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: cephalosporins / tetanus / demerol attending: chief complaint: chest pain major surgical or invasive procedure: cardiac cath aortic valve replacement with 21-mm biocor apical tissue valve history of present illness: 76 year old female with history of aortic stenosis followed by serial echocardiograms. she has been doing well until an episode earlier this year where she experienced tenderness in her chest and upper arm area. she underwent an echocardiogram which revealed worsening aortic stenosis with increase velocity and gradients compared to echo done just 4 months prior. she presents today for surgical evaluation. past medical history: aortic stenosis rheumatic fever hypertension hyperlipidemia obesity hypercholesterolemia asthma hypothyroidism c6 radiculopathy colon polyps occular migraines atrial fibrillation/?svt osteoarthritis elevated ferritin levels sleep apnea lichen planus urinary incontinence social history: race:caucasian last dental exam:last year lives with:daughter contact: cell home occupation:retired cigarettes: smoked no yes last cigarette 1963_____ hx:10yr pyhx other tobacco use:none etoh: < 1 drink/week drinks/week >8 drinks/week illicit drug use-none family history: no premature coronary artery disease-none;father died of ruptured aortic aneurysm physical exam: pulse: 48 resp:18 o2 sat: 95% b/p right: 149/78 left: 138/67 height: 5'1" weight: 167 lbs general:nad, obese skin: dry intact heent: perrla eomi anicteric sclera; op unremarkable neck: supple full rom no jvd chest: lungs clear bilaterally heart: rrr irregular murmur holosystolic abdomen: soft non-distended non-tender bowel sounds + no hsm/cva tenderness extremities: warm , well-perfused edema trace ble____ varicosities: none neuro: grossly intact mae strengths; nonfocal exam pulses: femoral right: 1+ left:1+ dp right: 1+ left:1+ pt : np left:np radial right:2+ left:2+ carotid bruit: murmur radiates to b carotids discharge exam: vs: t:98.8 hr: sr bp: 130-140/80 sats: 93% ra wt: 73.2 general: 76 year-old female in no apparent distress heent: normocephalic mucus membranes moist neck: supple no lymphadenopathy card: rrr normal s1,s2 no murmur resp: clear breath sounds throughout gi: benign extr: warm no edema incision: sternal incision clean dry intact neuro: awake,alert oriented, moves all extremities pertinent results: cath: 1. selective coronary angiography of this right dominant system demonstrated no angiographically significant coronary disease. the lmca and rca were patent. the lad had a 30% ostial lesion and the lcx had a 30% ostial lesion. 2. limited resting hemodynamics revealed normotension. . echo: pre-cpb: the left atrium is mildly dilated. no thrombus is seen in the left atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the descending thoracic aorta is mildly dilated. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets are severely thickened/deformed. there is severe aortic valve stenosis (valve area 0.8-1.0cm2). there is mild ai. mild (1+) mitral regurgitation is seen. post-cpb: there is a bioprosthetic valve in the aortic position. the valve is well seated with normally mobile leaflets. there are no paravalvular leaks and there is no ai. the left ventricular systolic function remains normal, ef>55%. there is no evidence of dissection. . cxr: there is a small right pneumothorax. small right pleural effusion is new or newly apparent. right lower lobe atelectasis has increased. there are low lung volumes. post-operative mediastinal widening is unchanged. moderate cardiomegaly is stable. right ij catheter tip is in the upper svc. left lower lobe retrocardiac opacity, a combination of atelectasis and pleural effusion is stable. . wbc-5.7 rbc-3.96* hgb-12.4 hct-34.4* mcv-87 mch-31.2 mchc-35.9* rdw-13.2 plt ct-131* wbc-10.7# rbc-3.67* hgb-11.4* hct-32.3* mcv-88 mch-31.1 mchc-35.3* rdw-13.6 plt ct-137* wbc-13.0* rbc-3.19* hgb-10.0* hct-27.2* mcv-85 mch-31.3 mchc-36.8* rdw-13.5 plt ct-102* wbc-11.7* rbc-3.35* hgb-10.4* hct-29.2* mcv-87 mch-31.0 mchc-35.5* rdw-13.3 plt ct-101* wbc-9.3 rbc-3.90* hgb-12.2 hct-35.0* mcv-90 mch-31.3 mchc-34.8 rdw-13.0 plt ct-202# pt-12.7* inr(pt)-1.2* pt-15.8* ptt-31.9 inr(pt)-1.5* glucose-118* urean-16 creat-0.6 na-139 k-3.5 cl-105 hco3-27 glucose-124* urean-12 creat-0.7 na-137 k-3.9 cl-101 hco3-34* urean-15 creat-0.7 na-135 k-4.1 cl-98 brief hospital course: mrs. underwent a cardiac cath on and following cath she was admitted for surgical work-up. on she was brought to the operating room where she underwent an aortic valve replacement. please see operative note for surgical details. following surgery she was transferred to the cvicu for invasive monitoring in stable condition. within 24 hours she was weaned from sedation, awoke neurologically intact and extubated. beta-blockers and diuretics were initiated and she was diuresed towards her pre-op weight. on post-op day two she was transferred to the step-down floor for further care. chest tubes and epicardial pacing wires were removed per protocol. chest x-ray post chest tube removal revealed small right pneumothorax. on post op day three she was started on antibiotics for a urinary tract infection. she worked with physical therapy for strength and mobility. she made good progress and was discharged to rehab on post-op day for with the appropriate medications and follow-up appointments. medications on admission: asa 81 mg daily multivitamin daily calcitrate /vit. d ( 350 mg/250 units) atenolol 100mg daily simvastatin 40mg daily enalapril 30mg daily levothyroxine 100mcg daily citalopram 20mg daily estradiol 0.01% vaginal cream discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 4. multivitamin tablet sig: one (1) tablet po daily (daily). 5. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 6. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 7. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 8. tramadol 50 mg tablet sig: one (1) tablet po every 4-6 hours as needed for pain. disp:*40 tablet(s)* refills:*0* 9. sulfamethoxazole-trimethoprim 800-160 mg tablet sig: one (1) tablet po bid (2 times a day) for 2 days. 10. atenolol 100 mg tablet sig: one (1) tablet po once a day: start . 11. enalapril maleate 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 12. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain/fever. 13. furosemide 20 mg tablet sig: one (1) tablet po once a day for 5 days. disp:*5 tablet(s)* refills:*0* discharge disposition: home with service facility: discharge diagnosis: aortic stenosis s/p aortic valve replacement past medical history: rheumatic fever hypertension hyperlipidemia obesity hypercholesterolemia asthma hypothyroidism c6 radiculopathy colon polyps occular migraines atrial fibrillation/?svt osteoarthritis elevated ferritin levels sleep apnea lichen planus urinary incontinence 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 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 clinic:phone: date/time: 10:30 in the building surgeon: dr. on phone: date/time: 1:45 in the building cardiologist: dr. please call for a follow-up appointment 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 coronary arteriography using two catheters left heart cardiac catheterization arterial catheterization open and other replacement of aortic valve with tissue graft diagnoses: obstructive sleep apnea (adult)(pediatric) anemia, unspecified urinary tract infection, site not specified unspecified essential hypertension unspecified acquired hypothyroidism atrial fibrillation asthma, unspecified type, unspecified aortic valve disorders personal history of tobacco use other and unspecified hyperlipidemia other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other complications due to other vascular device, implant, and graft osteoarthrosis, unspecified whether generalized or localized, site unspecified obesity, unspecified accidents occurring in residential institution examination of participant in clinical trial urinary incontinence, unspecified other and unspecified escherichia coli [e. coli] variants of migraine, not elsewhere classified, without mention of intractable migraine without mention of status migrainosus body mass index 31.0-31.9, adult 

Answer: The patient is high likely exposed to