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: benadryl / ace inhibitors attending: chief complaint: sternal drainage major surgical or invasive procedure: s/p sternal debridement/advancement of pec flap/talon plating history of present illness: 82m who underwent avr (tissue); cabg x3 on who was discharged to rehab on . he was then transferred to hospital on with sternal drainage and a leukocytosis of 23,000. he was started on broad spectum antibiotics and then transferred back to after 4 days at hospital. past medical history: s/p avr(#25 tissue)cabg x3(lima-lad, svg-pm, svg-drca/pda) insulin-dependent diabetes mellitus severe dilated cardiomyopathy macular degeneration (partially blind) emphysema neuropathy left leg social history: retired lives alone 20 pack-years -quit many years ago no recent etoh use family history: nc physical exam: admission: pulse: resp: o2 sat: b/p right: left: height: 5'9" weight: 91k vs: t 98.7 hr 68sr bp 100/50 rr 18 o2sat 93%-ra general: nad skin: dry intact - sternal wound open at mid point 3cm in lenth and tunnels 3cm cephalad and 1cm deep. scant amount of yellow drainage expressed. sternum stable. heent: perrla eomi neck: supple full rom chest: lungs course throughout -clear somewhat with coughing. heart: rrr abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema: 2+ pitting le edema neuro: seems angry and depressed regarding care recieved upon d/c from . alert and oriented x3 but conversation is tangential. pertinent results: 07:10pm sed rate-100* 07:10pm pt-29.0* inr(pt)-2.9* 07:10pm plt count-571* 07:10pm neuts-84.4* lymphs-8.2* monos-4.3 eos-2.6 basos-0.5 07:10pm wbc-14.8* rbc-3.70* hgb-10.9* hct-33.2* mcv-90 mch-29.4 mchc-32.8 rdw-15.4 07:10pm crp-26.1* 07:10pm albumin-3.3* calcium-8.5 phosphate-4.1 magnesium-2.2 07:10pm lipase-57 07:10pm alt(sgpt)-13 ast(sgot)-16 ld(ldh)-287* alk phos-93 amylase-106* tot bili-0.6 07:10pm glucose-103 urea n-39* creat-2.1* sodium-140 potassium-4.0 chloride-97 total co2-31 anion gap-16 09:13pm urine rbc->50 wbc- bacteria-many yeast-none epi-<1 09:13pm urine blood-lg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-tr 06:42am blood wbc-9.5 rbc-3.06* hgb-9.0* hct-27.2* mcv-89 mch-29.3 mchc-33.1 rdw-16.0* plt ct-406 06:42am blood plt ct-406 04:46am blood pt-13.6* ptt-30.8 inr(pt)-1.2* 06:42am blood glucose-98 urean-33* creat-1.6* na-142 k-4.0 cl-101 hco3-30 angap-15 , f m 82 radiology report chest (pa & lat) study date of 3:19 pm , fa6a 3:19 pm chest (pa & lat) clip # medical condition: 82 year old man with s/p sternal plating reason for this examination: evaluation for ptx and effusion final report chest history: sternal plating, evaluate for pneumothorax. ap and lateral views. comparison with . there is continued evidence of small bilateral pleural effusions, greater on the left. there is increased density in the retrocardiac area consistent with atelectasis or consolidation as before. the left heart border is obscured. the heart appears large. mediastinal structures are unchanged in appearance. multiple surgical clips are scattered about the mediastinum. four metallic clips are present in the sternum as demonstrated previously. a left picc line can be followed to the level of the right atrium. allowing for differences in technique, there is no significant change. impression: no significant interval change. dr. approved: mon 8:09 am brief hospital course: mr was admitted to for sternal drainage following avr/cabg. he had been on coumadin so his inr was corrected and he was brought to the operating room on for sternal debridement and talon plating with pectoral muscle advancement. please see operative report for details. he tolerated the procedure well and was transferred to the cardiac surgery icu after completion. he did well in the immediate post-operative period and was extubated shortly after arrival. he remained in the icu on pod1 to monitor his renal function(cri-baseline cr 1.9)creatine rose to 2.8 on day of surgery. by pod2 it was improving and he was transferred to the stepdown floor. once on the floor his post-op course was uneventful. culture data was positive for rare growth of propionibacterium acnes, infectious disease service was consulted and he will be treated with vancomycin for 6-8 weeks. during hospital stay the patient had a corneal abrasion , opthamology was consulted and treatment instituted. additionally he had periods of intermittant atrial fibrillation that were rate controlled with amiodarone and beta blockers. he was also anticoagulated with coumadin. the patient was not started on or ace inhibitor for his heart failure as his bp was not adequate and his elevated creatinine was still resolvoving. consider instituting this therapy as his condition continues to improve. he worked with physical therapy and on pod8 he was transferred to rehabilitation at . medications on admission: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. multivitamin tablet sig: one (1) tablet po daily (daily). 3. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 4. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 6. acetaminophen 325 mg tablet sig: 1-2 tablets po every hours as needed for temp. 7. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day). 8. carvedilol 3.125 mg tablet sig: one (1) tablet po bid (2 times a day). 9. glyburide 5 mg tablet sig: one (1) tablet po bid (2 times a day). 10. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 11. ciprofloxacin 250 mg tablet sig: three (3) tablet po q12h (every 12 hours) for 5 days. 12. furosemide 10 mg/ml solution sig: forty (40) mg injection (2 times a day). 13. potassium chloride 20 meq packet sig: twenty (20) meq po q12h (every 12 hours). 14. insulin glargine 100 unit/ml solution sig: twelve (12) units subcutaneous once a day. 15. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q2h (every 2 hours) as needed for wheezes. 16. warfarin 1 mg tablet sig: as directed tablet po once a day as needed for a fib: adjust dose daily to target inr 2-2.5***2mg to be administered on . last 3 days recieved 5/5/5.* tablet(s)* refills:*0* 17. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours). 18. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. 3. haloperidol 1 mg tablet sig: one (1) tablet po at bedtime as needed for confusion . 4. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 5. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 6. senna 8.6 mg tablet sig: one (1) tablet po daily (daily). 7. ipratropium-albuterol 18-103 mcg/actuation aerosol sig: two (2) puff inhalation q6h (every 6 hours). 8. insulin glargine 100 unit/ml solution sig: twelve (12) units subcutaneous daily-lunch. 9. insulin regular human 100 unit/ml solution sig: sliding scale injection q ac&hs. 10. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po twice a day. 11. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). 12. carvedilol 3.125 mg tablet sig: three (3) tablet po bid (2 times a day). 13. lasix 80 mg tablet sig: one (1) tablet po twice a day. 14. outpatient work while on antibiotics weekly cbc, chem 7, lft, esr, crp, vancomycin trough with results to clinic fax ( - phone rn if questions -current vancomycin dose 1000 mg iv q24h given at 8pm - needs trough prior to 4th dose which will be pm for further dosing - goal level 15-20 - results to clinic for management of antibiotics 15. outpatient work please check biweekly potassium, magnesium, creatinine, bun while on lasix 16. outpatient work pt/inr for coumadin dosing - atrial fibrillation with goal inr 2.0-2.5 please check at least twice a week until on steady dose first draw 17. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 18. erythromycin 5 mg/g ointment sig: one (1) strip ophthalmic four times a day for 7 days: to right eye . 19. polyvinyl alcohol-povidone 1.4-0.6 % dropperette sig: drops ophthalmic prn (as needed) as needed for dryness. 20. warfarin 1 mg tablet sig: one (1) tablet po once a day: goal inr 2.0-2.5 - started 1mg . 21. vancomycin in dextrose 1 gram/200 ml piggyback sig: one (1) gram intravenous q 24h (every 24 hours): given at 8pm - trough before dose . discharge disposition: extended care facility: discharge diagnosis: s/p sternal debridement/advancement of pectoral flap/talon plating s/p aortic valve replacement(#25 tissue)coronary artery bypass graft x3(left internal mamary artery-left anterior descending, saphenous vein graft-obtuse marginal, saphenous vein graft-distal right coronary aartery-posterior descending artery) acute on chronic systolic heart failure acute renal failure resolving from previous admission diabetes mellitus macular degeneration emphysema neuropathy discharge condition: good discharge instructions: please shower daily including washing incisions, no baths or swimming monitor wounds for infection - redness, drainage, or increased pain report any fever greater than 101 report any weight gain of greater than 2 pounds in 24 hours or 5 pounds in a week no creams, lotions, powders, or ointments to incisions no driving until cleared by dr lifting more than 10 pounds until cleared by dr please call with any questions or concerns pt/inr for coumadin dosing - atrial fibrillation with goal inr 2.0-2.5 please check at least twice a week until on steady dose first draw please check biweekly potassium, magnesium, creatinine, bun while on lasix while on antibiotics weekly cbc, chem 7, lft, esr, crp, vancomycin trough with results to clinic fax ( - phone rn ifquestions - current vancomycin dose 1000 mg iv q24h given at 8pm - needs trough prior to 4th dose which will be pm for further dosing - goal level 15-20 - results to clinic for management of antibiotics followup instructions: please call to schedule appointments dr (cardiac surgeon) in 2 weeks. (). dr (cardiologist) after discharge from rehab dr (pcp) after discharge from rehab dr (plastic surgery clinic) in 2 weeks. dr ( clinic) call to schedule pt/inr for coumadin dosing - atrial fibrillation with goal inr 2.0-2.5 please check at least twice a week until on steady dose first draw please check biweekly potassium, magnesium, creatinine, bun while on lasix while on antibiotics weekly cbc, chem 7, lft, esr, crp, vancomycin trough with results to clinic fax ( - phone rn if questions -current vancomycin dose 1000 mg iv q24h given at 8pm - needs trough prior to 4th dose which will be pm for further dosing - goal level 15-20 - results to clinic for management of antibiotics procedure: venous catheterization, not elsewhere classified other repair of chest wall local excision of lesion or tissue of bone, scapula, clavicle, and thorax [ribs and sternum] attachment of pedicle or flap graft to other sites other repair or plastic operations on bone, scapula, clavicle, and thorax [ribs and sternum] replacement of indwelling urinary catheter diagnoses: other primary cardiomyopathies congestive heart failure, unspecified acute kidney failure, unspecified aortocoronary bypass status diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes 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 long-term (current) use of insulin macular degeneration (senile), unspecified other emphysema retention of urine, unspecified heart valve replaced by transplant urinary complications, not elsewhere classified acute on chronic systolic heart failure delirium due to conditions classified elsewhere non-healing surgical wound 

Answer: The patient is high likely exposed to