ABSTRACT
Unrecognized skin conditions are highly prevalent among the elderly population.[10] Bullous pemphigoid (BP), an autoimmune dermatologic disease with greater incidence in the elderly, typically features pruritus, tense bullae formation, and negative Nikolsky's sign.[1,2] We describe a case of BP in an elderly Veteran that developed insidiously for months before it presented with a life-threatening secondary infection due to Methicillin Resistant Staphylococcus Aureus (MRSA).
Subject(s)
Bacteremia/etiology , Cellulitis/etiology , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Pemphigoid, Bullous/complications , Aged, 80 and over , Cellulitis/microbiology , Diagnosis, Differential , Humans , Male , Pemphigoid, Bullous/pathology , Severity of Illness Index , Skin/pathology , VeteransABSTRACT
An accessory papillary muscle is an uncommon congenital anomaly usually found incidentally on routine cardiac imaging. While frequently asymptomatic, it is occasionally associated with mitral regurgitation, left ventricular dynamic outflow obstruction and hypertrophic cardiomyopathy1 and it is important to differentiate it from other pathological processes including papillary fibroelastoma, left ventricle thrombus, hemangioma, a single papillary muscle with a parachute mitral valve and a left ventricle false tendon. The clinical implication of these findings varies according to the degree of left ventricular out flow obstruction, location and pathology. We report a case that underscores the importance of multimodality imaging in the diagnosis and differentiation of an accessory papillary muscle from other intracardiac masses. [Full article available at http://rimed.org/rimedicaljournal-2017-09.asp].