Post-Appendectomy: Persistent Low-Grade Fever, Dizziness, and Appetite Loss

After appendectomy, the body often experiences elevated temperature, dizziness, and decreased appetite?

Hello Doctor, in mid-July, I had a continuous high fever of 39 degrees Celsius for two days.
I was taken to the emergency room and found out that my appendix had ruptured.
The attending physician administered antibiotics for three days before performing an appendectomy.
After the surgery, I rested in the hospital for a few days, and my body temperature stabilized around 36.7 degrees Celsius before being discharged.

A week after discharge, I suddenly experienced nausea, a significant decrease in appetite (eating less than two meals a day), dizziness, and a slightly elevated body temperature ranging from 37.2 to 37.5 degrees Celsius (never exceeding 37.5).
I returned to the original surgeon, who ordered blood tests and X-rays, all of which came back normal.
I was then referred to an ENT specialist, who also conducted X-rays and blood tests with no issues found.

Next, I was sent to an infectious disease specialist, who performed additional blood tests to check my immune system.
After waiting about a week, my appetite improved, but my body still felt warm, and I lacked energy, experiencing slight dizziness.
The blood test results showed that my tests were normal, except for slightly elevated white blood cell counts.
The doctor noted that my lymph nodes felt smaller than the previous week and suggested that my body was fighting a viral infection, but did not specify which virus or the cause of the infection.
He mentioned that I should return to normal in about a week, but if my symptoms did not improve, I should come back for further evaluation.
Since the appendectomy, my appetite has only returned to about 70-80% of what it used to be.
I read online that appetite typically normalizes after surgery.
While waiting for the blood test results from the infectious disease specialist, I measured my ear temperature at home in the morning, which was 36.7 degrees Celsius, later rising to 37.2 to 37.3 degrees Celsius.
We use a Braun ear thermometer at home, which states that a temperature above 37.7 degrees Celsius is considered a fever.
My family members' temperatures ranged from 36.8 to 37 degrees Celsius, but my temperature tends to be 1 to 2 degrees higher than theirs, which is quite concerning to me.

Ri Ri, 20~29 year old female. Ask Date: 2022/08/20

Dr. Hong Yuanbin reply Internal Medicine

Hello, based on your description, the main issues seem to be elevated body temperature and poor appetite.
I'm not sure if there are any other discomforts, including those related to the surgical area or other parts of the body.
If there are, it may be necessary to conduct examinations focused on those areas.
If there are no other symptoms, it's worth noting that some individuals may occasionally have a body temperature around 37.3°C, which can still be considered within the normal range and may not indicate a problem.
If that's the case, I recommend continuing to monitor the situation.
Thank you for your inquiry.

Reply Date: 2022/08/20

More Info

After undergoing an appendectomy, it is not uncommon for patients to experience a range of symptoms, including persistent low-grade fever, dizziness, and appetite loss. These symptoms can be concerning, especially after a significant surgical procedure like an appendectomy, which may have been complicated by a ruptured appendix.
Firstly, it is important to understand that after surgery, the body goes through a healing process that can manifest in various ways. A low-grade fever, typically defined as a temperature between 37.2°C (99°F) and 38°C (100.4°F), can be a normal response to surgery as the body fights off potential infections and heals. However, persistent fever, especially if it is accompanied by other symptoms like dizziness and loss of appetite, warrants further investigation.

In your case, the fever you are experiencing (ranging from 37.2°C to 37.5°C) is slightly elevated but does not meet the criteria for a fever as defined by most medical standards (which is typically above 38°C). The fact that your blood tests and X-rays have returned normal results is reassuring, but it does not completely rule out the possibility of an underlying issue. Elevated white blood cell counts can indicate an ongoing infection or inflammation, but since your lymph nodes have decreased in size, this may suggest that your body is responding to whatever viral infection you may have.

Dizziness and appetite loss can also be attributed to several factors post-surgery. Dizziness may stem from dehydration, low blood pressure, or even anxiety related to your health concerns. Appetite loss is common after surgery due to changes in metabolism, pain, and the body’s focus on healing. It is also possible that the medications you were prescribed, including antibiotics, could have affected your gastrointestinal system, leading to nausea and reduced appetite.

Given that your symptoms have persisted for some time, it is crucial to maintain open communication with your healthcare providers. If your symptoms do not improve or worsen, it is advisable to return to your doctor for further evaluation. They may consider additional tests, such as imaging studies or more specific blood tests, to rule out any complications such as abscess formation or other infections that may not have been evident in initial evaluations.

In the meantime, here are some recommendations to help manage your symptoms:
1. Hydration: Ensure you are drinking plenty of fluids to stay hydrated, especially if you are experiencing dizziness.

2. Nutrition: Try to eat small, frequent meals that are easy to digest. Foods like bananas, rice, applesauce, and toast (the BRAT diet) can be gentle on the stomach.

3. Rest: Allow your body to rest and heal. Avoid strenuous activities until you feel better.

4. Monitor Symptoms: Keep a close eye on your temperature and any other symptoms. If your fever rises above 38°C or if you experience new symptoms such as severe abdominal pain, persistent vomiting, or changes in bowel habits, seek medical attention promptly.

5. Follow-Up: Make sure to follow up with your healthcare provider as advised. If you feel that your concerns are not being addressed, do not hesitate to seek a second opinion.

In conclusion, while some post-operative symptoms can be expected, persistent low-grade fever, dizziness, and appetite loss should be monitored closely. Your healthcare team is there to support you, and it is essential to advocate for your health by seeking further evaluation if necessary.

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