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: mrs. is a 74-year-old woman, with a several month history of shortness of breath leading to an echo which showed aortic stenosis as well as mitral regurgitation and tricuspid regurgitation. a cardiac cath done in showed minimal coronary artery disease. she had been admitted twice to the cardiothoracic service before, but was sent home for a yeast infection under her breast and an infection of the left forearm. she presented again on the day of admission, one day prior to her surgery for physical evaluation. past medical history: significant for rheumatic heart disease, obesity, aortic stenosis, mitral regurgitation, osteoarthritis, cataracts, atrial fibrillation, congestive heart failure, neuropathy, and rheumatoid arthritis. past surgical history: significant for tonsillectomy and hernia repair. she has no known drug allergies. meds at home: lasix 40 every day, diltiazem 30 q.i.d., potassium chloride 40 every day, coumadin 4 every day, and protonix 40 every day. social history: lives in with her son, still lives independently, remote tobacco history and rare alcohol use. family history: no significant history of cad. physical exam: weight 103.9 kg, temperature 95.6, heart rate 64 sinus rhythm, blood pressure 135/56, respiratory rate 18, o2 sat 97 percent on room air. in general no acute distress. neurological alert and oriented x3, nonfocal exam. cardiac showed regular rate and rhythm. respiratory was clear to auscultation bilaterally. abdomen was soft, nontender, nondistended with no hepatosplenomegaly. extremities warm and well perfused with bilateral lower extremity edema. laboratory data: pt 17.1, inr 1.9, sodium 142, potassium 4.1, chloride 106, co2 27, bun 26, creatinine 1.0, glucose 123, white count 9.2, hematocrit 39.2, platelets 301,000. chest x-ray showed mild cardiomegaly with no chf, consolidations or effusions. the patient was begun on a heparin infusion. she was typed and screened and was prepared for the operating room. due to her elevated inr the patient received subcutaneous vitamin k. on the patient was brought to the operating room. please see the or report for full details. in summary she underwent an avr, mvr and modified mays. avr was with a number 23 valve. the mvr was a number 25 valve. her bypass time was 196 minutes with a crossclamp time of 165 minutes. she tolerated the operation well and was transferred from the operating room to the cardiothoracic intensive care unit. at the time of transfer the patient was in sinus rhythm at 92 beats per minute, with a mean arterial pressure of 85 and a cvp of 18. she had epinephrine at 0.01 mcg per kilogram per minute, propofol at 40 mcg per kilogram per minute, and nipride at 0.2 mcg per kilogram per minute. the patient did well in the immediate postoperative period. propofol was discontinued. her anesthesia was reversed, however, she was slow to fully awaken from her anesthesia and she remained intubated throughout the day of her surgery. on postoperative day one the patient remained hemodynamically stable, requiring a nipride infusion to maintain blood pressure control. she was weaned from the ventilator and successfully extubated. by the end of the day the patient was begun on oral agents. her nipride infusion was discontinued. on postoperative day two she remained hemodynamically stable. she was begun on beta blockade as well as diuresis. her coumadin was restarted. swan ganz catheter was removed as were her chest tubes, however, the patient went back into atrial fibrillation and it was, therefore, decided to keep her in the intensive care unit for closer hemodynamic monitoring. on postoperative day three the patient continued to do well. the electrophysiology service was consulted regarding her atrial fibrillation following mays. she was begun on an amiodarone infusion and again she remained in the intensive care unit. she remained hemodynamically stable on postoperative day four. finally on postoperative day five the patient's temporary pacing wires were removed and she was transferred to the floor for continuing postoperative care and cardiac rehabilitation. once on the floor the patient was slowly progressing in her activity level. screening was begun for potential transfer to rehabilitation. on postoperative day seven the patient began to complain of increasing nausea as well as diarrhea. stools were sent at that time for c. diff and she was begun on empiric flagyl. the following morning the patient had a white count of 34,000. she was pan cultured and had abdominal films done at that time. general surgery was consulted. the general surgery service felt the patient had a toxic megacolon. she was brought to the operating room where she underwent a partial colectomy with ileostomy and as well as a cholecystectomy, following which the patient was transferred back to the cardiothoracic intensive care unit. throughout the remainder of the hospital course she was followed by both the hepatobiliary pancreatic surgery service as well as the cardiothoracic surgical service. she spent four days in the intensive care unit following her abdominal surgery, and was then transferred to the floor for continuing postoperative care. over the next week the patient was gradually transitioned from tpn to a p.o. diet. activity level was increased with the assistance of the nursing staff as well as physical therapy staff. her antibiotic coverage was tailored and on postoperative day 20 from her cardiac surgery, 11 from her abdominal surgery, it was decided the patient was stable and ready to be discharged to rehabilitation. at the time of this dictation the patient's physical exam is as follows: temperature 97.3, heart rate 66 atrial fibrillation, blood pressure 136/74, respiratory rate 20, o2 saturation 97 percent on room. laboratory data on showed pt 23.7, inr 3.5. medications on discharge: 1. amiodarone 200 mg b.i.d. 2. flagyl 500 mg t.i.d. 3. regular insulin sliding scale. 4. naprosyn 500 mg b.i.d. p.r.n. 5. percocet 5/325 one to two tablets q. six hours p.r.n. 6. prilosec 40 mg every day. 7. warfarin to maintain a target inr 2 to 2.5. physical exam shows in general she is in no acute distress. neurologically alert, oriented x3. moves all extremities. follows commands. nonfocal exam. pulmonary is clear to auscultation bilaterally. cardiac shows irregular rate and rhythm. sternum is stable. incision has steri-strips without erythema or drainage. abdomen is soft, nontender, with positive bowel sounds and ileostomy site with dark fluid drainage. abdominal incision with staples and minimal erythema at the staple line. no drainage. extremities are warm with trace edema. patient is to be discharged to rehabilitation. condition at time of discharge: good. discharge diagnoses.: 1. status post aortic valve replacement with number 23 tissue valve. 2. status post mitral valve replacement with number 25 tissue valve. 3. status post modified mays. 4. clostridium difficile colitis requiring partial colectomy with ileostomy as well as a cholecystectomy. 5. rheumatic heart disease. 6. obesity. 7. osteoarthritis. 8. cataracts. 9. atrial fibrillation. 10. congestive heart failure. 11. neuropathy. th is to have follow-up with dr. in his office in two weeks. the patient is to call the office to schedule an appointment and follow-up with dr. in four to six weeks. patient is also to call his office to schedule the appointment. discharge medications: 1. ketoconazole powder topically under the breast as needed. 2. amiodarone 200 mg b.i.d. times one week then 200 mg every day times two months. 3. percocet 5/325 one to two tablets q. four to six hours p.r.n. 4. prilosec 40 mg every day. 5. naprosyn 500 mg q.12 hours p.r.n. 6. flagyl 500 mg t.i.d. times two days. the patient's flagyl is to be discontinued on . 7. warfarin to maintain a target inr 2 to 2.5. the patient had been on 4 mg coumadin every day prior to admission. she has received 1 mg on the day prior to discharge, 5 mg two days prior to discharge, and 7.5 mg for the three days prior to that. , m.d. procedure: extracorporeal circulation auxiliary to open heart surgery parenteral infusion of concentrated nutritional substances diagnostic ultrasound of heart other electric countershock of heart temporary ileostomy excision or destruction of other lesion or tissue of heart, open approach cholecystectomy open and other replacement of aortic valve with tissue graft open and other replacement of mitral valve with tissue graft transfusion of packed cells transfusion of other serum infusion of vasopressor agent diagnoses: severe sepsis atrial fibrillation rheumatic heart failure (congestive) intestinal infection due to clostridium difficile long-term (current) use of anticoagulants mitral valve insufficiency and aortic valve stenosis rheumatoid arthritis obesity, unspecified septicemia due to anaerobes acute vascular insufficiency of intestine acute cholecystitis unspecified hereditary and idiopathic peripheral neuropathy other specified visual disturbances 

Answer: The patient is high likely exposed to