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: patient recorded as having no known allergies to drugs attending: chief complaint: chest and back pain major surgical or invasive procedure: 1. aortic valve sparing root replacement with a 30-mm gelweave valsalva graft with coronary button reimplantation using - technique. 2. replacement of the ascending aorta and hemi-arch using deep hypothermic circulatory arrest and a 30-mm gelweave graft. - cardiac catheterization history of present illness: 24 year old female with 1 month history of intermittent chest and back pain, increasing in frequency over past 2 weeks. presented to pcp who did echo and chest ct on . pcp called patient today telling her that ct scan revealed an aotic dissection and she should go to emergency room. patient was med flighted from osh er to for evaluation. repeat ct scan here showed dilated ascending aorta without extravasation past medical history: para 1 2(twins) s/p tubal ligation social history: pt is from , but has been in ma for the past 2 yrs staying with her mother who is being treated for breast cancer. denies tobacco social etoh and denies illicit substances and no ivda. denies current sexual activity. family history: mother has breast cancer, denies fh of sle or other rheumatologic disease physical exam: vital signs: t 98.1, hr 90-106, sbp < 110 with titration of gtts, rr 19, sat 95% on ra, yesterday had a left bp 110/40 and right arm bp 150/40 gen: well appearing adult in nad, but fatigued and resting in bed. pleasant and cooperative. aox3. neck: supple. no cervical lap. heent: perrla, eomi, mmm, op pink w/o ulcers injection or exudates. chest: cta w/o w/r/r. cor: rrr, s1s2, 2/6 sem that sounds holosystolic. no rub or gallop. abd: s/nd/nt, no hsm. extrem: warm, 2+ radial and pedal pulses, no c/c/e. comprehensive musc skel: ?????? jaw, neck without limited rom. ?????? shoulders, elbows, wrists, hands, fingers: no deformity, erythema, warmth, swelling, effusion, tenderness, limited rom. ?????? lumbosacral spine and hips without limited rom. ?????? knee, ankles, feet, toes: no deformity, erythema, warmth, swelling, effusion, tenderness, limited rom. neuro: good comprehension/cognition. cn 2-12 intact. muscle strength 5/5 in all extremities. skin: mild depigmented areas facial rash that spares the nasolabial folds. no alopecia, nail change, bruising, petechiae, telangiectasia, icterus, tophi, or nodules. pertinent results: ct scan- ascending aortic aneurysm measures 5.5 cm. although not aneurysmal, the descending aorta is also ectatic. there is smooth circumferential wall thickening along the entire length of the aorta as well as the major branches off the aortic arch. given the length of involvement and absence of surrounding stranding, infection is felt to be less likely. differential considerations for medium to large vessel vasculitis favor takayasu's arteritis. other considerations include connective tissue disorders (sle, -danlos disease), sarcoid, behcet's disease no dissection. echo the left atrium is normal in size. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). right ventricular chamber size and free wall motion are normal. the aortic root is markedly dilated at the sinus level. the ascending aorta is markedly dilated the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis. moderate to severe (3+) aortic regurgitation is seen. the aortic regurgitation vena contracta is >0.6cm. the mitral valve leaflets are structurally normal. trivial mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is a trivial/physiologic pericardial effusion. there are no echocardiographic signs of tamponade. compared with the prior study (images reviewed) of , the current study is more complete. the findings of severe dilatation of the aorta from the sinus level to the arch, moderate to severe aortic regurgitation and preserved lv dimensions and systolic function are similar. cardiac catheterization 1. coronary angiography in the right dominant system revealed no evidence of obstructive coronary artery disease. the lmca, lad, and rca were without angiographically apparent disease. the lcx had a 30% stenosis in the origin around a bend. of note, the aortic root was dilated and the rca had an anterior take off. 2. limited resting hemodynamics revealed normal systemic arterial blood pressures in the presence of esmolol and nitroglycerin infusions. mra 1. dilated ascending aorta measuring up to 56.5 mm. the annulus measures 42.7 mm. minimal wall thickening of the thoracic aorta. no dissection or intramural hematoma. mild beading of the descending aorta. bovine arch. three leaflet aortic valve. 2. wall thickening of the abdominal aorta as seen on the ct with enhancement of the infrarenal aorta. brief hospital course: admitted for managment of aorta. a repeat ct scan revealed that there was an aortic aneurysm without dissection. esmolol was started for blood pressure control and she was placed in the cardiac surgical intensive care unit. an echocardiogram was obtained which revealed a trileaflet valve with moderate to severe aortic insufficiency. the rheumatology service was consulted for assistance in her care. multiple labs were sent and an mra was obtained. the mra was consistent with a medium to large vessel vasculitis including takayasu's arteritis. on , she was taken to the operating room where she underwent an aortic valve sparing root replacement as well as an ascending aorta and hemiarch replacement. please see operative note for details. she received vancomycin for perioperative antibiotics. postoperatively she was taken to the cardiac surgical intensive care unit for monitoring. within 24 hours, she awoke neurologically intact and was extubated. on post operative day one she was transferred to the floor for the remainder of her care. her chest tubes and wires were removed per protocol. she was started on betablocker, , and diuretic. physical therapy worked with her on strength and mobility. she continued to progress slowly and was ready for discharge home with services on postoperative day six. medications on admission: none discharge medications: 1. 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:*0* 2. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 3. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 4. lasix 40 mg tablet sig: one (1) tablet po once a day for 7 days. disp:*7 tablet(s)* refills:*0* 5. losartan 25 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 7. ranitidine hcl 150 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 8. ascorbic acid 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 9. metoprolol tartrate 25 mg tablet sig: three (3) tablet po bid (2 times a day). disp:*180 tablet(s)* refills:*0* 10. dilaudid 2 mg tablet sig: one (1) tablet po every four (4) hours as needed for severe pain. disp:*30 tablet(s)* refills:*0* 11. ultram 50 mg tablet sig: one (1) tablet po every six (6) hours as needed for pain. disp:*50 tablet(s)* refills:*0* discharge disposition: home with service facility: all care vna of greater discharge diagnosis: aortic root and ascending aortic aneurysm s/p replacement aortic valve insufficiency hypertension discharge condition: good discharge instructions: 1) monitor wounds for signs of infection. these include redness, drainage or increased pain. report any issues with wounds to your surgeon at ( 2) report any fever greater then 100.5. 3) report any weight gain of 2 pounds in 24 hours or 5 pounds in 1 week. 4) you should wash your incision daily with soap and water. no swimming or bathing for 6 weeks. no lotions, creams or powders to incisions until they have fully healed. 5) no lifting more then 10 pounds for 10 weeks from date of surgery. 6) no driving for one month or while taking narcotics. 7) call with any questions or concerns followup instructions: wound check 6 - - prior to pcp appointment , md phone: date/time: 3:25 , md phone: date/time: 1:20 , md phone: date/time: 10:00 dr at 1:00 pm a () echocardiogram phone: date/time: 11:00 procedure: extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters left heart cardiac catheterization diagnostic ultrasound of heart arterial catheterization resection of vessel with replacement, thoracic vessels diagnoses: anemia, unspecified unspecified essential hypertension thoracic aneurysm without mention of rupture aortic valve disorders takayasu's disease 

Answer: The patient is high likely exposed to