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: aldactone attending: chief complaint: doe major surgical or invasive procedure: redo sternotomy/pvr ( 29 mm aortic mosaic porcine valve)/tv repair (36 mmce mc-3 annuloplasty ring)/mvr (33 mm mosaic porcine valve)/closure vsd/closure pfo picc line trach/open j-tube history of present illness: 56 yo male with congenital heart disease who had a pulmonic valvulotomy in and a vsd repair in . he presented in with pulmonic stenosis and sx of chf. referred for surgery. past medical history: chf congenital heart disease anxiety depression a fib rbbb rle varicosities psh: pulmonic valvulotomy vsd repair right hernia repair appy social history: disabled never used tobacco occasional etoh family history: father had mi at age 55 physical exam: admission 68" 80.4 kg 97.5 108/64 hr 80 rr 20 95% ra sat pale neck supple, full rom, no lymphadenopathy ctab rrr 3/6 sem soft, nt, nd extrems warm, well-perfused, no edema + fems/dp/pt/radials no carotid bruit appreciated discharge vs t 98.2 hr 88 sr bp 139/55 rr 23 o2sat 100% on 50% collar gen nad neuro a&ox3, nonfocal exam pulm scattered rhonchi. trach site cdi cv rrr freq pvc's. sternum stable, incision cdi abdm soft, nt/+bs. peg site cdi. abdm wound w/vac-cdi. wound 1 in diam x 1 in depth ext warm, no edema pertinent results: 10:13pm urine color-yellow appear-clear sp -1.022 10:13pm urine blood-lg nitrite-neg protein-tr glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-8.0 leuk-neg 10:13pm urine rbc-21-50* wbc-0-2 bacteria-rare yeast-none epi-0 07:30pm glucose-148* urea n-30* creat-1.4* sodium-139 potassium-4.3 chloride-99 total co2-32 anion gap-12 07:30pm wbc-3.8* rbc-3.63* hgb-11.7* hct-34.7* mcv-96 mch-32.2* mchc-33.6 rdw-13.7 07:30pm plt count-120* 07:30pm pt-12.8 ptt-40.4* inr(pt)-1.1 01:42am blood wbc-13.5* rbc-2.74* hgb-8.6* hct-26.4* mcv-96 mch-31.5 mchc-32.7 rdw-14.2 plt ct-450* 01:42am blood pt-15.9* ptt-57.5* inr(pt)-1.4* 01:42am blood plt ct-450* 01:42am blood glucose-118* urean-25* creat-0.7 na-143 cl-102 hco3-39* 01:42am blood calcium-8.3* phos-1.6*# mg-2.1 complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 04:34am 11.2* 2.44* 7.1* 23.2* 95 29.0 30.5* 15.9* 389 basic coagulation (pt, ptt, plt, inr) pt ptt plt smr plt ct inr(pt) 04:34am 389 source: line-picc 04:34am 19.8* 31.5 1.8* chemistry renal & glucose glucose urean creat na k cl hco3 angap 04:34am 137* 34* 0.7 138 4.4 98 37* 7 echocardiography report , portable tte (congenital, complete) done at 3:00:05 pm final referring physician information , division of cardiothoracic , status: inpatient dob: age (years): 56 m hgt (in): 66 bp (mm hg): 126/76 wgt (lb): 176 hr (bpm): 76 bsa (m2): 1.90 m2 indication: s/p redo mvr, tvr, pvr, pfo,vsd failure to wean of vent icd-9 codes: 745.4, 745.5, v43.3, 424.0, 424.2 test information date/time: at 15:00 interpret md: , md test type: portable tte (congenital, complete) son: doppler: full doppler and color doppler test location: west sicu/ctic/vicu contrast: none tech quality: adequate tape #: 2008w008-0:20 machine: vivid echocardiographic measurements results measurements normal range left atrium - long axis dimension: *8.4 cm <= 4.0 cm left atrium - four chamber length: *8.7 cm <= 5.2 cm right atrium - four chamber length: *8.1 cm <= 5.0 cm left ventricle - septal wall thickness: *1.4 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.3 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: *5.9 cm <= 5.6 cm left ventricle - systolic dimension: 3.8 cm left ventricle - fractional shortening: 0.36 >= 0.29 left ventricle - ejection fraction: 60% to 70% >= 55% left ventricle - lateral peak e': *0.07 m/s > 0.08 m/s left ventricle - septal peak e': *0.06 m/s > 0.08 m/s left ventricle - ratio e/e': *26 < 15 aorta - sinus level: *4.0 cm <= 3.6 cm aortic valve - peak velocity: 1.2 m/sec <= 2.0 m/sec mitral valve - peak velocity: 1.7 m/sec mitral valve - mean gradient: 8 mm hg mitral valve - e wave: 1.7 m/sec mitral valve - e wave deceleration time: *423 ms 140-250 ms tricuspid valve - peak velocity: 1.0 m/sec tricuspid valve - mean gradient: 2 mm hg tr gradient (+ ra = pasp): *42 to 48 mm hg <= 25 mm hg pulmonic valve - peak velocity: *2.8 m/sec <= 1.5 m/sec pulmonic valve - mean gradient: 17 mm hg findings left atrium: marked la enlargement. right atrium/interatrial septum: markedly dilated ra. left ventricle: mild symmetric lvh. mildly dilated lv cavity. overall normal lvef (>55%). no resting lvot gradient. muscular vsd. right ventricle: normal rv wall thickness. mildly dilated rv cavity. normal rv systolic function. aorta: moderately dilated aortic sinus. aortic valve: mildly thickened aortic valve leaflets (3). no as. mild to moderate (+) ar. mitral valve: bioprosthetic mitral valve prosthesis (mvr). mvr well seated, with normal leaflet/disc motion and transvalvular gradients. tricuspid valve: mildly thickened tricuspid valve leaflets. tricuspid valve annuloplasty ring. normal tricuspid valve supporting structures. mild tr. moderate pa systolic hypertension. pulmonic valve/pulmonary artery: abnormal pvr. normal main pa. pericardium: no pericardial effusion. conclusions the left atrium is markedly dilated. the right atrium is markedly dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is mildly dilated. overall left ventricular systolic function is normal (lvef60-70%). there is a possible muscular ventricular septal defect (vsd). the right ventricular cavity is mildly dilated with normal free wall contractility. the aortic root is moderately dilated at the sinus level. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. mild to moderate (+) aortic regurgitation is seen. a bioprosthetic mitral valve prosthesis is present. the mitral prosthesis appears well seated, with normal leaflet/disc motion and transvalvular gradients. the tricuspid valve leaflets are mildly thickened. a tricuspid valve annuloplasty ring is present. there is moderate pulmonary artery systolic hypertension. the pulmonic prosthesis is abnormal. there is no pericardial effusion. compared with the findings of the prior study (images reviewed) of , the mitral, tricuspid, and pulmonic valves have been repaired/replaced. electronically signed by , md, interpreting physician 15:54 radiology preliminary report chest (portable ap) 7:32 am chest (portable ap) reason: evaluation of effusion medical condition: 56 year old man with s/p pvr mvr mvr reason for this examination: evaluation of effusion chest radiograph indication: followup. comparison: . findings: the tracheostomy tube and the central venous access line right are in unchanged position. unchanged is the severity of the preexisting cardiomegaly with clear enlargement of the main pulmonary artery. the extent of the bilateral pleural effusions and of the perihilar opacities, both suggestive of fluid overload, are also unchanged. no newly appeared parenchymal changes. impression: no relevant changes as compared to . dr. dr. picc line placement indication: 56-year-old man who requires antibiotics. the procedure was explained to the patient. a timeout was performed. radiologist: drs. and performed the procedure. dr. , the attending radiologist, was present and supervised the entire procedure. technique: using sterile technique and local anesthesia, the right brachial vein was punctured under direct ultrasound guidance using a micropuncture set. hard copies of ultrasound images were obtained before and immediately after establishing intravenous access. a peel-away sheath was then placed over a guidewire and a double lumen picc line measuring 45 cm in length was then placed through the peel-away sheath with its tip positioned in the svc under fluoroscopic guidance. position of the catheter was confirmed by a fluoroscopic spot film of the chest. the peel-away sheath and guidewire were then removed. the catheter was secured to the skin, flushed, and a sterile dressing applied. the patient tolerated the procedure well. there were no immediate complications. impression: uncomplicated ultrasound and fluoroscopically guided 5-french double lumen picc line placement via the right brachial venous approach. final internal length is 45 cm, with the tip positioned in svc. the line is ready to use. brief hospital course: admitted after surgery prior week was cancelled due to elev. inr. he was on lovenox prior to this admission. underwent above procedure with dr. on and transferred to the cvicu in fair condition on epinephrine, phenylehrine, and propofol drips. central line removed pod #3.extubated on pod #4, but required re-intubation. bronchoscopy done pod #4 to help evaluate inability to wean from vent. tube feeds started and remained in a fib. heparin continued for a fib/flutter. extubated again on pod #8, but reintubated on pod #9. picc placed by interventional radiology pod #9 also. right thoracentesis done pod #10. trach/open j-tube done by dr. on pod #14. coumadin started and heparin drip restarted after trach/j-tube. coumadin started for anticoagulation. trach mask during day;vent at night for rest. off vent 18 hours on , but then back on for increasd wob. passey-muir valve evaluation and he tolerated wearing the valve for short periods of time. some bleeding noted from abdominal wound on , the wound was opened and vac dressing was placed, and his heparin drip was stopped. the bleeding resolved. he became confused and developed a fever on . he was pan cultured, and started on ceftriaxone for gram neg dipplococci in sputum. completed 10 day course for h. paraflu. he continued to tolerate trach collar during the day. blood culture from grew peptostreptococcus for which he will complete 2 weeks of vanocmycin. video swallow performed again on showed aspiration and recommendations were to remain strictly npo with peg feedings, as well as to possibly obtain a gi consult for upper esophageal sphincter dilation. cleared for discharge to rehab on . he has remained on trach mask for greater than 48 hours. he is day of vancomycin. medications on admission: lasix 80 mg daily spironolactone 25 mg daily captopril 12.5 mg lopressor 12.5 mg coumadin ( held) prozac 20 mg daily klonopin 0.5 mg iron magnesium mvi lovenox (ld am) discharge medications: 1. atorvastatin 20 mg tablet : one (1) tablet po daily (daily). 2. ascorbic acid 500 mg tablet : one (1) tablet po bid (2 times a day). 3. fluoxetine 20 mg capsule : one (1) capsule po daily (daily). 4. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 5. docusate sodium 50 mg/5 ml liquid : one (1) po bid (2 times a day). 6. spironolactone 25 mg tablet : one (1) tablet po daily (daily). 7. miconazole nitrate 2 % powder : one (1) appl topical qid (4 times a day) as needed. 8. aspirin 81 mg tablet, chewable : one (1) tablet, chewable po daily (daily). 9. camphor-menthol 0.5-0.5 % lotion : one (1) appl topical qid (4 times a day) as needed. 10. albuterol sulfate 2.5 mg/3 ml solution for nebulization : one (1) inhalation q6h (every 6 hours). 11. ipratropium bromide 0.02 % solution : one (1) inhalation q6h (every 6 hours). 12. ferrous sulfate 300 mg/5 ml liquid : one (1) po daily (daily). 13. clonazepam 0.5 mg tablet : one (1) tablet po qhs (once a day (at bedtime)). 14. tramadol 50 mg tablet : one (1) tablet po q6h (every 6 hours) as needed. 15. metoprolol tartrate 25 mg tablet : one (1) tablet po bid (2 times a day). 16. nystatin 100,000 unit/ml suspension : ten (10) ml po qid (4 times a day). 17. zolpidem 5 mg tablet : one (1) tablet po hs (at bedtime). 18. furosemide 40 mg tablet : 1.5 tablets po bid (2 times a day). 19. vancomycin in dextrose 1 gram/200 ml piggyback : one (1) intravenous q 12h (every 12 hours) for 7 days: is day . 20. insulin glargine 100 unit/ml solution : twenty (20) units subcutaneous at bedtime. 21. insulin lispro 100 unit/ml solution : per sliding scale subcutaneous four times a day. 22. warfarin 2 mg tablet : two (2) tablet po once for 1 doses: dose. 23. warfarin 1 mg tablet : as directed tablet po once a day: target inr 2-2.5. discharge disposition: extended care facility: - discharge diagnosis: congenital heart disease redo sternotomy/mvr/pvr/tv repair/pfo closure/vsd closure respiratory failure s/p trach/ open j-tube a fib anemia anxiety depression chf prior rbbb discharge condition: good discharge instructions: no lotions, creams or powders on any incision call for fever greater than 100.5, redness or drainage no lifting greater than 10 pounds for 6 weeks bathe daily and pat incisions dry target inr 2.0-2.5 for a fib followup instructions: see dr. in weeks see dr. in weeks see dr. in 4 weeks procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more extracorporeal circulation auxiliary to open heart surgery other enterostomy insertion of endotracheal tube fiber-optic bronchoscopy enteral infusion of concentrated nutritional substances thoracentesis temporary tracheostomy annuloplasty open and other replacement of mitral valve with tissue graft transfusion of packed cells other incision of skin and subcutaneous tissue other immobilization, pressure, and attention to wound open and other replacement of pulmonary valve with tissue graft other and unspecified repair of ventricular septal defect continuous intra-arterial blood gas monitoring diagnoses: pneumonia, organism unspecified other iatrogenic hypotension anemia, unspecified mitral valve disorders urinary tract infection, site not specified congestive heart failure, unspecified atrial fibrillation ventricular septal defect hemorrhage complicating a procedure anxiety state, unspecified bacteremia hyperosmolality and/or hypernatremia stenosis of pulmonary valve, congenital candidiasis of skin and nails other diseases of trachea and bronchus tricuspid valve disorders, specified as nonrheumatic 

Answer: The patient is high likely exposed to