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: this is a 73 year old male with a history of aortic valve replacement in , abdominal aortic aneurysm, hypertension who was transferred from an outside hospital with one week of dyspnea on exertion, shortness of breath, fever and violent chills. the patient denied a history of recent travel, sick exposure, cough, sputum production, nasal congestion, abdominal pain or skin infection. on admission the patient's temperature was 100.8. three blood cultures were drawn and he was started on vancomycin and gentamicin. the initial chest x-ray showed negative pleural effusions or evidence of congestive heart failure. transesophageal echocardiogram showed an left ventricular ejection fraction of 65% with thickened mitral valve with mild regurgitation, large echodense objects, suggestion of vegetation, and tricuspid regurgitation. the initial transesophageal echocardiogram done at showed dehiscence of the porcine arteriovenous graft and a positive abscess. he was admitted for evaluation and consideration for surgery. past medical history: significant for aortic valve replacement with porcine valve. the patient unclear reason for aortic valve replacement, abdominal aortic aneurysm and hypertension. hypercholesterolemia, chronic anemia, infrarenal abdominal aortic aneurysm, and chronic renal insufficiency. past surgical history: aortic valve replacement with porcine valve. medications: 1. lipitor 10 mg p.o. b.i.d. 2. vitamin b12 3. lopressor 25 mg b.i.d. 4. vancomycin started at outside hospital 5. gentamicin started at the outside hospital physical examination: temperature was 98.4, heartrate 64, blood pressure 120/70, respiratory rate 20 and saturations 97% on room air. general: he was alert, awake and in no acute distress, resting comfortably. head, eyes, ears, nose and throat: pupils are equal, round, and reactive to light, extraocular muscles intact, no lymphadenopathy. neck was supple, negative left axis deviation, negative masses, jugulovenous distension of 14 cm, negative bruits. trachea aortic murmur, 2 to 3 tricuspid murmur. pulmonary clear to auscultation bilaterally. abdomen was soft, nontender, nondistended, positive bowel sounds. abdominal had no bruits and no hepatosplenomegaly. extremities: +2 dorsalis pedis pulses bilaterally, negative edema. skin was negative for dermatitis, ecchymosis, negative splinter hemorrhages or axillary nodes. laboratory data: initial labs included a white blood cell count of 6, hemoglobin 11, hematocrit 34.8 and platelets 168. chem-7 included sodium 131, potassium 3.3, chloride 102, carbon dioxide 21, bun 14, creatinine 1.4, and 98% glucose. calcium was 8.6, phosphate was 3.9 and magnesium was 1.8. he showed dehiscence of the av. allergies: no known drug allergies hospital course: after admission the patient was continued on intravenous vancomycin and gentamicin. infectious disease was also consulted. the patient was transferred to the coronary care unit. on , the patient was taken to the operating room for an indication of infected aortic valve replacement and endocarditis. procedure was a redo sternotomy aortic valve replacement with homograft 29 mm. the patient tolerated the procedure well and was sent to the coronary intensive care unit. on , neurology was consulted for an altered mental status. their impression was that decreased alertness could be due to several factors including culture-negative endocarditis, recent propofol use and morphine. , infectious disease reassessed the situation and decided to continue the intravenous ceftriaxone, vancomycin and rifampin. on , renal was consulted for acute renal failure in which their assessment of the situation was acute renal failure but there was no indication for dialysis and that they would follow. the patient continued to course in the intensive care unit with close monitoring and broad spectrum antibiotics, including ceftriaxone, vancomycin, and rifampin. during the course of the intensive care unit stay cardiology had recommended placement of a pacemaker. on , the patient was brought back to the operating room for placement of a lead pacemaker. the patient tolerated the procedure well. neurology was consulted and the patient was started on dilaudid 200 mg. there were no complications. the patient continued his stay in the intensive care unit until , at which time he was transferred to the floor. during the intensive care unit stay the patient had signs and symptoms of what possibly could have been a seizure. on , the patient was assessed for placement of a percutaneous endoscopic gastrostomy tube due to a 24 hour caloric count well below calories. on , the patient was brought back to the operating room with placement of the percutaneous endoscopic gastrostomy tube. the patient tolerated the procedure well and was discharged back to the surgical floor. also on , the patient was assessed for rehabilitation placement. on , the patient was doing well and tolerating tube feeds without abdominal pain, nausea or vomiting. the discharge physical showed vital signs 98.6 temperature, 60 heartrate, 130/70, blood pressure was 105/58, 18 respiratory rate, and 96% on 2 liters. general: he was alert and oriented in no acute distress. cardiovascularly, he was regular rate and rhythm with no murmurs or rubs. respiratory rate was clear to auscultation bilaterally. abdomen was soft, nontender, nondistended with positive bowel sounds, positive percutaneous endoscopic gastrostomy placement. extremities, negative peripheral edema. incision was intact. physical therapy level was 1 out of 5. complications and significant events included acute renal failure treated without dialysis, pacemaker placement and percutaneous endoscopic gastrostomy placement. discharge laboratory data included a white blood cell count of 4.7, hemoglobin 10.1, hematocrit 30 on and a sodium of 141, potassium 4.0, chloride 109, carbon dioxide of 22, bun 19 and creatinine of 1.9 and glucose of 94. dilantin was 3.5 with a free dilantin of 1.1 on . discharge medications: 1. hydralazine 50 mg p.o. q. 4 hours 2. rifampin 600 mg p.o. q.d. 3. ceftriaxone 2 mg intravenously q. 24 4. vancomycin 1 gm intravenously q.d. 5. dilantin 250 mg b.i.d., hold to repeat 30 minutes prior and 30 minutes after administration of dilantin 6. docusate 100 mg p.o. b.i.d. 7. heparin 5000 units subcutaneous b.i.d. 8. vitamin c 500 mg p.o. b.i.d. 9. znso4 220 mg p.o. q.d. 10. amiodarone 400 mg p.o. q.d. 11. norvasc 10 mg p.o. q.d. 12. nephrocaps times one p.o. q.d. 13. nystatin powder to the groin b.i.d. prn 14. ultracal 80 cc/hr, hold 30 minutes prior and after administration or administration of dilantin 15. ibuprofen 400-600 mg p.o. q. 6 hours 16. milk of magnesia 30 ml p.o. prn 17. tylenol 650 mg p.o. q. 4 hours primary discharge diagnosis: 1. status post redo sternotomy and aortic valve replacement with homograft secondary diagnosis: 1. chronic renal insufficiency 2. hypertension 3. hypercholesterolemia 4. chronic anemia 5. infrarenal abdominal aortic aneurysm disposition: hospital, hospital & rehabilitation center. #, fax . dr., r. 02-358 dictated by: medquist36 procedure: extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart other esophagoscopy initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle percutaneous [endoscopic] gastrostomy [peg] arterial catheterization atrial cardioversion open and other replacement of aortic valve with tissue graft diagnoses: anemia, unspecified acute kidney failure, unspecified unspecified protein-calorie malnutrition atrial fibrillation aortic valve disorders mechanical complication due to heart valve prosthesis unspecified disorder of kidney and ureter abdominal aneurysm without mention of rupture infection and inflammatory reaction due to cardiac device, implant, and graft 

Answer: The patient is high likely exposed to