Q: My 64 years old father was diagnosed with benign meningioma in the brain and underwent surgery two weeks back. A day after the surgery, he caught fever and the doctors told us that it was due to some infection in the blood and urine as the blood cell count was above 15000 and the urine contained pus cells. My father has been prescribed antibiotics for more than 10 days now and this has decreased the blood count and the pus cells. My father still gets fever for an hour or so twice a day and his temperature rises to 99 - 99.8 F. On getting fever, he loses his ability to understand clearly and he urinates on the bed too. Can you explain why is this so? How long will it take for the fever to vanish if at all it is due to the infection? What else could be the cause of this fever? Could it be because of the surgery? What all should I enquire from his surgeon?

A:You have not told us the location of the meningioma. If the patient is right handed and the meningioma was located over the left half of the forebrain, especially the part termed the parietal lobe, there could be episodes of inability to understand what is said to him and lack of control over the passage of urine. These should settle over time as the swelling of the brain after surgery settles. Since the fever appears to be settling and the white cell count is returning to normal, the doctors appear to have controlled infection - if, indeed, there was any. I suggest you seek guidance from the neurosurgeon on the following: a) The exact cause for inability to control the flow of urine and understand what is said to him. If, as I suspect, you are told these follow expected post-operative swelling of the brain, these should return to normal over the next 3 weeks or so. b) Was there evidence of infection in the brain? If so, where was the infection and is it now under control? Has the infection caused any damage to the brain?