eye disorders
Cavernous Sinus Thrombosis
Treatment of Cavernous Sinus Thrombosis
IV high-dose antibiotics Sometimes corticosteroids Sometimes anticoagulation Initial antibiotics for patients with cavernous sinus thrombosis includenafcillinoroxacillin1 to 2 g every 4 hours combined with a 3rd-generation cephalosporin (eg,ceftriaxone1 g every 12 hours). In areas where methicillin-resistantS. aureusis prevalent,vancomycin1 g IV every 12 hours should be substituted fornafcillinoroxacillin. A drug for anaerobes (eg,metronidazole500 mg every 8 hours) should be added if an underlying sinusitis or dental infection is present. In cases with underlying sphenoid Treatment , surgical sinus drainage is indicated, especially if there is no clinical response to antibiotics within 24 hours. Secondary treatment for cavernous sinus thrombosis may include corticosteroids (eg,dexamethasone10 mg IV or orally every 6 hours) for cranial nerve dysfunction. Anticoagulation is controversial; unfractionated and low-molecular-weightheparinhave been used in patients without contraindications, but evidence establishing their efficacy will require further study. 