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: tylenol / sulfa (sulfonamide antibiotics) attending: chief complaint: chest pain major surgical or invasive procedure: cardiac catheterization with drug eluting stents to the left anterior descending artery and left circumflex artery history of present illness: 59 y/o m with h/o cad s/p pci (des in , om1, and lad in ), dm, and a heavy tobacco history transfered to from hospital for nstemi. he reports that 3 days ago he started feeling generally unwell with a fever. his fs were elevated, so he ate less. by 2 days before transfer he felt sick enough that he called 911. in the ambulance to the ed he developed substernal chest pain. he denies sob, nausea, or palpitations. of note, he has had a month of worsening doe and cp with exertion. he was take no hospital where he was admitted for acs. his pain improved with ntg but recurred. an ecg there showed st depressions in v4-6 with an intial set of negative ces, but follow up ces were positive with a tni of 1.34 from 0.12 8 hours prior. at that time his wbc was notable for 3.5 and he had a low grade fever. given his ecg changes and elevated tni he was transfered to for catheterization. . on arrival at he was in cp, diaphoretic, and febrile to 100.7. he underwent cath which showed 80% proximal lad lesion, 90% in stent restenosis, and a fully occluded rca with collaterals present. he was started on eptifibatide and a ntg drip for ongoing chest pain and transfered to the ccu. . in the ccu his pain was a and the best he had felt in several days. he denies sob at rest, orthopnea, or le edema. he feels feverish. . on review of systems, s/he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. s/he denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for presense of chest pain for the past several days for for the past month with exertion as well as dyspnea on exertion. he denies paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. past medical history: 1. cardiac risk factors: +diabetes, -dyslipidemia, hypertension 2. cardiac history: -percutaneous coronary interventions: multiple pcis with des in lad, , and om1 most recent in -pacing/icd: 3. other past medical history: - cerebral aneurysm - colostomy with reversal - ruptured diverticulum s/p colostomy - cerebral aneurysm s/p vp shunt (subsequently removed) - hernia repair - hip surgery - arthritis - diabetes, now off hypoglycemics and insulin - htn - hld . social history: - tobacco: 2ppd age 14 to age 53, 80 or so pys - etoh: social only - illicits: denies family history: no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: gen: nad, diaphoretic vs: 100.0 82 125/59 21 100% on ra heent: jvd to the angle of the jaw, no lad, neck is supple cv: rr, distant, nl s1s2 no s3s4 +ii/vi systolic murmur at the lusb pulm: prolonged expiratory phase relative to inspiration, crackles at the bases l>r abd: bs+, soft, ntnd, no hsm limbs: no le edema, mild clubbing skin: no hair of the , no skin breakdown neuro: reflexes are 2+ diffusely pulses: radial, femoral, tp, and dp pulses are 2+ bilaterally post cath check groin without murmur, masses, bruit, or hematoma . ecg: sinus, 82/min, leftward axis, rbbb, st-t in i, ii, avl, v4-5, twi in i, ii, iii, avf, v1-6, and possible st-e in avr and v1. . at discharge: same as above except heent: decreased jvp pertinent results: 11:46pm pt-14.3* ptt-26.8 inr(pt)-1.2* 11:46pm plt count-198 11:46pm neuts-70.5* lymphs-20.4 monos-7.9 eos-0.6 basos-0.6 11:46pm wbc-2.6*# rbc-4.47* hgb-13.4* hct-37.3* mcv-84 mch-29.9 mchc-35.8* rdw-14.9 11:46pm %hba1c-7.2* eag-160* 11:46pm albumin-3.8 calcium-8.9 phosphate-3.0 magnesium-1.9 11:46pm ck-mb-3 ctropnt-0.07* 11:46pm alt(sgpt)-28 ast(sgot)-29 ld(ldh)-217 ck(cpk)-179 alk phos-96 tot bili-0.8 11:46pm estgfr-using this 11:46pm estgfr-using this 06:40am blood wbc-4.0 rbc-4.37* hgb-13.3* hct-37.0* mcv-85 mch-30.3 mchc-35.8* rdw-15.3 plt ct-229 07:10am blood neuts-61.6 lymphs-26.8 monos-9.0 eos-2.0 baso-0.7 07:10am blood esr-8 05:55am blood gran ct-1600* 06:40am blood glucose-114* urean-10 creat-0.6 na-138 k-4.6 cl-101 hco3-25 angap-17 06:40am blood ck(cpk)-107 06:40am blood calcium-9.6 phos-3.6 mg-2.2 11:46pm blood %hba1c-7.2* eag-160* cardiac cath report :comments:coronary angiography in this right dominant system demonstrate three vessel disease. the lmca had no angiographic evidence of disease. the lad had a proximal 80% stenosis. the had a 90% instent restenosis with an occluded om. the rca was occluded but filled from left to right collaterals. resting hemodynamic reveal transient systemic hypotension that resolved after fluid resuscitation. final diagnosis: 1. three vessel coronary artery disease. 2. cabg vs pci of lad and , be discussed with primary cardiologist dr. and ct surgery. cxr : the heart is normal in size and lungs are clear without vascular congestion or pleural effusion. echo :the left atrium is elongated. left ventricular wall thicknesses and cavity size are normal. there is mild regional left ventricular systolic dysfunction with basal to mid inferior and inferolateral hypokinesis (inferior wall worst affected) there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is a trivial/physiologic pericardial effusion. there are no echocardiographic signs of tamponade. left ventricle - ejection fraction: 50% to 55%. impression: regional lv systolic dysfunction consistent with cad (inferior ischemia/infarction). mild mitral regurgitation. trace aortic regurgitation. ef 50-55%. cath report: cath: 80% lad=> des x1, => des x1, 175cc contrast, integrellin x 18 hours. brief hospital course: 59 y/o m with h/o cad s/p pci (des in , om1, and lad), dm, and a heavy tobacco histroy who was transfered from an osh for nstemi and was found to have 80% proximal lad lesion, 90% in stent restenosis, and a fully occluded rca with collaterals as well as a fever and a possible lll pna. . # cad: nstemi with trop peaking of 2.17 at osh now s/p cath showing 80% proximal lad lesion, 90% in stent restenosis, and a fully occluded rca with collaterals. patient was initially a candidate for cabg. he was started on a heparin drip with goal ptt 60-100 3 hours after pulling arterial sheath. we stopped simvastatin and start atorvastatin 80 mg po hs. he was briefly on a ntg drip for pain and to decrease cardiac work. while in hospital, we changed home metoprolol succinate 50 mg po daily to metoprolol tartrate 25 mg po daily to decrease cardiac work and cycled his cardiac enzymes. . # pump: initially presenting with some crackles on exam, jvd elevated and mildly hypoxic, but he may have tr on exam and has a heavy smoking history. his cxr was not particularly congested. we continued lisinopril 2.5 mg po daily to prevent remodelling. . # diabetes: per patient, now off hypoglycemics. a1c 7.2%. . # fever: febrile on admission and at osh. cxr here concerning for lll pna. he was given an empiric levofloxacin 750 mg po daily x 7 days for presumed cap. bcx no growth. he also had a low wbc count, but his workup for possible neutropenia was negative and his wbc count rebounded prior to discharge: (wbc 2.6 on , and up to 4 on ). medications on admission: - aspirin 325 mg po daily - simvastatin 20 mg po hs - clopidogrel 75 mg po daily - metoprolol succinate 50 mg po daily - lisinopril 2.5 mg po daily - lumigan 1 drop ou - timolol 1 drop ou discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*11* 3. metoprolol succinate 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. 4. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). 5. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime). 6. timolol maleate 0.25 % drops sig: one (1) drop ophthalmic (2 times a day). 7. simvastatin 80 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: discharge diagnosis: non st elevation myocardial infarction leukopenia hyponatremia diabetes mellitus discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you had a heart attack and a cardiac catheterization showed some blockages in your heart arteries. initially we were planning to do surgery but dr. decided to place 2 stents in blocked arteries instead. this went well and you will need to be on aspirin and plavix every day for at least one year and likely longer. do not stop taking plavix and aspirin or miss unless dr. tells you it is ok. your left groin site had some pain last night but there is no evidence of bleeding under the skin this morning. you should watch the site for any new bruising, bleeding or increasing pain. call dr. if you notice this. no lifting more than 10 pounds for one week. no baths or pools for one week. you can shower today. . medication changes: 1. increase your simvastatin to 80 mg daily please keep the rest of your medicines as before followup instructions: name: ,md location: medical associates address: , , phone: when: monday, at 10am name: ,md location: medical associates address: , , phone: when:monday, . please go upstairs to dr office after your visit with dr . procedure: coronary arteriography using two catheters coronary arteriography using two catheters injection or infusion of platelet inhibitor left heart cardiac catheterization left heart cardiac catheterization insertion of drug-eluting coronary artery stent(s) transposition of cranial and peripheral nerves insertion of two vascular stents excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on two vessels diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hyposmolality and/or hyponatremia other and unspecified hyperlipidemia cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other complications due to other cardiac device, implant, and graft fever, unspecified chronic total occlusion of coronary artery leukocytopenia, unspecified 

Answer: The patient is high likely exposed to