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: no known allergies / adverse drug reactions attending: chief complaint: fever/hypotension/sepsis/respiratory failure major surgical or invasive procedure: redo sternotomy, redo aortic root replacement(19mm homograft), mitral valve repair. history of present illness: ms. is a 67year old white female s/p aortic valve replacement in who presented 3 days ago with fever, myalgia, arthralgia and sore throat. she started feeling unwell 10 days previously with dyspnea, back pain and intermittent fevers. she went to her primary care who obtained a cxr (which was reportedly normal) and sent her to hospital where she was admitted. there she developed hypotension to the 70's/30s. vancomycin and ceftriaxone were started. she had increasing o2 demand in the setting of an initially normal cxr, with repeat cxr showing white out. she was transferred to the icu and intubated and sedated. levophed was started. her temperature rose to 103f. blood cultures showed gram positive cocci in chains. she was transferred here for further management. on arrival to the micu, she was intubated and sedated. cardiac surgery was consulted for surgical correction of bacterial endocarditis. past medical history: hypercholesterolemia hypertension s/p aortic valve replacement/asc aorta replacement on h/o pancreatitis cataract anxiety depression s/p c-section social history: unemployed quit smoking 5 years ago, ppd x 25 years occasional etoh lives alone no ivdu family history: noncontributory physical exam: admission exam t 102.7, hr 61, bp 129/54, pox 100% a/c tv 380, peep 12, rate 20, fio2 60% general: intubated, sedated heent: sclera anicteric, mm dry, perrl neck: supple, jvp not elevated, no lad cv: tachycardic, ejection murmur best heard at rusb lungs: intubated, junky breath sounds in b/l a/l fields abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly gu: foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema. no evidence of lesions, splinter hemorrhages, or osler nodes. neuro: perrl, not moving extremities sensation pertinent results: admission labs 07:28pm blood wbc-14.9*# rbc-3.40* hgb-10.0* hct-30.3* mcv-89 mch-29.4 mchc-33.1 rdw-14.3 plt ct-274# 07:28pm blood neuts-86.2* lymphs-9.8* monos-3.8 eos-0.2 baso-0.1 07:28pm blood pt-15.5* ptt-28.4 inr(pt)-1.5* 07:28pm blood fibrino-595* 07:28pm blood glucose-148* urean-11 creat-0.5 na-133 k-4.7 cl-106 hco3-21* angap-11 03:41am blood alt-29 ast-17 ld(ldh)-281* alkphos-47 totbili-0.7 07:28pm blood ck-mb-2 ctropnt-<0.01 probnp-7957* 09:01pm blood ck-mb-3 ctropnt-<0.01 03:15am blood ck-mb-2 ctropnt-<0.01 07:28pm blood calcium-7.4* phos-2.1* mg-2.5 micro data blood culture blood culture, routine-pending inpatient blood culture blood culture, routine-pending inpatient sputum gram stain-final; respiratory culture-final inpatient blood culture blood culture, routine-pending inpatient blood culture blood culture, routine-pending inpatient blood culture blood culture, routine-pending inpatient sputum gram stain-final; respiratory culture-final inpatient blood culture blood culture, routine-pending inpatient catheter tip-iv wound culture-final inpatient urine urine culture-final inpatient blood culture blood culture, routine-pending inpatient blood culture blood culture, routine-pending inpatient isolate from hospital for mic-preliminary {staphylococcus lugdunensis, staphylococcus, coagulase negative} imaging: cxr as compared to the previous radiograph, there is no relevant change. right internal jugular vein catheter that shows a normal course, the tip of the catheter projects over the mid svc. the patient has an endotracheal tube, the tip of the tube projects approximately 2.2 cm above the carina, the tube could be pulled back by approximately 1-2 cm. a nasogastric tube has been placed. the course of the tube is unremarkable, the tip of the tube is not included in the image. no other monitoring and support devices. unremarkable alignment of sternal wires after cardiac surgery. in unchanged manner, the lung displays extensive bilateral apical parenchymal opacities of reticular appearance. an additional alveolar component could also be present, given the presence of multiple air bronchograms. extensive retrocardiac atelectasis, small left pleural effusion. no newly appeared focal parenchymal opacities. no pneumothorax. tee moderately thickened and stenotic prosthetic aortic valve with probable vegetation. cannot exclude aortic root abscess. mild mitral regurgitation. hyperdynamic left ventricular systolic function. compared with the prior study dated (images reviewed)- the aortic bioprosthesis is now stenotic with a mass concerning for vegetation. the thickening around the aortic homograft is similar in size, but the echolucency is new. tee aortic prosthesis and mitral (native) valve vegetations/enodcarditis with aortic root abscess as described above. mild mitral regurgitation. compared with the prior study (images reviewed) of a vegetation is now seen on the mitral valve. ct head with con: enhancing 2 mm focus in the right frontal lobe may be a prominent vessel, but in this clinical setting, is concerning for a small septic embolus or septic aneurysm. would recommend an mri with and without contrast for further evaluation if clinically indicated. ct c/a/p with con: no focal fluid collections within the chest, abdomen or pelvis to suggest focal abscess. scattered mediastinal lymph nodes, though none pathologically enlarged. no mediastinal hematoma or fluid collection. multiple stable subcentimeter subpleural pulmonary nodules, unchanged since prior chest ct from . given the stability over several years, no further followup is necessary. bilateral pleural effusions and diffuse ground-glass opacities, findings consistent with diffuse pulmonary edema. an asymmetric opacity in the right upper lobe may reflect asymmetric edema, though superimposed infection is also within the differential. multiple bilateral renal hypodensities that are too small to characterize, though most likely represent simple cysts. mri t spine: multiple focal areas of high signal intensity throughout the vertebral bodies, likely consistent with non-expansile hemangiomas, some of them atypical with persistent high signal on the stir sequence. degenerative changes are identified at the t8/t9 and t9/t10 levels with no evidence of neural foraminal narrowing or spinal cord compression. there is no evidence of abnormal enhancement to indicate leptomeningeal disease or epidural abscess. there is no evidence of findings suggesting osteomyelitis. mri l spine: heterogeneous signal is noted in the bone marrow with multiple rounded areas of hyperintensity on t2- and t1-weighted sequences, likely consistent with non-expansile hemangioma with atypical high signal on the stir at the level of l1. if there is any clinical concern related with this findings, correlation with bone scan is recommended if clinically warranted. there is no evidence of epidural abscess, fluid collections or findings suggesting osteomyelitis. mild disc degenerative changes at l2-l3, l3/l4 and l4/l5 with no evidence of neural foraminal narrowing or spinal canal stenosis. tte: abnormal aortic valve bioprosthesis with thickened leaflets and high transvalvular gradients. aortic root abscess. moderate mitral regurgitation. hyperdynamic left ventricular systolic function. moderate pulmonary hypertension. no definite vegetations seen. mri head: a small enhancing focus in the right parietal lobe. this shows no slow diffusion. this likely represents a possible subacute embolic infarct. metastasis is another differential though is less likely as patient has no known primary. few chronic microhemorrhages in bilateral frontal lobes. a small extra-axial enhancing lesion along the right frontal convexity which likely represents a meningioma. no evidence of stenosis, occlusion or aneurysm in arteries of head brief hospital course: she was initially covered with vancomycin and ceftriaxone but per id this was changed to vancomycin and gentamicin when blood cultures fromnorwood grew coagulase negative staphlococcus. speciation showed staph lugdunensis sensitive to nafcillin/gent/rifampin so she was switched to these. aortic vegetation was noted on echo and repeat tee showed new mitral veg as well as aortic root abscess. she was transferred to the cardiology service where she remained hemodynamically stable and her ekg did not show any conduction abnormalities. she underwent extensive work up prior to cardiac ssrgery to rule out other involvement of the endocarditis. neurology was consulted and recommended mra/mri and continuing to avoid anti-coagulation. a mri was obtained and indicated possible subacute embolic infarct. discussion between infectious disease, cardiac surgery and cardiology was done and the decision was made to pursue surgery sooner rather than later as benefits outweighed the risks. she was taken to the operating room on and underwent redo sternotomy,redo aortic root replacement with a size 19 homograft and mitral valve repair by dr.. cardiopulmonary bypass time= 241 minutes. cross clamp time= 213 minutes. please refer to the operative note for further surgical details. she tolerated the procedure well and was transferred to the cvicu intubated and sedated requiring pressor support. she awoke neurologically intact and on pod#1 she weaned to extubation without incident. id continued to follow postoperatively for antibiotic recs regarding her bacterial endocarditis. she weaned off pressor support and was placed on beta-blocker, aspirin,and aggressively diuresed. all lines and tubes were discontinued per protocol. post op confusion was evident. neurology continued to follow postoperatively due to the subacute embolic infarct seen on mri preop. narcotics were minimized and her mental status improved. hemodynamically she remained stable with a transient postoperative episode of nsvt v. atrial fibrillation with abberancy. she tolerated beta-blocker well. pacing wires were removed per protocol. on she complained of right upper quadrant discomfort. lfts showed an elevated total bilirubin. ultrasound was done and revealed minimally distended gallbladder with sludge. no gallstones or signs of acute cholecystitis. nephrology was consulted for postop renal failure (baseline creatinine 0.4->3.7). antibiotics were adjusted and her renal function closely monitored and slowly stabilized and fell. she transferred to the step down unit for further monitoring and recovery. physical therapy was consulted for evaluation of strength and mobility. on she acutely decompensated with severe hypotension, respiratory distress and required intubation, a pa catheter and pressors. emergent tee showed moderate mitral regurgitation, fasirtly preserved lv function and the cxr demonstrated pulmonary edema. she was stabliized over several days, diuresed and her renal function improved. tube feeding were given and she awakened. the cxr progressed to one of ards, but she improved, weaned from high peep requirements and was eventually extubated on . bilateral chest drainages were performed and no souce of sepsis located. nafcillin and rifampin were continued. she was again encephalopathic, but cleared with some intermittent confusion. video swallow cleared her for soft solids and thick liquids. she was below her preop weight, without evidence of fluid overload so diuresis was stopped, but may be required in the future. at discharge wounds were clean and healing, she was beginning to ambulate with a lot of help and oriented mostly.follow up appointments were given as appropriate. she was transferred to northeast in for further recovery prior to returning home. medications on admission: - diovan 160mg po bid - asa 81mg po daily - fish oil 1200mg po daily - furosemide 20mg po daily discharge medications: 1. bisacodyl 5 mg tablet sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. rifampin 300 mg capsule sig: one (1) capsule po q8h (every 8 hours) for 14 days. 5. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 6. ipratropium-albuterol 18-103 mcg/actuation aerosol sig: puffs inhalation q6h (every 6 hours) as needed for wheeze. 7. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) units injection tid (3 times a day): until fully mobile. 8. amiodarone 200 mg tablet sig: as directed tablet po bid (2 times a day): 400mg(two tablets) twice daily for two weeks, then 200mg(one tablets) twice daily for two weeks, then 200mg(one tablet) daily until instructed otherwise,. 9. metoprolol tartrate 100 mg tablet sig: one (1) tablet po three times a day. 10. insulin lispro 100 unit/ml solution sig: per scale subcutaneous ac & hs: 120-160:2units sc ac,none hs;161-200:4units ac, 2units hs; 201-240:6units ac,4units hs,241-280:8units ac, 6units hs. 11. olanzapine 5 mg tablet sig: one (1) tablet po bid (2 times a day). 12. acetaminophen 325 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for fever or pain for 4 weeks. 13. nafcillin in d2.4w 2 gram/100 ml piggyback sig: two (2) gms intravenous q4h (every 4 hours) for 14 days. 14. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours) for 2 weeks. 15. heparin, porcine (pf) 10 unit/ml syringe sig: two (2) ml intravenous once a day as needed for line flush. discharge disposition: extended care facility: northeast - discharge diagnosis: -s/p redo sternotomy/ redo aortic root replacement with a size 19 homograft/mitral valve repair secondary to bacterial endocarditis- secondary: htn, hl, and bicuspid aortic valve with stenosis s/p aortic valve replacement in who now presents with bacterial endocarditis with vegetations on her aortic prosthesis, native mitral valve as well as aortic root abscess. - discharge condition: alert and oriented x3 mostly, nonfocal ambulating with unsteady gait with assistance incisional pain managed with oral analgesics incisions: sternal - healing well, no erythema or drainage edema- trace 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: dr. () on at 1:15pm infectious disease at : dr. () on at 10am medical office basement cardiologist:ask your primary care doctor for a referral please call to schedule appointments with: 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** weekly cbc w/diff,lfts,bun/creat. fax results to . call id nurses w/antibiotic questions- md procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart diagnostic ultrasound of heart enteral infusion of concentrated nutritional substances thoracentesis open and other replacement of aortic valve with tissue graft resection of vessel with replacement, thoracic vessels closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus open heart valvuloplasty of mitral valve without replacement diagnoses: mitral valve disorders unspecified pleural effusion acute kidney failure, unspecified hyposmolality and/or hyponatremia severe sepsis atrial fibrillation methicillin susceptible staphylococcus aureus septicemia candidiasis of mouth hypopotassemia acute respiratory failure surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation blood in stool septic shock other specified disorders of biliary tract acute and subacute bacterial endocarditis other encephalopathy cerebral embolism with cerebral infarction other and unspecified coagulation defects mixed acid-base balance disorder infection and inflammatory reaction due to cardiac device, implant, and graft personal history of (corrected) congenital malformations of heart and circulatory system 

Answer: The patient is high likely exposed to