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What Causes Low Grade Fever?

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Posted on Fri, 4 Apr 2014
Question: I had surgery on 26 July 12, removal of spleen, misdiagnosed for 11 months as nerve issue, felt good for 3 weeks and then several XXXXXXX seromas formed and filled to the point I felt I would burst above and below spleen incision. I didn't have drain tubes and fluid never aspirated. I can't get anyone to believe me that there still there cause there not showing up on cat scan but I know they are there because the fullness and pressure never went away and I watched these areas bulge with fluid. I just kept hearing military doctors say fluid will just absorb. I physically don't feel well, chills, low grade fevers, fullness and I can feel these blisters in my abdomen but have been misdiagnosed for 20 hellish months, and have repeatedly requested these seromas be removed surgically because this is why I feel so physically ill & can't recover from this surgery. Any ideas on how can I get a darn doctor to believe me because I am not functional due this and don't understand why a doctor wouldn't believe me. I verified with a experienced plastic surgeon that he has opened up people that cat scan and mri's also said there wasn't any proof but he believed patient. He said the fluid can be thin and not show up, which is exactly what's happening. These things are in several places and the fluid is trapped, I feel it. I have Tricare and Medicare which no one takes, very few. Any ideas on how I can get a PS to take me on a emergency basis, because I can't wait any longer for this surgery. This is now at a emergency level because issue has been misdiagnoses for so long. I retired military and even VA misdiagnosed me. Its extremely scary because of these low grade fevers. I'm the only one that seems to get this am truly scared. The doctor who could do the surgery only takes cash, any ideas?
doctor
Answered by Dr. Ashish Verma (1 hour later)
Brief Answer: seroma dosent causes fever Detailed Answer: Hi XXXX Thanks for writing to HCM. This is Dr. Ashish Verma, a general surgeon, answering to your query. First thing, seroma dosent causes fever...fever means an infection is there somewhere. Second, seroma dosent last for so long...almost a year...they will either get absorbed or calcified or get infected and turn into abscess...and abscess causes severe pain and HIGH grade fever....and calcification will ALWAYS show on CT scan. Low grade fever is seen in tuberculosis....or mild chronic infection like pneumonia or influenza. Look the function to spleen is to protect against bacterias...specially the capsulated one...and your spleen has already been removed... so now you are prone to infection by them...unless you have been already vaccinated against them...also your age is on the higher side... So just remove from your mind that those seromas are causing fever....they are not...its due to the infection as a result of your decreased immunity...see a physician for the fever...he will get a few blood tests done like blood routine and a chest xray to find the foci of infection... and get treated accordingly by antibiotics. Regarding your pain abdomen...it is highly possible for a nerve to get entrapped in the scar as it was your tenth surgery...as it is very difficult to get a plane after so many surgeries... another thing that can cause pain is your herniated discs... So it will be more fruitful if you concentrate on the source of infection and the fever. Hope that i have answered to all your queries. If you have further queries, i will be glad to answer. Regards Dr. Ashish Verma
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Ashish Verma (16 minutes later)
I tried for 10 long months for the VA to pay for this outside Plastic surgeon, who specializes in seroma issue and let me know you don't heal normally when seromas are left in you, which I know after having several surgeries, this is a true statement and have never healed like this. I also am a 100% Disabled Veteran, which I thought the VA would pay for XXXXXXX knowing this went on so long. I am extremely disgusted with the VA, knowing I served my country for over 20 years and this is how they treat their Veterans. I was in trouble several months after surgery, because until you have endured something like this for this amount of time, which is now 30 months and laying down because when you have spleen trauma and seromas, you don't feel well, and then your feeling fine after surgery for several weeks and then the seromas fill up in your body and sit in you month after month, you start having chills and low grade fever and when sitting up you compress the seromas three fold, and breathing problems because I have a pocket of fluid which is near my ribs which I was told by the Disabled Veterans who stated if the VA is going to refuse to pay your XXXXXXX just go to the Plastic Surgeon who will believe you and do surgery and report this as a emergency, and notify the VA within 3 days of surgery, and he says they have to pay the XXXXXXX because of your disability. I just can't continue to watch myself worsen, and let this turn into sepsis and do nothing. I let the doctors at the VA know if this ever happens to you that you will then get it and never let this happen to another patient, it's one thing to make a mistake, because everybody makes them but when I have told them exactly what is causing it and they do nothing, that is scary, and I'm tired of picking up the tab for there horrible mistakes just because they can't believe a patient over a darn Cat Scan. I watched this happen in my body and have never had a seroma just left in me after surgery and nothing is done, and they think you will have a successful postoperative recovery, its not possible with fluid left in your body and the seroma cavity's need to be removed and drain tubes placed and a compression garment worn. Is it possible if I presented a letter from the Disabled Veterans stating the surgery is an Emergency and the Plastic Surgeon has that proof, that the Surgeon would feel assured to proceed with surgery knowing he will get paid. I even called Wounded Warriors Project seeing if they had a money to lend for this surgery. I just need to find a Plastic Surgeon who deals with these issues to do surgery asap, so I can finally feel better and not have to lay here anymore and have no quality of life due to these back to back misdiagnoses. I would appreciate any assistance because you never feel that you will ever be in this position and not be believed over a Cat Scan or MRI. I just need a experienced Plastic Surgeon who knows this can happen, especially when having no drain tubes, who will believe me, do the surgery asap, XXXXXXX these insurances with appropriate coding. I had none of these issues prior to surgery and this happened after fluid filled up, and fullness and pressure, and bulging above and below incision happened due to fluid and my body couldn't keep up with the amount of fluid my body was producing. The fluid is stagnating in my body and that's why I don't feel well for all these months, I felt fine prior to surgery. Thank-you for your assistance or referral to a PS, who would be willing to XXXXXXX my Insurance and the VA. Respectfully, XXXX USN/Ret/100% Disabled Vet
doctor
Answered by Dr. Ashish Verma (1 hour later)
Brief Answer: its not seroma...its fat Detailed Answer: Hi, As i had told you earlier... seromas form in immediately postoperative period and if you were fine for several weeks, then there is no question of seroma formation at a later time. What i think that you are calling seroma is actually your abdominal fat...which is the norm in a disabled person post major surgery, due to lack of activities...you tend to start gaining weight. This abdominal fat behaves in exactly the same way you have describes...the collect between the scars as scar is a fibrosed are where no fat cells are there...the between area is normal with fat cells...and when you sit up, they too compress and make breathing a difficult task...seroma on the other hand does not gets limited by the scars as it is inside the peritoneal cavity, and is very easily picked up by ct scan or even a simple ultrasound. The fever...as i had explained earlier, is due to low immunity post spleen removal, leading to chronic infection. You get a complete blood count....your ESR will be raised and even your total WBC count. All you need is antibiotics for the infection and loosing weight by diet regulation. Regards Dr. Ashish Verma
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Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Dr. Ashish Verma

General Surgeon

Practicing since :2008

Answered : 1290 Questions

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What Causes Low Grade Fever?

Brief Answer: seroma dosent causes fever Detailed Answer: Hi XXXX Thanks for writing to HCM. This is Dr. Ashish Verma, a general surgeon, answering to your query. First thing, seroma dosent causes fever...fever means an infection is there somewhere. Second, seroma dosent last for so long...almost a year...they will either get absorbed or calcified or get infected and turn into abscess...and abscess causes severe pain and HIGH grade fever....and calcification will ALWAYS show on CT scan. Low grade fever is seen in tuberculosis....or mild chronic infection like pneumonia or influenza. Look the function to spleen is to protect against bacterias...specially the capsulated one...and your spleen has already been removed... so now you are prone to infection by them...unless you have been already vaccinated against them...also your age is on the higher side... So just remove from your mind that those seromas are causing fever....they are not...its due to the infection as a result of your decreased immunity...see a physician for the fever...he will get a few blood tests done like blood routine and a chest xray to find the foci of infection... and get treated accordingly by antibiotics. Regarding your pain abdomen...it is highly possible for a nerve to get entrapped in the scar as it was your tenth surgery...as it is very difficult to get a plane after so many surgeries... another thing that can cause pain is your herniated discs... So it will be more fruitful if you concentrate on the source of infection and the fever. Hope that i have answered to all your queries. If you have further queries, i will be glad to answer. Regards Dr. Ashish Verma