The patient is an elderly woman, beloved in her community, who comes to your surgery with a list of serious problems. She has night sweats and fevers that have been getting worse for the last few years. She has difficulty breathing, and on exam seems to have suffered from some sort of aspiration pneumonia. She has alopecia, having lost many of the individual fibers that used to cover her body. Her normal gastrointestinal flora have been invaded by a few noxious species, and she seems to have lost the variety of normal bacteria that help to ensure normal nutrition and GI function. And her skin is fissured, inflamed, gouged, scraped, denuded, and cracking in many places. These dermatological excoriations are caused by a small but extremely industrious organism whose numbers have grown exponentially over the last few years, displacing and even eliminating other organisms that used to be widely distributed on the skin of our patient. Let me finish this brief history by showing you a picture of the patient.