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: a 29-year-old man with history of as diagnosed in , followed by serial echocardiograms and mri. this year the mri showed worsening valvular function. patient does complain of shortness of breath with activity. also has a history of asthma. preoperative medications: 1. procardia xl 60 q.d. 2. albuterol mdi b.i.d. 3. pulmicort mdi q.d. 4. amoxicillin before dental visits. patient had a cardiac echocardiogram done on , which showed a bicuspid aortic valve with severe ar with a globally depressed lv function with an ef of 56 percent. he had a cardiac catheterization done on that showed clean coronaries with 4 plus aortic regurgitation and mild pulmonary hypertension. chest x-ray done preoperatively showed no cardiopulmonary processes. lab data prior to admission: white count 7.7, hematocrit 41.5, platelets 219. pt 12.3, ptt 28.5, inr 1.0. sodium 140, potassium 4.2, chloride 104, co2 26, bun 14, creatinine 0.8, glucose 86. alt 12, ast 15, alkaline phosphatase 64, total bilirubin 0.5, total protein 7.8, albumin 4.8, hemoglobin a1c 5.5. urinalysis preoperatively was negative. ekg showed sinus bradycardia with a occasional pvcs at a rate of 54. allergies: patient states an allergy to penicillin. family history: had an uncle who died at a young age of a mi. social history: lives with girlfriend. occupation is a salesman. tobacco use: quit six years ago. prior to that, smoked for seven years. alcohol use: drinks 5-6 drinks per week. others: rare marijuana use. physical examination: height 5'8". weight 195 pounds. heart rate 58. blood pressure 163/46. respiratory rate 22. o2 saturation 98 percent on room air. general: sitting in chair in no acute distress. skin: with no lesions or sores. heent: pupils are equal, round, and reactive to light. anicteric. extraocular motions intact. neck is supple with no lymphadenopathy or jvd. transmitted murmur. chest was clear to auscultation. heart: 3/6 systolic ejection murmur. abdomen is soft, nontender, and nondistended with positive bowel sounds. extremities: warm and well perfused with no edema, no varicosities. neurologically: alert and oriented times three. nonfocal exam. pulses: 2 plus throughout. hospital course: as stated previously, the patient was a direct admission to the operating room. please see the or report for full details. in summary, the patient had an aortic valve replacement with a . mechanical valve. cardiopulmonary pump time was 164 minutes with a cross-clamp time of 86 minutes. he tolerated the operation well and was transferred from the operating room to the cardiothoracic intensive care unit. at the time of transfer, the patient was in normal sinus rhythm at 75 beats per minute with a mean arterial pressure of 66 and a cvp of 11. he had nitroglycerin at 0.5 mcg/kg/minute and propofol 20 mcg/kg/minute. patient did well in the immediate postoperative period. his anesthesia was reversed. he was weaned from the ventilator and successfully extubated. during the course of the evening on the operative day, he was weaned from all cardioactive iv medications on postoperative day one. patient's chest tubes were removed and he was transferred from the icu to 2 for continuing postoperative care and cardiac rehabilitation. once on the floor, the patient had an uneventful postoperative course. he was begun on coumadin on postoperative day two. at that time, his temporary pacing wires were removed over the next several days, so the patient's beta blocker and diuretics were adjusted. his coumadin dose was also adjusted with an attempt to get to a goal inr of 3 to 3.5. during this period the patient's activity level was advanced with the assistance of physical therapy and the nursing staff. on postoperative day eight, the patient complained of a sore throat. at that time, he also had a fever to 100.5 with a white blood cell count of 16. a urinalysis done at that time was negative. a chest x-ray showed no effusions or infiltrates with a small amount of postoperative atelectasis. blood cultures and sputum cultures were also sent at that time. sputum gram stain was negative and showed contamination with oropharyngeal flora. blood cultures to date are negative. however, the patient did have an erythematous throat and he was dosed with zithromax 500 mg at that time. he will be continued on zithromax 250 mg q.d. x5 days. the following morning the patient had remained afebrile x24 hours and the decision was made that he was stable and ready to be discharged to home. at this time, the patient's physical exam was as follows: vital signs: temperature 99, heart rate 72, sinus rhythm, blood pressure 114/53, respiratory rate 20, and o2 saturation 91 percent on room air. weight at time of discharge 88.7 kg, preoperatively 88 kg. laboratory data on day of discharge: white count 13, hematocrit 26.1, platelets 245. pt 18, ptt 69, inr 2.1. potassium 4.6, bun 18, creatinine 0.8. physical exam: alert and oriented times three. moves all extremities, follows all commands. respiratory: clear to auscultation. cardiovascular: regular, rate, and rhythm, s1, s2 with mechanical click. sternum is stable. incision with steri-strips, open to air clean and dry, no erythema. abdomen is soft, nontender, and nondistended. extremities are warm and well perfused with no edema. medications on discharge: 1. albuterol mdi two puffs b.i.d. and q.6h prn. 2. flovent two puffs q.d. 3. dilaudid 2-4 mg q.4-6h prn. 4. metoprolol 75 mg b.i.d. 5. ferrous sulfate 325 mg q.d. 6. ascorbic acid 500 mg b.i.d. 7. lisinopril 5 mg q.d. 8. coumadin 7.5 mg on .5 mg on , check inr on , and then dosed per dr. . 9. azithromycin 250 mg q.d. x5 days. discharge diagnoses: status post aortic valve replacement with a number . mechanical valve. asthma. condition on discharge: good. fop: he is to have followup in the clinic in two weeks. follow up with dr. in weeks. follow up with dr. office by phone on to transmit inr results and to get a coumadin dose and follow up with dr. in weeks. also the patient is to followup with dr. in four weeks. , m.d. procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve diagnoses: unspecified essential hypertension asthma, unspecified type, unspecified congenital insufficiency of aortic valve 

Answer: The patient is high likely exposed to