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Evidence for the Non-Infectious Etiology of Early Postoperative Fever

Published online by Cambridge University Press:  02 January 2015

Richard A. Garibaldi ,
Susan Brodine ,
Sego Matsumiya  and
Miki Coleman
Richard A. Garibaldi*
Affiliation:
Departments of Medicine and Biostalislics, University of Utah College of Medicine
Susan Brodine
Affiliation:
Departments of Medicine and Biostalislics, University of Utah College of Medicine
Sego Matsumiya
Affiliation:
Departments of Medicine and Biostalislics, University of Utah College of Medicine
Miki Coleman
Affiliation:
Departments of Medicine and Biostalislics, University of Utah College of Medicine
*
Department of Medicine, University of Connecticut Health Center, Farmington, CT 06032
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Abstract

In a prospective study of infections in 871 general surgery patients, we identified 81 patients who developed unexplained postoperative fevers. The majority of these episodes (72%) occurred early (within the first 48 hours) following surgery. Patients who developed early, unexplained fevers differed significantly from patients who developed documented postoperative infections. Patients with unexplained fevers were younger, had less severe underlying disease and underwent less extensive surgeries than patients who subsequently developed infections. In these respects, they were more similar to non-infected, non-febrile patients.

We concluded that episodes of early, unexplained postoperative fever occur frequently in a wide range of general surgery patients. Most of these episodes are non-infectious in origin. Patients with early postoperative fevers should be evaluated to identify any obvious sources of infection. If no focus is identified, empiric antibiotic therapy should not be initiated nor should prophylactic antibiotics be extended for prolonged durations. Unexplained fevers will resolve in time without specific therapeutic interventions.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 6 , Issue 7 , July 1985 , pp. 273 - 277
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1985

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References

1.Allen, JL, Rampone, JF, Wlieeless, CR: Use of prophylactic antibiotic in elective major gynecologic operations. Obstet Gynecol 1972;39:218–224.Google ScholarPubMed
2.Nissen, ED. Goldstein, AI: A prospective investigation of the etiology of febrile morbidity following abdominal hysterectomy. Am J Obstet Gynecol 1972: 113:111–114.Google Scholar
3.Ledger, WJ, Kriewall, TJ: The fever index, a quantitative indirect measure of hospital-acquired infections in obstetrics and gynecology. Am J Obstet Gynecol 1973; 115:514–520.CrossRefGoogle ScholarPubMed
4.Gibbs, RS, Decherney, AM, Schwarz, RH: Prophylactic antibiotics in cesarean section: A double-blind study. Am J Obstet Gynecol 1972:114:1048–1053.Google Scholar
5.Gilstrap, LC, Cunningham, FG: The bacterial pathogenesis of infection following cesarean section. Obstet Gynecol 1979; 53:545–549.Google ScholarPubMed
6.Rudd, EG, Long, WH, Dillon, MB: Febrile morbidity following cefamandole nafate intrauterine irrigation during cesarean section. Am J Obstet Gynecol 1981; 141:12–16.Google Scholar
7.Stiver, HG. Forward, KR. Livingstone, RAA, et al: Multicenler comparison of cefoxitin versus cefazolin for prevention of infectious morbidity after nonelective cesarean section. Am J Obstet Gynecol 1983: 145:158–163.Google Scholar
8.Ledger, WJ: Infection in the Female. Philadelphia, Lea and Febiger. 1977.Google ScholarPubMed
9.Porges, RF: Vaginal hvsterectoniv at Bellevue Hospital: An experience in teaching residents 1963-1967. Obstet Gynecol 1970; 35:300–313.Google Scholar
10.McCabe, WR, Jackson, GG: Gram-negative bacteremia. I. Etiologvand Ecology. Arch Intern Med 1962; 110:847–855.Google Scholar
11.Dripps, RD. Lamont, A. Eckenhoff, JE: The role of anesthesia in surgical mortality. JAMA 1961; 178:261–266.CrossRefGoogle ScholarPubMed
12.Outline for Surveillance and Control of Nosocomial Infections. U.S. Department of Health. Education and Welfare. Public Health Service. Centers for Disease Control. Revised June, 1972.Google Scholar
13.Filker, R, Monif, G: The significance of temperature during the first 24 hours postpartum. Obstet Gynecol 1979: 53:358–361.Google Scholar
14.Dykes, MF: Unexplained postoperative fever. Its value as a sign of halothaue sensitization. JAMA 1971:216:641–644.CrossRefGoogle ScholarPubMed
15.Klimek, JJ, Ajemian, ER, Gracewski, J. et al: A prospective analvsis of hospital-acquired fever in obstetric and gynecologic patients. JAMA 1982: 247:3340–3343.CrossRefGoogle Scholar
16.Gibbs, RS, Weinstein, AJ: Puerperal infection in the antibiotic era. Am J Obstet Gynecol 1976; 124:769–787.Google Scholar
17.Garibaldi, RA, Maglio, S. Brock, S, et al: Risk factors for postoperative wound infections in patients undergoing non-clean surgeries. 23rd Interseience Conference on Antimicrobial Agents and Chemotherapy, Las Vegas. Nevada October 24-26. 1983.Google Scholar
18.Garibaldi, RA. Brill, MR, Coleman, MLL. et al: Risk factors for postoperative pneumonia. Am J Med 1981: 70:677–680.Google Scholar