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: tetracycline attending: chief complaint: doe major surgical or invasive procedure: avr(21mm porcine), cabgx2(svg>pda,lima>lad) history of present illness: 75 yo f with increasing doe over past several years, known as followed by serial echos, cath showed 3vd, referred for avr/cabg. past medical history: pmh: htn, sleep apnea on cpap, dm2, ^lipids, diverticulitis, as, poor balance w/frequent falls, l4 & l5 fractures, subdural hematoma psh: ccy, appendectomy, partial colectomy, knee arthroscopy x3, pilonidal cyst excision social history: retired lab tech no tobacco no etoh family history: father deceased from mi at age 41 physical exam: admission hr 82 rr 16 bp 129/69 nad lungs ctab heart rrr, hsm abdomen soft, nt, obese extrem 2+ edema discharge vs t 99.3 hr 87 first degree avb bp 110/44 rr 22 o2sat 97% 50% psv gen nad neuro alert/responsive. follows commands, answers(shakes head) appropriately pulm course rhonchi throughout cv rrr, sternum stable. incision small open area at base w/fibrinous tissue minimal drainage abdm soft, nt/obese. midline incision w/staples-cdi. j tube site-cdi. ext warm, 4+ edema bilat tld j tube, foley, piv, trach, picc-lft anticub pertinent results: 03:25am blood wbc-7.9 rbc-3.28*# hgb-9.6*# hct-28.4* mcv-86 mch-29.1 mchc-33.7 rdw-18.7* plt ct-295 08:59pm blood hct-28.7* 03:03pm blood hct-24.7* 06:37am blood hct-22.2* 03:25am blood pt-13.4 ptt-27.1 inr(pt)-1.1 03:25am blood glucose-170* urean-24* creat-0.5 na-138 k-3.8 cl-104 hccomplete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 10:37am 29.0* o3-32 angap-6* chest (portable ap) 7:25 am chest (portable ap) reason: ?ptx medical condition: 75 year old woman with s/;p cabg reason for this examination: ?ptx indication: 75-year-old woman with status post cabg; evaluate for pneumothorax. comparison: . single ap upright radiograph of the chest at 7:40 a.m.: there are moderate bilateral pleural effusions, slightly worse than prior study. there are associated bibasilar opacities which are also worse and may reflect worsening atelectasis and/or pneumonia. left picc is terminating at the upper svc. there is no pulmonary edema or pneumothorax. impression: no pneumothorax. worsening moderate bilateral pleural effusions and bibasilar consolidation. ct abdomen w/o contrast 4:38 pm ct abdomen w/o contrast; ct pelvis w/o contrast reason: r/o retroperitoneal bleed with drop in hct medical condition: 75 year old woman with s/p cabg reason for this examination: r/o retroperitoneal bleed with drop in hct contraindications for iv contrast: none. history: 75-year-old female after cardiac surgery with falling hematocrit and concern for retroperitoneal hematoma. the patient has known right groin hematoma after removal of a femoral catheter. comparison: right groin ultrasound . technique: mdct axial images of the abdomen and pelvis without oral or iv contrast. coronal and sagittal reformats were obtained. ct of the abdomen without iv contrast: the patient is status post sternotomy. there are small bilateral pleural effusions and atelectasis of much of both lower lobes. diffuse body wall edema is noted. there are scattered pockets of ascites within the abdomen. a drainage catheter enters the left upper abdomen and terminates near the inferior liver edge. evaluation of the solid abdominal organs is limited without iv contrast. there is a small subcentimeter hypodense focus of the left hepatic lobe, too small to characterize. gallbladder is not seen and may be surgically absent or collapsed. both kidneys are atrophic. the pancreas, spleen, and adrenal glands are unremarkable. there are numerous colonic diverticula, but no evidence of acute diverticulitis. oral contrast from prior examination is present throughout the colon. there is no evidence of retroperitoneal hematoma. there is extensive body wall edema. ct of the pelvis without iv contrast: again seen is a large right groin hematoma, which extends down the medial leg. assessment for change in size compared to recent ultrasound is difficult due to differences in modalities. today on greatest axial dimension dimensions, it measures about 17 x 6 cm. the hematoma has high-density component, suggesting more recent hemorrhage. the bladder is decompressed by a foley catheter. the rectum, uterus, adnexa, and pelvic loops of bowel are unremarkable. bone windows: no concerning bone lesions are seen. there are degenerative changes of the spine. there is an old wedge compression fracture deformity of l2 with hyperdense material within it, probably from vertebroplasty. impression: 1. right groin hematoma redemonstrated. assessment for change in size is difficult due to differences in modalities compared to prior ultrasound . maximal axial dimensions today are 17 x 6 cm. presence of hyperdense material within the hematoma suggest more recent hemorrhage into the hematoma. if clinically indicated, further evaluation with a followup ultrasound to assess for pseudoaneurysm is suggested. 2. anasarca evidenced by small bilateral pleural effusions, scattered pockets of intra-abdominal ascites and diffuse body wall edema. 3. atelectasis of a large portion of the lower lobes. 4. atrophic kidneys. 5. diverticulosis. femoral vascular us right port 5:24 pm femoral vascular us right port reason: evaluation of rt groin hematoma if changes and evaluation of medical condition: 75 year old woman with s/p cabg reason for this examination: evaluation of rt groin hematoma if changes and evaluation of flow ? pseudoaneurysm - please compare to previous ultrasound right groin hematoma. comparison: . history: hematoma. findings: panoramic images were obtained of the right groin to assess the known complex fluid collection. this known complex fluid collection measures 17.5 x 8.0 x 11.1 cm on today's examination. please note however that similar views were not obtained on prior study and therefore not accurately comparable. when comparing the most similar views from today's study to prior study, the dimensions appear slightly decreased when compared to prior exam. the right common femoral artery and vein are patent with normal waveforms. there is no evidence of pseudoaneurysm or av fistula. impression: large right groin hematoma, slightly decreased in size as best can be compared to prior exam. echocardiography report , tte (complete) done at 4:12:19 pm final referring physician information , r. division of cardiothoracic , status: inpatient dob: age (years): 75 f hgt (in): 66 bp (mm hg): 124/66 wgt (lb): 280 hr (bpm): 100 bsa (m2): 2.31 m2 indication: prosthetic valve function. endocarditis. icd-9 codes: 424.90, v43.3 test information date/time: at 16:12 interpret md: , md test type: tte (complete) son: cardiology fellow doppler: full doppler and color doppler test location: west echo lab contrast: none tech quality: adequate tape #: 2008w9-9:9 machine: other sedation: versed: 1 mg fentanyl: 50 mcg patient was monitored by a nurse throughout the procedure echocardiographic measurements results measurements normal range findings right atrium/interatrial septum: no asd by 2d or color doppler. left ventricle: normal lv wall thickness and cavity size. right ventricle: normal rv chamber size and free wall motion. aorta: simple atheroma in aortic arch. complex (>4mm) atheroma in the descending thoracic aorta. aortic valve: bioprosthetic aortic valve prosthesis (avr). avr well seated, normal leaflet/disc motion and transvalvular gradients. no masses or vegetations on aortic valve. no as. no ar. mitral valve: normal mitral valve leaflets. mild (1+) mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: pulmonic valve not well seen. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was monitored by a nurse throughout the procedure. local anesthesia was provided by benzocaine topical spray. the patient was sedated for the tee. medications and dosages are listed above (see test information section). 0.1 mg of iv glycopyrrolate was given as an antisialogogue prior to tee probe insertion. no tee related complications. the patient appears to be in sinus rhythm. echocardiographic results were reviewed with the houseofficer caring for the patient. conclusions no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses and cavity size are normal. right ventricular chamber size and free wall motion are normal. there are simple atheroma in the aortic arch. there are complex (>4mm) atheroma in the descending thoracic aorta. a bioprosthetic aortic valve prosthesis is present. no masses or vegetations are seen on the aortic valve bioprosthesis. there is no aortic valve stenosis or aortic regurgitation. the mitral valve leaflets are structurally normal. mild (1+) mitral regurgitation is seen. conclusions: normal bioprosthetic aortic valve without echocardiographic evidence of vegetation or mass present. brief hospital course: she was taken to the operating room on where she underwent an avr/cabg x 2. please see operative note for details. she was transferred to the icu in stable condition. she underwent bronchoscopy that night for thick secretions and airway obstruction. she had low urine output and was started on natrecor and lasix drips. she remained intubated for hemodynamic instability on epinephrine and levophed. she developed a fever and was cultured. she was seen by renal for continued low urine output. she was seen by cardiology for continued hypotension and ectopy and bundle branch block, and she was seen by infectious diseases for ?sepsis. she continued on vanocmycin for cns from arterial line, and was started on cefepime and flagyl for ? of vap and empiric gi coverage. she was started on tube feeds. chest tube insertion was attempted for pleural effusion but was unsuccessful secondary to body habitus. meropenum was added and flagyl was dc'd. she received free water for hypernatremia. repeat bronchoscopy on showed significant secretions and airway collapse. she underwent thoracentesis for left pleural effusion. she was extubated on but required bipap. she was seen by cardiology for svt that converted with adenosine and medications (lopressor) were adjusted. she was reintubated on for respiratory failure. she was seen by thoracic surgery for tracheostomy placement, and on she underwent an open tracheostomy, flexible bronchoscopy and open jejunostomy. she developed an acute abdomen and new pressor requirement and on she was taken to the operating room for a duodenal ulcer with perforation and succus throughout the abdominal cavity and she underwent a exploratory laparotomy and washout, lysis of adhesions, and duodenal ulcer patch with drain placement. tube feeds were advanced to goal. she was started on caspofungin for fungemia and positive fungal wound cultures. she was transfused multiple times. picc line was placed. she was seen by vascular surgery for blue right toes. right femoral artery ultrasound showed complex fluid collection with no evidence of pseudoaneurysm or av fistula and she was followed with serial hcts which remained stable. he did not tolerate passy-muir valve placement on . she tolerated trach mask trials. picc line was replaced given candidemia after previous picc placed. she was started on bumex, and then aldactone and hctz for diuresis. on she underwent left thoracentesis for 1200 cc serous fluid. she developed guaiac positive stools and ppi was increased to . hct fell and she was transfused. she was started on vanco for coag negative staph in blood cultures from , the vanco was subsequently dc'd as only 1 bottle was positive. subsequent cultures remained negative. hct subsequently remained stable and she was ready for transfer to rehab. medications on admission: glucophage 850", avandia 8', glipizide 10", dumex 2', asa 81' spironolactone/hctz 25/25', , paxil 40', lipitor 20', amitryptiline 25', lopressor 25''', ranitidine 150'', serevent inh , mvi, vit c 500", vit e 400', calcium + d 600", methadone 5"" discharge medications: 1. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for temperature >38.0. 2. paroxetine hcl 10 mg/5 ml suspension sig: one (1) po daily (daily). 3. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 4. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 5. amitriptyline 25 mg tablet sig: one (1) tablet po hs (at bedtime). 6. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 7. albuterol 90 mcg/actuation aerosol sig: four (4) puff inhalation q4h (every 4 hours). 8. docusate sodium 50 mg/5 ml liquid sig: po bid (2 times a day). 9. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 10. hydrochlorothiazide 12.5 mg capsule sig: two (2) capsule po daily (daily). 11. spironolactone 25 mg tablet sig: one (1) tablet po daily (daily). 12. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 13. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). 14. papain-urea 830,000-10 unit/g-% ointment sig: one (1) appl topical (2 times a day): to sternal and coccyx wounds . 15. insulin glargine 100 unit/ml solution sig: twenty five (25) units subcutaneous breakfast (breakfast). 16. pantoprazole 40 mg iv q12h 17. meropenem 500 mg recon soln sig: five hundred (500) mg intravenous q8h (every 8 hours): through . 18. caspofungin 70 mg recon soln sig: fifty (50) mg intravenous q24h (every 24 hours): through . 19. bumex 2 mg tablet sig: one (1) tablet po once a day: 30 min after hctz. 20. roxicet 5-325 mg/5 ml solution sig: 2.5-5 mls po every hours as needed for pain. discharge disposition: extended care facility: - discharge diagnosis: as, cad s/p avr, cabg respiratory failure s/p tracheostomy, jejunostomy perforated duodenal ulcer s/p exploratory laparotomy, patch pmh: htn, sleep apnea on cpap, dm2, ^lipids, diverticulitis, poor balance w/frequent falls, l4 & l5 fractures, subdural hematoma psh: ccy, appendectomy, partial colectomy, knee arthroscopy x3, pilonidal cyst excision discharge condition: stable. 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. followup instructions: dr. after discharge from rehab dr. after discharge from rehab dr. after discharge from rehab dr /general surgery clinic in weeks patient to call for all appointments procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery other enterostomy diagnostic ultrasound of heart diagnostic ultrasound of heart diagnostic ultrasound of heart diagnostic ultrasound of heart insertion of endotracheal tube enteral infusion of concentrated nutritional substances thoracentesis thoracentesis (aorto)coronary bypass of one coronary artery other intubation of respiratory tract other intubation of respiratory tract temporary tracheostomy open and other replacement of aortic valve with tissue graft closed [endoscopic] biopsy of bronchus suture of duodenal ulcer site injection or infusion of nesiritide diagnoses: pneumonia, organism unspecified obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery unspecified pleural effusion unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hematoma complicating a procedure aortic valve disorders other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure morbid obesity hyperosmolality and/or hypernatremia other and unspecified infection due to central venous catheter other and unspecified mycoses other diseases of trachea and bronchus unspecified peritonitis acute duodenal ulcer with perforation, without mention of obstruction myocardial degeneration 

Answer: The patient is high likely exposed to