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: no known allergies / adverse drug reactions attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: - aortic valve replacement (. epic porcine) transureteral resection of bladder tumor (greater than 6 cm), clot evacuation, bladder fulguration history of present illness: 73yo woman known aortic stenosis followed by echocardiogram, now becoming increasingly fatigued with activity. pre-op for mastectomy for breast cancer. past medical history: aortic stenosis breast cancer-scheduled for mastectomy mild aortic regurgitation anemia hematuria hypertension mild dementia social history: lives with: she lives w/son :quit 10 yrs ago etoh:none family history: non contributory physical exam: vs: 144/60 80sr, 100%ra, 18 general: nad skin: warm dry intact heent: ncat perrla eomi neck: supple full rom chest: lungs clear bilaterally large, firm, non-mobile, non-tender right breast mass heart: rrr irregular murmur 4/6 systolic, loudest at left sternal border, radiation to carotids and abdomen, +thrill abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema trace varicosities: none spiders neuro: grossly intact a&o x 2 pulses: femoral right: 2+ left:2+ dp right: 2+ left:2+ pt : 1+ left:1+ radial right: 2+ left:2+ carotid bruit right: left: radiation of cardiac murmur vs bruits bilaterally +thrill left carotid pertinent results: echo pre-bypass: the left atrium is mildly dilated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. right ventricular chamber size and free wall motion are normal. there are simple atheroma in the descending thoracic aorta. there are three aortic valve leaflets. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). moderate (2+) aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. there is moderate thickening of the mitral valve chordae. mild (1+) mitral regurgitation is seen. there is no pericardial effusion. post cpb: 1.preserved -ventricular systolci function. 2. transient mild to moderate mitral and tricuspid regurgitation which improved to pre-cpb levels 3. bioprosthetic valve in aortic position. well seated and mechanically stable and godd leaflet excursion 4. trace valvular ai (pg = 23 mm hg mg - 11 mm hg.) 5. no othe rchange 05:10am blood wbc-10.2 rbc-3.69* hgb-11.0* hct-32.2* mcv-87 mch-29.7 mchc-34.0 rdw-15.3 plt ct-454* 01:00pm blood wbc-9.8# rbc-2.42*# hgb-7.8*# hct-21.3*# mcv-88 mch-32.3* mchc-36.7* rdw-14.0 plt ct-169 03:19am blood neuts-92.7* lymphs-4.5* monos-2.6 eos-0.1 baso-0.1 11:13am blood pt-17.6* inr(pt)-1.6* 05:10am blood pt-14.1* ptt-23.7 inr(pt)-1.2* 05:15am blood pt-13.3 ptt-23.4 inr(pt)-1.1 03:35pm blood pt-14.5* ptt-50.6* inr(pt)-1.3* 01:00pm blood pt-15.0* ptt-37.0* inr(pt)-1.3* 11:13am blood urean-18 creat-0.6 na-137 k-4.7 cl-98 05:10am blood glucose-105* urean-18 creat-0.6 na-140 k-4.3 cl-100 hco3-28 angap-16 01:54am blood glucose-150* urean-14 creat-0.5 na-139 k-4.7 cl-113* hco3-23 angap-8 04:15pm blood urean-9 creat-0.4 na-144 k-3.2* cl-115* hco3-22 angap-10 05:15am blood alt-18 ast-33 ld(ldh)-234 alkphos-122* amylase-98 totbili-1.6* 01:21pm blood alt-29 ast-39 ld(ldh)-296* alkphos-145* amylase-187* totbili-0.7 05:15am blood lipase-37 01:21pm blood lipase-74* 11:13am blood mg-2.1 05:15am blood albumin-3.0* mg-2.3 urine culture (final ): enterobacter cloacae. >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 after initiation of therapy. for serious infections, repeat culture and sensitivity testing may therefore be warranted if third generation cephalosporins were used. sensitivities: mic expressed in mcg/ml _________________________________________________________ enterobacter cloacae | cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s ciprofloxacin---------<=0.25 s gentamicin------------ <=1 s meropenem-------------<=0.25 s nitrofurantoin-------- 64 i piperacillin/tazo----- <=4 s tobramycin------------ <=1 s trimethoprim/sulfa---- <=1 s brief hospital course: ms. was admitted to the on for surgical management of her aortic stenosis. she was taken to the operating room where she underwent an aortic valve replacement using a tissue prosthesis. please see operative note for details. postoperatively she was taken to the intensive care unit for monitoring. she later awoke neurologically intact and was extubated. on postoperative day one, aspirin, beta blockade and a statin were resumed. she countinued to be somewhat hypertensive requiring a nicardipine drip. she developed atrial fibrillation and diltiazem was started. she continued to have bursts of rapid atrial fibrillation and amiodarone replaced her diltiazem, but was stopped due to pause. a psychiatry consult was obtained for postoperative delirium and agitation. haldol was recommended as needed. precedex was also used with good results. the physical therapy service was consulted for assistance with her postoperative strength and mobility. as she continued to have paroxysmal atrial fibrillation, coumadin was started for anticoagulation. on postoperative day four, she was transferred to the step down unit for further recovery. she continued to be gently diuresed towards her preoperative weight. she experienced urinary retention with hematuria and urology was consulted. she had an acute drop in hematocrit and urology brought her to the or for cystoscopy. large bladder tumors were found and evacuated. continuous bladder irrigation was initiated until urine ran clear. her foley was removed and she has had no difficulty voiding. urine is positive for enterobacter sensitive to bactrim which she was placed on at discharge due to cipro interaction with seroquel. she will continue to f/u with urology as an outpatient. she was restarted on coumadin for atrial fibrillation and was ready for discharge to rehab at house on . medications on admission: hctz 25 dally vit d iu qweek alendronate 70 qweek lisinopril 10 daily asa 81 daily discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily): check lfts in one month. 3. polyethylene glycol 3350 17 gram/dose powder sig: seventeen (17) gram powder po daily (daily). 4. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 5. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 6. metoprolol tartrate 25 mg tablet sig: three (3) tablet po bid (2 times a day): 75 mg twice a day . 7. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 8. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain. 9. quetiapine 25 mg tablet sig: one (1) tablet po bid (2 times a day). 10. bactrim 400-80 mg tablet sig: one (1) tablet po twice a day for 10 days: enterobacter cloacae in urine . 11. warfarin 1 mg tablet sig: one (1) tablet po once a day for 1 days: please give 1 mg coumadin on and then inr check for further dosing by rehab physician inr 2.0-2.5. 12. zaroxolyn 2.5 mg tablet sig: one (1) tablet po once a day. 13. lasix 40 mg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: house - discharge diagnosis: aortic stenosis s/p aortic valve replacement hematuria s/p resection of bladder tumor postop atrial fibrillation post op delirium breast cancer anemia hypertension mild dementia discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with tylenol incisions: sternal - healing well, no erythema or drainage edema trace bilateral lower extremities discharge instructions: 1) 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. 2) please no lotions, cream, powder, or ointments to incisions. 3) each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart provided. 4) no driving for approximately one month and while taking narcotics. driving will be discussed at follow up appointment with surgeon when you will likely be cleared to drive. 5) no lifting more than 10 pounds for 10 weeks 6) please call with any questions or concerns *females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge **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. at on thursday @ 9:30am cardiologist: at on @ 10:30am please call to schedule appointments with your primary care dr. in weeks urology: dr. ( **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** labs: pt/inr for coumadin ?????? indication atrial fibrillation inr 2.0-2.5 first draw friday please check inr monday, wednesday and friday for first 2 weeks and then decrease to biweekly please arrange for coumadin/inr f/u at prior ro discharge from rehab procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft other transurethral excision or destruction of lesion or tissue of bladder transurethral clearance of bladder diagnoses: other iatrogenic hypotension anemia, unspecified unspecified pleural effusion urinary tract infection, site not specified unspecified essential hypertension cardiac complications, not elsewhere classified atrial fibrillation aortic valve disorders other persistent mental disorders due to conditions classified elsewhere retention of urine, unspecified nontraumatic hematoma of soft tissue gross hematuria precipitous drop in hematocrit delirium due to conditions classified elsewhere other specified bacterial infections in conditions classified elsewhere and of unspecified site, other gram-negative organisms malignant neoplasm of other specified sites of female breast malignant neoplasm of other specified sites of bladder 

Answer: The patient is high likely exposed to