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: type b aortic dissection major surgical or invasive procedure: replacement of descending thoracic aortic aneurysm using a 32-mm vascutek dacron tube graft and deep hypothermic circulatory arrest. catalog #, lot #, serial #. clipping of thoracic duct and placement of fibrin glue. right video assisted thoracoscopy and thoracic duct ligation history of present illness: this 73 year old gentleman developed left upper extremity swelling 3 months ago. an ultrasound was performed which revealed thrombus in his left subclavian vein and jugular vein. he was placed on coumadin and underwent a hematologic work-up which revealed factor v leiden. he was subsequently referred for a ct which revealed an old type b dissection with an aneurysmal component of the descending thoracic aorta measuring 6cm. he was subsequently referred to drs. and for surgical evaluation. past medical history: type b dissection left subclavian deep vein thrombosis extending into internal jugular factor v leiden hypertension s/p cholecystectomy laparoscopic s/p left wrist surgery for fracture2001 s/p umbilical hernia repair social history: last dental exam:edentulous lives with:wife occupation:retired electrician tobacco:17 py hx, quit 41 yrs ago etoh: 2 drinks/month family history: brother with mi at 43 and other brother with cabg at 68. diebetes in parents and siblings. physical exam: pulse: 54 resp: 16 o2 sat: 97%-ra b/p right: 120/80 left: height: 66" weight: 185 general: skin: warm dry intact heent: ncat perrla eomi mmm, normal oropharynx neck: supple full rom no jvd or lymphadenopathy chest: lungs clear bilaterally heart: rrr irregular murmur- no mrg abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema: none varicosities: none neuro: grossly intact- non focal exam pulses: femoral right: 2+ left: 2+ dp right: 2+ left: 2+ pt : 2+ left: 2+ radial right: 2+ left: 2+ carotid bruit none pertinent results: prebypass the left atrium is moderately dilated. no spontaneous echo contrast is seen in the body of the left atrium or left atrial appendage. no spontaneous echo contrast is seen in the body of the right atrium. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size is normal with normal free wall contractility. the descending thoracic aorta is markedly dilated with an intimal flap extending distally from the distal aortic arch. the false lumen (without evidence of flow on color doppler) contains a large thrombus. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no pericardial effusion. postbypass the patient is on a phenylephrine infusion and is v-paced. there is a new descending aortic graft extending from the distal arch to the distal thoracic descending aorta. below the graft there is the native aorta which continues to have a false and true lumen. biventricular systolic function continues to be normal. the tricuspid regurgitation is now mild. mitral regurgitation continues to be trivial and there continues to be no aortic regurgitation. the ascending aorta is intact. electronically signed by , md, interpreting physician 16:27 04:58am blood wbc-12.1* rbc-2.86* hgb-9.3* hct-25.5* mcv-89 mch-32.5* mchc-36.4* rdw-15.4 plt ct-290 06:50pm blood wbc-11.5*# rbc-3.50*# hgb-10.8*# hct-30.7* mcv-88 mch-30.9 mchc-35.2* rdw-14.7 plt ct-103* 04:58am blood glucose-158* urean-33* creat-1.2 na-135 k-3.9 cl-106 hco3-21* angap-12 04:49am blood glucose-158* urean-26* creat-0.9 na-135 k-4.5 cl-108 hco3-22 angap-10 06:50pm blood urean-14 creat-0.8 na-140 k-4.1 cl-109* hco3-24 angap-11 06:30am blood pt-15.1* ptt-45.4* inr(pt)-1.3* brief hospital course: he was admitted on and underwent surgery with drs. and . see operative note for details of the procedure. there was an injury to the tthoracic duct noted at surgery and fibrin tissue glue was utilized in an attempt to seal it. dr. was asked to see the patient in the operating room for this as well. there remained an obvious ooze of chyle at the end of the case and drain was placed neat this. he was transferred to the cvicu in stable condition, extubated on pod #1 and was neurologically intact. he was transferred to the floor to begin increasing his activity level. heparin was started and coumadin held pending evaluation of further chyle leak. octreotide was given but the chylous drainage persisted from the drain after cts were removed. after several days his low fat diet was changed to npo and tpn was begun. drainage persisted, however. he continued to be followed by dr. from thoracic surgery. an attempt was made by interventional radiology to embolize the leak but they could not gain access for this. on he was returned to the operating room with thoracic surgery for repair. a right video assisted thoracoscopy was performed with duct ligation. he tolerated this well, the right chest tuybe was subsequently removed and he was fed. there seemed to be no further chyle leakage and tpn was tapered and dicontinued toatally on . the left drain was removed on and a cxr was okay. he was begun on coumadin after the second surgery and heparin continued. at discharge the inr was subtherapeutic and lovenox was utilized (he was injecting himself previously). arrangements were made for follow up with all concerned parties and for coumadin management by clinic as preoperatively. medications on admission: ***coumadin 5 mg daily labetalol 100 mg vit. d 1000 units daily vit. b12 500 mg daily discharge medications: 1. influenza vaccine tr-s 10 (pf) 45 mcg (15 mcg x 3)/0.5 ml syringe sig: one (1) ml intramuscular now x1 (now times one dose) for 1 doses. 2. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain for 4 weeks. disp:*50 tablet(s)* refills:*0* 3. ibuprofen 200 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for fever or pain. 4. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 5. acetaminophen 500 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain/temp. 6. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 7. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*2* 8. enoxaparin 80 mg/0.8 ml syringe sig: one (1) subcutaneous q12h (every 12 hours) for 7 days: until inr is >2.0. disp:*14 * refills:*0* 9. amiodarone 200 mg tablet sig: as directed tablet po bid (2 times a day): 2 tablets(400mg) for 2 weeks, then one tablet (200mg) for 2 weeks, then 1 tablet (200mg) daily . disp:*100 tablet(s)* refills:*2* 10. coumadin 5 mg tablet sig: as directed tablet po once a day: inr goal 2-2.5 one daily unless otherwise instructed. 11. outpatient lab work inr then prn. phone results to: at . discharge disposition: home with service facility: discharge diagnosis: type b aortic dissection s/p graft repair of type b dissection,left subclavian to internal jugular artery graft factor v leiden deficiency h/o deep vein thrombosis of left internal jugular & subclavian veins thoracic duct injury hypertension discharge condition: alert and oriented x3, nonfocal ambulating with steady gait incisional pain managed with oral analgesics incisions: sternal - healing well, no erythema or drainage edema trace 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 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 2pm please call to schedule appointments with: primary care: dr. in weeks () thoracic surgeon: 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 ue- dvts goal inr 2-2.5 first draw results to phone: clinic (att: ) procedure: venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery parenteral infusion of concentrated nutritional substances thoracentesis laryngoscopy and other tracheoscopy resection of vessel with replacement, thoracic vessels transpleural thoracoscopy hypothermia (systemic) incidental to open heart surgery ligation of thoracic duct ligation of thoracic duct intrathoracic lymphangiogram diagnoses: other iatrogenic hypotension unspecified pleural effusion unspecified essential hypertension accidental puncture or laceration during a procedure, not elsewhere classified bacteremia primary hypercoagulable state dissection of aorta, thoracic other noninfectious disorders of lymphatic channels accidental cut, puncture, perforation or hemorrhage during surgical operation dysphonia 

Answer: The patient is high likely exposed to