Postoperative fever

Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

## Overview

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Postoperative fever is a common condition challenging doctor's to find the right diagnosis, because it can be a hallmark of serious underlying conditions.

## Differential diagnosis of causes of postoperative fever

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The most common causes have been summarized in a handy mnemonic: the five W's. These tend to occur at specific days after surgery (postoperative days or POD).

* Wind, POD1-2: the lungs, i.e. pneumonia, aspiration, and pulmonary embolism, but not atelectasis
* Water, POD3-5: urinary tract infection
* Walking (or VEINS, which then sounds like "Weins"), POD4-6: deep vein thrombosis or pulmonary embolism
* Wound, POD5-7: surgical site infection, which in obstetrics or gynaecology, may refer to the uterus.
* Wonder drugs or “What did we do?”, POD7+: drug fever, infections related to intravenous lines

Numerous variants on the same theme may exist: sometimes another W for "Wonder why" may indicate an abscess somewhere in the body or the site of surgery. Of course, this list is not comprehensive: catheter-related sepsis is also frequent, but also easily recognised.

## References

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Symptoms and signs: circulatory (R00–R03, 785)

Cardiovascular|

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Myeloid/blood|

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Symptoms and signs: respiratory system (R04–R07, 786)

Hemorrhage|

* Epistaxis
* Hemoptysis

Abnormalities
of breathing|

Respiratory sounds

Stridor
Wheeze
Crackles
Rhonchi
Hamman's sign

Apnea
Dyspnea
Hyperventilation/Hypoventilation
Hyperpnea/Tachypnea/Hypopnea/Bradypnea
Orthopnea/Platypnea
Trepopnea

Biot's respiration
Cheyne-Stokes respiration
Kussmaul breathing

Hiccup
Mouth breathing/Snoring
Breath-holding

Other|

* Asphyxia
* Cough
* Pleurisy
* Sputum

* Respiratory arrest
* Hypercapnia/Hypocapnia

* Pectoriloquy: Whispered pectoriloquy
* Egophony
* Bronchophony

* Pleural friction rub

* Fremitus

* Silhouette sign

Chest, general|

* Chest pain
* Precordial catch syndrome

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Symptoms and signs: digestive system and abdomen (R10–R19, 787,789)

GI tract|

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Accessory|

Hepatosplenomegaly/Hepatomegaly
Jaundice

Abdominopelvic|

Ascites

Abdominal – general|

Abdominal pain (Acute abdomen, Colic, Baby colic)

Splenomegaly

Abdominal guarding * Abdominal mass * Rebound tenderness

Shifting dullness * Bulging flanks * Puddle sign * Fluid wave test

Template:Skin and subcutaneous tissue symptoms and signs Template:Nervous and musculoskeletal system symptoms and signs Template:Urinary system symptoms and signs Template:Cognition, perception, emotional state and behaviour symptoms and signs Template:Speech and voice symptoms and signs Template:General symptoms and signs

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Symptoms and signs: Symptoms concerning nutrition, metabolism and development (R62–R64, 783)

Ingestion/Weight|

decrease: Anorexia • Weight loss/Cachexia/Underweight

increase: Polyphagia • Polydipsia • Orexigenia • Weight gain

Growth|

Delayed milestone • Failure to thrive • Short stature (e.g., Idiopathic)

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