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Toumi, A., Larbi Ammari, F., Loussaief, C., Hadhri, R., Ben Brahim, H., Harrathi, K., Ben Romdhane, F., Koubaa, J. and Chakroun, M. (2012) Rhino-orbito-cerebral mucormycosis: Five cases. Médecine et Maladies Infectieuses, 42, 591-598. doi:10.1016/j.medmal.2012.10.001

has been cited by the following article:

• TITLE: Rhino-orbito-cerebral mucormycosis complicated with an ophthalmic artery occlusion followed by subarachnoid hemorrhage

  AUTHORS: Kun Wook Kang, Young Ki Kwon, Jae Pil Shin, In Taek Kim, Dong Ho Park

  KEYWORDS: Intracranial Aneurysm; Mucormycosis; Ophthalmic Artery; Rhino-Orbito-Cerebral Mucormycosis; Subarachnoid Hemorrhage

  JOURNAL NAME: Case Reports in Clinical Medicine, Vol.2 No.6, August 28, 2013

  ABSTRACT: A 70-year-old female with poorly controlled diabetes developed sudden visual loss, ptosis and complete ophthalmoplegia of the right eye. Funduscopic examination showed the pale retina and the cherry red spot in the right eye. Fluorescein angiography and indocyanine green angiography demonstrated the absence of retinal arterial filling and choroidal perfusion in the right eye even 20 minutes after injecting the dye. The patient was diagnosed with right ophthalmic artery occlusion. Computed tomography (CT) showed diffuse mucosal thickening in the right ethmoidal sinus. Based on the clinical findings and endoscopic biopsy result, mucormycosis was confirmed. Amphotericin B (40 mg/day) and ceftriaxone (2 g/day) were intravenously administered. Despite the improvement of the right ethmoidal sinusitis and the right proptosis, the patient deteriorated into a comatose state after 19 days of systemic amphotericin B therapy. Although the previous CT showed no cerebral aneurysm, a repeated CT showed newly developed posterior communicating artery aneurysm and the subarachnoid hemorrhage. Despite the amphotericin B treatment and the improvement of the sinusitis, mucormycosis could cause sudden cerebral aneurysm rupture and subarachnoid hemorrhage resulting in coma.