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: penicillins attending: chief complaint: shortness of breath major surgical or invasive procedure: aortic valve replacement(21mm pericardial) and two vessel coronary artery bypass grafting(saphenous vein grafts to diagonal and obtuse marginal arteries) history of present illness: this 70 year old male with 3 weeks of progressive shortness of breath and productive cough. presented to osh in heart failure, treated with lasix, nebulizers and prednisone with improvement. with further workup, echocardiogram showed severe aortic stenosis and cardiac catheterization revealed coronary artery disease, additionally he had nonsustained ventricular tachycardia. he was transferred for surgical evaluation. past medical history: insulin dependent diabetes mellitus hypertension chronic obstructive pulmonary disease acute systolic and diastolic heart failure anxiety aortic stenosis s/p appendectomy s/p tonsillectomy s/p left wrist plating social history: lives with:significant other :3ppdxmany years etoh:none in 8 months-recovering family history: non contributory physical exam: admission: pulse:87 resp:20 o2 sat: 97% on 3l nc b/p right:122/47 general: skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs rhonchi and expiratory wheezes bilat r>l heart: rrr distant heart sounds semurmur abdomen: soft obese, non-distended non-tender bowel sounds + extremities: warm , well-perfused edema1+ varicosities: none neuro: grossly intact pulses: femoral right:+ecchymosis, no hematoma 2+ left:2+ dp right: 2+ left:2+ pt : 1+ left:1+ radial right:2+ left:2+ carotid bruit right: none left:none pertinent results: 04:50am blood wbc-11.8* rbc-2.69* hgb-8.5* hct-25.2* mcv-94 mch-31.7 mchc-33.8 rdw-14.9 plt ct-207 08:50pm blood wbc-10.2 rbc-3.78* hgb-11.8* hct-35.8* mcv-95 mch-31.2 mchc-32.9 rdw-14.0 plt ct-264 04:50am blood glucose-114* urean-30* creat-1.1 na-138 k-3.7 cl-102 hco3-32 angap-8 04:50am blood glucose-65* urean-38* creat-1.3* na-140 k-3.6 cl-104 hco3-28 angap-12 08:50pm blood glucose-289* urean-31* creat-0.9 na-136 k-4.2 cl-99 hco3-28 angap-13 08:50pm blood alt-35 ast-20 ld(ldh)-197 ck(cpk)-42* alkphos-80 amylase-29 totbili-0.6 11:15am blood %hba1c-8.0* eag-183* 04:08pm blood type-art temp-37.2 po2-85 pco2-44 ph-7.44 caltco2-31* base xs-4 intubat-not intuba brief hospital course: following transferred from the outside hospital for surgical evaluation he underwent preoperative workup, including a pulmonary consult due to his tobacco history. his steroids started at the outside hospital were stopped and he was started on lasix for diuresis. on he was taken to the operating room and underwent aortic valve replacement and coronary artery bypass graft surgery. please see operative report for details, in summary he had aortic valve replacement with a 21-mm magna ease pericardial tissue valve, coronary artery bypass grafting x2, with reverse saphenous vein graft to the second diagonal artery and the obtuse marginal artery. his bypass time was 118 minutes with a crossclamp of 97 minutes. he tolerated the opration and was transferred to the cardiac surgery icu. he received vancomycin for perioperative antibiotics. he remained stable in the immediate post-op period, awoke neurologically intact and was extubated. he remained in the cardiac surgery icu for several days post-operatively because there were no beds available on the stepdown floor. all tubes, lines, and drains were removed per cardiac surgery protocol. once on the stepdown floor he worked with physical therapy to improve his strength and endurance. the remainder of his hospital course was uneventful. his progress was somewhat slow and it was felt he would benefit from a short rehabilitation stay. on he was cleared to be transferred to health care center for rehab. lasix was continued at discharge and can be discontinued when edema clears. medications on admission: medications at home: temazepam 30 mg at bedtime lisinopril 40 mg daily symbicort 160 2 puffs spiriva inh 1 cap daily procardia 90 mg daily buspar 10 mg 4x day paxil 40 mg daily metformin 500 mg actos 40 mg daily ativan 0.5mg prn outside hospital prednisone 60 mg daily metoprolol 12.5 mg tid asa 162 mg daily insulin nph 12 units , regular 5 units with each meal doxycycline 100 mg buspar 10 mg daily albuterol nebs atrovent nebs lisinopril 40 mg daily paxil 40 mg daily metformin 500 mg nicotine patch 21 mg daily procardia 90 mg daily discharge medications: 1. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 4. paroxetine hcl 40 mg tablet sig: one (1) tablet po once a day. 5. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). 6. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day) for 10 days. 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 8. potassium chloride 20 meq tab sust.rel. particle/crystal sig: two (2) tab sust.rel. particle/crystal po twice a day for 10 days. 9. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain for 4 weeks. 10. buspirone 10 mg tablet sig: one (1) tablet po four times a day. 11. pioglitazone 45 mg tablet sig: one (1) tablet po daily (daily). 12. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 13. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain/fever. 14. amiodarone 200 mg tablet sig: as directed tablet po bid (2 times a day): two tablets (400mg) twice daily for two weeks, then one tablet (200mg) twice daily for two weeks, then one tablets (200mg) daily until discontinued by physician. 15. nph insulin human recomb 100 unit/ml cartridge sig: 12 units subcutaneous breakfast and dinner. 16. humalog kwikpen 100 unit/ml insulin pen sig: five (5) units subcutaneous breakfast, lunch, dinner. 17. humalog kwikpen 100 unit/ml insulin pen sig: as directed subcutaneous ac & hs: 120-160-2 units ac, none hs;161-200-4 units ac,2units hs;201-240-6units ac,4unitshs,241-280 ac,4units hs. discharge disposition: extended care facility: long term care - discharge diagnosis: aortic stenosis coronary artery disease s/p aortic valve replacement/coronary artery bypass grafts acute systolic and diasystolic heart failure insulin dependent diabetes mellitus hypertension chronic obstructive pulmonary disease anxiety discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with ultram incisions: sternal - healing well, no erythema or drainage leg left - healing well, no erythema or drainage. edema 2+ legs discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage please no lotions, cream, powder, or ointments to incisions each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart no driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive no lifting more than 10 pounds for 10 weeks please call with any questions or concerns **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: you are scheduled for the following appointments surgeon: dr (for dr at heart center () on thursday, at 9:15am cardiologist: dr at heart center () on at 10am please call to schedule appointments with your primary care dr. in weeks () **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** procedure: extracorporeal circulation auxiliary to open heart surgery extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of two coronary arteries open and other replacement of aortic valve with tissue graft diagnoses: coronary atherosclerosis of native coronary artery tobacco use disorder congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled chronic airway obstruction, not elsewhere classified aortic valve disorders acute combined systolic and diastolic heart failure panic disorder without agoraphobia 

Answer: The patient is high likely exposed to