Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Low Grade Fever When Diagnosed With Acute Appendicitis?
Question: Hello. I have had appendicitis three yrs ago. They did not operate because of waiting time and did it with antibiotics.
I have had dull pain in right quadrant all my life when pressurin on it, and a straight Line below the belly button.
After the acute appendicitis it has returned every now and then with pain across lower belly and in the area i assume the appendix is located. But not shown on blood work or ct without contrast. I Wonder if it could be i have chronic appendicitis? Would this be treat able with medicine?
I have numerous other health issues and afraid a operation would be hard on me.
No fever. But feels like i have low grade fever and pain also wanders the the lower back.
I have had dull pain in right quadrant all my life when pressurin on it, and a straight Line below the belly button.
After the acute appendicitis it has returned every now and then with pain across lower belly and in the area i assume the appendix is located. But not shown on blood work or ct without contrast. I Wonder if it could be i have chronic appendicitis? Would this be treat able with medicine?
I have numerous other health issues and afraid a operation would be hard on me.
No fever. But feels like i have low grade fever and pain also wanders the the lower back.
Brief Answer:
Colitis - typhlitis or IBS is possible...
Detailed Answer:
Hi.
Thanks for your query, albeit specific.
To recapitulate: Male/41 - dull pain in right quadrant on pressure - diagnosed as appendicitis three years ago - given antibiotics - was not operated due to waiting time - pain returns now and then since appendicitis - not shown on blood work and plain CT - numerous other health issues - hence afraid of surgery - feels low-grade fever - pain wanders to lower back - wants to know whether this can be a chronic appendicitis and would this be treatable with medicines ....
Since pain and tenderness are present since long back the most probable cause I can think of, with the history that you have provided, to be typhlitis that is colitis or inflammation of the starting point of the colon, the end point of the small intestine and appendix in the right iliac fossa.
Since appendix is a part of this area, it too will be inflamed and hence can show the symptoms and signs.
It may be dormant when the blood work and CT scan was done - ideally one needs a Contrast enhanced CT scan to show - if the contrast is not contraindicated.
I would advise you the following in such a situation:
Send the stool for routine microscopy tests for three consecutive days as this can give a lot of information. Also get urine tests done.
Clinical evaluation, examination by a General Surgeon or take a second opinion of another Surgeon and further investigations to get an appropriate diagnosis and medical management to begin with. An antibiotic active against intestinal infection, Metronidazole, and other medications as may be required.
Just see the results, it can be dramatically good and your problem may be over.
If no results, then you would need additional investigations of colonoscopy and others as needed.
Diagnostic Laparoscopy is a good option as it helps in a proper diagnosis and also may help for definitive treatment as anything positive is found out.
If a definitive diagnosis is not made and all the investigations are normal a possibility of IBS that is irritable bowel syndrome can be considered.
I hope this answers your query and helps you in the further exploration for the cause and get a plan of definitive management.
Please feel free to ask for further relevant queries if you feel that there is a gap of communication.
Regards
Colitis - typhlitis or IBS is possible...
Detailed Answer:
Hi.
Thanks for your query, albeit specific.
To recapitulate: Male/41 - dull pain in right quadrant on pressure - diagnosed as appendicitis three years ago - given antibiotics - was not operated due to waiting time - pain returns now and then since appendicitis - not shown on blood work and plain CT - numerous other health issues - hence afraid of surgery - feels low-grade fever - pain wanders to lower back - wants to know whether this can be a chronic appendicitis and would this be treatable with medicines ....
Since pain and tenderness are present since long back the most probable cause I can think of, with the history that you have provided, to be typhlitis that is colitis or inflammation of the starting point of the colon, the end point of the small intestine and appendix in the right iliac fossa.
Since appendix is a part of this area, it too will be inflamed and hence can show the symptoms and signs.
It may be dormant when the blood work and CT scan was done - ideally one needs a Contrast enhanced CT scan to show - if the contrast is not contraindicated.
I would advise you the following in such a situation:
Send the stool for routine microscopy tests for three consecutive days as this can give a lot of information. Also get urine tests done.
Clinical evaluation, examination by a General Surgeon or take a second opinion of another Surgeon and further investigations to get an appropriate diagnosis and medical management to begin with. An antibiotic active against intestinal infection, Metronidazole, and other medications as may be required.
Just see the results, it can be dramatically good and your problem may be over.
If no results, then you would need additional investigations of colonoscopy and others as needed.
Diagnostic Laparoscopy is a good option as it helps in a proper diagnosis and also may help for definitive treatment as anything positive is found out.
If a definitive diagnosis is not made and all the investigations are normal a possibility of IBS that is irritable bowel syndrome can be considered.
I hope this answers your query and helps you in the further exploration for the cause and get a plan of definitive management.
Please feel free to ask for further relevant queries if you feel that there is a gap of communication.
Regards
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Wow that was fast! Thank you for Your good advice!
Would you think this is dangerous acute like for right now, or can I wait to my doctors appointment in two days?
It does NOT feel as bad as when i got the appendicitus first time, which was acute. And I have had this , like right now, many times since then, and it has passed by itself.
But in my head, it feels like the appendix- its like very tight feeling and some cramps sometimes in which I feel is exactly where the appendix is located. Bbut I also am tender like in a straight line across the belly below the navel.
So I should ask my doctor to consider antibitotics to see?
Would you think this is dangerous acute like for right now, or can I wait to my doctors appointment in two days?
It does NOT feel as bad as when i got the appendicitus first time, which was acute. And I have had this , like right now, many times since then, and it has passed by itself.
But in my head, it feels like the appendix- its like very tight feeling and some cramps sometimes in which I feel is exactly where the appendix is located. Bbut I also am tender like in a straight line across the belly below the navel.
So I should ask my doctor to consider antibitotics to see?
Brief Answer:
Watch for symptoms and aggravation.
Detailed Answer:
Thanks for your appreciation.
It is never possible to actually foresee what can happen in future due to the local responses to the disease process unless a proper diagnosis is done as explained above.
It is the combination of clinical evaluation, investigations and their correlation that will decide the future course of actions.
If the problem is not severe, your can certainly wait for two days as this i being recurrent problems but keeping in mind to visit ER if the symptoms get aggravated.
I can understand the feeling you must be going through once the suffering starts, the stress and anxiety and the best part is to get a proper diagnosis to get a proper plan of management.
I hope this answer helps you further.
Please feel free to ask for any relevant queries, will be happy to assit you further.
Watch for symptoms and aggravation.
Detailed Answer:
Thanks for your appreciation.
It is never possible to actually foresee what can happen in future due to the local responses to the disease process unless a proper diagnosis is done as explained above.
It is the combination of clinical evaluation, investigations and their correlation that will decide the future course of actions.
If the problem is not severe, your can certainly wait for two days as this i being recurrent problems but keeping in mind to visit ER if the symptoms get aggravated.
I can understand the feeling you must be going through once the suffering starts, the stress and anxiety and the best part is to get a proper diagnosis to get a proper plan of management.
I hope this answer helps you further.
Please feel free to ask for any relevant queries, will be happy to assit you further.
Above answer was peer-reviewed by :
Dr. Kampana
Hi again. I have been at docs, and took some bloodwork. Not returned results yet.
However: Will they treat an cronic appendicitus With antibiotics?
If not- With my Medical history, i am scared for the operation that i wont be able to cope. I have had findings of mobitz pauses (two) during a ecg 24 hr, and I have a lot of issues With irregular heart rythm etc. My list is like a long borrelia list, you know?
Sop- is the anastetics same as other ones? I do know of a guy in my area that died during an operation.
However: Will they treat an cronic appendicitus With antibiotics?
If not- With my Medical history, i am scared for the operation that i wont be able to cope. I have had findings of mobitz pauses (two) during a ecg 24 hr, and I have a lot of issues With irregular heart rythm etc. My list is like a long borrelia list, you know?
Sop- is the anastetics same as other ones? I do know of a guy in my area that died during an operation.
Brief Answer:
Do not be scared
Detailed Answer:
Thanks for your feedback.
Understood your concerns about the Heart condition, anesthesia and surgery since there was a death of a person you knew during operation.
Very true, but the anesthetist would be taking all the precaustion in such a case assisted by the Cardiologist or whoever is needed.
Secondly the present condition is not yet fully diagnosed hence the need of further clinical evaluation preferably by a General Surgeon and investigations to support the proper diagnosis. This alone can decide the plan of management as discussed above.
Anesthetics would be cardio-safe hence no need to worry.
get checked by a Cardiologist also.
Do not be scared as such complicated cases are no routinely done with extra safety and precautions.
Do not be scared
Detailed Answer:
Thanks for your feedback.
Understood your concerns about the Heart condition, anesthesia and surgery since there was a death of a person you knew during operation.
Very true, but the anesthetist would be taking all the precaustion in such a case assisted by the Cardiologist or whoever is needed.
Secondly the present condition is not yet fully diagnosed hence the need of further clinical evaluation preferably by a General Surgeon and investigations to support the proper diagnosis. This alone can decide the plan of management as discussed above.
Anesthetics would be cardio-safe hence no need to worry.
get checked by a Cardiologist also.
Do not be scared as such complicated cases are no routinely done with extra safety and precautions.
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
