Assessment of postoperative fever

Last reviewed: 7 Apr 2025
Last updated: 03 Jun 2024

Summary

Differentials

Common

  • Pyrexial response to surgery
  • Urinary tract infection
  • Wound infection
  • Pneumonia
  • Superficial thrombophlebitis
  • Catheter-associated intravascular infection
  • Abdominal abscess
  • Foreign body infection
  • Clostridium difficile colitis
  • Sepsis
  • Haematoma
  • Deep venous thrombosis
  • Pulmonary embolism
Full details

Uncommon

  • Drug fever
  • Myocardial infarction
  • Stroke
  • Alcohol withdrawal
  • Fat embolism
  • Transfusion reaction
  • Transplant rejection
  • Toxic shock syndrome
  • Ischaemia of operated tissue
  • Gout exacerbation
  • Pseudogout exacerbation
  • Acute pancreatitis
  • Acalculous cholecystitis
  • Seroma
  • Malignant hyperthermia
  • Hyperthyroidism exacerbation
  • Phaeochromocytoma exacerbation
  • Adrenal crisis
  • Transfusion-related infection
  • Underlying malignancy
  • Meningitis post neurosurgery
  • Subarachnoid haemorrhage post neurosurgery
  • Otitis media post ENT surgery
  • Sinusitis post nasogastric tube insertion
  • Sialadenitis
  • Cavernous sinus thrombosis post ENT or neurosurgery
  • Osteomyelitis following orthopaedic surgery
  • Infective endocarditis following cardiac surgery
Full details

Contributors

Authors

Program Director Internal Medicine

Assistant Professor

University of Florida-Health Science Center

Internal Medicine Residency Program

Jacksonville

FL

Disclosures

JH declares that he has no competing interests.

Professor of Medicine

Florida State University

College of Medicine

Tallahassee

FL

Disclosures

IA declares that she has no competing interests.

Peer reviewers

Consultant Paediatrician

Honorary Senior Lecturer

Chelsfield Park Hospital

Chelsfield

Orpington

UK

Disclosures

ASER declares that he has no competing interests.

Consultant

Infectious Diseases

Associate Professor

Section of Infectious Diseases

Department of Medicine

University of Manitoba

Director

Infection Prevention and Control Unit Health Sciences Centre

Winnipeg

Manitoba

Canada

Disclosures

JME declares that he has no competing interests.

Professor of Medicine

Department of Microbiology and Immunology

Albert Einstein College of Medicine

Bronx

NY

Disclosures

SGB declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

McLaren AC, Lundy DW. AAOS systematic literature review: summary on the management of surgical site infections. J Am Acad Orthop Surg. 2019 Aug 15;27(16):e717-20.Full text  Abstract

McDonald LC, Gerding DN, Johnson S, et al. Clinical practice guidelines for clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis. 2018 Mar 19;66(7):e1-48.Full text  Abstract

O'Grady NP, Alexander E, Alhazzani W, et al. Society of Critical Care Medicine and the Infectious Diseases Society of America guidelines for evaluating new fever in adult patients in the ICU. Crit Care Med. 2023 Nov 1;51(11):1570-86.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Assessment of postoperative fever images
  • Guidelines

    • Guidelines for evaluating new fever in adult patients in the ICU
    • Strategies to prevent surgical site infections in acute-care hospitals: 2022 update
    More Guidelines
  • Patient information

    Deep vein thrombosis

    Pulmonary embolism: what is it?

    More Patient information
  • Calculators

    Modified Wells score for deep vein thrombosis (DVT)

    Pulmonary Embolism Wells Score

    More Calculators
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