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. coronary artery disease status post mi , , , , status post cabg with saphenous vein graft to rca, saphenous vein graft to d-1, status post cardiac catheterization with rca stent in , left circumflex ptca in , rca stent in 11/00, and . 2. peripheral vascular disease status post bilateral aorto-femoral bypass in 2/00, status post axillo-femoral bypass in 5/00, status post left brachial stent in which was complicated by an aneurysm that required surgical repair. 3. heparin induced thrombocytopenia. 4. hypothyroidism. 5. status post sdh with evacuation in . 6. seizures. past surgical history: as above. outpatient medications: 1. dilantin, 500 mg po q d. 2. levoxyl, 125 mg po q d. 3. folate, 1 gram po q d. 4. pepcid, 20 mg po b.i.d.. 5. flexeril, 10 mg po t.i.d.. 6. metoprolol, 50 mg po b.i.d.. 7. aspirin, 325 mg po q d. 8. accupril, 5 mg po q d. 9. isordil, 10 mg po t.i.d.. 10. tricor, 108 mg po q d. 11. zocor, 80 mg po q d. 12. senokot, two tabs q h.s.. 13. colace, 100 mg po b.i.d.. allergies: 1. heparin, induced thrombocytopenia. 2. codeine. 3. sulfa. 4. ceclor. social history: lives at home with husband in , reformed tobacco smoker of one-and-a-half packs per day times 20 years. family history: significant for coronary artery and peripheral vascular disease. physical examination: upon arrival to the unit, general exam: the patient was intubated and sedated on 30 of dopamine. vital signs: blood pressure 125/77, pulse of 122 and regular, temperature of 102 rectally. the patient was on a ventilator, fimb at 814, 5, and 5. heent: pupils were equally round and reacted to light and accommodation. cardiovascular exam: s1, s2, tachycardiac, no murmurs, rubs or gallops. there is a carotid bruit on the left side. chest: clear to auscultation bilaterally. abdomen: soft, nontender, nondistended. positive bowel sounds in all four quadrants. extremities: no dopplerable pulses, radial, dp, pt, no edema, extremities cool to touch. neuro: patient was sedated. laboratories in the emergency room: sodium 142, potassium 4.2, chloride 103, bicarbonate 24, bun 16, creatinine 0.7, glucose of 106. white blood cell count of 9.1, hematocrit 29.8, platelets of 341, mcv of 92. differential: neutrophils 54.3, lymphs 35.7, monos 5, eos 3, basos 0.1. pt of 13.1, inr of 1.2, ptt of 30. creatine kinase of 113 initially and with repeat to 1381, with troponin unable to be interpreted given previous troponin at discharge was greater than 50. calcium 9.1, phosphorus 5.8, magnesium 1.5. tsh of 0.1. alt 29, ast 19, alkaline phosphatase 67, total bilirubin 0.3. an abg on admission was 7.44, 27, 350. ekg one at baseline revealed normal rate, rhythm, axis, and intervals, first in the emergency room revealed st depressions in v3 through v5. ekg number three corresponding with hypotensive episode revealed 2 mm elevations in v2, 3 mm elevation in v3, and 1 mm elevations in v4 and v5. chest x-ray revealed patchy opacities which may represent developing pulmonary edema. hospital course: 1. coronary vascular system: 1. coronary artery disease: the patient was transferred to the ccu status post cardiac catheterization with lad stent times two. the patient was continued on aspirin and integrilin with initial holding of her beta blocker and ace inhibitor secondary to pressor. plavix was initially held for possible upcoming cab. the patient was continued on antihyperlipidemia medication. cardiac thoracic surgery was consulted and was aware of this patient for determination of future need for cabg. the patient was weaned off dopamine and metoprolol and captopril were added as the patient tolerated. the patient remained chest pain free until hospital day number seven when the patient began to experience chest and jaw pressure after she got up to go to the bathroom. the pain was described as chest pressure with mild sternal and radiation to the jaw, and patient states that this pain is similar to her angina pain. the patient received sublingual nitroglycerin times three with decrease in the pain from to . vital signs remained stable, at this time. an ekg revealed nonspecific st and t wave changes. nitro drip was started and iv lopressor was started for heart rate control, and ck's were cycled. the patient experienced pain episodic throughout the day and, again, had no ekg changes, patient had no increase in her creatine kinase enzyme. lopressor was given as needed to control heart rate. c-surgery was contact and the patient underwent pain mibi to assess for ischemia of anterior left ventricle. mibi revealed moderate to severe perfusion defects anteriorly, inferiorly, and at the apex, mild global hypokinesis, decreased ejection fraction of 44%. ct surgery did not feel that this patient is a candidate for surgical intervention at this time, given risk-benefit ratio. the goal for this patient was to medically optimize cardiac risk factors and anti-anginal medications prior to discharge. prior to discharge, the patient was weaned off the nitro drip and started on imdur 90 mg po q d, and patient was started on plavix prior to discharge. integrilin was also dc'd at this time. please see discharge medications for outpatient medications. 2. cardiovascular system: an echocardiogram on revealed an ejection fraction of 55%. a repeat echo revealed a decrease in the ejection fraction to 35% following this ischemic insult. the patient was optimized on ace inhibitor and beta blockers prior to discharge. 3. cardiovascular system: rhythm: the patient has no history of arrhythmias, and patient remained arrhythmia free throughout the hospital stay. 4. pulmonary: patient was ventilated for impending respiratory arrest and was continued on ventilatory support through hospital day number three. extubation was notable in that, 15 minutes after extubation, the patient became stridorous and was given racemic epinephrine and nebulizer with resolution. ent was consulted to evaluate air rate. ent reports not evidence of airway obstruction, and felt episode was possibly due to laryngospasm. there was no recurrence of the symptoms. patient remained extubated, saturating well throughout the remainder of hospital stay. 5. infectious disease: on day of the admission, the patient was noted to have high fevers which continued throughout the first three days of hospital stay, and the patient's gram stain was notable for gram positive cocci in pairs. the patient was started empirically on megalomicin and levaquin and treated for a 14 day course of antibiotics. the patient defervesced on hospital day number six and continued to remain afebrile with a stable white blood cell count throughout remainder of hospital stay. 6. musculoskeletal: given high fevers and increased creatine kinase of greater than with an mb index of less than 0.3, it was believed that the patient developed muscle damage perhaps secondary to seizure experienced in the emergency room or possible rhabdomyolysis given history of peripheral vascular disease and hypotensive episode. the patient was hydrated during this time and enzymes continued to down trend throughout the remainder of hospital stay. 7. neurology: it is notable that the patient, while in the emergency room, had an episode of shaking that was perhaps consistent with seizure that had been controlled with ativan. patient again had another shaking episode upon arriving to the ccu that was also treated with ativan and patient experienced no other episode of seizure-like activity throughout the remainder of the hospital stay. the patient was continued on dilantin for her history of seizures. 8. endocrine: the patient was continued on synthroid for history of hypothyroidism. 9. code status: the patient signed a dnr-dni prior to discharge, as discussed with the attending. condition on discharge: fair. discharge status: to home. discharge diagnoses: 1. st elevation myocardial infarction. 2. cardiogenic shock. 3. seizure. 4. hypothyroidism. 5. bacteremia. discharge medications: 1. aspirin, 325 mg po q d. 2. imdur, 90 mg po q d. 3. lipitor, 10 mg po q d. 4. captopril, 25 mg po t.i.d.. 5. metoprolol, 50 mg po b.i.d.. 6. vancomycin, 1 gram q 12 hours times five days. 7. levaquin, 500 mg po times six days. 8. levoxyl. 9. depakote, 500 mg po q d. 10. plavix, 75 mg po q d. 11. percocet, 5 mg/125 mg, one tab po q 6 p.r.n. for pain. follow-up plans: 1. patient to follow-up with , patient's pcp, two weeks. 2. vancomycin is to be continued via picc line with home nursing times five days after discharge. 3. patient to follow with ent appointment to reassess posterior vocal cords in one to two months after trauma has resolved. follow-up with dr. at . , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of non-drug-eluting coronary artery stent(s) injection or infusion of platelet inhibitor left heart cardiac catheterization other and unspecified coronary arteriography insertion of endotracheal tube diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery unspecified essential hypertension unspecified acquired hypothyroidism aortocoronary bypass status other convulsions bacteremia cardiogenic shock 

Answer: The patient is high likely exposed to