PMID: 9537542Apr 16, 1998Paper

Management of postoperative fever in cardiovascular surgery

The Journal of Cardiovascular Surgery
S IshikawaY Morishita

Abstract

The causes and management of postoperative fever were studied. During a four-year-period beginning in January of 1991, high fever over 38.5 degrees C max occurred in twenty-five (6%) out of 395 patients who underwent cardiovascular surgery. Nine of the patients (28%) evidenced bacteriological infections as follows; 3 cases of mediastinitis, 2 cases of respiratory tract infection, 1 case of MRSA colitis and a wound infection in one case. The three patients with mediastinitis died and the two cases of MRSA were detected from the culture of pacemaker leads. Bacteriological infection was not detected in other 18 (72%) patients with fever. However, we speculated that the clinical causes of fever in 9 out of 18 patients were as follows; catheter fever in 3 patients, acalculous cholecystitis in 2, fungus infection in 2, aseptic meningitis in one and viral myelitis in one patient. Two patients with acalculous cholecystitis recovered after percutaneous transhepatic gallbladder drainage. The causes of fever were not apparent in nine patients, however the source might be related to artificial prostheses used intraoperatively in five patients. C-reactive protein (CRP) was elevated beyond 10 mg/dl in 13 (52%) of the 25 patients. CRP increas...Continue Reading

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