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: history of present illness: this 57-year-old gentleman was admitted, referred in after cardiac catheterization to dr. for probably aortic valve replacement. he had a cardiac catheterization done on the date of admission, , which showed "normal" coronaries, no mitral regurgitation, an ejection fraction of 45%, with critical aortic stenosis with an aortic valve area of approximately 0.5-0.6 cm squared. patient also had diffuse mild hypokinesis. he was admitted to the cardiology service postcatheterization, and was seen by dr. with plans to do aortic valve replacement for his congestive heart failure symptoms. on admission, he had allergies to shellfish, otherwise no other known drug allergies. past medical history: 1. atrial fibrillation which was new onset. 2. critical aortic stenosis. 3. congestive heart failure. 4. pulmonary hypertension. medications on admission: 1. coumadin 5 mg po q day. 2. digoxin 0.25 mg po q day. 3. cardizem 60 mg po qid. 4. heparin drip was started on transfer in. he had no other medications prior to the hospital. he did present with a cough and dyspnea and some pleuritic chest pain. he was a former smoker. he also mentioned that his daughter recently had a strep infection. the patient did have some symptoms of orthopnea, but no chest pain at the time. he was taken to the emergency room. his blood pressure was found to be 190/120. he was given iv cardizem for control. he was also found to be in congestive heart failure with new onset atrial fibrillation for which he was given lasix, coumadin, heparin, digoxin, and cardizem for rate control. he was transferred to for catheterization. on admission, his hematocrit was 47.8, a k of 3.1 for which he was given 40 meq of potassium repletion. sodium 135, chloride 99, co2 27, bun 9, creatinine 1.2. blood sugar of 123. he quit smoking approximately 15 years ago, but still admitted to occasional tobacco use. he is admitted to the cardiology service. ct surgery consult was requested. the patient continued to be diuresed for congestive heart failure, and he remained on dr. service while the patient was diuresed and rate controlled was achieved for atrial fibrillation. the patient remained in atrial fibrillation. of note, his pulmonary artery pressures were 68 systolic. on examination, he had some ankle edema and a little bit of abdominal distention. his only past surgical history was an operation for a right club foot in childhood. also of a more greater importance which delayed his surgery, he had rotten teeth. he never had dental checkup and this needed to be addressed before the patient could have aortic valve replacement for risk of infecting his biprosthetic valve. dental consult was requested which could not take place that evening. the patient was seen on the 14th by the oral surgery service. on the 12th, the coumadin continued to be dosed. it was stopped. the inr was 1.3. additional laboratories were sent off in preparation for his operation. dental recommended extracting all of his remaining teeth given his periodontal compromise and in his great infectious risk. they recommended full extraction for the patient. his aortic valve replacement surgery was delayed. until this was completed, the patient continued to be diuresed and in-house, they already diuresed off 2.5 liters the day prior. he underwent his dental procedure on the 15th, and was monitored for bleeding given his slightly elevated inr. he was switched over to heparin to cover his atrial fibrillation which he remained in, in the 90s-100s on house day four. his urinalysis was negative. he remained asymptomatic from his atrial fibrillation. it is also recommended that he receive noninvasive carotid studies which showed essentially normal carotid arteries. please refer to the examination on . he continued on diltiazem and digoxin for his rate control of his atrial fibrillation. his hematocrit rose to 52.1 and then back down to 48.2. his bun and creatinine were stable. he continued to receive lasix diuresis and continued to have a heparin drip off coumadin for a therapeutic goal of ptt to 60-80 range. patient continued to have bleeding from his gums which again delayed his surgery, and was recommended that his lasix be held and his heparin be discontinued as he would not be able to undergo his surgery until his oral bleeding stopped. he was seen again on the 18th by oral surgery. they cleared him to proceed with surgery. the patient was delayed another day for continued oozing. heparin was restarted on the 18th with ptt to be followed. patient had some blood clots that were loosen and dislodged from his gums. early in the morning on the 19th, he was examined again and his bleeding stabilized. ned on diltiazem also for his rate control, and he continued to bleed on with oozing while he was back on his heparin. he was seen on the by dr. for cardiothoracic surgery. prosthetic options were discussed with the patient. in the evening on the 20th, the patient continued to have some persistent bleeding from his mouth, but was ultimately cleared for surgery, and on , the patient underwent aortic valve replacement with a 27 mm pericardial tissue valve by dr. , and was transferred to the cardiothoracic intensive care unit in stable condition on a propofol drip. he was seen by case management also. on postoperative day one, he remained in the cardiothoracic intensive care unit. he was extubated with a respiratory rate of 24, sating 95% on 4 liters nasal cannula. he continued on his perioperative vancomycin. his hematocrit rose from 25.2 to 30.2. he had a pt of 16.7, ptt of 26.6, with an inr of 1.2. postoperative laboratories as follows: sodium 134, potassium 4.6, chloride 107, co2 23, bun 12, creatinine 0.7 with a blood sugar of 130. was awake, alert, and responding appropriately. his lungs were clear. he had no air leak. he began lopressor, beta blocker. his chest tubes were discontinued. his diet was advanced and aspirin was started. diuresis was begun. he remained in sinus rhythm with good blood pressure of 118/64. he was transferred out to the floor on postoperative day two in stable condition with a blood pressure of approximately 88/62 in sinus rhythm in the 80s. he was seen by physical therapy to begin his ambulation, which he did well. he was taking po percocet for pain management. on the 24th, he had no events overnight. was in sinus rhythm in the 60s. lungs were clear. he was sating 99% on 4 liters. he continued with good diuresis. his pacing wires were removed. he continued ambulating with physical therapy. on postoperative day four, he had no events. again, he was hemodynamically stable. his lungs are clear. he had 1+ pedal edema. he continued ambulating with physical therapy. he remained in sinus rhythm without any ectopy with a temperature max of 99.1 and a blood pressure of 120/68. he was seen by case management with a plan to discharge him to home with or stoten vna services. on the , he had an unremarkable physical exam. his incision was clean, dry, and intact without sternal instability. discharge diagnoses: 1. status post aortic valve replacement 27 mm - pericardial tissue valve. 2. congestive heart failure. 3. atrial fibrillation. 4. pulmonary hypertension. discharge medications: 1. lopressor 25 mg po bid. 2. aspirin 325 mg po q day. 3. lasix 20 mg po bid x7 days. 4. 20 meq po bid x7 days. 5. percocet 5/325 po prn q4h prn for pain. 6. colace 100 mg po bid. fop instructions: the patient was instructed to followup with his cardiologist, dr. in approximately 1-2 weeks, and to see dr. in the office in approximately four weeks. the patient was discharged to home with vna services on . , m.d. dictated by: medquist36 procedure: extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures diagnostic ultrasound of heart open and other replacement of aortic valve other surgical extraction of tooth removal of residual root diagnoses: atrial fibrillation aortic valve disorders other chronic pulmonary heart diseases personal history of tobacco use systolic heart failure, unspecified hemorrhage complicating a procedure unspecified sleep apnea obesity, unspecified dental caries, unspecified 

Answer: The patient is high likely exposed to