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: penicillins attending: chief complaint: aortic stenosis major surgical or invasive procedure: tavi-aortic valve replacement via right thoracotomy ( 29 mm porcine corevalve) history of present illness: mr. is an 84 year old man with severe symptomatic aortic stenosis a history of coronary bypass grafting in at the (lima to lad, svg-pda,svg-omb),atrial fibrillation, severe obstructive lung disease, peripheral vascular disease, carotid artery disease, post-polio syndrome, pulmonary hypertension. he was seen approximately 6 months ago for aortic valve treatment options. he was determined to be of prohibitively extreme risk for surgical aortic valve replacement due to frailty. he was undergoing evaluation for tavi with incidental findings of a pulmonary nodule. workup included a repeat ct scan of the chest which showed improvement of the nodule consistent with resolving a infectious process. he returned for corevalve procedure via direct aortic approach. he continues to be symptomatic with the ability ambulate bed to bathroom before being limited by shortness of breath. nyha class: iii past medical history: aortic stenosis s/p coronary artery bypass noninsulin dependent diabetes mellitus hyperlipidemia s/p carotid stent s/p carotid endarterectomies h/o bladder cancer with neurogenic bladder s/p pacemaker implant chronic atrial fibrillation post polio syndrome social history: he lives with a caretaker and was a former venture capitalist. he is a former smoker. family history: - htn, heart disease, stroke - mother died at 99 of old age - father died at 52 of an mi - 1 sister with chf - 1 sister deceased from cancer (unknown type) - brother has ?stomach cancer - 2 sisters are healthy physical exam: pulse:77 b/p: 163/72 resp: 20 o2 sat: 976 temp:98.4 height: 68 inches weight: 145lbs general: frail, elderly male in wheelchair skin: color pale, turgor fair, warm and dry. stage ii excoriation left buttock. heent: normocephalic, anicteric, oropharynx moist. neck:supple, trachea midline, bilat bruits vs referred murmer chest: mild kyphosis, well healed surgical scar, ls decreased bases. heart: murmer throughout abdomen: soft, nontender, nondistended, hyperactive bowel sounds, last bm today. foley insitu on arrival, clear yellow urine. extremities: 1+ lower extremity edema, prosthetic shoes, leg lengths unequal, calves mild atrophy. left foot deformity. no femoral bruits. neuro: hoh, pleasant, vague at times, generalized weakness, unsteady gait. pulses: weakly palpable peripheral pulses. pertinent results: 04:05am blood wbc-9.8 rbc-3.83* hgb-10.4* hct-32.1* mcv-84 mch-27.1 mchc-32.4 rdw-15.4 plt ct-226 05:15am blood pt-21.0* inr(pt)-2.0* 05:15am blood urean-28* creat-1.3* na-142 k-4.2 cl-102 08:05pm blood ck(cpk)-387* 12:40pm blood alt-21 ast-20 ck(cpk)-75 alkphos-75 totbili-0.3 04:05am blood probnp-4948* 04:05am blood mg-2.1 12:40pm blood %hba1c-6.9* eag-151* tte : the left atrium is elongated. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). the estimated cardiac index is normal (>=2.5l/min/m2). right ventricular chamber size and free wall motion are normal. an aortic corevalve prosthesis is present. the aortic valve prosthesis appears well seated, with normal leaflet motion and transvalvular gradients. mild (1+) perivalvular aortic regurgitation is seen. the mitral leaflets are mildly thickened. mild to moderate (+) mitral regurgitation is seen. moderate tricuspid regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is an anterior space which most likely represents a prominent fat pad. impression: well seated corevalve aortic prosthesis with normal gradient mild perivalvular aortic regurgitation. mild symmetric left ventricular hypertrophy with preserved global and regional biventricular systolic function. mild-moderate mitral regurgtiation. pulmonary artery hypertension. compared with the prior study (images reviewed) of , the severity of aortic regurgitation has increased/more apparent. the severity of mitral regurgitation, tricuspid regurgitation, and estimated pa systolic pressure are now reduced. clinical implications: based on aha endocarditis prophylaxis recommendations, the echo findings indicate prophylaxis is recommended. clinical decisions regarding the need for prophylaxis should be based on clinical and echocardiographic data. electronically signed by , md, interpreting physician 13:52 04:05am blood wbc-9.8 rbc-3.83* hgb-10.4* hct-32.1* mcv-84 mch-27.1 mchc-32.4 rdw-15.4 plt ct-226 06:20am blood pt-27.2* inr(pt)-2.6* 05:15am blood pt-21.0* inr(pt)-2.0* 04:05am blood pt-18.3* inr(pt)-1.7* 05:47am blood pt-15.6* inr(pt)-1.5* 04:01am blood pt-13.4* inr(pt)-1.2* 04:55am blood pt-25.7* inr(pt)-2.5* brief hospital course: h e was admitted and completed pre-op work up. he underwent tavi// corevalve via mini right thoracotomy with dr. on . he was transferred to the cvicu in stable condition and extubated later that day. he transferred to the floor on pod #1 to begin increasing his activity level. the chest tubes were removed per protocol. he remains with his chronic indwelling foley. coumadin was restarted for chronic atrial fibrillation and plavix was given and discontinued when the inr reached 2. beta blockade and ace inhibitors were given. he was diuresed towards his preoperative weight and edema had essentially cleared by discharge. he continued to make good progress and was cleared for discharge to rehab on , pod 7. the atrial pacer lead was found to have a high impedance on evaluation , having been normal on . the electrophysiology service felt this could be evaluated by his primary cardiologist after rehab discharge. he was walking with assistance and a walker at discharge and lisinopril and lopressor were titrated to good blood pressure control. medications on admission: bumetanide - (prescribed by other provider) - 1 mg tablet - tablet(s) by mouth twice a day take 3 tablets in the am and 2 tablets in the afternoon digoxin - 125 mcg tablet - one tablet(s) by mouth every other day finasteride - (prescribed by other provider) - 5 mg tablet - tablet(s) by mouth once a day metoprolol tartrate - (prescribed by other provider) - 25 mg tablet - 0.5 (one half) tablet(s) by mouth twice daily nitrofurantoin macrocrystal - 100 mg capsule - one capsule(s) by mouth daily paroxetine hcl - 20 mg tablet - one tablet(s) by mouth in the evening pravastatin - 40 mg tablet - one tablet(s) by mouth daily prednisone - (prescribed by other provider) - 5 mg tablet - 1.5 tablet(s) by mouth daily ranitidine hcl - (prescribed by other provider) - 150 mg capsule - capsule(s) by mouth twice a day sitagliptin - (prescribed by other provider) - 100 mg tablet - 1 tablet(s) by mouth once a day - 0.4 mg capsule, ext release 24 hr - 2 capsule(s) by mouth daily tiotropium bromide - 18 mcg capsule, w/inhalation device - one capsule orally daily warfarin - 3 mg tablet - one tablet(s) by mouth daily - last dose medications - otc ascorbic acid - (prescribed by other provider) - 500 mg tablet - 1 tablet(s) by mouth twice a day aspirin - 81 mg tablet, delayed release (e.c.) - one tablet(s) by mouth daily cholecalciferol (vitamin d3) - 1,000 unit tablet - two tablet(s) by mouth daily docusate sodium - 100 mg capsule - one capsule(s) by mouth daily ferrous sulfate - (prescribed by other provider) - 325 mg (65 mg iron) tablet - tablet(s) by mouth once a day nph insulin human recomb - (prescribed by other provider) - 100 unit/ml suspension - 15 units twice a day vitamin e - 1,000 unit capsule - one capsule(s) by mouth daily --------------- --------------- --------------- --------------- allergies: penicillin - anaphylaxis discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). 4. paroxetine hcl 20 mg tablet sig: one (1) tablet po daily (daily). 5. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 6. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours). 7. prednisone 10 mg tablet sig: one (1) tablet po daily (daily). 8. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 9. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 10. ipratropium-albuterol 18-103 mcg/actuation aerosol sig: puffs inhalation q6h (every 6 hours) as needed for bronchospasm. 11. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). 12. pravastatin 40 mg tablet sig: one (1) tablet po once a day. 13. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 14. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). 15. furosemide 20 mg tablet sig: two (2) tablet po qam (once a day (in the morning)). 16. potassium chloride 10 meq tablet extended release sig: two (2) tablet extended release po daily (daily). 17. warfarin 1 mg tablet sig: as directed tablet po once a day: inr 2-2.5. discharge disposition: extended care facility: nursing & rehabilitation center - discharge diagnosis: severe aortic stenosis s/p core valve insertion coronary artery disease asthma noninsulin dependent diabetes mellitus s/p right carotid stent parosxymal atrial fibrillation s/p dual chamber pacemaker () h/o stroke hypertension dyslipidemia chronic obstructive pulminary disease peripheral vascular disease post-polio syndrome with atrophy bilateral legs pulmonary hypertension gastrointestinal reflux disease h/o bladder cancer - indwelling foley psoriasis urinary tract infection discharge condition: alert and oriented x3, nonfocal ambulating with assistance incisional pain managed with oral analgesics incisions: mini right thoracotomy - healing well, no erythema or drainage edema:trace lower extremeties alert and oriented x3, nonfocal ambulating with assistance incisional pain managed with oral analgesics incisions: mini right thoracotomy - healing well, no erythema or drainage edema:trace lower extremeties alert and oriented x3, nonfocal ambulating with assistance incisional pain managed with oral analgesics incisions: mini right thoracotomy - healing well, no erythema or drainage edema:trace lower extremeties alert and oriented x3, nonfocal ambulating with assistance incisional pain managed with oral analgesics incisions: mini right thoracotomy - healing well, no erythema or drainage edema:trace lower extremeties discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage 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:drs. / phone: date/time: @ 12:00, 2a device clinic phone: date/time: 10:00 echocardiogram phone: date/time: 9:00 please call to schedule appointments with your primary care dr. in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** labs: pt/inr for coumadin ?????? indication afib goal inr 2.0-3.0 first draw day after discharge ****coumadin follow up to be arranged prior to discharge from rehab procedure: extracorporeal circulation auxiliary to open heart surgery endovascular replacement of aortic valve diagnoses: tobacco use disorder urinary tract infection, site not specified congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation aortocoronary bypass status aortic valve disorders other chronic pulmonary heart diseases peripheral vascular disease, unspecified other and unspecified hyperlipidemia personal history of malignant neoplasm of bladder pressure ulcer, buttock late effects of cerebrovascular disease, hemiplegia affecting unspecified side chronic obstructive asthma, unspecified diastolic heart failure, unspecified other psoriasis examination of participant in clinical trial delirium due to conditions classified elsewhere fitting and adjustment of cardiac pacemaker late effects of acute poliomyelitis pressure ulcer, stage ii other and unspecified escherichia coli [e. coli] neurogenic bladder nos physical restraints status dementia, unspecified, without behavioral disturbance 

Answer: The patient is high likely exposed to