II. Causes: Early Postoperative Fever
- Major surgery
- Results in fever in 15-40% on postoperative day 1 (most without infection)
- Major surgery related early fever resolves in first 24-48 hours (if not infectious)
- Fever in first 48 hours in non-infectious in 90% of cases
- Malignant Hyperthermia (Anesthetic induced)
-
Atelectasis is NOT a cause of fever
- Atelectasis is coincidental with Post-operative Fever and resolves in the same timeline
- Engoren (1995) Chest 107(1):81-4 +PMID:7813318 [PubMed]
- Warlitier (2005) Anesthesiology 102:838-854 +PMID:15791115 [PubMed]
III. Causes: Infectious
- Soft-tissue infection (including Necrotizing Fasciitis)
- Pneumonia
- Clostridium difficile
- Abdominal surgery complications (e.g. anastomotic leak or abscess)
- Urinary Tract Infection
- Infected Joint Replacement (or other infected prosthesis)
- Catheter Related Bloodstream Infection (CRBI)
IV. Causes: Noninfectious
- Atelectasis is NOT a cause of fever (see above)
- Pulmonary Embolism
- Alcohol Withdrawal
-
Adrenal Insufficiency
- Consider Hydrocortisone IV in addition to other management
V. Evaluation
- Evaluate for Sepsis (Vital Signs, SIRS Criteria, Lactic Acid)
- Evaluate for source
- Labs (e.g. Urinalysis)
- Imaging (e.g. Chest XRay, Abdominal CT)
- Obtain cultures (Blood Cultures, Urine Culture)
Images: Related links to external sites (from Bing)
Related Studies
| Concepts | Pathologic Function (T046) |
| ICD9 | 998.5 |
| SnomedCT | 213290006, 157790006, 269448008, 33910007 |
| English | Postoperative infection NOS, postoperative infection, postoperative infection (diagnosis), Infection;post-op, infections post op, infection postoperative, infection post op, infections postoperative, Postoperative infection NOS (disorder), Post-op. infection, Infection: post-op., Postoperative infection, Postoperative infection (disorder), post-op infection |
| Dutch | postoperatieve infectie NAO, postoperatieve infectie |
| French | Infection postopératoire SAI, Infection post-opératoire |
| German | postoperative Infektion NNB, postoperative Infektion |
| Italian | Infezione post-operatoria, Infezione post-operatoria NAS |
| Portuguese | Infecção pós-operatória, Infecção pós-operatória NE |
| Spanish | Infección posoperatoria NEOM, Infección postoperatoria, infección posquirúrgica, SAI, infección posquirúrgica, SAI (trastorno), infección posoperatoria, infección postoperatoria (trastorno), infección postoperatoria |
| Japanese | ｼﾞｭﾂｺﾞｶﾝｾﾝ, ｼﾞｭﾂｺﾞｶﾝｾﾝNOS, 術後感染ＮＯＳ, 術後感染 |
| Czech | Pooperační infekce NOS, Pooperační infekce |
| Hungarian | Postoperativ fertőzés k.m.n., Postoperativ fertőzés |
Ontology: Postoperative fever (C0424786)
| Concepts | Pathologic Function (T046) |
| SnomedCT | 248450003 |
| Italian | Febbre post-operatoria |
| Japanese | 術後発熱, ｼﾞｭﾂｺﾞﾊﾂﾈﾂ |
| Czech | Pooperační horečka |
| Hungarian | Műtét utáni láz |
| English | Postoperative fever, Postoperative fever (finding), fever; postoperative, postoperative; fever |
| Dutch | koorts; postoperatief, postoperatief; koorts, postoperatiekoorts |
| Spanish | fiebre posoperatoria (hallazgo), fiebre posoperatoria, Fiebre postoperatoria |
| Portuguese | Febre pós-operatória |
| French | Fièvre post-opératoire |
| German | postoperatives Fieber |
