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: ciprofloxacin / ambien / trazodone attending: chief complaint: aortic stenosis major surgical or invasive procedure: - aortic valve replacement(19-mm biocor tissue valve) history of present illness: this 89 year old woman with severe diastolic dysfunction,critical calcific aortic stenosis and severe pulmonary hypertension and has had numerous hospitalizations for acutely decompensated heart failure over the last few years. her most recent admission was . she has shortness of breath that occurs when she exerts herself and when she is emotionally stressed. she can walk 10 feet before needing to rest due to shortness of breath. she occasionally has chest pain in the setting emotional distress. she reports having some dizziness when she changes position quickly or after ambulation. she was undergoing consideration for corevalve protocol vs surgical avr. under this study, she was randomized to surgical intervention and was admitted for same day surgery. past medical history: hypertension coronary artery disease multiple percutaneous coronary interventions/stents h/o paroxysmal atrial fibrillation(no coumadin secondary to gastrointestinal bleeds diastolic dysfunction (lvef >55%) aortic stenosish: chonic kidney disease gout diverticulosis obstructive sleep apnea(cpap) spinal stenosis obesity s/p l orif of femur fx s/p cholecystectomy social history: - tobacco: denies - etoh: denies - illicit drugs: denies lives at facility. close support supports in place, 3 children deeply involved in her care. widowed >30 years. becomes dyspneic with walking 5 feet or talking for extended periods of time. family history: family history: father, mother and 5 siblings all had or have heart disease. physical exam: admission vss height: 60" weight: 156lbs general: well-developed elderly female in no acute distress skin: dry intact heent: perrla eomi neck: supple full rom chest: mostly clear bilaterally, sl decreased at base heart: rrr irregular murmur grade sys abdomen: soft non-distended non-tender +bs extremities: warm , well-perfused edema trace varicosities: none neuro: grossly intact pulses: femoral right: 2+ left: 2+ dp right: 1+ left: 1+ pt : 1+ left: 1+ radial right: 2+ left: 2+ carotid bruit right/left: trans murmur discharge gen nad neuro a&o x3, mae-nonfocal exam pulm diminished bases bilat-scattered rhonchi cv rrr, sternum stable incision cdi abdm soft, nt/nd/nabs, obese ext warm, well perfused. no edema pertinent results: echo pre bypass the left atrium is dilated. mild spontaneous echo contrast is seen in the body of the left atrium. moderate to severe spontaneous echo contrast is present in the left atrial appendage. the left atrial appendage emptying velocity is depressed (<0.2m/s). a left atrial appendage thrombus cannot be completely excluded. the right atrium is dilated. no thrombus is seen in the right atrial appendage a patent foramen ovale is present. a left-to-right shunt across the interatrial septum is seen at rest. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). the right ventricle displays normal free wall contractility. there are simple atheroma in the ascending aorta. there are complex (>4mm) atheroma in the descending thoracic aorta. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). trace aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. moderate (2+) mitral regurgitation is seen. the left ventricular inflow pattern suggests a restrictive filling abnormality, with elevated left atrial pressure. moderate tricuspid regurgitation is seen. dr. was notified in person of the results in the operating room at the time of the study. post bypass the patient is av paced. there is normal biventricular systolic function. there is a bioprosthesis located in the aortic position. it appears well seated. the leaflets are not well seen. the maximum pressure through the aortic valve was 28 mmhg with a mean pressure of 14 mmhg at a cardiac output of about 3.5 liters/minute. the effective orifice area is in the range of 0.8 to 1 cm2. the rest of the cardiac valves appear unchanged from pre-bypass. the thoracic aorta is intact after decannulation. left to right shunt flow persists through the patent foramen ovale. admission : 09:40am ck-mb-6 09:40am ck(cpk)-298* 10:07am hgb-9.8* calchct-29 10:07am glucose-109* lactate-0.9 na+-141 k+-3.9 cl--109* 01:06pm fibrinoge-254 01:06pm pt-14.4* ptt-28.5 inr(pt)-1.3* 01:06pm wbc-6.7 rbc-3.12* hgb-8.9* hct-28.5* mcv-91 mch-28.5 mchc-31.2 rdw-14.3 01:06pm plt count-134* 02:36pm urea n-66* creat-1.1 sodium-139 potassium-4.9 chloride-112* total co2-20* anion gap-12 discharge : 04:37am blood wbc-7.9 rbc-3.39* hgb-9.5* hct-32.8* mcv-97 mch-27.9 mchc-28.9* rdw-15.9* plt ct-190 02:16am blood pt-10.0 ptt-30.3 inr(pt)-0.9 04:37am blood glucose-85 urean-48* creat-1.0 na-140 k-3.5 cl-100 hco3-30 angap-14 brief hospital course: ms. was admitted to the on for surgical management of her aortic valve disease. she was taken to the operating room where she underwent aortic valve replacement using a 19-mm biocor tissue valve. please see operative note for details. cardiopulmonary bypass time= 53 minutes. cross clamp time=40 minutes. postoperatively she was taken to the intensive care unit for monitoring. she awoke neurologically intact, was weaned from the ventilator and extubated on the day of surgery. her chest tubes and epicardial pacing wires were removed per cardiac surgery protocol. amiodarone was resumed for paroxysmal atrial fibrillation, and was stopped when lfts became elevated. coumadin was not started due to a history of gi bleed. she transfered to the floor on pod2 where she was diuresed towards her preoperative weight. on pod 3 she developed severe shortness of breath and was transferred back to the icu where for additional pulmonary support. bipap was used and a right thoracentesis was performed. she gradually improved and on pod 10 she returned to the step down floor. she was evaluated by physical therapy for mobility and screened for rehabilitation placement. a cxr on showed a large right sided pleural effusion. she had another thoracentesis which yielded 350cc serosanguinous fluid. she developed a contraction alkalosis. lasix was stopped and she began diamox. she continued to be diuresed and developed acute on chronic renal failure. increased somnolence along with a reaccumulation of her bilat effusions resulted in yet another transfer back to the cvicu where she was reintubated. a pa catheter was placed, a chest tube was placed to drain the effusion and she was seen by the renal service to assist with ongoing diuresis. she was noted to have a uti and appropriate antibiotics were initiated. the patient was also seen by the heart failure service. her renal function gradually improved and she continued to diurese. her chest tube continued to drain serous fluid and thoracic surgery was consulted for possible pleuradesis. on pod# 28 she was again transferred to the step down floor. the remainder of her hospital course was essentially uneventful. on pod#31 she was discharged to rehabilitaion. all follow up appointments were advised. medications on admission: carvedilol - 12.5 mg tablet - 1 tablet(s) by mouth twice a day cholestyramine (with sugar) - 4 gram packet - 1 by mouth once a day compression stocking - as directed wear daily please measure pt for size. knee high. diagnosis: edema febuxostat - 40 mg tablet - one tablet(s) by mouth once a day ipratropium bromide - 21 mcg spray, non-aerosol - 1 spray nasally twice a day losartan - 25 mg tablet - one tablet(s) by mouth daily metoprolol succinate - (prescribed by other provider) - 25 mg tablet extended release 24 hr - 1 tablet(s) by mouth daily nitroglycerin - 0.3 mg tablet, sublingual - 1 tablet(s)sublingually as needed repeat 2 times in 10 minutes. simvastatin - 80 mg tablet - 1 tablet(s) by mouth once a day torsemide - (prescribed by other provider) - 20 mg tablet - 1 tablet(s) by mouth daily (daily) medications - otc acetaminophen - 500 mg tablet - 1 (one) tablet(s) by mouth four times a day as needed aspirin - 325 mg tablet - 1 (one) tablet(s) by mouth once a day cholecalciferol (vitamin d3) - (prescribed by other provider) - 1,000 unit tablet, chewable - 1 (one) tablet(s) by mouth once a day loratadine - (otc) - 10 mg tablet - 1 tablet(s) by mouth sodium chloride - (prescribed by other provider) - dosage uncertain discharge medications: 1. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain. 2. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 3. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 4. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 6. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 7. sodium chloride 0.65 % aerosol, spray sig: sprays nasal qid (4 times a day) as needed for dryness. 8. insulin regular human 100 unit/ml solution sig: one (1) injection achs: per ss. 9. nifedipine 10 mg capsule sig: three (3) capsule po q8h (every 8 hours). 10. potassium chloride 10 meq tablet extended release sig: two (2) tablet extended release po q12h (every 12 hours). 11. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 12. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 13. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 14. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 15. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 16. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 17. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for fever. 18. tramadol 50 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 19. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed for dyspnea. 20. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed for dyspnea. 21. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 22. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). 23. torsemide 20 mg/2 ml (10 mg/ml) solution sig: one (1) intravenous (2 times a day). 24. sodium chloride 0.9 % aerosol, spray sig: sprays nasal qid (4 times a day) as needed for dry nose. discharge disposition: extended care facility: for the aged - macu discharge diagnosis: s/p aortic valve replacement obesity diastolic heart failure(class iv ) critical aortic stenosis severe pulmonary hypertension tricuspid regurgitation hypertension hypercholesterolemia coronary artery disease -s/p pci, 2 midlad instent restenosis treated with ptca and 2 to mid lad paroxysmal atrial fibrillation chronic kidney disease (baseline crea 1.7) gout diverticulosis obstructive sleep apnea(cpap) spinal stenosis obesity s/p left orif of femur fracture h/o gastrointestinal bleed s/p cholecystectomy discharge condition: alert and oriented x3, nonfocal ambulating with assistance-very deconditioned incisional pain managed with tramadol incisions: sternal - healing well, no erythema or drainage edema 1+ bilat discharge instructions: 1) 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. 2) please no lotions, cream, powder, or ointments to incisions. 3) each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart provided. 4) no driving for one month or while taking narcotics. driving will be discussed at follow up appointment with surgeon. 5) no lifting more than 10 pounds for 10 weeks 6) please call with any questions or concerns *females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge **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: dr. () on at 2:30pm cardiologist:dr. on at 1pm on 7 please call to schedule appointments with: 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** procedure: insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more continuous invasive mechanical ventilation for 96 consecutive hours or more extracorporeal circulation auxiliary to open heart surgery insertion of endotracheal tube insertion of endotracheal tube fiber-optic bronchoscopy enteral infusion of concentrated nutritional substances thoracentesis thoracentesis non-invasive mechanical ventilation arterial catheterization open and other replacement of aortic valve with tissue graft diagnoses: acidosis other iatrogenic hypotension obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery acute kidney failure with lesion of tubular necrosis unspecified pleural effusion urinary tract infection, site not specified congestive heart failure, unspecified acute posthemorrhagic anemia hyposmolality and/or hyponatremia cardiac complications, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified gout, unspecified atrial fibrillation acute on chronic diastolic heart failure aortic valve disorders other chronic pulmonary heart diseases percutaneous transluminal coronary angioplasty status chronic kidney disease, unspecified pulmonary collapse other and unspecified hyperlipidemia alkalosis old myocardial infarction other respiratory complications obesity, unspecified urinary complications, not elsewhere classified examination of participant in clinical trial proteus (mirabilis) (morganii) infection in conditions classified elsewhere and of unspecified site pseudomonas infection in conditions classified elsewhere and of unspecified site tricuspid valve disorders, specified as nonrheumatic family history of other cardiovascular diseases acute respiratory failure following trauma and surgery body mass index 30.0-30.9, adult 

Answer: The patient is high likely exposed to