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: lasix / codeine / ceclor / keflex / voltaren / penicillins attending: chief complaint: prosthetic mitral valve thrombosis major surgical or invasive procedure: none history of present illness: 66 y/o f s/p cva with hemorrhagic evolution () with prior prosthetic mitral valve and tricuspid ring transferred from osh with mv thrombosis and gi bleed with likely need for cardiac surgery. approx one month ago, patient was hospitalized for cva, receiving tpa which subsequently led to hemorrhagic conversion of the infarct and worsening neurological status. during that admission, the patient's coumadin was held and then restarted prior to discharge to rehab. pt was admitted on at good hospital for a gi bleed after restarting coumadin upon transfer to rehab. upon presentation to the osh, patient was found to have blood in her rectal vault. her coumadin was held and she received im vitamin k for her inr of 1.7 on admission. her hct on admission was 39 and was 29 on transfer from osh, she did not receive blood products. cardiology was consulted and an echocardiogram was performed. the echo showed mitral valve thrombosis and acute mtiral stenosis. fluroscopy was performed and showed that one of the valve leaflets was immobile. patient was transferred initially for cardiac surgery, but was soon deemed to be a poor candidate in the setting of a gi bleed and recent hemorrhagic stroke. past medical history: - atrial fibrillation with multiple failed attempts at cardioversion - cad - ppm - hypothyroidism s/p cva with hemorrhagic conversion () h/o multiple cvas in past h/o gi bleed, unknown etiology. h/o anti-cardiolipin antibody osa with cpap social history: smokes 1ppd x 36 yrs family history: noncontrib physical exam: vs: 98.5, 83, 116/58, 71, 21, 98% 2l general: oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: no jvd cardiac: rrr, prosthetic s1, with loud s2, crescendo-decrescendo murmur at lusb lungs: ctab in anterolateral chest. abdomen: soft, nt/nd. no hsm. rlq ttp. extremities: no c/c/e. no femoral bruits. neuro: cn ii-x intact. unable to assess, vii, ix, xii. plantar flexion of l and r le. handgrip on r, on l. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ pertinent results: cxr: findings: in comparison with the earlier study of this date, there is continued elevation of pulmonary venous pressure consistent with volume overload. however, more coalescent areas at the left base and both mid lung zones suggest superimposed multifocal pneumonia. tubes remain in place. the study and the report were reviewed by the staff radiologist. . echo the left atrium is dilated. mild spontaneous echo contrast is seen in the body of the left atrium. moderate to severe spontaneous echo contrast is present in the left atrial appendage. the left atrial appendage emptying velocity is depressed (<0.2m/s). a probable thrombus is seen in the tip of the left atrial appendage. no atrial septal defect is seen by 2d or color doppler. there are simple atheroma in the ascending aorta. there are simple atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta up to 35cm from the incisor. the aortic valve leaflets (3) are moderately thickened. there is severe aortic valve stenosis (area 0.6cm2 by planimetry). trace aortic regurgitation is seen. a mechanical mitral valve prosthesis is present. there is extensive thrombus around the ring of the prosthesis that measures at least 3.4cm by 1.1cm by dimension. there is a highly mobile component of the thrombus that measure 1.9cm x 0.5cm that prolapses through the mitral valve orifice. the anterior/septal mitral valve leaflet is completely immobile. the posterior/lateral leaflet moves well. the gradients across the mitral valve is suggestive of severe valvular mitral stenosis. a tricuspid valve annuloplasty ring is present with trace tricuspid regurgitation. there is no pericardial effusion. impression: extensive thrombus around the mechanical mitral prosthesis causing severe mitral stenosis. severe aortic stenosis (although may be overestimated given poor lv function). thrombus in the left atrial appendage. brief hospital course: this is a 66 year old female with a history of avr, mvr, atrial fibrillation and recent stroke w/hemorrhagic conversion who presented to an osh with a gi bleed and found to have a new mv thrombus. the patient was urgently transferred to for the treatment of the mitral valve thrombus that was presumed to have formed since her recent discharge from (when her coumadin was held in the setting of a hemorrhagic conversion of a tpa treated embolic stroke). surgery was immediately consulted for possible intervention on the thrombus, but given her active gi bleed, it was felt she was not a good surgical candidate. in addition, thrombolysis was not an option given her recent stroke and the current gi bleed. initially, the patient was started on a heparin gtt to stabilize the thrombus. the risks/benefits of this were discussed with the family at length. the first few days of her stay, she was transfused 2 u and gi was consulted. a tee was done which showed a large thrombus overlying the mitral valve. the patient had a markedly elevated wbc as well as possible pneumonia on cxr and was given broad spectrum antibiotics with vancomycin and meropenem ( many drug allergies). she was diuresed as well for pulmonary edema. over the next 48 hours, pt continued to have melena and the family (and health care proxy) decided that the patient would be better served with comfort measures and hospice care. her daughter is the health care proxy and activated this option. she was discharged to hospice with plans to keep oral medications that would assist in comfort only. her antibiotics were discontinued. she was given morphine prn for comfort. medications on admission: paxil 30mg wellbutrin qdaily klonopin 0.5mg neurontin 300mg tid advair 250/50 coreg 3.125mg synthroid 25mcg qdaily aricept 5mg qhs zocor 40mg qhs nexium 40mg iv qdaily ssi discharge medications: 1. levothyroxine 25 mcg tablet sig: one (1) tablet po daily (daily). 2. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 3. gabapentin 300 mg capsule sig: one (1) capsule po tid (3 times a day). 4. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed. 5. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed for prn. 6. bumetanide 2 mg tablet sig: 0.5 tablet po bid (2 times a day). 7. digoxin 125 mcg tablet sig: one (1) tablet po daily (daily). 8. clonazepam 1 mg tablet sig: one (1) tablet po tid (3 times a day). 9. glipizide 5 mg tablet sig: 0.5 tablet po daily (daily). 10. acetaminophen 500 mg tablet sig: two (2) tablet po q 8h (every 8 hours). 11. morphine 10 mg capsule, sust. release pellets sig: one (1) capsule, sust. release pellets po every four (4) hours as needed for pain. discharge disposition: extended care facility: life care center of discharge diagnosis: mitral valve thrombus with acute mitral valve stenosis acute diastolic heart failure atrial fibrillation lower gi bleed pneumonia discharge condition: hospice level of care, alert and oriented x3 discharge instructions: you were admitted to the hospital because a clot was found on your mitral valve. you also had some evidence of bleeding coming from your gastrointestinal tract. on discussion with your family as well as with you, the decision was made to avoid invasive procedures. you were treated with comfort measures and will continue this at the nursing home. followup instructions: none procedure: venous catheterization, not elsewhere classified diagnostic ultrasound of heart diagnoses: pneumonia, organism unspecified coronary atherosclerosis of native coronary artery congestive heart failure, unspecified unspecified acquired hypothyroidism atrial fibrillation other complications due to heart valve prosthesis cardiac pacemaker in situ personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits acute diastolic heart failure hemorrhage of gastrointestinal tract, unspecified mitral valve stenosis and aortic valve stenosis 

Answer: The patient is high likely exposed to