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: addendum: discharge recompleted due to orginal summary incorrect chief complaint: left leg pain/nausea major surgical or invasive procedure: emergency aortic valve repalcement (29 mm mosaic porcine),replacement of ascending aorta and hemiarch (32 mm gelweave graft) bilateral tube thoracostomies flexible bronchoscopy with aspiration 8.0 adjustable tracheostomy tube, 20-french ponsky percutaneous endoscopic gastrostomy tube history of present illness: this 71 year old white male is visiting from , pa. while was in , ri. he developed left calf pain. he also had nausea earlier in the day and his wife noticed that he appeared pale and diaphoretic to her. he was taken to hospital. in the er was found to be hypotensive with a systolic bp in the 60s. doapmine was started and a ct of the chest/abdomen was obtained. this revealed an ascending aortic dissection extending into the descending aorta, down to the left femoral artery. also noted was a dilated aortic root of 4.7cm and pericardial fluid was alsopresent. he was transferred here by mediflight to be taken straight to the or. past medical history: abdominal aortic aneurysm hypertension obesity hyperlipidemia paroxysmal atrial fibrillation social history: unknown family history: noncontributory physical exam: pulse: resp:24 o2 sat: 92% b/p right: left: 105/64 height: weight:83.6 kg general: skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema varicosities: none neuro: grossly intact pulses: femoral right: +1 left:+1 dp right: +1 left: 0 pt : +1 left: 0 radial right: +1 left: 0 pertinent results: tee: pre-cpb:1. the left atrium is mildly dilated. no thrombus is seen in the left atrial appendage. 2. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is unusually small. overall left ventricular systolic function is normal (lvef>55%). 3. right ventricular chamber size and free wall motion are normal. 4. the aortic root is mildly dilated at the sinus level. the ascending aorta is moderately dilated. the aortic arch is markedly dilated. there are simple atheroma in the descending thoracic aorta. a mobile density is seen in the ascending aorta consistent with an intimal flap/aortic dissection. the dissection originates at the level of the sinotubular junction. flow is seen in the lmca. a mobile density is seen in the descending aorta consistent with an intimal flap/aortic dissection. the aortic wall is thickened consistent with an intramural hematoma. 5. there are three aortic valve leaflets. the aortic valve leaflets are severely thickened/deformed. the leaflet movements are severely restricted. significant aortic stenosis is present (not quantified). mild (1+) aortic regurgitation is seen. 6. the mitral valve appears structurally normal with trivial mitral regurgitation. 7. there is a large pericardial effusion. there is sustained right atrial collapse, consistent with low filling pressures or early tamponade. dr. was notified in person of the results. post-cpb: on infusions of epi, levo, neo av pacing. transient biventricular systolic dysfunction, probably secondary to air. improved with inotropic support but persistent inferior hypokinesis and globqal lv dysfunction, not appreciated prebypass due to tamponade and low lv volume status. mild mr. bioprosthetic valve in the aortic position. no ai or perivalvular leak. minimal gradient. aortic contour normal post decannulation. 06:11 ?????? caregroup is. all rights reserved. 02:13am blood wbc-15.9* rbc-3.20* hgb-9.1* hct-29.4* mcv-92 mch-28.6 mchc-31.0 rdw-15.4 plt ct-309 06:49am blood wbc-15.1* rbc-3.08* hgb-8.9* hct-28.1* mcv-91 mch-29.0 mchc-31.8 rdw-15.4 plt ct-334 02:13am blood pt-20.8* ptt-74.1* inr(pt)-1.9* 02:13am blood glucose-122* urean-41* creat-1.2 na-145 k-4.4 cl-108 hco3-30 angap-11 06:49am blood glucose-184* urean-43* creat-1.2 na-143 k-4.3 cl-107 hco3-29 angap-11 02:13am blood alt-41* ast-43* alkphos-76 amylase-106* 03:10am blood alt-37 ast-52* alkphos-67 amylase-91 totbili-0.8 02:13am blood lipase-169* 06:49am blood lipase-152* 01:32am blood wbc-13.6* rbc-2.96* hgb-8.4* hct-27.2* mcv-92 mch-28.5 mchc-30.9* rdw-15.2 plt ct-251 06:28am blood pt-25.5* ptt-32.7 inr(pt)-2.5* 01:32am blood glucose-113* urean-31* creat-0.9 na-146* k-4.6 cl-107 hco3-35* angap-9 01:09am blood amylase-111* 01:37am blood amylase-111* 01:09am blood lipase-185* 01:37am blood lipase-175* brief hospital course: he was admitted directly to operating room in critical condition and underwent surgery with dr. . see operative note for details. initial attempts at sparing the valve were unsuccessful and valve replacement was necessary. he weaned from bypass on levophed, epinephrine, phenyleprine and propofol infusions. he required prolonged resuscitation with fluids and ventilator adjustments to correct a profound acidosis. his bladder pressure was measured and was not elevated. his lactate cleared and ph normalized. pressors were modified and dobutamine was added to his regimen with improvment of his cardiovascular parameters. oliguria ensued, despite optimization of his hemodynamics, and his creatinine rose to above 4, acute renal failure. renal was consulted and continued to follow until renal function improved. milrinone was added eventually and a lasix drip begun and he slowly improved and did not require dialysis. continues on lasix for diuresis and will need to continue to monitor creatinine. he developed fever and sputum cultures grew proteus and serratia, which was treated with cipro. groin erythema was treated empirically with vancomycin and improved. he was noted to not move the left side to commands, although there was some spontaneous movement of the left toes. he improved over time and is able to move all extremities right side stronger than left but able to lift and hold. physical therapy worked with him and he was ambulating short distances with assistance prior to discharge due to difficult airway and inability to change over endotracheal tube with his respiratory failure he underwent tracheostomy. additionally he had a peg tube placed for nutrition. tube feedings were given, he had some diarrhea (c. diff was neagtive x 3) and banana flakes were added to his feeds. he was tolerating 24 hours of trach collar a day ( via a ). he had a mild increase in his amylase and lipase with a benign abdominal exam on and a general surgery consult was obtained. he remained asymptomatic and levels remained stable. there was no further intervention and plan just to continue abdominal exams daily medications on admission: diltiazem, atenolol, lisinopril, asa, simvastatin, coumadin (doses unknown) dopamine drip turned off in helicopter discharge medications: 1. warfarin 3 mg tablet sig: goal inr 2.0-2.5 tablets po once a day: please dose based on inr due for draw , please give 3 mg and then check inr for further dosing . 2. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 3. bupropion hcl 75 mg tablet sig: one (1) tablet po bid (2 times a day). 4. acetaminophen 500 mg/5 ml liquid sig: po every six (6) hours as needed for pain. 5. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po q6h (every 6 hours) as needed for constipation. 6. simvastatin 20 mg tablet sig: one (1) tablet po once a day. 7. metoprolol tartrate 25 mg tablet sig: three (3) tablet po tid (3 times a day). 8. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 9. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 10. amiodarone 200 mg tablet sig: one (1) tablet po once a day. 11. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 12. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation every six (6) hours. 13. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 14. ranitidine hcl 15 mg/ml syrup sig: fifteen (15) ml po daily (daily). 15. norvasc 10 mg tablet sig: one (1) tablet po once a day. 16. insulin insulin sc fixed dose orders bedtime glargine 15 units insulin sc sliding scale q4h regular glucose insulin dose 0-70 mg/dl 4 oz. juice 71-120 mg/dl 0 units 121-160 mg/dl 4 units 161-200 mg/dl 6 units 201-240 mg/dl 8 units 241-280 mg/dl 10 units 281-320 mg/dl 12 units 321-360 mg/dl 14 units > 360 mg/dl notify m.d. 17. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day). 18. outpatient work pt/inr please check for coumadin dosing then twice a week until on stable dose chem 10 weekly while on diuretics discharge disposition: extended care facility: & rehab center - discharge diagnosis: type a aortic dissection s/p aortic valve replacement,ascending aorta and hemiarch replacement abdominal aortic aneurysm hypertension paroxysmal atrial fibrillation obesity postoperative acute renal failure postoperative respiratory failure hyperlipidemia difficult intubation discharge condition: alert, with trach, following commands right side stronger than left side discharge instructions: no lotions, creams, powders or ointments on any incision please bath daily, wash incisions with mild soap (dove/) and rinse, pat dry, no baths (shower deferred due to trach) no driving until cleared by primary care in no lifting greater than 10 pounds for 10 weeks call for fever greater than 100.5, redness, drainage of 2 pounds in 2 days or 5 pounds in one week please call with any questions or concerns please note difficult intubation followup instructions: dr. after return to pa () dr. in prior to return to pa 1-3 weeks () - if any questions or concerns prior to return to pa please contact dr office will need to follow up with vascular surgeon and cardiothoracic surgeon after return to pa, dr office aware and will refer on return md procedure: insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified 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] temporary tracheostomy open and other replacement of aortic valve with tissue graft resection of vessel with replacement, thoracic vessels nonexcisional debridement of wound, infection or burn resection of vessel with replacement, aorta, abdominal bronchoscopy through artificial stoma diagnoses: pneumonia, organism unspecified acidosis acute kidney failure with lesion of tubular necrosis other postoperative infection unspecified pleural effusion unspecified essential hypertension hyposmolality and/or hyponatremia atrial fibrillation aortic valve disorders acute respiratory failure cardiogenic shock other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation long-term (current) use of anticoagulants hypoxemia diarrhea obesity, unspecified dissection of aorta, thoracoabdominal staphylococcus infection in conditions classified elsewhere and of unspecified site, other staphylococcus accidents occurring in residential institution cardiac tamponade non-healing surgical wound 

Answer: The patient is high likely exposed to