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: aspirin / iodine / penicillins / opioid analgesics / chocolate flavor / juice / benzodiazepines / red dye / egg / gluten / tomato attending: chief complaint: dyspnea major surgical or invasive procedure: 1. coronary bypass grafting x3( left internal mammary artery to left anterior descending coronary,saphenous vein graft to first diagonal coronary artery,saphenous vein graft to first obtuse marginal coronary artery),aortic valve replacement with a 23-mm magna aortic valve bioprosthesis,insertion of intra-aortic balloon pump through the right femoral artery. tracheostomy sternal debridement sternal closure with latissimus and pectoralis flaps history of present illness: this a 78 year old female with known aortic stenosis admitted to with chest pain and congestive heart failure. she was diuresed but continued to have chest pain, and was transferred to for cardiac catheterization. past medical history: hypertension hypercholesterolemia peripheral vascular disease with dry gangrene toes bilaterally insulin dependent diabete mellitus aortic stenosis coronary artery disease h/o gastric ulcer osteoarthritis morbid obesity mrsa in abdominal wall abscess s/p cholecystectomy s/p hernia repair social history: ms. tobacco use, alcohol, or drugs. she is married and lives with her husband. daughter lives on the of her house. she has five children. family history: ms. reports no family history of early myocardial infarction or coronary artery disease. physical exam: admission: vs: 97.6, 154-194/56-67, 14, general: wdwn femal in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. adentulous with prosthetics neck: supple with difficult to evaluate jvp cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. harsh, late peaking 3/6 systolic murmur in all fields, worst at lusb and radiating to carotids. no thrills, lifts. no s3 or s4. lungs: +pectus, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: swollen, brawny upper extremities. no femoral bruits. skin: + stasis dermatitis, + healing ulcers bilateral hallux, xanthomas. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ pertinent results: echocardiography report , (complete) done at 11:11:46 am final referring physician information , - department of cardiac s , 2a , status: inpatient dob: age (years): 78 f hgt (in): bp (mm hg): / wgt (lb): hr (bpm): bsa (m2): indication: abnormal ecg. aortic valve disease. chest pain. congestive heart failure. coronary artery disease. h/o cardiac surgery. hypertension. icd-9 codes: 402.90, 427.31, 786.05, 424.1 test information date/time: at 11:11 interpret md: , md test type: tee (complete) son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2010aw5-: machine: echocardiographic measurements results measurements normal range left atrium - long axis dimension: *6.0 cm <= 4.0 cm left ventricle - ejection fraction: 40% to 45% >= 55% aorta - ascending: 2.6 cm <= 3.4 cm findings left atrium: moderate la enlargement. no spontaneous echo contrast in the body of the laa. no mass/thrombus in the laa. good (>20 cm/s) laa ejection velocity. right atrium/interatrial septum: mildly dilated ra. no thrombus in the raa. no asd by 2d or color doppler. left ventricle: normal lv wall thickness. top normal/borderline dilated lv cavity size. mild regional lv systolic dysfunction. doppler parameters are most consistent with grade i (mild) lv diastolic dysfunction. right ventricle: normal rv wall thickness. normal rv chamber size. mild global rv free wall hypokinesis. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. normal aortic arch diameter. simple atheroma in aortic arch. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: bioprosthetic aortic valve prosthesis (avr). avr leaflets move normally. no masses or vegetations on aortic valve. no ar. mitral valve: mildly thickened mitral valve leaflets. moderate mitral annular calcification. mild to moderate (+) mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflet. no ps. physiologic pr. pulmonic valve not well seen. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was under general anesthesia throughout the procedure. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. no tee related complications. results were personally reviewed with the md caring for the patient. conclusions pt for sternal debridement. 1. the left atrium is moderately dilated. no spontaneous echo contrast is seen in the body of the left atrium or left atrial appendage. no mass/thrombus is seen in the left atrium or left atrial appendage. 2. no thrombus is seen in the right atrial appendage no atrial septal defect is seen by 2d or color doppler. 3. left ventricular wall thicknesses are normal. the left ventricular cavity size is top normal/borderline dilated. there is mild regional left ventricular systolic dysfunction with anterior and anteroseptal hypokinesis. doppler parameters are most consistent with grade i (mild) left ventricular diastolic dysfunction. 4. right ventricular chamber size is normal. with mild global free wall hypokinesis. 5. there are simple atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta. 6. a bioprosthetic aortic valve prosthesis is present. the aortic valve prosthesis leaflets appear to move normally. no masses or vegetations are seen on the aortic valve. no aortic regurgitation is seen. 7. the mitral valve leaflets are mildly thickened. mild to moderate (+) mitral regurgitation is seen. dr. was notified in person of the results. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 11:19 03:30am blood wbc-18.4* rbc-2.74* hgb-8.4* hct-25.1* mcv-92 mch-30.5 mchc-33.3 rdw-15.2 plt ct-499* 03:30am blood pt-13.4 ptt-27.9 inr(pt)-1.1 03:30am blood glucose-95 urean-47* creat-3.8* na-134 k-3.5 cl-95* hco3-31 angap-12 , s f 78 radiology report chest (portable ap) study date of 6:17 pm , csru 6:17 pm chest (portable ap) clip # reason: r/o aspiration medical condition: 78 year old woman s/p avr/cabg reason for this examination: r/o aspiration final report history: possible aspiration after cardiac surgery. findings: in comparison with study of , there has been decrease in the bilateral pleural effusions and pulmonary edema. persistent atelectatic changes at the bases, especially in the retrocardiac region on the left. the possibility of supervening pneumonia cannot be excluded. monitoring and support devices remain in place. brief hospital course: cardiac catheterization was done on and documented severe aortic stenosis and coronary artery disease. the pt. became delerious post cath and had several "code purples" called. she also had a uti which id stated was chronic and was not treated. while she was waiting for surgery she experienced unstable glucoses with some low measurments. she experienced heart block and sinus pauses as well. the patient had a wound nurse consult which determined that she had a stage 2 pressure ulcer on her glutealis. surgical evaluation was obtained and she was worked up for cardiac surgery in typical fashion. on ms. was taken to the operating room and underwent a coronary artery bypass grafting times three and an aortic valve replacement. please see the operative note for details. an intraaortic balloon pump was placed in the or secondary to wide open mitral regurgitation when weaning from bypass. fluid was removed and the regurgitation resolved. she weaned from bypass in complete heart block being pacing with temporary wires. levophed, epinephrine, amiodorone and vasopressin were required to wean from bypass. she was paced via her epicardial leads with atrial fibrillation with a ventricular rate in the 30s. her rhythm gradually improved with sinus rhythm and atrial fibrillation at times. amiodarone was stopped and the electrophysiology servive followed her. the temporary wires were finally removed on pod 18. a heparin infusion was initiated due to the fibrillation, but stopped when sinus persisted. her iabp was discontinued on pod#2 and she was extubated on pod #3. she had intermittent respiratory distress and was reintubated on pod#5 after trials with bipap. she was followed by the wound care nurse for a large gluteal ulcer which started preop and was aggravated by being in the or for 10 hours. her course was complicated by renal failure requiring dialysis and respiratory failure requiring placement of a tracheostomy. she was treated with bactrim for coag negative staph in the sputum. she was fed via a dobhoff tube. initial peg placment plans were deferred after an abdominal ct revealed ascites. she was seen by hepatology for her cirrhosis but no further workup was indicated. general surgery was consulted for a stage iii sacral ulcer and local care with enzymatic debriding was continued. eventually she was sharply debrided as well. infectious disease was consulted for positive blood cultures with gram positive rods and cefipime was added to the meropenum she was receiving already. on there was significant sternal drainage and she was taken to the operating room for exploration. nonhealing of the sternum with multiple bilateral fragments was found. debridement followed by application of a wound vac was carried out. plastics was consulted and on she returned to the operating room where she underwent sternal closure with pectoralis and latissimus flaps. she coninued to be ventilator and dialysis dependent and there were many family meetings with dr. , his team, and social work. eventually the family felt that mrs. would not want to be ventilator dependent and on chronic dialysis and on they decided to make her comfort measures only. she expired at 4am on . the family was present and did not want a post mortem examination. medications on admission: home medications tiazac 240 mg daily asa 325 mg daily levoquin 500 mg daily for uti carispodol 350 mg hs prn nph 67 units in am and 53 untis in pm regular insulin 23 units in am and 32 units with dinner discharge medications: none discharge disposition: expired discharge diagnosis: aortic stenosis s/p aortic valve replacement s/p coronary artery bypass grafts coronary artery disease hypertension morbid obesity insulin dependent diabetes mellitus peripheral vascular disease dry gangrene toes bilaterally hypercholesterolemia mrsa carrier s/p cholecystectomy postoperative renal failure postoperative respiratory failure deep sternal wound infection s/p sternal debridement decubitus ulcer post operative atrial fibrillation discharge condition: expired discharge instructions: none followup instructions: none procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters (aorto)coronary bypass of two coronary arteries enteral infusion of concentrated nutritional substances hemodialysis venous catheterization for renal dialysis other intubation of respiratory tract temporary tracheostomy open and other replacement of aortic valve with tissue graft closed [endoscopic] biopsy of bronchus local excision of lesion or tissue of bone, scapula, clavicle, and thorax [ribs and sternum] local excision of lesion or tissue of bone, scapula, clavicle, and thorax [ribs and sternum] attachment of pedicle or flap graft to other sites implant of pulsation balloon diagnoses: other iatrogenic hypotension end stage renal disease coronary atherosclerosis of native coronary artery acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified congestive heart failure, unspecified cirrhosis of liver without mention of alcohol atrial fibrillation disruption of internal operation (surgical) wound aortic valve disorders hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease ulcer of other part of foot atrioventricular block, complete 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 diabetes with other specified manifestations, type ii or unspecified type, not stated as uncontrolled blood in stool morbid obesity pressure ulcer, buttock pressure ulcer, lower back other ascites atherosclerosis of native arteries of the extremities with gangrene delirium due to conditions classified elsewhere pressure ulcer, stage iv candidiasis of skin and nails other staphylococcus pneumonia 

Answer: The patient is high likely exposed to