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: dicloxacillin attending: chief complaint: dyspnea major surgical or invasive procedure: left heart catheterization, coronary angiogram, left ventriculogram dental extractions aortic valve replacement(27mm mosaic ultra procine), coronary artery bypass grafts x 3(lima-lad,svg-pda,svg-plv),resection of left atrial appendage history of present illness: 78 yo m w/ dchf, diet controlled dm 2, htn and h/o afib w/ rvr presents from for admit of cp, sob. patient was diagnosed with new onset atrial fibrillation in 12/. esmalol drip and loading dose of digoxin were tried at that time, but patient has severe as and developed hypotension. the patient was also put on a heparin gtt and coumadin but had expanding hematomas and symptomatic anemia so was discontinued. he was cardioverted and discharged on metoprolol. since then he has occasional palpitations but these symptoms last 3-4 minutes and resolve w/ rest. one the day of presentation the patient again had palpitations but they did not resolve. he also felt sob and chest pain. he presented to , where he had afib w/ rvr with hr 130s, started on dilt drip at 15 mg/h (reportedly to 90s). 1st set trop neg <0.01. became chest pain free (did not get nitro, critical as). hr dropped to 40s but stabalized to 60s. sbp dropped to 80s but stabalized to 100s. . of note patient has also been complaining of fatigue for several weeks and dark stools for 1 week. he was guiac negative in the ed. no hematuria noted by patient. . in the er, vitals were: 96.6 55 101/54 18 100. ekg showed afib w/ rvr with rbbb but now in sinus brady w/ rbbb, no concerning st-t changes. cxr showed mild hilar fullness. his dilt gtt was weaned down. was also given asa, plavis 300, and started on a heparin gtt after repeat labs showed elevated cardiac enzymes. past medical history: noninsulin dependent diabetes mellitus dyslipidemia hypertension severe aortic valve stenosis peripheral disease s/p left axillary bifemoral bypass s/p left femoral posterior tibial bypass s/p cross-femoral bypass graft s/p abdominal aneurysmectomy h/o cataracts h/o bladder cancer chronic graft infection social history: pt is a pharmacist and lives with his wife - history: quit 6months ago 1/2ppd x40yrs -etoh: rare -illicit drugs: denied family history: father mi at 80 mother with brain tumor no other family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: admission: vs: t=96.3 bp=125/59 hr= 66 rr=22 o2 sat= 100 on 2l (for comfort) general: nad. mood, affect appropriate. heent: ncat. sclera anicteric. eomi. + conjunctival pallor but no cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvd to middle of neck cardiac: rr, normal s1, s2. no s3 or s4. 2/6 systolic murmur loudest at the apex lungs: resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. extremities: no edema skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: 2+ radial left: 2+ radial pertinent results: conclusions pre-cpb:1. the left atrium is markedly dilated. no spontaneous echo contrast is seen in the left atrial appendage. the left atrial appendage emptying velocity is depressed (<0.2m/s). no thrombus is seen in the left atrial appendage. no atrial septal defect is seen by 2d or color doppler. 2. there is severe symmetric left ventricular hypertrophy. the left ventricular cavity is mildly dilated. lvef = 40%. 3. right ventricular chamber size and free wall motion are normal. 4. the ascending aorta is mildly dilated. there are simple atheroma in the aortic arch. there are complex (>4mm) atheroma in the descending thoracic aorta. 5. the aortic valve is bicuspid. there is moderate aortic valve stenosis (valve area 1.0-1.2cm2). mild to moderate (+) aortic regurgitation is seen. the aortic regurgitation jet is eccentric. the annulus measures 23 mm. 6. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. 7. there is a small pericardial effusion. 8. moderate bilaterl pleural effusions are seen. dr. was notified in person of the results. post-cpb: on infusions of epinephrine and norepinephrine. av pacing. well-seated bioprosthetic valve in the aortic position. minimal ai. gradient is now 22, 13 mean at co = 5 l/min. lvef is now 45%, with inferior hypokinesis. mr is now trace. aortic contour is normal post decannulation. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 13:55 05:05am blood wbc-5.9 rbc-4.04* hgb-12.2* hct-36.8* mcv-91 mch-30.1 mchc-33.0 rdw-15.1 plt ct-78* 05:05am blood pt-22.1* ptt-36.1* inr(pt)-2.1* 05:05am blood glucose-86 urean-33* creat-1.3* na-137 k-4.2 cl-102 hco3-26 angap-13 , m 78 radiology report chest (pa & lat) study date of 10:58 am , fa6a 10:58 am chest (pa & lat) clip # reason: eval for infiltrate medical condition: 78 year old man s/p cabg reason for this examination: eval for infiltrate final report indication: 78-year-old man status post cabg, evaluate for infiltrate. comparison: chest radiograph from . pa and lateral chest radiograph: again noted is left lower lobe opacification with associated mild pleural effusion. mild right lower lobe opacification is unchanged. cardiac silhouette is moderately enlarged, unchanged. the mediastinal silhouette and hilar contours are normal. impression: persistent opacification of the left lower lobe with associated mild effusion may represent atelectasis or pneumonia. the study and the report were reviewed by the staff radiologist. dr. dr. brief hospital course: this 78 year old male presents from with chest pain and dyspnea. initially he had negative cardiac enzymes at another institution, however, after a tachycardic episode, enzymes were positive with no changes on ekg. he was referred for aortic valve replacement and a catherization showed significant three vessel disease. he was continued on asa 325, a statin and metoprolol. he was initially started on plavix but this was stopped once it was decided that he should have valve replacement. he has had atrial fibrillation with a rapid ventricular response. he was rate controlled with metoprolol and amiodarone. preoperative workup included dental extractions and on he went to the operationg room where surgery was performed. see operative note for detasils. he weaned from bypass on propofol, levophed, epinephrine and vasopressin infusions. he remained stable, pressors were gradually weaned and he was extubated. cts and temporary pacing wires were removed per protocol. he was diuresed towards his preoperative weight and beta blockers begun. physical therapy saw him for strength and mobility. the lopressor was changed to carvedilol for heart failure management and amlodipine and lisinopril were given as well. he was very debilitated and, therefore, a stay at a rehabilitation facility was recommended. his chronic doxycycline was resumed for his low grade arterial graft infection. he was discharged with the right staples in place and these will need to be removed a week after discharge. coumadin was given for his paroxysmal atrial fibrillation. the target inr is 2 to 2.5. this will be followed by dr. as an outpatient. medications on admission: finasteride 5 mg tablet once a day metoprolol succinate 25 mg tablet sustained release 24 hr 1 tablet(s) by mouth qd simvastatin 80 mg tablet daily tamsulosin 0.4 mg capsule, sust. release 24 hr 1 capsule(s) by mouth once a day aspirin 325 mg tablet once a day niacin 500 mg capsule, sustained release 2 capsule, once a day doxycycline 100mg po bid discharge medications: 1. simvastatin 40 mg tablet sig: two (2) tablet po daily (daily). 2. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po hs (at bedtime). 3. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). 4. niacin 500 mg capsule, sustained release sig: two (2) capsule, sustained release po daily (daily). 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) for 1 months. 6. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 7. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 8. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily) for 2 weeks. 9. carvedilol 3.125 mg tablet sig: one (1) tablet po twice a day. 10. amiodarone 200 mg tablet sig: as directed tablet po as directed: two tablets twice daily for two weeks then one tablet twice daily for two weeks then one tablet daily. 11. doxycycline hyclate 100 mg capsule sig: one (1) capsule po twice a day. 12. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 13. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain/fever. 14. furosemide 10 mg/ml solution sig: 40 mg injection once a day for 2 weeks: or until at preop weight (69kg). 15. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 16. warfarin 1 mg tablet sig: as directed tablet po once daily at 4 pm: inr goal 2-2.5. 17. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day for 2 weeks: or while on lasix. hold for k+>4.5. 18. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 19. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 20. sodium chloride 0.9 % 0.9 % syringe sig: one (1) ml injection daily (daily) as needed for flush: while iv in. 21. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 22. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 23. lasix 40 mg tablet sig: one (1) tablet po twice a day for 7 days. 24. warfarin 2.5 mg tablet sig: one (1) tablet po at bedtime for 1 days: titrate dose for inr goal of .5. discharge disposition: extended care facility: lifecare center discharge diagnosis: aortic stenosis coronary artery disease s/p aortic valve replacement, coronary artery bypass and left atrial appendage resection noninsulin dependent diabetes mellitus dental caries chronic renal insufficiency h/o atrial fibrillation peripheral disease hyperlipidemia hypertension peripheral disease left axillary bifemoral bypass s/p left femoral-posterior tibial bypass s/p cross-femoral bypass graft s/p abdominal aneurysmectomy h/o cataracts h/o bladder cancer discharge condition: alert and oriented x3, nonfocal ambulating, gait steady sternal pain managed with percocet prn discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions 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 until follow up with surgeon no lifting more than 10 pounds for 10 weeks please call with any questions or concerns followup instructions: provider: , md phone: date/time: 11:30 surgeon:dr. on at 1pm () primary care: dr. . (in - weeks cardiology: dr. in 2 weeks procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters (aorto)coronary bypass of two coronary arteries angiocardiography of left heart structures left heart cardiac catheterization open and other replacement of aortic valve with tissue graft other surgical extraction of tooth excision, destruction, or exclusion of left atrial appendage (laa) diagnoses: thrombocytopenia, unspecified subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery urinary tract infection, site not specified congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified atherosclerosis of native arteries of the extremities with intermittent claudication hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation acute on chronic diastolic heart failure aortic valve disorders personal history of tobacco use chronic kidney disease, unspecified other and unspecified hyperlipidemia other specified cardiac dysrhythmias long-term (current) use of anticoagulants personal history of malignant neoplasm of bladder iron deficiency anemia, unspecified internal hemorrhoids with other complication external hemorrhoids with other complication hemorrhage of rectum and anus personal history of methicillin resistant staphylococcus aureus acute apical periodontitis of pulpal origin streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group a microscopic hematuria 

Answer: The patient is high likely exposed to