Recognizing the primary source of infection (i.e., facial cellulitis, middle ear, and<unk>  infections) and treating the primary source expeditiously is the best way to prevent<unk> . Antibiotics Broad-spectrum intravenous antibiotics are used until a definite pathogen is found. # Nafcillin 1.5 g IV q4h # Cefotaxime 1.5 to 2 g IV q4h # Metronidazole 15 mg/kg load followed by 7.5 mg/kg IV q6h Vancomycin may be substituted for nafcillin if significant concern exists for infection by methicillin-resistant Staphylococcus aureus or resistant Streptococcus pneumoniae. Appropriate therapy should take into account the primary source of infection as well as possible associated complications such as brain abscess, meningitis, or subdural empyema. All people with<unk>  are usually treated with prolonged courses (3–4 weeks) of IV antibiotics. If there is evidence of complications such as intracranial suppuration, 6–8 weeks of total therapy may be warranted. All patients should be monitored for signs of complicated infection, continued sepsis, or septic emboli while antibiotic therapy is being administered. Heparin Anticoagulation with heparin is controversial. Retrospective studies show conflicting data. This decision should be made with subspecialty consultation. One systematic review concluded that anticoagulation treatment appeared safe and was associated with a potentially important reduction in the risk of death or dependency. Steroids Steroid therapy is also controversial in many cases of<unk> . However, corticosteroids are absolutely indicated in cases of pituitary insufficiency. Corticosteroid use may have a critical role in patients with Addisonian crisis secondary to ischaemia or necrosis of the pituitary that complicates<unk> . Surgery Surgical drainage with sphenoidotomy is indicated if the primary site of infection is thought to be the sphenoidal<unk> es.
Cavernous sinus thrombosis
Mucormycosis
Labyrinthine fistula
Labyrinthitis
Vitreous hemorrhage
Orbital cellulitis
Orbital apex syndrome
Retinal migraine