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: history of present illness: the patient is a 49 year-old hispanic woman who reports developing intermittent chest discomfort described as substernal tightness with radiation to the left arm sometimes related to activity and sometimes not, also associated with shortness of breath. this chest discomfort has been occurring more frequently in the recent past week. she also reports near syncope when she climbs a flight of stairs. all symptoms resolve with rest and sublingual nitroglycerin. the patient was transferred to from center in where she underwent echocardiographic evaluation and was found to have tight aortic stenosis. she subsequently underwent a cardiac catheterization also at bay state, which demonstrated normal coronary arteries, tight aortic stenosis and a possible ascending aortic aneurysm. she is referred to for aortic valve replacement. past medical history: 1. rheumatic fever. 2. noninsulin dependent diabetes mellitus. 3. hypertension. 4. hypercholesterolemia. 5. asthma. 6. status post hysterectomy. medications on transfer: cardizem, nitropaste, insulin and paxil. allergies: no known drug allergies. family history: noncontributory. social history: she smokes one pack per day. she lives with her daughter whose phone number is . she is spanish speaking only. physical examination on admission: vital signs heart rate 60 and regular. blood pressure 120/70. respiratory rate 20. general, hispanic woman in no acute distress. heent is unremarkable. neck is supple. bilateral carotid bruits with no lymphadenopathy. lungs are clear to auscultation. heart sounds 3/6 systolic ejection murmur. abdomen is soft, nontender, nondistended. no masses. well healed vertical midline incision. extremities no clubbing, cyanosis or edema. good pulses throughout. no varicose veins. neurological cranial nerves ii through xii grossly intact. alert, responsive and communicative. laboratory data: sodium 143, potassium 3.7, bun 6, creatinine 0.8, white count 4.9, hemoglobin 12.9, hematocrit 37.1, platelet count 222. cardiac catheterization at bay state normal coronary arteries. valve gradient per echocardiogram also done at bay state 65 mmhg with a mean and 115 mmhg for the peak. normal ejection fraction of 70%. hospital course: the patient was admitted to where she underwent preoperative workup, which included a dental examination as the patient states that she had not had a dental examination in quite some time. the dental examination recommended teeth extractions and on , the patient underwent dental extractions times four. the patient also had a preoperative cardiology consult as well as repeat cardiac catheterization. repeat catheterization showed clean coronaries with severe as, bicuspid aortic valve, hypertrophic cardiomyopathy, a peak gradient of 115 and a mean gradient of 68, aortic valve area 0.8 cm square. post catheterization discussion centered around degree of as versus left ventricular outflow obstruction and whether or not the patient could be treated medically or she was best served undergoing an aortic valve replacement. the decision was made by the cardiothoracic team as well as cardiology that the patient did indeed need to have her aortic valve replaced and on the the patient was brought to the operating room at which time she underwent an aortic valve replacement. please see the operating report for full details. in summary, the patient underwent an aortic root and valve replacement with a #19 carbomedics. it was a prolonged procedure with a bypass time of two and a half hours and a cross clamp time of two hours. postoperatively, tee showed bileaflet prosthesis in aortic position well situated with an aortic valve area of 1.5 cm squared and a gradient of 20 mmhg, severe tricuspid regurgitation, trace mitral regurgitation with no dynamic outflow tract obstruction. the patient was transferred from the operating room to the cardiothoracic intensive care unit. she did well in the immediate postoperative period. she remained hemodynamically stable, however, there was high chest tube output over the course of the first 24 hours. she received 5 units of packed red blood cells, 6 units of fresh frozen platelets, cryoprecipitate and several liters of crystalloid. for these reasons the patient was kept sedated and intubated throughout postoperative day one. on postoperative day two the patient's sedation was discontinued. she was weaned from the ventilator and successfully extubated. she did, however, fail a post extubation swallow test. on postoperative day three the patient spiked a temperature to 102.8. she was pan cultured at that time. she also became tachypneic and required reintubation. a chest x-ray done with reintubation showed a presumed aspiration pneumonia. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization insertion of endotracheal tube percutaneous [endoscopic] gastrostomy [peg] open and other replacement of aortic valve temporary tracheostomy aortography resection of vessel with replacement, aorta, abdominal diagnoses: other primary cardiomyopathies other postoperative infection thoracic aneurysm without mention of rupture atrial fibrillation aortic valve disorders pneumonitis due to inhalation of food or vomitus 

Answer: The patient is high likely exposed to