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: sulfa (sulfonamides) / acyclovir and derivatives / lasix attending: chief complaint: chest "tightness" major surgical or invasive procedure: none history of present illness: 52 yo female s/p des in cx who presented with chest tightness at , got cathed and was found to have in stent thrombosis on . pt was initially on neo gtt that was weaned off. echo in the other hospital showed moderate mr and severe as. pt is transferred to for further management. past medical history: past medical history lupus erythematosus lupus glomerulonephritis htn hypercholesterolemia coronary artery disease s/p stent left circumflex gerd history shingles in the past diverticulitis with resection of the colon with later reconstruction right below the knee amputation a year secondary mrsa infection social history: widowed -lives with 82yo mother family history: noncontributory physical exam: physical exam afebrile pulse: 91, resp: o2 sat: 97% b/p right: 110/60 left: height: weight: general: skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused lle, rle bka well healed edema varicosities: none neuro: grossly intact pulses: femoral right: +3 left:+3 dp right:+2 left:+2 pt :+2 left:+2 radial right:+2 left:+2 pertinent results: 10:45am blood wbc-10.6 rbc-3.42* hgb-10.0* hct-31.0* mcv-91 mch-29.2 mchc-32.3 rdw-17.7* plt ct-443* 10:10pm blood wbc-16.1* rbc-3.82* hgb-10.9* hct-32.8* mcv-86 mch-28.5 mchc-33.2 rdw-16.5* plt ct-470* 10:45am blood pt-14.1* ptt-59.4* inr(pt)-1.2* 10:10pm blood pt-12.9 ptt-22.9 inr(pt)-1.1 10:45am blood glucose-100 urean-15 creat-1.4* na-140 k-4.4 cl-107 hco3-22 angap-15 10:10pm blood glucose-107* urean-23* creat-1.3* na-141 k-4.0 cl-110* hco3-20* angap-15 05:45am blood alt-18 ast-17 ld(ldh)-397* alkphos-81 amylase-40 totbili-0.7 echocardiography report , portable tte (complete) done at 11:10:31 am final referring physician information , r. , division of cardiothorac , status: inpatient dob: age (years): 52 f hgt (in): 65 bp (mm hg): 91/71 wgt (lb): 162 hr (bpm): 102 bsa (m2): 1.81 m2 indication: aortic valve disease. left ventricular function. mitral valve disease. myocardial infarction. icd-9 codes: 410.91, 424.1, 424.0 test information date/time: at 11:10 interpret md: , md test type: portable tte (complete) son: , rdcs doppler: full doppler and color doppler test location: west sicu/ctic/vicu contrast: none tech quality: adequate tape #: 2009w016-0:13 machine: vivid echocardiographic measurements results measurements normal range left atrium - long axis dimension: *4.7 cm <= 4.0 cm left atrium - four chamber length: *6.1 cm <= 5.2 cm right atrium - four chamber length: 4.6 cm <= 5.0 cm left ventricle - septal wall thickness: *1.3 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.2 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 4.4 cm <= 5.6 cm left ventricle - systolic dimension: 3.6 cm left ventricle - fractional shortening: *0.18 >= 0.29 left ventricle - ejection fraction: 40% >= 55% left ventricle - lateral peak e': 0.11 m/s > 0.08 m/s left ventricle - septal peak e': *0.06 m/s > 0.08 m/s left ventricle - ratio e/e': 13 < 15 aorta - sinus level: 3.3 cm <= 3.6 cm aorta - arch: 2.1 cm <= 3.0 cm aortic valve - peak velocity: *2.6 m/sec <= 2.0 m/sec aortic valve - peak gradient: *27 mm hg < 20 mm hg aortic valve - mean gradient: 12 mm hg aortic valve - lvot pk vel: 0.90 m/sec aortic valve - lvot diam: 2.0 cm aortic valve - valve area: *1.1 cm2 >= 3.0 cm2 mitral valve - e wave: 1.1 m/sec mitral valve - e wave deceleration time: *114 ms 140-250 ms tr gradient (+ ra = pasp): 19 mm hg <= 25 mm hg findings left atrium: mild la enlargement. right atrium/interatrial septum: normal ra size. normal ivc diameter (<2.1cm) with <35% decrease during respiration (estimated ra pressure indeterminate). left ventricle: mild symmetric lvh. normal lv cavity size. mild regional lv systolic dysfunction. mildly depressed lvef. no resting lvot gradient. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. normal aortic arch diameter. no 2d or doppler evidence of distal arch coarctation. aortic valve: severely thickened/deformed aortic valve leaflets. moderate as (area 1.0-1.2cm2) mild (1+) ar. mitral valve: mildly thickened mitral valve leaflets. mild mitral annular calcification. mild thickening of mitral valve chordae. calcified tips of papillary muscles. mild to moderate (+) mr. lv inflow pattern c/w restrictive filling abnormality, with elevated la pressure. tricuspid valve: mildly thickened tricuspid valve leaflets. mild tr. normal pa systolic pressure. pulmonic valve/pulmonary artery: pulmonic valve not visualized. no ps. physiologic pr. pericardium: no pericardial effusion. general comments: resting tachycardia (hr>100bpm). the rhythm appears to be atrial fibrillation. regional left ventricular wall motion: n = normal, h = hypokinetic, a = akinetic, d = dyskinetic conclusions the left atrium is mildly dilated. the right atrial pressure is indeterminate. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. there is mild regional left ventricular systolic dysfunction with severe hypokinesis of the inferior, inferolateral, anterolateral, and apical walls. overall left ventricular systolic function is mildly depressed (lvef= 40 %). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are severely thickened/deformed. there is moderate aortic valve stenosis (valve area 1.1cm2). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild to moderate (+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. impression: regional left ventricular systolic function consistent with coronary artery disease. moderate aortic stenosis. mild aortic regurgitation. mild to moderate mitral regurgitation. electronically signed by , md, interpreting physician 15:04 ?????? caregroup is. all rights reserved. brief hospital course: 52 yo female s/p drug eluding stenet in the circumflex who presented with chest tightness at osh, got cathed and was found to have in stent thrombosis on . an echocardiogram at the other hospital showed moderate mr and severe as. pt was transferred to for further management and preoperative surgical evaluation and work up. while an inpatient, in anticipation of aortic and possible mitral valve replacement/repair, ms. was seen by the dental service for her poor dentition. it was determined that she would need dental extraction prior to surgery. the day before her planned dental extraction her oral surgery was cancelled because she was noted to have a diffuse, generalized rash with erythematous eruptions. dermatology was consulted for further evaluation and management of the rash. derm felt the rash was most consistent with a hypersensitvity type of reaction one could see with a drug reaction. as a precaution, a skin bx was performed. bx findings were consistent with agep/pustular drug eruption. culprit was unspecified but possible suspects were likely lasix and cipro which were both discontinued. her rash subsequently improved during the remainder of her hospitalization. infectious disease was consulted for her leukocytosis and recommendations followed. on , ms. was taken to the operating room for surgical extraction of teeth #14 and #19 which were infected /caries nonrestorable teeth in preparation for heart surgery. over the remaining course of her hospital admission ms. was in and out of atrial fibrillation and was placed on heparin drip for anticoagulation. as her leukocytosis and rash improved, her nutritional status waned. prior to her operative date her albumin level was 2.8. dr. discussed with ms. the risks and potential wound healing complications with nutritional depletion. it was agreed to get a nutrition evaluation and assessment to optimize ms. status, and reschedule her surgery for a later date to optimize her potential for postoperative recovery. ms. was discharged to home on after a nutritional consult was performed. she was advised of follow up with dr. at mwmc on to recheck her albumin level, coags, and to reschedule an operative date. inr/coumadin dosing follow up was arranged with mwmc. ms. was discharged on coumadin for her paroxysmal atrial fibrillation. medications on admission: medications at home: 1. mvi tab po daily 2. norvasc 5 mg po daily 3. lipitor 20 po daily 4. protonix 40 mg po daily 5. prednisone 2 mg daily 6. tramadol prn 7. asa 81 mg po daily 8. caltrate 600 mg po daily 9. actonel 35 mg po q sunday 10. atenolol 50 mg am and 100 mg qpm 11. cozaar 100mg 12. sodium bicarbonate discharge medications: 1. 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:*0* 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 3. warfarin 2.5 mg tablet sig: goal inr 2.0-2.5 tablets po goal inr 2.0-2.5: please take 2.5mg and please have inr drawn with results to mwhc coumadin clinic for further dosing - goal inr 2.0-2.5. disp:*60 tablet(s)* refills:*0* 4. metoprolol tartrate 25 mg tablet sig: three (3) tablet po twice a day. disp:*180 tablet(s)* refills:*0* 5. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 6. triamcinolone acetonide 0.1 % cream sig: one (1) appl topical (2 times a day). disp:*qs qs* refills:*0* 7. diphenhydramine hcl 25 mg capsule sig: one (1) capsule po q6h (every 6 hours) as needed for itching. disp:*30 capsule(s)* refills:*0* 8. prednisone 1 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*0* 9. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 10. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 11. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 12. ultram 50 mg tablet sig: one (1) tablet po every four (4) hours as needed for pain. disp:*50 tablet(s)* refills:*0* 13. caltrate 600 600 mg (1,500 mg) tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 14. cozaar 25 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 15. outpatient work pt/inr for coumadin dosing first draw and then as instructed by coumadin clinic results to coumadin clinic heart center # 16. outpatient work sma7, cbc, albumin - please have drawn results to mwhc attention dr fax discharge disposition: home discharge diagnosis: -coronary artery disease with in-stent thrombosis/moderate aortic stenosis/ mild-moderate mitral regurgitation -lupus erythematosus -lupus glomerulonephritis -hypertension -hypercholesterolemia -coronary artery disease s/p stent left circumflex -gerd -history shingles in the past -diverticulitis with resection of the colon with later reconstruction -right below the knee amputation a year secondary mrsa infection discharge condition: good discharge instructions: as per nutritional recommendations medication compliance followup instructions: clinic appointment with dr. on , -please call for appointment # **recheck albumin level/urine analysis and cx/coags -being discharged on coumadin procedure: closed biopsy of skin and subcutaneous tissue extraction of deciduous tooth extraction of deciduous tooth diagnoses: pneumonia, organism unspecified systemic lupus erythematosus nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere coronary atherosclerosis of native coronary artery urinary tract infection, site not specified unspecified essential hypertension atrial fibrillation cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure mitral valve insufficiency and aortic valve stenosis other complications due to other cardiac device, implant, and graft dermatitis due to drugs and medicines taken internally rash and other nonspecific skin eruption accidents occurring in residential institution other specified antibiotics causing adverse effects in therapeutic use surgical or other procedure not carried out because of contraindication other diuretics causing adverse effects in therapeutic use acute apical periodontitis of pulpal origin other dental caries 

Answer: The patient is high likely exposed to