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: no known allergies / adverse drug reactions attending: chief complaint: chest pain major surgical or invasive procedure: cardiac catheterization with placement of drug eluding stent in right coronary artery history of present illness: 61 yo m with history of hiv, dmii, hyperlipidemia who was transfered here from outside hospital emergent catheterization for inferior lateral . pt was in his usual state of health until last night around 10pm when he began having chest pain and nausea. he describes the pain as cramping feeling in the center of his chest, did not radiate to arm, jaw or back. the pain kept him up all night and was associated with diaphoresis and nausea/vomiting. he took 2 tylenol with no relief of pain. he presented to at 8am this morning where he was noted to have increased cardiac enzymes and st elevation in leads ii, iii, avf, v3-v6. he was given aspirin, lipitor, plavix, sublingual nitro x2 and started on a heparin drip before being transfered here for cath. his initial vital signs on presentation: 145/91, 108, 16, 100% ra. cardiac cath showed large rca thrombus which was treated with des. while in the cath lab, he developed self-limited vt lasting 60 seconds, not hypotensive, no shock necessary. post cath, st inferiolateral segments remain elevated despite being pain free. loaded with plavix, started integrilin, no antiarrythmics started. angioseal was placed in right groin at 10am. . at baseline, pt reports being fairly active and is not limited by chest pain or shortness of breath. he reports no cardiac history. . on review of systems, he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. he denies recent fevers, chills or rigors. he denies exertional buttock or calf pain. he does endorse heart burn that has been difficult to control given interactions between his ppi and arvs. all of the other review of systems were negative. . cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. past medical history: 1. cardiac risk factors: +diabetes, +dyslipidemia, (-)hypertension 2. cardiac history: -cabg: none -percutaneous coronary interventions: none -pacing/icd: none 3. other past medical history: - hiv - dmii non insulin dependent - gerd - hyperlipidemia social history: no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; mother and aunt with diabetes. family history: -tobacco history: former smoker, quit 20 years ago -etoh: occassional -illicit drugs: none lives with wife, she is unaware about his hiv status - he claims they have not had intercourse in six years and she has been tested in the interim. the rest of the family does not know. physical exam: admission exam: tmax: 36.7 ??????c (98 ??????f) tcurrent: 36.7 ??????c (98 ??????f) hr: 96 (96 - 104) bpm bp: 121/80(88) {121/75(86) - 131/85(95)} mmhg rr: 24 (20 - 25) insp/min spo2: 99% heart rhythm: sr (sinus rhythm) general appearance: well nourished, no acute distress eyes / conjunctiva: perrl head, ears, nose, throat: normocephalic cardiovascular: (s1: normal), (s2: distant), no(t) s3, no(t) s4, no(t) rub, (murmur: no(t) systolic, no(t) diastolic) peripheral vascular: (right radial pulse: present), (left radial pulse: present), (right dp pulse: present), (left dp pulse: present) respiratory / chest: (expansion: symmetric), (breath sounds: clear : , no(t) crackles : , no(t) wheezes : ) abdominal: soft, non-tender, bowel sounds present extremities: right lower extremity edema: absent, left lower extremity edema: absent skin: warm neurologic: attentive, responds to: verbal stimuli, movement: purposeful, tone: normal discharge exam: tmax: 99 tcurrent: 98.4 hr: 80-83bpm bp: 105-112/67-70 rr: 18 spo2: 99% heart rhythm: sr (sinus rhythm) general appearance: well nourished, no acute distress eyes / conjunctiva: perrl head, ears, nose, throat: normocephalic cardiovascular: (s1: normal), (s2: distant), no m/r/g peripheral vascular: no edema, feet warm, pulses pnd. respiratory / chest: crackles right base, clear with cough. abdominal: soft, non-tender, bowel sounds present extremities: right lower extremity edema: absent, left lower extremity edema: absent skin: warm/dry neurologic: attentive, responds to: verbal stimuli, movement: purposeful, tone: normal pertinent results: admission labs: 10:23am blood wbc-8.0# rbc-4.24* hgb-12.1* hct-36.5* mcv-86 mch-28.5# mchc-33.2 rdw-14.9 plt ct-83*# 10:23am blood neuts-85.7* lymphs-11.2* monos-2.8 eos-0.1 baso-0.2 10:23am blood pt-12.9 ptt-53.2* inr(pt)-1.1 10:23am blood glucose-384* urean-21* creat-0.9 na-137 k-4.3 cl-97 hco3-22 angap-22* 10:23am blood calcium-9.1 phos-4.3 mg-1.9 ========================= cardiac enzymes 10:23am blood ck(cpk)-1254* 05:44pm blood ck(cpk)-2623* 01:45am blood ck(cpk)-* 10:23am blood ck-mb-71* mb indx-5.7 ctropnt-5.02* 01:45am blood ck-mb-88* mb indx-4.5 ctropnt-4.33* ======================== 01:45am blood %hba1c-9.3* eag-220* 01:45am blood triglyc-206* hdl-47 chol/hd-3.8 ldlcalc-90 ==================== imaging/studies cardiac catheterization () 1. selective coronary angiography in this right dominant system demonstrated single vessel coronary artery disease. the lmca was normal. the lad was normal. the lcx was normal. the rca was totally occluded in the mid vessel. 2. limited resting hemodynamics demonstrated normal systemic arterial pressure with central aortic pressure 133/87 with a mean of 107 mmhg. 3. successful thrombectomy, ptca and sstenting of the rca with a 3.5 x 18 mm promus des (see ptca comments). 4. successful right femoral arteriotomy closure with a 6f angioseal. final diagnosis: 1. one-vessel coronary artery disease. 2. successful pci of the rca with a 3.5 x 18 mm promus des. 3. successful angioseal. echo() the left atrium is normal in size. the right atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. there is mild regional left ventricular systolic dysfunction with inferior/inferolateral akinesis and inferoseptal akinesis/hypokinesis. right ventricular chamber size is normal. with focal basal free wall hypokinesis. the aortic root is mildly dilated at the sinus level. the ascending aorta is mildly dilated. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. the mitral valve leaflets are structurally normal. mild to moderate (+) mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. brief hospital course: 61 yo m with hx of hiv, dmii, hld presented from osh with sx of chest pain found to have lateral , now s/p cardiac catheterization with des placed in rca. . active issues: # - pt presented with chest pain found to have st elevations in ii, iii, avf, v3-v6 with reciprocal depression in i, avl, v1 and v2. cardiac enzymes intially showed ck-mb 71 and troponin 5.02. cardiac catheterization showed large rca thrombus which was treated with a des to mid-distal rca. while in the cath lab, he developed self-limited vt lasting 60 seconds. post cath, st inferiolateral segments remain elevated despite being pain free. loaded with plavix, started integrilin, no antiarrythmics started. angioseal was placed in right groin at 10am. the patient was continued on integrillin for 18 hrs after cath, plavix, and asa. he was started on metoprolol, captopril and atorvastatin. nitro was held given that he had a large inferior mi. post cath echo showed lvef of 40-45 and inferior/inferolateral akinesis and inferoseptal akinesis/hypokinesis. patient remained chest pain free through the remainder of admission. he was discharged on asa, plavix, metoprolol, lisinopril, atorvastatin with plans to follow up with dr. . . #thrombocytopenia - on the evening of cardiac catheterization, platelet count was 12, repeat 13 (initially 83 on presentation). a peripheral smear verified this finding and there was no evidence of schistocytes present. the drop in platelet count was attributed to integrillin side effect. no platelet transfusion was given as transfused platelets will not have been exposed to aspirin and plavix and did not want to risk thrombosing new stent. there was no evidence of active bleed. after the discontinuation of integrillin platelets trended up. at time of discharge platelet count was 75. . chronic issues: # dm type 2: stable. non insulin dependent, reports home sugars 130-180s initially held home oral medications and was managed with ssi. on day 2, pt was restarted on home oral medications (metformin and glipizide). a1c was 9.3 on this admission. will need follow up for tighter glucose control with his primary care physician. . # hiv: on arv since . unknown last cd4 count or viral load home medications were verified with his pharmacy and continued . # gerd: stable given ranitidine 150 mg po bid during admission . # hyperlipidemia: lipid panel completed (see results section). pt started on atorvastatin 80 which was decreased from 80 to 40 given interaction risk of rhabdomyolysis. transitional issues: # diabetes: given elevated a1c on admission, patient needs tigher glucose control. he will need to follow up with his pcp for possible medication adjustments. medications on admission: - cholecalciferol 5000 u po daily - glipizide 10 mg daily - pravastatin 40 mg daily - metformin - 1000 mg po bid - nelfinavir 1250 mg po bid - didanosine ec 400 mg po qd discharge disposition: home discharge diagnosis: st elevation myocardial infarction acute systolic dysfunction hiv diabetes mellitus dyslipidemia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you had a heart attack and a cardiac catheterization that revealed a large clot in your right coronary artery. you received a drug eluting stent to open the artery and keep it from closing off again. it is crucially important that you take aspirin and plavix (clopidogrel) every day for at least one year to prevent the stent from clotting off and causing another heart attack. do not stop taking plavix or miss unless dr. tells you to. your blood sugars have been high here and we have restarted your medicines. please talk to dr. about changing your medicines and your diet to improve your blood sugars. this will help to prevent another heart attack. your platelets were low during this hospital stay but are improving now. . we have made the following changes to your medicines: 1. start taking aspirin and plavix every day to prevent the stents from clotting off and causing another heart attack 2. take nitroglycerin under your tongue if you have chest pain. you can take up to 2 tablets, each tablet 5 minutes apart. please call dr. if you have any chest pain at home. 3. start metoprolol to lower your heart rate and help your heart recover from the heart attack 4. start lisinopril to lower your blood pressure and help your heart recover from the heart attack. 5. change the pravastatin to atorvastatin to lower your cholesterol 6. continue your other medicines as before, do not miss or stop taking any of your medicines for any reason without speaking to dr. 7. start ranitidine as needed for your heartburn followup instructions: name: , specialty: internal medicine address: , , phone: appointment: monday at 12:30pm department: cardiac services when: monday at 4:00 pm with: , md building: campus: east best parking: garage **please contact our registration department at to update your information. they are open monday-friday between the hours of 7:30am-6:00pm.** procedure: coronary arteriography using two catheters injection or infusion of platelet inhibitor left heart cardiac catheterization insertion of drug-eluting coronary artery stent(s) cranial or peripheral nerve graft insertion of one vascular stent excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: pure hypercholesterolemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute myocardial infarction of inferolateral wall, initial episode of care asymptomatic human immunodeficiency virus [hiv] infection status other secondary thrombocytopenia 

Answer: The patient is high likely exposed to