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 attending: chief complaint: neck, jaw and chest pain major surgical or invasive procedure: ascending aorta and hemiarch replacement with 28mm gelweave graft, resuspension of aortic valve history of present illness: 48 y/o male who presented to osh c/o left-sided neck and jaw pain, along with chest pain. underwent a cta which showed a type a ascending aortic dissection. was then transferred to for surgical management. past medical history: hypertension, hemorrhoids, ankylosing spondylitis, subarachnoid hemrrhage (rupture of cerebral aneurysm) s/p craniotomy and clipping with vp shunt, occasional migraines, hydrocephalus, right renal cell carcinoma social history: denies tobacco or etoh use. family history: non-contributory physical exam: vs: 66 20 85/40 6'2" 163.5# gen: nad skin: unremarkable heent: eomi, perrl neck: supple, from, shunt noted right neck chest: ctab heart: rrr abd: soft, nt/nd +bs ext: warm, well-perfused, decreased pulse rt. arm neuro: a&o x 3, mae, non-focal pertinent results: echo: pre-cpb: no spontaneous echo contrast is seen in the left atrial appendage. right ventricular chamber size and free wall motion are normal. the ascending aorta is markedly dilated there are three aortic valve leaflets. moderate (2+) aortic regurgitation is seen. no mitral regurgitation is seen. there is no pericardial effusion. a large aneurysm of the ascending aorta is present with a dissection flap and entry point visible just above the stj. the stj is effaced. epi-aortic done to view arch. wire introduced into right femoral artery seen in descending aorta. post- bypass: patient is not paced, on norepinephrine infusion. procedure was an ascending aorta replacement and hemi-arch. good biventricular systolic fxn. trace mr. ai is now 1 - 2+. descending aorta is intact. cta of head/neck: 1. unchanged ct of the head with no acute intracranial process demonstrated. 2. density abutting the brachiocephalic artery represents either a false luminal thrombosis or postoperative hematoma compressing the vessel, although the vessel distal to this is patent and opacified. eeg: this is an abnormal portable eeg due to dimunition of voltages broadly over the right side suggestive either of a structural or destructive process of the cortical and subcortical structures on the right versus material interposed between the skull and cortex on the right side. in addition, there were intermittent bursts of mixed frequency slowing noted in the left anterior quadrant suggestive of an underlying area of subcortical dysfunction in that region as well. transient sharp discharges were noted in the right frontal region but appeared most likely artifactual in nature given their narrow morphology and atypical field. on video, there was no clinical correlate for these. the background was disorganized and consisted mainly of a low voltage fast activity which may reflect medication effects from concomitant benzodiazepine administration. if clinically warranted, consideration could be given for a period of extended monitoring to further characterize the abnormalities noted above. mra of head/neack: 1) multiple tiny scattered infarcts in both cerebral hemispheres, suggesting a central source of emboli. 2) patent major intracranial arteries. 3) very limited but grossly normal mra of the neck, which excludes the origins of the carotid and vertebral arteries. abd x-ray: single supine radiograph, which is limited by motion is presented for review. upper abdomen is excluded from the field of view. air and stool are present throughout the colon. small bowel is not dilated. the liver appears to be enlarged. the evaluation for free intraperitoneal air is limited by technique, however, there is no supine evidence of free air. ct of spine: alignment is within normal limits. no fracture is demonstrated. multilevel degenerative changes are seen. there has been a recent median sternotomy. brief hospital course: as mentioned in the hpi, mr. was transferred from osh with a type a aortic dissection. he was emergently taken to the operating room where he underwent an ascending aorta and hemiarch replacement with aortic valve resuspension. please see operative report for surgical details. following surgery he was transferred to the cvicu for invasive monitoring in stable condition. later that night he was weaned from sedation and he was noted to have no left arm movement and onset of rhythmic movement of the right arm (epilepsia partialis continue per neuro). neurology and stroke service were consulted on the morning of post-op day one. he was started on dilantin with continuous eeg monitoring. ct of the head was negative for stroke. both services continued to follow pt. throughout hospital course. he required post-op transfusions for low hct. he remained intubated over the next several days d/t lack of purposeful movements and not following commands. chest tubes and epicardial pacing wires were removed per protocol. on post-op day five he underwent a head mra which revealed multiple tiny scattered infarcts in both cerebral hemispheres, suggesting a central source of emboli. on post-op day six he was again weaned from sedation. neurologically he was more alert and following commands with weaker right side along with tremors. he was then successfully extubated without incident. on post-op day seven he appeared stable and was transferred to the telemetry floor for further medical care. in the morning of post-op day eight he was found unresponsive and hypotensive (bp 50/30's w/ hr in 60's). this episode was felt related to hypotension d/t pt. recently receiving increased dose of beta blocker. received appropriate treatment with increase in responsiveness and was transferred to the cvicu for closer monitoring. he was eventually found to be septic and was started on antibiotics. on post-op day nine he underwent ct of spine to evaluate for vertebral fracture d/t his h/o ankylosing spondylitis and current extremity weakness. study was negative for fracture which reassured weakness not d/t cord compromise. over the next several days patient became increasingly confused and delusional. he required a patient observer and was appropriately treated with haldol, along with psychiatry consult. on post-op day twelve he was transferred back to the telemetry floor for further care. his haldol was weaned. by post-op day 16 he was ready to be transferred to rehab. medications on admission: lisinopril , iron, percocet prn, fentanyl patch discharge medications: 1. phenytoin sodium extended 100 mg capsule sig: one (1) capsule po daily (daily). disp:*30 capsule(s)* refills:*0* 2. levetiracetam 750 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 4. fentanyl 50 mcg/hr patch 72 hr sig: one (1) patch 72 hr transdermal q72h (every 72 hours). disp:*10 patch 72 hr(s)* refills:*0* 5. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 6. 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* 7. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed. disp:*30 tablet(s)* refills:*0* 8. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). disp:*10 tablet(s)* refills:*0* 9. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 10. labetalol 200 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*0* 11. vancomycin in dextrose 1 gram/200 ml piggyback sig: one (1) bag intravenous q 12h (every 12 hours). disp:*60 bag* refills:*0* 12. outpatient lab work weekly cbc/diff, bun/cre, esr, crp, and vancomycin trough faxed to at infectious diseases ( discharge disposition: extended care facility: rehab unit at - discharge diagnosis: type a aortic dissection s/p ascending aorta and hemiarch replacement post-op seizures pmh: hypertension, hemorrhoids, ankylosing spondylitis, subarachnoid hemrrhage (rupture of cerebral aneurysm) s/p craniotomy and clipping with vp shunt, occasional migraines, hydrocephalus, right renal cell carcinoma discharge condition: stable/good discharge instructions: 1)please shower daily. no baths. pat dry incisions, do not rub. 2)avoid creams and lotions to surgical incisions. 3)call cardiac surgeon if there is concern for wound infection. 4)no lifting more than 10 lbs for at least 10 weeks from surgical date. 5)no driving for at least one month. followup instructions: dr. in 4 weeks. dr. in 2 weeks. cardiologist in 2 weeks. dr. (infectious diseases) in weeks. call ( to make an appointment. fax weekly cbc/diff, bun/cre, esr, crp and vacomycin trough to at infectious diseases (. obtain cta of chest in 2 weeks. md procedure: venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery enteral infusion of concentrated nutritional substances resection of vessel with replacement, thoracic vessels transfusion of packed cells ventriculopuncture through previously implanted catheter continuous intra-arterial blood gas monitoring diagnoses: other iatrogenic hypotension anemia, unspecified unspecified essential hypertension aortic valve disorders other nervous system complications bacteremia other antihypertensive agents causing adverse effects in therapeutic use dissection of aorta, thoracic delirium due to conditions classified elsewhere iatrogenic cerebrovascular infarction or hemorrhage presence of cerebrospinal fluid drainage device epilepsia partialis continua, without mention of intractable epilepsy ankylosing spondylitis 

Answer: The patient is high likely exposed to