Disseminated Zygomycosis Due to Rhizopus schipperae after Heatstroke (1999)

A 21-year-old woman suffered heatstroke and developed diarrhea while trekking across south Texas. The
heatstroke was complicated by seizures, rhabdomyolysis, pneumonia, renal failure, and disseminated
intravascular coagulation. The patient's stool and blood cultures grew Campylobacter jejuni. The patient
subsequently developed paranasal and gastrointestinal zygomycosis and required surgical debridement and
a prolonged course of amphotericin B. The zygomycete cultured was Rhizopus schipperae. This is only the
second isolate of R. schipperae that has been described. R. schipperae is characterized by the production of
clusters of up to 10 sporangiophores arising from simple but well-developed rhizoids. These asexual
reproductive propagules are produced on Czapek Dox agar but are absent on routine mycology media, where
only chlamydospores are observed. Despite multiorgan failure, bacteremia, and disseminated zygomycosis,
the patient survived and had a good neurological outcome. Heatstroke has not been previously described as
a risk factor for the development of disseminated zygomycosis.