1. From the Clinic for Internal Medicine and Geriatrics, St Marien-Hospital Borken, Borken, Germany, and Friedrich-Alexander-Universität Erlangen-Nuremberg, Clinic for Internal Medicine II, Nuremberg Hospital, Nuremberg, Germany. Rainer Wirth provided the case treatment and preparation of the article; Jürgen Bauer and Cornel Sieber provided the critical review.