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: past medical history: 1. hypercholesterolemia. 2. coronary artery disease. 3. aortic stenosis. 4. benign prostatic hypertrophy. 5. status post coronary artery bypass graft in . 6 status post tonsillectomy. 7. status post right below the knee amputation secondary to a war injury in . allergies: no known drug allergies. preoperative medications: 1. aspirin 81 mg p.o. twice a day. 2. zocor 20 mg p.o. once daily. 3. flomax 0.4 mg p.o. once daily. 4. propranolol 10 mg p.o. twice a day. 5. multivitamin. 6. aciphex 20 mg p.o. once daily. social history: the patient denies tobacco or etoh. the patient is married and lives with his wife. preoperative laboratory data: white blood cell count was 6.0, hematocrit 35.4, platelet count 162,000. sodium 134, potassium 4.0, chloride 103, bicarbonate 27, blood urea nitrogen 16, creatinine 0.9, glucose 176. inr 1.2. physical examination: preadmission physical examination was significant for a heart rate of 66, blood pressure in the left arm of 226/85 and in the right arm 200/88, oxygen saturation 95% in room air. the patient was awake, alert and oriented times three and neurologically nonfocal. head, eyes, ears, nose and throat examination - the neck is supple. mucous membranes are moist. upper and lower dentures. heart - s1 and s2 with audible harsh blowing systolic murmur and a well healed surgical scar over his sternum. the lungs were clear to auscultation bilaterally. the abdomen is soft, positive bowel sounds, nontender, nondistended, no hepatosplenomegaly. pulses - carotids were 2+ bilaterally with radiating murmur. all other peripheral pulses were equal bilaterally with the exception of his right lower extremity due to his previous below the knee amputation. the patient underwent carotid ultrasound on , which showed minimal bilateral internal carotid artery plaque without any appreciable associated stenosis and the patient was scheduled for surgery. ho course: the patient was admitted on , and taken to the operating room with dr. for an aortic valve replacement and an attempted coronary artery bypass graft through a redo sternotomy. upon opening the sternum, it was found that the patient had dense adhesions and the cardiac surgery team was unable to obtain adequate access to perform a bypass graft. it was decided at that time that the patient postoperatively would be taken to the cardiac catheterization laboratory for a percutaneous coronary intervention. the patient, however, did have an aortic valve replacement with a 23 millimeter bovine pericardial valve. please see operative note for further details. the patient was transferred to the intensive care unit in stable condition on a milrinone infusion. the patient was weaned and extubated from mechanical ventilation on the first postoperative day. the milrinone was weaned to off for a good cardiac index. it was noted on postoperative day number two that the patient had mild thrombocytopenia with a platelet count of 85. heparin antibody was sent at the time which was subsequently negative. the patient was again on lopressor and captopril for blood pressure control. the patient also required nipride infusion to maintain systolic blood pressure less than 140. the patient was taken to the cardiac catheterization laboratory on postoperative day number two and underwent a percutaneous transluminal coronary angioplasty and stent to the left anterior descending distal to the previous left internal mammary artery graft. the patient tolerated this procedure well and returned to the intensive care unit. over night on postoperative day number two, the patient had increasing confusion and was started on some haldol. the patient continued to improve during the day. however, on the evening of postoperative day number three, the patient began experiencing rigors with a low grade fever as well as labored respirations. the patient was electively intubated. after intubation, the patient became severely hypotensive and required large amounts of volume resuscitation and pressors. the patient had a pulmonary artery catheter placed at this time which showed hyperdynamic numbers consistent with sepsis. the patient underwent bronchoscopy which showed dense secretions in the right upper lobe and left lower lobe. this was sent for culture. the patient was pancultured at this time. subsequent cultures grew out gram negative rods. the patient was started on broad spectrum antibiotics and the cultures grew out serratia which was pansensitive. serratia was found in the sputum, the blood and on the right internal jugular introducer. the patient also had an urgent bedside echocardiogram performed by the cardiology fellow which showed an ejection fraction that was well preserved, hyperdynamic left ventricle and no pericardial effusion, no obvious wall motion abnormalities. the patient continued to require pressors to maintain adequate blood pressure as well as volume resuscitation. it was noticed on the evening of postoperative day number three that the patient had a large amount of subcutaneous emphysema across his chest. the patient had been noticed to have an air leak from one of his chest tubes presumed from a lung injury intraoperatively. chest x-ray at that time showed no pneumothorax and bilateral pleural chest tubes. the infectious disease team was consulted and the patient's antibiotics were changed to ceftazidime and levofloxacin for the gram negative rods. the patient also received one dose of gentamicin and continued on flagyl and vancomycin which were subsequently discontinued when all remaining cultures were negative for anything but gram negative rods. the patient continued to have fevers. on postoperative day number five, the patient had a fever of 101.7. the patient remained intubated with minimal ventilatory support. the patient underwent a cat scan of his abdomen and pelvis that showed a right pneumothorax with bilateral chest tubes and bilateral lower lobe consolidation/collapse, bilateral pleural effusions, and no intra-abdominal pathology noted. the patient continued to remain intubated and required frequent suctioning of his endotracheal tube for moderate amount of thick white secretions. it was decided on , after the patient had a subsequent positive blood culture on , that the patient should have all central lines removed. the patient had no bedside access for a picc, however, the patient went to interventional radiology for placement of a picc catheter in the right basilic vein for long term antibiotic therapy. on postoperative day number seven, infectious disease team discontinued the vancomycin and flagyl and recommended continuing the levofloxacin and ceftazidime for a total of three week course. the patient had a bronchoscopy on , which showed minimal amount of whitish secretions bilaterally. the patient continued to have an air leak from the left pleural chest tube. the patient required intermittent doses of haldol for agitation. the patient underwent a repeat bronchoscopy on , which showed scant secretions in the right lower lobe. the patient was weaned and extubated from mechanical ventilation on the afternoon of , and required a fair amount of pulmonary toilet, however, was quickly weaned down to nasal cannula. the patient was coughing on his own. off sedation, the patient was awake, alert and oriented times three. on , the patient underwent a bedside speech and swallow evaluation which showed no evidence of aspiration or dysphagia. on , the patient was transferred from the intensive care unit to the regular floor. the patient continued to have an air leak from his chest tube. the chest tube was taken off suction and placed on water seal, however, it did continue to have an air leak. on , thoracic surgery was consulted for the continued air leak. they recommended clamping the chest tube and repeating the chest x-ray in 24 hours. if there as no pneumothorax in 24 hours with the chest tube clamped, to discontinue the chest tube. a chest x-ray was performed on , after 24 hours of chest tube clamp that showed no pneumothorax. the chest tube was removed without difficulty. at this time, the patient had been evaluated by physical therapy and it was determined due to the patient's age, the patient's disability of his right lower extremity amputation, the patient would benefit from short term rehabilitation. on , postoperative day number fifteen, the patient was cleared for discharge to rehabilitation. condition on discharge: temperature maximum 98.8, pulse 100, sinus rhythm, blood pressure 107/60, respiratory rate 16, oxygen saturation 95% in room air. the patient is awake, alert and oriented times three, occasionally repeating himself and occasionally forgetful. strength in his bilateral upper extremities is equal and strength of his bilateral thighs is equal. the heart is regular rate and rhythm without rub or murmur. breath sounds are clear bilaterally without wheezes or rhonchi. there is no subcutaneous air palpated across his chest. gastrointestinal positive bowel sounds, soft, nontender, nondistended, tolerating a regular diet, having normal bowel movements. chest x-ray on , showed no pneumothorax, no subcutaneous air. lower extremities without edema. sternal incision steri-strips are intact. the incision is clean and dry and sternum is stable. white blood cell count is 6.8, hematocrit 32.0, platelet count 311,000. sodium 137, potassium 3.9, chloride 102, bicarbonate 26, blood urea nitrogen 18, creatinine 0.9, glucose 99. discharge diagnoses: 1. aortic stenosis. 2. status post aortic valve replacement via redo sternotomy with a 23 millimeter - pericardial valve. 3. coronary artery disease, status post coronary artery bypass graft in the past, now status post percutaneous transluminal coronary angioplasty and stent to the left anterior descending. 4. postoperative gram negative rods/serratia sepsis. 5. postoperative confusion. 6. picc insertion. 7. prolonged air leak from chest tube. medications on discharge: 1. lopressor 25 mg p.o. twice a day. 2. lasix 20 mg p.o. once daily times seven days. 3. potassium chloride 20 meq p.o. once daily times seven days. 4. colace 100 mg p.o. twice a day. 5. enteric coated aspirin 325 mg p.o. once daily. 6. tylenol 650 mg p.o. q4-6hours p.r.n. 7. levofloxacin 500 mg p.o. once daily times two weeks. 8. ceftazidime one gram intravenously q8hours times two weeks. 9. plavix 75 mg p.o. once daily. 10. zocor 20 mg p.o. once daily. 11. flomax 0.4 mg p.o. once daily. 12. haldol 1 mg p.o. twice a day. 13. prevacid 30 mg p.o. once daily. fop: the patient is to be discharged to rehabilitation in stable condition. the patient is to follow-up with dr. in two weeks. the patient is to follow-up with dr. in two weeks, and the patient is to follow-up with dr. in three to four weeks. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters left heart cardiac catheterization diagnostic ultrasound of heart insertion of endotracheal tube enteral infusion of concentrated nutritional substances other bronchoscopy open and other replacement of aortic valve with tissue graft insertion of drug-eluting coronary artery stent(s) diagnoses: thrombocytopenia, unspecified coronary atherosclerosis of native coronary artery pure hypercholesterolemia coronary atherosclerosis of autologous vein bypass graft aortic valve disorders iatrogenic pneumothorax other septicemia due to gram-negative organisms infection and inflammatory reaction due to other vascular device, implant, and graft coronary atherosclerosis of artery bypass graft 

Answer: The patient is high likely exposed to