Fever C28 P180-181

Question 1

Define postoperative fever.

P180

Answer 1

Temperature >38.5 C or 101.5 F

Question 2

What are the classic W’s of
postoperative fever? (5)
P180

Answer 2

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

Question 3

Give the classic postoperative
timing for the following
causes of postoperative fever:

Atelectasis (Wind)
P180

Answer 3

First 24 to 48 hours

Question 4

Give the classic postoperative
timing for the following
causes of postoperative fever:

UTI (Water)
P180

Answer 4

Anytime after POD #3

Question 5

Give the classic postoperative
timing for the following
causes of postoperative fever:

Wound infection (Wound)
P180

Answer 5

Usually after POD #5 (but it can be

anytime!)

Question 6

Give the classic postoperative
timing for the following
causes of postoperative fever:

DVT/PE/thrombophlebitis
(Walking)
P180

Answer 6

PODs #7 to #10

Question 7

Give the classic postoperative
timing for the following
causes of postoperative fever:

Drug fever (Wonder
drugs)
P180

Answer 7

Anytime

Question 8

What is the most common
cause of fever on
postoperative days 1 to 2?
P180

Answer 8

Atelectasis

Question 9

What is a “complete” fever
workup?
P181

Answer 9

Physical exam (look at wound, etc.),
CXR, urinalysis, blood cultures, CBC

Question 10

What causes fever before
24 postoperative hours?
P181

Answer 10

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

Question 11

What causes fever from
postoperative days 3 to 5?
P181

Answer 11

UTI, pneumonia, IV site infection,

wound infection

Question 12

What is an anesthetic cause
of fever INTRAoperatively?
P181

Answer 12

Malignant hyperthermia—treat with

dantrolene

Question 13

What causes fever from
postoperative days 5 to 10?
P181

Answer 13

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

Question 14

What causes wound
infection on postoperative
days 1 to 2?
P181

Answer 14

Streptococcus
Clostridia (painful bronze-brown weeping
wound)

Question 15

What can cause fever at any
time?
P181

Answer 15

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