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 68-year-old woman with a history of coronary artery disease (status post myocardial infarction in and status post right coronary artery stent), rheumatic heart disease (with 2 to 3+ mitral regurgitation, moderate mitral stenosis with a valve area of 0.9 cm2 and a gradient of 11 mmhg), congestive heart failure (with an ejection fraction of 20% to 25%), atrial fibrillation (status post biventricular pacemaker placement but not cardioverted due to left atrial clot seen on and transesophageal echocardiograms). the patient also had a chronic right pleural effusion (status post therapeutic thoracentesis) in the recent past and severe chronic obstructive pulmonary disease (on home oxygen). she presented to an outside hospital with weakness, hemoptysis with dime-size clots, and worsening dyspnea on exertion. the initially impression at the outside hospital was that she was in decompensated congestive heart failure and was given lasix as well as antibiotics for a possible pneumonia. her coumadin was held as her inr was supracervical at 4.7. she was diuresed with lasix and was becoming hypotensive. she was started on dopamine and dobutamine and transferred to the for further management. past medical history: 1. cardiomyopathy with a left ventricular ejection fraction of 25%, severe mitral regurgitation, and mitral stenosis secondary to rheumatic fever. 2. coronary artery disease; status post myocardial infarction in and status post right coronary artery stent, atrial fibrillation (on coumadin). 3. cerebrovascular accident in with subsequent left-sided weakness. 4. chronic obstructive pulmonary disease and chronic right lower lobe infiltrate (on home oxygen). allergies: allergies include amoxicillin. medications on transfer: medications at the time of transfer included aspirin, ambien, multivitamin, lipitor, digoxin 0.125 mg p.o. q.d., captopril 12.5 mg p.o. t.i.d., spironolactone 25 mg p.o. q.d., lasix 120 mg p.o. b.i.d., carvedilol 3.125; coumadin was held. social history: social history was not obtainable. physical examination on presentation: examination on admission revealed the patient was afebrile with a temperature of 97.4, heart rate was 104, blood pressure ranged from 96 to 108/62 to 70, respiratory rate was 35. in general, she appeared uncomfortable and was tachypneic. she had mild scleral icterus. her lungs had decreased breath sounds; particularly at the right base, with dullness to percussion and diffuse rales. her heart examination revealed normal first heart sound and second heart sound with a 2/6 systolic ejection murmur with a diastolic soft component. her abdomen was soft and nontender. her liver was palpable approximately 8 cm below the right costal margin. her extremities had 1 to 2+ peripheral edema with dopplerable pulses bilaterally. pertinent laboratory data on presentation: laboratories at the time of admission revealed white blood cell count was 15.1, hematocrit was 39.3, and platelets were 262. inr was 4.6. chemistry-7 was unremarkable except for a bicarbonate of 19, a blood urea nitrogen of 22, and creatinine of 1. inr was repeated at the time of arrival which was 3.4. hospital course: cardiovascular system: on the morning following admission, the patient was found to be in worsening respiratory distress using multiple accessory muscles for respiration and was found to be tiring. she was again asked if she wanted to be intubated, and she responded in the affirmative. anesthesia was called, and the patient was electively intubated and placed on ventilator. shortly thereafter she had a swan-ganz catheter placed which showed elevated filling pressures with pulmonary artery filling pressures of 60/35, and a wedge pressure of 30. using these numbers, she was diuresed accordingly with intravenous lasix. she was tried on multiple combinations of pressors including dopamine, dobutamine, milrinone, and natrecor; none of which effectively increased her renal perfusion and urine output nor her cardiac output and index. on , she became febrile; spiking temperatures up to 102. her white blood cell count was increasing; reaching a peak of 29. cultures were sent including sputum, blood cultures, and urine cultures. sputum cultures ultimately grew out staphylococcus aureus and pseudomonas aeruginosa. the urine cultures had gram-negative rods which were not yet typed at the time of this dictation. the patient developed septic physiology with a transient increase in her cardiac output and a decrease in her systemic vascular resistance. she was treated with broad spectrum antibiotics and continued on pressors. her liver function tests continued to climb with her transaminases reaching near 200, and her total bilirubin reaching a peak of 8.2. the patient's skin became further jaundiced, and a right upper quadrant ultrasound had been ordered to evaluate for acute cholecystitis as gallstones had been seen on ultrasounds from the prior hospitalization. the right upper quadrant ultrasound was actually never performed. on , the patient's right pleural effusion was tapped; removing 1400 cc of cloudy pleural fluid. the cultures from the fluid grew no organisms, and this appeared to be exudative; likely a parapneumonic effusion. by this time, her pressors were changed to levophed and vasopressin to maintain blood pressures. on , the coronary care unit resident had a long conversation with the patient's family regarding prognosis and possible quality of life following this hospitalization. if the patient were ever to be extubated, it was decided at that time that her prognosis was very poor and hope for a quality of life equal to what she had prior to admission was unlikely. the family decided at that time to make the patient do not resuscitate/do not intubate status; specifically, treating as comfort measures only. antibiotic and pressor support were withdrawn after morphine constant infusion was initiated, and there was every assurance that the patient was comfortable. she expired on at 8:38 a.m. the patient family was notified and declined postmortem evaluation. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances thoracentesis pulmonary artery wedge monitoring injection or infusion of nesiritide diagnoses: other primary cardiomyopathies abnormal coagulation profile unspecified pleural effusion other pulmonary insufficiency, not elsewhere classified unspecified septicemia chronic airway obstruction, not elsewhere classified atrial fibrillation rheumatic heart failure (congestive) other shock without mention of trauma 

Answer: The patient is high likely exposed to