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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.

clinical infectious diseases/clinical infectious diseases (online. university of chicago. press)

Milkers’ Nodules Complicated by Erythema Multiforme and Graft‐versus‐Host Disease after Allogeneic Hematopoietic Stem Cell Transplantation for Multiple Myeloma