Disseminated zygomycosis due to Rhizopus schipperae after heatstroke

A 21-year-old woman suffered heatstroke and developed diarrhea while trekki ng across south Texas. The heatstroke was complicated by seizures, rhabdomy olysis, pneumonia, renal failure, and disseminated intravascular coagulatio n, The patient's stool and blood cultures grew Campylobacter jejuni. The pa tient subsequently developed paranasal and gastrointestinal zygomycosis and required surgical debridement and a prolonged course of amphotericin B. Th e zygomycete cultured was Rhizopus schipperae. This is only the second isol ate of R. schipperae that has been described. R. schipperae is characterize d by the production of clusters of up to 10 sporangiophores arising from si mple but well-developed rhizoids, These asexual reproductive propagules are produced on Czapek Dox agar but are absent on routine mycology media, wher e only chlamydospores are observed. Despite multiorgan failure, bacteremia, and disseminated zygomycosis, the patient survived and had a good neurolog ical outcome. Heatstroke has not been previously described as a risk factor for the development of disseminated zygomycosis.