Fever after D&C

[otto12]

I just had a D&C for post menapausal bleeding. I started getting a fever and chills the next day. I called the surgeon and she had some blood work done and blood cultures. She put me on clindamiacin .  I had sepsis in February after surgery for appendicitis  now in terrified that it's happening again. When I had sepsis I only had a fever no shaking chills or anything else and it took 3 separate days of blood cultures to find it. So I'm home taking clindamiacin  hoping im not making the wrong decision by staying home waiting for the resuls of the cultures they took instead of going to the ER.  Any ideas on what might be going on would help. Thank you.

[mkh9]

That is great news. I thought so but was just being cautious. Happy Holidays to you too.
take care,
mkh9

[otto12]

Temp is back to normal. Doctor took more cultures and CBC to make sure all is ok. Thank you again. Happy holidays!  

[mkh9]

The body does change temperatures throughout the day. Usually in the afternoon is when it goes up. I had 99 the other day when went to the doctors office and didn't even know it and it was in the morning. I am not sick at all and I generally run low. So it is pretty low grade. Not sure about the chills and sweats though. How do you feel? Are you getting your energy back? I'm not sure you are having a problem yet. I know you are worried.  I hope I don't have to go through what you are going through. I am going into menopause and the periods are all over the place. My doctor warned me about possible heavy periods too. Do you feel any pelvic pain now? Has that cleared up? So I would still continue to monitor your temperature. I think you are ok as long as the temperature doesn't change. That is my opinion.
mkh9

[otto12]

My temp is 99.4 it's the morning and I have sweats and chills. Guess the clindamycin didn't knock whatever it is out. Scared. The antibiotic is a strong one don't know what's going to happen now.

[mkh9]

Ok that is good. But since you have a low grade fever still. Keep an eye on your temperature.
kind regards,
mkh9

[otto12]

My blood cultures were negative. I've finished the clindamycin my temp right now is 99.3. Hopefully it doesn't keep going up. Thank you for your help!  

[mkh9]

Usually, if the antibiotic works it will kill the bacteria off and it won't come back. Again, the main thing to watch for is a spike in fever. Since your fever went away that is great. If your blood cultures were negative it is not likely to come back. Usually, they take a large volume of blood at the first blood draw. This helps with assuring they find the bacteria in the blood stream. Just keep an eye on your temperature. I think you will be okay this time.
mkh9

[otto12]

Thanks for asking about the cultures. Still have not heard anything. I called the doctors office and they said if there's any growth they will call back. If not, they won't. Have not heard back. After I'm done with the clindamiacin I hope the fever does not come back. Is it possible for the clindamiacin to keep sepsis at bay for a while?  I hope not. Thank you I'll let you know how it turns out.

[mkh9]

FYI, I got a couple of responses from the American Society for Microbiology group I belong to and they agree that the standard is 5 days of incubation of blood cultures. So whomever you talked to is wrong. It may vary a little in other countries but most follow a very similar time frame.
mkh9

[mkh9]

Hospitals are required to keep blood culture bottles for 5 days. So I don't know who you talked to. Definitely 72 hours if things have changed. This is because some bacteria are slower growing. Whoever you talked to doesn't know what they are talking about. I am a licensed clinical microbiologist and have worked in the clinical laboratory for years. I haven't worked for  a while due to injuries though. I keep up to date though. No I haven't had sepsis but have read many blood cultures in my time. So I know that end of it as well as some issues as to the clinical end of how the patients symptoms are and so forth when they are septic. Maybe it has already been 72 hours for them? I can ask my colleagues how long they are now holding blood culures as I have access to the US hospital system supervisors and so forth news and question site. It may take a couple of days to get a response depending on who answers though. It does sound like you are responding to the antibiotic very well.  No you are not out ol line. You can ask me any thing you like.
mkh9

[otto12]

My temp is normal right now. It was 99 last night not bad. I asked the hospital if they keep the blood cultures longer than this they said no. I'm not happy about that. I'm surprised they talked to me on the phone.  Still nervous since the last time it took more cultures to be positive. Can I ask you if you had sepsis. You seem to know about it.  Sorry if I'm out of line.  Thank you for your help I'll keep you posted.

[mkh9]

That is great news. 48 hours is equally critical time for some other bacteria to come up but the more common ones would have come up by now. How high is your fever? Are you feeling better? You could get another set of blood cultures done if your fever goes up. The fever is the key thing. That is my advice.
mkh9

[otto12]

I received negative results from blood culture so far. I still feel maybe I should have 1 more done as it took cultures on 2 separate days to find sepsis before. My fever so far is a lot better on clindamiacin. Still unsure about this

[mkh9]

p.s. keep an eye on your temperature for any high fevers.
mkh9

[mkh9]

If you are feeling better this soon that is a great sign that the antibiotic is working. It takes a couple of days to kick in. I would keep in touch with a doctor about your results. They should have a negative at 24 hours coming out soon. If it is positive and the drug you are on wouldn't work on that organism they would call you. But since the drug is working so far. It sounds very promising. As the saying goes no news is good news. The antibiotic sensitivity results will take an extra day. But since your doctor is leaving if you don't hear from him then keep in touch with one on staff.

After you know your results and are doing better I would think about getting on a probiotic. Clindamycin is known for causing intestinal problems due to the bacteria Clostridium difficile, so keeping the normal intestinal bacterial flora is important. Not everyone gets this but it is a good precaution to take. I would wait until you are done with the drug then start taking them for  a couple of months. You can get them at Costco, or any local pharmacy. They should have live bacteria that are 'good' bacteria such as lactobacillus sp. and bifidobacteria. Let me know how your results come out. Also, if you have any other questions.
Take care,
mkh9

[otto12]

They didn't take any vaginal swabs. The blood cultures were done yesterday so it's been 24 hours. My doctor is going away for a conference I will have to have the doctor on call see what she can do to get results. I am feeling better on the antibiotics at least so far. After the sepsis I'm terrified about post surgical infections. Thank you for your response.

[mkh9]

Well it sounds like you got an infection from the procedure. The doctor put you on Clindamycin to help knock down whatever infection you have until they get results from the culture(s) they took. You can get chills (rigors) from a high fever. You don't have to have a blood infection to have the chills but its possible too. How long has it been since you had the blood cultures taken? Usually they hold them for 5 days but you should have a preliminary result in about 24 hours-48 hours after the blood was taken. Did they also take a swab of the vaginal area or cervical, or some type near the area where they did the surgery? They will know within 24 hours of the blood culture and up to 48 hours of the wound or genital culture if there is bacteria growing and what type of antibiotic the bacteria is sensitive to. So you should stay on the antibiotic and if you get any worse call the doctor and if you can't reach the doctor you can of course go to the ER. But since they are working on these samples I would try to get the doctor on call to give you some information. In the meantime if you are okay then wait until you hear from them. It depends on how long it has been and if you feel any worse.
mkh9