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: addendum: mr. was placed on bactrim for a urinary tract infection. he was discharged to home on . chief complaint: asymptomatic, serial ct scan reveal increasing aneurysm major surgical or invasive procedure: - endovascular stent graft repair of descending thoracic aneurysm - endovascular stent graft extension and evacuation of left groin hematoma history of present illness: 80 year old male with a history of descending thoracic aneurysm s/p open stent graft in . recent surveilance reveals an increase in the size of aneurysm and he was referred for endovascular stent placement. past medical history: descending thoracic aortic aneurysm aortic stenosis s/p aortic valve replacement (mechanical) benign prostatic hyperplasia hypothyroidism ?lymphoma - s/p surgery, chemo, xrt lymph node excision (?cervical) aortic valve replacement (mechanical) descending thoracic aortic aneurysm stent (open) appendectomy remotely social history: occupation: retired contractor/carpenter lives alone tobacco: quit 40 yrs. ago etoh: denies family history: father deceased at 65 of heart condition physical exam: pulse: 61 resp: 18 o2 sat: 99%ra b/p right: 121/78 left: height: weight: 73.2 general: skin: dry intact no rash well healed sternotomy/upper abdominal midline incision heent: perrl eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur audible mechanical click, no murmur abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema varicosities: none 2+edema bilateral ankles neuro: grossly intact x pulses: femoral right: 1+ left: 1+ dp right: 1+ left:1+ pt : left: not palpable edema radial right: 2+ left: 2+ carotid bruit right: left: no bruits pertinent results: 12:35pm blood wbc-3.4* rbc-3.20* hgb-9.1* hct-28.3* mcv-89 mch-28.5 mchc-32.2 rdw-15.0 plt ct-249 05:35am blood wbc-2.7* rbc-2.91* hgb-8.4* hct-25.5* mcv-88 mch-28.8 mchc-32.9 rdw-15.0 plt ct-322 07:10am blood wbc-4.3# rbc-3.23* hgb-9.1* hct-29.4* mcv-91 mch-28.1 mchc-30.9* rdw-14.4 plt ct-363 09:20am blood pt-36.0* inr(pt)-3.7* 05:35am blood pt-36.0* ptt-46.5* inr(pt)-3.7* 07:10am blood pt-34.8* ptt-52.4* inr(pt)-3.6* 07:30am blood pt-26.1* inr(pt)-2.5* 05:10am blood glucose-119* urean-32* creat-1.4* na-139 k-4.4 cl-102 hco3-28 angap-13 05:35am blood glucose-99 urean-21* creat-1.3* na-141 k-4.5 cl-109* hco3-25 angap-12 07:10am blood glucose-131* urean-19 creat-1.1 na-139 k-4.9 cl-105 hco3-26 angap-13 10:47 pm urine source: cvs. **final report ** urine culture (final ): serratia marcescens. 10,000-100,000 organisms/ml.. this organism may develop resistance to third generation cephalosporins during prolonged therapy. therefore, isolates that are initially susceptible may become resistant within three to four days therefore be warranted if third generation cephalosporins were used. sensitivities: mic expressed in mcg/ml _________________________________________________________ serratia marcescens | amikacin-------------- <=2 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s ciprofloxacin--------- 2 i gentamicin------------ =>16 r imipenem-------------- <=1 s meropenem-------------<=0.25 s nitrofurantoin-------- 256 r piperacillin---------- <=4 s piperacillin/tazo----- <=4 s tobramycin------------ 8 i trimethoprim/sulfa---- <=1 s final report history: 85-year-old male with new onset right knee pain and swelling. right knee, three views: there are no prior radiographs for comparison. there is diffuse osteophytic spurring and joint space narrowing in all three compartments of the knee. there is a small joint effusion. there are no fractures or dislocations. there is mild soft tissue swelling. . impression: tricompartmental osteoarthritis, small joint effusion. the study and the report were reviewed by the staff radiologist. brief hospital course: the patient developed confusion and discharge was delayed. urine culture was sent, which would return positive for serratia marcescens. he was treated accordingly. additionally, geriatrics consult was obtained. we appreciate their recommendations. the confusion did clear and the patient returned to his baseline mental status prior to discharge. colchicine and indocin were discontinued when the patient developed leukopenia, diarrhea and anemia. symptoms improved on discontinuation of these meds. the patient was cleared for discharge home on . explicit instructions regarding follow up and necessary appointments were given. medications on admission: coumadin 6' (last dose 7/15) finasteride lasix 20' flomax 0.4' synthroid naproxen prn discharge medications: 1. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). 2. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po hs (at bedtime). 3. levothyroxine 50 mcg tablet sig: one (1) tablet po daily (daily). 4. warfarin 6 mg tablet sig: one (1) tablet po once a day: dose to be adjusted based on inr by dr goal inr 2.5-3.0. 5. outpatient lab work please have pt/inr drawn on tues. for coumadin dosing with results to dr office # fax # 6. metoprolol succinate 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). disp:*30 tablet sustained release 24 hr(s)* refills:*2* 7. trimethoprim-sulfamethoxazole 160-800 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for uti for 3 days. disp:*6 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: descending thoracic aortic aneurysm s/p endovascular stent placement left groin hematoma s/p evacuation gout vs pseudogout right knee aortic stenosis s/p avr (mechanical) benign prostatic hypertrophy hypothyroidism discharge condition: good discharge instructions: monitor wounds for signs of infection. these include redness, drainage or increased pain. report any fever greater then 100.5. no lotions, creams or powders to incision until it has healed. you may shower and wash incision. gently pat the wound dry. please shower daily. left groin has staples that need to remain for two weeks please call with question or concerns followup instructions: please follow up with dr ct scan torso in 6 months and then yearly results to dr and dr please have pt/inr drawn on tues. for coumadin dosing with results to dr , office # fax # follow up with dr staple removal left groin appointment wednesday at 2:30pm at pcp md procedure: aortography aortography other incision with drainage of skin and subcutaneous tissue endovascular implantation of graft in thoracic aorta endovascular implantation of graft in thoracic aorta diagnoses: thrombocytopenia, unspecified urinary tract infection, site not specified unspecified acquired hypothyroidism thoracic aneurysm without mention of rupture hematoma complicating a procedure hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) heart valve replaced by other means other malignant lymphomas, unspecified site, extranodal and solid organ sites long-term (current) use of anticoagulants surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation mechanical complication of other vascular device, implant, and graft osteoarthrosis, unspecified whether generalized or localized, lower leg osteoarthrosis, localized, not specified whether primary or secondary, forearm 

Answer: The patient is high likely exposed to