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: iodine-iodine containing attending: chief complaint: abdominal aortic aneurysm pericardial tamponade major surgical or invasive procedure: endovascular repair of abdominal aortic aneurysm on . pericardiocentesis on . history of present illness: this is an 85 year old gentleman with a recently diagnosed very large abdominal aortic aneurysm. he moved from approximately five years ago. many of his records are there and unobtainable. in , he apparently had a cardiac arrest. he survived that and underwent angioplasty and stress testing since then. he has also had two carotid endarterectomies approximately 10 years ago, again details are unknown. a year ago, he had evidence of pericardial effusion that required a pericardiocentesis at hospital. the etiology to this is unknown. past medical history: htn, mi, copd, kidney stones, smoker, hypothyroidism, not on any of his medication. social history: he smokes one pack of cigarettes a day. he lives alone. son () is hcp and closest relative. family history: no family history of premature coronary disease or sudden death. physical exam: admission baseline: he was alert and oriented. his weight is 135 pounds. his blood pressure: 130/80, pulse is 50/min. neck supple. no carotid bruits. palpation of the heart reveals normally placed pmi, normal s1, s2, no murmurs, rubs or gallops. respiratory effort is adequate. lungs are clear to auscultation bilaterally. abdomen was nontender. i did not feel for his aneurysm. extremities showed no cyanosis, clubbing, or edema. distal pulses are absent. inspection and palpation of skin is normal. the gait and muscle tone are normal. on medicine floor: physical examination: vs: t= 98.2 bp= 157/80 hr= 49 rr= 18 o2 sat= 97% ra general: elderly male lying in bed watching tv in nad. responds appropriately, hard of hearing. heent: sclera anicteric. perrl 3-->2mm, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple, jvp not elevated. cardiac: irregular rhythm with rare premature beats, bradycardic, normal s1, s2. no murmurs/rubs/or gallops. distant heart sounds. no s3 or s4. lll not dull (neg sign). lungs: no accessory muscle use. course rhonchi diffusely. minor wheezes. abdomen: soft/nt/nd. no hsm or tenderness. pos bs. extremities: no clubbing/cyanosis/edema. no pain in bilateral femoral area. cath site right inguinal area clean, nonerythematous, nonedematous. dp/pt 2+ bilat. skin: skin flaking arms bilat. ecchymoses overlying triceps bilat. no stasis dermatitis, ulcers, scars, or xanthomas. pertinent results: 07:50pm glucose-131* urea n-15 creat-1.0 sodium-139 potassium-3.1* chloride-106 total co2-23 anion gap-13 07:50pm alt(sgpt)-9 ast(sgot)-22 alk phos-41 amylase-52 tot bili-0.9 07:50pm lipase-13 07:50pm wbc-5.0 rbc-3.48* hgb-11.3* hct-32.9*# mcv-94# mch-32.4* mchc-34.3 rdw-17.1* 07:50pm wbc-5.0 rbc-3.48* hgb-11.3* hct-32.9*# mcv-94# mch-32.4* mchc-34.3 rdw-17.1* admission chemistry () 138 105 16 3.2 23 1.0 < 101 ca 7.6 phos 2.4 mg 2.1 thyroid labs () tsh 99 t4 4.4 () t3 49 free t4 0.72 ( to ) crit 25.5 --> 33 --> 37 wbc 5.0 --> 8.2 ---> 5.1 plts 92 --> 107 --> 116 ck 429 --> 907 ---> 593 trop 0.05 () --> 0.06 --> 0.07 --> 0.09 --> 0.10 --> 0.11 --> 0.12 --> 0.08 () ua () neg nitrites, neg leuks, 21-50 rbcs pericardial fluid () wbc 55 rbc 45 poly 0 lymph 3 mono 0 macro 92 other 5 time taken not noted log-in date/time: 4:52 pm fluid received in blood culture bottles fluid culture in bottles (preliminary): viridans streptococci. vancomycin sensitivity testing performed by sensititre. viridans streptococci. second morphology. sensitivities: mic expressed in mcg/ml _________________________________________________________ viridans streptococci | vancomycin------------ <=1 s aerobic bottle gram stain (final ): gram positive cocci in chains. discharge chemistry (latest as of ) 137 100 18 3.8 22 1.0 < 70 ca 7.7 phos 2.4 mg 2.1 echo (): the estimated right atrial pressure is 0-5 mmhg. there is mild symmetric left ventricular hypertrophy with normal cavity size. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is mildly depressed (lvef= 45 %). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. the mitral valve leaflets are mildly thickened. there is a large pericardial effusion. there is brief right atrial diastolic collapse. there is significant, accentuated respiratory variation in mitral valve inflows, consistent with impaired ventricular filling. there is also inconsistent very brief right ventricular diastolic collapse. compared with the images of the prior study (images reviewed) of , the size of the pericardial effusion has increased and there are echo signs for early tamponade (however, estimated right atrial pressure is low, which indicate low circulatory volume. this may accentuate the echocardiographic signs of tamponade). repeat echo (): there is a trivial/physiologic pericardial effusion. compared with the prior study (images reviewed) of , large pericardial effusion is no longer present. cxr (): impression: interval extubation without complication. persistent prominence of the cardiac silhouette related to known pericardial effusion. brief hospital course: four days before aaa repair, mr. had a thallium stress test at hospital which found no evidence of ischemia or infarct and borderline left ventricular systolic function with an ejection fraction of 50%. he was aymptomatic at admission on and underwent aaa repair the same day, which was complicated by an episode of hypotension/bradycardia responsive to requiring some atropine and neosynephrine, iv fluids, and two units of prbcs. he was kept intubated overnight and extubated the next morning. tsh done post procedure was 99 uiu/ml with t4 4.4ug/dl. known hypothyroid but he had apparently stopped taking his medications. on , patient developed shortness of breath, bnp 784, diuresed with iv lasix with some improvement; required 2l o2. echo was obtained and showed worsening pericardial effusion from with possible tamponade physiology. cardiac enzymes were also cycled for vomiting. troponins were 0.05/ 0.06/ 0.07. known to have pericardial effusion preoperatively. bnp 784, diuresed with iv lasix with some improvement; required 2l o2. echo was obtained and showed worsening pericardial effusion from with possible tamponade physiology. cardiology was consulted and recommended percardiocentesis and deferral of further diuresis.cardiology was consulted and recommended percardiocentesis and deferral of further diuresis. mr. was given gentle ivf to limit tamponade physiology and taken for pericardiocentesis and pericardial drain placement. during the procedure, he breifly became hypotensive and bradycardic, responsive to 500 cc bolus; thought to be vagal episode at sheath insertion. ra mean 6mmhg, rvedp 8, wedge 12. bp 140 > 87 > 140s. hr 70s > 40s > 70s. removal of 460 cc serous fluid. repeat echo afterwards with improvement. . mr. arrived at the ccu with no complaints. no chest pain. no pnd, orthopnea. reports that at baseline, he can walk around his 2 acre property that is limited primary due to pain in his legs attributed to his pvd. he also has noted some proximal weakness in his lower extremities over the past few months. while in the ccu, psychiatry consulted and found patient to lack capacity due to poor insight/judgement. he stayed in the ccu to , when he transfered to general medicine floor. . on the floor, the pericardia fluid culture returned with strep viridans sensitive to vancomycin. however, he showed no signs of systemic infection (afebrile to 98.1, hemodynamically stable, low-normal wbcs, clinically looked well, and denied any pain or other complaints). the culture result was considered contaminant, so vancomycin was discontinued after briefly starting him on it. on the floor, he intermittently refused all treatment (food, vital signs, blood draws, telemetry). he did permit some physical exams. his catheterization site was clean, dry, and intact throughout stay on medicine floor. there were family meetings on and with son and hcp , who was aware of the dilemma due to patient lacking capacity. with assistance of team, social work, case management, and son , plan was made for patient to be discharged to country rehab hospital in , ma. medications on admission: - aspirin 81 mg a day - patient reports that he was not taking any other medications as prescribed discharge medications: 1. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. 2. aspirin 325 mg tablet sig: one (1) tablet po once a day. 3. ranitidine hcl 150 mg tablet sig: one (1) tablet po every eight (8) hours. 4. levothyroxine 125 mcg tablet sig: one (1) tablet po daily (daily). 5. 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* 6. prednisone 50 mg tablet sig: 1 tablet 13hours prior to ct scan, 1 tablet 7 hours prior to ct scan and 1 tablet 1 hr prior to ct scan tablet po as directed for 3 doses: this is given as prophylaxis given your iodine allergy. disp:*3 tablet(s)* refills:*0* 7. benadryl 25 mg capsule sig: two (2) capsule po once, one hour prior to your ct scan for 1 doses: due to your contrast dye allergy. 8. outpatient lab work blood labs for : tsh, tt4, ft4, t3 uptake 9. simvastatin 20 mg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: country rehabilitation and nursing center - discharge diagnosis: x abdominal aortic aneurysm x pericardial effusion discharge condition: good responds appropriately ambulate as tolerated discharge instructions: medications: ?????? take aspirin 325mg (enteric coated) once daily ?????? do not stop aspirin unless your vascular surgeon instructs you to do so. ?????? continue all other medications you were taking before surgery, unless otherwise directed ?????? you make take tylenol or prescribed pain medications for any post procedure pain or discomfort what to expect when you go home: it is normal to have slight swelling of the legs: ?????? elevate your leg above the level of your heart (use pillows or a recliner) every 2-3 hours throughout the day and at night ?????? avoid prolonged periods of standing or sitting without your legs elevated it is normal to feel tired and have a decreased appetite, your appetite will return with time ?????? drink plenty of fluids and eat small frequent meals ?????? it is important to eat nutritious food options (high fiber, lean meats, vegetables/fruits, low fat, low cholesterol) to maintain your strength and assist in wound healing ?????? to avoid constipation: eat a high fiber diet and use stool softener while taking pain medication what activities you can and cannot do: ?????? when you go home, you may walk and go up and down stairs ?????? you may shower (let the soapy water run over groin incision, rinse and pat dry) ?????? your incision may be left uncovered, unless you have small amounts of drainage from the wound, then place a dry dressing or band aid over the area that is draining, as needed ?????? no heavy lifting, pushing or pulling (greater than 5 lbs) for 1 week (to allow groin puncture to heal) ?????? after 1 week, you may resume sexual activity ?????? after 1 week, gradually increase your activities and distance walked as you can tolerate ?????? no driving until you are no longer taking pain medications ?????? call and schedule an appointment to be seen in weeks for post procedure check and cta what to report to office: ?????? numbness, coldness or pain in lower extremities ?????? temperature greater than 101.5f for 24 hours ?????? new or increased drainage from incision or white, yellow or green drainage from incisions ?????? bleeding from groin puncture site sudden, severe bleeding or swelling (groin puncture site or incision) ?????? lie down, keep leg straight and have someone apply firm pressure to area for 10 minutes. if bleeding stops, call vascular office. if bleeding does not stop, call 911 for transfer to closest emergency room. followup instructions: 1. get bloodwork drawn on (thyroid tests: tsh, tt4, ft4, t3 uptake). we are giving you a prescription for this. please fax results to your pcp's office at . 2. you have a follow-up appt with endocrinology: tuesday at 11am dr , hospital, 1 . 3. you have an appointment with dr. in vascular surgery on at . first you will get a ct scan at 11:30am, then have your appointment at 1:15pm. provider: scan phone: date/time: 11:30 provider: , md phone: date/time: 1:15 ** because you have an allergy to iodine/ contrast dye, you will need to have a prednisone and benadryl prep prior to the scan. please see the prescriptions attached and take the prednisone and benadryl as prescribed prior to the scan ** 4. will need follow up with your primary care physician, . , for monitoring tft and to ensure compliance. call before you are discharged from the rehabilitation facility to make that appointment. 5. you might consider making an appointment with a geriatric psychiatrist at . team was consulted on your care, and would be happy to evaluate and treat any concerns you or family members have about mood or behavior, as an outpatient. phone (. procedure: pericardiocentesis endovascular implantation of other graft in abdominal aorta right heart cardiac catheterization diagnoses: other iatrogenic hypotension coronary atherosclerosis of native coronary artery tobacco use disorder congestive heart failure, unspecified unspecified essential hypertension unspecified acquired hypothyroidism peripheral vascular disease, unspecified other persistent mental disorders due to conditions classified elsewhere other specified forms of chronic ischemic heart disease unspecified disease of pericardium other specified cardiac dysrhythmias personal history of other malignant neoplasm of skin old myocardial infarction other emphysema chronic systolic heart failure iron deficiency anemia, unspecified personal history of noncompliance with medical treatment, presenting hazards to health personal history of urinary calculi abdominal aneurysm without mention of rupture cardiac tamponade 

Answer: The patient is high likely exposed to