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In 2012, we examined lead exposure in 58 bald eagles Haliaeetus leucocephalus found dead in Iowa, Minnesota, and Wisconsin. We determined lead concentrations in livers, examined differences in exposure among ages and between sexes, and recorded clinical signs consistent with lead poisoning. Most (60%) of the bald eagles had detectable lead concentrations, and 38% of the 58 had concentrations within the lethal range for lead poisoning. We found no differences in exposure based on sex or age, but we did find an inverse relationship between body and liver mass and liver lead concentration. The high percentage of lead-exposed bald eagles encouraged us to further examine potential sources of lead in our local environment. We initiated a study on the Fish and Wildlife Service's Upper Mississippi River National Wildlife and Fish Refuge to investigate if discarded offal piles from hunter-killed deer were a potential source of lead exposure to scavenging wildlife such as the bald eagle. Radiographs showed that 36% of offal piles in our sample area contained lead fragments ranging from 1 to 107 particles per pile. Our study indicated that 1) lead exposure rates for bald eagles found dead in our Upper Midwest study area were high, 2) more than one-third of the bald eagles found dead in Iowa, Minnesota, and Wisconsin had liver lead concentrations consistent with lead poisoning, and 3) discarded offal piles from deer shot with lead ammunition can be a potential source of lead exposure for bald eagles.

Pulmonary mucormycosis is a rare and almost invariably fatal complication that can occur in the context of severe deficits in host defenses. Antemortem diagnosis is difficult and requires a high index of suspicion together with invasive diagnostic techniques. Mucor species exhibit a pronounced affinity to invade vessels; mucormycosis involving the pulmonary vasculature has rarely been documented antemortem, and survival in this context has been rare. In this report, we describe a patient with chronic renal failure and systemic lupus erythematosus who developed extensive invasion of the left main pulmonary artery by mucormycosis. Chest computed tomographic (CT) scans and pulmonary arteriogram demonstrated a massive pseudoaneurysm of the left pulmonary artery; these radiographic findings have not previously been described in mucormycosis. Aggressive combination therapy, employing preoperative amphotericin B (AmB) followed by surgical resection (pneumonectomy) and a full course of AmB, was curative. This favorable outcome supports the role of surgery as adjunctive therapy, and it underscores the need for early diagnosis and aggressive treatment.

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