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: cough, fever major surgical or invasive procedure: transesophageal echocardiography cardiac catheterization history of present illness: 56 yom w/ a h/o mitral valve prolapse presents with l sided sharp pleuritic chest pain radiating up to his chin and down to his umbilicus as well as dry cough x 3 days. his pain was x 45 minutes 3 days ago and since has been only while coughing. it is sharp and stabbing. no exertional component. no positional component. no doe, no pnd, no orthopnea. no pedal edema. cough is non productive. he has had chills and sweats x 3 days. no other symptoms. no diarrhea / constipation, no urinary symptoms. otherwise ros is negative. no recent dental work. in the ed t 102, hr 122 ceftriaxone and azithro given rec'd fluids 99.2 134/70 hr 86 ekg changes: ste in v1-v3 which appear to be early repolarization past medical history: mitral valve prolapse, otherwise no other medical history social history: drinks 1-2 bottles of wine per day. has not stopped ever so does not know about withdrawal. smokes - 1 ppd x 30 years. no drug use. family history: father w/ cad (angina) at upper 50s. aunt and uncle with lung cancer (smokers). no other cad, mother and brother healthy. physical exam: general: nad, aox3 heent: perrl, eomi, op clear neck: no lad, supple, jvp of 13cm heart: rrr, hsm radiating to back, + thrill lungs: l sided rales 1/2 up abd: +bs, ntnd, soft ext: no edema neuro: 5/5 strength, sensation intact to light touch psych: appropriate skin: no rashes pertinent results: 10:35am glucose-162* urea n-14 creat-0.9 sodium-139 potassium-4.6 chloride-101 total co2-30 anion gap-13 10:35am wbc-7.1 rbc-4.10* hgb-14.1 hct-39.3* mcv-96 mch-34.4* mchc-35.8* rdw-12.9 10:35am neuts-85.0* lymphs-9.7* monos-4.7 eos-0.4 basos-0.2 10:35am sed rate-55* 10:35am ck(cpk)-36* 10:35am ctropnt-<0.01 . hiv ab - negative. ekg: sinus tach, rate 115, lvh and lae. normal axis and intervals. horizontal 1.5mm ste in v1 and 1-2mm ste in v2-v3 that are upsloping and appear to be possible j point elevation. std in v5 and v6. no q waves, normal rwp. cxr (): there is a somewhat ill-defined, hazy airspace opacity in the left mid-lung zone, partially obscuring the left cardiac silhouette, suggesting consolidation in the lingula. the right lung and left upper lung are clear, without other foci of consolidation or pleural effusion. there is no pneumothorax. the heart is not enlarged, and there is no hilar or mediastinal enlargement. pulmonary vascular structures are normal. soft tissue and bony structures are unremarkable. impression: findings consistent with lingular pneumonia. tte (): the left atrium is moderately dilated. left ventricular wall thicknesses are normal. the left ventricular cavity is moderately dilated. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion. no aortic regurgitation is seen. the mitral valve leaflets are myxomatous and elongated. there is severe prolapse of the anterior leaflet with associated, posteriorly-directed jet of moderate to severe (3+) mitral regurgitation. due to the eccentric nature of the regurgitant jet, its severity may be significantly underestimated (coanda effect). no mass or vegetation is seen on the mitral valve. there is no pericardial effusion. impression: myxomatous mitral valve disease with at least moderate to severe mitral regurgitation. dilated left ventricle with preserved global biventricular systolic function. cxr (): since the previous study, there has been development of consolidation at left base. this is likely due to a combination of pleural effusion as well as focal infiltrate from pneumonia. followup to resolution is recommended. there are no signs of overt pulmonary edema. tee (): 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%). right ventricle is normal in size, with normal free wall contractility. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets are mildly thickened. trace aortic regurgitation is seen. the mitral valve leaflets are myxomatous. there is moderate/severe mitral valve prolapse. no mass or vegetation is seen on the mitral valve. moderate to severe (3+) mitral regurgitation is seen. due to the eccentric nature of the regurgitant jet, its severity may be significantly underestimated (coanda effect). there is no pericardial effusion. impression: no evidence of endocarditis. myxomatous mitral valve disease with bileaflet prolapse and moderate to severe regurgitation. cxr - marked interval improvement in left pleural effusion, now tiny. persistent lingular opacity. followup chest x-ray to resolution. brief hospital course: 56 yo male with a history of mvp who presented with cough and l sided chest pain found to have pna as well as chronic sever mr. # severe mr: the patient has a history of mitral valve proplase and was seen to have severe mr on a tte with an elarged left atrium suggesting that this is a chronic process. myxomatous mitral valve leaflets were seen with moderate/severe mvp. no mass or vegetation was seen on the mitral valve. his had preserved systolic function w/ lvef > 55%. due to concern initally for endocarditis given his presentation with fevers and chills he was intially treated with vanc and gent, but given no vegetations on tee, these were discontinued on hd2. tee also showed , myxomatous mv, moderate mvp w/ severe mr w/ eccentric jet. blood cultures were negative at time of discharge. given his tachycardia and elevated sbp's he was treated with nitroprusside for afterload reduction as well as lasix for diuresis. by hd2, he was weaned off nitroprusside and started on captopril titrated up to 25mg tid, w/ sbps 110 - 139. at time of discharge bp was 123/79 and he was transitioned to lisinopril 20mg qd. pt was also discharged on 20mg lasix daily for the week prior to surgery. cardiac surgery evaluated the patient for mvr. the patient underwent a cardiac catheterization which showed 40% mid lad and d1 stenoses, non-flow limiting and clean rca and lcx. # coronaries. see above for cath report results. pt. was not started on asa for primary prevention due to likely surgery within next week. his lipid panel was checked and was pending at time of discharge. this will be follow up as op by his cardiologist. he was not started on a statin, this will also be assessed on outpatient basis after mvr. . # pneumonia: the patient presented with cough, pleuritic chest pain, and intermittent fevers and was seen to have a lingular infiltrate on cxr. he then developed a left-sided pleural effusion the day after admission. he was initally given ceftriaxone and azithromycin in the ed. antibiotics were switched to levofloxacin for a 5 day course at 750 mg daily to treat a community-aquired pna. on hd4, cxr showed much improved l pleural effusion (likely improved from diuresis) and slightly improved l lingular infiltrate. at time of discharge, patient was asymptomatic with oxygen requirement resolved. # rhythm: the patient was monitored on telemetry and remained in sinus rhythm. he was initally tachycardic which was attributed to his pna. he had significant ectopy w/ nsvt of < 9 beats and frequent bigeminy. given nl ef, no icd evaluation was performed and this was deferred to op setting once ef stabilized after mv repair. # hx of heavy alcohol use: the patient had a history of drinking 1-2 bottles of wine per day prior to admission. he was placed on a ciwa scale w/ scocres consistently < 4, and diaphoresis as only sx. he did not require valium. pt. was counseled for drinking sessation. he reported that he will likely continue to drink wine daily. this should be addressed as op as well as during next admission for mv repair to prevent withdrawal and further manage abuse. # tobacco abuse. pt. was placed on nicotine patch and reported quitting smoking. he received counseling and encouragement. he will require op follow up within two weeks. patient was discharged home in hemodynamically stable condition, afebrile and with no oxygen requirement. medications on admission: none discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. 2. levofloxacin 750 mg tablet sig: one (1) tablet po daily (daily) for 2 days. disp:*2 tablet(s)* refills:*0* 3. nicotine 14 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily). disp:*30 patch 24 hr(s)* refills:*2* 4. lisinopril 20 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 5. zolpidem 5 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. disp:*10 tablet(s)* refills:*0* 6. lasix 20 mg tablet sig: one (1) tablet po once a day for 10 days. disp:*10 tablet(s)* refills:*0* 7. outpatient lab work please have your laboratory work done, chem 7 by . have results called to your , , . and cardiologist: dr. , md phone: discharge disposition: home discharge diagnosis: primary: pneumonia, severe mitral valve regurgitation secondary: mitral valve prolapse, alcohol abuse, tobacco abuse discharge condition: hemodynamically stable, afebrile. discharge instructions: you were admitted to with fevers, chills, chest pain and cough. you were diagnosed with pneumonia and treated with antibiotics (levofloxacin). you were also found to have severe mitral regurgitation (valve problem), which will require surgery. you were evaluated by the surgical team, but it was deeemed important for you pneumonia to resolve prior to surgery. you should follow up w/ dr. as below. you also underwent cardiac catheterization which showed some plaques, but no flow limiting plaques. you will need to follow up with dr. (cardiologist) for this as well as further mangement of your heart condition (valvular disease and primary prevention). you were started on a blood lowering medication (lisinopril) and should continue to take this at home. in addition, you were started on a water pill (lasix) you shoud continue to take this at home as well. please take your medications as prescribed (below). please stop smoking. information was given to you on admission regarding smoking cessation as well as a nicotine patch. please follow up with your primary care doctor and your cardiologist. should you experience any new chest pain, fevers, chills, shortness of breath, leg swelling, difficulty with balance, changes in vision, new rash or any other symptom concerning to you, please call your primary care doctor or go to the nearest emergency room. you should also obtain follow up laboratory tests by , a prescription has been provided. followup instructions: please follow up with your , . : , . within one week of discharge from the hospital. please follow up with dr. (cardiac surgery) on monday, at 1.15pm at the buidling, please confirm the appointment: (. please follow up with your cardiologist dr. , md phone: date/time: 3:00. please call to confirm your appointment. procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures diagnostic ultrasound of heart diagnoses: pneumonia, organism unspecified mitral valve disorders 

Answer: The patient is high likely exposed to