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: mr. was in his usual state of health until the beginning of , when his primary care physician on physical examination heard a loud systolic murmur on a routine clinic visit. the patient reported at the time that he had been noticing increasing dyspnea on exertion in the months prior to admission to the hospital, which he had attributed to his chronic anemia and persistent diarrhea which also had been worse over some time. during the week prior to admission, he had also noticed some worsening edema in his ankles. the patient at the time had been having frequent dental work, and mentioned that he often forgot to take prophylactic antibiotics secondary to his mitral valve regurgitation. he denied any history of intravenous drug use. he also denied any lightheadedness or paroxysmal nocturnal dyspnea, but he did have orthopnea with three to four pillows. past medical history: 1. psoriasis; 2. iga deficiency for which the patient receives monthly transfusions of intravenous immunoglobulin; 3. bronchiectasis; 4. crohn's disease for which the patient is on chronic prednisone; 5. severe osteoporosis; 6. history of malignant polyp; 7. esophageal stricture, status post dilatation in , status post small bowel resection in ; 8. mitral valve prolapse; 9. hypothyroidism; 10. chronic anemia; 11. duodenitis; 12. gastroesophageal reflux disease; 13. emphysema; 14. prostate cancer in situ; 15. tobacco and alcohol abuse. medications on admission: prednisone 10 mg q. day; levothyroxine 50 mcg q. day; combivent 2 puffs twice per day; ativan 0.5 mg prn; lisinopril 2.5 mg q. day allergies: penicillin social history: the patient lives alone in and has a strong history of alcohol and tobacco use, stating that he had smoked two packs per day for 28 years. he works as a certified public accountant. physical examination: on initial physical examination the patient's height was 5 feet 6 inches, weight 135 lb, heartrate 82 in sinus rhythm, and the blood pressure was 120/64 with a room air oxygen saturation of 96%. the patient was a pleasant, elderly male in no acute distress. his neck was supple with no lymphadenopathy, no jugulovenous distension and no carotid bruits. his cardiac examination showed a regular rate and rhythm with normal s1 and s2, and a loud holosystolic murmur. his lungs were clear to auscultation bilaterally. his abdomen was soft, nontender, nondistended with no hepatosplenomegaly or other palpable masses. his extremities were warm and dry with peripheral edema, especially around the ankles. he had 2+ palpable dorsalis pedis pulses bilaterally. hospital course: the patient was admitted to the operating room on where he underwent a minimally invasive mitral valve repair with quadrangular resection of the posterior leaflet and 28 mm ring. please refer the dictated operative note for full details of this procedure. the patient was subsequently transferred to the cardiac surgical intensive care unit in good condition, and weaning from the ventilator was begun. the patient was subsequently extubated later that evening after having shown a good arterial blood gas. he tolerated the extubation well with no difficulty. he was at this time requiring a neosynephrine drip in order to maintain adequate blood pressure. an insulin drip was also started at this time to help control his blood sugar. on postoperative day #1 he continued to be on insulin and neosynephrine drips, with sinus rhythm at 77 beats/minute. he was tolerating extubation well, and was in no acute distress. on postoperative day #2 he was weaned off of the neosynephrine and insulin drips but did demonstrate a decrease in urine output for which he was given lasix with good response. the patient was able to maintain his blood pressure without pressors, and by postoperative day #2, it was deemed that the patient was stable and doing well enough fro transfer to the floor. his chest tube had been left in place on transfer from the intensive care unit, and the patient had an air leak from his chest tube as well as some subcutaneous emphysema on the right side. the chest tubes were subsequently removed on postoperative day #3 without incidents once the air leak was gone. the patient also was set up for and received his intravenous immunoglobulin infusion on postoperative day #3 which he tolerated well. he did well with incentive spirometry and pulmonary toilet and was ambulating without much difficulty at that time. later on postoperative day #3, he was seen by physical therapy and evaluated, and later deemed safe to be discharged home. the patient continued to do quite well, and on postoperative day #4 he was deemed stable and ready for discharge home. physical examination on discharge: the patient's temperature was 97.8 degrees f. his heartrate was 80 in sinus rhythm and a blood pressure of 90s/50s and a room air oxygen saturation of 91 to 93%. he was showing a good urine output and having a good diuresis. he was in no acute distress. his cardiac examination showed regular rate and rhythm with no murmurs. lungs were clear to auscultation bilaterally. his abdomen was soft, nontender and nondistended with no hepatosplenomegaly or other palpable masses. his subcutaneous emphysema had decreased to the point of being nearly negligible. his incisions were healing nicely with no erythema or drainage. medications on discharge: 1. enteric coated aspirin 325 mg q. day 2. lopressor 12.5 mg b.i.d. 3. prednisone 10 mg q. day 4. zantac 150 mg b.i.d. 5. levothyroxine 50 mcg p.o. q. day 6. percocet 1 to 2 tablets every 4-6 hours as needed for pain 7. multivitamins one caplet q. day 8. thiamine 100 mg p.o. q. day 9. folic acid 1 mg p.o. q. day 10. lasix 20 mg b.i.d. for seven days 11. potassium chloride 20 meq p.o. b.i.d. times seven days condition on discharge: the patient was stable. discharge instructions: activity was as tolerated. diet was a cardiac heart healthy diet. discharge diagnosis: 1. severe mitral regurgitation status post mitral valve repair with ring of 28 mm 2. psoriasis 3. iga deficiency 4. bronchiectasis 5. crohn's disease 6. osteoporosis 7. esophageal stricture 8. hypothyroidism 9. anemia 10. duodenitis 11. gastroesophageal reflux disease 12. emphysema 13. prostate cancer 14. alcohol abuse 15. cigarette abuse follow up: the patient was instructed to follow up with his cardiologist in approximately one or two weeks time and with dr. in approximately three to four weeks time. dictated by: medquist36 procedure: open heart valvuloplasty of mitral valve without replacement diagnoses: coronary atherosclerosis of native coronary artery mitral valve disorders unspecified acquired hypothyroidism chronic airway obstruction, not elsewhere classified regional enteritis of unspecified site 

Answer: The patient is high likely exposed to