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: patient recorded as having no known allergies to drugs attending: chief complaint: shortness of breath major surgical or invasive procedure: - avr(23 mechanical) history of present illness: this is a 49 yo male with long standing history of heart murmur who has been followed the last 6 years for aortic stenosis. serial echocardiograms have shown worsening gradients and patient has developed dyspnea on exertion. his shortness of breath has gradually worsened over the last several years. he denies chest pain and syncope. past medical history: past medical history: aortic stenosis, niddm, hypertension, obesity past surgical history: right knee arthroscopy orchiectomy social history: occupation: vending machine worker last dental exam: over 1 year ago lives with: wife : caucasian tobacco: 35 pack year history, quit etoh: denies family history: no premature cad physical exam: pulse: 73 resp: 16 o2 sat: 99% ra b/p right: 133/84 left: 130/89 height: 68 inches weight: 272 lbs general: obese male in no acute distress skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur 3/6 systolic ejction murmur best heard at rusb, radiates to carotids abdomen: soft non-distended non-tender bowel sounds + +++ventral hernia noted extremities: warm , well-perfused edema - trace varicosities: none neuro: grossly intact pulses: femoral right: 1 left: 1 dp right: 1 left: 1 pt : 1 left: 1 radial right: 2 left: 2 carotid bruit right: trans murmur left: trans murmur pertinent results: 09:48am hgb-14.5 calchct-44 09:48am glucose-174* lactate-2.0 na+-138 k+-4.6 cl--105 12:02pm glucose-201* k+-6.5* 01:19pm glucose-148* lactate-2.3* na+-136 k+-4.5 cl--107 01:20pm pt-14.6* ptt-32.2 inr(pt)-1.3* 02:26pm urea n-20 creat-1.0 chloride-116* total co2-24 06:19am blood wbc-6.7 rbc-3.14* hgb-9.8* hct-29.3* mcv-93 mch-31.1 mchc-33.3 rdw-14.6 plt ct-229# 06:19am blood pt-21.4* inr(pt)-2.0* 06:19am blood glucose-111* urean-15 creat-0.7 na-138 k-4.7 cl-103 hco3-28 angap-12 chest (pa & lat) clip # reason: interval chnage findings: compared to the prior study, there is slight increase in retrocardiac density and the lateral view suggests a more patchy confluent projecting over the lower thoracic vertebral bodies. those findings are suspicious for pneumonia. please correlate clinically. pulmonary vascular markings are within normal limits and not substantially different. the right picc line has been removed. there is no ptx. impression: suspicion for left lower lobe pneumonia. please correlate clinically. dr. brief hospital course: mr. was admitted to the on for aortic valve replacement. he was taken to the operating room where he underwent an aortic valve replacement using a #23 mechanical valve. please see operative note for details. his bypass time was 116 minutes with a crossclamp of 87 minutes. he tolerated the operation well and postoperatively he was taken to the intensive care unit for monitoring. over the next several hours, he awoke neurologically intact and was extubated. he was weaned from his pressors. on the following day he was transferred to the surgical step down floor. all tubes lines and drains were removed by cardiac surgery protocol. he was gently diuresed toward his pre-operative weight. his activity level was gradually advance until he was moving about independently. his epicardial wires were removed and he was started on coumadin for his mechanical valve. heparin drip was started to bridge the coumadin. inr was 2.4 on and heparin was d/c'd. a small area of erythema without drainage was noted at the upper pole of his sternal incision and iv cefazolin was started on . the drainage resolved and antibiotics were discontinued. he was discharged to home with visiting nurses on . he will return for a wound check on . medications on admission: glyburide, metformin, lisinopril, atenolol, aspirin discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 3. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 4. glyburide 5 mg tablet sig: one (1) tablet po once a day. disp:*60 tablet(s)* refills:*2* 5. metformin 850 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 6. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain. disp:*50 tablet(s)* refills:*0* 7. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 8. warfarin 2 mg tablet sig: as directed tablet po once a day: take 6mg(3tabs)on then as directed by dr on and after . disp:*100 tablet(s)* refills:*2* discharge disposition: home with service facility: area vna discharge diagnosis: aortic stenosis s/p avr (mechcanical) past medical history: aortic stenosis, niddm, hypertension, obesity discharge condition: good discharge instructions: 1) monitor wounds for signs of infection. these include redness, drainage or increased pain. in the event that you have drainage from your sternal wound, please contact the at (. 2) report any fever greater then 100.5. 3) report any weight gain of 2 pounds in 24 hours or 5 pounds in 1 week. 4) no lotions, creams or powders to incision until it has healed. you may shower and wash incision. gently pat the wound dry. please shower daily. no bathing or swimming for 1 month. use sunscreen on incision if exposed to sun. 5) no lifting greater then 10 pounds for 10 weeks from date of surgery. 6) no driving for 1 month or while taking narcotics for pain. 7) call with any questions or concerns. followup instructions: wound check on friday on f6 please follow-up with dr. in 1 month. ( please follow-up with dr. in weeks. please follow-up with dr. in 2 weeks. dr. to follow your inr and adjust your couamdin dose. first inr draw on (wed) procedure: venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve diagnoses: unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled aortic valve disorders obesity, unspecified unspecified erythematous condition 

Answer: The patient is high likely exposed to