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: this is a 63-year-old female patient with a history of atrial fibrillation, hypertension, diabetes mellitus, severe mitral regurgitation, significant history of asthma with two recent hospital admissions to for asthmatic exacerbation. she was also admitted to through with severe mitral regurgitation and rapid atrial fibrillation. heart catheterization was performed on , which revealed left ventricular ejection fraction of 68%, single-vessel coronary artery disease, questionable degree of mitral regurgitation, and moderate pulmonary hypertension. the patient subsequently had a retroperitoneal hematoma requiring blood transfusion after cardiac catheterization. the patient also had some prerenal azotemia which resolved during that hospitalization. the patient was subsequently discharged home with a plan to be readmitted early in for mitral valve replacement with dr. . on the day of admission, , however, the patient was admitted with chest pain and palpitations which was of fairly significant onset. the patient had been on amiodarone at that time. when ems responded, she was found to have a heart rate in the 130s, blood pressure 220 systolic. she was given aspirin and nitroglycerin with relief of her symptoms. she was also treated with intravenous lopressor at that time. the patient was admitted to the medicine service. past medical history: type ii diabetes mellitus, atrial fibrillation, hypertension, chronic renal insufficiency with a baseline creatinine of 1.5-2.0, granulomatous hepatitis, reactive airway disease with significant history of asthma, 3+ mitral regurgitation, moderate pulmonary hypertension, status post 6 u blood transfusion for a retroperitoneal bleed/hematoma status post cardiac catheterization, prerenal azotemia, hematuria, partial small bowel ileus, history of monoclonal gammopathy, status post total abdominal hysterectomy for fibroids, history of hypercholesterolemia. medications on admission: amiodarone 400 mg p.o. q.d., diltiazem sr 180 mg p.o. b.i.d., univasc 30 mg p.o. q.d., hydrochlorothiazide 25 mg p.o. q.d., premarin 0.625 mg p.o. q.d., glyburide 10 mg p.o. b.i.d., avandia 2 mg p.o. q.d., lipitor 10 mg p.o. q.d., colace b.i.d., coumadin 2.5 mg p.o. q.d., asthmacort metered dose inhaler, albuterol metered dose inhaler, prednisone 10 mg p.o. q.d. physical examination: general: on admission, exam revealed the patient to be in no acute distress. neck: supple. no jugular venous distention. heent: unremarkable. lungs: clear to auscultation bilaterally. cardiovascular: irregularly, irregular rhythm with a grade 2/6 systolic murmur. abdomen: soft, nontender, nondistended. positive bowel sounds. extremities: without edema. there were 2+ palpable dorsalis pedis pulses bilaterally. neurological: alert and oriented times three. nonfocal exam. laboratory data: on admission white blood cell count was 21.9; potassium 3.9, creatinine 1.5; the rest of the admission laboratories were unremarkable; her inr upon admission was 3.0, and she was on coumadin. hospital course: the patient was admitted to the medicine service. her heparin was discontinued with the anticipation of her needing to go to the operating room for her cardiac surgery, and she was placed on intravenous heparin drip. an endocrinology consult was obtained on the day of admission. it was their impression that the patient had thyrotoxicosis, although mild. it was their recommendation to rate control the patient with beta-blocker as needed and to discontinue the amiodarone. the amiodarone was subsequently discontinued on . on , the patient was taken to the operating room by dr. where she underwent a mitral valve replacement with a st. mechanical mitral valve, #29 mm, as well as left-sided maze procedure. she also had removal of left atrial appendage. postoperatively she was transported from the operating room to the cardiac surgery recovery unit on epinephrine drip. she was also on levophed. both the epinephrine and levophed were weaned off readily. she remained on insulin drip and some nitroglycerin, as well as some propofol for sedation, and low-dose dopamine drip for labile blood pressure. on postoperative day #1, the patient was seen by the renal medicine service for increasing creatinine. it was their recommendation to let the patient stay with a higher blood pressure for better renal profusion and to follow the patient's potassium closely. the patient was weaned from the mechanical ventilator and extubated on postoperative day #1. on postoperative day #2, the patient remained in the intensive care unit requiring insulin drip still for blood sugar which was not adequately controlled. she remained on low-dose dopamine as well. amiodarone was resumed on postoperative day #2 due to continued problems with atrial fibrillation. on postoperative day #3, the patient was weaned off all vasoactive drips, and he remained hemodynamically stable and was transferred out of the intensive care unit to the telemetry floor. cardiology electrophysiology service had been following the patient, and they recommended to discontinue the amiodarone due to her preoperative problems with thyrotoxicosis. the patient had some intermittent problems with nausea over the next couple of days. the patient required pulmonary toilet and bronchodilators, however, remained essentially stable. the patient had some difficulties with rapid atrial tachycardiac arrhythmias, and the electrophysiology service thought that she may at some point require an ab nodal ablation with permanent pacemaker placement, and coumadin was discontinued on for that reason. over the next 24-48 hours, from to , the patient had continuing problems with worsening shortness of breath. on , 6 p.m., the patient was transferred back to the intensive care unit due to worsening shortness of breath. she had bibasilar crackles, some hypertension to 150s to 170s systolic. the patient had been on a non-rebreather mask at that point. her respiratory rate was in the 30s. over the course of the next three days in the intensive care unit, she had been started on broad-spectrum antibiotics and aggressively worked with diuresis and pulmonary toilet; however, on the morning of , the patient required reintubation for increasing shortness of breath and fatigue, at which point she was sedated to tolerate mechanical ventilation. subsequent sputum gram stain grew out gram-negative rods; however, the culture was consistent with oropharyngeal flora and budding yeast and no definitive organisms. a pulmonary medicine consultation was obtained on . it was their thought that the patient may have been experiencing postpericardiotomy syndrome with questionable exacerbation of her reactive airway disease. for this reason, it was their recommendation to increase her steroids. she had been on her baseline of prednisone 10 mg per day at this time. the patient also upon admission to the intensive care unit had a significant pleural effusion drained of approximately 700 cc. on , the patient had significantly improved from a respiratory standpoint after being on stress dose steroids for about 48 hours, and she was extubated on , and significant improvement in her pulmonary status was evident at that time. the patient continued to do well hemodynamically. she was begun on oral medication and nutrition which she tolerated well. on , the patient was transferred out of the intensive care unit to the telemetry floor once again. over the next few days, she had been restarted on her coumadin. her inr had increased nicely to the 2.1 to 2.5 range. she remained hemodynamically stable. she began to progress with some ambulation, however was still extremely unsteady with her gait and unable to ambulate independently. the renal medicine service signed off on her care since this was no longer an active issue. the patient remained hemodynamically stable and was ready to be discharged to her rehabilitation facility today, , postoperative day #19. condition on discharge: temperature 99.1??????, pulse 104, in atrial fibrillation, respiratory rate 20, blood pressure 145/68, room air oxygen saturation 93%, discharge weight 56 kg, which is actually somewhat below her preoperative weight of 58.2. most recent laboratory values include a prothrombin time of 17.4, with an inr of 2.1, sodium 137, potassium 3.9, chloride 93, co2 38, bun 31, creatinine 1.6, fasting glucose 68; white blood cell count 15.8, which is stable, hematocrit 29.1, platelet count 293,000. physical exam revealed the patient to be neurologically alert with no apparent deficit. coronary exam is irregular, rate, and rhythm. no murmurs or rubs noted. positive valve click audible. the patient's lungs are essentially clear to auscultation bilaterally with the exception of minimal fine bibasilar crackles. her abdomen is somewhat distended, although it is soft with positive bowel sounds. the patient stated that she had a bowel movement today. she has had intermittent episodes of complaints of nausea. her sternum is stable. her steri-strips are clean, dry, and intact over her incision. her extremities are warm and well perfused with palpable pulses bilaterally. there is some superficial skin breakdown in the sacral area which is reddened and healing over. discharge medications: coumadin 4 mg on and , the patient is to have a prothrombin time checked at that point in time to determine ongoing doses, her target inr should be 3.0-3.5 to anticoagulate her for mechanical mitral valve, catapres tts patch 0.1 mg transdermaly q.week, lipitor 10 mg p.o. q.h.s., levofloxacin 250 mg p.o. q.d. x 5 more days to complete a course for presumed tracheal bronchitis, peri-colace 1 p.o. b.i.d., protonix 40 mg p.o. q.d., enteric coated aspirin 325 mg p.o. q.d., beclovent metered dose inhaler 2 puffs b.i.d., albuterol metered dose inhaler 2 puffs q.4 hours, premarin 0.625 mg p.o. q.d., amaril 2 mg p.o. q.a.m., prednisone 10 mg p.o. q.d., reglan 10 mg p.o. q.8 hours, diltiazem sr 180 mg p.o. b.i.d., percocet 5/325 1 p.o. q.4 hours p.r.n. pain, sliding regular insulin coverage in addition before meals and at bed time for blood sugar of 150-200 3 u subcue regular insulin, 201-250 6 u, 251-300 9 u, 301-350 12 u. follow-up: the patient should follow-up with her primary care physician . upon discharge from the rehabilitation facility to reestablish her plan for diabetes management, she is on less oral hypoglycemics at this time because her nutritional status and eating and nausea has not quite become stable. the patient is also to follow-up with dr. upon discharge from the rehabilitation facility. the patient should follow-up with dr. from the electrophysiology service upon discharge from the rehabilitation facility. the patient is discharged in stable condition. discharge diagnosis: mitral regurgitation status post mitral valve replacement. , m.d. dictated by: medquist36 procedure: insertion of intercostal catheter for drainage continuous invasive mechanical ventilation for less than 96 consecutive hours extracorporeal circulation auxiliary to open heart surgery insertion of endotracheal tube open and other replacement of mitral valve other operations on heart and pericardium diagnoses: pneumonia, organism unspecified mitral valve disorders acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified atrial fibrillation thyrotoxicosis without mention of goiter or other cause, and without mention of thyrotoxic crisis or storm diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled functional disturbances following cardiac surgery 

Answer: The patient is high likely exposed to