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,
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)