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: dilaudid attending: chief complaint: shortness of breath, increasing fatigue,endocarditis, back pain major surgical or invasive procedure: aortic valve replacement (25mm st. mechanical) history of present illness: 47 yo m with recent diagnosis of bicuspid aortic valve and enterococcal endocarditis and likely vertebral osteomyelitis in of this year. pt originally presented to pcp with cough and was treated with z-pack, however it did not resolve and pt began having night sweats. around the same time, the patient attempted to lift a fax machine and developed severe back pain. he presented to hospital for the back pain and fevers to 101.6. he was admitted and blood cultures grew out enterococcus in bottles. tee revelealed a bicuspid aortic valve and a 1.6cm vegetation with moderate ai and no abscess. there also reported a possible vertebral osteomyelitis. mr. also underwent a colonoscopy to look for a source of his enteroccoal bacteremia which was negative. he was subsequently transferred to for further management of his endocarditis. repeat blood cultures were negative and the patient was evaluated by cardiology and infectious disease services. pt is now s/p 6 weeks of ampicillin and gentamicin therapy and presents for surgical evaluation. has continuing back issues due to endocarditis. past medical history: aortic valve endocarditis bicuspid aortic valve obesity vertigo vertebral osteomyelitis renal calculi social history: smoke - smoked 1ppd for 6 years; quit 3y ago etoh-occassional drugs - never sexually active with one female partner for 22 years family history: mother-deceased at 68 physical exam: physical exam pulse: 76 reg resp: o2 sat: b/p right:128/66 left: 132/68 height: 5'9" weight: 235# preop: general:walks with crutches and back brace skin: dry intact heent: perrla eomi anicteric sclera; op unremarkable neck: supple full rom no jvd chest: lungs clear bilaterally heart: rrr irregular murmur 2/6 sem heard best at lusb; diastolic murmur heard best at rusb; radiates to carotids abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema: none varicosities: none neuro: grossly intact, mae strengths, nonfocal exam pulses: femoral right: 2+ left: 2+ dp right: 2+ left: 2+ pt : 2+ left: 2+ radial right: 2+ left: 2+ carotid bruit : murmur radiates to both carotids pertinent results: conclusions pre-bypass: no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses and cavity size are normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the number of aortic valve leaflets cannot be determined, 3 cusps are seen, non coronary cusp is larger than than right and left, partial commisural fusion of the right and left cusps is seen. the aortic regurgitation vena contracta is >0.6cm. severe (4+) aortic regurgitation is seen. the mitral valve leaflets are structurally normal. trivial mitral regurgitation is seen. there is no pericardial effusion. dr. was notified in person of the results. post-bypass: for the post-bypass study, the patient was receiving no vasoactive infusions. a prothetic valve is well-seated in the aortic position with good leaflet excursion. there is no paravalvular regurgitation. there is trace valvular regurgitation consistent with washing jets. aorta is intact post decannulation/ all other findings consistent with pre-bypass findings. all findings communicated to surgeon. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, md, interpreting physician 12:24 ?????? caregroup is. all rights reserved. brief hospital course: the patient was admitted and underwent cardiac catheterization on to reveal normal coronaries. on he underwent aortic valve replacement with a 25mm st. mechanical valve. multiple cultures were sent from the operating room. he weaned from bypass easily on no pressors. he awakened, remained stable and was extubated easily. beta blockade was begun, diuresis instituted and coumadin started on pod 1. he was transferred to the floor in stable condition. physical therapy worked with him for mobility and strengthening. pacing wires and chest tubes removed per protocol. he was cleared for discharge with vna on pod #.........first blood draw..........with inr results to dr......................target inr 2.5-3.5 for mechanical valve. stop medications on admission: advil,tylenol sennakot prn vicodin prn discharge medications: 1. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*50 tablet(s)* refills:*0* 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 3. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 4. lasix 40 mg tablet sig: one (1) tablet po once a day for 10 days. disp:*10 tablet(s)* refills:*2* 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 6. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 7. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po daily (daily). disp:*10 tab sust.rel. particle/crystal(s)* refills:*0* 8. coumadin 2.5 mg tablet sig: three (3) tablet po once a day: coumadin dose to be determined by dr. inr 2.0-3. disp:*90 tablet(s)* refills:*2* 9. outpatient lab work inr check then every other day until inr stable and fax results to dr. for couamdin dose titration. discharge disposition: home with service facility: home health of discharge diagnosis: aortic valve endocarditis s/p avr bicuspid aortic valve aortic insufficiency vertigo vertbral body osteomyelitis discharge condition: good discharge instructions: shower daily, no baths or swimming no lotions, creams or powders to incisions no driving for 4 weeks and off all narcotics no lifting more than 10 pounds for 10 weeks report any redness of, or drainage from incisions report any fever greater than 100.5 report any weight gain greater than 2 pounds a day or 5 pounds a week take all medications as directed followup instructions: dr. in 4 weeks dr. and dr. 10:30 clinical center in 6 wound clinic in 2 weeks dr. in 2 weeks first inr blood draw with results to dr. . target inr 2.0-3.0 for mechanical valve scheduled appointments: provider: xray (scc 2) phone: date/time: 9:40 provider: , md phone: date/time: 10:00 provider: phone: date/time: 11:15 md procedure: extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters left heart cardiac catheterization open and other replacement of aortic valve diagnoses: aortic valve disorders personal history of tobacco use long-term (current) use of anticoagulants acute and subacute bacterial endocarditis streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] obesity, unspecified congenital insufficiency of aortic valve 

Answer: The patient is high likely exposed to