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: sulfa (sulfonamide antibiotics) / seasonale attending: chief complaint: dyspnea major surgical or invasive procedure: aortic valve #23 pericardial valve, coronary artery bypass graft x1 (svg-drca) history of present illness: 71 yo female with known aortic stenosis. recent cardiac catheterization revealed single vessel coronary artery disease. she is now referred for avr/cabg. current symptoms include progressive dyspnea on exertion. she has had surgery cancelled recently for a uti and tpresents today for pats past medical history: - hypertension - dyslipidemia - hypothyroid - morbid obesity - diabetes mellitus, diet controlled - recent uti past surgical history: r tkr r cataract social history: lives with:husband occupation:retired tobacco:denies etoh:denies family history: family history:non-contrib. race:caucasian last dental exam:on emonth ago physical exam: pulse: 79 o2 sat: 97% b/p right: 122/62 left: height: 64 inches weight: 275 lbs general:has a difficult time lying flat due to back pain, orthopnea skin: dry intact moist large area of fungal rash right groin heent: perrla eomi ptosis r upper lid; anicteric sclera; op unremarkable neck: supple full rom no jvd appreciated chest: lungs clear bilaterally heart: rrr irregular murmur- 4/6 sem radiates to carotids abdomen: soft non-distended non-tender bowel sounds + ;obese extremities: warm , well-perfused edema- trace ble varicosities: superficial spider veins neuro: grossly intact; mae strengths; nonfocal exam pulses: femoral right: 2+ left:2+ dp right: np left:np pt : 1+ left:1+ radial right:2+ left: 2+ pertinent results: pre-cpb: no spontaneous echo contrast is seen in the left atrial appendage. overall left ventricular systolic function is low normal (lvef 50-55%). right ventricular chamber size and free wall motion are normal. the descending thoracic aorta is mildly dilated. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). moderate (2+) aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. moderate (2+) mitral regurgitation is seen. there is no pericardial effusion. post-cpb: the patient was initially av-pace, then in sr. no inotropes. an aortic tissue-valve is seen to be well-seated with no leak and no ai. residual mean gradient = 5 mmhg. preserved biventricular systolic fxn. aorta intact. mr is now trace. 03:01am blood wbc-10.0 rbc-2.75* hgb-8.9* hct-25.3* mcv-92 mch-32.2* mchc-35.0 rdw-13.8 plt ct-151 01:35pm blood wbc-17.3*# rbc-2.90*# hgb-9.2*# hct-26.5*# mcv-91 mch-31.6 mchc-34.6 rdw-13.6 plt ct-165 03:01am blood glucose-144* urean-27* creat-1.1 na-135 k-4.0 cl-103 hco3-25 angap-11 echocardiography report , (complete) done at 11:07:23 am final referring physician information , r. , division of cardiothorac , status: inpatient dob: age (years): 71 f hgt (in): bp (mm hg): / wgt (lb): hr (bpm): bsa (m2): indication: avr/cabg icd-9 codes: 786.05, 786.51, 424.1, 424.0 test information date/time: at 11:07 interpret md: , md test type: tee (complete) son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2011aw1-: machine: us6 echocardiographic measurements results measurements normal range left ventricle - inferolateral thickness: *1.3 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 5.0 cm <= 5.6 cm left ventricle - ejection fraction: 50% to 55% >= 55% aorta - ascending: 3.0 cm <= 3.4 cm aorta - descending thoracic: *2.6 cm <= 2.5 cm aortic valve - peak gradient: *66 mm hg < 20 mm hg aortic valve - mean gradient: 36 mm hg aortic valve - lvot diam: 2.0 cm aortic valve - valve area: *0.6 cm2 >= 3.0 cm2 findings left atrium: no spontaneous echo contrast is seen in the laa. right atrium/interatrial septum: normal interatrial septum. left ventricle: low normal lvef. right ventricle: normal rv chamber size and free wall motion. aorta: normal ascending aorta diameter. mildly dilated descending aorta. simple atheroma in descending aorta. aortic valve: severely thickened/deformed aortic valve leaflets. critical as (area <0.8cm2). moderate (2+) ar. mitral valve: moderately thickened mitral valve leaflets. moderate (2+) mr. tricuspid valve: mild to moderate +] tr. pulmonic valve/pulmonary artery: physiologic (normal) pr. pericardium: no pericardial effusion. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was under general anesthesia throughout the procedure. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. no tee related complications. conclusions pre-cpb: no spontaneous echo contrast is seen in the left atrial appendage. overall left ventricular systolic function is low normal (lvef 50-55%). right ventricular chamber size and free wall motion are normal. the descending thoracic aorta is mildly dilated. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). moderate (2+) aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. moderate (2+) mitral regurgitation is seen. there is no pericardial effusion. post-cpb: the patient was initially av-pace, then in sr. no inotropes. an aortic tissue-valve is seen to be well-seated with no leak and no ai. residual mean gradient = 5 mmhg. preserved biventricular systolic fxn. aorta intact. mr is now trace. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 11:11 ?????? caregroup is. all rights reserved. brief hospital course: the patient was brought to the operating room on where the patient underwent aortic valve replacement with # 23 pericardial valve and coronory artery bypass graft x 1 svg to drca. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring on pod #3. pod 1 found the patient extubated, alert and oriented and breathing comfortably. the patient was neurologically intact hemodynamically stable, weaned from inotropic and vasopressor support by pod#2. beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. the patient was transferred to the telemetry floor for further recovery. chest tubes and pacing wires were discontinued without complication. the patient was evaluated by the physical therapy service for assistance with strength and mobility. patient is a known diabetic diet controlled she was started on lantus and sliding scale insulin during this admission for optimal blood glucose control. by the time of discharge on pod #7 the patient was ambulating with assist, the wound was healing and pain was mimimal. the patient was discharged to hellenic nursing and rehab in in good condition with appropriate follow up instructions. medications on admission: medications at home: folate 1 mg daily levothyroxine 100 mcg daily lisinopril 20 mg daily metoprolol er 25 mg daily simvastatin 40 mg daily aspirin 81 mg daily allergies: sulfa - pruritis discharge medications: 1. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 2. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 3. potassium chloride 10 meq tablet extended release sig: two (2) tablet extended release po q12h (every 12 hours). 4. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain. 5. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 6. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 8. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 9. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 10. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 11. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 12. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 13. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. 14. lasix 40 mg tablet sig: one (1) tablet po once a day for 7 days: re-eval need to continue diuretics after 1 week. 15. potassium chloride 20 meq tablet, er particles/crystals sig: one (1) tablet, er particles/crystals po once a day for 7 days. 16. insulin glargine 100 unit/ml cartridge sig: thirty (30) units subcutaneous once a day for daily days: please 30units q am. discharge disposition: extended care facility: tba discharge diagnosis: aortic stenosis coronary artery disease hypertension, dyslipidemia, hypothyroid, morbid obesity, diabetes mellitus-diet controlled, recent uti psh: right tkr ', right cataract discharge condition: alert and oriented x3 nonfocal ambulating, gait steady sternal pain managed with oral analgesics sternal incision - healing well, no erythema or drainage discharge instructions: monitor vitals signs including weight and temperature concerns - fever of 100.5 degrees fahrenheit or higher - weight increase more than two pounds in one day or five pounds in a week ?????? monitor wound healing, teach wound care care - shower daily - including first washing incisions gently with mild soap - no lotions, cream, powder, or ointments to incisions concerns - warmth, redness, swelling or increased tenderness/pain - any fluid or drainage coming out of incisions ?????? medication, diet and exercise teaching and compliance ?????? follow-up appointment assistance and compliance **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: you are scheduled for the following appointments: wound check at cardiac surgery office surgeon dr. , md phone: date/time: cardiologist dr. on at 11:15 please call to schedule the following: primary care dr., m. in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** procedure: extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of one coronary artery open and other replacement of aortic valve with tissue graft diagnoses: coronary atherosclerosis of native coronary artery unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism aortic valve disorders other and unspecified hyperlipidemia morbid obesity knee joint replacement body mass index 45.0-49.9, adult 

Answer: The patient is high likely exposed to