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 / biaxin / erythromycin base / morphine / cipro / demerol / iv dye, iodine containing contrast media / sulfa (sulfonamide antibiotics) attending: chief complaint: shortness of breath major surgical or invasive procedure: aortic valve replacement with a 23-mm magna ease aortic valve bioprosthesis. history of present illness: the patient is a 77yo diabetic female who was hospitalized 4 months ago for dyspnea and was found to be in congestive heart failure with aortic stenosis. she reports worsening shortness of breath over the past few months during conversation, and lightheadedness when getting out of bed, or going from sitting to standing position. symptoms increased over last 3 weeks. she has to stop three times to rest 15min each time to make bed. able to go up only 3 stairs, then rest. near syncopal episodes daily. after extensive workup, she was cleared to proceed with high risk aortic valve replacement. past medical history: - aortic stenosis - hypertrophic cardiomyopathy (ef 35%) - chf - dvt (lle ) - coumadin d/c'd 2 months ago - hypercalcemia - atypical pneumonia (ground glass opacities both lungs) - dm type 2 - temporal ateritis (chloroquine, imuran, prednisone) - ? lupus (rheum workup in progress) - abdominal aortic aneurysm s/p repair (eastern me med ctr) - htn - ckd - hyporenemic,hyperaldosteronism - osteoarthritis - osteoporosis - dyslipidemia - reactive airway disease - bilateral cataract surgery - tah/bso - cholecystectomy - vertebroplasty x2 secondary to compression fracture - colonoscopy () - bilateral retinal occlusion (dr - opthal., ) (avastin injections q 6 wks) social history: social history: lives with 86yo husband. local (), son in ( ). friends assist at home. race: caucasian last dental exam: 1 year ago (acadia dental arts) lives with: husband occupation: retired postal carrier (27yrs) tobacco: quit 40 yrs ago (3/4ppd x 25yrs) etoh: none family history: mother(89) and father (60's) deceased from cad. physical exam: pulse: 85 b/p: right 137/82 left resp: 18 o2 sat: 99 temp: 97.8 height: weight: general: alert pleasant elderly female in wheelchair skin: multiple areas of echymosis, turgor poor heent: normocephalic, anicteric, eyeglasses, oropharynx moist, conjunctiva pink neck: referred murmer ausculatated, neck supple, trachea midline chest: no obvious deformities/scars heart: murmer throughout abdomen: soft, nontender, nondistended, well healed midline incisional scar extremities: trace pedal edema neuro: alert and oriented, in wheelchair, pleasant asking questions approp. pulses: palpable peripheral pulses pertinent results: intraop tee pre-bypass: 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. there is mild symmetric left ventricular hypertrophy with normal cavity size and global systolic function (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. there are focal calcifications in the aortic arch. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets are severely thickened/deformed. there is severe aortic valve stenosis (valve area 0.8-1.0cm2). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. there is no pericardial effusion. dr. was notified in person of the results before surgical incision. . post-bypass: normal rv systolic function. poor echo windows does not allow to rule out possible segmental wall motion abnormalities. lvef 55%. intact thoraic aorta. . chest x-ray: removal of endotracheal tube and other support and monitoring devices, with residual right internal jugular vascular sheath remaining in place. no visible pneumothorax. cardiomediastinal contours are stable in the postoperative period, improving atelectasis in left lower lobe. slight worsening minor atelectasis at right lung base. persistent small left pleural effusion, but no visible pneumothorax. labs 06:25am blood wbc-7.6 hct-28.4* 06:02am blood wbc-12.9* rbc-3.62* hgb-10.6* hct-31.3* mcv-87 mch-29.4 mchc-34.0 rdw-16.3* plt ct-150 06:25am blood urean-28* creat-1.0 na-136 k-4.4 cl-102 10:50am blood glucose-252* urean-22* creat-0.9 na-138 k-3.3 cl-101 hco3-30 angap-10 06:02am blood glucose-151* urean-23* creat-1.0 na-138 k-3.5 cl-101 hco3-29 angap-12 06:10pm blood na-136 k-4.2 cl-103 01:46am blood glucose-113* urean-27* creat-1.1 na-139 k-5.5* cl-112* hco3-22 angap-11 brief hospital course: mrs. was admitted and underwent an aortic valve replacement by dr. . given penicillin allergy, she required vancomycin for perioperative antibiotic coverage. for surgical details, please see operative note. following surgery, she was brought to the cvicu for invasive monitoring. within 24 hours, she awoke neurologically intact and was extubated without incident. she maintained stable hemodynamics and transferred to the cardiac sdu on postoperative day one. she continued to progress well and worked with physical therapy for strength and mobility. her lopressor and lisinopril were increased for better heart rate and blood pressure control. lantus was also titrated up for hyperglycemia. on pod5 she was ambulating with assistance, tolerating a full oral diet and her incisions were healing well. it was thought that she was safe for transfer to rehab at this time. azathrioprine was restarted upon transfer to rehab. all follow up appointments were advised. medications on admission: amlodipine - (prescribed by other provider) - 10 mg tablet - 1 tablet(s) by mouth once a day azathioprine - (prescribed by other provider) - 50 mg tablet - 1 tablet(s) by mouth twice a day calcitonin (salmon) - (prescribed by other provider) - 200 unit/dose spray, non-aerosol - 1 spray in each nostril once a day alternating each nostril escitalopram - (prescribed by other provider) - 10 mg tablet - 1 tablet(s) by mouth qd am fentanyl - (prescribed by other provider) - 50 mcg/hour patch 72 hr - apply topically q72 hrs as needed for prn fludrocortisone - (prescribed by other provider) - 0.1 mg tablet - 1 tablet(s) by mouth once a day fluticasone-salmeterol - (prescribed by other provider) - 250 mcg-50 mcg/dose disk with device - 1 puff inh twice a day furosemide - (prescribed by other provider) - 40 mg tablet - 1 tablet(s) by mouth once a day hydroxychloroquine - (prescribed by other provider) - 200 mg tablet - 1 tablet(s) by mouth once a day alternate with 200mg lorazepam - (prescribed by other provider) - 1 mg tablet - 1 tablet(s) by mouth once a day as needed for prn sleep lorazepam - (prescribed by other provider) - 0.5 mg tablet - 1 tablet(s) by mouth q6hrs as needed for prn anxiety pantoprazole - (prescribed by other provider) - 40 mg tablet, delayed release (e.c.) - 1 tablet(s) by mouth once a day as needed for prn prednisone - (prescribed by other provider) - 1 mg tablet - 6 tablet(s) by mouth once a day discharge medications: 1. prednisone 5 mg/5 ml solution sig: 6 ml po daily (daily). 2. norvasc 10 mg tablet sig: one (1) tablet po once a day. 3. hydroxychloroquine 200 mg tablet sig: one (1) tablet po once a day. 4. escitalopram 10 mg tablet sig: one (1) tablet po daily (daily). 5. hydromorphone 2 mg tablet sig: 1-2 tablets po every four (4) hours as needed for pain. disp:*65 tablet(s)* refills:*0* 6. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 8. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 9. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 10. calcitonin (salmon) 200 unit/actuation spray, non-aerosol sig: one (1) nasal daily (daily). 11. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 12. fentanyl 12 mcg/hr patch 72 hr sig: one (1) patch 72 hr transdermal q72h (every 72 hours). disp:*7 patch 72 hr(s)* refills:*0* 13. lorazepam 0.5 mg tablet sig: 0.5 tablet po q6h (every 6 hours) as needed for anxiety. 14. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 15. fludrocortisone 0.1 mg tablet sig: one (1) tablet po daily (daily). 16. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*65 tablet(s)* refills:*0* 17. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). 18. metoprolol tartrate 25 mg tablet sig: three (3) tablet po tid (3 times a day). 19. hydralazine 25 mg tablet sig: one (1) tablet po q6h (every 6 hours). 20. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain, fever. 21. potassium chloride 20 meq tablet, er particles/crystals sig: one (1) tablet, er particles/crystals po once a day for 7 days. 22. azathioprine 50 mg tablet sig: one (1) tablet po twice a day. 23. lantus 30 units sq daily at b-fast 24. furosemide 20 mg tablet sig: one (1) tablet po daily (daily) for 7 days: d/c when le edema resolved and at pre-op weight of 60kg. 25. regular insulin regular insulin per sliding scale based on qid fingerstick discharge disposition: extended care facility: center rehab discharge diagnosis: aortic stenosis, s/p avr chronic diastolic congestive heart failure hypertrophic cardiomyopathy type ii diabetes mellitus temporal arteritis hypertension chronic kidney disease history of dvt prior repair of abd aortic aneurysm discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with dilaudid incisions: sternal - healing well, no erythema or drainage lower extremities - trace edema discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions please no lotions, cream, powder, or ointments to incisions each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart no driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive no lifting more than 10 pounds for 10 weeks please call with any questions or concerns **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge followup instructions: you are scheduled for the following appointments surgeon: on at 1:45pm in the medical office building, cardiologist: in 3 weeks - office will contact patient with appointment please call to schedule appointments with your primary care dr. in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft diagnoses: congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified aortic valve disorders chronic kidney disease, unspecified other and unspecified hyperlipidemia osteoporosis, unspecified long-term (current) use of anticoagulants osteoarthrosis, unspecified whether generalized or localized, site unspecified personal history of venous thrombosis and embolism chronic diastolic heart failure giant cell arteritis other hypertrophic cardiomyopathy 

Answer: The patient is high likely exposed to