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: codeine attending: chief complaint: sob, volume overload major surgical or invasive procedure: none history of present illness: this 66wf underwent an avr(21mm st. mechanical) on . she was discharged to rehab and over the past 3 days had gotten progressively sob and was anuric. she presented to the clinic and was very edematous and sob. past medical history: aortic stenosis-s/p avr type ii diabetes mellitus hypertension hyperlipidemia obesity hysterectomy cholecystectomy appendectomy tonsillectomy post op afib social history: quit tobacco in . denies etoh. she is married and retired. family history: father died of mi ?age physical exam: at the time of discharge, ms. was found ot be in no acute distress. she was awake, alert, and oriented times three. her heart was of regular rate and rhythm. her sternal incision was noted to have no drainage and no erythema. her abdomen was soft, non-tender, and she had bowel sounds. her extremities were warm and she had 1+ edema. pertinent results: cardiology report echo study date of patient/test information: indication: aortic valve disease s/p avr. small ericardial effusion, r/o tamponade. height: (in) 61 weight (lb): 306 bsa (m2): 2.27 m2 bp (mm hg): 174/75 hr (bpm): 74 status: inpatient date/time: at 15:26 test: portable tee (complete) doppler: full doppler and color doppler contrast: none tape number: 2007w000-0:00 test location: west other technical quality: adequate referring doctor: dr. measurements: left ventricle - ejection fraction: >= 65% (nl >=55%) interpretation: findings: left atrium: no spontaneous echo contrast or thrombus in the la/laa or the ra/raa. good (>20 cm/s) laa ejection velocity. right atrium/interatrial septum: a catheter or pacing wire is seen in the ra. no asd by 2d or color doppler. left ventricle: overall normal lvef (>55%). right ventricle: normal rv chamber size and free wall motion. aorta: simple atheroma in aortic arch. simple atheroma in descending aorta. aortic valve: mechanical aortic valve prosthesis (avr). avr leaflets move normally. mitral valve: normal mitral valve leaflets with trivial mr. tricuspid valve: normal tricuspid valve leaflets. mild tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets. pericardium: small pericardial effusion. no echocardiographic signs of tamponade. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was monitored by a nurse throughout the procedure. local anesthesia was provided by benzocaine topical spray. the patient was sedated for the tee. medications and dosages are listed above (see test information section). the posterior pharynx was anesthetized with 2% viscous lidocaine. no tee related complications. 0.2 mg of iv glycopyrrolate was given as an antisialogogue prior to tee probe insertion. conclusions: no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. no atrial septal defect is seen by 2d or color doppler. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. there are simple atheroma in the aortic arch and simple atheroma in the descending thoracic aorta. a mechanical aortic valve prosthesis is present. the aortic prosthesis leaflets appear to move normally. there is no paravalvular leak. the mitral valve appears structurally normal with trivial mitral regurgitation. there is a small pericardial effusion. there are no echocardiographic signs of tamponade. electronically signed by , md on 16:21. physician: , brief hospital course: ms. was admitted on from rehab, to which she was discharged after undergoing a st. mechanical avr on with dr. and . rehab reported increased dyspnea, tachypnea, diarrhea, and failure to thrive over the past 36-48 hours. upon admission she was seen in consultation by the renal service. she was dialyzed during her stay and her renal function improved markedly. it was determined that she likely wound not need long term dialysis. she was also seen in consultation by the infectious disease service during her admission and she was placed on vancomycin per their recommendations. once it was determined that she would not require long term dialysis access, she was re-coumadinized for her mechanical aortic valve. by hospital day ###### she was ready for discharge to a rehabiliation facility. medications on admission: metformin 1000mg po bid oxybutynin 5 mg po bid senna 2 tabs qhs lactinex lasix 20 mg po bid amiodorone 200 mg po daily lopressor 75 mg po bid digoxin mg po daily discharge medications: 1. 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:*0* 2. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 3. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 4. zolpidem 5 mg tablet sig: one (1) tablet po hs (at bedtime). disp:*30 tablet(s)* refills:*0* 5. insulin glargine 100 unit/ml solution sig: one (1) 35 subcutaneous at breakfast. disp:*1 35* refills:*0* 6. atenolol 25 mg tablet sig: 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 7. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 8. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 9. vancomycin 250 mg capsule sig: one (1) capsule po q6h (every 6 hours) for 14 days. disp:*56 capsule(s)* refills:*0* 10. warfarin 1 mg tablet sig: as directed tablet po once a day: target inr 2-2.5 pt received 0.5/1/1mg doses over the last 3 days-. 11. ferrous gluconate 300 mg tablet sig: one (1) tablet po daily (daily). 12. ascorbic acid 500 mg tablet sig: one (1) tablet po bid (2 times a day). discharge disposition: extended care facility: - discharge diagnosis: acute renal failure s/p avr iddm obdsity ^chol. discharge condition: good. discharge instructions: follow medications on discharge instructions. do not lift more than 10 lbs. for 2 months. shower daily, let water flow over wounds, pat dry with a towel. do not use creams, lotions, or powders on wounds. call our office for sternal drainage, temp>101.5 followup instructions: make an appointment with dr. for 1-2 weeks. make an appointment with dr. for 4 weeks. md procedure: venous catheterization, not elsewhere classified diagnostic ultrasound of heart hemodialysis venous catheterization for renal dialysis thoracentesis non-invasive mechanical ventilation transfusion of other serum diagnoses: anemia, unspecified acute kidney failure with lesion of tubular necrosis unspecified pleural effusion congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hyposmolality and/or hyponatremia cardiac complications, not elsewhere classified atrial fibrillation personal history of tobacco use other and unspecified hyperlipidemia heart valve replaced by other means unspecified disease of pericardium intestinal infection due to clostridium difficile hypovolemia other and unspecified coagulation defects 

Answer: The patient is high likely exposed to