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: tetracycline attending: chief complaint: shortness of breath/edema major surgical or invasive procedure: none history of present illness: 63 y/o female s/p asd closure and right femoral artery repair on who was readmitted for a sternal wound infection. she underwent a debridement and flap closure on by the plastic surgery service. she was discharged with intravenous nafcillin for 6 weeks. today she noted increasing lower extremity edema and dyspnea. she also noted some new sternal drainage. she is now readmitted for further management. past medical history: asd now s/p closure copd, ^lipids, htn, s/p meningitis, s/p t+a, s/p appy, s/p wrist surgery, sternal wound infection, sternal debridement and flap closure , femoral artery repair. social history: retired 45 pack year smoking history, wuit . no etoh family history: nc physical exam: 99.0 mild resp distress no icterus, mmm rrr bilateral crackles on lung exam abd soft, nt/nd ext: 3+ pitting le edema neuro nonfocal pertinent results: 10:20pm neuts-83.3* lymphs-11.2* monos-3.6 eos-1.9 basos-0.1 10:20pm wbc-11.1* rbc-2.98* hgb-8.9* hct-27.5* mcv-92 mch-29.8 mchc-32.3 rdw-15.2 10:20pm glucose-112* urea n-10 creat-1.5* sodium-138 potassium-3.2* chloride-104 total co2-25 anion gap-12 cxr enlarging left-sided pleural effusion and mild pulmonary edema. 07:58am blood wbc-6.9 rbc-2.91* hgb-8.6* hct-27.1* mcv-93 mch-29.6 mchc-31.8 rdw-16.2* plt ct-713* 07:58am blood plt ct-713* 07:58am blood glucose-98 urean-11 creat-1.7* na-141 k-3.7 cl-101 hco3-32 angap-12 07:58am blood calcium-8.5 phos-3.7 mg-1.7 radiology final report chest (pa & lat) 8:52 am chest (pa & lat) reason: eval for pleural effusions medical condition: 63 year old woman s/p asd repair reason for this examination: eval for pleural effusions two-view chest comparison: . indication: pleural effusion assessment. indwelling devices are unchanged in position. moderate left pleural effusion has slightly decreased in size and small-to-moderate partially loculated right pleural effusion is unchanged. cardiomegaly and enlargement of central pulmonary arteries is again demonstrated as well as bibasilar areas of atelectasis. impression: slight decrease in left pleural effusion. no substantial change in right pleural effusion. dr. approved: sat 1:17 pm echocardiography report , portable tte (complete) done at 12:07:03 pm final referring physician information , division of cardiothoracic , status: inpatient dob: age (years): 63 f hgt (in): 66 bp (mm hg): 126/68 wgt (lb): 177 hr (bpm): 72 bsa (m2): 1.90 m2 indication: mitral valve disease. icd-9 codes: 424.0, 424.2 test information date/time: at 12:07 interpret md: , md test type: portable tte (complete) son: , rdcs doppler: full doppler and color doppler test location: / 6 contrast: none tech quality: suboptimal tape #: 2007w079-0:27 machine: vivid echocardiographic measurements results measurements normal range left atrium - long axis dimension: 3.6 cm <= 4.0 cm left atrium - four chamber length: *6.1 cm <= 5.2 cm left atrium - peak pulm vein s: 0.2 m/s left atrium - peak pulm vein d: 0.7 m/s right atrium - four chamber length: *6.0 cm <= 5.0 cm left ventricle - septal wall thickness: 1.0 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: 1.0 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 4.8 cm <= 5.6 cm left ventricle - ejection fraction: >= 60% >= 55% aorta - sinus level: 2.6 cm <= 3.6 cm aorta - ascending: 2.8 cm <= 3.4 cm aortic valve - peak velocity: 1.4 m/sec <= 2.0 m/sec aortic valve - lvot diam: 2.1 cm mitral valve - e wave: 1.1 m/sec mitral valve - e wave deceleration time: 232 ms 140-250 ms mitral valve - : 0.20 cm2 mitral valve - regurgitation volume: 28 ml tr gradient (+ ra = pasp): *50 mm hg <= 25 mm hg findings this study was compared to the prior study of . left atrium: moderate la enlargement. right atrium/interatrial septum: mildly dilated ra. left ventricle: normal lv wall thickness, cavity size, and systolic function (lvef>55%). suboptimal technical quality, a focal lv wall motion abnormality cannot be fully excluded. no resting lvot gradient. right ventricle: normal rv chamber size and free wall motion. . aortic valve: normal aortic valve leaflets (3). no as. no ar. mitral valve: mildly thickened mitral valve leaflets. mild mitral annular calcification. eccentric mr jet. moderate (2+) mr. tricuspid valve: normal tricuspid valve leaflets. moderate tr. moderate pa systolic hypertension. pericardium: trivial/physiologic pericardial effusion. general comments: suboptimal image quality - poor parasternal views. conclusions the left atrium is moderately dilated. left ventricular wall thickness, cavity size, and systolic function are normal (lvef>55%). due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are mildly thickened. an eccentric, laterally directed jet of moderate (2+) mitral regurgitation is seen. moderate tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. compared with the prior study (images reviewed) of , the severity of mitral and tricuspid regurgitaition as well as the estimated pulmonary artery systolic pressure are now reduced. clinical implications: based on aha endocarditis prophylaxis recommendations, the echo findings indicate prophylaxis is not recommended. clinical decisions regarding the need for prophylaxis should be based on clinical and echocardiographic data. electronically signed by , md, interpreting physician 12:24 ?????? brief hospital course: ms. was admitted to the on for further management of her dyspnea and lower extremity edema. she was placed on lasix and oxygen. she was seen in consultation by the infectious disease service and the plastic surgery service. an echocardiogram was performed which revealed moderate mitral regurgitation, moderate tricuspid regurgitation, and severe pulmonary hypertension. she was placed on imdur for afterload reduction and gentle diuresis continued given her mildly elevated creatinine.beta blockade was titrated and she continued on iv abx therapy as per her prior discharge. after echo, she was cleared for discharge to home with services for abx therapy on . medications on admission: lopressor 25mg aspirin 81mg qd lipitor 10mg qd colace 100mg zantac 150mg qd dilaudid 2mg prn q4 flagyl 500mg tid nafcillin 2mg iv q4 discharge medications: 1. nafcillin in d2.4w 2 gram/100 ml piggyback sig: one (1) intravenous q4h (every 4 hours) for 7 weeks: completes (total 8 week course started ). disp:*qs qs* refills:*0* 2. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 7 weeks: continue through completion of naficillin . disp:*147 tablet(s)* refills:*0* 3. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day for 2 weeks. disp:*14 tab sust.rel. particle/crystal(s)* refills:*0* 4. furosemide 40 mg tablet sig: one (1) tablet po once a day for 2 weeks. disp:*14 tablet(s)* refills:*0* 5. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). disp:*30 tablet, chewable(s)* refills:*0* 6. miconazole nitrate 2 % powder sig: one (1) appl topical (2 times a day) as needed. disp:*qs qs* refills:*0* 7. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 8. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 9. isosorbide mononitrate 30 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). disp:*30 tablet sustained release 24 hr(s)* refills:*0* 10. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*0* 11. picc line flush heparin flush picc (100 units/ml) 2 ml iv daily:prn 10 ml ns followed by 2 ml of 100 units/ml heparin (200 units heparin) each lumen daily and prn. inspect site every shift. 12. outpatient lab work outpatient lab work qweekly (thrusdays) cbc , bun/creat, lfts. fax results to dr. in id at discharge disposition: home with service facility: vna discharge diagnosis: peripheral edema s/p asd closure 11/6sternal infection with debridement and flap closure copd htn elev. lipids discharge condition: stable discharge instructions: 1) monitor wounds for signs of infection. these include redness, drainage or increased pain. call surgeon at ( with any wound issues. 2) report any fever greater then 100.5. 3) monitor daily weights. report any weight gain of 2 pounds in 24 hours or 5 pounds in 1 week. 4) no lifting greater then 10 pounds for 10 weeks from day of surgery. 5) jp to bulb suntion - please measure daily and record followup instructions: please follow-up with dr. in 1 month. ( please follow-up with pcp . in weeks. please follow-up with dr. on friday . scheduled appointments - provider: ,md mph: date/time: 11:00 procedure: local excision of lesion or tissue of bone, scapula, clavicle, and thorax [ribs and sternum] graft of muscle or fascia excisional debridement of wound, infection, or burn other immobilization, pressure, and attention to wound diagnoses: pneumonia, organism unspecified other postoperative infection cellulitis and abscess of trunk unspecified essential hypertension acute kidney failure, unspecified chronic airway obstruction, not elsewhere classified cardiac complications, not elsewhere classified atrial fibrillation other and unspecified hyperlipidemia methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site intestinal infection due to clostridium difficile 

Answer: The patient is high likely exposed to