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: chief complaint: chest pain major surgical or invasive procedure: pericardectomy history of present illness: 32 y.o. m with multiple episodes of pericarditis presenting with cp. . the patient states that he awoke from sleep several times the evening prior to admission with severe aching substernal chest pain. at 6am he awoke for good with 8/10 pain. he describes associated shortness of breath and episodes of chills and sweats. the patient took 2 percocet with improvement in the pain to and then 2 more percocet with improvement in the pain to . the patient's pain resolved in the ed 12 hours after it began. this is identical to the patient's prior episodes of chest pain associated with pericarditis except today's episode is not as severe. of note, the patient was feeling well in the days prior to admission and interviewed for a job at a health club as a personal trainer 1 day prior to admission. the interview consisted of a strenuous workout. . the patient had multiple episodes of pericarditis, last 11.02.07-11.06.07 at . during that admission, the patient presented with cp radiating to the back, diaphoresis, n/v and abdominal pain with some hypotension. the patient had no echo and cath signs suggestive of tamponade with small-moderate sized effusion. the patient underwent pericardiocentesis on . he transiently had a pericardial drain in place. extensive work-up of for a source of pericarditis, including rheumatologic, infectious and malignant is ongoing and thus far negative (including pericardial fluid negative for afb, viral cultures or malignant cells). 1 out of 2 bottles of pericardial fluid is growing presumptive peptostreptococcus from . the patient was scheduled for outpatient rheumatology follow-up though this has not yet occured. . in the ed 98.7 92-98 120-138/60-70 18 97% ra. pulsus <4 by report. the patient received aspirin 325 mg and toradol 30mg iv. he underwent bedside echocardiogram with verbal report of small pericardial effusion, elevated ra pressure but no tamonade. the patient had a cxr with a question of left lower lobe pneumonia and he received levofloxacin 500mg iv. . past medical history: pericarditis x 4 , last time complicated by tamponade social history: social history is significant for occasional tobacco and occasional marijuana use. he admits to cocaine use in the past, but not in the past 5 years. he denies ivdu. he occasionally drinks etoh. family history: there is no family history of pericarditis. he has a first cousin with a diagnosis of lupus, otherwise no other rheumatological diseases. physical exam: admissionphysical examination: vs 99.1 102 140/78 18 99%ra gen: well-appearing. nad. heent: perrl. pink, moist oral mucosa without lesions. cv: rrr. normal s1 and s2. no m/r/g. pulsus 5. pulm: cta bilaterally. abd: soft, nontender. ext: no edema. discaharge vs 99.3 82sr 118/76 18 100% ra gen nad pulm cta bilat cv rrr s1-s2. sternum stable, incision cdi abdm soft, nt/nd/+bs ext warm, well perfused, no edema pertinent results: 07:40pm glucose-142* urea n-14 creat-1.0 sodium-132* potassium-4.6 chloride-98 total co2-25 anion gap-14 07:40pm ctropnt-<0.01 07:40pm wbc-20.0*# rbc-4.01* hgb-11.5* hct-35.3* mcv-88 mch-28.7 mchc-32.6 rdw-13.3 07:40pm plt count-783* 06:05am blood wbc-14.5* rbc-3.34* hgb-9.3* hct-28.8* mcv-86 mch-27.8 mchc-32.3 rdw-14.3 plt ct-1189* 06:05am blood plt ct-1189* 06:05am blood glucose-93 urean-18 creat-1.7* na-132* k-4.8 cl-91* hco3-29 angap-17 radiology final report chest (pa & lat) 9:27 am chest (pa & lat) reason: eval for effusions medical condition: 32 year old man s/p pericardectomy reason for this examination: eval for effusions examination: chest x-ray. clinical history: 32-year-old man status post pericardiectomy, evaluate for effusions. findings: two views of the chest were obtained and compared to the prior examination dated . a tiny left apical pneumothorax persists that has slightly decreased in size since the prior examination. there is an interval decrease of the right pleural effusion associated with improved aeration of the right base. there is a minimal right basilar atelectasis present. no new focal opacities are seen. sternotomy wires are intact and unchanged in position. the cardiac silhouette is mildly enlarged, grossly unchanged since the prior examination. radiology final report renal u.s. 11:51 am renal u.s. reason: hydo/stones medical condition: 32 year old man with increase creat x 4 days / no hiistory of cri reason for this examination: hydro / stones indication: 30-year-old man with increasing creatinine for four days. comparison: ct of the torso, . renal ultrasound: the right kidney measures 12.8 cm. the left kidney measures 13.2 cm. there is no evidence of hydronephrosis or stones. relatively echogenic region within the interpolar left kidney appears to correspond to an area of normal cortex seen on ct in association with a duplicated collecting system on the left side. impression: no evidence of hydronephrosis or stones. the study and the report were reviewed by the staff radiologist. dr. . dr. echocardiography report , portable tte (focused views) done at 11:08:39 pm final referring physician information , s. c , e/rw-453 , status: inpatient dob: age (years): 32 m hgt (in): 72 bp (mm hg): 123/68 wgt (lb): 180 hr (bpm): 92 bsa (m2): 2.04 m2 indication: pericarditis, r/o tamponade. icd-9 codes: 786.05, 423.9, 786.51 test information date/time: at 23:08 interpret md: , md test type: portable tte (focused views) son: doppler: limited doppler and color doppler test location: west echo lab contrast: none tech quality: adequate tape #: 2007w000-0:00 machine: vivid echocardiographic measurements results measurements normal range left atrium - long axis dimension: 2.9 cm <= 4.0 cm left atrium - four chamber length: *6.4 cm <= 5.2 cm right atrium - four chamber length: *6.4 cm <= 5.0 cm left ventricle - septal wall thickness: 1.0 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: 1.1 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 4.0 cm <= 5.6 cm left ventricle - systolic dimension: 3.0 cm left ventricle - fractional shortening: *0.25 >= 0.29 left ventricle - ejection fraction: 50% >= 55% tr gradient (+ ra = pasp): 16 mm hg <= 25 mm hg pericardium - effusion size: 1.0 cm findings this study was compared to the prior study of . left atrium: elongated la. right atrium/interatrial septum: moderately dilated ra. normal ivc diameter (<2.5cm) with <50% decrease during respiration (estimated rap 10-15mmhg). left ventricle: normal lv wall thickness and cavity size. mild global lv hypokinesis. low normal lvef. right ventricle: normal rv chamber size. mild global rv free wall hypokinesis. aorta: normal aortic diameter at the sinus level. normal descending aorta diameter. aortic valve: normal aortic valve leaflets (3). no as. no ar. mitral valve: normal mitral valve leaflets with trivial mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pericardium: small to moderate pericardial effusion. effusion circumferential. effusion echo dense, c/w blood, inflammation or other cellular elements. pericardium appears thickened. no echocardiographic signs of tamponade. no ra or rv diastolic collapse. echo findings are suggestive but not diagnostic of constriction. general comments: emergency study performed by the cardiology fellow on call. echocardiographic results were reviewed with the houseofficer caring for the patient. conclusions the left atrium is elongated. the right atrium is moderately dilated. the estimated right atrial pressure is 11-15mmhg. left ventricular wall thicknesses and cavity size are normal. there is mild global left ventricular hypokinesis (lvef = 50 %). overall left ventricular systolic function is low normal (lvef 50-55%). right ventricular chamber size is normal. there is mild global right ventricular free wall hypokinesis. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is a small to moderate sized pericardial effusion. the effusion appears circumferential. the effusion is echo dense, consistent with blood, inflammation or other cellular elements. the pericardium appears thickened. there are no echocardiographic signs of tamponade. no right atrial or right ventricular diastolic collapse is seen. the echo findings are suggestive but not diagnostic of pericardial constriction. compared with the prior study (images reviewed) of , the small echolucent pericardial effusion has become a small to moderate sized circumferential pericardial effusion that is echodense, largest posterior to the left ventricle. there is severe tethering of both the left and right ventricular epicardium resulting in mildly depressed function. there is no echocardiographic evidence of tamponade, but effusive/constrictive process is suggested. electronically signed by , md, interpreting physician 00:32 dr. brief hospital course: mr. is a 32 yo m with multiple episodes of pericarditis presenting with cp, leukocytosis, and cough due to recurrence of pericarditis versus pna. patient has a history of recurrent pericarditis and now presents with chest pain similar to previous episodes. echo showed no signs of tamponade, but showed small to moderate effusion and constrictive process. pt was seen by rheum on previous admission and extensive workup was positive only for mildly elevated rf and ssa anitbodies. pericardial fluid was found to be positive for peptostreptoccocus and 1+wbcs. he was started on penicillin g for peptostreptococcus in pericardial fluid. and levo for pna. echo showed pericardial effusion and constriction. cardiac surgery was consulted and he underwent subtotal pericardiectomy on . he was extubated post op. he spiked a temp to 102 on pod #1 and was pancultured. infectious diseases and rheumatology were consulted. he continued on pcn. his chest tube was dc'd on pod #2. his creatinine became elevated and his toradol was dc'd. the renal ultrasound was negative. his urine lytes were normal. he spike a temp to 101.1. he was pancultured, ua was negative, blood cultures with no growth to date and a chest x-ray reveal atelectasis. he remained afebrile and was discharged to home on pod #7. medications on admission: current medications: indomethacin 25 mg tid x 2 weeks famotidine 20 mg colchicine 0.6 mg oxycodone-acetaminophen 5-325 1-2 tablets po q4 hr colace 100 mg x 2 weeks . discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 2. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 3. 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:*0* 4. hydromorphone 2 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain. disp:*50 tablet(s)* refills:*0* 5. amoxicillin 500 mg tablet sig: one (1) tablet po q8h (every 8 hours) for 2 weeks. disp:*2 tablet(s)* refills:*0* 6. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* discharge disposition: home with service facility: homecare discharge diagnosis: pericarditis x 4 now s/p subtotal pericardiectomy 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 or driving until follow up with surgeon. no motrin or aleve followup instructions: , m.d. phone: date/time: 9:00 , md phone: date/time: 1:30 provider: , md phone: date/time: 10:00 dr in 2-3weeks, pt to call to schedule appt procedure: other endoscopy of small intestine pericardiectomy endoscopic polypectomy of large intestine closed [endoscopic] biopsy of large intestine diagnoses: pneumonia, organism unspecified tobacco use disorder hyposmolality and/or hyponatremia pulmonary collapse benign neoplasm of colon tachycardia, unspecified constrictive pericarditis leukocytosis, unspecified long-term (current) use of aspirin other specified bacterial infections in conditions classified elsewhere and of unspecified site, other anaerobes cannabis abuse, unspecified ulceration of intestine 

Answer: The patient is high likely exposed to