A 2011 outbreak of necrotizing cutaneous mucormycosis occurred after a force 5
tornado in the central United States. This outbreak included 13 individuals, 5 of whom
died. The etiology was an infrequently encountered mucormycete, Apophysomyces trapezi-
formis. Outbreaks due to mucormycetes have also occurred following tsunamis and volca-
nic eruptions. In these outbreaks, patients receive significant trauma whereby soil and
organic debris such as pieces of wood are introduced into traumatic injuries. In the most
recent outbreak, the patients had multiple traumatic, penetrating injuries. Death in at least
some of the patients in the recent outbreak was likely the result of the traumatic injuries
rather than infection.