Expert: Ronald Levy, M.D. - 12/28/2009

Question
I'm wondering what types of risks there are to being given general anesthesia while having a fever. My 48mth old son has had a fever now for 50days. The cause as of yet, is unknown. He recently has ended up with an ear infection (around 22days now) that wont clear with antibiotics. ENT will be removing adenoids/tonsils, irrigating his ear and taking cultures. Basically examining inside his ear. He will also be getting a PICC line for antibiotics after for the ear. His neuro would like to do muscle biopsies to test for mito also. My son has several other diagnosis as well. One of them being mastocytosis, which already puts him at very high risk for anesthesia. I'm very concerned about him being put to sleep for this procedure. Another note that you may need to know is that this fever started in post op from an EGD and has never went away. We have ruled out any viruses and urinary issues, but other than that not much else has been tested for. What kind of risks can he have, other than the normal risks everyone has with anesthesia. Could this be a problem? I am asking for a second opinion. Only person I've spoke with is his ENT on this regard. What is your opinion on this issue. Any thoughts would be greatly appreciated. The surgery is in a week, so as soon as possible would be much appreciated. Thank you. Concerned mother.

Answer
With regard to anesthesia in the presence of fever, it is generally not an issue if the problem is not of respiratory origin. In those cases, the patient is at higher risk for laryngo or bronchospasm. Furthermore, there is a slightly higher chance of pneumonia. Is the fever is of other origin, this is not a problem. As for the Mastocytosis, while there is a higher risk of anesthesia, it is usually not a problem. I have attached a link to a medical paper specifically on this issue (http://www.anesthesia-analgesia.org/cgi/content/abstract/107/2/422). I don't think the EGD had anything to do with it (unless there was a perforation at the time of the study).

Hope this helps,

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston