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: zestril / fioricet / codeine / ibuprofen attending: chief complaint: nausea major surgical or invasive procedure: liver biopsy history of present illness: 50f w/recurrent mrsa endocarditis on rifampin and vancomycin p/w transaminitis, jaundice, and decreased hepatic synthetic function. history of mvr for severe mitral stenosis, complicated by readmission for serious sternal wound infection that led to seeding of her porcine valve with mrsa. tee showing mobile mv mass in that has persisted despite vancomycin via picc. s/p vancomycin x8 wks and rifampin/gentamycin x2wks. bacteremia w/ +bcx that have been negative since . admission for anasarca due to chf that resolved w/diuresis. presented to clinic from rehab w/nausea on rifampin and hemolytic anemia requiring transfusion. admitted to osh from rehab and found to have elevated lfts (ast 69, alt 67, ap 161) and creatinine (1.1). tx to for further evaluation. c/o nausea with dry heaves and mild pain. past medical history: prosthetic valve endocarditis diagnosed by tee on , present and (ef 60%, 3+tr, mod pulm htn,sig worsened pulm regurg) sternal wound infxn s/p bilateral pectoral flap on by plastics s/p mvr on severe mitral stenosis nqwmi diabetes type i (age 19, mult dka,peripheral neuropathy, gastroparesis w/reflux esophagitis,retinopathy s/p laser s/p b vitrectomy) hypertension hypercholesterolemia migraine osteoporosis depression/anxiety chronic hyponatremia h/o foot ulcers ? osteo s/p tah/bso, s/p appy/peritonitis, s/p cataract removal, s/p b carpal tunnel release social history: patient lives alone, smoke 1 pack/day, no alcohol or recreational drug use. family history: father died from mi at age 45 physical exam: 97 132/72 93 20 70kg (66kg) 2470/1725 fs 298/168/154/101 gen - nad, aox3, resting comfortably in bed heent - mmm, no oropharyngeal lesions, jvp at jawline heart - rrr, sem lungs - b-crackles to mid lung zones abdomen - no increased distention, active bs, nt, palpable liver edge ext - 3+ ble edema bilaterally, +1 pedal pulses, symmetric neuro - aox3, responding appropriately, no asterixis, ambulating pertinent results: admission labs: glucose-171* urea n-62* creat-1.7* sodium-126* potassium-5.0 chloride-84* total co2-29 anion gap-18 alt(sgpt)-755* ast(sgot)-628* alk phos-201* amylase-17 tot bili-0.8 lipase-11 albumin-3.7 magnesium-2.9* tsh-3.7 wbc-14.1* rbc-3.70* hgb-11.1* hct-34.9* mcv-94 mch-30.1 mchc-31.9 rdw-19.6* plt smr-very low plt count-48*# pt-23.3* ptt-36.3* inr(pt)-3.4 . echo study date of the left atrium is dilated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. no atrial septal defect is seen by 2d or color doppler. overall left ventricular systolic function is normal (lvef>55%). the right ventricle appears dilated. right ventricular systolic function is normal. there are simple atheroma in the ascending aorta. there are simple atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened. no masses or vegetations are seen on the aortic valve. mild (1+) aortic regurgitation is seen. a bioprosthetic mitral valve prosthesis is present with lateral rocking/separation from the mitral annulus consistent with dehiscense with associated paravalvular mitral regurgitation. there are small echodense structures associated with the prosthetic ring which may represent suture material. no definite vegetation is seen on the mitral valve. moderate to severe (3+) mitral regurgitation is seen. the mitral regurgitation jet is eccentric. the tricuspid valve leaflets are moderately thickened. moderate to severe tricuspid regurgitation is seen. no vegetation/mass is seen on the pulmonic valve. significant pulmonic regurgitation is seen. there is no pericardial effusion. compared to the prior transesophageal study of , the previously noted vegetations are not present in the current study. dehiscense of the lateral border of the prosthetic mitral valve is new. . us liver: the liver is normal in echotexture without evidence of focal hepatic masses. there is no intrahepatic biliary duct dilatation. the left, middle, and right hepatic veins are all patent and demonstrate normal venous waveforms. the portal vein is patent and demonstrates normal hepatopetal flow. the main hepatic artery, and branches of the left and right posterior hepatic arteries are all patent and demonstrate normal arterial waveforms. . liver bx 1. prominent centrolobular hemorrhage with associated hepatocellular necrosis, hemosiderin-laden macrophages and nodular regenerative hyperplasia; see note. 2. necrotic hepatocytes compose approximately 20% of the biopsy. 3. trichrome stain shows minimal centrivenular fibrosis, no significant portal fibrosis. 4. no stainable iron seen on iron stain. 05:12am blood wbc-10.8 rbc-4.03* hgb-11.8* hct-35.2* mcv-87 mch-29.3 mchc-33.6 rdw-16.2* plt ct-336 03:04am blood glucose-161* urean-21* creat-0.6 na-128* k-4.8 cl-89* hco3-34* angap-10 02:01am blood alt-16 ast-32 ld(ldh)-372* alkphos-129* amylase-45 totbili-0.6 brief hospital course: 51f with porcine mvr dehiscence s/p mrsa endocarditis sternal wound infection after mvr 3 months ago. mrsa endocarditis: now cleared on tee after vanco x8wks and gent & rifampin x2wks; however, dehiscence of porcine appeared. pt p/w heart failure and hepatic failure that has been treated. heart and hepatic function are now optimized with reversal of coagulopathy and improvement in thrombocytopenia. bcx x3 and negative,including mycolytic. c. diff negative x3. hepatic failure/encephalopathy: transaminitis, hyperuricemia, coagulopathy, reduced synthetic fxn all improved. likely worsening dchf. abd u/s with normal appearing liver and patent vessels. hepatitis serologies and hcv viral load. afp and igg normal. negative. positive. -liver bx consistent with recovery from episode of chf induced hepatocellular damage from which complete recovery may be expected. mrs. underwent aggressive diuresis and treatment of her heart failure preoperatively, which included an intra aortic balloon pump and inotropic therapy. once she was cleared by the hepatology service, she was taken to the operating room on with dr. for a redo mvr via r thoracotomy with a 27mm mosaic valve. she also required a r femoral artery thrombectomy by vascular surgery. post operatively she was started on epinephrine, milrinone and inhaled nitric oxide, continued with her iabp and transferred to the icu in stable condition. she was seen by vascular surgery on pod#1 because her l foot was cool. it was recommended that the iabp be removed, this was done with improvement in her vascular exam. she was started on heparin for anticoagulation. she was started on fluconazole postoperatively because it was noted that she had a rash consistent with yeast on her chest, this was continued for 14 days postoperatively per the infectious disease team. her nitric oxide and milrinone were weaned over the next several days, her support from the ventilator was decreased, and she was extubated on pod#4 without difficulty. she was started on natrecor and aggressive diuretic therapy to achieve diuresis. she had been started on amiodarone for atrial fibrillation, which she had a few short episodes postoperatively. she was transferred from the icu on pod#9. her anticoagulation was discontinued on pod#14. she underwent an echocardiogram on which showed an lvef of 60, mildly dialated la/ra, lvh dialated rv with normal function and abnormal septal motion consistent with rv overload, moderate to severe tr, and normal mv prosthesis. although she remained volume overloaded, it was felt by the cardiology service, the cardiac surgery service and the medicine service that she could continue diuresis at rehab. on , she was cleared for discharge to rehab, and on she was dischared to rehab. medications on admission: metoprolol atorvastatin calcium 20 mg daily benzoyl peroxide 5 %--apply qd - calcium-600 600mg--one by mouth every day cozaar 100mg--one by mouth every day docusate sodium 100mg--one by mouth four times a day enteric coated aspirin 81 mg--one every day fosamax 70mg--one by mouth qwk humulin r 100u/ml--sliding scale with breakfast and dinner hydroxyzine hcl 10mg--one to 3 by mouth q 8h as needed for nausea insulin, lantus as directed by dr directed lantus 100 u/ml--20 units sq at bedtime or as directed lasix 40mg--one by mouth , take additional 40mg dose 4 xweek. magnesium oxide 400mg--one by mouth every day metoclopramide 10 mg--one by mouth four times a day as needed morphine sulfate 15 mg--1 tablet(s) by mouth ms contin 15mg--tid multivitamin with iron --one by mouth every morning nicotrol 10mg--use 6 cartidges/day protonix 40mg--one by mouth every day senna 1 tablet--use 4 pills a day with plenty of water tegretol 200mg--3 by mouth qd, rxed by dr terazosin hcl 2mg--one by mouth at bedtime trazodone hcl 100mg--2 by mouth at hs, per dr vitamin d unit--one by mouth q wk discharge medications: 1. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 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. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 5. sertraline hcl 50 mg tablet sig: three (3) tablet po daily (daily). 6. atorvastatin calcium 20 mg tablet sig: one (1) tablet po daily (daily). 7. levothyroxine sodium 75 mcg tablet sig: one (1) tablet po daily (daily). 8. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 9. losartan potassium 25 mg tablet sig: one (1) tablet po daily (daily). 10. miconazole nitrate 2 % powder sig: one (1) appl topical tid (3 times a day) as needed. 11. amiodarone hcl 200 mg tablet sig: one (1) tablet po daily (daily). 12. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day). 13. guaifenesin 100 mg/5 ml syrup sig: 5-10 mls po q6h (every 6 hours) as needed. 14. trazodone hcl 50 mg tablet sig: one (1) tablet po hs (at bedtime) as needed. 15. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po daily (daily). 16. rifampin 300 mg capsule sig: two (2) capsule po q24h (every 24 hours) for 4 weeks: thru ld . 17. vancomycin hcl 500 mg recon soln sig: 750 mg recon solns intravenous q24h (every 24 hours) for 4 weeks: ld . 18. senna 8.6 mg tablet sig: two (2) tablet po bid (2 times a day) as needed. 19. heparin lock flush 10 unit/ml syringe sig: 5 cc mls intravenous prn (as needed): for picc care. 20. combivent 103-18 mcg/actuation aerosol sig: two (2) puffs inhalation four times a day as needed for shortness of breath or wheezing. 21. insulin glargine 100 unit/ml solution sig: eighteen(18) units subcutaneous at bedtime. 22. insulin regular human 300 unit/3 ml syringe sig: as directed subcutaneous four times a day: see attached sliding scale. discharge disposition: extended care facility: of discharge diagnosis: s/p redo mvr prosthetic valve endocarditis type i dm s/p liver biopsy chronic hyponatremia discharge condition: good discharge instructions: weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet fluid restriction:1200cc you may wash your incisions with mild soap and water do not apply lotions, creams, ointments or powders to your incision do not swim or take a bath for 1 month do not drive for 1 month followup instructions: provider: , md where: lm disease phone: date/time: 10:00 provider: , : cardiac services phone: date/time: 9:00 provider: , .d. where: phone: date/time: 10:50 follow up with dr. in weeks follow up with the clinic in 1 month procedure: venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart closed (percutaneous) [needle] biopsy of liver open and other replacement of aortic valve with tissue graft implant of pulsation balloon incision of vessel, lower limb arteries injection or infusion of nesiritide diagnoses: thrombocytopenia, unspecified anemia, unspecified mitral valve disorders urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension acute and subacute necrosis of liver acute kidney failure, unspecified hyposmolality and/or hyponatremia cardiac complications, not elsewhere classified atrial fibrillation polyneuropathy in diabetes peripheral vascular complications, not elsewhere classified surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation other and unspecified coagulation defects diastolic heart failure, unspecified arterial embolism and thrombosis of lower extremity diabetes with neurological manifestations, type i [juvenile type], not stated as uncontrolled infection and inflammatory reaction due to cardiac device, implant, and graft 

Answer: The patient is high likely exposed to