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Bird-Mite Infestation
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     A 46-year-old woman and her husband had their sleep disturbed by pruritus, waking up to find similar, itchy papular lesions over their finger webs (Panel A), axillae, groins, and buttocks. They found small (less than 1 mm) mites (Panel B) moving across their skin, which light microscopy revealed to be Ornithonyssus bursa (Panel C), bloodsucking bird mites commonly found in pigeons' nests. Their pruritus improved after the application of crotamiton to their lesions and after the pigeon's nest hidden under the air conditioner above their bedroom was cleaned. When unexplained scabies-like illness occurs in humans during late spring or early summer, potential avian sources of mites should be considered.

    Tak K. Kong, F.R.C.P.

    Wing K. To, F.R.C.P.A.

    Princess Margaret Hospital

    Hong Kong, SAR, China