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: no known allergies / adverse drug reactions attending: chief complaint: type a dissection major surgical or invasive procedure: replacement of ascending aorta with 28mm gelweave graft history of present illness: this 31 year old male awoke on with substernal chest pain radiating to his back and then legs with shortness of breath. a cta elsewhere revealed a type a dissection, extending to the renal, without visualization of the right kidney. he was life flighted here after diversion from . past medical history: remote stroke after rodding, no residual left deep vein thrombophlebitis chronic low back pain obstructive sleep apnea sinusitis- completed course antibiotics/prednisone s/p lumbar laminectomies s/p femoral rodding h/o tympanic membrane surgeries social history: 15pk year history (active smoker) heavy etoh until 2years ago disabled from back pain family history: noncontributory physical exam: admission: pulse: 88 resp: o2 sat: b/p right: 116/60 left: height: weight: 95 kg general: skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur 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: dop pt : dop left: dop radial right: 2+ left: 2+ carotid bruit right: no left: pertinent results: echo: pre-cpb:1. the left atrium is normal in size. no atrial septal defect is seen by 2d or color doppler. 2. left ventricular wall thicknesses are normal. the left ventricular cavity is mildly dilated. overall left ventricular systolic function is mildly depressed (lvef= 50 %). 3. right ventricular chamber size and free wall motion are normal. 4. the aortic root is mildly dilated at the sinus level. the ascending aorta is mildly dilated. the descending thoracic aorta is mildly dilated. a mobile density is seen in the ascending aorta consistent with an intimal flap/aortic dissection. the aortic wall is thickened consistent with an intramural hematoma, which extends into the descending aorta. 5. there are three aortic valve leaflets. there is no aortic valve stenosis. mild to moderate (+) aortic regurgitation is seen. mild (1+) mitral regurgitation is seen. 6. there is a small left pleural effusion. 7. there is a trivial/physiologic pericardial effusion. dr. was notified in person of the results. post-cpb: on infusion of phenylephrine. a pacing for slow sinus. repaired ascending aorta with synthetic material seen. no residual dissection flap seen. preserved biventricular systolic function. no ai seen. mr remains 1+. the descending aortic contour is unchanged post decannulation. i certify that i was present for this procedure in compliance with hcfa regulations. kidney u/s: 1. no normal arterial venous waveforms noted within the right kidney with an abnormal-appearing pulsatile flow only seen within the right renal hilum likely representing collateral flow from lumbar vessels. 2. more normal-appearing arterial and venous waveforms within the left kidney. although, this also appears slightly hypoperfused as demonstrated by the lack of significant vascularity extending out into the cortex on the color images. cxr: the heart size is stable. post-sternotomy wires are unremarkable. the aortic contour is still enlarged which might be related to recent surgery and the presence of known dissection. there is no pneumothorax. there is small amount of left pleural effusion but overall the aeration at the lung bases has improved in the interim. 07:20pm blood wbc-13.4* rbc-3.79* hgb-11.0* hct-33.1* mcv-88 mch-29.0 mchc-33.2 rdw-12.9 plt ct-297 01:51am blood wbc-25.1*# rbc-3.44* hgb-10.3* hct-29.8* mcv-87 mch-30.1 mchc-34.7 rdw-13.4 plt ct-238 05:50am blood wbc-14.4* rbc-3.21* hgb-9.4* hct-28.3* mcv-88 mch-29.4 mchc-33.4 rdw-14.2 plt ct-316 07:20pm blood pt-16.3* ptt-27.4 inr(pt)-1.4* 01:51am blood pt-17.7* ptt-28.8 inr(pt)-1.6* 07:20pm blood urean-15 creat-1.5* 04:56am blood glucose-112* urean-15 creat-1.5* na-137 k-4.6 cl-108 hco3-23 angap-11 05:50am blood glucose-94 urean-20 creat-1.5* na-134 k-4.0 cl-100 hco3-26 angap-12 brief hospital course: following admission he was taken in stable condition emergently to the operating room where the ascending aorta was replace. please see operative report for surgical details. he tolerated the procedure well and weaned from bypass on neo-synephrine and propofol and transferred to the cvicu for invasive monitoring in stable condition. he remained stable, weaned from sedation, awoke neurologically intact and extubated with 24 hours. during surgery, the aorta appeared abnormal and aortitis was considered. biopsy was sent from the operating room. rheumatology and infectious disease were consulted for assistance in elucidation of this. blood cultures were sent. he was transferred to the floor on post-op day #2 to begin increasing his activity level. he was gently diuresed toward his preop weight. his pathology report suggested a differential diagnosis that included ehlers-danlos type iv. as such he was referred to see the genetic counselling service at of as an outpatient. as mentioned earlier infectious disease was consulted to evaluate for an infectious cause of his dissection or aortitis but it was felt that there was not evidence for either. he continued to make good progress and by post-operative day five he was ready for discharge to home with vna services, appropriate medications and follow-up appointments. medications on admission: naprosyn prn amoxicillin 500 mg po tid-just completed 10 day course for sinusitis cipro 500 mg po bid for 14 days-just completed 14 day course prednisone taper just completed 5 days ago for sinusitis discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) for 1 months. disp:*60 capsule(s)* refills:*0* 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*1* 3. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*50 tablet(s)* refills:*0* 4. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily) for 2 weeks. disp:*14 tablet(s)* refills:*0* 5. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po bid (2 times a day). disp:*90 tablet(s)* refills:*2* 6. lasix 20 mg tablet sig: one (1) tablet po once a day for 3 days. disp:*3 tablet(s)* refills:*0* 7. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day for 3 days. disp:*3 tab sust.rel. particle/crystal(s)* refills:*0* discharge disposition: home with service facility: vna of southeastern mass. discharge diagnosis: type a aortic dissection s/p replacement of ascending aorta postop uti past medical history: remote stroke chronic low back pain obstructive sleep apnea s/p lumbar laminectomies s/p femoral rodding h/o tympanic membrane surgeries discharge condition: alert and oriented x3, nonfocal ambulating with steady gait incisional pain managed with oral analgesics incisions: sternal - healing well, no erythema or drainage edema: trace discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage 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 and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive 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 **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: you are scheduled for the following appointments: surgeon: dr. () on wednesday at 1:00 ( 2a) *** cardiologist: please ask dr. for a referral to a cardiologist and make appt for 4 weeks dr. office from genetic testing at of will be calling you on monday to arrange an appointment. his office phone is (. please call to schedule appointments with your primary care dr. in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** procedure: extracorporeal circulation auxiliary to open heart surgery resection of vessel with replacement, thoracic vessels diagnoses: urinary tract infection, site not specified other and unspecified alcohol dependence, in remission mitral valve insufficiency and aortic valve insufficiency personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits dissection of aorta, thoracoabdominal arteritis, unspecified cyst of kidney, acquired ehlers-danlos syndrome 

Answer: The patient is high likely exposed to