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: penicillins attending: chief complaint: chest pain, sob major surgical or invasive procedure: cardiac catheterization mvr (27mm st. mechanical) via right thoracotomy, rib removal history of present illness: 54 yo female, h/o av in , chf, cad, ivdu, hcv, presenting from clinic with symptoms of chest pain with worsening sob and fatigue. past medical history: 1. recurrent endocarditis, first aortic then mitral involvement. on chronic suppressive fluconazole therapy given history of candidal endocarditis avr with st. jude's valve in c/b embolic cva and seizure. mrv possible will be replaced in the future. 2. chronic venous stasis 3. pvd - s/p left fem ant tibial bypass graft with saf vein for non healig ulcers 4. venous stasis ulcer for 4 years, s/p failed skin graft. . plastics considering vac. 5. anemia, iron deficiency 6. h/o ugib gastritis with hct of 23 - 7. iv drug use on methadone 8. hepatitis c - hep c viral load -over 2 mill.no bx done 9. peripheral neuropathy 10. hearing loss (ad) 11. mild gastritis 12. cad with 60-70% lad lesion, rt. dominant - pmibi on showed fixed defects. social history: has a history of iv heroin use 20 years ago, denies any current drug use. denies current tobacco use but used to smoke cigarettes/day for 15 years (quit 2 yrs prior). denies any etoh use. she currently lives with her mother and is on disability. family history: n/a physical exam: vs: 99.0 97/67 76 18 99% ra 43.3 kg gen: very thin appearing woman, speech somewhat slowed, nad, very pleasant heent: perrl, op clear, no lad, no carotid bruits, no jvd neck: no jvd, no bruits lungs: cta bilat, no w/r/r heart: rrr, mech s2, 4/6 sem heard throughout but most prominently at apex abd: soft, nt/nd, nabd ext: dp 2+ bilat; no c/c/e. on lle, ulcer on posterior ankle/calf, with granulation tissue, no surrounding erythema pertinent results: 05:37am blood wbc-8.8 rbc-3.34* hgb-9.8* hct-29.8* mcv-89 mch-29.3 mchc-32.8 rdw-14.0 plt ct-521* 05:37am blood pt-25.0* ptt-28.1 inr(pt)-2.5* 04:15am blood pt-22.8* ptt-94.4* inr(pt)-2.3* 08:28pm blood pt-21.7* ptt-111.2* inr(pt)-2.1* 05:37am blood glucose-92 urean-12 creat-0.7 na-139 k-4.5 cl-102 hco3-28 angap-14 05:37am blood alt-20 ast-27 ld(ldh)-356* alkphos-105 amylase-158* totbili-0.2 cxr:comparison demonstrates that the multiple linear atelectasis and local right- sided pleural thickening is related to the most recent mitral valve replacement. a linear left lower lobe posterior segment atelectasis that is present now was not found on the preoperative examination. there is, however, no evidence of any significant chf, nor are there any new parenchymal infiltrates identified. brief hospital course: pre-operative: chf: symptoms may be worsening, perhaps mitral failing valve. lv systolic diameter abnormal, necessitating valve replacement before permanent damage ensues. she was continued on her lasix/acei and remained clinically euvolemic. valve replacement as below. mv: cardiac surgery was consulted for consideration of replacement of the mitral valve. she underwent pre-operative workup, including ua, cxr, ct of the head, and carotid us. all were normal. ct of the head showed evidence of old stroke. she was taken for surgery on . pvd: vascular surgery was consulted for input on her left lower extremity non-healing ulcer. they felt that it was not infected and recommended continued wet to dry dressing changes. it was not felt that this would be a contraindication to surgery. ivdu: methadone and percocet were continued in-house as per her outpatient regimen. cva: she sustained a stroke during aortic valve surgery and has been on tegretol since that time for seizure prophylaxis. this was continued in-house. disposition: she was taken for mitral valve replacement on and transferred to the cardiac surgery service at this time. taken to the operating room on , for a mitral valve replacement (. mechanical) via right thoracotomy with rib removal. post-op, she was transferred to the cardiac surgery recovery unit in stable condition, on epinephrine and neosynephrine gtts. sedation and vasopressors were weaned off, but she was slow to wake. on pod # 2, the neurology service was consulted due to continued decreased responsiveness. eeg at that time did show some seizure activity, and tegretol was subsequently increased. mri showed multiple appearing infarcts, with no acute lesions. she began to awaken over the next few days, had remained hemodynamically stable, and was ultimately transferred to the post-op telemetry floor on pod # 5. anticoagulation was started with heparin, and transitioned to coumadin as her inr increased. a wound care consult was obtained for her foot ulcer, and silvadene dressings were recommended. physical therapy was begun, but the patient is slow to progress with ambulation and stability. her methadone dose had been decreased during her post-operative course (from her pre-op dose of 30 mg daily) to 10 mg daily due to her decreased mental status and overall sedation. she has remained hemodynamically stable, and is ready for discharge to rehab for physical therapy and progression to independent ambulation. medications on admission: meds: coumadin enalapril 5 mg fe 325 fluconazole 200 mg lasix 40 mg methadone 15 ml (30 mg) daily prilosec percocet prn folic acid 1 mg thiamine 100 mg tegretol 200 mg . all: pcn - ?out of body feeling discharge medications: 1. protonix 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 2. docusate sodium 100 mg capsule sig: one (1) capsule 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. methadone 10 mg tablet sig: one (1) tablet po daily (daily). 5. fluconazole 200 mg tablet sig: one (1) tablet po q24h (every 24 hours). 6. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 7. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 8. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 9. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 10. carbamazepine 200 mg tablet sig: two (2) tablet po bid (2 times a day). 11. ibuprofen 400 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed. 12. warfarin 2 mg tablet sig: two (2) tablet po once a day for 3 days: 4mg (2 tablets) on , and , then inr check and dose for target inr 3.0-3.5. 13. silvadene 1 % cream sig: one (1) topical twice a day for 10 days: to foot ulcer. discharge disposition: extended care facility: discharge diagnosis: chf mitral regurgitation lower extremity non-healing ulcer discharge condition: good discharge instructions: please take all your medications exactly as prescribed and described in this discharge paperwork. shower, no bathing for 1 month no creams, lotions or powders to any incisions p instructions: with dr. in weeks with dr. in weeks dr. in 4 weeks other appointments: provider: phone: date/time: 10:20 provider: , date/time: 11:20 procedure: venous catheterization, not elsewhere classified coronary arteriography using two catheters left heart cardiac catheterization arteriography of femoral and other lower extremity arteries open and other replacement of mitral valve aortography arteriography of renal arteries diagnoses: anemia, unspecified mitral valve disorders congestive heart failure, unspecified other convulsions ulcer of other part of foot heart valve replaced by other means unspecified late effects of cerebrovascular disease atherosclerosis of native arteries of the extremities with ulceration 

Answer: The patient is high likely exposed to