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: morphine / heparin agents attending: chief complaint: exertional angina major surgical or invasive procedure: coronary artery bypass grafting x4, left internal mammary artery graft, left anterior descending, reverse saphenous vein graft to the marginal branch, first diagonal branch, and posterior descending artery. exploration for bleeding closure of open sternotomy exploratory laparotomy, subtotal colectomy with placement of gastrojejunostomy tube and end ileostomy \n4/20/11- tracheostomy -tracheostomy history of present illness: mr. is a 63 year old male with chest tightness with exertion such as lifting weights. he did have one episode of chest tightness radiating to his jaw after walking a long distance which was relieved with rest. an ecg performed during an office visit with dr. on revealed evidence of a prior myocardial infarction. subsequently, the patient completed a stress test which reportedly showed inferior and anterior ischemia. he was referred for cardiac catheterization which revealed significant three vessel coronary artery disease. based upon the results, he was referred for surgical revascularization. past medical history: coronary artery disease hypertension hyperlipidemia h/o fall with subdural hematoma to left parietal lobe gastroesophageal reflux anxiety depression s/p skull fracture after motor vehicle accidents s/p right rotator cuff repair s/p open reduction/internal fixation left ankle fracture social history: he is retired and lives alone. tobacco: quit 3 weeks prior to admission. admits to history of 7 cigarettes per day x 12 years etoh: denies family history: father, uncle and grandmother died of cad and mi's physical exam: admission: pulse: 62 o2 sat: 100% ra bp: 157/97 height: 5'" weight: 215 lbs general: middle aged male in no acute distress, very fit skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur: soft diastolic murmur w/o radiation. best heard at right parasternal border abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused no edema varicosities: none neuro: grossly intact pulses: femoral right: 2+ left: 2+ dp right: 1+ left: 1+ pt : 2+ left: 2+ radial right: 2+ left: 2+ carotid bruit: none bilaterally pertinent results: intraop tee: pre bypass: the left atrium is mildly dilated. the left atrium is elongated. the right atrium is markedly dilated. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. there is mild regional left ventricular systolic dysfunction with moderate to severe inferior wall hypokiesis. overall left ventricular systolic function is mildly depressed (lvef= 45 %). right ventricular chamber size and free wall motion are normal. there are simple atheroma in the aortic arch. there are complex (>4mm) atheroma in the descending thoracic aorta. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. the mitral valve leaflets are structurally normal. mild (1+) mitral regurgitation is seen. post bypass: patient is a paced on phenylepherine infusion. inferior wall motion is somewhat improved, with moderate inferior hypokinesis. lvef 45-50%. mitral regurgitation is trace to mild. aortic contours intact. remaining exam is unchanged. . transthoracic echo: there is mild regional left ventricular systolic dysfunction with inferior hypokinesis. overall left ventricular systolic function is mildly depressed (lvef= 45-50%). right ventricular chamber size and free wall motion are normal. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. brief hospital course: mr. was admitted and underwent coronary artery bypass grafting surgery by dr. . for surgical details, please see operative note. he weaned from bypass on neo synephrine and propofol and was brought to the cvicu for invasive monitoring. within 24 hours, he awoke neurologically intact, weaned from pressor and was extubated without incident. amiodarone was started for atrial fibrillation. beta blockade was resumed and he was diuresed towards his preoperative weight. he otherwise maintained stable hemodynamics and transferred to the sdu on postoperative day two. physical therapy was consulted for strength and mobility as usual. on postoperative day three he suffered cardiac arrest following routine removal of epicardial pacing wires. this required emergent open chest at the bedside for acute cardiac tamponade. he was temporarily placed on ecmo, required multiple units of prbc's, and returned to the operating room where the right coronary artery saphenous vein graft was repaired. following surgical intervention, his chest was left open and he returned to the cvicu in critical condition, on multiple inotropes. cvvh was begun that evening through a left femoral dialysis catheter. postoperative course will now be broken down by systems: cardiac: closure of sternotomy was performed on . amiodarone was continued for episodes of paroxysmal atrial fibrillation. over the next many days he was gradually weeaned from pressors and tolerated fluid removal with cvvh. he was anticoagulated for paf with a goal inr of .5. pulmonary: he remained ventilator dependent although was tolerating cpap. he had a moderate amount of secretions and due to his neurologic status he required tracheostomy for airway protection. sputum cultures grew only scant respiratory flora, there was no infiltrate on cxr and antibiotics were discontinued. the trach cuff is down and he requires rare suctioning now. renal: he developed acute renal failure secondary to hypotension from acute cardiac tamponade. cvvh was initiated, and he was followed closely by the renal service. his creatinine peaked to 3.5 on postoperative day ten. he remained on cvvh for a couple of weeks and fluid was removed. cvvh was then discontinued and he made adequate urine. his creatinine gradually fell to 1.2. neuro: given prolonged cardiac arrest, there was significant concern for anoxic brain injury. however, given his critical condition, he was kept sedated and paralyzed until the chest was closed. sedation was gradually weaned. neurology was consulted and a head ct did not demonstare acute pathology. he awoke, moved his extremities, although the right arm was weaker. he followed commands intermittently, but appeared to be visually limited to light - dark perception. his interaction with family and staff has increased almost daily. he is reproducably interactive and seems to recognize faces of family at times. an mri is not feasible due to the presence ofplates/screws in his left ankle. visual acuity was impossible to assess given his lack of communication. apahasia was also a concern, although on with the trach cuff deflated he spkoe his name.when asked. he did not tolerate the passy-muir valve on the first try on . infectious disease: intially he was administered empiric antibiotics for an open sternal wound. eventually he went on to developed diarrhea and on was c. difficile positive. he appeared to become more septic with concern for toxic colitis given a rising white count and lactate. the infectious disease service was consulted and broad spectrum antibiotics were initiated and titrated accordingly. he was off all antibiotics at discharge. the infectious disease service recommended he remain on precautions for life for c.diff despite having finished and responded to a full course of treatment. gi: he underwent subtotal colectomy with placement of gastrojejunostomy tube and end ileostomy on for toxic colitis with evidence of perforation. he tolerated the operation, and returned to the icu in critical but stable condition. tube feeds initially were with nutren 2.0. he was hypernatremic. this was corrected with iv d5w and oral water. the tube feeds were changed to replete with fiber on and the rate increased to the goal of 80cc/hr. heme: he was diagnosed with heparin induced thrombocytopenia. his platelet count dropped as low as 29k. he was anticoagulated with argatroban. while on argatroban, there was no evidence of bleeding or thromboembolism. coumadin was begun when appropriate with cross coverage until coumadin made the inr therapeutic. by discharge, his platelet count was 280,000 and argatroban had been discontinued. nutrition: at discharge, tube feedings were at goal through the gj tube. hypernatremia had been corrected with free water via the g tube and iv d5w. see nutrition above. wounds: the sternal wound was clean and stable. the staples from the abdominal wound were removed and the was minor skin seperation and drainage. two small areas were packed. the ileostomy was clean, beefy red and functioning well. on he was transferred in stable condition to in . all follow-up appointments were advised. medications on admission: albuterol sulfate - 90 mcg hfa - 2 puffs three times a day bupropion hcl - 100 mg tablet - one tablet(s) by mouth twice a day fluoxetine - 10 mg capsule - one capsule(s) by mouth daily hydrocodone-acetaminophen - 5 mg-500 mg tablet - one tablet(s) by mouth three times a day as needed lisinopril - 20 mg tablet - one tablet(s) by mouth daily metoprolol tartrate - 25 mg tablet - one tablet(s) by mouth twice a day omeprazole - 20 mg capsule - one capsule(s) by mouth daily quetiapine - 50 mg tablet - one tablet(s) by mouth in the morning and two tablets at night sildenafil - as needed simvastatin - 40 mg tablet - one tablet(s) by mouth daily aspirin - 325 mg tablet - one tablet(s) by mouth daily discharge medications: 1. chlorhexidine gluconate 20 % solution sig: fifteen (15) ml miscellaneous twice a day. 2. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: four (4) puff inhalation q6h (every 6 hours) as needed for wheeze. 3. bupropion hcl 100 mg tablet sig: one (1) tablet po bid (2 times a day). 4. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 5. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 6. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain or fever. 7. sodium chloride 0.9 % 0.9 % parenteral solution sig: ten (10) ml intravenous prn (as needed) as needed for line flush. 8. fluoxetine 10 mg capsule sig: one (1) capsule po daily (daily). 9. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 10. quetiapine 25 mg tablet sig: four (4) tablet po qhs (once a day (at bedtime)). 11. amiodarone 200 mg tablet sig: one (1) tablet po bid (2 times a day) for 2 weeks: then daily for two weeks, then discontinue. 12. quetiapine 25 mg tablet sig: two (2) tablet po qam (once a day (in the morning)). 13. warfarin 1 mg tablet sig: five (5) tablet po daily (daily): inr 2-2.5 for atrial dysrhythmia. 14. outpatient lab work inr daily until coumadin dose stable, then as needed discharge disposition: extended care facility: - discharge diagnosis: coronary artery disease s/p coroary artery bypass grafts postoperative acute cardiac tamponade s/p exploration for tamponade postoperative acute renal failure postoperative respiratory failure s/p tracheostomy anoxic brain injury clostridium difficile colitis/toxic colitis with perforation s/p hemicolectomy, end ileostomy and gj tube placement heparin induced thrombocytopenia hypertension dyslipidemia paroxysmal atrial fibrillation s/p traumatic subdural hematoma/skull fracture and fractured left ankle s/p open reduction, internal fixation left ankle. discharge condition: ambulatory status:oob with lift to chairmental status: ???? incisions: sternal - healing well, no erythema or drainage leg right/left - healing well, no erythema or drainage. abdomen:occasional serous drainage lower woud. dry packing two open areas edema none-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 **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. () at 1:00 pm cardiologist: dr. at 12:30 pm please call to schedule appointments with: primary care dr. () 2-3 weeks after rehab discharge **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 continuous invasive mechanical ventilation for 96 consecutive hours or more (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery extracorporeal circulation auxiliary to open heart surgery fiber-optic bronchoscopy enteral infusion of concentrated nutritional substances hemodialysis venous catheterization for renal dialysis arterial catheterization reopening of recent thoracotomy site temporary tracheostomy other repair of chest wall closed [endoscopic] biopsy of bronchus other gastroenterostomy without gastrectomy pulmonary artery wedge monitoring open and other right hemicolectomy open chest cardiac massage other operations on vessels of heart ileostomy, not otherwise specified extracorporeal membrane oxygenation [ecmo] diagnoses: acidosis coronary atherosclerosis of native coronary artery acute kidney failure with lesion of tubular necrosis unspecified essential hypertension unspecified septicemia severe sepsis atrial fibrillation perforation of intestine other and unspecified hyperlipidemia hemorrhage complicating a procedure acute respiratory failure other and unspecified angina pectoris cardiac arrest anoxic brain damage 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 intestinal infection due to clostridium difficile encephalopathy, unspecified hyperosmolality and/or hypernatremia heparin-induced thrombocytopenia (hit) cardiac tamponade 

Answer: The patient is high likely exposed to