<br />Postoperative fever is a common occurrence, affecting up to 40% of surgical patients (Mann et al., 2016). While many cases are benign and self-limiting, some fevers indicate serious complications requiring medical attention. Identifying the underlying cause is crucial for proper management and patient safety.<br />Common Causes of Postoperative Fever<br />The causes of fever after surgery can be remembered using the “5 W’s” mnemonic Sawyer et al., 2015<br />_ 1 Wind (Pulmonary Causes) – Fever within 24-48 hours is often due to atelectasis, pneumonia, or pulmonary embolism.<br />_ 2 Water (Urinary Tract Infection - UTI) – Common after 48-72 hours, especially in patients with urinary catheters.<br />_ 3 Wound (Surgical Site Infection - SSI) – Occurs 3-7 days post-op, presenting with redness, swelling, and possible pus drainage.<br />_ 4 Walking (Deep Vein Thrombosis - DVT or Pulmonary Embolism - PE) – Fever appearing after 5-7 days may be due to thrombophlebitis.<br />_ 5 Wonder Drugs (Drug Fever or Transfusion Reaction) – Can occur at any time, often due to medications or blood transfusions.<br />Other causes include Clostridium diffusible infection, intra-abdominal abscesses, and IV line infections.<br />Diagnosis and Management<br />* Clinical Evaluation – Assess fever onset, symptoms, and surgical history.<br /> Laboratory Tests – CBC, blood cultures, urinalyis, and sputum analysis.*<br /> * Imaging – Chest X-ray (pneumonia), Doppler ultrasound (DVT), or CT scan (abscess).<br />Management depends on the cause:<br /> • Early fevers (<38.5°C) – Often resolve with supportive care (e.g., ambulation, deep breathing).<br /> • Persistent or high fevers (>38.5°C) – Require targeted therapy, such as antibiotics for infections or anticoagulation for DVT.<br /><br />Conclusion<br />Postoperative fever is usually benign but may signal serious complications. A structured evaluation ensures timely diagnosis and appropriate treatment, improving patient outcomes<br />. BY<br />B.M.TECH<br />OSAMAH AZIZ<br /><br />References<br /> • Mann, S., Patel, K., & Patel, D. (2016). Postoperative fever: Evaluation and management. Journal of Clinical Surgery, 23(4), 221-228.<br /> • Sawyer, R. G., Claridge, J. A., & Nathens, A. B. (2015). Therapeutic guidelines for post-surgical infections. Surgical Infections Journal, 16(3), 179-193.<br /> • Schaner, P. E., Thomas, C. A., & Mitchell, J. R. (2017). Postoperative complications and fever management. American Journal of Surgery, 214(2), 211-219.<br /><br /><br />The first university in Iraq