilized. 7. aortic valve replacement: the patient was on long-term coumadin which was restarted prior to transfer to the floor at low dose. 8. fluids, electrolytes, and nutrition: the patient has questionable safety to swallow. she was seen by speech and swallow during her admission and was approved for thickened fluids and soft solids. she was continued on this diet during her admission. 9. renal failure: the patient had mild acute renal failure upon admission likely due to a prerenal state and sepsis. following aggressive iv fluid hydration, the patient's creatinine decreased to 0.7. 10. status post fall: the patient's fall is presumably due to hypotension and tachycardia as well as sepsis. the patient was ruled out for a myocardial infarction and was observed on telemetry. she ruled out by enzymes. she had a cat scan of her spinal column as well as head which were negative for fracture or bleed. 11. code status: the patient is a dnr/dni. she has forms that accompanied her from the nursing home indicating these wishes. communication is with her daughter; work: ; home: . for further details of the patient's admission and discharge planning, please see addendum to this discharge summary for the remainder of her hospital course. dr., 11-599 dictated by: medquist36 procedure: transfusion of packed cells diagnoses: urinary tract infection, site not specified congestive heart failure, unspecified acute kidney failure, unspecified unspecified septicemia severe sepsis atrial fibrillation septic shock heart valve replaced by transplant chronic diastolic heart failure 

Answer: The patient is high likely exposed to