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 / heparin agents attending: chief complaint: stemi etoh withdrawal major surgical or invasive procedure: cardiac catherization with stent placement pre-op intubation/ ventilation avr (. epic porcine valve) history of present illness: 62 year old male with pmh of asthma, osa on cpap, htn and hyperlipidemia who presented to his pcp this morning after experiencing sudden onset right jaw pain. he states he felt unwell this morning. he went downstairs to have breakfast and experienced the right jaw pain. he then experienced substernal, non-radiating chest pain which did not improve. he endorses diaphoresis, denies nausea or vomiting. he had never experienced this in the past. the paramedics gave the patient 324 mg of aspirin, 5 of metoprolol, 4 mg of morphine. in the ed he received 600 mg, heparin, and eptifibatide. on review of systems, he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, cough, hemoptysis, black stools or red stools. he denies recent fevers, chills or rigors. he denies exertional buttock or calf pain. all of the other review of systems were negative. cardiac review of systems is notable for absence of paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. the patient endorses dyspnea on exertion. past medical history: asthma sleep apnea on cpap renal stone removal left patellectomy hypertension hypercholesterolemia pre-op delirium/confusion social history: social history is significant for the absence of current tobacco use. the patient quit smoking 7 years ago after smoking 1ppd for many years. he drinks several glasses of vodka/day. family history: there is family history of heart disease in his mother (age unknown). his father had emphysema. physical exam: on admission: ============== gen: wdwn middle aged male in nad. oriented x 3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple, unable to assess jvp cv: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. chest: resp were unlabored, no accessory muscle use. limited anterior exam as patient is currently on bedrest, clear anteriorly. abd: obese, soft, ntnd. normoactive bowel sounds. ext: +1 bilateral edema, both feet cool to touch skin: bilateral stasis dermatitis groin site: pressure bandage in place with +ooze, no bruit, small hematoma pulses: right: carotid 2+ dp 2+ pt 1+ left: carotid 2+ dp 2+ pt 1+ on transfer to micu: ===================== vital signs: t- 97.1 bp- 100/64 hr- 117 rr- 24 o2- 98% on ra . general: patient is a middle aged male, disheveled, combative with slurring speech. oriented to name, not place or year. patient does not follow commands heent: ncat, eom appear intact, does not follow command to follow. sclera anicteric. op: mmm, no lesions neck: obese, no jvp chest: uncooperative with exam. fair airmovement, relatively clear to auscultation anterior and posterior bilaterally with few course expiratory breath sounds cor: tachycardic. no obvious murmurs, rubs, gallops abd: obese, moderately distended. firm but not rigid, hypoactive bowel sounds. ext: hyperpigmented skin over le, 1+ pitting edema bilaterally at level of ankles neuro: difficult to fully assess, patient combative and uncooperative cn: no facial droop, appears to move eyes in all directions. pupils equally reactive motor: moves all extremities, attempts to get out of chair and requires fair amount of strength to keep from getting up sensory: unable to test cerebellum: unable to test gait: unable to test pertinent results: cardic cath (prelim): comments: 1. selective coronary angiography of this right dominant system demonstrated single (1) vessel coronary artery disease. the left main demonstrated no angiographically apparent atherosclerotic disease. the left anterior descending artery was calcified but demonstrated no angiographically obstructive disease. the left circumflex demonstrated no significant atherosclerotic disease. the right coronary artery demonstrated a 60% calcified ostial lesion along with a totally occluded right posterior lateral branch. 2. limited hemodynamics demonstrated elevated right (rvedp 17 mm hg) and left (mean pcwp of 23 mm hg) heart filling pressures. the cardiac index was preserved at 2.75 l/min/m2 via the fick. 3. lv ventriculography was deferred. 4. successful ptca and stenting of the right posterior lateral branch with a micro driver (2.25x12mm) bare metal stent. final angiography demonstrated no angiographically apparent dissection, no residual stenosis and timi iii flow throughout the vessel (see ptca comments). final diagnosis: 1. one vessel coronary artery disease. 2. normal ventricular function. 3. acute inferior st elevation myocardial infarction, managed by acute ptca and stenting with a bare metal stent to the right posterior lateral branch. renal us: findings: the right kidney measures 11.0 cm and the left kidney measures 11.6 cm. both kidneys have a normal echogenicity, without hydronephrosis or calculi. the bladder is decompressed. impressions: 1. interval resolution of right hydronephrosis. 05:42am blood wbc-6.2 rbc-3.19* hgb-10.0* hct-29.8* mcv-93 mch-31.3 mchc-33.6 rdw-16.0* plt ct-250 05:42am blood glucose-140* urean-9 creat-1.2 na-142 k-3.5 cl-106 hco3-24 angap-16 05:20am blood alt-18 ast-19 ld(ldh)-242 alkphos-115 amylase-50 totbili-0.9 03:34am blood pt-15.1* ptt-25.5 inr(pt)-1.3* conclusions due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. a bioprosthetic aortic valve prosthesis is present. the transaortic gradient is higher than expected for this type of prosthesis. no aortic regurgitation is seen. trivial mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. impression: normal global biventricular systolic function. aortic valve bioprosthesis with higher-than-expected gradients. no aortic regurgitation. electronically signed by , md, interpreting physician 16:58 05:42am blood wbc-6.2 rbc-3.19* hgb-10.0* hct-29.8* mcv-93 mch-31.3 mchc-33.6 rdw-16.0* plt ct-250 05:20am blood neuts-69.7 lymphs-18.3 monos-7.2 eos-4.6* baso-0.2 05:42am blood plt ct-250 05:42am blood glucose-140* urean-9 creat-1.2 na-142 k-3.5 cl-106 hco3-24 angap-16 05:20am blood alt-18 ast-19 ld(ldh)-242 alkphos-115 amylase-50 totbili-0.9 05:20am blood lipase-45 02:15pm blood probnp-6148* 05:42am blood calcium-9.7 phos-3.9 mg-1.6 03:45am blood heparin dependent antibodies- brief hospital course: he presented with inferior stemi for which he was loaded with , , heparin, integrillin and taken to the cath lab where he had a bms placed to the right posterior lateral branch. he was started on . the patient initally had acute renal failure, which resolved with hydration. one day post-catherization the patient appeared to go into early dts treated with ativan and valium. he was transferred to the micu. on he was intubated after aspirating for airway protection. he spiked a temp, blood cultures grew gram + cocci and he was started on vancomycin and gentamicin for urosepsis. his hct fell, he was transfused, ct was negative for rp bleed. tee showed aortic valve vegetation. he was seen by cardiac surgery and infectious diseases and cardiology. he was extubated on . he was reintubated on for respiratory distress. he was desensitized to and switched to ampicillin. gentamicin was held for progressive renal failure. he was taken to the operating room on where he underwent incision and debridement of deep abscess of the posterior lumbosacral spine which grew coag neg staph. ecoli grew in his sputum and he was treated with a 7 day course of ceftriaxone. he was extubated on and was subsequently reintubated for inability to protect his airway and decreasing sats. repeat echocardiogram showed worsening vegetation and aortic root abscess. hit antibody was very weakly positive, heme consult was called to confirm that low likelihood of hit. he was taken to the operating room on where he underwent an avr (23mm st. tissue valve). he was transferred to the icu in critical but stable condition on levophed and propofol. he had a right pneumothorax for which a chest tube was placed. he remained on mechanical ventilation, and was ultimately extubated on pod # 3, and pressors & inotropes were weaned off. he again developed a right pneumothorax, had a thoracic surgery consult, and had a tube placed with resolution. he was disoriented, and agitated, and remained in the icu for the next week due to the need for observation, and was transferred to the telemetry floor on (pod # 12). mental status has continued to improve over the next few days. he had numerous episodes of pauses and was re-evaluated by ep for further management. he has remained hemodynamically stable, and is ready to be discharged to rehab to progress with physical therapy/mobility. he is to remain on his gentamicin until , and ampicillin until per the id service. he should have labs as ordered twice weekly, faxed to the clinic ( dr. . additional pauses noted on evening of , and ep re-evaluated him to determine that he did not need a pacemaker. his evening pauses appear to be consistent with vasovagal events and may be related to his sleep apnea. cleared for discharge to rehab on pod #20. pt. is to make all followup appts. as per discharge instructions. medications on admission: advair 500 spiriva 18 mvc albuterol 17 g singulair 10 mg avapro 300 mg hctz 300 mg lipitor 20 mg allopurinol 300 mg folic acid 600 mcg l-theqnine 100 mg aspirin 81 mg vicodin ic 5-500mg tab q 6 hours prn gabapentin tid discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed. 3. montelukast 10 mg tablet sig: one (1) tablet po daily (daily). 4. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 5. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 6. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 7. sodium chloride 0.9% flush 10 ml iv prn line flush mid-line, non-heparin dependent: flush with 10 ml normal saline daily and prn per lumen. 8. ampicillin sodium 2 gram recon soln sig: two (2) grams injection q4h (every 4 hours) for until 5/28 days. 9. gentamicin in saline (iso-osm) 80 mg/50 ml piggyback sig: eighty (80) mg intravenous q24h (every 24 hours): until . 10. colace 100 mg capsule sig: one (1) capsule po twice a day for 10 days: for 10 days; may continue prn after 10 days. discharge disposition: extended care facility: for the aged - macu discharge diagnosis: endocarditis s/p avr on dyslipidemia,hypertension,cad s/p pci,asthma,sleep apnea on cpap, renal stone removal,left patellectomy, pre-op delirium discharge condition: good discharge instructions: call with fever, redness or drainage from incision or weight gain more than 2 pounds in one day or five in one week. shower, no baths, no lotions, creams or powders to incisions. no lifting more than 10 pounds for 10 weeks. no driving until follow up with surgeon or at least one month. followup instructions: ortho spine follow dr 2-4 weeks with dr. upon discharge for rehab, or in weeks. with dr. in weeks with dr. in 2 weeks already scheduled apppointments: provider: ,md mph: date/time: 9:30 provider: , m.d. phone: date/time: 8:00 procedure: insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more extracorporeal circulation auxiliary to open heart surgery insertion of non-drug-eluting coronary artery stent(s) combined right and left heart cardiac catheterization coronary arteriography using two catheters diagnostic ultrasound of heart insertion of endotracheal tube enteral infusion of concentrated nutritional substances open and other replacement of aortic valve with tissue graft closed [endoscopic] biopsy of bronchus local excision of lesion or tissue of bone, other bones transfusion of packed cells open biopsy of soft tissue biopsy of bone, other bones transfusion of other serum transfusion of platelets continuous intra-arterial blood gas monitoring cranial or peripheral nerve graft insertion of one vascular stent excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified cardiac complications, not elsewhere classified aortic valve disorders other and unspecified hyperlipidemia acute respiratory failure other specified cardiac dysrhythmias iatrogenic pneumothorax unspecified sleep apnea acute myocardial infarction of other inferior wall, initial episode of care pneumonia due to escherichia coli [e. coli] acute and subacute bacterial endocarditis acute systolic heart failure streptococcal septicemia other and unspecified complications of medical care, not elsewhere classified delirium due to conditions classified elsewhere other and unspecified alcohol dependence, continuous alcohol withdrawal delirium other disorders of muscle, ligament, and fascia other infections involving bone in diseases classified elsewhere, other specified sites 

Answer: The patient is high likely exposed to