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All infections need not be accompanied by temperature. It depends on the severity of infection and also differs from person to person. This is a clinical diagnosis and the first doctor cannot be blamed for his opinion and therefore insurance has to pay him too. Sometimes infection may subside only with Keflex
thereby avoiding a surgery. Second doctor also has put you on antibiotics and waiting to see improvement to avoid a surgery as much as possible. You may follow his advice.
Hope this helped