### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
my brother in law has ESRD and has been on HD for the last 4 years. recently it was determined by his heart Dr that he has Aortic Stenosis and that it has progressed significantly over the last year. He is actually in the hospital right now as he had mercer in his blood stream and has been treated with vancomycin after HD treatments to clear the infection. He seems to be not getting better and his mental state seems to be going in and out of lucidity which could be from pain meds he is being treated with for severe back pain. We are all very concerned and would like to know what your thoughts about his situation are. Thank yu.

### output:

Hi, welcome to our site. I am Chat Doctor. Read your query. That is a very significant question and I appreciate your problem. I will try my best to answer your query think this is a very difficult question, and one that should not be commented upon online. The reason being that the condition with ESD, AS, and sepsis, the condition is likely to be grave, and a poor prognosis is probably expected if his sensorial is affected. But one cannot be sure without having seen the reports. Maybe his sepsis is improving. And I am not sure what antibiotics he is getting, what is the level of care he is getting, his status ICU, as in is he on ventilatory support? I have no clues as to the source of the infection, and not even the age. So I cannot really answer your question fairly hope this helps you. Inform the reports mentioned above so I can be of help further. Best of luck. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you. Please do understand that some details could be extracted from a detailed history and examination. Looking forward to your return query with the details asked so that I can help you further.(If the answer has helped you, please indicate this)