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    Suggest treatment for high fever and gall bladder stones

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Posted on Thu, 20 Jul 2017 in Medicines and Side Effects
Question: Hello,
A close relative of mine was admitted to hospital with a high fever and spent several days recuperating. Within two weeks she had to have her Gall Bladder removed due to several Gall Bladder Stones. My relative went in for key hole surgery and came home the next day. Unfortunately, within hours she was readmitted to the emergency room due to a high fever again.

After further tests it seems there was no infection where the operation was and staff seem to be unable to identify what is causing the fever. She had been having hot flushes for several months prior to this and was advised by her doctor that it was her medication. She has since come off strong Arthritic medicine due to the affect it was having on her liver. My relative is on a lot of medication but we don't know if it's her tablet causing bad side effects, whether it's her low immune response (or allergies), or even a bladder infection. This has been suggested to staff but no one is sure of the cause. Do you have any ideas what may be causing the repeat fever?

Thanks for your feedback.
doctor
Answered by Dr. Noble Zachariah 23 minutes later
Brief Answer:
Discussion follows

Detailed Answer:
Hello,

Welcome and thanks for your query.
Fever may be due to several causes and infection is probably the commonest cause.
The infection does not have to be at the site of the surgery but may be at other sites like the bladder if she had a urinary catheter at the time of her cholecystectomy.
Please upload her temperature chart and the investigations like CBC, CRP and urine complete ( routine examination). Let me know her current medications including the different tablets she is taking for other health issues.
Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Noble Zachariah 25 minutes later
Thank you for your response, Doctor.

Unfortunately, I do not have a detailed report or medication list with me. My relative is still in hospital. I do know that when she had her first fever it was before a catheter was fitted. When the fever returned she had not passed urine the day she came home from hospital. When she was readmitted to the emergency room they drained her bladder and refitted a catheter for her second stay in hospital.

I also know that her temperature was 40.3 degrees when she first went into hospital. On the day she returned to hospital the temperature climbed in stages it went up to approximately 39.3, 39.8 and then 40.4. Eventually they managed to bring the temperature down.

The hospital staff said my relative was in Sepsis when she was over 40 degrees. Her heart was skipping beats and she was uncommunicative.
doctor
Answered by Dr. Noble Zachariah 2 hours later
Brief Answer:
Discussion follows

Detailed Answer:
The urinary infection can lead to septicemia as she has reduced immunity. Alteration in sensorium and abnormalities of heart beats are likely to be due to septicemia. It is a serious condition and I hope she will get better.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Noble Zachariah 32 minutes later
Thank you so much for your help Doctor.
doctor
Answered by Dr. Noble Zachariah 5 hours later
Brief Answer:
Welcome

Detailed Answer:
I am interested in knowing the progress of your friend and would appreciate if you would let me know the diagnosis and progress.
Also do get back to me if you have further questions.
Wish you a good day and good health.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Noble Zachariah 15 days later
Hello Doctor,

I thought I would update you with regard to my relative's condition. She was diagnosed with post operative Sepsis.

Please can you provide more information on things the family can do to look out for regarding any future problems with her health.

We regularly monitor my relative's temperature. It has been within the 37 degrees range and on occasions 36 degrees. If the temperature goes above 38 degrees that means there is an infection and if it goes below 36 degrees that is a sign too isn't it?

We need to look out for signs if she isn't passing water.
If there are any rash(es), disorientation, hot and cold sweats, slurring of words, severe muscle pain, etc.

We were told by a Nurse that recording the temperature is not always sufficient since it can appear normal at times especially if there is a low grade fever where the temperature can fluctuate.

We were also told that it is not always easy to diagnose as some people may not present many symptoms.

Due to the kind of illness my relative has had are there any other symptoms we need to look out for, especially early signs.

Many thanks.
doctor
Answered by Dr. Noble Zachariah 4 hours later
Brief Answer:
Welcome back, discussion follows.

Detailed Answer:
Hello,

Welcome back and thanks for updating me.
I am very glad that your relative got over a serious illness and are back with you.
As we had suspected she had septicemia.
In the elderly and immunocompromised infections may not produce high fever. If there is one degree elevation from temperature on waking up and the evening temperature, it may be an indication. A sense of not feeling well, poor appetite, change of mood, change of sleep pattern, frequent urination, discomfort during urination, decrease in urine volume etc can mean an infection. Any change from the usual normal self should alert you.

Do get back to me if you have further queries.
Wish her good health and a good day to both of you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Noble Zachariah 8 minutes later
Thanks for your feedback, Doctor.

So if my relative wakes up say with a temperature of 37.3 degrees and then has an evening temperature of 38.1 degrees that is an indication of an infection? If she wakes up with a normal temperature and it falls below 36 degrees, again that is a sign of infection?

If there is a more frequent sign of urination then this could be a sign of not only a bladder infection but possibly sepsis? She has been very tired the last few days but her temperature appeared in the normal range. The main concern for us is that not only may an infection be present at a given time but that it could potentially lead to sepsis especially since she is immunocompromised and is elderly.
doctor
Answered by Dr. Noble Zachariah 10 minutes later
Brief Answer:
Welcome back, discussion follows.

Detailed Answer:
Temperature variation of more than a degree should alert towards an infection.
Any infection in the elderly and the immunocompromised should be treated early and effectively. Then the chances of septicemia is less. Frequent urination can mean a urinary infection and if untreated can progress to septicemia. A urine examination would help in diagnosing a urinary infection.

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Noble Zachariah 13 minutes later
Doctor, thanks for your further feedback it has been very helpful.
doctor
Answered by Dr. Noble Zachariah 19 minutes later
Brief Answer:
Most welcome.

Detailed Answer:
It was a pleasure interacting with you.

Do get back to me if you have any queries in the future.
God bless.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Noble Zachariah

Internal Medicine Specialist

Practicing since :1974

Answered : 2276 Questions

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