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: chief complaint: syncope major surgical or invasive procedure: - removal of right atrial clot, removal of pacemaker, closure of pfo, placement of epicardial right ventricular leads x2 with permenant pacemeaker, history of present illness: 79 yo m with h/o rue dvt, afib on coumadin, pcm with h/o infection, was brought to ed at in nh on after having passed out at shopping mall. was found bradycardic and hypotensive. cta showed bilateral pulmonary embolism with a large embolus in the l main stem pa. inr on admission was 2.6, cr 1.6, wbc 20.7 with 66.7%pmns. leni's were negative but b upper ext u/s's revealed a 90% r subclavian vein stenosis associated with pacer lead. the l subclavian/axillary was patent with atretic with thickened calcified wall c/w post-phlebitic changes. there appeared to be good collateral flow around both subclavian systems, suggesting mostly chronic condition. the vascular service at the osh felt that the r subclavian likely had the acute dvt which traveled to the pulmonary artery. echo showed large ra thrombus occupying approx 2/3rds of the ra. at the osh he initially required bipap to keep o2sats up and was given solumedrol. he was started on vancomycin empirically for leukocytosis with concern for infection of pcm leads. this was later changed to linezolid given concern that vanc had caused renal failure? he was started on iv heparin and given coumadin, aspirin 81, and plavix 75. cr was seen to rise to 4.0. moxifloxacin was added on . troponin was initially 0.03 and rose to 0.37. he is now admitted to the for further management. past medical history: -copd on 4l home o2 -bronchiectasis with chronically elevated wbc (baseline ) -cri (baseline 1.6-2.0) -niddm - per pcp's report has been largely diet controlled. last hgba1c 6.3% -htn -afib on coumadin -bradycardia with tachybrady syndrome, s/p pcm - placed in , c/b infection in (was found to be prodruding out of his skin), requiring pacemaker removal on the left side with placement of a new pacer on the r side in . pacer is vvir sigma ssr303b. v lead is st. -pacesetter. -hypothyroidism -s/p hernia repair -pna in -occlusion of cephalic, basilic, and brachial veins of l arm on ultrasound in social history: retired truck driver for a concrete company with a lot of dust exposure. also retired volunteer fireman who never wore a respirator x 25 years. served in navy in pacific in ww2. total 30 pack year h/o tobacco, but quit 40 yrs ago. denies etoh or tobacco currently but has h/o tobacco use. family history: father had heart condition. no other knowledge of clotting disorders. physical exam: vitals: 97.4, 94/75, 62, 22, 96% on 4l nc gen: appears sob, speaking in broken sentences heent: op very dry, perrla cv: distant hs, no m/r/g audible. irregular abd: s/nt/nd, +bs lungs: poor aeration throughout, no wheezes or rhonchi. ext: no c/c/e. neuro: slight dysphagia (missing dentures). a&ox3. pertinent results: ecg: afib with several v paced beats, rate 53. rbbb. inverted t waves in v1-4. t waves were previously upright on osh ecg's from and . . 07:12pm wbc-21.5* rbc-5.83 hgb-13.9* hct-42.8 mcv-74* mch-23.9* mchc-32.5 rdw-19.5* 07:12pm neuts-89* bands-4 lymphs-0 monos-7 eos-0 basos-0 atyps-0 metas-0 myelos-0 07:12pm pt-27.5* ptt-34.8 inr(pt)-2.8* 07:12pm plt smr-normal plt count-170 lplt-2+ 07:12pm tsh-0.27 07:12pm albumin-4.0 calcium-8.5 phosphate-7.8* magnesium-1.9 07:12pm alt(sgpt)-61* ast(sgot)-23 ld(ldh)-566* alk phos-85 tot bili-0.5 07:12pm glucose-101 urea n-81* creat-5.2* sodium-134 potassium-5.2* chloride-99 total co2-18* anion gap-22* 01:36am blood wbc-42.3* rbc-5.08 hgb-12.4* hct-38.3* mcv-75* mch-24.4* mchc-32.4 rdw-18.7* plt ct-256 06:05am blood pt-28.1* ptt-47.9* inr(pt)-2.9* 01:36am blood glucose-278* urean-71* creat-2.6* na-147* k-3.3 cl-102 hco3-17* angap-31* echo pre-bypass: 1. the left atrium is normal in size. the left atrial appendage emptying velocity is depressed (<0.2m/s). 2. the right atrium is markedly dilated. a mass/thrombus associated with a catheter/pacing wire is seen in the right atrium. 3. the right atrial appendage ejection velocity is depressed (<0.2m/s). 4. a right-to-left shunt across the interatrial septum is seen at rest. a small secundum atrial septal defect is present. 5. the right ventricular free wall is hypertrophied. the right ventricular cavity is moderately dilated. there is moderate global right ventricular free wall hypokinesis. 6. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). 7. there are simple atheroma in the ascending aorta. 8. there are three aortic valve leaflets. there is no aortic valve stenosis. no aortic regurgitation is seen. 9. mild (1+) mitral regurgitation is seen. 10.there is a trivial/physiologic pericardial effusion. post-bypass: pt is in svt at a rate of 110, pt is receiving and infusion of phenylephrine and epinephrine. 1. the thrombus and the pacing wire in the ra are no longer seen. 2. rv function is severely depressed. lv function appears hyperdynamics and lv appears underfilled. abdominal ultrasound 1. splenomegaly. 2. trace ascites. 3. poor visualization of the pancreas secondary to overlying bowel gas. radiology successful placement of a temporary right femoral vein 3 port hemodialysis catheter, with the tip positioned in the ivc. the catheter is ready to use. brief hospital course: mr. was admitted to the for further management of his right atrial clot and pulmonary embolism. heparin and plavix were continued for anticoagulation despite being therapeutic on coumadin. steroids and nebulizer treatments were given to improve his hypoxia with good results. given the nature of his clot in relation to his pacemaker, the cardiac surgical service was consulted for surgical removal of his pacer lead and atrial clot. mr. was worked-up in the usual preoperative manner and despite being such high risk, it was elected to proceed. the electrophysiology service was consulted for interrogation of his pacemaker and to make adjustments to assist with his hypotension. given his acute renal failure, the renal service was consulted. a temporary line was placed for hemodialysis by the radiology service. as a hypercoagulable state was suspected, appropriate studies were sent per the hematology service. on , mr. was taken to the operating room where he underwent removal of a right atrial clot, closure of pfo, placement of pacer leads and placement of a new pacemaker. postoperatively he was taken to the cardiac surgical intensive care unit for monitoring. an emergency echocardiogram was obtained for deteriorating hemodynamics. no significant pericardial effusion was seen however mobile thrombus was seen in the right atrium. his sternum was opened at the bedside and cpr was initiated with success. his family was made aware of the grave situation and supportive care was withdrawn. mr. d shortly thereafter on . medications on admission: meds on admission to osh: hctz 25 daily synthroid 125mcg daily benicar 20 daily vitamin b12 1mg daily atenolol 25 daily lipitor 10mg daily norvasc 10mg daily coumadin . meds on transfer from osh: coumadin 5mg daily aspirin 81mg daily plavix 75mg daily solumedrol 40mg iv q8 linezolid 600mg iv q12 moxifloxacin 400mg iv qd hctz 25mg daily synthroid 125mcg daily olmesartan 20mg daily atenolol 25mg daily norvasc 10mg daily vitamin b12 2000mcg daily lipitor 10mg daily ssi heparin gtt (900 units/hr) morphine 1-2mg iv q6 prn resp distress ativan 1mg po q6 prn anxiety temazepam 15mg po qhs prn discharge disposition: home discharge diagnosis: severe hemodynamic compromise following pfo closure, lead extraction and placement and right atrial clot removal as a result of a hypercoaguable state. discharge condition: expired procedure: extracorporeal circulation auxiliary to open heart surgery other and unspecified repair of atrial septal defect open chest cardiac massage insertion or replacement of epicardial lead [electrode] into epicardium open chest coronary artery angioplasty procedure on single vessel replacement of any type of pacemaker device with single-chamber device, rate responsive diagnoses: hyperpotassemia subendocardial infarction, initial episode of care diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified unspecified acquired hypothyroidism atrial fibrillation other chronic pulmonary heart diseases chronic kidney disease, unspecified ostium secundum type atrial septal defect other emphysema long-term (current) use of anticoagulants other complications due to other cardiac device, implant, and graft hemorrhage of gastrointestinal tract, unspecified bronchiectasis without acute exacerbation other pulmonary embolism and infarction acute venous embolism and thrombosis of unspecified deep vessels of lower extremity acute endocarditis, unspecified 

Answer: The patient is high likely exposed to