Re: prolonged PP fever
From: Betsy Hyde (elishyde@mindspring.com)
Fri Aug 25 15:12:38 2006
per our MFMs it can take 48-72 hours *after* reaching therapeutic
heparin levels to defervesce. She finally got therapeutic levels
this am. Her temps are lower.
--
Betsy Hyde CNM
Branford, CT
On Aug 25, 2006, at 3:55 PM, R. Daniel Braun wrote:
> Doesn't anyone read the case presentations? She's been on Heparin
> for 36 prior to the posting of the case yesterday.
>
> Dan
>
> On 8/25/06, Andrew Folley <agfolley@hotmail.com> wrote:
> Stop the antibiotics and heparinize the patient. andrew
>
> >From: Betsy Hyde < elishyde@mindspring.com>
> >Reply-To: ob-gyn-l@obgyn.net
> >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net >
> >Subject: prolonged PP fever
> >Date: Thu, 24 Aug 2006 20:08:20 -0500
> >
> >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
