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 an 80-year-old gentleman status post coronary artery bypass graft in and a percutaneous transluminal coronary angioplasty in with complaints of shortness of breath on exertion and fatigue over the past four years which has worsened over the past year, prompting the patient to finally consent to surgery which he has been refusing for at least one year prior to this surgical date. the patient had a cardiac catheterization done on that showed left main disease with a patent right coronary artery stent a left internal mammary artery to the left anterior descending artery, saphenous vein graft to the left circumflex; both patent. severe mitral regurgitation and an ejection fraction of 67%. his echocardiogram done on showed right ventricular enlargement with moderate-to-severe tricuspid regurgitation and moderate mitral regurgitation. past medical history: 1. coronary artery disease. 2. atrial fibrillation. 3. prostate cancer. 4. colon cancer. 5. pancytopenia. past surgical history: 1. status post coronary artery bypass graft times two in . 2. status post colonoscopy in . 3. status post colectomy in . 4. status post radical prostatectomy in . 5. status post penile implant. 6. status post right urethral stent. 7. status post bone marrow biopsy to diagnose pancytopenia in . medications on admission: medications prior to admission included atenolol 50 mg p.o. q.d., aspirin 81 mg p.o. q.d., coumadin 2 mg p.o. q.d., lasix 20 mg p.o. q.d., and vasotec 5 mg p.o. q.d. allergies: he has no known drug allergies. family history: the patient's family history revealed father died of a myocardial infarction at the age of 59. mother died of breast cancer at 48. social history: he lives alone in lundinary, . positive tobacco use; four packs per day times 35 years; quit about 35 years ago. social alcohol use; about 10 beers per month. he denies any other drug use. physical examination on presentation: physical examination prior to admission revealed height was 5 feet 10 inches, weight was 185 pounds, heart rate was 85 and irregular, blood pressure was 106/62, respiratory rate was 24. in general, a pleasant male who appeared his stated age, in no acute distress. skin was well hydrated. left cheek with a half-dollar size lesion, purplish in color. head, eyes, ears, nose, and throat revealed pupils were equally round and reactive to light with extraocular movements intact. positive glasses. positive hearing aid. positive upper and lower dentures. normal buccal mucosa. the neck was supple. no jugular venous distention. no thyromegaly. no lymphadenopathy. no carotid bruits. chest with positive crackles at the right base. a sternal incision was well-healed. the sternum was stable. heart was irregular, second heart sound and second heart sound, with a positive murmur heard best at the apex. slightly distant heart sounds. the abdomen was soft, nontender, and nondistended. normal active bowel sounds with a median abdominal incision that was well-healed. a colostomy bag and the ileostomy bag were both intact. diffuse bilateral varicosities; right greater than left. neurologically, cranial nerves ii through xii were grossly intact. a nonfocal examination. femoral pulses were 2+ bilaterally. dorsalis pedis pulses were 2+ on the right and 1+ on the left. posterior tibialis pulses were not palpated. radial pulses were 2+ bilaterally. hospital course: on , the patient was a direct admission to the operating room at which time he underwent a beating heart mitral valve replacement with a #27 mosaic valve and a tricuspid valve repair with a 32-mm ring. the patient tolerated the operation and was transferred from the operating room to the cardiothoracic intensive care unit. at the time of transfer, the patient was in atrial fibrillation at a rate of 100 with a central venous pressure of 13, a mean arterial pressure was 67. he had propofol at 30 mcg/kg per minute, and epinephrine at 0.3 mcg/kg per minute. the patient had an extended postoperative recovery in the cardiothoracic intensive care unit. he received large amounts of volume during his surgical repair. the first several days of his intensive care unit admission were spent diuresing the patient in an attempt to get him successfully extubated. during that time, he remained hemodynamically stable. he was weaned from all cardioactive drugs. he did, however, have frequent episodes of rapid atrial fibrillation; for which he was initially loaded with amiodarone and later switched to digoxin for rate control. during the surgical repair of the patient's mitral valve and tricuspid valve repair, he received large amounts of fluid, and the first several days of the intensive care unit were spent with the patient undergoing vigorous diuresis in an attempt to successfully extubate him. on postoperative day eight, an attempt was made to extubate the patient. he rapidly failed the attempted extubation a reintubated within 60 minutes of his initial extubation. the patient again weaned to cpap following reintubation and remained in the intensive care unit ventilatory dependent. on , the patient underwent a percutaneous tracheostomy and percutaneous gastric tube placement. he had a #8 percutaneous tracheostomy placed at the bedside. the patient tolerated that procedure well and remained in the intensive care unit for the next several days; again, undergoing ventilatory wean and ramping up of the patient's tube feeds. he was noted to have a large right loculated pleural effusion. on , he underwent a right videoscopic thoracoscopy for removal of his loculated right pleural effusion. from that time forward, the patient remained in the intensive care unit with attempts being made to wean the patient from the ventilator and get him to tracheostomy collar. the patient did tolerate ventilatory wean to a pressure support of 5 and 5 during the day, resting at night, with increased amounts of pressure support (up to 15) or intermittent mandatory volumes with a rate of 8 to 10 breaths per minute. during this period of time, the patient was also restarted on his anticoagulation given his history of atrial fibrillation. the patient is now postoperative day 27 from his valvular surgery and on postoperative day seven from his tracheostomy and percutaneous endoscopic gastrostomy tube, and it was felt that he was stable and ready to be transferred to rehabilitation for continuing weaning from his ventilator. physical examination on discharge: a review of the patient's physical examination at this time is as follows; temperature was 99.8, heart rate was 100 in atrial fibrillation, blood pressure was 129/50, respiratory rate was 20, oxygen saturation was 100% (that was with pressure support of 10, positive end-expiratory pressure of 5, and 40% fio2). his tidal volume with those settings was a tidal volume of between 450 and 500, and his respiratory ranges 20 to 25. neurologically, the patient was alert and oriented. he followed commands and moved all extremities. he does have periods of agitation, and he felt frustrated that he could not eat or talk. cardiovascularly, he had a heart rate from 80 to 100, in atrial fibrillation. second heart sound and second heart sound with no murmurs. the patient had a well-healed old sternal incision. respiratory revealed he had a #8 portex tracheostomy. he remained on cpap 40%, 5 of positive end-expiratory pressure, 10 of pressure support, oxygen saturations were 96% to 100%. he had scattered rhonchi throughout, and no rales. suctioned for thick tan secretions. the abdomen was soft, nontender, and nondistended, with positive bowel sounds. tube feeds via his gastrectomy tube at a goal rate. he also had an intact colostomy drainage bag. he had an ileal loop that had a collection bag that was intact, draining yellow urine with some sediment in it. endocrine wise, the patient was receiving sliding-scale insulin to cover blood sugars of greater than 150. he had a right thoracotomy with clean margins, a small amount of sanguinous drainage from the upper portion of that incision. pertinent laboratory data on discharge: the patient's laboratories on discharge were white blood cell count of 15, hematocrit was 25, platelets were 240. pt was 16, inr was 1.8. sodium was 149, potassium was 4.7, chloride was 115, bicarbonate was 31, blood urea nitrogen was 48, creatinine was 1, blood glucose was 151. magnesium was 1.8, phosphate was 3, and calcium was 8.7. medications on discharge: (the patient's discharge medications included). 1. vancomycin 1000 mg q.24h. (therapy to be terminated on ). 2. fluoxetine 20 mg p.o. q.d. 3. colace 100 mg p.o. b.i.d. 4. digoxin 0.25 mg p.o. q.d. 5. xanax 0.25 mg p.o. t.i.d. as needed. 6. prevacid oral solution 30 mg p.o. b.i.d. 7. combivent 4 puffs q.6h. and as needed. 8. tolnaftate powder topically t.i.d. 9. regular insulin sliding-scale; less than 150 use 0 units, 150 to 200 use 4 units, 201 to 250 use 7 units, 251 to 300 use 10 units, 301 to 351 use 13 units, greater than 350 use 16 units. 10. coumadin 5 mg p.o. q.d. (titrate to achieve a goal inr of 2.5). 11. tube feeds via his percutaneous endoscopic gastrostomy tube; impact with fiber at 75 cc per hour. at this time, he continues to receive free water 250 cc q.i.d. discharge diagnoses: 1. coronary artery disease; status post coronary artery bypass graft times two. 2. atrial fibrillation. 3. prostate cancer; status post radical prostatectomy and ileal conduit. 4. colon cancer; status post colectomy and status post colonoscopy. 5. status post mitral valve replacement with a #27 mosaic valve. 6. status post tricuspid valve repair with a #32 annuloplasty ring. 7. status post percutaneous tracheostomy and percutaneous endoscopic gastrostomy tube placement on . 8. status post right videoscopic thoracoscopy on for evacuation of a loculated pleural effusion. 9. also, the patient was noted to have a positive screen during this admission, and he was treated for methicillin-resistant staphylococcus aureus in his sputum. discharge status: the patient was to be discharged to rehabilitation. die followup: he was to have follow up with dr. in three weeks from the time of his discharge from rehabilitation. , m.d. dictated by: medquist36 procedure: insertion of intercostal catheter for drainage continuous invasive mechanical ventilation for 96 consecutive hours or more extracorporeal circulation auxiliary to open heart surgery insertion of endotracheal tube percutaneous [endoscopic] gastrostomy [peg] decortication of lung temporary tracheostomy open and other replacement of mitral valve open heart valvuloplasty of tricuspid valve without replacement insertion of intercostal catheter for drainage continuous invasive mechanical ventilation for 96 consecutive hours or more extracorporeal circulation auxiliary to open heart surgery insertion of endotracheal tube percutaneous [endoscopic] gastrostomy [peg] decortication of lung temporary tracheostomy open and other replacement of mitral valve open heart valvuloplasty of tricuspid valve without replacement diagnoses: mitral valve disorders unspecified pleural effusion atrial fibrillation personal history of malignant neoplasm of prostate aortocoronary bypass status acute respiratory failure personal history of malignant neoplasm of large intestine diseases of tricuspid valve 

Answer: The patient is high likely exposed to