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: not feeling well and hypotension major surgical or invasive procedure: sternotomy wound superficial abscess drainage history of present illness: mr. is s/p avr/ascending aorta replacement on and was discharged home on after an hospital course. he was feeling well until this am when he reports he woke up not feeling well. denies lightheadedness, dizziness, chest pain, nausea, vomiting. when the visiting nurse evaluated him, he was found to have a blood pressure of 60/40. he was sent to hospital where he was hemodynamicaly stable w/systolic bood pressures 90s to 100s. he had a non-contrast ct scan which showed "ill-defined fluid collection/induration containing a dot of air inferiorly; mild pericardial effusion mostly in the pericardial recess of the superior mediastinum, containing air with slightly complicated appearance. infectedpericardial effusion cannot be ruled out." he was transfered to for further evaluation. past medical history: past medical history: neuroblastoma (chemo/radiation left eye, subsequent enucleation) hypertension skin ca hypercholesterolemia pterygium right eye ? thyroid disorder ( being evaluated) past surgical history: enucleation left eye ln bx left neck social history: race:caucasian last dental exam:6 months ago lives with:wife occupation:part-time clothing sales tobacco:never etoh:occ. glass of wine family history: non-contributory physical exam: pulse:89 sr resp:16 o2 sat:98 on ra b/p right:100/62 left: general: skin: dry intact heent: r prrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur no rub/murmur abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema 1+ , no calf erythema or tenderness neuro: grossly intact pulses: dp right:2+ left:2+ pt :2+ left:2+ radial right:2+ left:2+ sternum: sternum stable, incision clean, dry, area of mild erythema on superior portion to the r side of sternal incision, +blanchable pertinent results: echo due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef>55%). with normal free wall contractility. the appearance of the ascending aorta is consistent with a normal tube graft. a bioprosthetic aortic valve prosthesis is present. the transaortic gradient is normal for this prosthesis. a paravalvular aortic valve leak is probably present. no masses or vegetations are seen on the aortic valve, but cannot be fully excluded due to suboptimal image quality. the mitral valve leaflets are mildly thickened. no masses or vegetations are seen on the mitral valve, but cannot be fully excluded due to suboptimal image quality. trivial mitral regurgitation is seen. there is a small pericardial effusion. impression: no valvular vegetations seen. normally-functioning aortic valve bioprosthesis. compared with the prior study (images reviewed) of , the findings are similar. admission 09:25pm pt-14.0* ptt-28.0 inr(pt)-1.2* 09:25pm plt count-357# 09:25pm neuts-84.1* lymphs-8.8* monos-4.2 eos-2.0 basos-0.9 09:25pm wbc-17.5*# rbc-3.58* hgb-10.7* hct-31.6* mcv-88 mch-29.8 mchc-33.7 rdw-13.8 09:25pm lipase-25 09:25pm alt(sgpt)-110* ast(sgot)-87* alk phos-84 amylase-26 tot bili-1.0 09:25pm urea n-25* creat-1.2 09:32pm glucose-115* lactate-1.4 na+-130* k+-4.3 cl--94* tco2-27 discharge 04:58am blood wbc-8.8 rbc-3.30* hgb-9.9* hct-28.8* mcv-87 mch-30.1 mchc-34.6 rdw-14.0 plt ct-414 04:58am blood plt ct-414 04:58am blood esr-83* 04:58am blood glucose-81 urean-34* creat-2.1* na-131* k-4.8 cl-98 hco3-28 angap-10 04:58am blood glucose-81 urean-34* creat-2.1* na-131* k-4.8 cl-98 hco3-28 angap-10 05:01am blood alt-10 ast-74* alkphos-101 amylase-37 totbili-0.2 04:40am blood hbsag-negative hbsab-negative igm hav-negative radiology report ct chest w/o contrast study date of 10:44 am medical condition: 70 year old man superficial sternal wound reason for this examination: eval for sternal infection final report ct chest without iv contrast: the patient has undergone prior graft placement in the ascending aorta and aortic valve replacement, with a median sternotomy. since the prior exam, there has been further decrease in size of multiple collections. the retrosternal collection centered behind the manubrium and upper sternum has decreased in size and density, which suggests an evolving hematoma. the periaortic collection is likely comprised of two regions, including an intrapericardial component of pericardial effusion containing locules of air, and an extrapericardial component extending cranially along the aorta. both collections have decreased in size, and there is much less air within the pericardial space. overall, this collection has improved greatly from the prior exam of . additionally, inflammatory changes and stranding in the retrosternal space has also improved. additional pericardial fluid layering dependently, moderate in size, is unchanged. a defect in the subcutaneous tissues overlying the sternum is compatible with recent debridement. however, the sternum itself demonstrates new lucency on either side of the sternotomy line, concerning for developing dehiscence or osteomyelitis. the sternal closure wires remain intact and in unchanged position at this time. aortic graft material, aortic valve prosthesis and a right picc remain in place. dense atherosclerotic calcifications are noted of the coronary arteries and the aortic arch. there is no new hilar or mediastinal lymphadenopathy by size criteria. the largest lymph node measures 9 mm in the precarinal space. there is no axillary lymphadenopathy by size criteria. lungs again demonstrate small bilateral pleural effusions with rounded atelectasis at the left lung base, in an unchanged configuration. small calcified granulomas in the right lung are unchanged. there is no new lesion. the tracheobronchial tree is patent to subsegmental levels. the esophagus remains patulous, containing aerosolized material in the upper esophagus, placing the patient at increased risk for aspiration. while this exam is not optimized for assessment of the abdomen, a right hepatic cyst is unchanged, and there are no acute abnormalities in the upper abdomen. osseous structures: for discussion of the sternal changes, see above. no additional worrisome bony abnormalities are seen. multilevel degenerative changes are present in the spine. impression: 1. interval improvement in the retrosternal and periaortic collections. the retrosternal collection likely represents evolving hematoma. the paraaortic collection likely reflect both intrapericardial fluid and extrapericardial collection, both improved. 2. new sternal lucencies on either side of the sternotomy line, concerning for developing dehiscence or osteomyelitis. sternal wires remain intact. followup imaging recommended as needed. 3. unchanged bilateral pleural effusions with rounded atelectasis at the left lung base. moderate pericardial effusion, also unchanged. 4. patulous esophagus containing aerosolized material, placing the patient at increased risk for aspiration. brief hospital course: 70 year old man s/p aortic valve replacement/ascending aprta replacement on discharged home on . readmitted with fevers and hypotension on . the sternal wound was noted to be erythematous on admission. he was pan cutured and started on broad spectrum antibiotics, initially vancomycina nd cipro which were changed to nafcillin after cultures revealed staph aureus coag +. infectious disease service was consulted. the patient had developed acute renal failure with a bun/cr that peaked at 46/2.8. he also became hyponatremic durung this period and was placed on a free water restriction. the renal service was consulted and they felt the renal dysfunction was an interstitial nephritis likely from the nafcilin. the antibiotics were changed and his renal function gradually improved. the wound continued to be erythematous and the pateint continued to have leukocytosis, on he was brought to the operating room for: sternotomy wound superficial abscess drainage. the wound was left open and a vac dressing was placed. after the wound was opened the erythema began to resolve and the leukocytosis also resolved. he remained in the hospital for several days after debridement for subsequent vac changes and antibiotic review. on pod 7 he was discharged home with a vac dressing in place, visiting nurses and home infusion therapy. he is to continue antibiotics through . he is to follow-up with dr in 1 week and with infectious diseases on . medications on admission: colace 100mg by mouth twice daily ranitidine 150mg by mouth twice daily aspirin 81 mg by mouth daily simvastatin 80 mg by mouth daily percocet 5/325 1 tab by mout every 4 hours as needed ferrous sulfate 300mg by mouth daily losartan 100mg by mouth daily folic acid 1mg by mouth daily lopressor 100mg by mouth twice daily multivitamin 1 tab my mouth daily omega 3 fatty acids 1 cap by mouth daily furosimide 40mg by mouth daily x 7 days potassium chloride 20meq by mouth daily x 7 days discharge medications: 1. outpatient lab work weekly safety labs: cbc, k, bun/cr, lfts results to id fax: 2. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 4. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 5. simvastatin 80 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 6. hydromorphone 2 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. disp:*50 tablet(s)* refills:*0* 7. zinc sulfate 220 mg capsule sig: one (1) capsule po daily (daily). disp:*30 capsule(s)* refills:*2* 8. ascorbic acid 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 9. multivitamin tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 10. cefazolin 1 gram recon soln sig: one (1) gm injection every eight (8) hours for 5 weeks: end date . discharge disposition: home with service facility: vna discharge diagnosis: superficial sternal infection pmh: aortic stenosis s/p avr dilated aorta s/p replacement of ascending aorta hypertension skin cancer hypercholesterolemia pterygium right eye neuroblastoma discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with tylenol incisions: sternal - wound vac discharge instructions: 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 one month or while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive no lifting more than 10 pounds for 10 weeks please call with any questions or concerns **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: provider: , md phone: date/time: 1:00 provider: , m.d. date/time: 2:10 clinic, lmob basement provider: , md phone: date/time: 11:00, clinic, lmob basement weekly safety labs: cbc, k, bun/cr, lfts faxed to id cardiologist: dr at 4pm please call to schedule appointments with your primary care dr in weeks chest ct on @11am-. procedure: reopening of recent thoracotomy site diagnoses: hyperpotassemia pure hypercholesterolemia other postoperative infection unspecified essential hypertension acute kidney failure, unspecified hyposmolality and/or hyponatremia hypotension, unspecified methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation heart valve replaced by transplant mediastinitis acute pericarditis, unspecified 

Answer: The patient is high likely exposed to