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 / aspirin / vancomycin attending: chief complaint: prosthetic aortic valve insufficiency, prosthetic valve aortic stenosis major surgical or invasive procedure: re-do sternotomy, bentall procedure with a 23-mm freestyle graft with coronary button reimplantation on history of present illness: the patient is a 60-year-old woman with a history of bicuspid aortic valve who underwent aortic valve replacement with a 19-mm pericardial valve back in by dr. . the patient did well initially but presented with prosthetic valve endocarditis approximately 6 months ago prior to presentation. she was treated with appropriate antibiotic regimen for her prosthetic valve endocarditis but developed acute renal failure secondary to gentamicin toxicity. the patient therefore was felt to need to recover from the gentamicin nephrotoxicity prior to proceeding with re-do aortic valve replacement in the form of a bentall procedure using the freestyle graft. the patient's creatinine returned almost to baseline and she was cleared by renal to proceed with re-do surgery. past medical history: s/p avr for bicuspid aortic valve hypertension hypercholesterolemia s/p partial hysterectomy anxiety/depression arthritis spine/hip osteoporosis hx of gi bleed allergies: codeine->hives "asa"->upset stomach penicillin causes itch. social history: lives alone in , no children, no local family. had hx psa, including etoh, cocaine, tobacco. quit smoking with chantix 11 mo ago. no etoh or cocaine x 2 years. retired. family history: family history non-contributory. physical exam: pulse:84 resp:16 o2 sat: 100% ra b/p right:147/85 left: height: weight: general:aao x 3 in nad skin: dry intact well healed sternal incision heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur iv/vi sem abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema varicosities: none neuro: grossly intact pulses: femoral right:2+ left:2+ dp right:2+ left:2+ pt :2+ left:2+ radial right: left: carotid bruit right: left: transmitted murmur pertinent results: echocardiography report at 11:57:39 am findings left atrium: no spontaneous echo contrast or thrombus in the la/laa or the ra/raa. good (>20 cm/s) laa ejection velocity. all four pulmonary veins identified and enter the left atrium. right atrium/interatrial septum: a catheter or pacing wire is seen in the ra and extending into the rv. no asd by 2d or color doppler. left ventricle: wall thickness and cavity dimensions were obtained from 2d images. normal lv wall thickness, cavity size, and global systolic function (lvef>55%). right ventricle: normal rv chamber size and free wall motion. aorta: focal calcifications in aortic root. mildly dilated ascending aorta. simple atheroma in aortic arch. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: bioprosthetic aortic valve prosthesis (avr). thickened avr leaflets. increased avr gradient. no masses or vegetations on aortic valve. severe as (area 0.8-1.0cm2). severe (4+) ar. mitral valve: mildly thickened mitral valve leaflets. mild mitral annular calcification. no ms. trivial mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: pulmonic valve not well seen. conclusions pre bypass 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. left ventricular wall thickness, cavity size, and global systolic function are normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the ascending aorta is mildly dilated. there are simple atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta. a bioprosthetic aortic valve prosthesis is present. the valve apperas well seated. the prosthetic aortic valve leaflets are thickened. the transaortic gradient is higher than expected for this type of prosthesis. no masses or vegetations are seen on the aortic valve. there is severe aortic valve stenosis (valve area 0.8-1.0cm2). severe (4+) aortic regurgitation is seen. the regurgitation appears valvular. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. post bypass the patient is being a paced. there is normal biventricular systolic function. there is a stentless bioprosthetic aortic valve and ascending aortic xenograft in situ. very trace valvular regurgitation is visible. the maximum gradient through the valve is about 23 mm hg with a mean of 14 mmhg at a cardiac output of 3.7 liters per minute. the effective orifice area of the valve is 1.7 cm2. the thoracic aorta appears intact. the rest of the exam is unchanged from the pre bypass study. 03:15pm urea n-26* creat-1.3* chloride-115* total co2-22 03:33pm glucose-95 na+-138 k+-4.4 03:15pm wbc-16.5* rbc-3.55* hgb-10.5* hct-31.8* mcv-90 mch-29.7 mchc-33.2 rdw-13.4 03:15pm plt count-165 03:15pm pt-14.7* ptt-34.8 inr(pt)-1.3* 02:17pm fibrinoge-160 04:26am blood wbc-11.4* rbc-2.98* hgb-8.9* hct-26.5* mcv-89 mch-29.8 mchc-33.4 rdw-14.1 plt ct-178 04:26am blood plt ct-178 03:15pm blood pt-14.7* ptt-34.8 inr(pt)-1.3* 04:26am blood glucose-100 urean-24* creat-1.2* na-141 k-3.7 cl-103 hco3-33* angap-9 chest (portable ap) clip # eval for ptx wet read: jmgw sat 1:49 pm no ptx post removal of chest tubes. right ij out. stable retrocardiac atlectesis. final report portable chest, clinical information: chest pa portal. findings: comparison is made to the prior study from . multiple chest tubes and drains have been removed. right picc remains. right ij catheter has been removed. no pneumothorax identified. there is persistent mild atelectasis at the left lung base. there is a small left pleural effusion. heart is mildly enlarged. there is patchy airspace opacity in the right mid lung zone as well. the study and the report were reviewed by the staff radiologist. dr. dr. approved: 8:25 am brief hospital course: this a 60-year-old woman with a history of bicuspid aortic valve who underwent aortic valve replacement with a 19-mm pericardial valve in . the patient did well initially but presented with prosthetic valve endocarditis approximately 6 months ago. she was treated with appropriate antibiotic regimen for her prosthetic valve endocarditis but developed acute renal failure secondary to gentamicin toxicity. she recovered from the gentamicin nephrotoxicity prior to proceeding with re-do aortic valve replacement with a creatinine of 1.6 at the time of surgery. she was seen by the renal team and cleared preoperatively. she presented as a same day admission on and underwent a re-do sternotomy and bentall procedure with a 23-mm freestyle graft with coronary button reimplantation. see operative note for full details. she was transferred to the intensive care unit in stable condition. she was started on dexmedetomidine post operatively and extubated on post operative morning. she did have an episode of rapid atrial fibrillation on postoperative night and converted to sinus rhythm in the 70's. she stayed in sinus rhythm for the remainder of her hospital course on po lopressor and amiodarone. chest tubes and pacing wires were removed per cardiac surgery protocol. she was transferred to the sdu in stable condition. once on the floor, she continued to work with physical therapy for increased strength and endurance. she initially had no gag on postoperative day 1 but was tolerating a full po diet at the time of discharge with no signs of aspiration. she was given plavix instead of aspirin due to an aspirin allergy. it was felt that she was safe for transfer to rehab on post operative day 4. medications on admission: chlorzoxazone 500 mg po tid prn:muscle pain crestor lamotrigine 50mg po daily lorazepam 0.5mg po qhs prn:insomnia olmesartan 20mg po daily raloxifene 60 mg po daily sertraline 150mg po daily allergies: codeine - hives, aspirin - rash; vancomycin- ? rash discharge medications: 1. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 3. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. sertraline 100 mg tablet sig: 1.5 tablets po once a day. disp:*45 tablet(s)* refills:*2* 5. lamotrigine 25 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 6. rosuvastatin 5 mg tablet sig: two (2) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. tramadol 50 mg tablet sig: one (1) tablet po every 4-6 hours as needed for pain. disp:*50 tablet(s)* refills:*0* 8. potassium chloride 10 meq tablet sustained release sig: two (2) tablet sustained release po once a day for 2 weeks. disp:*28 tablet sustained release(s)* refills:*0* 9. amiodarone 200 mg tablet sig: two (2) tablet po daily (daily): 400mg qd x 7days then 200mg qd. disp:*40 tablet(s)* refills:*2* 10. furosemide 20 mg tablet sig: one (1) tablet po once a day for 2 weeks. disp:*14 tablet(s)* refills:*0* 11. raloxifene 60 mg tablet sig: one (1) tablet po once a day: resume preop schedule. discharge disposition: extended care facility: of discharge diagnosis: prosthetic valve endocarditis, prosthetic aortic valve insufficiency, prosthetic valve aortic stenosis-status post aortic valve replacement pmhx: biscuspid aortic valve, aortic stenosis, hypertension, depression, peptic ulcer disease, chronic bilat ankle pain, uterine fibroids, s/p bioprosthetic aortic valve replacement , s/p partial hysteretomy discharge condition: alert and oriented x3 nonfocal ambulating, gait steady sternal pain managed with percocet prn sternal wound-clean and dry healing well, no erythema discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions please no lotions, cream, powder, or ointments to incisions each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart no driving for approximately one month until follow up with surgeon no lifting more than 10 pounds for 10 weeks please call with any questions or concerns females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge followup instructions: surgeon dr. in 4 weeks at 1:15 pm please call to schedule appointments primary care dr. in weeks cardiologist dr in weeks wound check appointment - 6 () - your nurse will schedule before discharge procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft resection of vessel with replacement, thoracic vessels other repair of vessel heart revascularization by arterial implant diagnoses: pure hypercholesterolemia unspecified essential hypertension atrial fibrillation personal history of tobacco use accidental puncture or laceration during a procedure, not elsewhere classified dysthymic disorder osteoporosis, unspecified accidents occurring in residential institution infection and inflammatory reaction due to cardiac device, implant, and graft accidental cut, puncture, perforation or hemorrhage during surgical operation arthropathy, unspecified, multiple sites 

Answer: The patient is high likely exposed to