Chapter 27: Fever Flashcards

1
Q

Define postoperative fever

A

Temperature >38.5°C or 101.5°F

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2
Q

What are the five classic W’s of postoperative fever?

A
  1. Wind—atelectasis
  2. Water—urinary tract infection (UTI)
  3. Wound—wound infection
  4. Walking—DVT/thrombophlebitis
  5. Wonder drugs—drug fever
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3
Q

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

Atelectasis (Wind)

A

First 24 to 48 hours

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4
Q

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

UTI (Water)

A

Anytime after POD #3

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5
Q

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

Wound infection (Wound)

A

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

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6
Q

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

DVT/PE/thrombophlebitis (Walking)

A

PODs #7 to #10

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7
Q

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

Drug fever (Wonder drugs)

A

Anytime

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8
Q

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

A

Atelectasis (most likely cytokine release from tissue damage!)

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9
Q

What is a “fever” workup?

A
  • Physical exam (look at wound)
  • CXR
  • urinalysis
  • blood cultures
  • CBC
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10
Q

What causes fever before 24 postoperative hours?

A
  • Atelectasis
    • cytokine release
    • β-hemolytic streptococcal or clostridial wound infections
    • anastomotic leak
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11
Q

What causes fever from PODs #3 to #5?

A
  • UTI
  • pneumonia
  • IV site infection
  • wound infection
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12
Q

What is an anesthetic cause of fever INTRAoperatively?

A

Malignant hyperthermia—treat with dantrolene

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13
Q

What causes fever from PODs #5 to #10?

A
  • Wound infection
  • pneumonia
  • abscess
  • infected hematoma
  • Clostridium difficile colitis
  • anastomotic leak
  • DVT
  • peritoneal abscess
  • drug fever
  • PE
  • abscess
  • parotitis
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14
Q

What causes wound infection on PODs #1 to #2?

A
  • Streptococcus
  • Clostridia (painful bronze-brown weeping wound)
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15
Q

What can cause fever at any time?

A
  • IV site infection
  • Central line infection
  • Medications
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16
Q

38-year-old female diabetic with cellulitis on broad-spectrum antibiotics for 2 weeks develops fever, massive diarrhea, and abdominal pain

A

C. difficile colitis

17
Q

27-year-old woman who following menses develops rash,hypotension, and fever

A

Toxic shock syndrome