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: the patient is a 75-year-old male, who was admitted to early a.m. on with the complaints of chest tightness and shortness of breath. he was then transferred to for further care, catheterization, and possible surgery. he has known coronary artery disease in the past. he has had a ptca with stent to his left lad in , which was complicated by acute renal failure with a creatinine in between 2.5 and 4.0. he also has critical aortic stenosis with of 0.6 centimeter squared in . he was referred to cardiac surgery for a possible aortic valve replacement plus or minus cabg. past medical history: his past medical history is as follows: coronary artery disease status post mi in and pci/stent to the lad; aortic stenosis, of 0.6 centimeter squared in ; hypertension; acute renal failure after pci in , he was on dialysis, but not presently, with a creatinine of 2.5 to 4.0; hypercholesterolemia; prostate cancer status post radical prostatectomy and radiation treatment; anemia, the patient is on epogen; copd. also, the patient is status post a gi bleed (secondary to infection as per wife). he is also status post mrsa uti. the patient has diabetes mellitus. past surgical history: the patient is status post cholecystectomy, status post right thr x2, status post urinary tract revision with sphincter. current medications: the patient's current medications are: 1. zocor. 2. norvasc. 3. lopressor 5 mg q.d. 4. allopurinol 150 mg q.d. 5. casodex 150 mg q.d. 6. felodipine 5 mg q.d. 7. epogen every week. 8. humulin 70/30 25 units q.a.m. and nph 20 units at dinner. 9. ceftriaxone. 10. zithromax. allergies: the patient has no known drug allergies. social history: he does not drink alcohol. he quit smoking 40 years ago. physical examination: neurologically, he is grossly intact. alert and oriented x3. pulmonary: his lungs are clear to auscultation. his heart has regular rate and rhythm, with a 4/6 systolic ejection murmur. his abdomen is soft, nontender, and nondistended with bowel sounds. his extremities are warm with positive pulses, no clubbing, no cyanosis or edema. his carotid arteries have bilateral murmurs from the heart that radiate up. laboratory data: his chest x-ray was negative for any cardiopulmonary abnormalities. vq scan was negative. ua was negative. his white blood count was 9.5 and hematocrit 27.6. platelets 128,000. sodium 139, potassium 4.2, chloride 104, bicarbonate 22, bun 57, creatinine 2.7, glucose 178, cpk 463, and troponin t is 1.3. pt 12.7, ptt 34.1, and inr 1. impression and plan: so, once again, the plan for this patient: this is a 75-year-old male with multiple medical problems, which he currently has a fever, and the plan was to follow up on his cultures that were taken a day before. we will get a panorex x-ray and dental consult, have cardiac catheterization, an echocardiogram, and a carotid study, and also have an id consult to rule out infectious source of his fever and a hematology/oncology consult to evaluate his anemia and a possible metastatic workup for his prostate ca. carotid ultrasounds revealed no significant hemodynamic lesion in either the left or right carotid artery. cardiac catheterization was performed on , which showed the following results: lmca was normal. his lad had a mid 70 percent stenosis, the left circumflex with moderate diffuse disease mid 50 percent, distal 70 percent. the right rca demonstrated mild luminal irregularities. the patient had gradient of 0.627 meter squared. final diagnoses: severe and progressive aortic stenosis, moderate two-vessel coronary artery disease with left anterior descending stent, and severely elevated left-side filling pressures. hospital course: echocardiogram performed on showed the following results: severe aortic stenosis, mild symmetric left ventricular hypertrophy with mild regional systolic dysfunction, mild aortic regurgitation, at least mild mitral regurgitation. there was no regurgitation present in any other valves. so, on hospital day number 2, the patient was seen by infectious disease for a possible source of infection secondary to increased hematuria and fever, and cardiac surgery continued to follow up until given consent was okayed for surgery. on hospital stay day number 3, the patient had a bilateral lower limb ultrasound doppler to rule out any dvt for source of fever and possible asymmetry of his calves. there were no dvts found on the doppler examination, no evidence of abnormality, and the day earlier, the patient was seen by dental and was cleared for surgery as per dental. on hospital day number 9, which was , the patient appeared to be ready for his cabg and avr in the near future. following a urology consult, the patient will need a suprapubic tube placed as a urethral catheter could cause erosion of urethra and also need recommendations from urology to comment on when full authorization for cardiopulmonary bypass is safe status post a placement of the suprapubic catheter. throughout the last nine days of the hospital stay, he has been followed by medicine, cardiology, nephrology, infectious disease, physical therapy, and hematology/oncology in the need to find any source of infection following his renal status and following his chf status and his anemia. the patient has also received several blood transfusions secondary to a decreased hematocrit during the last week. on , which was hospital day number 11, the patient had a foley inserted with the help of cystoscopy and pelvic ultrasound guidance, and was planned for surgery the next day, which would be . cardiac surgery had done this. on , the patient was brought into the operating room for cardiac surgery. the surgeon was dr. . the procedure was coronary artery bypass graft x2. the grafts were lima to lad and saphenous vein graft to om. the patient also received aortic valve replacement with a 21-mm - pericardial tissue valve. the patient tolerated the procedure well. the cardiopulmonary bypass time was 108 minutes. cross-clamp time was 88 minutes. the patient's condition on transfer to the csiu is as follows: he had a rate of 80 beats per minute in normal sinus rhythm, mean arterial pressure of 67, cvp of 5, pa diastolic of 13, and pa mean of 21. he was receiving epinephrine drip of 0.02 mcg/kg per minute, nitroglycerin at 0.5 mg, insulin at 2 units per hour, and propofol 20 mg en route to the csiu. on postoperative day number 1, the patient was still receiving the following drips: insulin of 1 unit, milrinone of 0.5 mg, natrecor of 0.01 mg, and propofol of 25 mg. the patient had a specifically low cardiac index. examination-wise, the patient was in no acute distress. his heart rate was regular rate and rhythm. his lungs were clear. his wounds were clear, dry, and intact. his temperature was 99.7 degrees f., 94 normal sinus rhythm heart rate, bp 106/45, and respirations 14. his white blood count was 11.3, hematocrit was 29.2, and platelet count was 84,000, which was down from 113,000. his hematocrit, i guess, was 29.2, which was down from 37. the plan was to start lasix t.i.d., get a hepatic panel with possible decrease in milrinone, and extubate the patient as soon as the patient was tolerable. on postoperative day number 2, the patient was still receiving milrinone at 0.3 mg now, which was down from 0.5 mg, insulin of 4 units, natrecor of 0.01 mg, and he was on 40 mg of lasix intravenously. the patient was extubated. he had received 1 unit of packed red blood cells secondary to a decrease in his hematocrit, and we have been slowing weaning his milrinone. hemodynamically, he was stable. his hematocrit now was 31.2. his heart rate was a little tachycardic at 100. on physical examination, he was unremarkable, and his milrinone was decreased to 0.2 mg. on postoperative day number 3, the patient was still receiving insulin drip before milrinone of 0.2 mg and natrecor of 0.01 mg. following his removal of his chest tubes, there appeared to be a small apical pneumothorax, and 5:30 a.m. this morning, which was , the patient developed a subcutaneous emphysema. urology recommended to remove his foley today, which was done so, and a condom catheter with artificial sphincter in the open position was in place. hemodynamically, he was tachycardic at 106, bp 129/54, and oxygen saturation was 94 percent. hematocrit was 32.7, white blood count was 10.3, his bun was 46, creatinine 2.8, which was down from 2.9. the plan was to recheck a x-ray to see if there was any expansion, which was not of his pneumothorax, and to wean his milrinone and to check the hepatic panel. on postoperative day number 4, which was hospital day number 12, the patient was transferred to the inpatient telemetry floor, and his milrinone was weaned off. he was still receiving natrecor at 0.1 mg and lasix at 40 mg t.i.d. he was on aspirin. hemodynamically, his bp was 152/63, temperature of 99 degrees f., heart rate of 99, and his oxygen saturation was 96 percent. white blood count was down to 7.8, hematocrit was stable at 32.6, and his platelet count was down to 60,000 from 67,000. the plan was to discontinue his natrecor, start lopressor, and remove his epicardial pacing wires. on postoperative day number 6, the patient was complaining to have troubled breathing overnight, but improved with morning. the patient reported troubled breathing secondary to pain. currently, he was hemodynamically very stable. heart rate was 76, sinus rhythm. bp 126/63, temperature of 99.3 degrees f. the patient was alert and oriented x3. he was weak, but intact with no focal deficits. he had rhonchorous breath sounds bilaterally with a productive cough and yellow sputum. his extremities revealed 1 plus edema. the plan was to increase his lopressor to 50 mg b.i.d., decrease his lasix to 40 mg b.i.d., continue monitoring of his creatinine, and have rehab physical therapy screen the patient in cardiac intensive care. the patient had been ambulating with pt and ot. the patient was also being seen by physicians from secondary to his blood glucose and diabetes management better under control. on postoperative day number 7, the patient appears to be doing well. his creatinine continually lowered. today, it was at 2.2 down from 2.5, which shows a continual improvement. his white blood count was now 5.9, his hematocrit is 34.4, and his platelets are 114,000. physical examination was unremarkable besides plus edema on his extremities. his sternum was stable, and incision was clear, dry, and intact. lasix was changed to p.o., and the plan was to have urology consulted to see the patient again secondary to the urinary sphincter, and now that the patient was on p.o. lasix, it was probable to remove as long as the patient continues to do well and ambulating and getting out of bed and meets the criteria for discharge. the patient will be seen by pt until he does so. on postoperative day number 8, which is hospital day number 20, the patient had no events overnight. he appears to be doing well. the bp was slightly elevated at 153/69, and his respiratory rate was elevated at 24. his oxygen saturation was 99 percent on room air. his physical examination was unremarkable. the patient continued to get out of bed and slowly attempted stairs. his lopressor was increased to 75 mg p.o. b.i.d. on , the patient continued to appear doing well. this is hospital day number 22. the hospital course was complicated secondary to multiple medical problems when admitted to the hospital, fever, chf, multiple medical issues that the patient had in the past like chronic renal insufficiency, anemia, and the patient needed to be worked up for all those prior to cardiac surgery. following cardiac surgery, his course improved dramatically, and he was discharged postoperatively from cardiac surgery on day number 10. his physical examination on discharge: neurologically, he was grossly intact. his lungs were clear to auscultation with decrease at the left lower base. his heart rate was regular rate and rhythm, positive s1 and s2, with a 2/6 systolic ejection murmur. his sternum was stable. steri- strips were intact and clean and dry without erythema or drainage. his right calf incision with the saphenectomy site had steri-strips intact and was clean, dry, and intact. his extremities had trace edema. his temperature was 99.3 degrees f., pulse of 78 and sinus rhythm, respiratory rate of 20, bp of 107/54, and oxygen saturation of 96 percent. his weight was 79 kg; preoperatively, he was 78 kg. on the physical therapy standpoint, he was doing well, ambulating, going up stairs and out of bed, and was ready to be discharged to home today. condition on discharge: the patient was discharged to home in good condition with vna services. discharge diagnoses: his discharge diagnoses are as follows: his coronary artery disease status post coronary artery bypass graft x2, aortic stenosis status post aortic valve replacement with 21-mm pericardial tissue valve, hypertension, hypercholesterolemia, chronic obstructive pulmonary disease, chronic renal insufficiency, prostate cancer status post radical prostatectomy and radiation treatment, anemia, and the patient is on epogen, urinary tract revision with sphincter. recommendations: the patient was recommended a follow-up with dr. in two to three weeks, dr. in two to three weeks, and dr. in four weeks. discharge medications: discharge medications are as follows: 1. calcium chloride 10-meq capsules, two capsules q.12h. 2. lasix 40 mg one tablet b.i.d. 3. colace 100 mg one p.o. b.i.d. 4. aspirin 325 mg one p.o. q.d. 5. lopressor 25 mg three p.o. b.i.d. 6. pantoprazole 40 mg one p.o. q.24h. 7. hydromorphone 2 mg p.o. q.4h. p.r.n. 8. insulin 70/30 units per millimeter suspension. the patient was told to take 32 units subcutaneously once a day, and insulin nph, the patient is told to take 18 units subcutaneous at bedtime. , m.d. procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters (aorto)coronary bypass of one coronary artery open and other replacement of aortic valve with tissue graft endoscopic polypectomy of large intestine esophagogastroduodenoscopy [egd] with closed biopsy transfusion of packed cells insertion of indwelling urinary catheter injection or infusion of nesiritide diagnoses: anemia in chronic kidney disease subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery congestive heart failure, unspecified personal history of malignant neoplasm of prostate aortic valve disorders gastric ulcer, unspecified as acute or chronic, without mention of hemorrhage or perforation, without mention of obstruction benign neoplasm of colon diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled 

Answer: The patient is high likely exposed to