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: orthopnea major surgical or invasive procedure: 1. urgent coronary artery bypass graft x5; left internal mammary artery to left anterior descending artery, saphenous vein graft to diagonal obtuse marginal, saphenous vein sequential graft to posterior descending artery, and posterior left ventricular branch. 2. endoscopic harvesting of the long saphenous vein. history of present illness: mr. presented to hospital in with respiratory distress on , was intubated, had an nstemi, was diagnosed with 3 vessel disease and declined surgical revascularization in preferring to come to where he has family (son and daughter). newly diagnosed with copd and started on prednisone 20mg daily (which was stopped prior to transfer) and spiriva and albuterol. was discharged from hospital in , flew commercial air liner to and went directly to er where he was admitted and remained pain free. he was seen by nephrology for stage 3 chronic kidney disease (creat 1.9) believed to be due to htn and diabetes. found to have eblr (enterococcus betalactame resistant to quinolones)uti- on nitrofurantoin ( also sensitive to bactrim and zosyn). he was transferred to for consideration of surgical revascularizationwith for known 3 vessel coronary disease. past medical history: coronary artery disease pmh: hypertension, diabetes, copd, diastolic heart failure, ef 45-50% past surgical history penile implant social history: race: hispanic- born in republic last dental exam: edentulous lives with: unknown/has family in -he is a resident of contact: son and daughter living in occupation: retired factory worker cigarettes: smoked no yes last cigarette hx: 1-2 packs x 50 years of smoking other tobacco use: marijuana occasional etoh: < 1 drink/week drinks/week >8 drinks/week illicit drug use: cocaine use weekly and just prior to nstemi family history: unknown physical exam: pulse: 69 resp: 18 o2 sat:100% ra b/p right: 134/63 general: skin: dry intact -open blisters on bilateral lower extremities heent: perrla eomi neck: supple full rom -neck veins distended chest: lungs clear bilaterally heart: rrr irregular murmur grade ______ abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema varicosities: none neuro: grossly intact pulses: femoral right: +2 left:+2 dp right: doppler left: doppler pt : doppler left: doppler radial right: doppler left: doppler carotid bruit right: bruit left:none pertinent results: echocardiography report , portable tte (complete) done at 1:21:23 pm final referring physician information , division of cardiothoracic , status: inpatient dob: age (years): 68 m hgt (in): 65 bp (mm hg): 132/61 wgt (lb): 130 hr (bpm): 71 bsa (m2): 1.65 m2 indication: pericardial effusion icd-9 codes: 427.31, 786.05, 423.9 test information date/time: at 13:21 interpret md: , md test type: portable tte (complete) son: , rdcs doppler: full doppler and color doppler test location: west sicu/ctic/vicu contrast: none tech quality: adequate tape #: 2012w000-0:00 machine: q-2 vivid echocardiographic measurements results measurements normal range left atrium - long axis dimension: *4.2 cm <= 4.0 cm left ventricle - septal wall thickness: *1.2 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.2 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 4.9 cm <= 5.6 cm left ventricle - systolic dimension: 3.3 cm left ventricle - fractional shortening: 0.33 >= 0.29 left ventricle - ejection fraction: 65% >= 55% aorta - sinus level: 3.3 cm <= 3.6 cm aortic valve - lvot diam: 2.0 cm mitral valve - e wave: 0.8 m/sec mitral valve - e wave deceleration time: 190 ms 140-250 ms tr gradient (+ ra = pasp): 19 mm hg <= 25 mm hg findings left atrium: mild la enlargement. left ventricle: mild symmetric lvh. normal lv cavity size. overall normal lvef (>55%). no resting lvot gradient. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. focal calcifications in aortic root. mitral valve: mildly thickened mitral valve leaflets. no mvp. mild mitral annular calcification. mild thickening of mitral valve chordae. calcified tips of papillary muscles. no ms. mild to moderate (+) mr. tricuspid valve: normal tricuspid valve leaflets. normal tricuspid valve supporting structures. no ts. mild to moderate +] tr. normal pa systolic pressure. pericardium: moderate pericardial effusion. effusion echo dense, c/w blood, inflammation or other cellular elements. conclusions the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef 65%). right ventricular chamber size and free wall motion are normal. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild to moderate (+) mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is a moderate sized pericardial effusion. the effusion is echo dense, consistent with blood, inflammation or other cellular elements. this most likely represents a postoperative hematoma and is located posterior to the heart. no definite tamponade, but the usual signs may be absent in the presence of a consolidating effusion. brief hospital course: mr. was admitted for further pre-operative evaluation. carotid ultrasound showed 70-79% stenosis bilaterally. he is asymptomatic and will follow-up with vascular surgery as an outpatient. an echo revealed ef 60% without significant valvular disease. surgery was post-poned for several days due to a rise in creatinine. this stabilized and the patient was brought to the operating room on where the patient underwent coronary artery bypass graft x5; left internal mammary artery to left anterior descending artery, saphenous vein graft to diagonal obtuse marginal, saphenous vein sequential graft to posterior descending artery, and posterior left ventricular branch with dr. . see operative note for full details. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. pod 1 found the patient extubated, alert and oriented and breathing comfortably. the patient was neurologically intact and hemodynamically stable, weaned from inotropic and vasopressor support. beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. he did have an elevated creatinine post operatively with a peak of 5.7. lasix was decreased and kidney function was monitored closely. his creatinine was decreasing at the time of discharge. the foley catheter had to be reinserted due to failure to void and to closer monitor urine output. he did have two episodes of rapid atrial fibrillation on pod3 which resolved with increased lopressor dose. he was placed on coumadin for the atrial fibrillation. the patient was transferred to the telemetry floor for further recovery. pleural chest tubes left in several days with high amounts of serous drainage (the patient had preop pleural effusions) chest tubes and pacing wires were discontinued without complication once they met criteria. the patient was evaluated by the physical therapy service for assistance with strength and mobility. by the time of discharge on pod 23 the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. the patient was discharged to ne in good condition with appropriate follow up instructions. medications on admission: preadmissions medications listed are incomplete and require futher investigation. information was obtained from records from osh. pt only knows insulin dose - does not know any other medications. 1. isosorbide dinitrate 10 mg po tid 2. labetalol 200 mg po tid 3. rosuvastatin calcium 10 mg po daily 4. furosemide 20 mg po daily 5. aspirin 81 mg po daily 6. tiotropium bromide 1 cap ih daily 7. albuterol inhaler 2 puff ih q6h 8. 70/30 20 units breakfast 70/30 15 units bedtime humalog 8 units breakfast humalog 8 units lunch humalog 8 units dinner discharge medications: 1. 70/30 20 units breakfast 70/30 15 units bedtime humalog 8 units breakfast humalog 8 units lunch humalog 8 units dinner 2. aspirin 81 mg po daily 3. albuterol 0.083% neb soln 1 neb ih q6h:prn sob/wheezing 4. atorvastatin 40 mg po daily 5. cepacol (menthol) 1 loz po prn sore throat 6. diltiazem 30 mg po qid 7. ipratropium bromide neb 1 neb ih q6h:prn sob/wheezing 8. metoprolol tartrate 6.25 mg po bid hold for sbp<110 9. metronidazole (flagyl) 500 mg iv q8h stop 10. ondansetron 4 mg po q8h:prn nausea 11. pantoprazole 40 mg po q24h 12. vancomycin oral liquid 500 mg po q6h end date 13. warfarin md to order daily dose po daily for atrial fibrillation 14. warfarin 0.5 mg po once duration: 1 doses daily coumadin dosing for goal inr for atrial fibrillation 15. furosemide 40 mg po prn edema resume once renal function improves discharge disposition: extended care facility: discharge diagnosis: coronary artery disease pmh: hypertension, diabetes, copd, diastolic heart failure, ef 45-50% past surgical history penile implant discharge condition: alert and oriented x3 nonfocal ambulating, gait steady sternal pain managed with oral analgesics sternal incision - healing well, no erythema or drainage right lower extremity saph site clean/dry/intact discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions 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. , 1:00 cardiologist dr. . office will call you with an appointment please call to schedule the following: primary care dr. , in weeks please follow up with dr. call to schedule an appointment dialysis,schedule hemodialysis unit date/time: 12:00 renal: dr. 10:30 ( diabetes: if patient requires endocrine follow-up after discharge from rehab, please contact , at **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** inr draw on goal inr indication: atrial fibrillation md procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery hemodialysis (aorto)coronary bypass of four or more coronary arteries diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery tobacco use disorder mitral valve disorders acute kidney failure with lesion of tubular necrosis unspecified pleural effusion urinary tract infection, site not specified congestive heart failure, unspecified long-term (current) use of steroids chronic airway obstruction, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation acute on chronic diastolic heart failure cocaine abuse, unspecified chronic kidney disease, stage iii (moderate) intestinal infection due to clostridium difficile cerebral embolism with cerebral infarction diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled iatrogenic cerebrovascular infarction or hemorrhage ulcer of other part of lower limb other and unspecified escherichia coli [e. coli] other speech disturbance 

Answer: The patient is high likely exposed to