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 / erythromycin base attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: - redo sternotomy, avr (19mm onyx mechanical valve) history of present illness: this is a 32-year-old patient who has had a prior homograft replacement of the aortic root for aortic stenosis, presented at this time with severe aortic stenosis confirmed by echo with symptoms. he was electively admitted for redo sternotomy and replacement of the aortic valve and possibly root replacement. past medical history: - s/p homograft avr in - h/o atrial flutter, status post cardioversion - h/o subarachnoid bleed in the right parietal temporal region secondary to lovenox; w/u in progress for platelet dysfunction - s/p appendectomy in - hernia repair in social history: he is married, with three children. owns a restaurant in , cooks there. social etoh, quit smoking several months ago, previous pack per day for 12-years. family history: -mother with diabetes -father is healthy -no strokes in family -no h/o premature cad/sudden cardiac death physical exam: 98.7, 101/60, 81, 22, 97/ra, 128.3 kg gen: comfortable, no distress heent: no lad, mmm, perla, no op lesions neck: thick, no jvd appreciable heart: s1/s2, rrr, 3/6 sem best heard at rusb abd: obese, soft/nt ext: no edema, 2+ pulses neuro: aox3, no focal deficits pertinent results: echopre-bypass: 1. no spontaneous echo contrast is seen in the left atrial appendage. no atrial septal defect is seen by 2d or color doppler. 2. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is moderately dilated. overall left ventricular systolic function is mildly depressed globally. 3. the right ventricular cavity is mildly dilated. there is moderate global right ventricular free wall hypokinesis, more toward the middle and apical free wall. 4. there are simple atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta. 5. the aortic valve appears to be a homograft. the prosthetic aortic valve leaflets are thickened. the transaortic gradient is higher than expected for this type of prosthesis. a mass is present on the aortic valve, consistent with possible endocarditis. no obvious abscess cavities seen . there is severe aortic valve stenosis (area <0.8cm2). severe (4+) aortic regurgitation is seen. 6. mild (1+) mitral regurgitation is seen. post-bypass: for the post-bypass study, the patient was receiving vasoactive infusions including norepinephrine and vasopressin. 1. biventricular systolic function slightly improved. 2. mechanical valve seen in the aortic position. trace to mild central aortic insufficiency present. however views of the prosthetic aortic valve are limited and poor. mean gradient across the valve was 20 mm hg. 3. trace mitral insufifciency present. cxr: comparison with the previous study done . there is interval improvement in minimal left basilar atelectasis. the lungs appear otherwise clear. no pleural effusion is identified. the heart appears enlarged, as before. the patient is status post median sternotomy. mediastinal structures are unchanged. the bony thorax is grossly intact. 04:45pm blood wbc-7.9 rbc-4.44* hgb-13.2* hct-36.0* mcv-81* mch-29.8 mchc-36.7* rdw-16.1* plt ct-186 07:15am blood wbc-4.4 rbc-2.87* hgb-8.2* hct-23.3* mcv-81* mch-28.6 mchc-35.3* rdw-16.2* plt ct-166 06:15am blood wbc-8.5 rbc-3.09* hgb-8.6* hct-25.3* mcv-82 mch-27.7 mchc-33.8 rdw-17.3* plt ct-398 04:45pm blood pt-13.2* ptt-24.4 inr(pt)-1.2* 06:15am blood pt-20.4* ptt-87.4* inr(pt)-2.0* 04:45pm blood glucose-107* urean-22* creat-1.1 na-137 k-4.1 cl-101 hco3-29 angap-11 06:15am blood glucose-95 urean-19 creat-0.9 na-134 k-4.6 cl-99 hco3-27 angap-13 brief hospital course: mr. was admitted to the on for surgical management of his aortic valve disease. he was taken to the operating room where he underwent a redo sternotomy with an aortic valve replacement using a 19mm onyx valve. please see operative note for details. postoperatively he was taken to the cardiac intensive care unit for monitoring. over the next 24 hours, mr. neurologically intact and was extubated. he was noted to be in a junctional rhythm which occasionally alternated with sinus rhythm. the electrophysiology service was consulted who recommended holding his amiodarone and lopressor until sinus rhythm returns. it was also recommended that he be pancultured in the event that he becomes febrile as an infectious cause could be the cause of his rhythm disturbance. coumadin was started for anticoagulation for his mechanical valve. on postoperative day two, mr. was transferred to the step down unit for further recovery. he was gently diuresed towards his preoperative weight. the physical therapy service was consulted for assistance with his postoperative strength and mobility. mr. continued to make steady progress and was discharged home on postoperative day eleven. he will follow-up with dr. , his cardiologist and primary care physician as an outpatient. dr. will follow his coumadin and target inr is 2.0-3.0. medications on admission: lopressor 25 mg daily multivitamin aldactazide 25 mg/ 25 mg daily discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) for 1 months. disp:*60 capsule(s)* refills:*0* 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 3. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day) for 1 months. disp:*60 tablet(s)* refills:*0* 4. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 5. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. ascorbic acid 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 8. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* discharge disposition: home with service facility: home health and hospice care discharge diagnosis: aortic stenosis s/p avr homograft s/p redo-sternotomy, aortic valve replacement (mechanical) pmh: aflutter s/p cardioversion, subarachnoid hemorrhage, sleep apnea, obesity, platelet disfunction ? , cardiobacterium endocarditis, glomerulonephritis, cerebral aneurysm discharge condition: stable discharge instructions: 1) monitor wounds for signs of infection. these include redness, drainage or increased pain. in the event that you have drainage from your sternal wound, please contact the at (. 2) report any fever greater then 100.5. 3) report any weight gain of 2 pounds in 24 hours or 5 pounds in 1 week. 4) no lotions, creams or powders to incision until it has healed. you may shower and wash incision. please shower daily. no bathing or swimming for 1 month. use sunscreen on incision if exposed to sun. 5) no lifting greater then 10 pounds for 10 weeks. 6) no driving for 1 month. 7) please take coumadin as instructed. please note your dose may change based on you blood levels (pt/inr). take only as directed for a mechanical aortic valve replacement. goal inr 2.0-3.0. 7) call with any questions or concerns. followup instructions: provider: phone: date/time: 1:00 provider: , m.d. phone: date/time: 2:00 provider: , md phone: date/time: 10:00 follow-up with pcp . in weeks. first blood draw: ..........with results to be called to dr. for coumadin follow-up follow-up with dr. in 1 month ( clinic , call for appt. upon discharge for complete eye exam. procedure: extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart open and other replacement of aortic valve transfusion of other serum transfusion of platelets diagnoses: obstructive sleep apnea (adult)(pediatric) atrial flutter systolic heart failure, unspecified other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other specified cardiac dysrhythmias mechanical complication due to heart valve prosthesis obesity, unspecified other specified visual disturbances nephritis and nephropathy, not specified as acute or chronic, with unspecified pathological lesion in kidney qualitative platelet defects 

Answer: The patient is high likely exposed to