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: ace inhibitors / angiotensin recp antg&calcium chanl blkr / lipitor / zetia attending: chief complaint: non-healing chest wound major surgical or invasive procedure: left thoracotomy/removal pacer leads history of present illness: 72 yo male s/p original abdominal pacer placement in for myocarditis. this failed due to infection and hemothorax. subsequently a pacer was placed in the left chest which was complicated and difficult. has had multiple surgeries including 16 generator changes. developed a mass in the left chest which proved to be a retained sponge from a prior surgery. this was removed surgically in along with a new generator change. this incision developed a mrsa infection and did not heal. referred for surgery to remove hardware. past medical history: myocarditis s/p pacemaker chf, most recent echo showing normal lv function. last report shows ef 40-45% cad, s/p prior stenting (lad and om) hypertension hyperlipidemia atrial flutter/fib on coumadin hepatitis c mass on left chest wall - negative needle biospy b renal cysts erectile dysfunction bipolar disorder . arthritis of spine social history: social history is significant for the absence of current tobacco use.smoked pipe for 2 years. there is no history of alcohol abuse. he lives alone in basement apartment in with some local friends, but no family nearby. he has a brother, dr. (urologist) in la who is involved in his life. family history: there is no family history of premature coronary artery disease or sudden death. physical exam: 69", 186# t:98.3, 106/58,p:60, rr:20,100% o2sat on r/a general: a&ox3, nad heent: wnl cvs:irreg.irreg, v-paced lungs:decreased bases abd: benign extr:venous stasis changes, 1+edema left thoracotomy wound vac intact/staples intact pertinent results: conclusions 09:09am blood wbc-4.9 rbc-2.70* hgb-9.0* hct-27.2* mcv-101* mch-33.3* mchc-33.1 rdw-15.8* plt ct-117* 12:53am blood wbc-6.8 rbc-3.21* hgb-10.4* hct-30.5* mcv-95 mch-32.5* mchc-34.1 rdw-14.9 plt ct-103* 09:09am blood pt-23.6* inr(pt)-2.3* 05:50am blood pt-17.6* ptt-36.7* inr(pt)-1.6* 05:01am blood glucose-89 urean-42* creat-1.8* na-135 k-4.0 cl-106 hco3-24 angap-9 12:53am blood glucose-119* urean-23* creat-1.3* na-135 k-3.8 cl-104 hco3-25 angap-10 06:13am blood alt-68* ast-75* ld(ldh)-313* alkphos-90 totbili-1.2 12:53am blood caltibc-295 vitb12-1401* folate-greater th ferritn-207 trf-227 echocardiography report , (complete) done at 1:28:24 pm preliminary referring physician information , c. , status: inpatient dob: age (years): 72 m hgt (in): 69 bp (mm hg): 123/69 wgt (lb): 180 hr (bpm): 60 bsa (m2): 1.98 m2 indication: evaluate for endocarditis, intraoperative management icd-9 codes: 440.0 test information date/time: at 13:28 interpret md: , md test type: tee (complete) son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2008aw2-: machine: echocardiographic measurements results measurements normal range left atrium - long axis dimension: *5.6 cm <= 4.0 cm left atrium - four chamber length: *6.2 cm <= 5.2 cm left atrium - volume: *52 ml < 32 ml left atrium - la volume/bsa: *26 ml/m2 < 22 ml/m2 right atrium - four chamber length: *5.2 cm <= 5.0 cm left ventricle - inferolateral thickness: *1.2 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 5.3 cm <= 5.6 cm left ventricle - systolic dimension: 4.5 cm left ventricle - fractional shortening: *0.15 >= 0.29 left ventricle - ejection fraction: 55% >= 55% aorta - annulus: 2.2 cm <= 3.0 cm aorta - sinus level: 3.2 cm <= 3.6 cm aorta - sinotubular ridge: *3.1 cm <= 3.0 cm aorta - ascending: 3.4 cm <= 3.4 cm aorta - arch: 2.3 cm <= 3.0 cm aorta - descending thoracic: 2.4 cm <= 2.5 cm findings left atrium: moderate la enlargement. right atrium/interatrial septum: mildly dilated ra. a catheter or pacing wire is seen in the ra and extending into the rv. no asd by 2d or color doppler. left ventricle: normal lv wall thickness and cavity size. low normal lvef. right ventricle: normal rv chamber size and free wall motion. aorta: complex (>4mm) atheroma in the ascending aorta. normal aortic arch diameter. complex (>4mm) atheroma in the aortic arch. normal descending aorta diameter. complex (>4mm) atheroma in the descending thoracic aorta. aortic valve: normal aortic valve leaflets (3). mildly thickened aortic valve leaflets. mild to moderate (+) ar. eccentric ar jet. mitral valve: mildly thickened mitral valve leaflets. moderate (2+) mr. tricuspid valve: moderate tr. pulmonic valve/pulmonary artery: physiologic (normal) pr. pericardium: no pericardial effusion. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was under general anesthesia throughout the procedure. no tee related complications. results were conclusions 1. the left atrium is moderately dilated. 2. no atrial septal defect or pfo is seen by 2d or color doppler. 3. left ventricular wall thicknesses and cavity size are normal. overall left ventricular systolic function is low normal (lvef 50-55%). 4. right ventricular chamber size and free wall motion are normal. 5. there are complex (>4mm) atheroma in the ascending aorta, the aortic arch and descending thoracic aorta. 6. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion. the aortic valve leaflets are mildly thickened. mild to moderate (+) aortic regurgitation is seen. the aortic regurgitation jet is eccentric originating from the base of the right and left coronary leaflets. no aortic vegetations seen.. 7. the mitral valve leaflets are mildly thickened. moderate (2+) mitral regurgitation is seen. no mitral vegetations seen. 8. moderate tricuspid regurgitation is seen. no tricuspid vegetations seen. 9. there is no pericardial effusion. 10. a circumflex artery aneurysm is noted 11. dr. was notified in person of the results during the surgery. i certify that i was present for this procedure in compliance with hcfa regulations. interpretation assigned to , md, interpreting physician brief hospital course: the patient is a 71 year old male with a history of multiple revisions of pace-maker, coronary artery disease, chronic systolic congestive heart failure-?acute on chronic systolic chf, and bipolar disorder who presents from for evaluation of non-healing wound and likely pacemaker revision. non-healing wound, pacemaker: patient with first pacer placed cardiomyopathy secondary to myocarditis. this was an abdominal pacemaker and his course was complicated by infection; patient reportedly has a fistula. since that time, he has had multiple revisions, with one hematoma. he reports that he has had continued drainage and bleeding from his chest wall abnormality that is concerning for persistent infection (either abscess, infected new or old wires that are in place) in setting of sinus tract. he has had no fevers, chills, or other features to suggest systemic disease. he had been on levofloxacin for treatment for approximately ten days prior to admission, however he was started on vancomycin upon admission. his wound culture subsequently grew mrsa. an echo was obtained which showed no vegetation. cardiac surgery evaluated the patient for hardware removal and this was done by dr. on . extubated that evening.please refer to operative report for further details. pod #1ep interrogated pacer. mr. had postoperative confusion. narcotics were discontinued. no focal defecit.id following with antibiotic reccommendations->vanco x 14 days, start date ;trough level maintained 15-20. he was restarted on coumadin for chronic afib. inr goal 2.0. transiently postoperative he was placed on tube feeds to improve nutritional intake. speech and swallow was consulted. supervised feedings were instituted. pod#7 mini vac dressing was applied to left thoracotomy leteral wound. staples remain in place, to be discontinued at wound clinic scheduled with dr office at 1 week following discharge to rehab . postoperative delerium continues to improve. on pod#8 mr. continued to progress and he was discharged to rehab. all follow up appointments were advised. medications on admission: asa 81 mg daily calcium plus d 600 mg tid digoxin 0.25 mg daily folic acid 400 mcg daily iron 325 mg daily lasix 40 mg daily levofloxacin lithobid 600 mg hs lopressor 25 mg mvi daily ntg prn warfarin 5 mg daily (ld ) vit. c 500 mg daily vit. e 200 units daily vancomycin ( started at admission) discharge medications: 1. aspirin 81 mg , delayed release (e.c.) sig: one (1) , delayed release (e.c.) po daily (daily). 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. calcium carbonate 500 mg , chewable sig: one (1) , chewable po tid (3 times a day). 4. cholecalciferol (vitamin d3) 400 unit sig: one (1) po daily (daily). 5. folic acid 1 mg sig: one (1) po daily (daily). 6. ferrous sulfate 325 mg (65 mg iron) sig: one (1) po daily (daily). 7. ascorbic acid 500 mg sig: one (1) po bid (2 times a day). 8. multivitamin sig: one (1) po daily (daily). 9. vitamin e 400 unit capsule sig: one (1) capsule po daily (daily). 10. lithium carbonate 300 mg sustained release sig: two (2) sustained release po qhs (once a day (at bedtime)). 11. tramadol 50 mg sig: one (1) po q6h (every 6 hours) as needed. 12. simvastatin 10 mg sig: two (2) po daily (daily). 13. furosemide 40 mg sig: one (1) po daily (daily). 14. ranitidine hcl 150 mg sig: one (1) po daily (daily). 15. metoprolol tartrate 25 mg sig: one (1) po bid (2 times a day). 16. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day). 17. warfarin 1 mg sig: md po once daily at 4 pm. 18. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 19. bisacodyl 5 mg , delayed release (e.c.) sig: two (2) , delayed release (e.c.) po bid (2 times a day) as needed. 20. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po daily (daily). 21. zinc sulfate 220 mg capsule sig: one (1) capsule po bid (2 times a day). 22. vancomycin in dextrose 1 gram/200 ml piggyback sig: one (1) intravenous q 24h (every 24 hours) for 7 days. 23. heparin, porcine (pf) 10 unit/ml syringe sig: one (1) ml intravenous prn (as needed) as needed for line flush. discharge disposition: extended care facility: - discharge diagnosis: pacer lead site infection s/p left thoracotomy/removal of pacer leads hypertension myocarditis/cardiomyopathy congestive heart failure/ef 40-45% a fib/flutter hepatitis c bil. renal cysts coronary artery disease s/p lad and om stents left chest wall hematoma removal of chest wall foreign body/pacer generator change prior pacer ( removed)/subsequent 16 generator changes bipolar disorder erectile dysfunction hyperlipidemia . arthritis of spine discharge condition: good discharge instructions: weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet call for fever greater than 100.5, redness or drainage no driving for at least 2-3 weeks and until off all narcotics shower daily and pat incision dry no lotions, creams or powders on any incision followup instructions: see dr. in weeks see dr. in weeks see dr. at clinic for wound check/staple removal on at 1:30pm.# procedure: venous catheterization, not elsewhere classified enteral infusion of concentrated nutritional substances excisional debridement of wound, infection, or burn removal of lead(s) [electrode] without replacement revision or removal of pacemaker device diagnoses: other primary cardiomyopathies anemia, unspecified coronary atherosclerosis of native coronary artery esophageal reflux congestive heart failure, unspecified unspecified viral hepatitis c without hepatic coma hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation atrial flutter percutaneous transluminal coronary angioplasty status chronic kidney disease, unspecified other and unspecified hyperlipidemia chronic systolic heart failure long-term (current) use of anticoagulants cardiac pacemaker in situ surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation methicillin resistant staphylococcus aureus in conditions classified elsewhere and of unspecified site bipolar disorder, unspecified disruption of external operation (surgical) wound cyst of kidney, acquired persistent postoperative fistula infection and inflammatory reaction due to cardiac device, implant, and graft spondylosis of unspecified site, without mention of myelopathy allergic rhinitis, cause unspecified impotence of organic origin dysphagia, unspecified cough postprocedural fever 

Answer: The patient is high likely exposed to