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: penicillins / codeine / morphine attending: chief complaint: chest discomfort major surgical or invasive procedure: s/p mitral valve replacement(#27 mechanical) s/p cardiac history of present illness: 58 yo f with pmh of cad s/p pci x3 presents with chest and left arm discomfort, along with sob, for the past 1 week. past medical history: coronary artery disease s/p multiple pci's (stent lad , , ) congestive heart failure hypertension hypercholesterolemia fibromyalgia chronic obstructive pulmonary disease asthma chronic renal insufficiency(1.3) lower back pain hiatal hernia psh: ectopicx2 in ,79 social history: 50 pack year h/o smoking (quit in ) does not drink alcohol family history: not contributory physical exam: afebrile, hr 80, bp 140/52 rr 22 5'3" 126kg gen: sleepy but arousable, aaox3 heent: no lymphadenopathy, no carotid bruits neck: jvp around cms heart: s1 s2, rrr, 3/6 sem lungs: bs w/ rales 1/2 up abd: soft/nt/nd, bs+ ext: 1+ edema, warm, well-perfused neuro: no focal deficits, mae pertinent results: tte : severe mitral regurgitation with probably rheumatic mitral valve disease. moderate to severe pulmonary artery systolic hypertension. left ventricular cavity enlargement with regional dysfunction c/w cad : 1. one vessel coronary artery disease.2. severe diastolic ventricular dysfunction.3. moderate precapilary pulmonary hypertension.4. successful deployment of a cypher drug-eluting stent in the distal rca carotid u/s : moderate plaque with bilateral 40-59% carotid stenosis. of note, both of the stenoses will fall into the lower end of the range. 04:30pm blood wbc-13.2* rbc-4.62 hgb-11.8* hct-36.5 mcv-79* mch-25.5* mchc-32.2 rdw-16.4* plt ct-390 07:50am blood wbc-12.3* rbc-4.52 hgb-11.8* hct-36.4 mcv-81* mch-26.1* mchc-32.4 rdw-17.3* plt ct-352 01:23am blood wbc-19.0* rbc-3.78* hgb-10.0* hct-30.8* mcv-82 mch-26.4* mchc-32.4 rdw-18.6* plt ct-354 06:21am blood wbc-12.8* rbc-3.11* hgb-8.4* hct-26.9* mcv-87 mch-27.0 mchc-31.2 rdw-20.6* plt ct-508* 01:00am blood pt-13.9* ptt-45.1* inr(pt)-1.3 02:24am blood pt-27.6* ptt-39.4* inr(pt)-5.0 12:30am blood pt-17.3* ptt-54.8* inr(pt)-2.0 04:30pm blood glucose-120* urean-26* creat-1.3* na-141 k-4.1 cl-100 hco3-27 angap-18 06:21am blood glucose-87 urean-13 creat-1.0 na-138 k-3.7 cl-100 hco3-29 angap-13 08:49am blood alt-178* ast-96* ld(ldh)-516* alkphos-127* amylase-66 totbili-1.7* 05:37pm urine color-amber appear-clear sp -1.018 05:37pm urine blood-lg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-1 ph-6.5 leuks-neg 05:37pm urine rbc-* wbc- bacteri-mod yeast-none epi- brief hospital course: pt. was admitted on and then underwent both a cardiac echo and on . the echo revealed severe mr showed 1 vessel cad and a stent was placed in the distal rca. cardiac surgery was consulted following these procedures for replacement/repair of her mitral valve. but pt needed to be aggressively diuresed before surgery d/t chf (pt was sob and fluid overloaded-edema & bilat pleural effusions). please see medical records for cxr reports. she continued to be followed by us along with medicine and cardiology (see notes in medical records). pt. underwent a carotid u/s on along with a dental consult and was cleared for surgery pending her wbc(12). on pt was brought to the operating room where she underwent a mitral valve replacement with a mechanical valve. she tolerated the procedure well with no complications. please see op note for surgical details. she was transferred to csru in stable condition on a propofol gtt. later on op day pt was weaned from mechanical ventilation and propofol and was extubated. she was mae, following commandes, and a&o. on pod #1 pt appeared somewhat hypoxic w/ cxr showing chf. albuterol mdi, along with diuresis, oxygen via face tent and nc was started. heparin was being given and coumadin would be started later that night until target inr/pt/ptt was reached. pod #2 pt was stable and being diuresed with increased pulmonary toilet. chest tubes and swan-ganz catheter were removed. on pod #3 levofolx was started for increased wbc and yellow sputum. sputum was cultered. she also received a blood transfusion b/c hct was 24. pt. remained in the csru until pod #12 and was then transferred to step-down unit. during that time (pod #) she continued to have pulm symptoms and required aggressive pulm toilet w/ high flow oxygen. pt. was encouraged to get oob and ambulate. pulmonary eventually was consulted. also during this time pt's heart rhythm went into atrial flutter (ep followed pt). amiodarone and verapamil were started. pt. also experienced a rise in her wbc while in the csru, multiple cultures were performed and appropriate antibiotics coverage was given. from pod #13 to 15 her oxygen was slowly weaned down. also during here entire post-op period her coumadin and heparin were adjusted to reach a goal inr of 2.5 to 3 d/t her mechanical valve. physical therapy followed pt during post-op period as well. she was transferred to rehab on pod #15 in stable condition and will have her inr followed and coumadin adjusted until goal is reached. she will also make appropriate f/u's with physicians. medications on admission: 1. atenolol 50mg qd 2. plavix 75mg qd 3. protonix 40mg qd 4. lasix 40mg 5. asa 325mg qd 6. folic acid 7. kcl 8. lipitor 40mg qd 9. nitro 10. atrovent 11. flovent discharge medications: 1. potassium chloride 10 meq capsule, sustained release sig: two (2) capsule, sustained release po q12h (every 12 hours). 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed. 4. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 5. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 6. atorvastatin calcium 40 mg tablet sig: one (1) tablet po daily (daily). 7. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 8. levofloxacin 250 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 10 days. 9. hydromorphone 2 mg tablet sig: one (1) tablet po q2h (every 2 hours) as needed. 10. amiodarone 200 mg tablet sig: two (2) tablet po once a day for 1 weeks: then 200mg qd for 1 month. 11. albuterol sulfate 0.083 % solution sig: one (1) inhalation q6h (every 6 hours). 12. advair diskus 250-50 mcg/dose disk with device sig: two (2) inhalation twice a day. 13. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). 14. warfarin sodium 1 mg tablet sig: as directed tablet po daily (daily): to maintain target inr 2.5-3. 15. lasix 40 mg tablet sig: 1.5 tablets po twice a day. discharge disposition: extended care facility: & rehab center - discharge diagnosis: mitral regurgitation s/p mitral valve replacement(#27 mechanical) pmh:coronary artery disease s/p multiple pci's congestive heart failure hypertension hypercholesterolemia fibromyalgia chronic obstructive pulmonary disease asthma chronic renal insufficiency(1.3) lower back pain discharge condition: stable discharge instructions: please follow up with your doctors below. take all of your medications as directed. please seek medical attention immediately if you feel any chest pain, shortness of breath, or any otehr concerning symptoms. do not lift more than 10 pounds for 2 months. do not drive for 1 month. can take shower. wash incision with warm water and gentle soap. gently pat dry. do not take bath or go swimming. do not apply lotions, creams, ointments or powders to incision. followup instructions: dr. 2-3 weeks. dr. in 4 weeks. procedure: extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters injection or infusion of platelet inhibitor open and other replacement of mitral valve transfusion of packed cells insertion of drug-eluting coronary artery stent(s) continuous intra-arterial blood gas monitoring diagnoses: anemia, unspecified intermediate coronary syndrome unspecified essential hypertension cardiac complications, not elsewhere classified personal history of tobacco use atrial flutter rheumatic heart failure (congestive) other and unspecified hyperlipidemia old myocardial infarction unspecified disorder of kidney and ureter other complications due to other cardiac device, implant, and graft myalgia and myositis, unspecified rheumatic mitral insufficiency 

Answer: The patient is high likely exposed to