Post-Surgery Complications: Managing Fever and Possible Infections

Post-operative deterioration after gastric surgery with recurrent fever?

Continuing from the previous issue, I appreciate Dr.
Ke's patience and willingness to respond.
Currently, the patient is intubated and relies on mechanical ventilation.
Previously, the doctor mentioned that all tests were normal (CT, MRI, relevant ultrasounds, EEG, etc.).
On June 3rd, the patient developed a fever and experienced seizures.
The doctor suspects a urinary tract infection, as a urine culture taken on June 3rd indicated the presence of fungi.
However, the long-term urine culture results are still pending, so the doctor has prescribed antibiotics for treatment.
Once the long-term culture results are available, the treatment can be adjusted accordingly.
Therefore, we can only continue to observe the situation.
We maintain a trusting and professional attitude in our communication with the doctor, as they may have their own insights.
The ongoing fever complicates the chances of weaning off the ventilator, and there have been no signs of improvement in the patient's strength.
If there are any reminders or suggestions that could be discussed with the doctor, Dr.
Ke, I would appreciate your input.
Thank you for your response.

takashi, 30~39 year old female. Ask Date: 2010/06/04

Dr. Ke Fangxu reply Surgery

Hello, in response to your question, the common occurrence of seizures in elderly individuals who have been bedridden for a long time often leads to a consultation with internal medicine, where a CT scan of the brain or blood tests are typically requested.
However, based on my personal experience, these tests usually come back normal.
The exact cause remains unknown; sometimes patients improve after their original illness resolves, while other times they do not.
This is generally attributed to vague reasons such as aging, poor physical condition, and degeneration.
To be honest, we can only continue to observe.
The issue of fever is similar; if a urine culture shows fungal growth, it is usually due to long-term antibiotic use.
Whether this represents a significant infection depends on the colony count of the cultured organism.
If the concentration of fungal growth is not high, antifungal medications may not be necessary.
If the white blood cell count is not elevated and the fever is not severe, the current treatment approach can focus on increasing food intake to improve nutritional status, thereby enhancing the patient's immune function and overall physical condition, which may provide a better chance of weaning off the ventilator.

Reply Date: 2010/06/04

More Info

Post-surgery complications can be a significant concern for patients, especially when symptoms such as fever and pain persist. In your case, it appears that you are experiencing ongoing issues following a surgical procedure, which may include a possible urinary tract infection (UTI) indicated by the presence of fungi in your urine culture.
Fever after surgery can be attributed to several factors, including infections, inflammatory responses, or even complications related to the surgery itself. It's essential to differentiate between these causes to provide appropriate treatment. Infections are the most common cause of post-operative fever, and they can arise from various sources, including surgical site infections, urinary tract infections, or pneumonia, especially in patients who have been intubated or on mechanical ventilation.

Given that your doctor has already conducted a thorough evaluation, including CT scans, MRIs, and ultrasounds, and has identified a potential UTI, it is crucial to follow their recommendations closely. The initiation of antibiotics is a standard approach to manage infections, and monitoring your response to treatment will help determine if the right course of action is being taken.
It is also important to communicate any new or worsening symptoms to your healthcare team. For instance, if you experience increased pain, changes in urination, or any signs of systemic infection (such as chills or increased heart rate), these should be reported immediately.
In terms of managing your ongoing symptoms and improving your overall condition, here are some suggestions you might consider discussing with your healthcare provider:
1. Hydration: Ensure you are adequately hydrated, as this can help flush out the urinary system and may assist in recovery from a UTI.

2. Pain Management: If you are experiencing significant discomfort, discuss pain management options with your doctor. They may adjust your medications or suggest alternative therapies.

3. Nutritional Support: Proper nutrition can play a vital role in recovery. If you are able to eat, focus on a balanced diet rich in vitamins and minerals to support your immune system.

4. Physical Therapy: If your condition allows, gentle physical therapy or mobility exercises can help improve your strength and overall recovery.

5. Follow-Up Testing: If your symptoms persist despite treatment, ask your doctor about the possibility of further testing to rule out other complications or infections.

6. Open Communication: Maintain an open line of communication with your healthcare team. If you have concerns or questions about your treatment plan, do not hesitate to bring them up.

In conclusion, while post-surgical complications such as fever and infections can be concerning, they are manageable with appropriate medical care. Your proactive approach in communicating with your healthcare provider and seeking further clarification on your treatment options is commendable. Continue to advocate for your health, and ensure that you are receiving the comprehensive care you need during this recovery period.

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