Fever

Question 1

What is postoperative fever?

Answer 1

Temperature > 38.5 (or 101.5)

Question 2

What are the 5 classic Ws of postoperative fever?

Answer 2

Wind (atelectasis)
Water (UTI)
Wound (wound infection)
Walking (DVT/thrombophlebitis)
Wonder drugs (drug fever)

Question 3

What is the classic timing of postoperative atelectasis?

Answer 3

First 24-48 hours

Question 4

What is the classic timing of postoperative UTI?

Answer 4

Anytime after POD #3

Question 5

What is the classic timing of postoperative wound infection?

Answer 5

Usually after POD #5 (but it can be anytime)

Question 6

What is the classic timing of postoperative DVT/PE/thrombophlebitis?

Answer 6

PODs #7-10

Question 7

What is the classic timing of postoperative drug fever?

Answer 7

Anytime

Question 8

What is the most common cause of fever on PODs #1-2?

Answer 8

Atelectasis

Question 9

What is the complete fever workup?

Answer 9

Physical exam, CXR, U/A, blood cultures, CBC

Question 10

What causes fever before 24 postoperative hours?

Answer 10

Atelectasis, B-hemolytic streptococcal or clostridial wound infections, anastomotic leak

Question 11

What causes fever from POD #3-5?

Answer 11

UTI, pneumonia, IV site infection, wound infection

Question 12

What is an anesthetic cause of fever intraoperatively?

Answer 12

Malignant hyperthermia (treat with dantrolene)

Question 13

What causes fever from POD #5-10?

Answer 13

Wound infection, pneumonia, abscess, infected hematoma, C. difficile colitis, anastomotic leak, DVT, peritoneal abscess, drug fever, PE, parotitis

Question 14

What causes wound infection on POD #1-2?

Answer 14

Streptococcus or Clostridium

Question 15

What can cause fever at any time post-op?

Answer 15

1. IV site infection
2. Central line infection
3. Medications