Fever and mild RUQ pain

Hey all, any guidance on figuring out whether a fever (100.4) indicates ascending cholangitis? No jaundice at the moment, and I’m waiting on Covid test results. I left a message with my GI to see if I need liver labs. But how do I even get labs drawn if I haven’t ruled out Covid yet?

Until it gets up to 101.5 or 102 it probably isn’t cholangitis. I’d send a message to your doctor though to be sure what protocol’s he wants you to follow. If it keeps going up you can go to the ER, they can run all your liver labs and do the rapid COVID test while you are there. At least that was my experience.

I think it depends on the clinic. One place I went did an initial screening – do you have any of these symptoms? I answered yes, and they sent me to a covid testing desk where they took extra precautions.

Good to know, thank you both. I’m still waiting on the COVID results, and no symptoms of it other than the fever. Luckily the fever completely went away overnight, the RUQ pain is mostly gone, and still no jaundice. I think if the fever wasn’t from COVID, maybe it was my body’s response to a stone briefly clogging the stent, but that’s just a guess.

Good news was that my Covid results were negative. But a low fever came back today. I spoke with my GI today, he prescribed oral cipro and metradazinole, with a couple of refills for if this happens again.

I haven’t had much luck getting in touch with my hepatologist. My GI said to try to contacting the doctor who put in the stent, so I’ll try that next. Maybe they can bump up ERCP #2 to this week instead of next week.

I think with a little luck, lots of rest, and plenty of Gatorade, I’ll be fine. But I’ll definitely check in to the ER if my symptoms deteriorate.

Also, a random thought but both times recently when I’ve had PSC specific symptoms, it was after taking a multivitamin. I take one occasionally if I’m feeling off, but there’s maybe some bad stuff in there - I suspect niacin could be a trigger.

Hi. I always went for labs when I had a fever. The GI doctor may need to see you. You absolutely do not want an infection in your bile ducts. Always better to be safe than sorry. If there is a blockage , they can remove it. I was diagnosed in 1990 and got a piece of a girls liver in 2012. I was better by 2016. The drs at the Cleveland Clinic saved my life many times over … you need to know your bilirubin level. It takes quite some time for jaundice to set it.

MB, I was under strict orders that if my temp got to 101.5, to get to the ER.
Post tx, it is call the center if I hit 100.5. I have hit that once, close several other times.

Got the ERCP done yesterday. They removed the old stent, swept down with a balloon and found some pus, took some brushings, and put in a new, wider stent in the same location (common bile duct). Feeling good today. Still on the antibiotics, probably for sometime longer.

I glad you’re feeling better, MB. I always followed up an ERCP with ice cream and popsicles.