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Re: prolonged PP feverFrom: DoctorJoe@aol.comThu Aug 24 20:47:19 2006
In a message dated 8/24/06 8:08:34 PM, elishyde@mindspring.com writes:
> Now 10 days post c/s and still spiking to 101.5. Blood cultures while Start heparin and expect "spiking down" in 48 hours. Classic SPVT is non-tender and unless it's ovarian vein thrombosis, may have negative imaging (CT or MRI) because the veins are very small, rather than the larger ovarian veins. Another possibility is drug fever -- same presentation, possibly eosinophilia, but "spiking down" after D/Cing antibiotics. In this case, Amp is a good suspect. Gent almost never. NOTE: It takes "big ones" to stop all meds in a patient with significant fever. The rationale is, if the EXAM is negative, you can't be that far behind the 8-ball. In fact, if they "spike up" without antibiotics, they may actually show you where the actual infection is by developing some localizing signs or symptoms. On the other hand, if they defervesce, then you've made your Dx. Joe P.
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