Post Operative Fever

Post Operative Fever

1- Malignant hyperthermia
Onset immediately post op

2- Benign postoperative fever
Associated with trauma of surgery and diagnosis of exclusion

3- Pneumonia
Productive cough or dyspnea; evidence of consolidation on lung exam; hypoxemia on arterial blood gases or oximetry; diagnosis confirmed by chest x-ray film

4- UTI
Onset 2-3 days; increased risk associated with urinary tract instrumentation and indwelling urinary catheter

5- Alcohol withdrawl
Onset 2-5 days; history may not show alcohol or drug dependence; other CNS depressants are associated with similar manifestations, but time frame may vary. Alcohol withdrawal symptoms and signs may include hypertension, tachycardia, nausea, piloerection, seizures, and delirium; these peak at 48-96 hours after cessation of drinking.

6- Superficial vein thrombophlebitis

7- Cellulitis
Wound and other surgical infections
Onset 4-10 days; wound infections can occur early in the postoperative period, whereas deeper infections such as abscesses occur later

8- Medication toxicity

9- Deep venous thrombosis/pulmonary embolism
DVT: Unilateral leg swelling; palpable popliteal cord; diagnosis confirmed by Doppler ultrasound
PE: Acute onset dyspnea or pleuritic chest pain; hypoxemia on arterial blood gases or oximetry; diagnosis confirmed by ventilation perfusion scan or CT angiography

10- Blood product transfusion reaction

11- Infected decubitus ulcer

12- Sepsis / bacteremia

Hypotension, altered mental status, or unexplained acidosis with or without evidence of focal infection (sepsis syndrome); diagnosis confirmed by blood cultures
13- Hematoma

14- Myocardial infarction

15- Bowel ischemia/infarction
Periumbilical pain out of proportion to tenderness; other GI symptoms may be associated; abdominal x-ray may show bowel distension and submucosal edema; diagnosis confirmed by mesenteric angiography

16- Hypoadrenalism
Anorexia, hypotension, hyponatremia, or hyperkalemia; diagnosis confirmed by abnormal cosyntropin stimulation test

17- Hyperthyroidism

18- Neuroleptic malignant syndrome
19- Transplant rejection