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: n/v/f/c/night sweats/cough/sob/doe/orthopnea at osh major surgical or invasive procedure: transesophageal echocardiogram. history of present illness: 41 f with h/o endocarditis 12 yrs ago s/p mv annuloplasty/repair w/ subsequent dehiscence of valve requiring mvr () in ' with maze procedure; chf(ef >55% 3+ mr); h/o aflutter. presented to osh w/ 1 day n/v/f/c/night sweats/cough/sob/doe/orthopnea. w/u at osh included cta neg for pe, but revealing pna and chf. echo done showed evidence of clot in mitral valve vs possible vegetation. she was empirically started on vanc/gent/rifampin for endocarditis though the patient had wbc wnl and was found to be afebrile. pt had stopped taking her meds 5 mo ago (including coumadin) due to lack of money. pt was also found to have urine positive for cocaine, opiates, and cannabinoids at the osh. past medical history: anxiety, aflutter, cervical ca s/p cryotherapy, h/o polysubstance abuse, annuloplasty/repair of mv 12 yrs ago with subsequent mvr () 2 yrs ago social history: currently living w/friends. as a baby sitter, smokes (transferred on a nicotine patch), denies using etoh, cocaine physical exam: afebrile gen: appears fatigued and dishelved heent: miotic pupils, mmm, sclerae anicteric cv: iii/vi holosystolic murmer lungs: soft crackles throughout abd: soft, nt/nd, pos bs ext: trace edema pertinent results: 08:29pm glucose-107* urea n-21* creat-1.1 sodium-139 potassium-3.8 chloride-102 total co2-25 anion gap-16 08:29pm ck-mb-2 08:29pm calcium-9.9 phosphate-4.8* magnesium-1.9 cholest-206* 08:29pm triglycer-119 hdl chol-53 chol/hdl-3.9 ldl(calc)-129 08:29pm wbc-6.7 rbc-4.15*# hgb-13.3# hct-36.7# mcv-89 mch-32.0 mchc-36.1* rdw-13.6 08:29pm plt count-228 08:29pm pt-13.0 ptt-32.4 inr(pt)-1.1 brief hospital course: 41 f with a pmh sig for chf(ef >55% 3+ mr), chronic aflutter, and endocarditis 12 yrs ago s/p mv annuloplasty/repair w/ subsequent dehiscence of valve requiring mvr () in ' with maze procedure transferred from an osh for evaluation of a clot on her mitral valve vs a vegetation seen on echo, after not taking her coumadin x5 months. pt was empirically started on vanc/gent/rifampin for endocarditis. studies: 1. cath (): clean coronaries, elevated pcw, decreased co, nl ef, severe mr 2. ct chest @ osh: prominent pulm vasculature, dilated la and pulm veins c/w pulm htn, b/l pleural effusion r>l. no pe. 3. tte (): mobile mass on mv ~0.8 cm, ? clot vs vegetation w/ septal paradoxical , 45%, lv fxn mildly depressed 4. tee (): ef>60%; a 3.5cm long by 1cm thick mural thrombus (cannot exclude vegetation or superimposed vegetation) is seen in the body of the la involving the mitral prosthesis (completely surrounding one disc that is immobile) and extending along in a "mural" fashion the interatrial septum and posterior aortic root a definite 3-4mm partially mobile thrombus is seen in the mid-portion of the appendage. 5. tte (): the left atrium is mildly dilated. there is mild symmetric lvh. the lv cavity size is normal.(lvef>55%). rv chamber size and free wall motion are normal. av leaflets (3) appear structurally normal with good leaflet excursion and no ar. the av leaflets are mildly thickened. a bileaflet mv prosthesis is present. the mitral prosthesis appears well seated, the anteriorl leaflet/disc motion is restricted with a small mass at that site, consistent with a thrombus. the transvalvular gradients are higher than expected for this type of prosthesis.(gradient of 10 dwn from 20) the estimated pasp is normal. there is no pericardial effusion. problems: 1. mobile mass/clot on mv: (most likely clot vs vegetation) - pt informed of risk of stroke w/lysis (20%) vs. obstruction/deterioration of valve w/no tx. tpa done on . repeat tte showed improved gradient across mechanical mv but persistent clot. pt did not have further lysis. - started on heparin gtt on admission with transition to coumadin - low suspicion for endocarditis so d/c'ed gent, rifampin, vanco * 2. pump: ef >55% w/3+ mr - no s/sx of overload. fluid goal even. * 3. rhythm: aflutter w/occasional rapid hr - restarted metoprolol for rate control (had been held for hypotn) - no indication for cardioversion * 4. neuro/psych: polysubstance abuse/anxiety - pre-lysis ct head w/old lacunar infarcts; question of small bleed, however neurorads felt unlikely--more likely calcification of choroid plexus - no signs of withdrawal, ativan prn for agitation - sw/case management helped follow pt and set up free care for meds at discharge - psych consult obtained, suggest giving haldol prn for agitation and trazadone for insomnia, hold bz's unless physical signs of w/drawel (ciwa scale written) 5. rll pna: afebrile, wbc stable - treated with course of levoflox for cap - bld cx ng, sputum cx ng left against medical advice. medications on admission: not taking meds for past 5 months. discharge medications: 1. thiamine hcl 100 mg tablet sig: one (1) tablet po qd (once a day). disp:*30 tablet(s)* refills:*2* 2. multivitamin capsule sig: one (1) cap po qd (once a day). disp:*30 cap(s)* refills:*2* 3. folic acid 1 mg tablet sig: one (1) tablet po qd (once a day). disp:*30 tablet(s)* refills:*2* 4. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 5. warfarin sodium 2.5 mg tablet sig: three (3) tablet po at bedtime. disp:*120 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: left atrial and mitral valve thrombus mitral valve replacement with st. jude valve in pneumonia discharge condition: poor. discharge instructions: pt is signing out against medical advice. please call your primary care physician or return to the hospital if you experience shortness of breath, chest pain, or any other problems. followup instructions: please go to the blood lab at dr. office on monday at 10:30 am and then go to her office to make a follow-up appointment. procedure: diagnostic ultrasound of heart injection of anticoagulant combined alcohol and drug detoxification diagnoses: pneumonia, organism unspecified congestive heart failure, unspecified atrial fibrillation other complications due to heart valve prosthesis heart valve replaced by other means cerebral artery occlusion, unspecified with cerebral infarction drug withdrawal alcohol abuse, continuous cocaine abuse, continuous 

Answer: The patient is high likely exposed to