Re: prolonged PP fever

From: R. Daniel Braun (rd.braun@gmail.com)
Thu Aug 24 20:31:40 2006


Sounds like Ovarian Vein Septic Thrombophlebitris. It should show up on CT. Sometimes never respond to Abx, only to surgical removal of ovarian vein. I had one patient who had a 15 cm in diameter purulent ovarian vein on the right. We had to excise it all the way to the IVC.

Dan

On 8/24/06, Betsy Hyde <elishyde@mindspring.com> wrote: >
> G1P1 now s/p c/s for something or other in labor. Don't remember
> what, and don't think it is relevant to the presentation. It wasn't
> sepsis.
>
> Now 10 days post c/s and still spiking to 101.5. Blood cultures while
> spiking are neg. EKG neg. No hx travel to tropical climates.
>
> Post op course includes normal CT scan, WBC never >11.9, courses of
> triples (amp/gent/clinda and also amp/gent/metronidazole).
>
> Now on amp/gent/metronidazole/heparin x 36 hours and still spiking to
> 101.5. No localizing signs. Patient feels fine.
>
> Today's plans include MRI.
>
> Thoughts???
>
> How long does it take for septic thrombophlebitis to defervese on
> heparin?
>
> Anything else we should consider? I raised the possibility of
> valvular disease and vegetative emboli, but cultures during spikes
> were neg, and EKG was neg as well.
>
> Drug fever???
>
> (MFM is involved as well as the OBs in my practice..this is not a
> midwifery management question...)
>
> Betsy Hyde CNM
> Branford, CT
>

--
R. Daniel Braun

"The way to health is an aromatic bath and scented massage everyday". Hippocrates





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