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: atenolol / lisinopril attending: chief complaint: endocarditis major surgical or invasive procedure: - redo sternotomy, aortic valve replacement(21mm st. regent mechanical)/closure of aortic abscess (patch pericardium)/ascending aorta replacement(28mm gelweave graft). history of present illness: 66m w h/o bicuspid aortic valve, s/p mechanical avr (on ) in at . the ascending aorta was noted to be 4.5cm at the time, and was not replaced. he had an episode of enterococcal aortic valve endocarditis in . enterococcal endocarditis was again diagnosed in with concern for aortic valve ring abscess on echo. the patient was evaluated for the source of his enterococcal bacteremia and mild ischemic colitis and several polyps were found. a polypectomy was performed. an egd found mild gastritis and he was started on pantprazole. the patient was discharged on ampicillin and gentamicin on . he was admitted on for preoperative workup and cardiac cath. cardiac cath did not reveal obstructive coronary lesiosn. on admission, the patient exhibited gait instability and neurology was consulted. it was determined that the patient was experiencing vestibulopathy secondary to gentamycin. mri revealed very small microembolic infarcts which were attributed to his time off resulting in subtherapeutic inr, or, less likely, septic emboli. gentamicin was discontinued and the patient was discharged home on ampicillin, which will continue until surgery. id has continued to follow him as an outpatient with weekly blood cultures. the patient returns for heparin bridge preoperatively. past medical history: -mechanical avr -enterococcal faecalis endocarditis diagnosed in , avr ring abscess diagnosed -hypertension -hyperlipidemia -ischemic colitis -colonic polyps -gerd -hiatal hernia -gastritis -diverticulosis social history: lives with wife in , ma. former smoker. rare etoh. family history: non-contributory. physical exam: pulse:80 resp:16 o2 sat:99% b/p right:122/60 left:122/64 height: 5'" weight: 88kg general:wdwn, nad skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur n 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:2 left:2 carotid bruit right:n left:n discharge physical vs: t: 97.4 hr 76 sr bp: 109/67 sats: 97 ra general: 66 year-old male in no apparent distress heent: normocephalic, mucus membranes moist neck: supple no lymphadenopathy cardiac: rrr normal s1,s2 good click resp: clear breath sounds throughout gi: benign extr: warm + edema incision: sternal clean, dry, intact, margins well approximated no erythema iv: left picc site no erythema neuro: awake, alert oriented. pertinent results: echo the left atrium is normal in size. left ventricular wall thicknesses and cavity size are normal. with mild global free wall hypokinesis. a bileaflet aortic valve prosthesis is present. a paravalvular aortic valve leak is probably present. an aortic annular abscess is seen. severe (4+) aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. post bypass s/p avr with 21 mechanical valve prosthesis and graft placement. the patient is now on an epi drip @.04 mcg/kg/min,nor epinephrine @.14 mcg/kg/min the mean gradient across the aortic valve is 16,with a cardiac index of 2.6 the valve is well seated,with no paravalvular leak. the ejection fraction is estimated at 35% wbc-6.5 rbc-3.70* hgb-9.6* hct-28.8* plt ct-121* wbc-11.4* rbc-3.85* hgb-9.9* hct-30.0 plt ct-101* wbc-9.7 rbc-3.78* hgb-9.7* hct-29.4* plt ct-70* wbc-4.7 rbc-4.02* hgb-9.7* hct-30.7* plt ct-159 glucose-92 urean-23* creat-1.1 na-138 k-3.7 cl-100 hco3-29 glucose-116* urean-23* creat-1.2 na-132* k-3.8 cl-97 hco3-26 alt-17 ast-25 ld(ldh)-216 alkphos-88 totbili-0.3 pt-21.4* inr(pt)-2.0* pt-19.7* ptt-29.1 inr(pt)-1.8* pt-16.2* ptt-26.2 inr(pt)-1.4* pt-15.7* ptt-25.3 inr(pt)-1.4* pt-17.2* ptt-27.7 inr(pt)-1.5* pt-15.5* ptt-20.9* inr(pt)-1.4* cxr: : right apical pneumothorax is minimal, unchanged since the prior study. the replaced aortic valve and the entire appearance of the cardiomediastinal silhouette is stable. no interval development of pleural effusion has been demonstrated except for minimal amount of most likely presence left pleural effusion. no evidence of pulmonary edema is seen. picc line: 44 cm picc placed in left berachial vein 1. left picc tip projects over the expected region of the upper/mid svc. 2. removal of et tube and swan-ganz catheter in the interim. 3. improved retrocardiac opacification compared to . 4. bilateral small basilar atelectases. brief hospital course: mr. was admitted to the on for surgical management of his aortic valve endocarditis. heparin was started as a bridge to surgery as he had stopped his five days prior to admission. he was worked-up in the usual preoperative manner. on , he was taken to the operating room where he underwent a redo sternotomy, a mechanical aortic valve replacement, an ascending aorta replacement and closure of an aortic abscess with patch pericardium. please see operative note for details. postoperatively he was taken to the intensive care unit for monitoring. over the next 24 hours, he awoke neurologically intact and was extubated. he continued to make steady progress and was discharged to home on postoperative with infusion for completion of his iv antibiotics. his will managed by dr. as per preoperatively. he will follow-up with dr. , his cardiologist and his primary care physician and infectious disease as an outpatient. medications on admission: 1. ampicillin 2 g iv q4h 2. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day) as needed for constipation. 3. ascorbic acid 500 mg tablet sig: one (1) tablet po daily (daily). 4. multivitamin tablet sig: one (1) tablet po daily (daily). 5. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 6. 2.5 mg tablet sig: as directed for mechcanical avr tablet po once a day: take 5mg on mon, wed, fri, sat, sun and 2.5 mg on tuesday and thursday. last dose discharge medications: 1. ampicillin sodium 2 gram recon soln sig: two (2) gm recon soln injection q4h (every 4 hours) for 2 weeks. disp:*84 2 gm recon soln(s)* refills:*0* 2. heparin, porcine (pf) 10 unit/ml syringe sig: two (2) ml intravenous prn (as needed) as needed for line flush: flush w/10 ml ns then 2 ml heparin. disp:*qs ml(s)* refills:*0* 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 4. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 5. multivitamin tablet sig: one (1) tablet po daily (daily). 6. valsartan 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. furosemide 20 mg tablet sig: one (1) tablet po twice a day for 7 days. disp:*14 tablet(s)* refills:*2* 8. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day. disp:*7 tab sust.rel. particle/crystal(s)* refills:*2* 9. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*2* 10. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain. disp:*60 tablet(s)* refills:*0* 11. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain/fever. 12. warfarin 2.5 mg tablet sig: one (1) tablet po as directed : inr goal 2.0-3.0. 13. ascorbic acid 500 mg tablet sig: one (1) tablet po bid (2 times a day). 14. senna 8.6 mg capsule sig: one (1) capsule po twice a day. discharge disposition: home with service facility: home discharge diagnosis: enterococcal endocarditis ( and ) lower gi bleed hypertension aortic insufficiency s/p avr iron deficiency anemia hypercolesterolemia tachy/brady syndrome gastroesophageal reflux/erosive gastropathy colonic adenomas/ resolving ischemic colitis hiatal hernia diverticulosis discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with incisions: sternal - healing well, no erythema or drainage leg right/left - healing well, no erythema or drainage. edema 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 **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 surgeon: dr. cardiologist: dr. phone: date/time: 8:00 infectious disease: dr. phone: date/time: 11:30 in the building ground floor, , please call to schedule with your primary care physician . labs: pt/inr for for aortic valve replacement. goal inr 2.0-3.0 first draw monday . inr 2.0 please call dr. for further dosing procedure: venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve resection of vessel with replacement, thoracic vessels diagnoses: thrombocytopenia, unspecified esophageal reflux pure hypercholesterolemia unspecified essential hypertension thoracic aneurysm without mention of rupture aortic valve disorders personal history of tobacco use diaphragmatic hernia without mention of obstruction or gangrene iron deficiency anemia, unspecified acute and subacute bacterial endocarditis other encephalopathy streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] diverticulosis of colon (without mention of hemorrhage) personal history of colonic polyps other sedatives and hypnotics causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to