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: the patient is a 62 year old with a history of pericardial aortic valve replacement and one vessel coronary artery bypass graft admitted for worsening dyspnea on exertion over the last month. the patient was without known heart disease until , when he developed heart failure with an ejection fraction of 15% with severe aortic stenosis. catheterization was performed , followed by one vessel coronary artery bypass graft and pericardial aortic valve replacement. follow-up transthoracic echocardiogram at outside hospital reported an ejection fraction of 50%. the patient had no further events until one month ago when he started having dyspnea on exertion and lower extremity edema. he was admitted to on , with congestive heart failure. at this time, four out of four blood cultures were positive for alpha streptococcus and the patient was started on penicillin g and gentamicin for bacterial endocarditis. subsequent cultures have been negative. transthoracic echocardiogram performed on , revealed an ejection fraction of less than 20% with an ao mean gradient of 42. transthoracic echocardiogram on , showed vegetation with moderate aortic stenosis, severe global left ventricular hypokinesis, trace aortic regurgitation with multiple vegetations. the test also revealed mild to moderate mitral regurgitation and 3+ tricuspid regurgitation. despite medical management of lasix, antibiotics and ace inhibitors, the patient's condition has not improved. by , the patient's systolic blood pressure had fallen to 60s to 70s and his urine output declined to less than 30 cc/hour. he was started on dopamine and subsequently transferred to the cardiac intensive care unit. during his stay in the cardiac intensive care unit, the patient was subsequently taken for catheterization and placement of an intra-aortic balloon pump. after successful placement of this balloon pump, the patient was subsequently evaluated for cardiac surgery. past medical history: 1. coronary artery disease. 2. anemia of uncertain origin. 3. status post excision of rectal cancer. 4. coronary artery bypass graft times one with pericardial aortic valve replacement. social history: the patient quit smoking twenty years ago. he does not consume any alcohol. he lives with his wife and has a very supportive family. family history: father died of myocardial infarction at age 61. medications on admission: 1. aspirin 81 mg once daily. 2. iron sulfate. 3. colace. 4. ambien. 5. captopril and amiodarone which were stopped . review of systems: negative unless otherwise stated above. physical examination: temperature is 96.6, blood pressure 86/58, heart rate 107, respiratory rate 16, oxygen saturation 98% on two liters. the patient is comfortable in no apparent distress. head, eyes, ears, nose and throat examination - the pupils are equal, round, and reactive to light and accommodation. extraocular movements are intact. the neck is supple with no lymphadenopathy or bruits. respiratory clear to auscultation bilaterally. cardiac examination - regular rate and rhythm, ii/vi holosystolic murmur. abdomen was soft, nontender, nondistended with normoactive bowel sounds. extremities were remarkable for 2+ pitting edema in the bilateral lower extremities. hospital course: the patient was taken to the operating room on , for redo aortic valve replacement. valve placed was a #19 millimeter carbomedics mechanical valve. the operation was performed without complication. the patient was subsequently transferred to the cardiothoracic surgical intensive care unit. the patient was given perioperative vancomycin and continued his intravenous penicillin g administration. he was gradually weaned off drips and hemodynamically stabilized. he was extubated on postoperative day one. on postoperative day two, the intra-aortic balloon pump was discontinued which the patient tolerated well. the patient's condition progressively improved. foley catheter and central line were discontinued as well as his pacing wires. his hematocrit was stable and he was progressively diuresed. anticoagulation was begun with heparin infusion and oral coumadin. the patient was then transferred to the floor postoperative day five. he was tolerating an oral diet and ambulating well. his pain was controlled with oral medications. due to the long course of his illness, the patient was encouraged to increase his p.o. intake and was provided with nutritional supplements. the patient continued to be diuresed with increasing amounts of lasix. his lower extremity edema continues to slowly improve. captopril was started from low dose and gradually increased which the patient tolerated well. on , an echocardiogram was performed which revealed a large pericardial effusion over the right ventricle with suggestive tamponade physiology. the patient was subsequently taken for pericardiocentesis where 200 cc of hemorrhagic fluid were removed. the patient tolerated this procedure well and was subsequently observed in the cardiothoracic surgical intensive care unit. he remained stable over the next several days. his postprocedure course was complicated by an extended episode of atrial fibrillation. he does remain rate controlled and hemodynamically stable and on , the patient was felt stable for transfer to a rehabilitation facility on long term anticoagulation therapy. physical examination: discharge vital signs revealed temperature 96.8, pulse 67, blood pressure 108/62, respiratory rate 20, oxygen saturation 98% in room air. the heart is regular rate and rhythm. the lungs are clear to auscultation bilaterally. the incisions are clean, dry and intact. the abdomen is soft, nontender, nondistended with normoactive bowel sounds. extremities are remarkable for 2+ pitting edema. medications on discharge: 1. lisinopril 10 mg p.o. once daily. 2. penicillin g 3 million units intravenously q4hours for a total of six weeks - course ending . 3. amiodarone 400 mg p.o. once daily. 4. calcium carbonate 500 mg three times a day. 5. docusate 100 mg p.o. twice a day. 6. potassium chloride 40 meq p.o. twice a day. 7. lasix 40 mg p.o. twice a day. 8. hydromorphone 2 to 4 mg q4-6hours p.r.n. for pain. follow-up: the patient should follow-up with dr. in four weeks and follow-up with dr. in three to four weeks. condition on discharge: stable. discharge status: the patient is to be discharged to a rehabilitation facility. discharge diagnoses: status post redo mechanical aortic valve replacement following bacterial subacute bacterial endocarditis. , m.d. dictated by: medquist36 procedure: extracorporeal circulation auxiliary to open heart surgery left heart cardiac catheterization diagnostic ultrasound of heart pericardiocentesis open and other replacement of aortic valve implant of pulsation balloon pulmonary artery wedge monitoring monitoring of cardiac output by other technique right heart cardiac catheterization diagnoses: acute and subacute necrosis of liver acute kidney failure, unspecified atrial fibrillation rheumatic heart failure (congestive) cardiogenic shock mitral valve insufficiency and aortic valve stenosis acute and subacute bacterial endocarditis hemopericardium infection and inflammatory reaction due to cardiac device, implant, and graft 

Answer: The patient is high likely exposed to