Pyrexia and delirium Flashcards
Post op infection sources and tines
Infection
Day 1-2 – consider a respiratory source
Day 3-5 – consider a urinary tract source
Day 5-7 – consider a surgical site infection or abscess/collection formation
Any day post-operatively – consider infected IV lines or central lines as a source
post op causes of pyrexia
Iatrogenic – drug-induced reaction (e.g. antibiotics or anaesthetic agents) or from a transfusion reaction.
Venous thromboembolism – rare - PE or DVT can cause a low grade fever
Secondary to prosthetic implantation – foreign body
Pyrexia of Unknown Origin
Pyrexia of Unknown Origin
Recurrent fever (>38) persisting for >3wks without an obvious cause, despite >1wk of inpatient investigation
Investigations for pyrexia
Sepsis screening
Blood tests– FBC, CRP, U&Es.
Urine dipstick
Cultures– blood, urine, sputum, and wound swab
Imaging– Chest X-ray
If source of infection cannot be identified
CT scan - anastomotic leak
Doppler USS - DVT
Management of pyrexia
Look for non - infectious causes
Abx
Fluids
Lower Respiratory Tract abx
Co-Amoxiclav 5 days
Lower Urinary Tract abx
Trimethoprim 3 days
Upper Urinary Tract abx
Co-Amoxiclav 14 days
Surgical Site or Cellulitis abx
Flucloxacillin 5 days
IV line
(Central Line) abx
Flucloxacillin 5 days
Intra-Abdominal
Cefuroxime IV
Metronidazole IV
Septic Arthritis
Flucloxacillin IV
Unknown source
Cefuroxime IV
Metronidazole IV
Gentamycin STAT
Delirium
Acute confusional state
Disturbed consciousness and reduced cognitive function
