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: ascending aortic aneurysm (8.9cm)-incidental finding major surgical or invasive procedure: repair of ascending aortic aneurysm, aortic valve replacement (21mm tissue /) under circulatory arrest , chest closure , permanent pacemaker , evacuation of tamponade history of present illness: the patient is an 85yo white male who was found to have an 8.9cm ascending aortic aneurysm during a recent workup for prostate cancer. he does admit to dyspnea on exertion as well as worsening fatigue. he is admitted for surgical management. past medical history: ascending aortic aneurysm prostate cancer, s/p external beam radiation gastroesophageal reflux diseaase (h/o esophageal stricture) atrial fibrillation/ atrial flutter- s/p cardioversion/ablations diverticular disease cholelithiasis s/p appendectomy, hernia repair, decortication for empyema (2yo), esophageal dilatation social history: retired machinist, lives with wife, currently maintains two family homes, denies tobacco, 1 alcoholic beverage per day family history: denies family history of premature coronary artery disease physical exam: admission: vs: 124/92, 74, 20 general: elderly white male in nad skin: unremarkable heent: unremarkable neck: supple, full rom chest: lungs ctab heart: irregular with murmur abdomen: soft, non-tender, non-distended, +bs extremities: warm, well-perfused, gross edema bilaterally, no varicosities neuro: grossly intact pulses: 1+ throughout bilaterally no carotid bruits pertinent results: hematology complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 04:47am 11.6* 2.87* 9.3* 27.6* 96 32.5* 33.9 18.5* 268 source: line-picc basic coagulation (pt, ptt, plt, inr) plt ct 04:47am 268 source: line-picc chemistry renal & glucose glucose urean creat na k cl hco3 angap 04:47am 95 38* 1.8* 142 3.9 108 28 10 source: line-picc enzymes & bilirubin alt ast ld(ldh) ck(cpk) alkphos amylase totbili dirbili 04:47am 98* 140* 444* 216* 10.1* source: line-picc chemistry totprot albumin globuln calcium phos mg uricacd iron 04:47am 2.4* source: line-picc pathology examination name birthdate age sex pathology # , j. 86 male report to: dr. gross description by: dr. /dif specimen submitted: aortic valve leaflets, aortic tissue. procedure date tissue received report date diagnosed by dr. . /dsj?????? diagnosis: 1. heart valve, aortic (a): with calcification and degenerative changes. 2. aortic tissue (b): with atherosclerosis, medial degeneration and adventitial chronic inflammation. clinical: coronary artery disease, avr; ascending aorta; ? coronary artery bypass. gross: the specimen is received fresh labeled with the patient's name, ", " and the medical record number. part 1 is additionally labeled "aortic valve leaflets." it consists of three aortic valve leaflets. they are arbitrarily designated 1, 2, and 3. leaflet 1 measures 2.9 cm across the base, 1.6 cm from apex to base and 0.5 cm in thickness. leaflet 2 measures 2.8 cm across the base, 1.7 cm from apex to base, and 0.3 cm in thickness. leaflet 3 measures 1.8 cm across the base and 1.7 cm from apex to base and 0.4 cm in thickness. all three leaflets are mildly calcified. it is represented in a. part 2 is additionally labeled "aortic tissue." it consists of a segment of aorta, measuring 10.1 cm in length and 7.5 cm in greatest diameter. the adventitial surface is pink, red and mottled. the intimal surface is irregular and heterogeneously yellow and tan. the aorta measures 0.4 cm in maximal thickness. additionally received are smaller fragments of aorta measuring 11.5 x 6.0 x 0.4 cm in aggregate. these fragments are similar to the large section of aorta. it is represented in b. by his/her signature above, the senior physician certifies that he/she personally conducted a gross and/or microscopic examination of the described specimens(s) and rendered or confirmed the diagnosis(es) related thereto. immunohistochemistry test(s), if applicable, were developed and their performance characteristics were determined by the department of pathology at , , ma. they have not been cleared or approved by the u.s. food and drug administration. the fda has determined that such clearance or approval is not necessary. these tests are used for clinical purposes. they should not be regarded as investigational or for research. this laboratory is certified under the clinical laboratory improvement amendments of (clia - 88) as qualified to perform high complexity clinical laboratory testing. , j. m 86 radiology report abdomen u.s. (portable) study date of 8:35 pm , csru 8:35 pm abdomen u.s. (portable) clip # reason: ruq us to r/o biliary obstruction medical condition: 86 year old man with elevated bilirubin reason for this examination: ruq us to r/o biliary obstruction final report indication: 86-year-old male with elevated bilirubin. evaluate for biliary obstruction. comparison: none. findings: ultrasound of the right upper quadrant performed. exam is limited by poor acoustic windows secondary to overlying bandage. the liver shows normal echogenicity without focal lesion. the gallbladder is normal without evidence of stone. there is no intra- or extra-hepatic biliary dilatation. the common duct measures 3 mm. the portal vein is patent with hepatopetal flow. the right kidney shows no hydronephrosis. impression: limited exam secondary to poor acoustic windows from overlying bandage. the liver and gallbladder are normal. no intra- or extra-hepatic biliary dilatation. the study and the report were reviewed by the staff radiologist. dr. dr. approved: sun 4:45 pm imaging lab echocardiography report , (complete) done at 4:44:21 pm final referring physician information , c. , status: inpatient dob: age (years): 86 m hgt (in): 63 bp (mm hg): / wgt (lb): 128 hr (bpm): bsa (m2): 1.60 m2 indication: ascending aorta and hemiarch replacement with avr icd-9 codes: 440.0, 424.1, 424.0 test information date/time: at 16:44 interpret md: , md test type: tee (complete) son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2009aw2-: machine: 2 echocardiographic measurements results measurements normal range left ventricle - ejection fraction: 55% >= 55% aorta - annulus: 1.9 cm <= 3.0 cm aorta - ascending: *8.0 cm <= 3.4 cm aorta - arch: *8.3 cm <= 3.0 cm findings right atrium/interatrial septum: a catheter or pacing wire is seen in the ra and extending into the rv. left ventricle: normal lv wall thickness and cavity size. overall normal lvef (>55%). right ventricle: normal rv chamber size and free wall motion. aorta: markedly dilated ascending aorta. aortic valve: severely thickened/deformed aortic valve leaflets. moderate to severe (3+) ar. mitral valve: mild mitral annular calcification. the mr vena contracta is <0.3cm. mild (1+) mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: pulmonic valve not well seen. pericardium: no pericardial effusion. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was under general anesthesia throughout the procedure. no tee related complications. results were conclusions prebypass * patient has a histroy of esophageal strictures which have been dilated ~ 20 times over the past 25 years. he has had successful tee (without transgastric view) without problems in the past. only midesophageal views obtained. 1. left ventricular wall thicknesses and cavity size are normal. overall left ventricular systolic function is normal (lvef>55%). 2. right ventricular chamber size and free wall motion are normal. 3. the ascending aorta is markedly dilated the aortic valve leaflets are severely thickened/deformed. moderate to severe (3+) aortic regurgitation is seen. 4. mild (1+) mitral regurgitation is seen. 5. there is no pericardial effusion. 6. dr. was notified in person of the results during the surgery. postbypass 1. patient on norepinephrine, epinephrine, phenylephrine, and vasopressin 2. left ventricular function remains good with an ef 55% 3. a well seated, well functioning prostetic valve is seen in the aortic position. no transgastric views were obtained. 4. as volume transfusion progresses, the rv function began to decline. epinephrine started with moderate return of function. 5. dr aware i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 09:26 ?????? caregroup is. all rights reserved. echocardiography report , portable tte (complete) done at 11:24:30 am final referring physician information , c. , status: inpatient dob: age (years): 86 m hgt (in): 63 bp (mm hg): 105/67 wgt (lb): 128 hr (bpm): 96 bsa (m2): 1.60 m2 indication: evaluate for tamponade. icd-9 codes: 423.9 test information date/time: at 11:24 interpret md: , md test type: portable tte (complete) son: doppler: limited doppler and no color doppler test location: west sicu/ctic/vicu contrast: none tech quality: adequate tape #: 2009w005-0:00 machine: vivid echocardiographic measurements results measurements normal range left ventricle - ejection fraction: >= 55% >= 55% pericardium - effusion size: 2.7 cm findings this study was compared to the prior study of . left ventricle: suboptimal technical quality, a focal lv wall motion abnormality cannot be fully excluded. overall normal lvef (>55%). pericardium: large pericardial effusion. effusion echo dense, c/w blood, inflammation or other cellular elements. rv diastolic collapse, c/w impaired fillling/tamponade physiology. general comments: echocardiographic results were reviewed by conclusions due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef>55%). there is a large pericardial effusion anterior to the right ventricle. the effusion is echo dense, most consistent with blood. there is right ventricular diastolic collapse, consistent with impaired fillling/tamponade physiology. impression: large anterior intrapericardial hematoma with right ventricular compression and tamponade physiology. compared with the prior study (images reviewed) of , anterior pericardial effusion has expanded, compressing the right ventricle. electronically signed by , md, interpreting physician 11:38 ?????? caregroup is. all rights reserved. brief hospital course: the patient was brought to the operating room on where he underwent aortic valve replacement and replacement of the ascending aorta and hemi-arch with a 28mm gelweave graft. please see full operative report for details. the patient had significant bleeding and multiple blood products were used. satisfactory hemostasis could not be achieved, so the patient's chest was left open. he returned to the operating room the following day, for mediastinal exploration and chest closure. the patient tolerated this procedure well and left the operating room on levophed. on pod 2 the patient developed rapid atrial fibrillation, which he did not tolerate hemodynamically. he was started on amiodarone and cardioverted to an underlying rhythm of asystole. he was a-paced and remained pacer dependent. electrophysiology was consulted and placed a temporary pacing wire at the bedside under fluoro. the patient received a st. permanent pacemaker on . the patient had a prolonged intubation, and tube feeds were started for nutrition. chest tubes were discontinued on pod 3. the patient was extubated on . he became confused and agitated and attempted to remove his lines, therefore was placed in restraints. coumadin was initiated for atrial fibrillation. on , the patient was found to be slightly hypotensive with a rising pt/inr. echo demonstrated tamponade physiology with rv collapse, and the patient returned to the operating room for evacuation of pericardial clot and left pleural effusion. following this, the patient returned to on epi and neo. the patient was found to have hematuria, and gu consult was obtained. given his history of prostate cancer and radiation treatment, and anticoagulation- hematuria is not an unusual finding. the patient is instructed to follow up with gu weeks post-op. he developed a leukocytosis and infectious disease was consulted. he was found to grow pseudomonas from sputum and urine, and zosyn therapy was initiated. the patient was again extubated on . he developed jaundice, and was found to have elevated lfts, including a tbili of 15. gi was consulted. likely explanation is hemolysis from multiple blood products received. the patient made progress and was transferred to the telemetry floor on . he continue to do well w/ wbc, lft's, bun/creat trending downward. he is diuresisng slowly. remains on zosyn until . he was screened by pt and rehab was recommended. 2/4/9 medications on admission: atenolol 25mg daily spectravite multivitamin daily advil pm prn discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. amiodarone 200 mg tablet sig: one (1) tablet po once a day. 5. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 6. lidocaine hcl 2 % gel sig: one (1) appl mucous membrane prn (as needed). 7. furosemide 20 mg tablet sig: one (1) tablet po twice a day for 2 weeks: until edema resloves. 8. piperacillin-tazobactam 2.25 gram recon soln sig: 2.25 gms intravenous q6h (every 6 hours) for 3 days. 9. picc line care pic line care and flushes per protocol non-heparin dependent line. 10. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day for 2 weeks. discharge disposition: extended care facility: & rehab center - discharge diagnosis: 9cm ascending aortic aneurysm, prostate cancer (s/p external radiation ), gerd (h/o esophageal stricture), h/o afib/flutter-s/p ablations, diverticular dz, cholelithiasis, s/p appy, herniorraphy, empyema s/p r decortication @2yo, esophageal dilatation hematuria- blood clots- keep foley until urology appointment. discharge condition: deconditioned. discharge instructions: no driving for 4 weeks and off all narcotics no lifting more than 10 pounds for 10 weeks shower daily, no baths or swimming for 6 weeks no lotions, creams or powders to incisions report any redness of, or drainage from incisions report any weight gain greater than 2 pounds a day or 5 pounds a week report any fever greater than 100.5 take all medications as directed zosyn will be completed last dose keep foley until urology follow up - irrigant as needed. followup instructions: dr. (urology) , 4pm, , follow up with dr. in 4 weeks follow up with pcp and cardiologist when d/c'd from rehab procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours continuous invasive mechanical ventilation for 96 consecutive hours or more extracorporeal circulation auxiliary to open heart surgery initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle insertion of temporary transvenous pacemaker system atrial cardioversion open and other replacement of aortic valve with tissue graft resection of vessel with replacement, thoracic vessels other incision of pleura other incision of pleura pericardiotomy closure of skin and subcutaneous tissue of other sites diagnoses: esophageal reflux unspecified pleural effusion acute posthemorrhagic anemia thoracic aneurysm without mention of rupture cardiac complications, not elsewhere classified personal history of malignant neoplasm of prostate aortic valve disorders chronic kidney disease, unspecified hemorrhage complicating a procedure acute respiratory failure defibrination syndrome cardiac arrest 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 gross hematuria sinoatrial node dysfunction delirium due to conditions classified elsewhere diverticulosis of colon (without mention of hemorrhage) cardiac tamponade other transfusion reaction 

Answer: The patient is high likely exposed to