Postoperative fever is a common condition challenging doctors to find the right diagnosis, because it can be a hallmark of serious underlying conditions. One third of patients develop fever after surgery depending on type of surgery but only a small percentage turn out to be due to infection. [1 ]
The most common causes have been summarized in a handy
mnemonic: the five Ws. These tend to occur at specific days after surgery (postoperative days or POD). [2 ]
Numerous variants on the same theme may exist: sometimes another W for "Wonder why" may indicate an abscess somewhere in the body or the site of surgery. Of course, this list is not comprehensive:
catheter-related sepsis is also frequent, but also easily recognised. Other important, yet omitted, causes of early post-operative fever include malignant hyperthermia- a potentially life threatening but treatable response to halogenated anesthetics and paralytics, as well as a febrile non-hemolytic transfusion reaction and transfusion-related acute lung injury due to blood products which may have been given during or after the surgery, such as packed red blood cells, platelets or fresh frozen plasma.
Postoperative fever, especially when appearing in the first 24 hours after a major surgery, are most often a result of a natural and non-infectious inflammatory response to tissue injury sustained in the procedure itself, and often requires no medical intervention.
[5 ] [6 ]
Popular culture [ edit ]
first season of , Meredith Grey refers to this mnemonic. Grey's Anatomy
See also [ edit ]
References [ edit ]
^ Walid MS, Woodall MN, Nutter JP, Ajjan M, Robinson JS Jr (2009). "Causes and risk factors for postoperative fever in spine surgery patients". South Med J 102 (3): 283–286. doi: 10.1097/SMJ.0b013e31819676a4. PMID 19204624.
^ David Cline; Latha G. Stead (10 December 2007). . McGraw Hill Professional. pp. 146–. Abdominal Emergencies ISBN 978-0-07-146861-9 . Retrieved . 7 August 2010
^ Pile JC (2006). "Evaluating postoperative fever: a focused approach". Cleve Clin J Med 73 (Suppl_1): S62–6. doi: 10.3949/ccjm.73.Suppl_1.S62. PMID 16570551.
^ Mavros MN, Velmahos GC, Falagas ME (2011). "Atelectasis as a cause of postoperative fever: where is the clinical evidence?". Chest 140 (2): 418–24. doi: 10.1378/chest.11-0127. PMID 21527508.
^ Harrison G Weed, MS, MD, FACP; Larry M Baddour, MD, FIDSA. "Postoperative Fever". UpToDate . Retrieved . 30 June 2011
^ Marino's The ICU Book