Avian botulism and avian chlamydiosis in wild water birds, Benton Lake National Wildlife Refuge, Montana, USA.

In 1999, the U.S. Geological Survey (USGS) National Wildlife Health Center, Madison, Wisconsin, conducted a diagnostic investigation into a water bird mortality event involving intoxication with avian botulism type C and infection with avian chlamydiosis at the Benton Lake National Wildlife Refuge in Montana, USA. Of 24 carcasses necropsied, 11 had lesions consistent with avian chlamydiosis, including two that tested positive for infectious Chlamydophila psittaci, and 12 were positive for avian botulism type C. One bird tested positive for both avian botulism type C and C. psittaci. Of 61 apparently healthy water birds sampled and released, 13 had serologic evidence of C. psittaci infection and 7 were, at the time of capture, shedding infectious C. psittaci via the cloacal or oropharyngeal route. Since more routinely diagnosed disease conditions may mask avian chlamydiosis, these findings support the need for a comprehensive diagnostic investigation when determining the cause of a wildlife mortality event.

Milkers' nodules complicated by erythema multiforme and graft-versus-host disease after allogeneic hematopoietic stem cell transplantation for multiple myeloma.

We describe a case of cow-transmitted parapoxvirus infection--also known as milkers' nodules--after a hematopoietic stem cell transplantation for multiple myeloma. The infection was complicated by erythema multiforme and acute exacerbation of graft-versus-host disease. Parapoxvirus was confirmed by electron microscopy. The natural history of milker's nodules in immunocompetent hosts is described and compared to that in our immunocompromised patient.