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Journal of Clinical Microbiology, August 1999, p. 2656-2662, Vol. 37, No. 8
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Disseminated Zygomycosis Due to Rhizopus schipperae after Heatstroke

Gregory M. Anstead,1,* Deanna A. Sutton,2 Elizabeth H. Thompson,2 Irene Weitzman,3,4 Randal A. Otto,5 and Sunil K. Ahuja1

Departments of Internal Medicine,1 Pathology,2 and Otolaryngology,5 University of Texas Health Science Center at San Antonio, San Antonio, Texas 78240-6200; Department of Microbiology, Arizona State University, Tempe, Arizona 85287-17013; and Department of Pathology in Medicine, Columbia University, New York, New York 100274

Received 3 December 1998/Returned for modification 10 January 1999/Accepted 17 March 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.

* Corresponding author. Mailing address: Division of Infectious Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX 78284. Phone: (210) 567-4666. Fax: (210) 567-4670. E-mail: anstead{at}uthscsa.edu.

Journal of Clinical Microbiology, August 1999, p. 2656-2662, Vol. 37, No. 8
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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