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Had CABG Surgery, Having Fever Post Surgery. Blood Test Report Shows High CRP. What Is The Right Solution To This?
my father went a cabg surgery x 2 with ef 35 to 40 % . after the surgery with in 2 months he got fever which persisted for more then 15 days he was admitted in a hospital. he reamianed well for one month but again got fever . which went 102 . he had blood test and the report show crp( c reactive protien ) was 7.71 mg/l high senstive , ESR is 47 and TLC is 14.1 and leucocytes is 2-3? can you tell what is the right solution for this and what are its risks? his age is 54 years, weight is 67 kg.
Tue, 10 Jul 2012
Hi Divya,
Thanks for writing in.
I am a cardiologist and read your mail with diligence.
This is post surgical infection with possibly septicemia. High ESR, High tolal leukocytes count 14100 with Differential count what you have mentioned is not clear. High CRP does not hep. His ejection fraction was on the lower side so first possibility remains resolving or persistent pneumonia. Hospital acquired infection are usually recalcitrant. If his blood pressure is maintained, he is alert and renal functions are not impaired. It would be better to find the organism responsible for this fever. Suggest to your doctor to stop all antibiotics for 3 days then repeat blood cultures for aerobic, anaerobic and fungal infections. Not to forget tuberculosis and Infective endocarditis.
Look for urinary tract infection. Also include in fever work up the causes related to surgery that is sternal wound infection, sub phrenic abscess and wound infection of various catheter side. In short work up for Pyrexia (Fever) of unknown origin. That should be one way to resolve -please discuss this with the treating physician and surgeon for ultimately they are the one on the site doing the job.
With Best Wishes
Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/healthcaremagic.com/dr-anil-grover/63370
Thanks for writing in.
I am a cardiologist and read your mail with diligence.
This is post surgical infection with possibly septicemia. High ESR, High tolal leukocytes count 14100 with Differential count what you have mentioned is not clear. High CRP does not hep. His ejection fraction was on the lower side so first possibility remains resolving or persistent pneumonia. Hospital acquired infection are usually recalcitrant. If his blood pressure is maintained, he is alert and renal functions are not impaired. It would be better to find the organism responsible for this fever. Suggest to your doctor to stop all antibiotics for 3 days then repeat blood cultures for aerobic, anaerobic and fungal infections. Not to forget tuberculosis and Infective endocarditis.
Look for urinary tract infection. Also include in fever work up the causes related to surgery that is sternal wound infection, sub phrenic abscess and wound infection of various catheter side. In short work up for Pyrexia (Fever) of unknown origin. That should be one way to resolve -please discuss this with the treating physician and surgeon for ultimately they are the one on the site doing the job.
With Best Wishes
Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/healthcaremagic.com/dr-anil-grover/63370
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