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: dyspnea on exertion, dizziness, fatigue major surgical or invasive procedure: : 1. aortic valve replacement with a 23-mm on-x mechanical aortic valve prosthesis, serial #, reference #. 2. primary sternal repair using talon x4 and 1 ml of bone morphogenic protein. history of present illness: 58 year old obese female with dyspnea on exertion and dizziness with progressively worsening aortic stenosis. he aortic stenosis was orginally diagnosed in as a heart murmur was detected. she was referred to dr. roughly one year ago where serial echocardiograms have demonstrated worsening aortic stenosis. her current symptoms include dyspnea on exertion, palpitations, fatigue and dizziness. she has now been referred for surgical management. past medical history: aortic stenosis atrial flutter s/p cardioversion obesity gerd diabetes mellitus type 2 - diet controlled left lower extremity cellulitis - following a burn injury hypertension dissociative indentity disorder depression post traumatic stress disorder - h/o sexual abuse as child rheumatoid arthritis past surgical history: tonsillectomy d+c social history: race: caucasian last dental exam: every 6 months. last in . lives with: husband occupation: disabled tobacco: distant mild use 25 years ago. etoh: rare family history: father with cabgx5 in his 80's. died of mrsa complications. physical exam: pulse: 76 resp: 20 o2 sat: 98% b/p left: 162/53 height: 63"-64" not sure weight: 360lb general: nad. a&ox3 skin: warm dry intact heent: ncat perrla eomi sclera anicteric teeth in fair repair. neck: supple full rom no jvd chest: lungs clear bilaterally heart: rrr, nl s1-s2, iv/vi systolic murmur abdomen: soft non-distended non-tender bowel sounds + . obese with very large panus. extremities: warm , well-perfused trace edema varicosities: none noted on standing neuro: grossly intact pulses: femoral right: left: dp right:2 left:2 pt : left: radial right: left: carotid bruit transmitted vs bruit (b) pertinent results: admission: 08:38am hgb-12.5 calchct-38 08:38am glucose-159* lactate-1.5 na+-137 k+-4.4 cl--101 12:12pm pt-15.4* ptt-24.8 inr(pt)-1.3* 12:12pm plt count-180 02:46pm urea n-13 creat-1.0 sodium-139 potassium-4.7 chloride-107 total co2-25 anion gap-12 05:54am blood alt-82* ast-539* ld(ldh)-533* alkphos-49 amylase-39 totbili-0.5 discharge 04:19am blood wbc-12.5* rbc-3.32* hgb-10.7* hct-31.1* mcv-94 mch-32.3* mchc-34.5 rdw-13.7 plt ct-307 04:19am blood plt ct-307 04:19am blood pt-33.9* ptt-33.2 inr(pt)-3.4* 04:19am blood glucose-82 urean-24* creat-0.7 na-141 k-3.8 cl-100 hco3-32 angap-13 04:19am blood mg-1.7 echocardiography report echocardiographic measurements results measurements normal range left ventricle - septal wall thickness: 1.1 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: 1.1 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 5.0 cm <= 5.6 cm left ventricle - ejection fraction: 55% to 60% >= 55% left ventricle - stroke volume: 91 ml/beat aorta - annulus: 2.1 cm <= 3.0 cm aorta - sinus level: 2.9 cm <= 3.6 cm aorta - sinotubular ridge: 2.3 cm <= 3.0 cm aorta - ascending: *3.5 cm <= 3.4 cm aorta - arch: 2.7 cm <= 3.0 cm aorta - descending thoracic: 2.2 cm <= 2.5 cm aortic valve - peak velocity: *3.1 m/sec <= 2.0 m/sec aortic valve - peak gradient: *38 mm hg < 20 mm hg aortic valve - mean gradient: 26 mm hg aortic valve - lvot pk vel: 1.30 m/sec aortic valve - lvot vti: 32 aortic valve - lvot diam: 1.9 cm aortic valve - valve area: *1.1 cm2 >= 3.0 cm2 findings multiplanar reconstructions were generated and confirmed on an independent workstation. left atrium: no spontaneous echo contrast in the body of the laa. good (>20 cm/s) laa ejection velocity. right atrium/interatrial septum: normal interatrial septum. no asd by 2d or color doppler. left ventricle: normal lv wall thickness. normal lv cavity size. overall normal lvef (>55%). right ventricle: normal rv chamber size. normal rv systolic function. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. normal aortic arch diameter. normal descending aorta diameter. focal calcifications in descending aorta. aortic valve: mildly thickened aortic valve leaflets (3). moderate as (area 1.0-1.2cm2) mild (1+) ar. mitral valve: mildly thickened mitral valve leaflets. trivial mr. tricuspid valve: normal tricuspid valve leaflets. mild to moderate +] tr. pulmonic valve/pulmonary artery: pulmonic valve not well seen. physiologic (normal) pr. pericardium: no pericardial effusion. conclusions prebypass no spontaneous echo contrast is seen in the body of the left atrium or left atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size is normal with normal free wall contractility. the aortic valve leaflets (3) are mildly thickened. there is moderate aortic valve stenosis (valve area 1.0-1.2cm2). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is no pericardial effusion. postbypass the patient is av paced on no vasoactive infusions. there is a new mechanical aortic valve prosthesis which is well seated. there are washing jets. there is no aortic insufficiency. mean gradient is 13 mmhg with a cardiac output of 6.57 l/min. trace mitral regurgitation and mild tricuspid regurgitation persist. left ventricular function remains normal. the thoracic aorta is intact. interpretation assigned to , md, interpreting physician brief hospital course: ms was a direct admission to the operating room for aortic valve replacement, please see operative report for details. in summary she had: 1. aortic valve replacement with a 23-mm on-x mechanical aortic valve prosthesis, serial #, reference #. her cardiopulmonary bypass time was 84 minutes. with a crossclamp time of 63 minutes. the plastic surgery service closed her chest immediately following the aortic valve replacement with: primary sternal repair using talon x4 and 1 ml of bone morphogenic protein. she tolerated the surgery well and post-operatively was transferred to the cardiac surgery icu in stable condition. she was hemodynamically stable in the immediate post-operative period, woke neurologically intact and was extubated on the morning after surgery. she remained hemodynamically stable but was kept in the cardiac surgery icu to closely monitor her post-operative progress. all tubes, lines and drains were removed per cardiac surgery protocol. coumadin and heperin were initiated for anticoagulation given mechanical valve. on pod3 she was transferred to the stepdown floor. once on the stepdown unit she worked with nursing and the physical therapist to increase her strength and endurance. it was felt that she would benefit from a short stay at rehabilitation and on pod 5 she was cleared for discharge. at that time she was transferred to rehabilitation at . medications on admission: atorvastatin - (prescribed by other provider) - 20 mg tablet - 1 tablet(s) by mouth once a day bupropion hcl - (prescribed by other provider) - 200 mg tablet sustained release - 1 tablet(s) by mouth twice a day candesartan - (prescribed by other provider) - 4 mg tablet - 1 tablet(s) by mouth once a day celecoxib - (prescribed by other provider) - 200 mg capsule - 1 capsule(s) by mouth twice daily citalopram - (prescribed by other provider) - 40 mg tablet - 1 tablet(s) by mouth once a day diazepam - (prescribed by other provider) - 5 mg tablet - 1 tablet(s) by mouth prn hydroxychloroquine - (prescribed by other provider) - 200 mg tablet - 2 tablet(s) by mouth once a day as needed for bedtime metoclopramide - (prescribed by other provider) - 10 mg tablet - 1 tablet(s) by mouth four times a day propoxyphene n-acetaminophen - (prescribed by other provider) - 100 mg-650 mg tablet - 1 tablet(s) by mouth twice daily rabeprazole - (prescribed by other provider) - 20 mg tablet, delayed release (e.c.) - 1 tablet(s) by mouth once a day ramipril - (prescribed by other provider) - 5 mg capsule - 1 capsule(s) by mouth once a day sulfasalazine - (prescribed by other provider) - 500 mg tablet, delayed release (e.c.) - 2 tablet(s) by mouth twice a day trazodone - (prescribed by other provider) - 100 mg tablet - 1 tablet(s) by mouth qhs ziprasidone hcl - (prescribed by other provider) - 20 mg capsule - 1 capsule(s) by mouth twice daily aspirin - (prescribed by other provider) - 81 mg tablet, delayed release (e.c.) - 1 tablet(s) by mouth twice a day calcium-magnesium-zinc - (prescribed by other provider) - tablet - 1 tablet(s) by mouth twice a day coenzyme q10 - (prescribed by other provider) - 100 mg capsule - 1 capsule(s) by mouth twice a day ergocalciferol (vitamin d2) - (prescribed by other provider) - 1,000 unit capsule - 1 capsule(s) by mouth once a day multivitamin - (prescribed by other provider) - tablet - 1 tablet(s) by mouth once a day vit b complex 100 combo no.2 - (prescribed by other provider) - dosage uncertain discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). 3. warfarin 1 mg tablet sig: as directed tablet po daily (daily): for mechanical aortic valve, target inr 2.5-3.5. 4. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 5. miconazole nitrate 2 % powder sig: one (1) appl topical qid (4 times a day) as needed for yeast. 6. ziprasidone hcl 20 mg capsule sig: one (1) capsule po bid (2 times a day). 7. sulfasalazine 500 mg tablet sig: two (2) tablet po bid (2 times a day). 8. citalopram 20 mg tablet sig: two (2) tablet po daily (daily). 9. hydromorphone 2 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for pain. 10. bupropion hcl 100 mg tablet sustained release sig: two (2) tablet sustained release po bid (2 times a day). 11. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain/fever. 12. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 13. metoclopramide 10 mg tablet sig: one (1) tablet po qidachs (4 times a day (before meals and at bedtime)). 14. ramipril 5 mg capsule sig: one (1) capsule po daily (daily). 15. aspirin 81 mg tablet sig: one (1) tablet po once a day. 16. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). 17. rabeprazole 20 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 18. trazodone 100 mg tablet sig: one (1) tablet po at bedtime as needed for insomnia. 19. multivitamin tablet sig: one (1) tablet po once a day. 20. calcium-magnesium-zinc tablet sig: one (1) tablet po once a day. 21. coenzyme q10 100 mg capsule sig: one (1) capsule po twice a day. 22. ergocalciferol (vitamin d2) 400 unit tablet sig: two (2) tablet po once a day. 23. vitamin b complex capsule sig: one (1) capsule po once a day. 24. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 25. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed for wheezing. discharge disposition: extended care facility: rehab hospital discharge diagnosis: s/p aortic valve replacement pmh: aortic stenosis, atrial flutter s/p cardioversion obesity, gerd, diabetes mellitus type 2 - diet controlled left leg cellulitis ' following a burn injury, hypertension dissociative indentity disorder, depression, post traumatic stress disorder -h/o sexual abuse as child, rheumatoid arthritis discharge condition: alert and oriented x3 nonfocal ambulating with assistance incisional pain managed with dilaudid incisions: sternal - healing well, no erythema or drainage edema: trace pedal edema, no lower extremity cellulitis discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage 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 females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: you are scheduled for the following appointments surgeon: , md phone: date/time: 1:45 cardiologist: dr @10:20am plastic surgery: dr tues, 2:00pm please schedule follow up with your pcp , in 4 weeks please call to schedule appointments with your primary care dr , d in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** procedure: venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve other repair or plastic operations on bone, scapula, clavicle, and thorax [ribs and sternum] insertion of recombinant bone morphogenetic protein diagnoses: obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery esophageal reflux diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled aortic valve disorders personal history of tobacco use depressive disorder, not elsewhere classified morbid obesity osteoarthrosis, unspecified whether generalized or localized, site unspecified pressure ulcer, buttock rheumatoid arthritis pressure ulcer, stage ii posttraumatic stress disorder dissociative identity disorder history of physical abuse personal history of traumatic brain injury body mass index 60.0-69.9, adult 

Answer: The patient is high likely exposed to